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Sample records for medicine london england

  1. London, England

    NASA Image and Video Library

    2003-01-18

    For almost 2,000 years, the River Thames has served as the life force of London, capital of the United Kingdom and one of the world's most famous cities. In AD 43 the Romans established the trading settlement of Londinium at a favorable crossing point on the river. The Romans remained until the 5th century, when the city came under Saxon control. The early 17th century saw enormous growth, but the deadly plague of 1664 and 1665 ravaged the population, and in the following year the Great Fire, which burned for four days, destroyed most of the city. A public transportation system and other city services in the early 19th century eased many of the increasing urban problems of the burgeoning capital of the wealthy British Empire. After coping with the devastating effects of bombing during World War II and the gradual dismantling of the empire, London today thrives as a vital modern metropolis. London is one of 100 cities being studied using ASTER data to map and monitor urban use patterns and growth. This image was acquired on October 12, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet. http://photojournal.jpl.nasa.gov/catalog/PIA04301

  2. London, England

    NASA Technical Reports Server (NTRS)

    2003-01-01

    For almost 2,000 years, the River Thames has served as the life force of London, capital of the United Kingdom and one of the world's most famous cities. In AD 43 the Romans established the trading settlement of Londinium at a favorable crossing point on the river. The Romans remained until the 5th century, when the city came under Saxon control. The early 17th century saw enormous growth, but the deadly plague of 1664 and 1665 ravaged the population, and in the following year the Great Fire, which burned for four days, destroyed most of the city. A public transportation system and other city services in the early 19th century eased many of the increasing urban problems of the burgeoning capital of the wealthy British Empire. After coping with the devastating effects of bombing during World War II and the gradual dismantling of the empire, London today thrives as a vital modern metropolis. London is one of 100 cities being studied using ASTER data to map and monitor urban use patterns and growth.

    This image was acquired on October 12, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats

  3. London, England

    NASA Technical Reports Server (NTRS)

    2003-01-01

    For almost 2,000 years, the River Thames has served as the life force of London, capital of the United Kingdom and one of the world's most famous cities. In AD 43 the Romans established the trading settlement of Londinium at a favorable crossing point on the river. The Romans remained until the 5th century, when the city came under Saxon control. The early 17th century saw enormous growth, but the deadly plague of 1664 and 1665 ravaged the population, and in the following year the Great Fire, which burned for four days, destroyed most of the city. A public transportation system and other city services in the early 19th century eased many of the increasing urban problems of the burgeoning capital of the wealthy British Empire. After coping with the devastating effects of bombing during World War II and the gradual dismantling of the empire, London today thrives as a vital modern metropolis. London is one of 100 cities being studied using ASTER data to map and monitor urban use patterns and growth.

    This image was acquired on October 12, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats

  4. City lights of London, England taken during Expedition Six

    NASA Image and Video Library

    2003-02-04

    ISS006-E-22939 (4 February 2003) --- City lights of London, England were captured with a digital still camera by one of the Expedition Six crewmembers on the International Space Station (ISS). This nighttime view of the British capital shows the city’;s urban density and infrastructure as highlighted by electrical lighting. Beyond lie isolated bright areas marking the numerous smaller cities and towns of the region and as far southeast as Hastings on the coast. London’;s two major airports, Heathrow and Gatwick, are visible to the south of the city.

  5. Characterization and reconstruction of historical London, England, acidic aerosol concentrations.

    PubMed Central

    Ito, K; Thurston, G D

    1989-01-01

    Several past studies of the historical London air pollution record have reported an association between daily mortality and British Smoke levels. However, this pollution index does not give direct information on particulate mass or its chemical composition. A more specific particulate matter index, aerosol acidity, was measured at a site in central London, and daily data are available for the period 1963-1972. British Smoke and SO2 were also measured at the same site. Also, meteorological parameters were routinely measured at a nearby British Meteorological Office. Thus, daily fluctuation of the acidic aerosols was characterized in terms of other environmental parameters. Each of the other parameters analyzed seems necessary, but not sufficient to explain a high level of acidic aerosol. Overall, about half of the variance of log-transformed daily fluctuations of acidic aerosols can be explained by a combination of parameters including SO2 and British Smoke concentrations, temperature, ventilation by wind, and humidity. The rest of the variance cannot be explained by the parameters included in this analysis. Potential factors responsible for this unique variance would be variations in the availability of basic gases to cause neutralization and variation in the availability of catalytic metal salts. Because the acidic aerosol has a unique component of variation, it may be possible to distinguish health effects due to this specific pollutant from other available pollution indices or environmental factors. PMID:2651105

  6. Are the birch trees in Southern England a source of Betula pollen for North London?

    PubMed

    Skjøth, C A; Smith, M; Brandt, J; Emberlin, J

    2009-01-01

    Birch pollen is highly allergenic. Knowledge of daily variations, atmospheric transport and source areas of birch pollen is important for exposure studies and for warnings to the public, especially for large cities such as London. Our results show that broad-leaved forests with high birch tree densities are located to the south and west of London. Bi-hourly Betula pollen concentrations for all the days included in the study, and for all available days with high birch pollen counts (daily average birch pollen counts>80 grains/m3), show that, on average, there is a peak between 1400 hours and 1600 hours. Back-trajectory analysis showed that, on days with high birch pollen counts (n=60), 80% of air masses arriving at the time of peak diurnal birch pollen count approached North London from the south in a 180 degree arc from due east to due west. Detailed investigations of three Betula pollen episodes, with distinctly different diurnal patterns compared to the mean daily cycle, were used to illustrate how night-time maxima (2200-0400 hours) in Betula pollen counts could be the result of transport from distant sources or long transport times caused by slow moving air masses. We conclude that the Betula pollen recorded in North London could originate from sources found to the west and south of the city and not just trees within London itself. Possible sources outside the city include Continental Europe and the Betula trees within the broad-leaved forests of Southern England.

  7. VOC emission rates over London and South East England obtained by airborne eddy covariance.

    PubMed

    Vaughan, Adam R; Lee, James D; Shaw, Marvin D; Misztal, Pawel K; Metzger, Stefan; Vieno, Massimo; Davison, Brian; Karl, Thomas G; Carpenter, Lucy J; Lewis, Alastair C; Purvis, Ruth M; Goldstein, Allen H; Hewitt, C Nicholas

    2017-08-24

    Volatile organic compounds (VOCs) originate from a variety of sources, and play an intrinsic role in influencing air quality. Some VOCs, including benzene, are carcinogens and so directly affect human health, while others, such as isoprene, are very reactive in the atmosphere and play an important role in the formation of secondary pollutants such as ozone and particles. Here we report spatially-resolved measurements of the surface-to-atmosphere fluxes of VOCs across London and SE England made in 2013 and 2014. High-frequency 3-D wind velocities and VOC volume mixing ratios (made by proton transfer reaction - mass spectrometry) were obtained from a low-flying aircraft and used to calculate fluxes using the technique of eddy covariance. A footprint model was then used to quantify the flux contribution from the ground surface at spatial resolution of 100 m, averaged to 1 km. Measured fluxes of benzene over Greater London showed positive agreement with the UK's National Atmospheric Emissions Inventory, with the highest fluxes originating from central London. Comparison of MTBE and toluene fluxes suggest that petroleum evaporation is an important emission source of toluene in central London. Outside London, increased isoprene emissions were observed over wooded areas, at rates greater than those predicted by a UK regional application of the European Monitoring and Evaluation Programme model (EMEP4UK). This work demonstrates the applicability of the airborne eddy covariance method to the determination of anthropogenic and biogenic VOC fluxes and the possibility of validating emission inventories through measurements.

  8. Stratified, precision or personalised medicine? Cancer services in the 'real world' of a London hospital.

    PubMed

    Day, Sophie; Coombes, R Charles; McGrath-Lone, Louise; Schoenborn, Claudia; Ward, Helen

    2017-01-01

    We conducted ethnographic research in collaboration with a large, research-intensive London breast cancer service in 2013-2014 so as to understand the practices and potential effects of stratified medicine. Stratified medicine is often seen as a synonym for both personalised and precision medicine but these three terms, we found, also related to distinct facets of treatment and care. Personalised medicine is the term adopted for the developing 2016 NHS England Strategy, in which breast cancer care is considered a prime example of improved biological precision and better patient outcomes. We asked how this biologically stratified medicine affected wider relations of care and treatment. We interviewed formally 33 patients and 23 of their carers, including healthcare workers; attended meetings associated with service improvements, medical decision-making, public engagement, and scientific developments as well as following patients through waiting rooms, clinical consultations and other settings. We found that the translation of new protocols based on biological research introduced further complications into an already-complex patient pathway. Combinations of new and historic forms of stratification had an impact on almost all patients, carers and staff, resulting in care that often felt less rather than more personal. © 2016 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

  9. Ethnic Disparities in Oral Health Related Quality of Life among Adults in London, England.

    PubMed

    Abdelrahim, R; Delgado-Angulo, E K; Gallagher, J E; Bernabé, E

    2017-06-01

    To explore ethnic disparities in oral health related quality of life (OHQoL) among adults, and the role that socioeconomic factors play in that association. Data from 705 adults from a socially deprived, ethnically diverse metropolitan area of London (England) were analysed for this study. Ethnicity was self-assigned based on the 2001 UK Census categories. OHQoL was measured using the Oral Health Impact Profile (OHIP-14), which provides information on the prevalence, extent and intensity of oral impacts on quality of life in the previous 12 months. Ethnic disparities were assessed in logistic regression models for prevalence of oral impacts and negative binomial regression models for extent and intensity of oral impacts. The prevalence of oral impacts was 12.7% (95% CI: 10.2-15.1) and the mean OHIP-14 extent and severity scores were 0.27 (95% CI: 0.20-0.34) and 4.19 (95% CI: 3.74-4.64), respectively. Black adults showed greater and Asian adults lower prevalence, extent and severity of oral impacts than White adults. However, significant differences were only found for the extent of oral impacts; Black adults reporting more and Asian adults fewer OHIP-14 items affected than their White counterparts. After adjustments for socioeconomic factors, Asian adults had significantly fewer OHIP-14 items affected than White adults (rate ratio: 0.28; 95%CI: 0.08-0.94). This study found disparities in OHQoL between the three main ethnic groups in South East London. Asian adults had better and Black adults had similar OHQoL than White adults after accounting for demographic and social factors. Copyright© 2017 Dennis Barber Ltd.

  10. Gonorrhoea in a south London genitourinary medicine department.

    PubMed

    Newell, A; Herbert, E; Vigus, J; Grieg, A; Rodgers, M E

    2003-09-01

    The management and outcome of all cases of gonorrhoea which presented to a south London genitourinary medicine clinic during 1999 were assessed and compared with published national guidelines. The incidence of penicillin resistance was calculated, as was the rate of co-infection with chlamydia and trichomonas. Information regarding demographic data, microscopy, culture results, test of cure, antibiotic use, sensitivity and health adviser contact was examined. A total of 257 cases of gonorrhoea were diagnosed in 238 patients. Heterosexual men constituted 52.9% of cases, 6.6% were in homosexual men and 40.5% in women. Direct microscopy was positive in 88.8% of men and in 40.5% of women. In women, the rate of gonorrhoea co-infection with chlamydia was 34.7% and with trichomonas was 11.5%. In men the rate of chlamydia co-infection was only 3.3%, however, we do not believe this to be an accurate figure as we are unable to routinely screen all men for chlamydia due to financial restrictions. Amoxicillin with probenecid were the most commonly used antibiotics in line with local guidelines. Penicillin resistance was demonstrated in 4.6% of infected cases. Health advisers saw 73.2% of patients.

  11. Workloads in genitourinary medicine clinics in England.

    PubMed Central

    Thin, R N

    1989-01-01

    Work loads in venereal disease--sexually transmitted disease (STD)--genitourinary medicine (GUM) clinics have risen greatly in recent years. The increase in viral infections which are more difficult and time consuming to manage than those caused by bacteria and the higher expectations and demands of patients have combined to increase workloads more than the case figures indicate. This prompted the Department of Health and Social Security in 1988 to set up a survey of clinics in England with the following terms of reference: "To examine current and forecast workloads on GUM clinics, taking account of AIDS and other STDs, and to recommend any action which may need to be taken on manpower (including nursing manpower), training, resources and accommodation". The team concluded that the GUM service was ill equipped to meet the demands for its services, and made 36 recommendations. The priority recommendations included: the need to provide more resources; government ministers should give a lead in developing the service; all health districts should provide care for STD and HIV infection; all new patients should be seen on the day of presentation or failing that on the next occasion the clinic was open. Other recommendations included: location of all GUM clinics in the general outpatient department of general hospitals; accommodation of the same standard as other outpatient departments; review of the distribution of clinics; review of staffing levels and roles; and coordination of care of HIV infection. Many of these recommendations have already led to action including a lead from government ministers and provision of more funds. Many of the problems and recommendations will apply in other countries. PMID:2613217

  12. The Beginnings of Industrial Medicine in England*

    PubMed Central

    Buess, H.

    1962-01-01

    Industrial medicine saw its tentative beginnings among the inquiring minds of 16th century physicians such as Paracelsus. In the 17th century, reports of conditions in mines on the Continent prompted natural scientists at the Royal Society to initiate a research programme into what we now know as mercurial poisoning. The latter part of the eighteenth century witnessed the change from domestic to factory industry with its concomitant social, economic, and technological upheaval, resulting in great shifts of population away from the countryside to the towns. Men, women, and children were employed in the new factories in primitive, unhygienic conditions, and mill fever and illness generally were rife. It was against this background that Percival and Thackrah, prompted no doubt in large measure by the conditions of child labour, inquired into, and made recommendations for, the improvement of hygiene in the factories, thus laying the foundations of industrial medicine as we know it today.

  13. Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot

    PubMed Central

    Atkins, Katherine; van Hoek, Albert Jan; Watson, Conall; Baguelin, Marc; Choga, Lethiwe; Patel, Anika; Raj, Thara; Jit, Mark; Griffiths, Ulla

    2016-01-01

    Objective To evaluate the effectiveness and cost of the pan-London pharmacy initiative, a programme that allows administration of seasonal influenza vaccination to eligible patients at pharmacies. Design We analysed 2013–2015 data on vaccination uptake in pharmacies via the Sonar reporting system, and the total vaccination uptake via 2011–2015 ImmForm general practitioner (GP) reporting system data. We conducted an online survey of London pharmacists who participate in the programme to assess time use data, vaccine choice, investment costs and opinions about the programme. We conducted an online survey of London GPs to assess vaccine choice of vaccine and opinions about the pharmacy vaccine delivery programme. Setting All London boroughs. Participants London-based GPs, and pharmacies that currently offer seasonal flu vaccination. Interventions Not applicable. Main outcome measures Comparison of annual vaccine uptake in London across risk groups from years before pharmacy vaccination introduction to after pharmacy vaccination introduction. Completeness of vaccine uptake reporting data. Cost to the National Health Service (NHS) of flu vaccine delivery at pharmacies with that at GPs. Cost to pharmacists of flu delivery. Opinions of pharmacists and GPs regarding the flu vaccine pharmacy initiative. Results No significant change in the uptake of seasonal vaccination in any of the risk groups as a result of the pharmacy initiative. While on average a pharmacy-administered flu vaccine dose costs the NHS up to £2.35 less than a dose administered at a GP, a comparison of the 2 recording systems suggests there is substantial loss of data. Conclusions Flu vaccine delivery through pharmacies shows potential for improving convenience for vaccine recipients. However, there is no evidence that vaccination uptake increases and the use of 2 separate recording systems leads to time-consuming data entry and missing vaccine record data. PMID:26883237

  14. A Qualitative Study of the Impact of the London 2012 Olympics on Families in the East Midlands of England: Lessons for Sports Development Policy and Practice

    ERIC Educational Resources Information Center

    Mackintosh, Chris; Darko, Natalie; Rutherford, Zoe; Wilkins, Hetty-May

    2015-01-01

    The dynamics and culture of families are central to individual and community sport and physical activity participation. This research project examined the lived experiences and day-to-day realities of the London 2012 Olympics from the perspectives of five families in the East Midlands region of England. The aims of the project were to assess the…

  15. A Qualitative Study of the Impact of the London 2012 Olympics on Families in the East Midlands of England: Lessons for Sports Development Policy and Practice

    ERIC Educational Resources Information Center

    Mackintosh, Chris; Darko, Natalie; Rutherford, Zoe; Wilkins, Hetty-May

    2015-01-01

    The dynamics and culture of families are central to individual and community sport and physical activity participation. This research project examined the lived experiences and day-to-day realities of the London 2012 Olympics from the perspectives of five families in the East Midlands region of England. The aims of the project were to assess the…

  16. Timeliness of electronic reporting and acceptability of public health follow-up of routine nonparatyphoidal and nontyphoidal Salmonella infections, London and South East England, 2010 to 2011.

    PubMed

    Severi, E; Dabrera, G; Boxall, N; Harvey-Vince, L; Booth, L; Balasegaram, S

    2014-01-01

    Nonparatyphoidal and nontyphoidal Salmonella (NTS) infections are major causes of food poisoning in England. Diagnostic laboratories and clinicians have a statutory responsibility to report NTS infection cases to the Health Protection Agency via various means, with electronic reporting encouraged as the universal method. The Health Protection Agency (Public Health England since 1 April 2013) refers cases to environmental health departments for follow-up. Timeliness of reporting and adequacy of NTS infection case follow-up are key factors in the implementation of public health actions. Laboratories, health protection units, and environmental health departments in London and South East (SE) regions of England completed three surveys between December 2010 and April 2011, collecting data about the NTS infection case reporting methods and the time elapsed between symptom onset and public health actions. The median period between symptom onset and public health investigation was 25 days in London and 23 days in SE when electronic reporting was used and 12 days in London and 11 days in SE when other means of reporting were used. The most common follow-up method was a telephone questionnaire in London (53%) and a postal questionnaire in SE (52%). The telephone questionnaire had the highest response rate (98% in London; 96% in SE). Timeliness and efficiency of electronic NTS infection case reports can be improved by decreasing the electronic laboratory report period and using telephone-administered questionnaires to maximize the public health benefit when following up single cases of NTS infection.

  17. Families and Parenting: Conference Report. Proceedings of a Conference (London, England United Kingdom, September 26, 1995).

    ERIC Educational Resources Information Center

    Utting, David, Ed.

    These proceedings contain papers presented at a conference sponsored by the Family Policy Studies Centre in London, September, 1995, which brought together professionals to describe their parenting support or education projects which were part of the Department of Health's Parenting Initiative. Conference papers discussed the role of government in…

  18. Families and Parenting: Conference Report. Proceedings of a Conference (London, England United Kingdom, September 26, 1995).

    ERIC Educational Resources Information Center

    Utting, David, Ed.

    These proceedings contain papers presented at a conference sponsored by the Family Policy Studies Centre in London, September, 1995, which brought together professionals to describe their parenting support or education projects which were part of the Department of Health's Parenting Initiative. Conference papers discussed the role of government in…

  19. Reexamination of London, England, mortality in relation to exposure to acidic aerosols during 1963-1972 winters.

    PubMed Central

    Thurston, G D; Ito, K; Lippmann, M; Hayes, C

    1989-01-01

    Air pollution epidemiology since the 1950s has been able to demonstrate that increases in daily mortality in London, England, were associated with elevated concentrations of index air pollutants, i.e., British Smoke (BS) and sulfur dioxide (SO2). In this work, we reanalyze that portion of the 1958-1972 winter mortality-pollution record for which daily direct acid aerosol measurements were made at a central site in London (St. Bartholomew's Medical College). The purposes of these exploratory analyses are to examine the dataset for indications of a relationship between acid aerosol pollution and human mortality and to compare any noted associations with those for other pollution variables. It is found that the log of acid aerosol concentrations is more strongly associated with raw total mortality in bivariate analyses than is BS or SO2, despite the fact that acid data are available from only one central site (versus seven disperse sites for BS and SO2). The logarithmic nature of the exposure side of the H2SO4-mortality relationship implies a saturation model of pollution effects, possibly due to multiday pollution harvesting influences on a susceptible subpopulation. Moreover, mortality-pollution cross-correlation analyses indicate that mortality effects usually follow pollution in time, supporting a causal relationship between the two. The apparent advantage of H2SO4 over BS in predicting total raw mortality is consistent with the hypothesis that it is the portion of particulate mass of greater health significance and may also allow the development of London mortality results which are more easily transferable to other environments than is the case for existing BS results. PMID:2785034

  20. The Development of Forensic Pathology in London, England: Keith Simpson and the Dobkin Case, 1942.

    PubMed

    Bell, Amy

    2012-01-01

    During the Second World War in London, the bombing raids targeting civilians led to a greater public reliance on forensic pathologists. Hospitals used their skills to identify the victims of raids and determine their cause of death, though many bomb victims were never identified. The public reputation of forensic pathology was enhanced by Dr. Keith Simpson's 1942 identification of a body found in a bombed church as the missing Mrs. Dobkin, murdered by her husband and hidden in the rubble. The devastation wrought by the Blitz was countered by this public display of the collaboration between forensic pathology and wartime authorities desperate to maintain order.

  1. The intercalated BSc in sports and exercise medicine at Barts and The London School of Medicine and Dentistry

    PubMed Central

    Morrissey, Dylan; Nutt, James L.; Mehdian, Roshana; Maffulli, Nicola

    2013-01-01

    Summary Object: To report about the intercalated Bsc(Hons) in Sports and Exercise Medicine at Barts and The London School of Medicine and Dentistry (BLSMD), Queen Mary University of London. Design: Educational study. Setting: The course is currently in its tenth year, providing medical students with the opportunity to develop knowledge in the field of Sports and Exercise Medicine (SEM) during one academic year of full time study. Participants: There have been more than 150 graduates, and 22 students are enrolled for the 2012–13 academic year on what has been the most popular and largest intercalated degree at BLSMD in recent years. External applicants typically make up 30–40% of entrants. Results: Equal weighting on taught modules and a portfolio of research activity provides a strong foundation in Sports and Exercise Medicine, and equips successful students with evidence based translational skills, and the opportunity to perform publishable research. Conclusion: This article outlines the increasing demand for Sports and Exercise Medicine education, and how the course prepares graduates for practising SEM as a sub-specialist interest or to compete for entry into the Specialist Trainee training route. PMID:24367778

  2. The intercalated BSc in sports and exercise medicine at Barts and The London School of Medicine and Dentistry.

    PubMed

    Morrissey, Dylan; Nutt, James L; Mehdian, Roshana; Maffulli, Nicola

    2013-08-11

    To report about the intercalated Bsc(Hons) in Sports and Exercise Medicine at Barts and The London School of Medicine and Dentistry (BLSMD), Queen Mary University of London. Educational study. The course is currently in its tenth year, providing medical students with the opportunity to develop knowledge in the field of Sports and Exercise Medicine (SEM) during one academic year of full time study. There have been more than 150 graduates, and 22 students are enrolled for the 2012-13 academic year on what has been the most popular and largest intercalated degree at BLSMD in recent years. External applicants typically make up 30-40% of entrants. Equal weighting on taught modules and a portfolio of research activity provides a strong foundation in Sports and Exercise Medicine, and equips successful students with evidence based translational skills, and the opportunity to perform publishable research. This article outlines the increasing demand for Sports and Exercise Medicine education, and how the course prepares graduates for practising SEM as a sub-specialist interest or to compete for entry into the Specialist Trainee training route.

  3. The developing world in The New England Journal of Medicine.

    PubMed

    Lown, Bernard; Banerjee, Amitava

    2006-03-16

    Rampant disease in poor countries impedes development and contributes to growing North-South disparities; however, leading international medical journals underreport on health research priorities for developing countries. We examined 416 weekly issues of the New England Journal of Medicine (NEJM) over an eight-year period, January 1997 to December 2004. A total of 8857 articles were reviewed by both authors. The content of each issue was evaluated in six categories: research, review articles, editorial, correspondence, book reviews and miscellaneous. If the title or abstract concerned a topic pertinent to any health issue in the developing world, the article was reviewed. Over the eight years covered in this study, 1997-2004, in the three essential categories of original research articles, review articles and editorials, less than 3.0 percent of these addressed health issues in the developing world. Publications relevant to DC were largely concerned with HIV and communicable diseases and constituted 135 of the 202 articles of which 63 were devoted to HIV. Only 23 articles addressed non-communicable disease in the DC and only a single article - a book review - discussed heart disease. The medical information gap between rich and poor countries as judged by publications in the NEJM appears to be larger than the gap in the funding for research. Under-representation of developing world health issues in the medical literature is a global phenomenon. International medical journals cannot rectify global inequities, but they have an important role in educating their constituencies about the global divide.

  4. Reduced infant birth weight in the North West of England consequent upon 'maternal exposure' to 7/7 terrorist attacks on central London.

    PubMed

    Nugent, J L; Khashan, A S; Baker, P N

    2011-01-01

    The effect of media coverage of the London terrorist attacks on 7 July 2005 on pregnancy outcome in mothers living in the North Western region of England was assessed. Pregnant women exposed to media coverage of these attacks had infants with mean birth weight lowered by 16 g and increased risks of a small and very small for gestational age infant (odds ratio 1:10 and 1:09, respectively). This small, but significant reduction in birth weight may indicate excess glucocorticoid exposure within the fetus, which could contribute to fetal programming and an increased likelihood of disease in adult life.

  5. Seven years of teenage pregnancy in an inner London genitourinary medicine service - a retrospective cohort study.

    PubMed

    Hegazi, Aseel; Daley, Natalie; Williams, Elizabeth; McLeod, Felicity; Rafiezadeh, Saba; Prime, Katia

    2014-12-01

    Young people attending genitourinary medicine services are at high risk of unplanned pregnancy. We performed a retrospective cohort study to identify characteristics of pregnant teenagers accessing an inner London genitourinary medicine service. There were 481 pregnancies in 458 teenagers with 54 previous pregnancies and 46 previous terminations of pregnancy. The under-18 and under-16 teenage pregnancy rates were 92.1 and 85.8 per 1000 age-matched clinic attendees, respectively. Median age was 17.1 years. 'Black Other' teenagers ('Black British', 'Mixed White-Black Caribbean' and 'Mixed White-Black African') were over-represented, compared to our clinic population, while those of White ethnicity were under-represented. Few pregnancies (1.5%) were planned with the majority (64%) intending terminations of pregnancy. Most teenagers did not use consistent contraception. Two-thirds of patients had attended genitourinary medicine services in the past and sexually transmitted infection prevalence at presentation was high. Effectively targeting the sexual and reproductive health needs of teenage genitourinary medicine clinic attendees may have a significant impact on reducing sexually transmitted infections, unplanned pregnancy and terminations of pregnancy in this group.

  6. European Medicines Agency workshop on biosimilar monoclonal antibodies: July 2, 2009, London, UK.

    PubMed

    Reichert, Janice M; Beck, Alain; Iyer, Harish

    2009-01-01

    The European Medicines Agency (EMEA) workshop on biosimilar monoclonal antibodies (mAbs), held July 2, 2009 at the EMEA headquarters in London, was a harbinger with potentially far-reaching implications for all groups interested in antibody therapeutics development. These groups include not only regulators and the innovator and generic biopharmaceutical industries, but also physicians, patients and payers. The objective of the workshop was to discuss and assess the feasibility of the development and authorization of mAbs using EMEA's biosimilar regulatory pathways. The workshop sequentially focused on questions relevant to three areas: (1) chemistry, manufacturing and controls (CMC), (2) non-clinical issues and (3) clinical issues, including outcome measures. Proceedings of the workshop are presented in Part 1 of this report, and discussed within the context of the legal, regulatory and business environments of the European Union, Asia and the United States in Parts 2, 3 and 4, respectively.

  7. The developing world in The New England Journal of Medicine

    PubMed Central

    Lown, Bernard; Banerjee, Amitava

    2006-01-01

    Background Rampant disease in poor countries impedes development and contributes to growing North-South disparities; however, leading international medical journals underreport on health research priorities for developing countries. Methods We examined 416 weekly issues of the New England Journal of Medicine (NEJM) over an eight-year period, January 1997 to December 2004. A total of 8857 articles were reviewed by both authors. The content of each issue was evaluated in six categories: research, review articles, editorial, correspondence, book reviews and miscellaneous. If the title or abstract concerned a topic pertinent to any health issue in the developing world, the article was reviewed. Results Over the eight years covered in this study, 1997–2004, in the three essential categories of original research articles, review articles and editorials, less than 3.0 percent of these addressed health issues in the developing world. Publications relevant to DC were largely concerned with HIV and communicable diseases and constituted 135 of the 202 articles of which 63 were devoted to HIV. Only 23 articles addressed non-communicable disease in the DC and only a single article – a book review – discussed heart disease. Conclusion The medical information gap between rich and poor countries as judged by publications in the NEJM appears to be larger than the gap in the funding for research. Under-representation of developing world health issues in the medical literature is a global phenomenon. International medical journals cannot rectify global inequities, but they have an important role in educating their constituencies about the global divide. PMID:16542448

  8. Aspirin for the older person: report of a meeting at the Royal Society of Medicine, London, 3rd November 2011

    PubMed Central

    Armitage, J; Cuzick, J; Elwood, P; Longley, M; Perkins, A; Spencer, K; Turner, H; Porch, S; Lyness, S; Kennedy, J; Henderson, GN

    2012-01-01

    On November 23rd 2011, the Aspirin Foundation held a meeting at the Royal Society of Medicine in London to review current thinking on the potential role of aspirin in preventing cardiovascular disease and reducing the risk of cancer in older people. The meeting was supported by Bayer Pharma AG and Novacyl. PMID:22423252

  9. The Need for a College of Veterinary Medicine to Serve New England and New Jersey.

    ERIC Educational Resources Information Center

    New England Board of Higher Education, Wellesley, MA. New England Library Information Network.

    This report documents the need for and presents well-founded recommendations for the establishment of a college of veterinary medicine to serve New England and New Jersey. The need for a veterinary medicine college is discussed in relation to today's veterinarians, and future shortage estimations. Major recommendations suggest that (1) a regional…

  10. McMaster's pioneer in evidence-based medicine now spreading his message in England.

    PubMed Central

    Cohen, L

    1996-01-01

    Dr. David Sackett, formerly of McMaster University and now at Oxford University in England, is considered one of the pioneers of the evidence-based medicine movement. This article looks at his colleagues' assessment of Sackett's contributions to medicine and at Sackett's own views on his lengthy career. Images p389-a PMID:8564911

  11. King’s College London, a cardiac centre of excellence: will it only be possible to deliver the best cardiovascular medicine in 'capital cities' in the future?

    PubMed

    2011-09-01

    New developments at King's College, London, suggest that the complexity of modern cardiovascular medicine, and the enormous prospects for future advances, means that smaller cities will find it hard to compete, reports Barry Shurlock, MA, PhD.

  12. College of Veterinary Medicine for New England and New Jersey: A Feasibility Study.

    ERIC Educational Resources Information Center

    Cole, Clarence R.; And Others

    This study marks the completion of basic research and analysis for a proposed regional college of veterinary medicine to serve the New England states and New Jersey. Following introductory material, procedures for collection and analysis of data are discussed. Chapters cover programs for fulfilling regional needs, size and organization of the…

  13. The New England Journal of Medicine: commercial conflict of interest and revisiting the Vioxx scandal.

    PubMed

    Wilson, Mark

    2016-01-01

    At a recent cardiology conference in New Delhi, the cardiologist Deepak Natarajan raised the concern that commercial conflicts of interest (COIs) were corrupting medical journals. Natarajan cited "manipulated" publications in The New England Journal of Medicine (NEJM) as one example to support his view. His comments were met with silence and an air of indignation. Natarajan's medical colleagues were stunned, disbelieving, and then, angry.

  14. Survey of women's experiences of care in a new freestanding midwifery unit in an inner city area of London, England. 1: Methods and women's overall ratings of care.

    PubMed

    Macfarlane, Alison J; Rocca-Ihenacho, Lucia; Turner, Lyle R; Roth, Carolyn

    2014-09-01

    to describe and compare women's choices and experiences of maternity care before and after the opening of the Barkantine Birth Centre, a new freestanding midwifery unit in an inner city area. telephone surveys undertaken in late pregnancy and about six weeks after birth in two separate time periods, Phase 1 before the birth centre opened and Phase 2 after it had opened. Tower Hamlets, a deprived inner city borough in east London, England, 2007-2010. 620 women who were resident in Tower Hamlets and who satisfied the Barts and the London NHS Trust's eligibility criteria for using the birth centre. Of these, 259 women were recruited to Phase 1 and 361 to Phase 2. women who satisfied the criteria for birth centre care and who booked antenatally for care at the birth centre were significantly more likely to rate their care as good or very good overall than corresponding women who also satisfied these criteria but booked initially at the hospital. Women who started labour care in spontaneous labour at the birth centre were significantly more likely to be cared for by a midwife they had already met, have one to one care in labour and have the same midwife with them throughout their labour. They were also significantly more likely to report that the staff were kind and understanding, that they were treated with respect and dignity and that their privacy was respected. this survey in an inner city area showed that women who chose the freestanding midwifery unit care had positive experiences to report. Taken together with the findings of the Birthplace Programme, it adds further weight to the evidence in support of freestanding midwifery unit care for women without obstetric complications. Copyright © 2014. Published by Elsevier Ltd.

  15. Casebooks in early modern England: medicine, astrology, and written records.

    PubMed

    Kassell, Lauren

    2014-01-01

    Casebooks are the richest sources that we have for encounters between early modern medical practitioners and their patients. This article compares astrological and medical records across two centuries, focused on England, and charts developments in the ways in which practitioners kept records and reflected on their practices. Astrologers had a long history of working from particular moments, stellar configurations, and events to general rules. These practices required systematic notation. Physicians increasingly modeled themselves on Hippocrates, recording details of cases as the basis for reasoned expositions of the histories of disease. Medical records, as other scholars have demonstrated, shaped the production of medical knowledge. Instead, this article focuses on the nature of casebooks as artifacts of the medical encounter. It establishes that casebooks were serial records of practice, akin to diaries, testimonials, and registers; identifies extant English casebooks and the practices that led to their production and preservation; and concludes that the processes of writing, ordering, and preserving medical records are as important for understanding the medical encounter as the records themselves.

  16. Complementary and alternative medicine use in England: results from a national survey.

    PubMed

    Hunt, K J; Coelho, H F; Wider, B; Perry, R; Hung, S K; Terry, R; Ernst, E

    2010-10-01

    In many countries, recent data on the use of complementary and alternative medicine (CAM) are available. However, in England, there is a paucity of such data. We sought to determine the prevalence and predictors of CAM use in England. Data were obtained from the Health Survey for England 2005, a national household survey that included questions on CAM use. We used binary logistic regression modelling to explore whether demographic, health and lifestyle factors predict CAM use. Data were available for 7630 respondents (household response rate 71%). Lifetime and 12-month prevalence of CAM use were 44.0% and 26.3% respectively; 12.1% had consulted a practitioner in the preceding 12 months. Massage, aromatherapy and acupuncture were the most commonly used therapies. Twenty-nine percent of respondents taking prescription drugs had used CAM in the last 12 months. Women (OR 0.491, 95% CI: 0.419, 0.577), university educated respondents (OR 1.296, 95% CI: 1.088, 1.544), those suffering from anxiety or depression (OR 1.341, 95% CI: 1.074, 1.674), people with poorer mental health (on GHQ: OR 1.062, 95% CI 1.026, 1.100) and lower levels of perceived social support (1.047, 95% CI: 1.008, 1.088), people consuming ≥ 5 portions of fruit and vegetables a day (OR 1.327, 95% CI: 1.124, 1.567) were significantly more likely to use CAM. Complementary and alternative medicine use in England remains substantial, even amongst those taking prescription drugs. These data serve as a valuable reminder to medical practitioners to ask patients about CAM use and should be routinely collected to facilitate prioritisation of the research agenda in CAM. © 2010 Blackwell Publishing Ltd.

  17. Validation of primary metal-on-metal hip arthroplasties on the National Joint Registry for England, Wales and Northern Ireland using data from the London Implant Retrieval Centre

    PubMed Central

    Sabah, S. A.; Henckel, J.; Cook, E.; Whittaker, R.; Hothi, H.; Pappas, Y.; Blunn, G.; Skinner, J. A.; Hart, A. J.

    2015-01-01

    Arthroplasty registries are important for the surveillance of joint replacements and the evaluation of outcome. Independent validation of registry data ensures high quality. The ability for orthopaedic implant retrieval centres to validate registry data is not known. We analysed data from the National Joint Registry for England, Wales and Northern Ireland (NJR) for primary metal-on-metal hip arthroplasties performed between 2003 and 2013. Records were linked to the London Implant Retrieval Centre (RC) for validation. A total of 67 045 procedures on the NJR and 782 revised pairs of components from the RC were included. We were able to link 476 procedures (60.9%) recorded with the RC to the NJR successfully. However, 306 procedures (39.1%) could not be linked. The outcome recorded by the NJR (as either revised, unrevised or death) for a primary procedure was incorrect in 79 linked cases (16.6%). The rate of registry-retrieval linkage and correct assignment of outcome code improved over time. The rates of error for component reference numbers on the NJR were as follows: femoral head category number 14/229 (5.0%); femoral head batch number 13/232 (5.3%); acetabular component category number 2/293 (0.7%) and acetabular component batch number 24/347 (6.5%). Registry-retrieval linkage provided a novel means for the validation of data, particularly for component fields. This study suggests that NJR reports may underestimate rates of revision for many types of metal-on-metal hip replacement. This is topical given the increasing scope for NJR data. We recommend a system for continuous independent evaluation of the quality and validity of NJR data. Cite this article: Bone Joint J 2015;97-B:10–18. PMID:25568407

  18. Survey of women's experiences of care in a new freestanding midwifery unit in an inner city area of London, England: 2. Specific aspects of care.

    PubMed

    Macfarlane, Alison J; Rocca-Ihenacho, Lucia; Turner, Lyle R

    2014-09-01

    to describe and compare women's experiences of specific aspects of maternity care before and after the opening of the Barkantine Birth Centre, a new freestanding midwifery unit in an inner city area. telephone surveys undertaken in late pregnancy and about six weeks after birth. Two separate waves of interviews were conducted, Phase 1 before the birth centre opened and Phase 2 after it had opened. Tower Hamlets, a deprived inner city borough in east London, 2007-2010. 620 women who were resident in Tower Hamlets and who satisfied the Barts and the London Trust's eligibility criteria for using the birth centre. Of these, 259 women were recruited to Phase 1 and 361 to Phase 2. the replies women gave show marked differences between the model of care in the birth centre and that at the obstetric unit at the Royal London Hospital with respect to experiences of care and specific practices. Women who initially booked for birth centre care were more likely to attend antenatal classes and find them useful and were less likely to be induced. Women who started labour care at the birth centre in spontaneous labour were more likely to use non-pharmacological methods of pain relief, most notably water and less likely to use pethidine than women who started care at the hospital. They were more likely to be able to move around in labour and less likely to have their membranes ruptured or have continuous CTG. They were more likely to be told to push spontaneously when they needed to rather than under directed pushing and more likely to report that they had been able to choose their position for birth and deliver in places other than the bed, in contrast to the situation at the hospital. The majority of women who had a spontaneous onset of labour delivered vaginally, with 28.6 per cent of women at the birth centre but no one at the hospital delivering in water. Primiparous women who delivered at the birth centre were less likely to have an episiotomy. Most women who delivered at the

  19. Sports medicine across Missouri: interviews with Dr. Paul Meyer and Dr. Stanley London. Interview by Thomas D. Eppright, Shane Bradley, Maureen Alwood.

    PubMed

    Meyer, P; London, S

    1998-12-01

    Paul Meyer and Stanley London are two Missourians who have led the way for many in the field of Sports Medicine. The careers of many professional athletes have been extended due to the clinical expertise of these exemplary physicians who both began their medical careers in the 1940s. Through this interview, they offer a historical perspective of Sports Medicine and baseball. They also share their life experiences, as well as their formulas for successful careers and long-lasting marriages.

  20. Chinese herbal medicine for treating menopausal symptoms in London women: developing a good practice protocol via the factor analysis of prescribing patterns in a clinical study.

    PubMed

    Scheid, Volker; Tuffrey, Veronica; Bovey, Mark

    2017-06-01

    The objective of the study described in this paper was to define Chinese medicine formula patterns for the treatment of menopausal women in London. These formula patterns are intended to inform the development of best practice guidelines for a future pragmatic randomised controlled trial, with the ultimate goal of evaluating the possibility of integrating Chinese medicine treatment strategies for menopausal symptoms into the UK National Health Service. Data from a clinical study that had demonstrated the effectiveness and safety of Chinese medicine in treating 117 perimenopausal women at the Westminster University Polyclinic in London were analysed for symptom occurrence and herb use. The frequency of occurrence of different presenting symptoms and the frequency of use of individual herbs is described, the patterns of combined herb use were analysed by means of factor analysis, and the correlations between these patterns and the presenting symptoms were analysed using the chi square test. Treating the emergent use patterns as Chinese herbal medicine formulas, five distinctive formula patterns emerged in the course of this study. While there is some overlap between these formulas and their associated symptom patterns and those described in Chinese medicine textbooks and guidelines, some formula patterns appear to be unique to London women. This indicates that best practice guidelines for the Chinese medicine treatment of menopausal symptoms, which have been shown to vary cross-culturally, need to be derived from local clinical practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. How to read Simon Forman's casebooks: medicine, astrology, and gender in Elizabethan London.

    PubMed

    Kassel, L

    1999-04-01

    Simon Forman's astrological casebooks record thousands of medical consultations. Amidst the wealth of information in these documents, however, it is unclear to what extent Forman relied on the stars for diagnoses and therapies, or how the casebooks reflect the dymanic between Forman and his clients. This article attempts to answer these questions by reading the casebooks alongside Forman's guide to astrological physic. This approach reveals that astrology was paramount in Forman's evaluations and treatments of his patients. According to Forman, in order for him to effect a cure, he had to be trusted. It was particularly difficult to treat women because their health depended on the state of their wombs, and on their sexual activity, subjects about which women were notoriously duplicitous. The task of the astrologer was first to assess whether or not a woman was sexually active, and only then could he make a judgement about her disease. At the same time, in demonstrating an ability to discern whether or not she was being honest about her sexual activities, Forman won her confidence. By accounting for the role of astrology and the dynamics between the patient and the physician, this article provides the framework within which to read one of the most comprehensive records of medical practices in early modern England.

  2. Use of statistical analysis in the New England Journal of Medicine.

    PubMed

    Emerson, J D; Colditz, G A

    1983-09-22

    A sorting of the statistical methods used by authors of the 760 research and review articles in Volumes 298 to 301 of The New England Journal of Medicine indicates that a reader who is conversant with descriptive statistics (percentages, means, and standard deviations) has statistical access to 58 per cent of the articles. Understanding t-tests increases this access to 67 per cent. The addition of contingency tables gives statistical access to 73 per cent of the articles. Familiarity with each additional statistical method gradually increases the percentage of accessible articles. Original Articles use statistical techniques more extensively than other articles in the Journal. Research studies based on a longitudinal design make heavier use of statistics than do those using a cross-sectional design. The tabulations in this study should aid clinicians and medical investigators who are planning their continuing education in statistical methods, and faculty who design or teach courses in quantitative methods for medical and health professionals.

  3. Examination of England's New Medicine Service (NMS) of complex health care interventions in community pharmacy.

    PubMed

    Latif, Asam; Waring, Justin; Watmough, Deborah; Barber, Nick; Chuter, Anthony; Davies, James; Salema, Nde-Eshimuni; Boyd, Matthew J; Elliott, Rachel A

    Community pharmacies are increasingly commissioned to deliver new, complex health interventions in response to the growing demands on family doctors and secondary health care services. Little is known about how these complex interventions are being accommodated and translated into the community pharmacy setting and whether their aims and objectives are realized in practice. The New Medicine Service (NMS) is a complex medicine management intervention that aims to support patients' adherence to newly prescribed medicines for a long-term condition. This study explores the recent implementation of the NMS in community pharmacies across England. It also seeks to understand how the service is becoming manifest in practice and what lessons can be learned for future service implementation. Structured, organizational ethnographic observations and in situ workplace interviews with pharmacists and support staff were undertaken within 23 English community pharmacies. Additionally, one-to-one, semi-structured interviews were carried out with 47 community pharmacists and 11 general practitioners (GPs). Observational and interview data were transcribed and analyzed thematically and guided by Damschroder's consolidated framework for implementation research. The NMS workload had been implemented and absorbed into pharmacists' daily routines alongside existing responsibilities with no extra resources and little evidence of reduction in other responsibilities. Pharmacists were pragmatic, simplifying, and adapting the NMS to facilitate its delivery and using discretion to circumvent perceived non-essential paperwork. Pharmacist understanding of the NMS was found to impact on what they believed should be achieved from the service. Despite pharmacists holding positive views about the value of the NMS, not all were convinced of its perceived benefits and necessity, with reports that many consultations did not identify any problems with the patients' medicines. GPs were generally

  4. Comparison of risk factors for four sexually transmitted infections: results from a study of attenders at three genitourinary medicine clinics in England.

    PubMed

    Hughes, G; Catchpole, M; Rogers, P A; Brady, A R; Kinghorn, G; Mercey, D; Thin, N

    2000-08-01

    To compare the risk factors for four common sexually transmitted infections (STIs) in attenders at three large urban genitourinary medicine (GUM) clinics in England. Clinical, demographic, and behavioural data on attenders at two clinics in London and one in Sheffield were collected. Risk factors associated with first episodes of genital warts and genital herpes simplex virus (HSV), and uncomplicated gonorrhoea and chlamydia were investigated using the presence of each of these STIs as the outcome variable in separate multiple logistic regression analyses. Using data on the first attendance of the 18,238 patients attending the clinics in 1996, the risk of a gonorrhoea or chlamydia diagnosis was strongly associated with teenagers compared with those aged over 34, with black Caribbeans and black Africans compared with whites, and increased with the number of sexual partners. The risk of genital warts or HSV diagnosis was lowest in black Caribbeans and black Africans compared with whites and was not associated with the number of sexual partners. While genital warts were associated with younger age, odds ratios were much lower compared with those for the bacterial infections. Genital HSV diagnoses were not associated with age. This study of GUM clinic attenders suggests a reduction in the incidence of bacterial STIs may be achievable through targeted sexual health promotion focusing particularly on black ethnic minorities, teenagers, and those with multiple sexual partnerships. Viral STIs were less clearly associated with population subgroups and a broader population based approach to sexual health promotion may be more effective in controlling these infections.

  5. Behavioural and demographic characteristics of attenders at two genitourinary medicine clinics in England.

    PubMed

    Catchpole, M; Connor, N; Brady, A; Kinghorn, G; Mercey, D; Band, B; Thin, N

    1997-12-01

    To investigate how attenders with sexually transmitted disease (STD) differ from the general population with respect to sexual behaviour, and to identify which attenders at genitourinary medicine (GUM) clinics are at particular behavioural risk for acquiring STD. Multicentre cross sectional survey. Two genitourinary medicine clinics, one in London and one in Sheffield 20,516 patients attending the two clinics over an 18 month period. Behavioural and demographic characteristics and clinical diagnoses were recorded for each patient. 8862 patients, in whom 12,506 diagnoses were made, were seen in the Sheffield clinic, and 11,654 patients, in whom 20,243 diagnoses were made, were seen in the London clinic. When compared with the reported results from a general population survey, there were higher proportions of clinic attenders reporting two or more sexual partners in the preceding 12 months (p < 0.001), and a higher proportion of males reporting homosexual contact (13% compared with 1%, p < 0.001). Only age and number of sexual partners in the past 12 months were significantly associated with acute STDs for each sex in each clinic. Acute STDs tended to occur with greater frequency in the younger age groups, peaking among 16-19 year olds, particularly among females. The results have confirmed that patients with STDs exhibit higher risk sexual behaviour than the general population, and have highlighted the problem of continuing high risk behaviour among younger attenders, particularly younger homosexual men. This study has demonstrated that among GUM clinic attenders age and number of sexual partners are key risk factors for the acquisition of an acute STD. The results of this survey also indicate, however, that half of the females and more than one quarter of males with acute STDs reported only one sexual partner in the past 12 months, suggesting that health education messages should point out that it is not only those who have multiple recent sexual partners, or who

  6. Geography and Environmental Education: International Perspectives. Proceedings of the Annual Meeting of the IGU Commission on Geographical Education (London, England, April 11-13, 1999).

    ERIC Educational Resources Information Center

    International Geographical Union.

    This document contains the proceedings from the London conference on geography and environmental education sponsored by the International Geographical Union (IGU) Commission on Geographical Education. Papers include: (1) "The Ecocitizen: A Challenge to Environmental and Geographical Education" (Haubrich, Hartwig); (2) "Learning To…

  7. The association between periodontal disease and periosteal lesions in the St. Mary Graces cemetery, London, England A.D. 1350-1538.

    PubMed

    Dewitte, Sharon N; Bekvalac, Jelena

    2011-12-01

    Numerous studies have demonstrated significant associations between periodontal disease and many other diseases in living populations, and some studies have shown that individuals with periodontal disease are at elevated risks of mortality. Recent analysis of a medieval skeletal sample from London has also shown that periodontal disease was associated with increased risks of mortality in the past. This study examines whether periodontal disease is associated with periosteal lesions in a skeletal sample from the urban St. Mary Graces cemetery (n = 265) from medieval London. The results reveal a significant association between periodontal disease and periosteal lesions in the St. Mary Graces sample (i.e., individuals with periodontal disease were also likely to have periosteal lesions), and the association between the two is independent of age. The association between the two pathological conditions might reflect underlying reduced immune competence and thus heightened susceptibility to pathogens that cause periodontal disease or periosteal lesions, exposure to an environmental factor, or underlying heightened inflammatory responses.

  8. New England journal of medicine article evaluating the usefulness of meniscectomy is flawed.

    PubMed

    Elattrache, Neal; Lattermann, Christian; Hannon, Michael; Cole, Brian

    2014-05-01

    A controversial article was recently published in the New England Journal of Medicine titled "Arthroscopic Partial Meniscectomy Versus Sham Surgery for a Degenerative Meniscal Tear" by Sihvonen et al. We believe that readers of this article should be careful about making sweeping generalizations regarding the study findings given several methodologic flaws inherent in the population studied. There are significant concerns regarding the generalizability of these data. The actual study sample group is exceedingly small as compared with the normal volume of meniscal surgery the authors are reported to routinely perform. The authors' definition of a sham procedure must be revisited. The authors' final conclusion that "arthroscopic partial meniscectomy is of no value" is simply not what the study found. We share the concerns that several other leading authorities have recently expressed about the societal implications of this work. Arthroscopic partial meniscectomy has revolutionized the way we are able to treat symptomatic meniscal pathology. However, this procedure, like all surgical procedures, must be properly indicated to truly benefit our patients. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  9. Conflict of Interest and the CREATE-X Trial in the New England Journal of Medicine.

    PubMed

    Ozaki, Akihiko

    2017-09-15

    There is an increasing emphasis on clear disclosure of conflict of interest in medical communities, following repeated scientific frauds in clinical trials. However, incomplete COI statements continue to be prevalent in the medical community, as appears to have occurred in the Capecitabine for Residual Cancer as Adjuvant Therapy (CREATE-X) trial, which was recently published in the New England Journal of Medicine. The authors of the article did not clearly report the roles of the Japan Breast Cancer Research Group, a sponsor and funder of the study, although a majority of the Japanese authors served in important positions in the organization. Furthermore, the conflict of interest related to Chugai Pharmaceutical Company, a Japanese distributor of capecitabine, was not correctly disclosed. More transparent statements of conflict of interest and clarification of sponsors and funders' roles, as well as rigorous review by academic journals are required to fairly interpret the findings of clinical trials, including and beyond the single case of the CREATE-X trial.

  10. Assessment of the feasibility of conducting population prevalence studies of chronic renal failure according to ethnic group: a survey of clinical biochemistry laboratories in Greater London and south east England.

    PubMed

    Hickman, M; Barker, M; Roderick, P; Wright, D

    1999-01-01

    The planning of renal replacement therapy is based on assessment of population need for the white population, but uses historical trends in treatment uptake for black and Asian ethnic minority groups, for whom the incidence of chronic renal failure (CRF) is not known. Epidemiological studies of CRF are based upon follow-up of plasma creatinine results obtained from clinical biochemistry laboratories. We conducted a postal questionnaire survey of UK National Health Service (NHS) and private clinical biochemistry laboratories in Greater London and the south east of England to arrange the design and test the feasibility of carrying out a study to determine ethnic-specific rates of CRF. Fifty-five NHS laboratories (90%) and 19 private laboratories (57%) responded. Few pathology computer systems recorded ethnic group, patient post code, or diagnosis; although 31 of the laboratory computers (42%) were linked with the hospital Patient Administration System which could supply these data. Approximately 5.5 million electrolyte profiles and 20 million individual renal function tests are carried out annually in south east England. Ninety per cent of those were performed within NHS laboratories, implying that a study can use NHS sources alone without risk of any undue bias. Sixty laboratories (81%) included creatinine in their routine electrolyte profile, which would be a requirement for any study. Thirty-one laboratories (42%) archived tests within 1 year of entry, which would rule out a retrospective study design. A prospective study is feasible and should be carried out as soon as is practicable.

  11. Mortality of people with chronic fatigue syndrome: a retrospective cohort study in England and Wales from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Clinical Record Interactive Search (CRIS) Register.

    PubMed

    Roberts, Emmert; Wessely, Simon; Chalder, Trudie; Chang, Chin-Kuo; Hotopf, Matthew

    2016-04-16

    Mortality associated with chronic fatigue syndrome is uncertain. We investigated mortality in individuals diagnosed with chronic fatigue syndrome in secondary and tertiary care using data from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Clinical Record Interactive Search (CRIS) register. We calculated standardised mortality ratios (SMRs) for all-cause, suicide-specific, and cancer-specific mortality for a 7-year observation period using the number of deaths observed in SLaM records compared with age-specific and sex-specific mortality statistics for England and Wales. Study participants were included if they had had contact with the chronic fatigue service (referral, discharge, or case note entry) and received a diagnosis of chronic fatigue syndrome. We identified 2147 cases of chronic fatigue syndrome from CRIS and 17 deaths from Jan 1, 2007, to Dec 31, 2013. 1533 patients were women of whom 11 died, and 614 were men of whom six died. There was no significant difference in age-standardised and sex-standardised mortality ratios (SMRs) for all-cause mortality (SMR 1·14, 95% CI 0·65-1·85; p=0·67) or cancer-specific mortality (1·39, 0·60-2·73; p=0·45) in patients with chronic fatigue syndrome when compared with the general population in England and Wales. This remained the case when deaths from suicide were removed from the analysis. There was a significant increase in suicide-specific mortality (SMR 6·85, 95% CI 2·22-15·98; p=0·002). We did not note increased all-cause mortality in people with chronic fatigue syndrome, but our findings show a substantial increase in mortality from suicide. This highlights the need for clinicians to be aware of the increased risk of completed suicide and to assess suicidality adequately in patients with chronic fatigue syndrome. National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London

  12. Racial origin, sexual lifestyle, and genital infection among women attending a genitourinary medicine clinic in London (1992)

    PubMed Central

    Evans, B. A.; Kell, P. D.; Bond, R. A.; MacRae, K. D.

    1998-01-01

    OBJECTIVES: To compare variables of sexual behaviour and incidence of genital infections among women of different racial origins and lifestyles. DESIGN: A prospective cross sectional study of sexual behaviour reported by a standardised self administered questionnaire in new patients who presented for screening and diagnosis. SETTING: A genitourinary medicine clinic in west London. SUBJECTS: 1084 consecutive women newly attending in 1992. MAIN OUTCOME MEASURES: Variables relating to sociodemographic status, sexual lifestyle, condom use, sexually transmitted diseases, and other genital infections stratified by racial origin. RESULTS: There were 948 evaluable women, of whom 932 (98.3%) were heterosexual and 16 (1.7%) were lesbian. Previous heterosexual intercourse was reported by 69% of lesbian women and their most frequent diagnosis was bacterial vaginosis (38%). The majority of heterosexual women were white (78%) and 16% were black. The black women were more likely to be teenagers (18% cf 8%; p = 0.0004) or students (28% cf 15%; p = 0.0008), and to have had an earlier coitarche (48% cf 38% before aged 17; p < 0.004). They also had a higher proportion of pregnancies (58% cf 38%; p < 0.00001) and births (38% cf 20%; p < 0.00001). The white women showed significantly more sexual partners during the preceding year (p = 0.004) and in total (p < 0.00001) and more reported non-regular partners (48% cf 35%; p = 0.004) with whom they were more likely to use condoms (p = 0.009). However, the black women were more likely to have gonorrhoea (7% cf 2% p < 0.0003), chlamydial infection (12% cf 5% p < 0.002), trichomoniasis (10% cf 2% p < 0.00001), or to sexual contacts of men with non-gonococcal urethritis (19% cf 12% p < 0.02). They were less likely to have genital warts (3% cf 12% p = 0.002). Logistic regression showed that all these variables were independently associated with the black women. The Asian women (2%), none of whom had a sexually transmitted disease, had commenced

  13. Factors associated with travel to non-local genitourinary medicine clinics for gonorrhoea: an analysis of patients diagnosed in London, 2009-10.

    PubMed

    Le Polain de Waroux, Olivier; Hughes, Gwenda; Maguire, Helen; Crook, Paul D

    2014-03-01

    We analysed factors associated with travelling to non-local genitourinary medicine clinics for gonorrhoea care in London. We used surveillance data on London residents attending genitourinary medicine clinics in 2009-10 and calculated distances between patients' areas of residence and both the nearest genitourinary medicine clinic and the clinic attended. Non-local clinics were attended by 5408 (46.7%) patients. Men having sex with men attended non-local services more than heterosexuals (OR 3.83, p < 0.001). Among heterosexual men, black Africans and black Caribbeans were more likely, and South Asians less likely, to attend non-local services compared to whites (OR [95%CI] 1.33 [1.04-1.72], 1.36 [1.11-1.67] and 0.46 [0.31-0.70] respectively). Similar associations, although not statistically significant, were found in women. People were more likely to attend local services if their local clinic provided walk-in and young people's services, weekend consultations and long opening hours. These findings could help design services meeting local population needs and facilitate prompt and equitable access to care.

  14. Co-Production at the Strategic Level: Co-Designing an Integrated Care System with Lay Partners in North West London, England.

    PubMed

    Morton, Michael; Paice, Elisabeth

    2016-05-03

    In North West London, health and social care leaders decided to design a system of integrated care with the aim of improving the quality of care and supporting people to maintain independence and participation in their community. Patients and carers, known as 'lay partners,' were to be equal partners in co-production of the system. Lay partners were recruited by sending a role profile to health, social care and voluntary organisations and requesting nominations. They formed a Lay Partners Advisory Group from which pairs were allocated to system design workstreams, such as which population to focus on, financial flow, information technology and governance. A larger and more diverse Lay Partners Forum provided feedback on the emerging plans. A key outcome of this approach was the development of an integration toolkit co-designed with lay partners. Lay partners provided challenge, encouraged innovation, improved communication, and held the actions of other partners to account to ensure the vision and aims of the emerging integrated care system were met. Key lessons from the North West London experience for effective co-production include: recruiting patients and carers with experience of strategic work; commitment to the vision; willingness to challenge and to listen; strong connections within the community being served; and enough time to do the work. Including lay partners in co-design from the start, and at every level, was important. Agreeing the principles of working together, providing support and continuously recruiting lay representatives to represent their communities are keys to effective co-production.

  15. A Report on the Need for a College of Veterinary Medicine in New England.

    ERIC Educational Resources Information Center

    New England Board of Higher Education, Winchester, MA.

    New England faces a critical shortage of over 1,200 veterinarians by 1980. In 1968 there were only 8.2 practicing veterinarians for every 100,000 New Englanders--5 fewer than the national average, and less than half as many as will be needed by the end of the present decade. The major problem arises from the fact that there has been no college of…

  16. Survey of women׳s experiences of care in a new freestanding midwifery unit in an inner city area of London, England – 1: Methods and women׳s overall ratings of care

    PubMed Central

    Macfarlane, Alison J.; Rocca-Ihenacho, Lucia; Turner, Lyle R.; Roth, Carolyn

    2014-01-01

    Objective to describe and compare women׳s choices and experiences of maternity care before and after the opening of the Barkantine Birth Centre, a new freestanding midwifery unit in an inner city area. Design telephone surveys undertaken in late pregnancy and about six weeks after birth in two separate time periods, Phase 1 before the birth centre opened and Phase 2 after it had opened. Setting Tower Hamlets, a deprived inner city borough in east London, England, 2007–2010. Participants 620 women who were resident in Tower Hamlets and who satisfied the Barts and the London NHS Trust׳s eligibility criteria for using the birth centre. Of these, 259 women were recruited to Phase 1 and 361 to Phase 2. Measurements and findings women who satisfied the criteria for birth centre care and who booked antenatally for care at the birth centre were significantly more likely to rate their care as good or very good overall than corresponding women who also satisfied these criteria but booked initially at the hospital. Women who started labour care in spontaneous labour at the birth centre were significantly more likely to be cared for by a midwife they had already met, have one to one care in labour and have the same midwife with them throughout their labour. They were also significantly more likely to report that the staff were kind and understanding, that they were treated with respect and dignity and that their privacy was respected. Key conclusions and implications for practice this survey in an inner city area showed that women who chose the freestanding midwifery unit care had positive experiences to report. Taken together with the findings of the Birthplace Programme, it adds further weight to the evidence in support of freestanding midwifery unit care for women without obstetric complications. PMID:24820003

  17. Assessment of the impact of the London Olympics 2012 on selected non-genitourinary medicine clinic sexual health services.

    PubMed

    Hartley, A; Foster, R; Brook, M G; Cassell, J A; Mercer, C H; Coyne, K; Hughes, G; Crook, P

    2015-04-01

    With minimal information on sexual health provision during mass-gathering events, our aim was to describe the use of sexual health, contraceptive, sex worker and sexual assault services during the London 2012 Olympics. We analysed data from five sources. One contraceptive service provider reported a 10% increase in attendance during the main Games, while emergency contraception prescriptions rose during the main Olympics, compared to the week before, but were similar or lower than at the beginning and end of the summer period. A health telephone advice line reported a 16% fall in sexual health-related calls during the main Olympics, but a 33% increase subsequently. London sexual assault referral centres reported that 1.8% of sexual assaults were Olympics-linked. A service for sex workers reported that 16% started working in the sex industry and 7% moved to London to work during the Olympics. Fifty-eight per cent and 45% of sex workers reported fewer clients and an increase in police crack-downs, respectively. Our results show a change in activity across these services during the 2012 summer, which may be associated with the Olympics. Our data are a guide to other services when anticipating changes in service activity and planning staffing for mass-gathering events. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Fritz London

    NASA Astrophysics Data System (ADS)

    Gavroglu, Kostas

    2005-11-01

    Preface; Acknowledgements; Part I. From Philosophy to Physics: The years that left nothing unaffected; 1. The appeal of ideas; 2. Goëthe as a scientist; 3. How absolute is our knowledge?; 4. How do we come to know things?; 5. London's teachers in philosophy; 6. Husserl's teachings; 7. Expectations of things to come; 8. The thesis in philosophy; 9. Tolman's principle of similitude; 10. The necessary clarifications; 11. Work on quantum theory; 12. Transformation theory; 13. Unsuccessful attempts at unification; Part II. The Years in Berlin and the Beginnings of Quantum Chemistry: The mysterious bond; 14. London in Zürich; 15. Binding forces; 16. The Pauli principle; 17. Reactions to the Heitler-London paper; 18. Polyelectronic molecules and the application of group theory to problems of chemical valence; 19. Chemists as physicists?; 20. London's first contacts in Berlin; 21. Marriage; 22. Job offers; 23. Intermolecular forces; 24. The book which could not be written; 25. Leningrad and Rome; 26. Difficulties with group theory; 27. Linus Pauling's resonance structures; 28. Robert Mulliken's molecular orbitals; Part III. Oxford and Superconductivity: The rise of the Nazis; 29. Going to Oxford; 30. Lindemann, Simon and Heinz London; 31. Electricity in the very cold; 32. The end of old certainties; 33. The thermodynamic treatment; 34. The theory of Fritz and Heinz London; 35. Initial reactions by von Laue; 36. The discussion at the Royal Society; 37. Termination of the ICI fellowship; Part IV. Paris and Superfluidity: The Front Populaire; 38. The article in Nature 1937 and 'Nouvelle Conception'; 39. Laue again; 40. The structure of solid helium; 41. The peculiar properties of helium; 42. Bose-Einstein condensation; 43. The note in Nature; 44. The two-fluid model; 45. The trip to Jerusalem; 46. Leaving again; 47. The observer in quantum mechanics; Part V. United States and the Typing up of Loose Ends: Duke University, North Carolina; 48. The Soviet Union, Kapitza and

  19. Investigation of the increased incidence of gonorrhoea diagnosed in genitourinary medicine clinics in England, 1994–6

    PubMed Central

    Hughes, G.; Andrews, N.; Catchpole, M.; Goldman, M.; Forsyth-Benson, D.; Bond, M.; Myers, A.

    2000-01-01

    Objectives: To determine important risk factors associated with cases of gonorrhoea in England, and whether any particular risk groups were associated with the substantial rise in numbers of cases seen between 1994 and 1996. Design: Two retrospective cross sectional surveys. Setting: 70 randomly selected genitourinary medicine (GUM) clinics in England. Subjects: 10% of all gonorrhoea patients attending GUM clinics in England in 1994 (847 patients) and 1996 (1146 patients). Main outcome measures: For risk factors in 1996 (study 1), unadjusted rates per 100 000 population aged 14–70 and relative rates (RR) with 95% confidence intervals (CIs). For the change in risk factors between 1994 and 1996 (study 2), adjusted odds ratios (ORs) with 95% CIs, derived from logistic regression analyses of data on patients in 1996, with patients in 1994 as the comparison group. Results: The incidence of gonorrhoea in 1996 was higher in homosexual males (812 per 100 000; RR=30.2, CI= 25.2 to 36.0) compared with heterosexual males (27 per 100 000); in black Caribbeans (467 per 100 000; 21.4, 17.9 to 25.5) and black Africans (235 per 100 000; 10.8, 7.5 to 15. 5) compared with white people (22 per 100 000); and in previous GUM clinic attenders (433 per 100 000; 37.93, 35.46 to 40.56) compared with those who had not attended previously (11 per 100 000). However, most patients were either white or heterosexual. Heterosexual patients in 1996 were significantly more likely to have reduced sensitivity to penicillin (2.55, 1.20 to 5.41) than those in 1994. Male homo/bisexual patients in 1996 were significantly more likely to be from the north west (3.77, 1.45 to 9.80) and to have either reduced sensitivity (2.63, 1.03 to 6.73) or complete resistance (1.98, 1.03 to 3.78) to penicillin, compared with those in 1994. Conclusions: Homo/bisexual men and the black Caribbean population in England experience a disproportionate burden of gonococcal infections, however, the bulk of diagnoses are in

  20. Panton-Valentine Leukocidin associated Staphylococcus aureus infections in London, England: clinical and socio-demographic characterisation, management, burden of disease and associated costs.

    PubMed

    Edelstein, Michael; Kearns, Angela; Cordery, Rebecca

    2011-08-01

    Routine notification of Staphylococcus aureus producing the Panton-Valentine Leucocidin toxin (PVL-SA) to the North East & Central London Health Protection Unit, a communicable disease control unit covering a population of 2.8 million, identified 115 cases in 2009-2010, including 99 skin and soft tissue infections (SSTIs), 15 severe infections and one asymptomatic colonisation. Most cases occurred in children and young adults, unequally distributed geographically and socio-economically. The majority of infections were community acquired and 60% were caused by methicillin resistant strains. Overall, 27% of cases had previous SSTIs, and 32% had contacts with SSTIs suggestive of PVL-SA albeit these were not confirmed microbiologically. This suggests that characteristics of PVL-SA infection in cases and their families are not recognised as such leading to delay in diagnosis and low case ascertainment. A lack of governance around effective case management may also be contributing to the burden of disease. Further studies are recommended to evaluate key aspects of PVL-SA management including the effectiveness of decolonisation in the elimination of carriage and prevention of local spread.

  1. Comparison of pharmacist and public views and experiences of community pharmacy medicines-related services in England

    PubMed Central

    Rodgers, Ruth M; Gammie, Shivaun M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet

    2016-01-01

    Background Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. Objective To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Methods Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Results Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists’ perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists. Conclusion Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a

  2. Comparison of pharmacist and public views and experiences of community pharmacy medicines-related services in England.

    PubMed

    Rodgers, Ruth M; Gammie, Shivaun M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet

    2016-01-01

    Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists' perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists. Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a better awareness of what the public, especially

  3. Characteristics and practices of Traditional Chinese Medicine retail shops in London, UK: A cross-sectional study using an observational approach.

    PubMed

    Teng, Lida; Shaw, Debbie; Barnes, Joanne

    2015-09-15

    Traditional Chinese Medicine (TCM) is a popular form of ethnomedicine in the UK, and is accessed by Western, Chinese and other ethnic groups. The current regulatory regime does not effectively protect the public against poor-quality and unsafe TCMs. Understanding ethnopharmacological information on how TCM is promoted and practiced may help to inform initiatives aimed at ensuring the safe use of TCMs in the UK, and put laboratory-based ethnopharmacological investigations of TCMs in a broader context. This study aimed to examine the characteristics and practices of TCM retail outlets in London, UK, and to identify factors relevant to the safe use of TCM in the UK. TCM retail outlets ('shops') in London, UK, were identified using a systematic approach. A structured questionnaire including questions on shop business type was used to recruit participant shops. Shops consenting to participate were visited within six weeks of providing consent. A piloted semi-structured questionnaire on shop characteristics was used for data collection following observation. The British National Formulary 53 was used to classify medical conditions/uses for TCMs promoted in the shops. Data were stored and analysed using MS Access 2003, MS Excel 2003 and SPSS 13. In total, 54 TCM shops in London were identified, of which 94% offered TCM consultations with a TCM practitioner. Detailed characteristics were described within 35/50 shops that gave consent to observing their premises. Most shops labelled and displayed over 150 Chinese Materia Medica (CMMs; crude materials, particularly herbs) for dispensing after consultations with a TCM practitioner. Medical conditions/uses and Patent Chinese Medicines (PCMs) were commonly promoted. In total, 794 occurrences of 205 different medical conditions/uses (median=32, QL=19, QU=48) were identified. These conditions/uses most commonly related to the following therapeutic systems: central nervous system (160/794, 20.2%); musculoskeletal and joint disease

  4. Validation of primary metal-on-metal hip arthroplasties on the National Joint Registry for England, Wales and Northern Ireland using data from the London Implant Retrieval Centre: a study using the NJR dataset.

    PubMed

    Sabah, S A; Henckel, J; Cook, E; Whittaker, R; Hothi, H; Pappas, Y; Blunn, G; Skinner, J A; Hart, A J

    2015-01-01

    Arthroplasty registries are important for the surveillance of joint replacements and the evaluation of outcome. Independent validation of registry data ensures high quality. The ability for orthopaedic implant retrieval centres to validate registry data is not known. We analysed data from the National Joint Registry for England, Wales and Northern Ireland (NJR) for primary metal-on-metal hip arthroplasties performed between 2003 and 2013. Records were linked to the London Implant Retrieval Centre (RC) for validation. A total of 67,045 procedures on the NJR and 782 revised pairs of components from the RC were included. We were able to link 476 procedures (60.9%) recorded with the RC to the NJR successfully. However, 306 procedures (39.1%) could not be linked. The outcome recorded by the NJR (as either revised, unrevised or death) for a primary procedure was incorrect in 79 linked cases (16.6%). The rate of registry-retrieval linkage and correct assignment of outcome code improved over time. The rates of error for component reference numbers on the NJR were as follows: femoral head category number 14/229 (5.0%); femoral head batch number 13/232 (5.3%); acetabular component category number 2/293 (0.7%) and acetabular component batch number 24/347 (6.5%). Registry-retrieval linkage provided a novel means for the validation of data, particularly for component fields. This study suggests that NJR reports may underestimate rates of revision for many types of metal-on-metal hip replacement. This is topical given the increasing scope for NJR data. We recommend a system for continuous independent evaluation of the quality and validity of NJR data.

  5. [Strategies to shorten the time from urgent admission to coronary angioplasty: a recent publication in the New England Journal of Medicine].

    PubMed

    Limet, R; Legrand, V

    2007-03-01

    A recent publication in New England Journal of Medicine stresses the fact that the mere presence of a coronarography equipment to dilate acute myocardial infarction is not sufficient to obtain the opening of the related myocardial infarction artery in due time.

  6. Use of flawed multiple-choice items by the New England Journal of Medicine for continuing medical education.

    PubMed

    Stagnaro-Green, Alex S; Downing, Steven M

    2006-09-01

    Physicians in the United States are required to complete a minimum number of continuing medical education (CME) credits annually. The goal of CME is to ensure that physicians maintain their knowledge and skills throughout their medical career. The New England Journal of Medicine (NEJM) provides its readers with the opportunity to obtain weekly CME credits. Deviation from established item-writing principles may result in a decrease in validity evidence for tests. This study evaluated the quality of 40 NEJM MCQs using the standard evidence-based principles of effective item writing. Each multiple-choice item reviewed had at least three item flaws, with a mean of 5.1 and a range of 3 to 7. The results of this study demonstrate that the NEJM uses flawed MCQs in its weekly CME program.

  7. Pharmacovigilance Discussion Forum--The European Generic Medicines Association's 8th Annual Meeting (January 21, 2015--London, UK).

    PubMed

    Lam, S

    2015-01-01

    The practice and science of pharmacovigilance first emerged following the disaster caused by thalidomide in 1961, which led to the initiation of systemic international efforts to address drug safety issues spearheaded by the WHO. Systems were developed in member states of the WHO to analyze cases of adverse drug reactions (ADRs) and collate these data into a central database to aid national drug regulatory authorities in improving safety profiles of medicines. Pharmacovigilance is a key public health function for monitoring all medicinal products to assess their quality, efficacy and safety before and following authorization. These medicines are continually assessed to detect any aspect that could compromise their safety, and ensure that the necessary measures are taken. In July 2012, new legislation for pharmacovigilance in the E.U. came into effect as a result of the changes set out in the Directive 2010/84/EU and the European Commission (EC) implementing Regulation (EU) No 520/2012 to reduce the increasing number of ADRs. The latest developments in pharmacovigilance in Europe, including news on E.U. pharmacovigilance legislation, were discussed at the 8th European Generic Medicines Association (EGA) Pharmacovigilance Discussion Forum. The meeting facilitated constructive dialogue between regulators and industry on a range of topics including how to simplify pharmacovigilance activities and improve the processes of risk management plans, periodic safety update reports, signal detection, joint studies and inspections.

  8. Knives and Other Weapons in London Schools

    ERIC Educational Resources Information Center

    Neill, S. R. St. J.

    2005-01-01

    London schools operate in an area where crime rates, including violent crime, is statistically more frequent than the average for the whole of England and Wales (Moore and Yeo 2004). Violent crime in the capital increased (though not to a statistically significant extent) between 2002/3 and 2003/4 (Moore and Yeo 2004b). This has led to a…

  9. Knives and Other Weapons in London Schools

    ERIC Educational Resources Information Center

    Neill, S. R. St. J.

    2005-01-01

    London schools operate in an area where crime rates, including violent crime, is statistically more frequent than the average for the whole of England and Wales (Moore and Yeo 2004). Violent crime in the capital increased (though not to a statistically significant extent) between 2002/3 and 2003/4 (Moore and Yeo 2004b). This has led to a…

  10. Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England.

    PubMed

    Lichtner, Valentina; Hibberd, Ralph; Cornford, Tony

    2016-01-01

    Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.

  11. Reflections on the impact of Title VII funding at the University of New England College of Osteopathic Medicine.

    PubMed

    Shannon, Stephen C

    2008-11-01

    Title VII funding played an important role in the development of the University of New England College of Osteopathic Medicine (UNECOM). These funds enabled the 90% tuition-funded school to implement a primary-care-based curriculum in its formative years and played a crucial role in the 1995-2005 period of curriculum revision. UNECOM successfully competed for Title VII program funding in Physician Faculty Development in Primary Care, Academic Units in Primary Care, Predoctoral Training in Primary Care, and Residency Training in Primary Care. This funding helped the institution refine its vision and mission as a result of the federal imperatives surrounding primary health care. Securing these funds enabled the institution to jump-start programs with start-up federal funding, expand faculty, access educational innovation by networking with other grantees across the nation, and expand faculty grant-making knowledge and skills via federal technical assistance and grant review processes. Subsequent institutionalization of the resulting innovations may have played a role in UNECOM maintaining its production of primary care physicians, as evidenced by 71% of its 1996-2002 graduates practicing in primary care specialties. The impact of Title VII funding at UNECOM provides an example of how new and existing medical schools whose missions align with federal priorities can use these programs to develop curriculum and resources congruent with their missions.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

  12. Learning 2010 (London, England, September 2000).

    ERIC Educational Resources Information Center

    Caseley, Clive

    The "Learning 2010" project began with the question of the implications of technology for teaching and learning in Great Britain. Participants at expert seminars narrowed the focus to identify scenarios for how teaching and learning will develop in the next 10 years. Six key themes emerged. The theme of multimedia highlighted computers…

  13. ‘Herbals she peruseth’: reading medicine in early modern England

    PubMed Central

    Leong, Elaine

    2014-01-01

    In 1631, Richard Brathwaite penned a conduct manual for ‘English Gentlewomen’. In Brathwaite's mind, the ideal English gentlewoman was not only chaste, modest and honourable but also an avid reader. In fact, Brathwaite specifically recommends English gentlewomen to first peruse herbals and then to deepen their medical knowledge via conference. Centred on the manuscript notebooks of two late seventeenth-century women, Margaret Boscawen (d. 1688) and Elizabeth Freke (1642–1714), this article explores women and ‘medical reading’ in early modern England. It first demonstrates that whilst both women consulted herbals by contemporary authors such as John Gerard and Nicholas Culpeper, their modes of reading could not be more different. Where Freke ruminated, digested and abstracted from Gerard's large tome, Boscawen made practical lists from Culpeper's The English Physitian. Secondly, the article shows that both supplemented their herbal reading with a range of other vernacular medical texts including printed medical recipe books, contemporary pharmacopoeia and surgical handbooks. Early modern English women's medical reading, I argue, was nuanced, sophisticated and diverse. Furthermore, I contend that well-informed readers like Boscawen and Freke made smart medical consumers and formidable negotiators in their medical encounters. PMID:25821333

  14. Estimated generic prices of cancer medicines deemed cost-ineffective in England: a cost estimation analysis.

    PubMed

    Hill, Andrew; Redd, Christopher; Gotham, Dzintars; Erbacher, Isabelle; Meldrum, Jonathan; Harada, Ryo

    2017-01-20

    The aim of this study was to estimate lowest possible treatment costs for four novel cancer drugs, hypothesising that generic manufacturing could significantly reduce treatment costs. This research was carried out in a non-clinical research setting using secondary data. There were no human participants in the study. Four drugs were selected for the study: bortezomib, dasatinib, everolimus and gefitinib. These medications were selected according to their clinical importance, novel pharmaceutical actions and the availability of generic price data. Target costs for treatment were to be generated for each indication for each treatment. The primary outcome measure was the target cost according to a production cost calculation algorithm. The secondary outcome measure was the target cost as the lowest available generic price; this was necessary where export data were not available to generate an estimate from our cost calculation algorithm. Other outcomes included patent expiry dates and total eligible treatment populations. Target prices were £411 per cycle for bortezomib, £9 per month for dasatinib, £852 per month for everolimus and £10 per month for gefitinib. Compared with current list prices in England, these target prices would represent reductions of 74-99.6%. Patent expiry dates were bortezomib 2014-22, dasatinib 2020-26, everolimus 2019-25 and gefitinib 2017. The total global eligible treatment population in 1 year is 769 736. Our findings demonstrate that affordable drug treatment costs are possible for novel cancer drugs, suggesting that new therapeutic options can be made available to patients and doctors worldwide. Assessing treatment cost estimations alongside cost-effectiveness evaluations is an important area of future research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Estimated generic prices of cancer medicines deemed cost-ineffective in England: a cost estimation analysis

    PubMed Central

    Hill, Andrew; Redd, Christopher; Gotham, Dzintars; Erbacher, Isabelle; Meldrum, Jonathan; Harada, Ryo

    2017-01-01

    Objectives The aim of this study was to estimate lowest possible treatment costs for four novel cancer drugs, hypothesising that generic manufacturing could significantly reduce treatment costs. Setting This research was carried out in a non-clinical research setting using secondary data. Participants There were no human participants in the study. Four drugs were selected for the study: bortezomib, dasatinib, everolimus and gefitinib. These medications were selected according to their clinical importance, novel pharmaceutical actions and the availability of generic price data. Primary and secondary outcome measures Target costs for treatment were to be generated for each indication for each treatment. The primary outcome measure was the target cost according to a production cost calculation algorithm. The secondary outcome measure was the target cost as the lowest available generic price; this was necessary where export data were not available to generate an estimate from our cost calculation algorithm. Other outcomes included patent expiry dates and total eligible treatment populations. Results Target prices were £411 per cycle for bortezomib, £9 per month for dasatinib, £852 per month for everolimus and £10 per month for gefitinib. Compared with current list prices in England, these target prices would represent reductions of 74–99.6%. Patent expiry dates were bortezomib 2014–22, dasatinib 2020–26, everolimus 2019–25 and gefitinib 2017. The total global eligible treatment population in 1 year is 769 736. Conclusions Our findings demonstrate that affordable drug treatment costs are possible for novel cancer drugs, suggesting that new therapeutic options can be made available to patients and doctors worldwide. Assessing treatment cost estimations alongside cost-effectiveness evaluations is an important area of future research. PMID:28110283

  16. [An approach to the evaluation of medical journals: application to original articles of La Presse Médicale and the New England Journal of Medicine published in 1982].

    PubMed

    Charpak, Y; Chastang, C

    1984-09-29

    Medical journals play an important role in the diffusion of scientific medical information. We tried to evaluate the French medical journal, La Presse Médicale, and to compare it with the New England Journal of Medicine. We reviewed all the original articles published in 1982 (207 articles In La Presse Medicale and 152 articles in the New England Journal of Medicine): specialties, methodologies used in the studies, environment (number of authors, geographical origin, institutional origin, number and language of references, number of subjects included in the studies). The articles in both journals concerned virtually the same specialties, more than 50% of the articles dealing with the following: cancerology, cardiology, infectious diseases, endocrinology, gastroenterology. Many specialties including highly prevalent diseases were underrepresented in both journals. When treating the same kind of problems, different methodologies were used: faced with a therapeutical problem, authors in La Presse Medicale used mostly non controlled evaluations (46%, 30 articles), and few randomized controlled trials (12%, 8 articles). On the other hand, authors in the New England Journal of Medicine used mostly randomised controlled trials (56%, 36 articles), and less non controlled evaluations (26%, 16 articles). Most references were in English, even in La Presse Medicale, in which 76% of all references were not in French, and 14% of all articles had no French references. In conclusion, this study shows differences between the two journals: in particular, the methodologies used by the authors in La Presse Medicale were less pertinent than those used by the authors in the New England Journal of Medicine. This finding is important with regard to the formation of and information given to the French speaking physicians, and a strong reaction from the editors and physicians concerned is desirable.

  17. Retrieving research studies: a comparison of bibliographic and full-text versions of the New England Journal of Medicine.

    PubMed

    Johnson, E D; Sievert, M C; McKinin, E J

    1995-01-01

    It has been established that subject searches of medical full-text databases obtain higher recall than subject searches in a bibliographic database. In this study we attempted to determine if the same rule might apply when searching for a non-subject parameter such as study design. A simultaneous search of bibliographic and full-text records from the New England Journal of Medicine provided data on the number of items retrieved by each kind of search. Filtering strategies were created for 5 different study types: randomized controlled trials, other clinical trials and prospective studies, cohort studies, longitudinal and follow-up studies, and multicenter studies. The point of the study was to compare the numbers of items retrieved from the bibliographic database, MEDLINE, and those retrieved from the full-text version of NEJM, and to examine the unique access points available in each file. For all the study types the full-text file retrieved a larger number of records than MEDLINE, most of which were retrieved because of methodology terms found in the text but not in the title or abstract. In MEDLINE, descriptors and publication types, two value-added fields supplied by indexers, retrieved 11-89% more than title and abstract alone.

  18. Retrieving research studies: a comparison of bibliographic and full-text versions of the New England Journal of Medicine.

    PubMed Central

    Johnson, E. D.; Sievert, M. C.; McKinin, E. J.

    1995-01-01

    It has been established that subject searches of medical full-text databases obtain higher recall than subject searches in a bibliographic database. In this study we attempted to determine if the same rule might apply when searching for a non-subject parameter such as study design. A simultaneous search of bibliographic and full-text records from the New England Journal of Medicine provided data on the number of items retrieved by each kind of search. Filtering strategies were created for 5 different study types: randomized controlled trials, other clinical trials and prospective studies, cohort studies, longitudinal and follow-up studies, and multicenter studies. The point of the study was to compare the numbers of items retrieved from the bibliographic database, MEDLINE, and those retrieved from the full-text version of NEJM, and to examine the unique access points available in each file. For all the study types the full-text file retrieved a larger number of records than MEDLINE, most of which were retrieved because of methodology terms found in the text but not in the title or abstract. In MEDLINE, descriptors and publication types, two value-added fields supplied by indexers, retrieved 11-89% more than title and abstract alone. PMID:8563411

  19. Dealing with uncertainty and high prices of new medicines: a comparative analysis of the use of managed entry agreements in Belgium, England, the Netherlands and Sweden.

    PubMed

    Ferrario, Alessandra; Kanavos, Panos

    2015-01-01

    Managed entry agreements are a set of instruments used to reduce the impact of uncertainty and high prices when introducing new medicines. This study develops a conceptual framework for these agreements and tests it by exploring variations in their implementation in Belgium, England, the Netherlands and Sweden and over time as well as their governance structures. Using publicly available data from HTA agencies and survey data from the European Medicines Information Network, a database of agreements implemented between 2003 and 2012 was developed. A review of governance structures was also undertaken. In December 2012 there were 133 active MEAs for different medicine-indications across the four countries. These corresponded to 110 unique medicine-indications. Over time there has been a steady growth in the number of agreements implemented, with the highest number in the Netherlands in 2012. The number of new agreements introduced each year followed a different pattern. In Belgium and England it increased over time, while it decreased in the Netherlands and fluctuated in Sweden. Only 18 (16%) of the unique medicine-indication pairs identified were part of an agreement in two or more countries. England uses mainly discounts and free doses to influence prices. The Netherlands and Sweden have focused more on addressing uncertainties through coverage with evidence development and, in Sweden, on monitoring use and compliance with restrictions through registries. Belgium uses a combination of the above. Despite similar reasons being cited for managed entry agreements implementation, only in a minority of cases have countries implemented an agreement for the same medicine-indication; when they do, a different agreement type is often implemented. Differences in governance across countries partly explain such variations. However, more research is needed to understand whether e.g. risk-perception and/or notion of what constitutes a high price differ between these countries

  20. Prevalence of long-term use of medicines with prolonged oral clearance in the elderly: a survey in north east England.

    PubMed

    Maguire, A; Baqir, W

    2000-09-09

    To determine the prevalence of long-term use by the elderly of prescribed and over-the-counter (OTC) medicines with prolonged oral clearance (POC), with regard to sugars content, dose form and therapeutic groups of medicines used. Two cross-sectional observational surveys in ten general medical practices in north-east England during 1996. Computerised patient records of all elderly patients (aged 60 years and over) were surveyed for prescribed medicines use. Within these practices, 50% of elderly patients registered with ten general medical practitioners were surveyed by postal questionnaire to assess over-the-counter (OTC) medicines use. Of 20,731 elderly patients registered, prevalence of use of prescribed prolonged oral clearance (POC) medicines was 9.8% (95% CI: 8.2%, 11.3%) and use in females aged 75 years and older was significantly more likely (P < 0.0001). Of 2,796 prescribing instances (PIs) for 143 POC medicines used long-term, 53% were gastrointestinal and 72% were sugars-free; however, 82% of 542 PIs for generic liquids were sugars-containing compared with 8% of 685 PIs for proprietary liquid oral medicines. Of 1,532 elderly respondents to a postal questionnaire, 17 were using 13 different OTC medicines with POC regularly and long-term (mean prevalence; 1.1%). Of the 17 instances of regular long-term use of OTC medicines, 59% were sugars-free. Prescribed medicines represent the bulk of regular, long-term medicines use in the elderly. Generic prescribing is more likely to result in sugars-containing medicines being dispensed. Generic medicines manufacturers must be encouraged to provide sugars-free alternatives to POC medicines used long-term, and health professionals should be vigilant when prescribing and dispensing these medicines to the increasingly dentate elderly.

  1. Medicinal perceptions of vegetables traditionally consumed by South-Asian migrants living in Bradford, Northern England.

    PubMed

    Pieroni, Andrea; Houlihan, Laura; Ansari, Nafeesa; Hussain, Bushra; Aslam, Saiqa

    2007-08-15

    Dietary habits change rapidly amongst migrant communities in Western countries, and these changes can cause major concerns for public-health policymakers because they frequently lead to increases in diet-related diseases like diabetes. Such is the case in most South-Asian communities in the UK. In this study, we carried out an ethnobiological survey of the vegetables traditionally consumed among the Indian and Pakistani communities of Bradford, in Western Yorkshire, UK. Our purpose was to analyse in depth details of the traditional culinary use of vegetables within these households, and to assess the health perceptions of them. Semi-structured interviews with a total of 150 South-Asian women were carried out. Twenty-five vegetables were recorded, as well as their traditional culinary use and their frequency of use. We found that a few of these vegetables, particularly those presenting bitter or aromatic tastes, were perceived to have remarkable medicinal value particularly against diabetes. Our study also found important generational differences in the women's knowledge of the culinary processes related to these foods, confirming that the consumption of traditional vegetables is inextricably embedded in cultural heritage and the representation of identity among migrants. Our findings may offer evidence of a link between the choice of food and the foods' perceived medicinal value among South-Asian migrants. It may also provide important information for health care professionals when designing strategies for improving health care counteracting type 2 diabetes. We strongly believe such strategies should take into account socio-cultural components and emic health beliefs, as well as patients' views of traditional dietary ingredients.

  2. Views and experiences of community pharmacists and superintendent pharmacists regarding the New Medicine Service in England prior to implementation.

    PubMed

    Wells, Katharine M; Thornley, Tracey; Boyd, Matthew J; Boardman, Helen F

    2014-01-01

    The New Medicine Service (NMS) was introduced to community pharmacies in England in October 2011. The NMS aims to improve adherence to new medicines in patients with selected long term conditions. The service consists of two follow-up consultations within 1 month in addition to usual care. This study explored community pharmacist and superintendent pharmacist views and experiences of the NMS in the 5 weeks prior to its implementation to identify potential facilitators and barriers to its success. The study also investigated participant experiences of the introduction and provision of existing pharmacy services in order to contrast with the implementation of the NMS. This study consisted of four focus groups with a total of 15 community pharmacists representing locums and employees of small, medium and large chain pharmacies. In addition, 5 semi-structured interviews were conducted with superintendent pharmacists representing independent, small chain, supermarket and large multiple pharmacies. Data were audio-recorded, transcribed verbatim and thematically analyzed. Both pharmacists and superintendent pharmacists were positive about the NMS and identified potential benefits for patients and the pharmacy profession. Awareness of the service was high, however, some confusion between the NMS and changes to Medicine Use Reviews was evident in all focus groups due to their similarity and coincidental implementation. This confusion was not observed in the interviews with superintendent pharmacists. Participants identified pharmacists' positive attitude, the similarity to current practice and the self-accreditation procedure as potential facilitators to service implementation. Potential barriers identified included a perceived lack of interest and awareness by GPs of the service, and the payment structure. Participants were concerned about the speed of implementation, and the absence of some materials needed prior to the start of the service. Participants were enthusiastic

  3. Randomized trial of epidural injections for spinal stenosis published in the New England Journal of Medicine: further confusion without clarification.

    PubMed

    Manchikanti, Laxmaiah; Candido, Kenneth D; Kaye, Alan D; Boswell, Mark V; Benyamin, Ramsin M; Falco, Frank J E; Gharibo, Christopher G; Hirsch, Joshua A

    2014-01-01

    Randomized controlled trials are considered the hallmark of evidence-based medicine. This conveys the idea that up-to-date evidence applied consistently in clinical practice, in combination with clinicians' individual expertise and patients own preference/expectations are enjoined to achieve the best possible outcome. Since its inception in 1990s, evidence-based medicine has evolved in conjunction with numerous changes in the healthcare environment. However, the benefits of evidence-based medicine have not materialized for spinal pain including surgical interventions. Consequently, the debate continues on the efficacy and medical necessity of multiple interventions provided in managing spinal pain. Friedly et al published a randomized controlled trial of epidural glucocorticoid injections for spinal stenosis in the July 2014 edition of the highly prestigious New England Journal of Medicine. This was accompanied by an editorial from Andersson. This manuscript provided significant sensationalism for the media and confusion for the spine community. This randomized trial of epidural glucocorticoid injections for spinal stenosis and accompanying editorial concluded that epidural injections of glucocorticoids plus lidocaine offered minimal or no short-term benefit as compared with epidural injections of lidocaine alone, with the editorial emphasizing proceeding directly to surgical intervention. In addition media statements by the authors also emphasized the idea that exercise or surgery might be better options for patients suffereing from narrowing of the spinal canal. The interventional pain management community believes that there are severe limitations to this study, manuscript, and accompanying editorial. The design, inclusion criteria, outcomes assessment, analysis of data and interpretation, and conclusions of this trial point to the fact that this highly sophisticated and much publicized randomized trial may not be appropriate and lead to misinformation. The

  4. Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013.

    PubMed

    Savage, E J; Mohammed, H; Leong, G; Duffell, S; Hughes, G

    2014-12-04

    A new electronic surveillance system for sexually transmitted infections (STIs) was introduced in England in 2009. The genitourinary medicine clinic activity dataset (GUMCAD) is a mandatory, disaggregated, pseudo-anonymised data return submitted by all STI clinics across England. The dataset includes information on all STI diagnoses made and services provided alongside demographic characteristics for every patient attendance at a clinic. The new system enables the timely analysis and publication of routine STI data, detailed analyses of risk groups and longitudinal analyses of clinic attendees. The system offers flexibility so new codes can be introduced to help monitor outbreaks or unusual STI activity. From January 2009 to December 2013 inclusive, over twenty-five million records from a total of 6,668,648 patients of STI clinics have been submitted. This article describes the successful implementation of this new surveillance system and the types of epidemiological outputs and analyses that GUMCAD enables. The challenges faced are discussed and forthcoming developments in STI surveillance in England are described.

  5. Lidar Observations of Pollution Transport From London to Rural Areas

    NASA Astrophysics Data System (ADS)

    Ricketts, Hugo; Vaughan, Geraint; Wareing, David

    2016-06-01

    The Clean Air for London (ClearfLo) Project took place in and around London, United Kingdom. The aim of the project was to learn how both atmospheric dynamics and chemistry affect air pollution in the south east of England. During the winter and summer of 2012 many different types of instrument including lidars were deployed throughout London city centre, suburbs and into rural areas. Amongst these instruments was the Boundary Layer Aerosol/Ozone Lidar owned by the National Centre for Atmospheric Sciences (NCAS) in the United Kingdom. Ozone and aerosol data are presented from data collected during July and August 2012 and compared to back trajectories to identify their origins.

  6. Teaching the History of Astronomy On Site in London

    NASA Astrophysics Data System (ADS)

    French, Linda M.

    2016-01-01

    In the autumn of 2014, the author had the opportunity to teach a class on the history of astronomy in England as part of a study abroad experience for students at Illinois Wesleyan University. The philosophy of the program is to use the rich cultural environment of London as a setting for active learning. In the classroom, students read and discussed selected works by Ptolemy, Copernicus, Kepler, Galileo, and Herschel. We visited Stonehenge, the Royal Greenwich Observatory, the London Science Museum, the London Monument, and the library of the Royal Astronomical Society. Lessons learned from the experience will be shared.

  7. Provision of services for the diagnosis and treatment of heart disease. Fourth report of a Joint Cardiology Committee of the Royal College of Physicians of London and the Royal College of Surgeons of England.

    PubMed Central

    1992-01-01

    The principal conclusions of the fourth report of the Joint Cardiology Committee are: 1 Cardiovascular disease remains a major cause of death and morbidity in the population and of utilisation of medical services. 2 Reduction in the risk of cardiovascular disease is feasible, and better co-ordination is required of strategies most likely to be effective. 3 Pre-hospital care of cardiac emergencies, in particular the provision of facilities for defibrillation, should continue to be developed. 4 There remains a large shortfall in provision of cardiological services with almost one in five district hospitals in England and Wales having no physician with the appropriate training. Few of the larger districts have two cardiologists to meet the recommendation for populations of over 250,000. One hundred and fifty extra consultant posts (in both district and regional centres) together with adequate supporting staff and facilities are urgently needed to provide modest cover for existing requirements. 5 The provision of coronary bypass grafting has expanded since 1985, but few regions have fulfilled the unambitious objectives stated in the Third Joint Cardiology Report. 6 The development of coronary angioplasty has been slow and haphazard. All regional centres should have at least two cardiologists trained in coronary angioplasty and there should be a designated budget. Surgical cover is still required for most procedures and is best provided on site. 7 Advances in the management of arrhythmias, including the use of specialised pacemakers, implantable defibrillators, and percutaneous or surgical ablation of parts of the cardiac conducting system have resulted in great benefit to patients. Planned development of the emerging sub-specialty of arrhythmology is required. 8 Strategies must be developed to limit the increased exposure of cardiologists to ionising radiation which will result from the expansion and increasing complexity of interventional procedures. 9 Supra

  8. Medicine, Morals and Mental Deficiency: The Contribution of Doctors to the Development of Special Education in England.

    ERIC Educational Resources Information Center

    Potts, Patricia

    1983-01-01

    The medical model of handicaps compartmentalizes and judges handicapped people. Physicians have played a crucial role in diagnosing mental deficiency, explaining its causes, and developing treatment programs in England. The prejudices inherent in the medical model must be discarded in order to meet the educational needs of disabled children. (IS)

  9. The New Education and the Institute of Education, University of London, 1919-1945

    ERIC Educational Resources Information Center

    Aldrich, Richard

    2009-01-01

    The London Day Training College (LDTC), founded in 1902, soon became the leading institution for the study of education and for the training of teachers in England. In 1932 it was transmuted into the Institute of Education of the University of London. Its title and pre-eminence have continued to this day. In the period 1919-1945 it was closely,…

  10. A Tale of Two Conferences: L.A.T.E., Two Key Moments in the Development of "London" English and the Questions That Still Need Asking

    ERIC Educational Resources Information Center

    Gibbons, Simon

    2012-01-01

    Current and recent policy around curriculum and pedagogy for English in England has seen a lack of principled thinking about what the subject should be and how it should best serve the needs of children. In postwar England, in London in particular, teachers and academics working within the London Association for the Teaching of English (L.A.T.E.)…

  11. The doctor's medicine and the ambiguity of amulets: life and suffering among Bangladeshi psychiatric patients and their families in London – an interview study – 1

    PubMed Central

    Littlewood, Roland; Dein, Simon

    2013-01-01

    An interview study of 44 Bangladeshi patients and relatives in London demonstrated simultaneous trust in psychiatrists as well as in the widespread use of healing amulets. At the same time, local Islamic clerics and traditional healers were seen by many with some degree of suspicion. The authors offer an interpretation in which local healers and their methods are regarded ambivalently: the more distant biomedical framework fits with the newer modernising ‘High’ Islam (literate, scripturalist, puritanical, unitarian, urban, clerical, perhaps masculinist), as opposed to Hindu-inflected traditional Sufi Islam in Bangladesh (peasant, popular, syncretic, saintly, magical, ecstatic and possibly more sympathetic to women's experience). PMID:23998259

  12. The doctor's medicine and the ambiguity of amulets: life and suffering among Bangladeshi psychiatric patients and their families in London--an interview study--1.

    PubMed

    Littlewood, Roland; Dein, Simon

    2013-01-01

    An interview study of 44 Bangladeshi patients and relatives in London demonstrated simultaneous trust in psychiatrists as well as in the widespread use of healing amulets. At the same time, local Islamic clerics and traditional healers were seen by many with some degree of suspicion. The authors offer an interpretation in which local healers and their methods are regarded ambivalently: the more distant biomedical framework fits with the newer modernising 'High' Islam (literate, scripturalist, puritanical, unitarian, urban, clerical, perhaps masculinist), as opposed to Hindu-inflected traditional Sufi Islam in Bangladesh (peasant, popular, syncretic, saintly, magical, ecstatic and possibly more sympathetic to women's experience).

  13. Autistic Disorder in Nineteenth-Century London. Three Case Reports

    ERIC Educational Resources Information Center

    Waltz, Mitzi; Shattock, Paul

    2004-01-01

    This article examines the existence, description, perception, treatment, and outcome of symptoms consistent with autistic disorder in nineteenth-century London, England, based on case histories from the notes of Dr William Howship Dickinson at Great Ormond Street Hospital for Children. Three cases meeting the DSM-IV criteria for autistic disorder…

  14. The development of forensic medicine in the United Kingdom from the 18th century.

    PubMed

    Eckert, W

    1992-06-01

    Forensic medicine in the United Kingdom includes both forensic pathology and clinical forensic medicine on the living. It began at the end of the 18th century, long after its development in Germany, Italy, France, and other countries in Europe. Initial beginnings were in Scotland, where a program began at the University of Edinburgh with the establishment of a chair in Forensic Medicine by Prof. Andrew Duncan Sr. The development in England began in London's Kings College Medical School with a chair held by Prof. William A. Guy. Later chairs in Forensic Medicine were established in Glasgow, Aberdeen, and in London, where Forensic Medicine was taught at St. Mary's Hospital Medical School, Guy's Hospital Medical School, London Hospital Medical School, Charing Cross Hospital Medical School, St. Thomas Hospital Medical School, and St. George's Hospital Medical School. In other cities in England, Wales, and Northern Ireland, departments were founded in Leeds, Manchester, Cardiff, and Belfast. Many textbooks were prepared during this time by professors from these medical schools and by others working in nonacademic areas. The development of coroner activities and those of the police surgeons is also part of the study of forensic medicine.

  15. The ethics of dental practice in London in the sixteenth century. 1. Henry Chettle's Kind-Harts dreame of 1592. An important lay view.

    PubMed

    Bishop, M

    2012-07-13

    Kind-Harts dreame (Fig. 1) is one of the proto-novels which first appeared in the Elizabethan age of literary wonders. It recounts the dream of the hero - a tooth-drawer (Kind-Hart) - who encounters the shades of five recently deceased characters, each of whom had been a famous star of their day in the London scene. Although short, and with medicine and dentistry occupying only part of the tale, the story contains invaluable detailed information about dental care in late Tudor England as observed by a layman. It is also an amusing read.

  16. Multicentre trial of preimplantation genetic screening reported in the New England Journal of Medicine: an in-depth look at the findings.

    PubMed

    Cohen, Jacques; Grifo, James A

    2007-10-01

    A randomized clinical trial of 406 patients with advanced maternal age by Mastenbroek and co-workers recently published in the New England Journal of Medicine showed a significant decrease in pregnancy outcome after preimplantation genetic screening (PGS). It is our opinion that this study suffers from a number of insurmountable inaccuracies and that these are either a direct consequence of the inexperience of the team or of a general disregard of vital guidelines reported in the literature. Most importantly, the authors show that in their hands embryo biopsy may affect as many as half the embryos. The error rate was not presented, shedding doubt on the authors' abilities to reliably diagnose the biopsied cells. An evaluation of the study indicates that poor biopsy technique, sub standard fixation and FISH methods, poor IVF outcomes and inappropriate patient selection are the cause of the discouraging results obtained by these authors rather than problems inherent to PGS.

  17. International differences in sport medicine access and clinical management

    PubMed Central

    Heron, Neil; Malliaropoulos, Nikolaos G.

    2012-01-01

    Summary I undertook the 2012 ECOSEP travelling fellowship, sponsored by Bauerfeind, between May and August 2012, which involved visiting 5 European sport medicine centres and spending approximately one week in each centre. The 5 centres included: National Track and Field Centre, SEGAS, Thessaloniki, Greece; Professional School in Sport & Exercise Medicine, University of Barcelona, Spain; Sport Medicine Frankfurt Institute, Germany; Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy, and Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, England. Throughout the fellowship, the clinical cases which were routinely encountered were documented. The following sections detail my experiences throughout the fellowship, the sports of the athletes and the injuries which were treated at each of the sport medicine centres during the fellowship visit and the different forms of management employed. PMID:23738305

  18. Jack London's "White Fang."

    ERIC Educational Resources Information Center

    Westall, Robert

    1993-01-01

    Relates the kinds of reading done in childhood by a now distinguished writer, Robert Westall. Describes specifically how Jack London's novel, "White Fang," influenced the development of this writer. Narrates and comments on the action of the novel. (HB)

  19. The London Schools Planetarium

    ERIC Educational Resources Information Center

    Richards-Jones, P.

    1973-01-01

    Summarizes the scientific activities conducted at the London Schools Planetarium by students of primary and secondary schools and of teacher colleges. Included is a table illustrating the astronomical background of student teachers. (CC)

  20. Materials modelling in London

    NASA Astrophysics Data System (ADS)

    Ciudad, David

    2016-04-01

    Angelos Michaelides, Professor in Theoretical Chemistry at University College London (UCL) and co-director of the Thomas Young Centre (TYC), explains to Nature Materials the challenges in materials modelling and the objectives of the TYC.

  1. Substitute decision making in medicine: comparative analysis of the ethico-legal discourse in England and Germany.

    PubMed

    Jox, Ralf J; Michalowski, Sabine; Lorenz, Jorn; Schildmann, Jan

    2008-06-01

    Health care decision making for patients without decisional capacity is ethically and legally challenging. Advance directives (living wills) have proved to be of limited usefulness in clinical practice. Therefore, academic attention should focus more on substitute decision making by the next of kin. In this article, we comparatively analyse the legal approaches to substitute medical decision making in England and Germany. Based on the current ethico-legal discourse in both countries, three aspects of substitute decision making will be highlighted: (1) Should there be a legally predefined order of relatives who serve as health care proxies? (2) What should be the respective roles and decisional powers of patient-appointed versus court-appointed substitute decision-makers? (3) Which criteria should be determined by law to guide substitute decision-makers?

  2. Are we meeting the psychological needs of Black African HIV-positive individuals in London? Controlled study of referrals to a psychological medicine unit.

    PubMed

    Malanda, S; Meadows, J; Catalan, J

    2001-08-01

    The changing pattern of HIV infection in the UK includes an increase in the number of infections acquired as a result of heterosexual contact and Black African individuals represent a sizeable proportion of those affected. In most UK centres for the treatment of HIV infection, clinicians have limited experience in caring for Black African patients, and there is a dearth of information about the recognition and management of mental health problems in this patient group. In this investigation the proportion of Black African individuals looked after in a large centre for the care of HIV infection in London was compared with the proportion of such patients referred for specialist mental health help, the results revealing that Black Africans were almost three times less likely to be referred for specialist mental health care. A case control investigation of those referred to mental health services showed that Black Africans were more likely to be suffering from AIDS at the time of referral, be referred for assessment of possible organic brain disease, and more likely to be found to be suffering from major depression or organic brain disease. Reasons for the lesser likelihood of referral to the mental health service are considered, including the possible failure of staff to recognize psychological morbidity in Black Africans, or reluctance and fear on the part of patients to be referred to services that may be perceived as threatening.

  3. Does the taste matter? Taste and medicinal perceptions associated with five selected herbal drugs among three ethnic groups in West Yorkshire, Northern England.

    PubMed

    Pieroni, Andrea; Torry, Bren

    2007-05-03

    In recent years, diverse scholars have addressed the issue of the chemosensory perceptions associated with traditional medicines, nevertheless there is still a distinct lack of studies grounded in the social sciences and conducted from a cross-cultural, comparative perspective. In this urban ethnobotanical field study, 254 informants belonging to the Gujarati, Kashmiri and English ethnic groups and living in Western Yorkshire in Northern England were interviewed about the relationship between taste and medicinal perceptions of five herbal drugs, which were selected during a preliminary study. The herbal drugs included cinnamon (the dried bark of Cinnamomum verum, Lauraceae), mint (the leaves of Mentha spp., Lamiaceae), garlic (the bulbs of Allium sativum, Alliaceae), ginger (the rhizome of Zingiber officinale, Zingiberaceae), and cloves (the dried flower buds of Syzygium aromaticum, Myrtaceae). The main cross-cultural differences in taste perceptions regarded the perception the perception of the spicy taste of ginger, garlic, and cinnamon, of the bitter taste of ginger, the sweet taste of mint, and of the sour taste of garlic. The part of the study of how the five selected herbal drugs are perceived medicinally showed that TK (Traditional Knowledge) is widespread among Kashmiris, but not so prevalent among the Gujarati and especially the English samples. Among Kashmiris, ginger was frequently considered to be helpful for healing infections and muscular-skeletal and digestive disorders, mint was chosen for healing digestive and respiratory troubles, garlic for blood system disorders, and cinnamon was perceived to be efficacious for infectious diseases. Among the Gujarati and Kashmiri groups there was evidence of a strong link between the bitter and spicy tastes of ginger, garlic, cloves, and cinnamon and their perceived medicinal properties, whereas there was a far less obvious link between the sweet taste of mint and cinnamon and their perceived medicinal

  4. Protocol for the New Medicine Service Study: a randomized controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England.

    PubMed

    Boyd, Matthew; Waring, Justin; Barber, Nick; Mehta, Rajnikant; Chuter, Antony; Avery, Anthony J; Salema, Nde-Eshimuni; Davies, James; Latif, Asam; Tanajewski, Lukasz; Elliott, Rachel A

    2013-12-01

    Medication non-adherence is considered an important cause of morbidity and mortality in primary care. This study aims to determine the effectiveness, cost effectiveness and acceptability of a complex intervention delivered by community pharmacists, the New Medicine Service (NMS), compared with current practice in reducing non-adherence to, and problems with, newly prescribed medicines for chronic conditions. Research subject group: patients aged 14 years and above presenting in a community pharmacy for a newly prescribed medicine for asthma/chronic obstructive pulmonary disease (COPD); hypertension; type 2 diabetes or anticoagulant/antiplatelet agents in two geographical regions in England. parallel group patient-level pragmatic randomized controlled trial. patients randomized to either: (i) current practice; or (ii) NMS intervention comprising pharmacist-delivered support for a newly prescribed medicine. proportion of adherent patients at six, ten and 26 weeks from the date of presenting their prescriptions at the pharmacy; cost effectiveness of the intervention versus current practice at 10 weeks and 26 weeks; in-depth qualitative understanding of the operationalization of NMS in pharmacies. impact of NMS on: patients' understanding of their medicines, pharmacovigilance, interprofessional and patient-professional relationships and experiences of service users and stakeholders.Economic analysis: Trial-based economic analysis (cost per extra adherent patient) and long-term modeling of costs and health effects (cost per quality-adjusted-life-year) will be conducted from the perspective of National Health Service (NHS) England, comparing NMS with current practice.Qualitative analysis: a qualitative study of NMS implementation in different community settings, how organizational influences affect NMS delivery, patterns of NMS consultations and experiences of professionals and patients participating in NMS, and patients receiving current practice. 250 patients in each

  5. Protocol for the New Medicine Service Study: a randomized controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England

    PubMed Central

    2013-01-01

    Background Medication non-adherence is considered an important cause of morbidity and mortality in primary care. This study aims to determine the effectiveness, cost effectiveness and acceptability of a complex intervention delivered by community pharmacists, the New Medicine Service (NMS), compared with current practice in reducing non-adherence to, and problems with, newly prescribed medicines for chronic conditions. Methods/design Research subject group: patients aged 14 years and above presenting in a community pharmacy for a newly prescribed medicine for asthma/chronic obstructive pulmonary disease (COPD); hypertension; type 2 diabetes or anticoagulant/antiplatelet agents in two geographical regions in England. Design: parallel group patient-level pragmatic randomized controlled trial. Interventions: patients randomized to either: (i) current practice; or (ii) NMS intervention comprising pharmacist-delivered support for a newly prescribed medicine. Primary outcomes: proportion of adherent patients at six, ten and 26 weeks from the date of presenting their prescriptions at the pharmacy; cost effectiveness of the intervention versus current practice at 10 weeks and 26 weeks; in-depth qualitative understanding of the operationalization of NMS in pharmacies. Secondary outcomes: impact of NMS on: patients’ understanding of their medicines, pharmacovigilance, interprofessional and patient-professional relationships and experiences of service users and stakeholders. Economic analysis: Trial-based economic analysis (cost per extra adherent patient) and long-term modeling of costs and health effects (cost per quality-adjusted-life-year) will be conducted from the perspective of National Health Service (NHS) England, comparing NMS with current practice. Qualitative analysis: a qualitative study of NMS implementation in different community settings, how organizational influences affect NMS delivery, patterns of NMS consultations and experiences of professionals and

  6. 110. Shaws Cove Bridge. New London, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    110. Shaws Cove Bridge. New London, New London Co., CT. Sec. 4209, MP 122.65. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  7. 111. Shaws Cove Bridge. New London, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    111. Shaws Cove Bridge. New London, New London Co., CT. Sec. 4209, MP 122.65. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  8. 117. Thames River Bridge. New London, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    117. Thames River Bridge. New London, New London Co., CT. Sec. 4215, MP 124.09. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  9. Varicella zoster virus, a cause of waxing and waning vasculitis: the New England Journal of Medicine case 5-1995 revisited.

    PubMed

    Gilden, D H; Kleinschmidt-DeMasters, B K; Wellish, M; Hedley-Whyte, E T; Rentier, B; Mahalingam, R

    1996-12-01

    A 73-year-old man developed an ill-defined fatal vasculitis involving the central nervous system. The case report was published as a clinicopathologic exercise in February 1995 in The New England Journal of Medicine. We restudied the pathologic material and found both varicella zoster virus (VZV) DNA and VZV-specific antigen, but not herpes simplex virus (HSV) or cytomegalovirus (CMV) DNA or HSV- or CMV-specific antigen, in three of the five cerebral arteries examined. The inflammatory response, disruption of the internal elastic lamina, and detection of viral antigen were patchy from one artery to another, as well as within a given artery. A search for VZV should be conducted in cases of vasculitis when both the central and peripheral nervous systems are involved, when focal narrowing is present in large arteries, when brain imaging reveals infarction in gray and white matter, both deep and superficial, and when white matter is disproportionally involved. Zosteriform rash is not required for diagnosis.

  10. A one-year audit of topics and domains in the Journal of the American Medical Association and the New England Journal of Medicine.

    PubMed

    Woolf, S H; Johnson, R E

    2000-08-01

    The relative emphasis that major medical journals give to topic areas has a potential effect on priorities in patient care, policy decisions, and public awareness. We measured the distribution of topics in two journals, by disease categories and domains, over a calendar year. All original investigations, reviews, editorials, and special articles published in 1998 by the Journal of the American Medical Association and the New England Journal of Medicine were classified by article type, disease category, and domain. The 12 domains ranged from basic science to health policy, and included primary and secondary prevention. The 1159 articles published in 1998 included 889 (77%) articles about specific diseases-590 falling within eight specialties-and 190 (16%) articles on generic topics. Eighty (7%) articles concerned the behaviors that cause disease. Primary prevention and screening were the subject of 71 (6%) and 29 (3%) articles, respectively. Most of these concerned uncommon issues in patient care. Although 27 (2%) articles dealt with essential health promotion (e.g., diet, exercise), and none included a study on how to help patients to exercise, stop smoking, or eat a healthy diet. In contrast, 451 (39%) articles concerned the diagnosis and treatment of patients with disease. The relative emphasis that journals gave to prevention during the sample period seems discordant with its importance to patients and public health. Potential explanations include poor volume and quality of submitted research and editorial concerns about importance and reader appeal.

  11. Editorial on the original article entitled "Permissive underfeeding of standard enteral feeding in critically ill adults" published in the New England Journal of Medicine on June 18, 2015.

    PubMed

    Casaer, Michael P; Van den Berghe, Greet

    2015-09-01

    On June 18, 2015, the New England Journal of Medicine published an article entitled "Permissive underfeeding of standard enteral feeding in critically ill adults", which reports the results of a study that examined the impact of prolonged nutritional energy restriction for critically ill patients. The study design was unique in the sense that patients in both groups received similar doses of protein during the intervention, while the non-protein energy intake was reduced in the intervention group. The study showed no differences in outcome between the two study groups. These results add to a growing body of high quality evidence against the dogmatic belief that full enteral or parenteral feeding should be given as early as possible during critical illness to prevent complications. Further research is now needed to address the question of the optimal timing to provide more nutritional support for the benefit of the patients, possibly guided by improved biomarkers that need to be developed and validated, and to investigate underlying mechanisms.

  12. The wrong London

    NASA Astrophysics Data System (ADS)

    Griffiths, Hugh; Tong, Kenneth

    2010-01-01

    Your article "Optics pioneers scoop Nobel prize" (November 2009 pp6-7) incorrectly states that Charles Kao, who shared the 2009 Nobel Prize for Physics with Willard Boyle and George Smith, received his PhD from Imperial College London.

  13. Impact of HIV on adult (15-54) mortality in London: 1979-96

    PubMed Central

    Hickman, M.; Bardsley, M.; De Angelis, D.; Ward, H.

    1999-01-01

    OBJECTIVE: To describe the impact of HIV on mortality in men and women aged 15-54 in London. DESIGN: Combination of routine mortality statistics with reports of AIDS deaths adjusted for underreporting and change in address from time of report to time of death. Calculation of standardised mortality ratios (SMRs) for males including and excluding HIV comparing inner London and outer London with the rest of England and Wales. METHODS: Comparison of trends in all cause mortality and SMRs in males over time. Comparison of trends in HIV related deaths with other main causes of deaths in males and females in London. RESULTS: Age standardised rates for the rest of England and Wales showed a continual decline from 1979 to 1996 but rates in inner London males (ages 15-54) stopped declining around 1984-5 leading to a considerable increase in the SMR for inner London from 127 for 1985-7 to 171 for 1994-6. SMRs excluding HIV related deaths for inner London, however, showed no significant change over this time. There was a fall in HIV related mortality in 1996, though HIV was still the leading cause of death in males and second leading cause of death in females in inner London, and the fourth commonest cause of death in males in outer London. CONCLUSION: These data are the first to indicate the impact of HIV on mortality within a significant population in England and Wales. They show that public health priorities in London are different from the rest of the country. Analyses of trends of all cause mortality in people under 65 may mislead unless they take account of HIV. 


 PMID:10754940

  14. Gonorrhoea in inner London: results of a cross sectional study.

    PubMed Central

    Low, N.; Daker-White, G.; Barlow, D.; Pozniak, A. L.

    1997-01-01

    OBJECTIVES: To estimate population based incidence rates of gonorrhoea in an inner London area and examine relations with age, ethnic group, and socioeconomic deprivation. DESIGN: Cross sectional study. SETTING: 11 departments of genitourinary medicine in south and central London. SUBJECTS: 1978 first episodes of gonorrhoea diagnosed in 1994 and 1995 in residents of 73 electoral wards in the boroughs of Lambeth, Southwark, and Lewisham who attended any of the departments of genitourinary medicine. MAIN OUTCOME MEASURES: Yearly age, sex, and ethnic group specific rates of gonorrhoea per 100,000 population aged 15-59 years; rate ratios for the effects of age and ethnic group on gonorrhoea rates in women and men before and after adjustment for confounding factors. RESULTS: Overall incidence rates of gonorrhoea in residents of Lambeth, Southwark, and Lewisham were 138.3 cases yearly per 100,000 women and 291.9 cases yearly per 100,000 men aged 15-59 years. At all ages gonorrhoea rates were higher in non-white minority ethnic groups. Rate ratios for the effect of age adjusted for ethnic group and underprivilege were 15.2 (95% confidence interval 11.6 to 19.7) for women and 2.0 (1.7 to 2.5) for men aged 15-19 years compared with those over 30. After deprivation score and age were taken into account, women from black minority groups were 10.5 (8.6 to 12.8) times as likely and men 11.0 (9.7 to 12.6) times as likely as white people to experience gonorrhoea. CONCLUSIONS: Gonorrhoea rates in Lambeth, Southwark, and Lewisham in 1994-5 were six to seven times higher than for England and Wales one year earlier. The presentation of national trends thus hides the disproportionate contribution of ongoing endemic transmission in the study area. Teenage women and young adult men, particularly those from black minority ethnic groups, are the most heavily affected, even when socioeconomic underprivilege is taken into account. There is urgent need for resources for culturally

  15. Atmospheric merger in London

    NASA Astrophysics Data System (ADS)

    At the invitation of Imperial College, the Laboratory for Planetary Atmospheres, University College London, will be integrated in August with the Atmospheric Physics Group to form a single teaching and research unit. The new group, to be located at Imperial College, will be headed by Garry Hunt.The new group will possess a balanced research program in the observational and interpretative aspects of atmospheric physics. The existing Imperial College group actively researches cumulonimbus dynamics and climate modeling.

  16. Disclosure and adverse effects of complementary and alternative medicine used by hospitalized patients in the North East of England.

    PubMed

    Bello, Nusirat; Winit-Watjana, Win; Baqir, Wasim; McGarry, Kenneth

    2012-07-01

    This study aimed to investigate the prevalence, disclosure and adverse effects of complementary and alternative medicine (CAM) use in hospitalised patients, and to explore the associations between patients' perceived side-effects and relevant factors. Patients who were admitted to a district general hospital and met the eligibility criteria were interviewed using a semi-structured questionnaire. Their medications and pertinent details were verified from the medical notes. All quantitative and qualitative data were collated and analysed. A chi-squared test was performed to test the associations of the perceived CAM side-effects with the significance level determined at α=0.05. A total of 240 in-patients completed the study. They were mostly white British (98.8%). The prevalence of CAM use within two years was 74.6% and one month 37.9%. Only 19 of 91 patients (20.9%) using CAM within one month disclosed their current CAM applications. Nearly half of patients (45.8%) who used CAM within two years experienced various CAM side-effects that tended to resolve after discontinuation. Slightly more than half (57.6%) perceived CAM side-effects and their perceptions were significantly associated with gender (P=0.048) and consideration for future CAM use (P=0.033). Potential interactions between herbal remedies/dietary supplements and prescribed drugs, such as garlic with lisinopril or aspirin, were assessed in 82 patients (45.8%). Most in-patients used CAM and experienced some adverse effects. The disclosure of CAM use and its adverse outcomes should be encouraged by healthcare professionals.

  17. Disclosure and adverse effects of complementary and alternative medicine used by hospitalized patients in the North East of England

    PubMed Central

    Bello, Nusirat; Winit-Watjana, Win; Baqir, Wasim; Mcgarry, Kenneth

    Objective This study aimed to investigate the prevalence, disclosure and adverse effects of complementary and alternative medicine (CAM) use in hospitalised patients, and to explore the associations between patients' perceived side-effects and relevant factors. Methods Patients who were admitted to a district general hospital and met the eligibility criteria were interviewed using a semi-structured questionnaire. Their medications and pertinent details were verified from the medical notes. All quantitative and qualitative data were collated and analysed. A chi-squared test was performed to test the associations of the perceived CAM side-effects with the significance level determined at α=0.05. Results A total of 240 in-patients completed the study. They were mostly white British (98.8%). The prevalence of CAM use within two years was 74.6% and one month 37.9%. Only 19 of 91 patients (20.9%) using CAM within one month disclosed their current CAM applications. Nearly half of patients (45.8%) who used CAM within two years experienced various CAM side-effects that tended to resolve after discontinuation. Slightly more than half (57.6%) perceived CAM side-effects and their perceptions were significantly associated with gender (P=0.048) and consideration for future CAM use (P=0.033). Potential interactions between herbal remedies/dietary supplements and prescribed drugs, such as garlic with lisinopril or aspirin, were assessed in 82 patients (45.8%). Conclusions Most in-patients used CAM and experienced some adverse effects. The disclosure of CAM use and its adverse outcomes should be encouraged by healthcare professionals. PMID:24155828

  18. Screening mammography: update and review of publications since our report in the New England Journal of Medicine on the magnitude of the problem in the United States.

    PubMed

    Bleyer, Archie

    2015-08-01

    After a half century of clinical trials, expansive observations, vigorous advocacy and debate, screening mammography could not be in a more controversial condition, especially the potential harm of overdiagnosis. Despite a simple rationale (catch the cancer early and either prevent death or at least decrease the amount of therapy needed for cure), the estimates to date of overdiagnosis rates are conflicting and the interpretations complex. Since the author's 2012 publication in the New England Journal of Medicine (NEJM), the peer-reviewed publications on overdiagnosis caused by screening mammography are reviewed and the NEJM analyses updated with three additional calendar years of results. The recent peer-reviewed medical literature on screening mammography induced overdiagnosis of breast cancer has increased exponentially, nearly 10-fold in 10 years. The average estimate of overdiagnosis is about 30%, but the range extends from 0% to 70+%. An update of the NEJM report estimates that in the US, 78,000 women and 30%-31% of those diagnosed with breast cancer at the age of 40 years or older during 2011 were overdiagnosed. Until we have better screening procedures that identify who really has cancer and needs to be treated, the risk of overdiagnosis relative to the benefit of screening merits more effective public and professional education. Radiologists, pathologists, and other professionals involved with screening mammography should recognize that the potential harm of overdiagnosis is downplayed or not discussed with the patient and family, despite agreement that the objective is informed choice. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  19. Multiple sclerosis among immigrants in Greater London.

    PubMed Central

    Dean, G; McLoughlin, H; Brady, R; Adelstein, A M; Tallett-Williams, J

    1976-01-01

    Among immigrants resident in greater London from Europe, Ireland, the USSR, the old Commonwealth countries of Australia, Canada, and New Zealand, North and South America, Egypt, Turkey, and Iran the incidence of admission to hospital for probable multiple sclerosis (MS) between 1960 and 1972 was high or moderately high. The incidence was the same order as that found in those born in the United Kingdom. Immigrants from India, Pakistan, and other Asian countries and from new Commonwealth Africa and America, which includes the West Indies, had a low incidence of hospital admission for MS. Immigrants from countries where the risk of MS is low whose parents were born in Europe had a reduced incidence of admission to hospital but not the very low incidence found in those parents were also born in these countries. Emigrating to England from low risk parts of the world did not seem to increase the risk of developing MS. PMID:1260384

  20. Optical legacy of Imperial College London

    NASA Astrophysics Data System (ADS)

    Kidger Webb-Moore, Tina E.

    2016-10-01

    The Industrial Revolution, beginning primarily in the UK, generated an increasing need for highly skilled technical people. Throughout the 19th century, technical instruction increased dramatically and the formation of schools specializing in science and technology grew quickly. In England, there was much motivation in favour of a national prestige center for science and technology centered in London. Central among the motivating forces was Queen Victoria's husband, Prince Albert. Although there were already existing specialist science and technology institutions in major English cities, the growth of superior institutions in other countries within Europe, especially Germany and the Charlottenburg area of Berlin (e.g., the Berlin Technical High School), encouraged important English dignitaries to become more competitive with continental Europe. As a result of this strong continental motivation, several science and technology institutions were built in the south Kensington part of London during the latter half of the 19th century. Imperial College, founded at the start of the 20th century, was a culmination and consolidation of several of these 19th century English institutions. Optical science and technology was an early beneficiary of the founding of Imperial College. This paper will attempt to provide the reader with an understanding of how great was the influence of the optical section of Imperial College in the further development of the world's optical science and technology.

  1. Graduate Education in Government: In England, France, and the United States.

    ERIC Educational Resources Information Center

    Vernardakis, George

    This book reports findings of a study comparing how the leading institutions of higher education in England, France, and the United States conduct their graduate programs in political science. Institutions studied were: Cambridge University, Oxford University, and the University of London in England; the University of Paris 1 (Sorbonne), Institute…

  2. Forging New Identities: Young Refugees and Minority Students Tell Their Stories. Views from London and Amsterdam.

    ERIC Educational Resources Information Center

    Minority Rights Group, London (England).

    This document is a collection of writings by refugee and minority children from the George Orwell School in London (England) and the Montessori College in Oost, Amsterdam (the Netherlands). About one-third of the students at the George Orwell School, were refugees. These students were aged 11 to 16 years old. About 30 to 40% of the students at the…

  3. Forging New Identities: Young Refugees and Minority Students Tell Their Stories. Views from London and Amsterdam.

    ERIC Educational Resources Information Center

    Minority Rights Group, London (England).

    This document is a collection of writings by refugee and minority children from the George Orwell School in London (England) and the Montessori College in Oost, Amsterdam (the Netherlands). About one-third of the students at the George Orwell School, were refugees. These students were aged 11 to 16 years old. About 30 to 40% of the students at the…

  4. From Apprentice to Master: Social Disciplining and Surgical Education in Early Modern London, 1570-1640

    ERIC Educational Resources Information Center

    Chamberland, Celeste

    2013-01-01

    Due to its ascendancy as the administrative and commercial center of early modern England, London experienced sustained growth in the latter half of the sixteenth century, as waves of rural immigrants sought to enhance their material conditions by tapping into the city's bustling occupational and civic networks. The resultant crowded urban…

  5. Cecilia John: An Australian Heads the London School of Dalcroze Eurhythmics, 1932-1955

    ERIC Educational Resources Information Center

    Pope, Joan

    2014-01-01

    The London School of Dalcroze Eurhythmics (LSDE) was established in 1913, and a significant figure in its history was the remarkable Cecilia John, one of seven Australians to complete the three-year course between 1917 and 1927. Apart from two short visits to Australia, John lived and taught in England for the remainder of her life. Following the…

  6. From Apprentice to Master: Social Disciplining and Surgical Education in Early Modern London, 1570-1640

    ERIC Educational Resources Information Center

    Chamberland, Celeste

    2013-01-01

    Due to its ascendancy as the administrative and commercial center of early modern England, London experienced sustained growth in the latter half of the sixteenth century, as waves of rural immigrants sought to enhance their material conditions by tapping into the city's bustling occupational and civic networks. The resultant crowded urban…

  7. London: An Art Teacher's Inspiration

    ERIC Educational Resources Information Center

    Guhin, Paula

    2012-01-01

    Often overshadowed in people's minds by Paris, London is truly an artist's jewel. The art and architecture, history, gardens and museums are inspiring, yes, but there's so much more to this ancient city. The performances, attractions and markets are a boon to the creative soul. London can be surprisingly inexpensive to visit. Gazing at statues,…

  8. London: An Art Teacher's Inspiration

    ERIC Educational Resources Information Center

    Guhin, Paula

    2012-01-01

    Often overshadowed in people's minds by Paris, London is truly an artist's jewel. The art and architecture, history, gardens and museums are inspiring, yes, but there's so much more to this ancient city. The performances, attractions and markets are a boon to the creative soul. London can be surprisingly inexpensive to visit. Gazing at statues,…

  9. London International Youth Science Forum

    ERIC Educational Resources Information Center

    Auty, Geoff

    2010-01-01

    In this article, the author discusses the 2010 London International Youth Science Forum (LIYSF) and shares his experience in attending the forum. Unlike the Harry Messel event in Sydney, which takes place every two years, LIYSF is an annual event. Before moving to Imperial College London, LIYSF was held at the Institute of Electrical Engineers and…

  10. An Abandoned Cliff in Weald Clay, near Lympne, Kent, England.

    DTIC Science & Technology

    1984-07-17

    NATIONAL BUREAU OF STANDARDS 1963-A O0 0 AN ABANDONED CLIFF IN 0 WEALD CLAY, NR. LYMPNE, KENT, ENGLAND Final Report 0 0 Principal Investigator: J.N...Technology 0 Prince Consort Road D T IC Uj London, England . TE . I-a.- -AUG7 984 CApproved for Public Release; Distribution Unlimited Unclassified...Report Feb 1980 - Dec 1983 ’X’EA-’Lf CLAY. NR. LYMPNE, KENT, ENGLAND 6. PERFORMING ORG. REPORT NUMBER 7. AUTHOSRS) S. CONTRACTOR GRANT NUMBER(F)PE John N

  11. Mental health service provision in England.

    PubMed

    Johnson, S; Zinkler, M; Priebe, S

    2001-01-01

    To describe mental health service provision for adults of working age in England. Services in an inner London area are described so as to illustrate current patterns of service organization in England. National trends are then discussed. Despite relatively low public expenditure, substantial progress has been made in deinstitutionalization and development of comprehensive community-based services. Persisting difficulties include high staff turnover, a minority of patients. who do not engage with community services, user and carer dissatisfaction with emergency services, and social exclusion because of stigma. Recent government policy advocates resolving some of these problems using new service models such as assertive outreach and crisis teams. Closure of the large asylums has largely been accomplished. England is now entering a new phase in community service development, with a range of innovative developments aimed at resolving problems still encountered after the initial phases of integrated community service development.

  12. Pupils' Fear in the Classroom: Portraits from Palestine and England

    ERIC Educational Resources Information Center

    Hargreaves, Eleanore; Affouneh, Saida

    2017-01-01

    This article explores the concept of fear related to the authoritarian classroom and how children express its influence on their learning. Its investigations draw on the comments of four classes of primary-age pupils, two from a school near London, England, and two from boys' and girls' schools in the West Bank, Palestine. It is written by one…

  13. Looking into 'London'

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This mosaic image from the microscopic imager on the Mars Exploration Rover Opportunity shows the rock abrasion tool target, 'London.' The image was taken by the Mars Exploration Rover Opportunity on its 149th sol on Mars (June 24, 2004). Scientists 'read' the geology of the image from bottom to top, with the youngest material pictured at the bottom of the image and the oldest material in the layers pictured at the top. Millimeter-scale layers run horizontally across the exposed surface, with two sliced sphere-like objects, or 'blueberries' on the upper left and upper right sides of the impression. This material is similar to the evaporative material found in 'Eagle Crater.' However, the intense review of these layers in Endurance Crater is, in essence, deepening the water story authored by ancient Mars.

    In Eagle Crater, the effects of water were traced down a matter of centimeters. Endurance Crater's depth has allowed the tracing of water's telltale marks up to meters. Another process that significantly affects martian terrain is muddying the water story a bit. Although it is clear that the layers in Endurance were affected by water, it is also evident that Aeolian, or wind, processes have contributed to the makeup of the crater.

  14. Banding and Ballots: Secondary School Admissions in England: Admissions in 2012/13 and the Impact of Growth of Academies

    ERIC Educational Resources Information Center

    Noden, Philip; West, Anne; Hind, Audrey

    2014-01-01

    This report provides key findings from a two part research project funded by the Sutton Trust and the London School of Economics & Political Science, (LSE) focusing on secondary school admissions in England. The research analyses secondary schools' admissions criteria and practices in England in 2012/13 and illustrative examples of how some…

  15. Banding and Ballots: Secondary School Admissions in England: Admissions in 2012/13 and the Impact of Growth of Academies

    ERIC Educational Resources Information Center

    Noden, Philip; West, Anne; Hind, Audrey

    2014-01-01

    This report provides key findings from a two part research project funded by the Sutton Trust and the London School of Economics & Political Science, (LSE) focusing on secondary school admissions in England. The research analyses secondary schools' admissions criteria and practices in England in 2012/13 and illustrative examples of how some…

  16. Urban and rural mortality and survival in Medieval England.

    PubMed

    Walter, Brittany S; DeWitte, Sharon N

    2017-06-01

    Late medieval England underwent intensive urbanisation, particularly in its largest city: London. Urban dwellers were exposed to factors such as high population density, elevated risk of infection, unsanitary living conditions and precarious food supplies. To assess whether the urban environment was more detrimental to health than the rural environment, this study compares risks of mortality and survival, as proxies for health, in medieval urban vs rural England. This study uses samples from rural St. Peter's cemetery in Barton-upon-Humber, Lincolnshire (c. 1150-1500) and urban St. Mary Spital cemetery in London (c. 1120-1539). Cox proportional hazards analysis and Kaplan-Meier survival analysis are used to assess differences in mortality and survival between urban and rural environments, including differences between sexes. The results indicate that urban adults faced elevated risks of dying and reductions in survivorship. Specifically, urban females faced elevated risks of dying and reductions in survivorship, while the risks for males were similar in both environments. These results suggest that the effects of urbanisation in medieval England varied by sex. Deleterious conditions associated with urbanisation in London were hazardous for adults, particularly females who may have migrated into London from rural areas for labour opportunities.

  17. Occupation and cancer in London: an investigation into nasal and bladder cancer using the Cancer Atlas.

    PubMed

    Baxter, P J; McDowall, M E

    1986-01-01

    The Atlas of Cancer Mortality for England and Wales showed pronounced excesses of male mortality from nasal and bladder cancer in certain London boroughs. These excesses were investigated by case-referent studies using death certificate data for male deaths, 1968-78. Nasal cancer was found to be significantly associated with occupations involving heavy exposure to wood dust. Bladder cancer was significantly associated with occupations in road transport driving and in the handling of leather, whereas consistently raised relative risk ratios were also found for wood-workers, engineering fitters, printers, machinists, plumbers, and motor mechanics. These findings highlight the potential role of occupational factors in cancer causation in London.

  18. Medicines

    MedlinePlus

    ... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...

  19. Did the London Initiative Zone investment programme affect general practice structure and performance in East London? A time series analysis of cervical screening coverage and asthma prescribing.

    PubMed

    Naish, J; Eldridge, S; Moser, K; Sturdy, P

    2002-11-01

    A programme of incentives was set up in the London Initiative Zones to improve primary care in inner London based on the findings of the Tomlinson Enquiry in 1992. This descriptive study is a 4-y time series analysis of changes in general practice structure in East London as the result of London Initiative Zone investment, and an exploration of the possible effect of investment on practice performance. We used routinely available administrative data for the whole analysis. General practice characteristics and two selected performance indicators: the asthma prophylaxis to bronchodilator ratio and cervical cytology screening rate, for all practices in the East London and the City Health Authority for 4 y, 1993-1996, were used. Both reflect practice efficiency, but relate to different aspects of practice performance. The prescribing indicator is more indicative of the quality of clinical practise, whereas cervical screening coverage relates more to the characteristics of the practice population and to practice organisation. Repeated measures analyses were used to identify trends and to explore the relationship between changes in practice characteristics and performance. Graphical methods were used to compare East London trends with the rest of England. There were significant improvements in practice structure as the consequence of London Initiative Zone investment. There was a positive association with improvements in practice performance, but East London still lagged some way behind national patterns. The findings suggest that while improvements in asthma prescribing follow the national trend, practices have difficulty in achieving and sustaining the 80% target for cervical cytology screening, and that an overall population coverage of 80% may be in doubt.Increased investment in practice staffing may be influential in improving some aspects of performance. However, in common with other inner cities, a greater effort and more innovative strategies may be needed to

  20. Nicholas Culpeper (1616-1654): London's first general practitioner?

    PubMed

    Farthing, Michael J G

    2015-08-01

    Nicholas Culpeper is often regarded as an ill-disciplined, maverick, mid-17th century herbalist and the father of contemporary alternative medicine. There are elements of this statement that have some truth but to dismiss his contribution to the development of health provision in London at the time would be a great injustice. Culpeper did not complete his apprenticeship as an apothecary and was not a formally trained physician, but he developed a clinical practice for the poor of London, indistinguishable from the role of the present day general practitioner. Observers at the time recognised his concern and compassion and his commitment to treat the whole patient and not just the disease. His enduring contribution was his translation from Latin of the physicians' Pharmacopoeia Londinensis which could be regarded as the first major step towards the demystification of medicine. Culpeper's London Dispensatory and the many other medical treatises that followed were affordable and widely available to the common man. Culpeper antagonised both apothecaries and physicians because he breached the regulations of the day by accepting patients directly. So perhaps Culpeper was, de facto, London's first general practitioner, at least 150 years before the role was formally recognised in the Apothecaries Act 1815.

  1. Bullying, "Cussing" and "Mucking About": Complexities in Tackling Homophobia in Three Secondary Schools in South London, UK

    ERIC Educational Resources Information Center

    Warwick, Ian; Aggleton, Peter

    2014-01-01

    In countries such as the UK, schools have a responsibility to prevent all forms of bullying, including those related to sexual orientation. However, relatively little is known about how schools go about this work successfully. This study aimed to identify how three secondary schools in south London, England, were addressing homophobia. Three…

  2. Bullying, "Cussing" and "Mucking About": Complexities in Tackling Homophobia in Three Secondary Schools in South London, UK

    ERIC Educational Resources Information Center

    Warwick, Ian; Aggleton, Peter

    2014-01-01

    In countries such as the UK, schools have a responsibility to prevent all forms of bullying, including those related to sexual orientation. However, relatively little is known about how schools go about this work successfully. This study aimed to identify how three secondary schools in south London, England, were addressing homophobia. Three…

  3. London through a Biologist's Eyes

    ERIC Educational Resources Information Center

    Flannery, Maura C.

    2004-01-01

    A professor of biology discovered that the people who are in literature rather than science, saw the same readings very differently and were looking for very different things like how nature writings expressed the author's views on nature, or what they communicated about the human experience of the living world. Further he visits London to see the…

  4. Eye casualty services in London

    PubMed Central

    Smith, H B; Daniel, C S; Verma, S

    2013-01-01

    The combined pressures of the European Working Time Directive, 4 h waiting time target, and growing rates of unplanned hospital attendances have forced a major consolidation of eye casualty departments across the country, with the remaining units seeing a rapid increase in demand. We examine the effect of these changes on the provision of emergency eye care in Central London, and see what wider lessons can be learned. We surveyed the managers responsible for each of London's 8 out-of-hours eye casualty services, analysed data on attendance numbers, and conducted detailed interviews with lead clinicians. At London's two largest units, Moorfields Eye Hospital and the Western Eye Hospital, annual attendance numbers have been rising at 7.9% per year (to 76 034 patients in 2010/11) and 9.6% per year (to 31 128 patients in 2010/11), respectively. Using Moorfields as a case study, we discuss methods to increase capacity and efficiency in response to this demand, and also examine some of the unintended consequences of service consolidation including patients travelling long distances to geographically inappropriate units, and confusion over responsibility for out-of-hours inpatient cover. We describe a novel ‘referral pathway' developed to minimise unnecessary travelling and delay for patients, and propose a forum for the strategic planning of London's eye casualty services in the future. PMID:23370420

  5. London's Tutorial Classes; An Assessment

    ERIC Educational Resources Information Center

    Brook, F. G.

    1970-01-01

    Growth during the 1960s in the number and scope of tutorial classes by the London University Department of Extra-Mural Studies is attributed to considerable help from voluntary personnel, emphasis on written work, and other factors potentially signficant to extension education elsewhere in Britain. (LY)

  6. An analysis of population and social change in London wards in the 1980s.

    PubMed

    Congdon, P

    1989-01-01

    "This paper discusses the estimation and projection of small area populations in London, [England] and considers trends in intercensal social and demographic indices which can be calculated using these estimates. Information available annually on vital statistics and electorates is combined with detailed data from the Census Small Area Statistics to derive demographic component based population estimates for London's electoral wards over five year periods. The availability of age disaggregated population estimates permits derivation of small area social indicators for intercensal years, for example, of unemployment and mortality. Trends in spatial inequality of such indicators during the 1980s are analysed and point to continuing wide differentials. A typology of population and social indicators gives an indication of the small area distribution of the recent population turnaround in inner London, and of its association with other social processes such as gentrification and ethnic concentration."

  7. Medical Practice, Urban Politics and Patronage: The London ‘Commonalty’ of Physicians and Surgeons of the 1420s *

    PubMed Central

    Ralley, Robert

    2015-01-01

    Medical practice in fifteenth-century England is often seen as suffering from the low status and unregulated practice of which Thomas Linacre later complained. Unlike in many European cities, the provision of physic was uncontrolled, and while urban guilds oversaw surgery as a manual art, no comprehensive system of medical organisation or regulation existed. However, in a remarkable episode of the 1420s, a group of university-trained physicians and elite surgeons associated with Humphrey, Duke of Gloucester, briefly established just such a system. While their efforts initially secured approval for a national scheme, it was only in the City of London that they succeeded in implementing their plans. The detailed ordinances of the collegiate ‘commonalty’ they founded provide a unique insight into their attitudes. Drawing on continental models, they attempted to control all medicine within the city by establishing a hierarchy of practitioners, preventing illicit and incompetent practice, and offering treatment to even the poorest Londoners. Yet they failed to appreciate the vested interests of civic politics: achieving these aims meant curtailing the rights of the powerful Grocers and the Barbers, a fact made clear by their adjudication of a case involving two members of the Barbers’ Company, and the Barbers’ subsequent riposte—a mayoral petition that heralded the commonalty’s end. Its founder surgeons went on to revitalise their Surgeons’ Fellowship, which continued independently of the Barbers until a merger in 1540; in contrast, the physicians withdrew from civic affairs, and physic remained entirely unregulated until episcopal licensing was instituted in 1511. PMID:27019518

  8. An early evaluation of clinical and economic costs and benefits of implementing point of care NAAT tests for Chlamydia trachomatis and Neisseria gonorrhoea in genitourinary medicine clinics in England.

    PubMed

    Turner, Katherine M E; Round, Jeff; Horner, Patrick; Macleod, John; Goldenberg, Simon; Deol, Arminder; Adams, Elisabeth J

    2014-03-01

    To estimate the costs and benefits of clinical pathways incorporating a point of care (POC) nucleic acid amplification test (NAAT) for chlamydia and gonorrhoea in genitourinary medicine (GUM) clinics compared with standard off-site laboratory testing. We simulated 1.2 million GUM clinic attendees in England. A simulation in Microsoft Excel was developed to compare existing standard pathways of management for chlamydia and gonorrhoea with a POC NAAT. We conducted scenario analyses to evaluate the robustness of the model findings. The primary outcome was the incremental cost-effectiveness ratio. Secondary outcomes included the number of inappropriate treatments, complications and transmissions averted. The baseline cost of using the point of POC NAAT was £103.9 million compared with £115.6 million for standard care. The POC NAAT was also associated with a small increase of 46 quality adjusted life years, making the new test both more effective and cheaper. Over 95 000 inappropriate treatments might be avoided by using a POC NAAT. Patients receive diagnosis and treatment on the same day as testing, which may also prevent 189 cases of pelvic inflammatory disease and 17 561 onward transmissions annually. Replacing standard laboratory tests for chlamydia and gonorrhoea with a POC test could be cost saving and patients would benefit from more accurate diagnosis and less unnecessary treatment. Overtreatment currently accounts for about a tenth of the reported treatments for chlamydia and gonorrhoea and POC NAATs would effectively eliminate the need for presumptive treatment.

  9. Editorial on the original article entitled "Changes in diabetes-related complications in the United States, 1990-2010" published in the New England Journal of Medicine on April 17, 2014.

    PubMed

    Ahmadieh, Hala

    2014-12-01

    The paper entitled "Changes in diabetes-related complications in the United States, 1990-2010" published recently in the New England Journal of Medicine examined the spectrum of diabetes complications over the past 20 years based on a unique, nationally representative database in the Unites States. It was noted that although adults with diagnosis of diabetes have more than tripled between the years 1990 and 2010, the rates of all five major complications of diabetes have declined significantly with the greatest absolute declines being noted for acute myocardial infarction followed by stroke, lower-extremity amputation, end-stage renal disease and finally the death from hyperglycemic crisis. The greatest declines in most of the diabetes-related complications were observed among elderly persons who are above the age of 75 years with the exception of end stage renal disease which declined only in younger people but not among elderly. These findings could be due to the fact that over the past years there have been great advancements with regards to creating diabetes education programs especially after the publication of many trials that looked at the importance of intensive versus conventional glucose control, along with the enhanced management of other associated risk factors such as blood pressure, lipid levels, and smoking cessation.

  10. Editorial on the original article entitled “Permissive underfeeding of standard enteral feeding in critically ill adults” published in the New England Journal of Medicine on June 18, 2015

    PubMed Central

    Casaer, Michael P.

    2015-01-01

    On June 18, 2015, the New England Journal of Medicine published an article entitled “Permissive underfeeding of standard enteral feeding in critically ill adults”, which reports the results of a study that examined the impact of prolonged nutritional energy restriction for critically ill patients. The study design was unique in the sense that patients in both groups received similar doses of protein during the intervention, while the non-protein energy intake was reduced in the intervention group. The study showed no differences in outcome between the two study groups. These results add to a growing body of high quality evidence against the dogmatic belief that full enteral or parenteral feeding should be given as early as possible during critical illness to prevent complications. Further research is now needed to address the question of the optimal timing to provide more nutritional support for the benefit of the patients, possibly guided by improved biomarkers that need to be developed and validated, and to investigate underlying mechanisms. PMID:26539443

  11. Editorial on the original article entitled “Changes in diabetes-related complications in the United States, 1990-2010” published in the New England Journal of Medicine on April 17, 2014

    PubMed Central

    2014-01-01

    The paper entitled “Changes in diabetes-related complications in the United States, 1990-2010” published recently in the New England Journal of Medicine examined the spectrum of diabetes complications over the past 20 years based on a unique, nationally representative database in the Unites States. It was noted that although adults with diagnosis of diabetes have more than tripled between the years 1990 and 2010, the rates of all five major complications of diabetes have declined significantly with the greatest absolute declines being noted for acute myocardial infarction followed by stroke, lower-extremity amputation, end-stage renal disease and finally the death from hyperglycemic crisis. The greatest declines in most of the diabetes-related complications were observed among elderly persons who are above the age of 75 years with the exception of end stage renal disease which declined only in younger people but not among elderly. These findings could be due to the fact that over the past years there have been great advancements with regards to creating diabetes education programs especially after the publication of many trials that looked at the importance of intensive versus conventional glucose control, along with the enhanced management of other associated risk factors such as blood pressure, lipid levels, and smoking cessation. PMID:25568871

  12. Japan Biotech Forum: London 2010.

    PubMed

    Al-Shamahi, Asma

    2010-11-01

    The Japan Biotech Forum, held in London, included topics covering new licensing developments in the Japanese pharma and biotech industries. This conference report highlights selected presentations on licensing opportunities from several Japanese companies, including CanBas, LivTech, REGiMMUNE, D Western Therapeutics Institute and Chiome Bioscience. Investigational drugs discussed include CBP-501 (CanBas), LIV-2008 (LivTech), RGI-2001 (REGiMMUNE), IVX-214 (D Western Therapeutics Institute/ Nippon Shinyaku) and anti-Sema 3A (Chiome Bioscience).

  13. Developing School Leaders: What the U.S. Can Learn from England's Model

    ERIC Educational Resources Information Center

    Toner, Mark

    2015-01-01

    The myriad challenges facing school principals in the United States have been well documented, including limited opportunities for distributed leadership, inadequate training, and a lackluster pipeline for new leaders. Recently, the Fordham Institute teamed up with the London-based Education Foundation to seek a better understanding of England's…

  14. Symbol Communication in Special Schools in England: The Current Position and Some Key Issues

    ERIC Educational Resources Information Center

    Abbott, Chris; Lucey, Helen

    2005-01-01

    In this article, originally submitted to BJSE's Research Section, Chris Abbott of King's College, London, and Helen Lucey of the Open University report on the outcomes of a survey of special schools in England. The aim of the research, funded by the Nuffield Foundation, was to understand the nature and extent of symbol use for communication and…

  15. Perspectives on Pupil Creativity in Design and Technology in the Lower Secondary Curriculum in England

    ERIC Educational Resources Information Center

    Rutland, Marion; Barlex, David

    2008-01-01

    This paper is based on work carried out as part of a research study into the professional practices of secondary design and technology teachers in England. It focused on fostering creativity or teaching for creativity as defined by the Robinson Report (1999, All our futures: creativity, culture and education. London: Department for Education and…

  16. Reading Recovery as an Example of Early Intervention in Early Years Literacy in England

    ERIC Educational Resources Information Center

    Paige-Smith, Alice; Soler, Janet

    2004-01-01

    The ways in which the Reading Recovery Programme supports children with reading difficulties is considered in this article within the context of the national development of the programme in England which began in the 1990s. We go on to describe the implementation of this early intervention programme in one London LEA. We then compare the Early…

  17. Local Authorities and the Education of Young People with Sickle Cell Disorders in England

    ERIC Educational Resources Information Center

    Dyson, S. M.; Abuateya, H.; Atkin, K.; Culley, L. A.; Dyson, S. E.; Rowley, D. T.

    2008-01-01

    The successful inclusion of minority ethnic pupils with sickle cell disorders (SCD) raises a number of challenges for educational systems. In England, local education authorities were important drivers for innovative responses to complex needs and the former Inner London Education Authority produced guidance in 1989 on SCD in schools. Local…

  18. Local Authorities and the Education of Young People with Sickle Cell Disorders in England

    ERIC Educational Resources Information Center

    Dyson, S. M.; Abuateya, H.; Atkin, K.; Culley, L. A.; Dyson, S. E.; Rowley, D. T.

    2008-01-01

    The successful inclusion of minority ethnic pupils with sickle cell disorders (SCD) raises a number of challenges for educational systems. In England, local education authorities were important drivers for innovative responses to complex needs and the former Inner London Education Authority produced guidance in 1989 on SCD in schools. Local…

  19. Low on the London Scale

    NASA Astrophysics Data System (ADS)

    Webb, S.

    2013-09-01

    Until relatively recently, many authors have assumed that if extraterrestrial life is discovered it will be via the discovery of extraterrestrial intelligence: we can best try to detect life by adopting the SETI approach of trying to detect beacons or artefacts. The Rio Scale, proposed by Almár and Tarter in 2000, is a tool for quantifying the potential significance for society of any such reported detection. However, improvements in technology and advances in astrobiology raise the possibility that the discovery of extraterrestrial life will instead be via the detection of atmospheric biosignatures. The London Scale, proposed by Almár in 2010, attempts to quantify the potential significance of the discovery of extraterrestrial life rather than extraterrestrial intelligence. What might be the consequences of the announcement of a discovery that ranks low on the London Scale? In other words, what might be society's reaction if 'first contact' is via the remote sensing of the byproducts of unicellular organisms rather than with the products of high intelligence? Here, I examine some possible reactions to that question; in particular, I discuss how such an announcement might affect our views of life here on Earth and of humanity's place in the universe.

  20. The decline of adult smallpox in eighteenth-century London: a commentary.

    PubMed

    Razzell, Peter

    2011-01-01

    This article is a response to Davenport, Schwarz, and Boulton's article, ‘The decline of adult smallpox in eighteenth-century London’. It introduces new data on the parish of St Mary Whitechapel which casts doubt on the pattern of the age incidence of smallpox found by Davenport et al. However, it is concluded that there was a decline in adult smallpox in London, accompanied by a concentration of the disease among children under the age of five. Davenport et al.'s argument that the shift in the age incidence was due to the endemicization of smallpox in England is challenged, with an alternative view that these age changes can be accounted for by the practice of inoculation, both in the hinterland southern parishes of England and in London itself. A detailed discussion is carried out on the history of inoculation in London for the period 1760–1812. It is suggested that inoculation became increasingly popular in this period, rivalling in popularity the practice of vaccination. This was associated with a class conflict between the medical supporters of Jenner and the general population, with many of the latter being practitioners of the old inoculation.

  1. London's Jewish Communities and State Education

    ERIC Educational Resources Information Center

    Martin, Jane

    2012-01-01

    The Inner London education authority was a notable example of a radical and powerful local government body from which the fight for the comprehensive principle in English secondary education emerged. Building on previous work of women's contribution to state education in London, this articles focuses on Anglo-Jewish educator activists who helped…

  2. School Improvement in London: A Global Perspective

    ERIC Educational Resources Information Center

    McAleavy, Tony; Elwick, Alex

    2016-01-01

    This report considers how successful London's schools have been over the past decade and identifies potentially transferable components of the success story. There is much to be learned from the transformation undergone in London that is relevant to policymakers and educationalists worldwide, working in both high-income and low-income countries.…

  3. Jack London: The Paradox of Individualism.

    ERIC Educational Resources Information Center

    Deane, Paul

    1968-01-01

    Because of their interest in naturalism and socialism, critics often overlook the major intellectual conflict in Jack London's work: the paradox of individualism. London regards society as affecting the individual in two ways: it either promotes individuality or it demands a conformity that undermines individualism. When society fails Buck in…

  4. See you at London Vet Show.

    PubMed

    2016-11-05

    London Vet Show is fast approaching: it takes place from November 17 to 18 and is being held at ExCeL London for the first time. Zoe Davies, marketing manager, highlights some of what BVA is offering at the event. British Veterinary Association.

  5. Disproportionate effect on child admissions of the change in Medicines and Healthcare Products Regulatory Agency guidance for management of paracetamol poisoning: an analysis of hospital admissions for paracetamol overdose in England and Scotland.

    PubMed

    Narayan, Hafid; Thomas, Simon H L; Eddleston, Michael; Dear, James W; Sandilands, Euan; Bateman, D Nicholas

    2015-12-01

    The aim of the present study was to assess the effects of the changes in the management of paracetamol overdose recommended by the UK Commission for Human Medicines on rates of hospital admission. An interrupted time series analysis was carried out on data for hospital admissions for paracetamol poisoning for England between January 2010 and June 2014, and for Scotland between January 2010 and Sept. 2014. The main outcome measure was admissions to hospital with paracetamol poisoning (T39.1), as defined by first position coding in children and adults. The time series analysis (Jan 2010 to June 2014) showed that admission rates for paracetamol poisoning were steady from 2010 to the date of change (September 2012), with an estimated 269 [95% confidence interval (CI) 252.5, 285.5] child (0-14 years) and 3541 (95% CI 3454, 3628) adult admissions per month. In September 2013, 12 months after the change, there were an estimated additional 116 [37.3% (95% CI 17.2-67.4)] child and 426 [12.5% (95% CI 4.5-19.6)] adult admissions. Thus, in the year before the change (September 2011 to August 2012) there were 45,181 (3500 child and 41,681 adult) admissions, and in the year after (September 2012 to August 2013) there were 50,198 (4779 child and 45,419 adult) admissions. The overall proportion of child admissions was significantly greater after the change (Chi-square 32.486, P < 0.001), emphasizing the disproportionate effect in children. Changes to the management guidelines for paracetamol poisoning in September 2012 were rapidly implemented but have particularly increased paediatric hospital admissions for paracetamol poisoning. This impact in children, who are at low risk of mortality from paracetamol toxicity, appears excessive. © 2015 The British Pharmacological Society.

  6. Cross-cultural adaptation in urban ethnobotany: the Colombian folk pharmacopoeia in London.

    PubMed

    Ceuterick, Melissa; Vandebroek, Ina; Torry, Bren; Pieroni, Andrea

    2008-12-08

    To investigate traditional health care practices and changes in medicinal plant use among the growing Colombian community in London. Ethnobotanical fieldwork consisted of qualitative, in-depth, semi-structured interviews with 23 Colombians living in London and botanical identification of 46 plant species actively used as herbal remedies. Subsequently, research data were compared with literature on ethnobotany and traditional herbal medicine in the home country, using a framework on cross-cultural adaptation, adjusted for the purpose of this study. Similarities and discrepancies between data and literature are interpreted as potential indicators of continuity and loss (or deculturation) of traditional remedies, respectively. Remedies used in London that are not corroborated by the literature suggest possible newly acquired uses. Cross-cultural adaptation related to health care practices is a multifaceted process. Persistence, loss and incorporation of remedies into the Colombian folk pharmacopoeia after migration are influenced by practical adaptation strategies as well as by symbolic-cultural motives of ethnic identity.

  7. [Historical evidence of the beginning of modern medicine in the holy land: "list of medicinal preparations found in stores and dispensary on july 21st 1857"].

    PubMed

    Lev, E; Peri, Y

    2001-11-01

    The London Society for Promoting Christianity Amongst the Jews established the first Western hospital in Jerusalem in the middle of 19th century. It was built for the benefit of the Jewish population of the city, and it transposed the Holy Land, from a medical point of view, to the modern era. The huge archives of the London Society in England contain many documents dealing with its activity. One document, revealed here for the first time, describes the content of the medicinal preparations held in the stores of the British hospital and dispensary in Jerusalem on July 21 1857. The list, presented here in full, is impressive in its length, containing hundreds of medicinal substances originating from plants, minerals, and animals that were used in the Western world at the time. Most of the chemicals in the list had never previously appeared in any published historical source concerning Palestine. The list is thus one of the first pieces of evidence of modern medical and pharmacological activities in the Holy Land. A comparison of the list with several other 19th century lists of medicinal substances found in professional literature revealed that it contains most of the known medicinal substances of that time. Compared with medieval documents, or lists of traditional substances compiled a few years earlier, the 1857 list is richer and contains new substances and preparations originating in the New World (America) and chemicals unknown in the region before. It is evidence of the change that occurred in the field of pharmacology owing to the penetration of the modern medicine into the Holy Land. The 1857 list contains 268 substances: 147 medicinal preparations of plant origin, 117 preparations of chemical and mineral origin, and only four of animal origin.

  8. Antimicrobial assays of three native British plants used in Anglo-Saxon medicine for wound healing formulations in 10th century England.

    PubMed

    Watkins, Frances; Pendry, Barbara; Sanchez-Medina, Alberto; Corcoran, Olivia

    2012-11-21

    technologies and chemometric models paves the way for systematic investigation of Anglo-Saxon medical literature for further therapeutic indications to uncover knowledge of native British plants, some of which are currently lost to modern Western herbal medicine. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Occupation and cancer in London: an investigation into nasal and bladder cancer using the Cancer Atlas.

    PubMed Central

    Baxter, P J; McDowall, M E

    1986-01-01

    The Atlas of Cancer Mortality for England and Wales showed pronounced excesses of male mortality from nasal and bladder cancer in certain London boroughs. These excesses were investigated by case-referent studies using death certificate data for male deaths, 1968-78. Nasal cancer was found to be significantly associated with occupations involving heavy exposure to wood dust. Bladder cancer was significantly associated with occupations in road transport driving and in the handling of leather, whereas consistently raised relative risk ratios were also found for wood-workers, engineering fitters, printers, machinists, plumbers, and motor mechanics. These findings highlight the potential role of occupational factors in cancer causation in London. Images PMID:3947560

  10. The Rise of Massage and Medical Gymnastics in London and Paris before the First World War.

    PubMed

    Quin, Grégory

    2017-01-01

    Massage and medical gymnastics experienced a rapid institutionalization across Europe and North America between 1850 and 1914. This article explores how this process took place in London and Paris. Physiotherapy developed many of the hallmarks of an independent discipline during this period, including an identified corpus of manipulations and exercises, some autonomous training courses and degrees for future practitioners, and even the creation of departments within several hospitals. The article analyzes all of the processes surrounding this rise, paying special attention to the influence of the ambassadors of Swedish gymnastics (which led to the re-invention of massage across Europe), to the installation of physiotherapy in hospitals in London and in Paris, and to the practical and institutional innovations driven by nurses in England and by doctors in France.

  11. Pulmonary function of London firemen.

    PubMed Central

    Douglas, D B; Douglas, R B; Oakes, D; Scott, G

    1985-01-01

    In a longitudinal study of a sample of firemen in London 1006 firemen were interviewed and examined in 1976 and 895 were seen a second time 12 months later. On each occasion a Medical Research Council respiratory questionnaire was administered and forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured. The average levels of FEV1, FVC, and FEV1/FVC in both years compared favourably with conventional predicted values. Separate multiple regression analysis for the two years indicated that the FEV1 and FVC fell more rapidly in those aged over 40, and that cigarette smoking had a strong harmful effect on these measures of function. Only among men with over 20 years' service was there possibly any evidence (not statistically significant) of an effect from duration of employment. The comparatively large fall in FEV1 and FVC from 1976 to 1977 was due mainly to instrumental variation. The prevalence of respiratory symptoms was higher in smokers than non-smokers and increased with the number of cigarettes smoked. PMID:3965016

  12. Sex differentials in frailty in medieval England.

    PubMed

    DeWitte, Sharon N

    2010-10-01

    In most modern populations, there are sex differentials in morbidity and mortality that favor women. This study addresses whether such female advantages existed to any appreciable degree in medieval Europe. The analyses presented here examine whether men and women with osteological stress markers faced the same risks of death in medieval London. The sample used for this study comes from the East Smithfield Black Death cemetery in London. The benefit of using this cemetery is that most, if not all, individuals interred in East Smithfield died from the same cause within a very short period of time. This allows for the analysis of the differences between men and women in the risks of mortality associated with osteological stress markers without the potential confounding effects of different causes of death. A sample of 299 adults (173 males, 126 females) from the East Smithfield cemetery was analyzed. The results indicate that the excess mortality associated with several osteological stress markers was higher for men than for women. This suggests that in this medieval population, previous physiological stress increased the risk of death for men during the Black Death to a greater extent than was true for women. Alternatively, the results might indicate that the Black Death discriminated less strongly between women with and without pre-existing health conditions than was true for men. These results are examined in light of previous analyses of East Smithfield and what is known about diet and sexually mediated access to resources in medieval England.

  13. Sex Differentials in Frailty in Medieval England

    PubMed Central

    DeWitte, Sharon N.

    2011-01-01

    In most modern populations, there are sex differentials in morbidity and mortality that favor women. This study addresses whether such female advantages existed to any appreciable degree in medieval Europe. The analyses presented here examine whether men and women with osteological stress markers faced the same risks of death in medieval London. The sample used for this study comes from the East Smithfield Black Death cemetery in London. The benefit of using this cemetery is that most, if not all, individuals interred in East Smithfield died from the same cause within a very short period of time. This allows for the analysis of the differences between men and women in the risks of mortality associated with osteological stress markers without the potential confounding effects of different causes of death. A sample of 299 adults (173 males, 126 females) from the East Smithfield cemetery was analyzed. The results indicate that the excess mortality associated with several osteological stress markers was higher for men than for women. This suggests that in this medieval population, previous physiological stress increased the risk of death for men during the Black Death to a greater extent than was true for women. Alternatively, the results might indicate that the Black Death discriminated less strongly between women with and without pre-existing health conditions than was true for men. These results are examined in light of previous analyses of East Smithfield and what is known about diet and sexually-mediated access to resources in medieval England. PMID:20853482

  14. London Dispersion Forces and "The Wave"

    NASA Astrophysics Data System (ADS)

    Wilcox, C. Jayne

    1998-10-01

    An analogy is presented likening London dispersion forces to "The Wave", a popular ritual performed by fans attending sports events in large stadia. Similarities between people in the stands and electrons in atoms are emphasized.

  15. Career development at London Vet Show.

    PubMed

    2016-09-03

    Are you considering a career change? Perhaps you want help to develop within your current role? Either way, you will find a relevant session in the BVA Career Development stream at the London Vet Show in November. British Veterinary Association.

  16. The Tower of London bomb explosion.

    PubMed Central

    Tucker, K; Lettin, A

    1975-01-01

    After the detonation of a bomb in the Tower of London 37 people were brought to St. Bartholomew's Hospital. The explosion caused numerous severe injuries of a type rarely seen in peacetime. PMID:1148778

  17. What explains worse patient experience in London? Evidence from secondary analysis of the Cancer Patient Experience Survey

    PubMed Central

    Saunders, Catherine L; Abel, Gary A; Lyratzopoulos, Georgios

    2014-01-01

    Objective To explore why patients with cancer treated by London hospitals report worse experiences of care compared with those treated in other English regions. Design Secondary analysis of the 2011/2012 National Cancer Patient Experience Survey (n=69 086). Setting and participants Patients with cancer treated by the English National Health Service (NHS) hospitals. Main outcome measures 64 patient experience measures covering all aspects of cancer care (pre-diagnosis to discharge). Methods Using mixed effects logistic regression, we explored whether poorer scores in London hospitals could be explained by patient case-mix (age, gender, ethnicity and cancer type). Because patients referred to tertiary centres and/or with complex medical problems may report more critical experiences, we also explored whether the experiences reported in London may reflect higher concentration of teaching hospitals in the capital. Finally, using the data from the (general) Adult Inpatients Survey, we explored whether the extent of poorer experience reported by London patients was similar for respondents to either survey. Results For 52/64 questions, there was evidence of poorer experience in London, with the percentage of patients reporting a positive experience being lower compared with the rest of England by a median of 3.7% (IQR 2.5–5.4%). After case-mix adjustment there was still evidence for worse experience in London for 44/64 questions. In addition, adjusting for teaching hospital status made trivial difference to the case-mix-adjusted findings. There was evidence that London versus rest-of-England differences were greater for patients with cancer compared with (general) hospital inpatients for 10 of 16 questions in both the Cancer Patient Experience and the Adult Inpatients Surveys. Conclusions Patients with cancer treated by London hospitals report worse care experiences and by and large these differences are not explained by patient case-mix or teaching hospital status

  18. Incidence and reinfection rates of genital chlamydial infection among women aged 16–24 years attending general practice, family planning and genitourinary medicine clinics in England: a prospective cohort study by the Chlamydia Recall Study Advisory Group

    PubMed Central

    LaMontagne, D Scott; Baster, Kathleen; Emmett, Lynsey; Nichols, Tom; Randall, Sarah; McLean, Louise; Meredith, Paula; Harindra, Veerakathy; Tobin, Jean M; Underhill, Gillian S; Hewitt, W Graham; Hopwood, Jennifer; Gleave, Toni; Ghosh, Ajit K; Mallinson, Harry; Davies, Alisha R; Hughes, Gwenda; Fenton, Kevin A

    2007-01-01

    Background In England, screening for genital chlamydial infection has begun; however, screening frequency for women is not yet determined. Aim To measure chlamydia incidence and reinfection rates among young women to suggest screening intervals. Methods An 18‐month prospective cohort study of women aged 16–24 years recruited from general practices, family planning clinics and genitourinary medicine (GUM) clinics: baseline‐negative women followed for incidence and baseline‐positive women for reinfection; urine tested every 6 months via nucleic acid amplification; and behavioural data collected. Extra test and questionnaire completed 3 months after initial positive test. Factors associated with infection and reinfection investigated using Cox regression stratified by healthcare setting of recruitment. Results Chlamydia incidence was mean (95% CI) 4.9 (2.7 to 8.8) per 100 person‐years (py) among women recruited from general practices, 6.4 (4.2 to 9.8) from family planning clinics and 10.6 (7.4 to 15.2) from GUM clinics. Incidence was associated with young age, history of chlamydial infection and acquisition of new sexual partners. If recently acquiring new partners, condom use at last sexual intercourse was independently associated with lower incidence. Chlamydia reinfection was mean (95% CI) 29.9 (19.7 to 45.4) per 100/person‐year from general practices, 22.3 (15.6 to 31.8) from family planning clinics and 21.1 (14.3 to 30.9) from GUM clinics. Factors independently associated with higher reinfection rates were acquisition of new partners and failure to treat all partners. Conclusions Sexual behaviours determined incidence and reinfection, regardless of healthcare setting. Our results suggest annual screening of women aged 16–24 years who are chlamydia negative, or sooner if partner change occurs. Rescreening chlamydia‐positive women within 6 months of baseline infection may be sensible, especially if partner change occurs or all partners are

  19. Islip axis gas could support Central England power generation

    SciTech Connect

    Oswald, D.H.

    1996-08-05

    The Islip axis is part of a major structural feature in Central England that reaches its culmination about 4 miles north of Oxford. During Mesozoic time this area lay between the relatively stable London platform in the east and the subsiding Worcester basin in the west. Paleozoic rocks, Cambrian to Devonian, underlie the Mesozoic rocks on the London platform, while to the west Permo-Triassic rocks rest on coal measures. The subsurface structure and stratigraphy of the area have been established by many boreholes drilled in the early years of the century for coal and more recently by the British Gas Council exploring for a porous reservoir for gas storage. The paper discusses the reservoir, cap rock, structure, source rock, oil and gas occurrences, and economic potential.

  20. A New Kind of English: Cultural Variance, Citizenship and DiY Politics amongst the Exodus Collective in England

    ERIC Educational Resources Information Center

    Blackstone, Lee Robert

    2005-01-01

    This article addresses the construction of citizenship in contemporary England as a boundary between "proper" and "improper" English behavior. Through an ethnographic study of the Exodus Collective, a Rastafarian-anarchist community that was located north of London, I show that constructing citizenship also constructs…

  1. A New Kind of English: Cultural Variance, Citizenship and DiY Politics amongst the Exodus Collective in England

    ERIC Educational Resources Information Center

    Blackstone, Lee Robert

    2005-01-01

    This article addresses the construction of citizenship in contemporary England as a boundary between "proper" and "improper" English behavior. Through an ethnographic study of the Exodus Collective, a Rastafarian-anarchist community that was located north of London, I show that constructing citizenship also constructs…

  2. The End of Testing and Future Possibilities: An Examination of the Demise of SATs in England and Possible Alternative Assessments

    ERIC Educational Resources Information Center

    Marshall, Bethan

    2008-01-01

    This article looks at the controversial starting of testing, its boycott, the subsequent years of protest and, in October 2008, the apparent end of key stage examining in England. It considers a possible alternative to the tests based on a project carried out at King's College London based on portfolio assessment.

  3. "This Is a School, It's Not a Site": Teachers' Attitudes towards Gypsy and Traveller Pupils in Schools in England, UK

    ERIC Educational Resources Information Center

    Bhopal, Kalwant

    2011-01-01

    This article examines teachers' attitudes towards Gypsy and Traveller pupils in one primary and one secondary school in an inner-London borough in England, UK. The research is based on in-depth interviews with 20 teachers, heads, deputies and classroom assistants. The main aims of the study were to examine examples of "good practice" in…

  4. Neurofibromatosis type 2 service delivery in England.

    PubMed

    Lloyd, S K; Evans, D G

    2016-01-27

    Neurofibromatosis type 2 (NF2) is a complex disease characterized by the development of multiple schwannomas, especially vestibular schwannomas, as well as other types of benign tumours including meningioma and spinal ependymoma. Due to its multisystem nature, the management of NF2 requires a multidisciplinary approach. In England, the delivery of care for NF2 patients has been centralized to four-"hub" centres in Manchester, Cambridge, Oxford and London each having associated "spoke" centres. Each centre has a core multidisciplinary team consisting of genetics, otolaryngology, neurosurgery, paediatrics, neurology, audiology, radiology, psychology, physiotherapy, specialist nurses and administrative staff. In addition, the core team has access to plastic surgery, ophthalmology, peripheral nerve surgery and adult and paediatric oncology. There are weekly multidisciplinary clinics each with six to eight patients. Each patient is discussed during a team meeting and the management decisions that are made are then discussed with the patients. All patients are reviewed at least annually and have annual head magnetic resonance imaging (MRI) and three yearly spinal MRI. Annual audiological assessment is performed. Cochlear implantation and auditory brainstem implantation are offered if indicated. Surgery, stereotactic radiosurgery and bevacizumab therapy are available for the management of intracranial and spinal tumours. The integration of the service in England has provided significant benefits to patient care and, in the long term, will provide robust patient outcome data that will provide an evidence base to assist in optimizing management of patients with NF2.

  5. 12. Photo copy of drawing, May 21, 1963. NEW LONDON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. Photo copy of drawing, May 21, 1963. NEW LONDON LEDGE LIGHT STATION LIGHTING. Drawing no. 03-2730, U.S. Coast Guard Civil Engineering Unit, Warwick, Rhode Island. - New London Ledge Lighthouse, Long Island Sound, East of main harbor channel, New London, New London County, CT

  6. Epilepsy prevalence and socioeconomic deprivation in England.

    PubMed

    Steer, Samuel; Pickrell, William O; Kerr, Michael P; Thomas, Rhys H

    2014-10-01

    Epilepsy is more prevalent in areas of greater socioeconomic deprivation; however, the factors that comprise this deprivation are not understood. We aimed to investigate the association between epilepsy, individual elements of deprivation, and geographic region in order to identify modifiable elements. Epilepsy prevalence was calculated via retrospective analysis of data recorded by general practitioners via the Quality and Outcomes Framework. The Index of Multiple Deprivation scores at Local Authority level for the entire population of England was employed. Epilepsy prevalence was evaluated for correlation against all seven indicators within the Indices of Multiple Deprivation. Data were analyzed including and excluding the city of London. Of the 37,699,503 patients in this study, 304,331 were registered as having epilepsy (prevalence 8 per 1,000; range 4.3-11.6). Positive correlation was seen with total Index of Multiple Deprivation score (r = 0.468, p < 0.01); education skills and training (r = 0.665, p < 0.01); employment deprivation (r = 0.629, p < 0.01); health deprivation and disability (r = 0.617, p < 0.01); income deprivation (r = 0.358, p < 0.01); crime (r = 0.232, p < 0.01); but not living environment (r = 0.079, p = 0.08). Negative correlation was seen between epilepsy prevalence and barriers to housing and services (r = -0.415, p < 0.01). When the data were analyzed excluding London, all correlations were strengthened. Epilepsy prevalence in adults varies by 2.5-fold across England, from 4.3 per 1,000 in Kensington and Chelsea to 11.6 per 1,000 in Blackpool. This study shows a strong correlation between epilepsy prevalence and specific measures of socioeconomic deprivation. Many of these deprivation factors are potentially remediable. We hypothesize that people with epilepsy may move into urban areas and toward their general practitioner. This predominantly means an urban location but avoiding areas where the cost of living-particularly housing

  7. Interpreting atmospheric composition measurements around London during the ClearfLo campaign using the NAME dispersion model

    NASA Astrophysics Data System (ADS)

    Fleming, Zoë; Bohnenstengel, Sylvia; Lee, James; Monks, Paul

    2013-04-01

    In order to interpret composition measurements taken in London during the ClearfLo (Clean Air for London) campaign from 2011 to the present (with intensive measurement campaigns in summer and winter 2012), atmospheric dispersion modelling with the NAME model was undertaken. Measurements of a variety of trace gases, aerosols and meteorology were taken at five sites to the west of London, in central London and east of the city. Dispersion modelling showed when each site received the same air masses and whether the evolution of the air mass composition could be tracked as the air crossed the city. Variability in the level of pollutants and trace gases could be assigned to changes in air mass origin at certain times but more local events were too small scale to be assigned with this dispersion model. Dispersion modelling and using the resulting air mass footprints was found to be a useful visualisation as well as quantitative tool to interpret the many trace gas measurements at strategically different geographical locations around a city and help explain the complex air quality influences on London and the South east of England.

  8. Patterns and prevalence of violence-related skull trauma in medieval London.

    PubMed

    Krakowka, Kathryn

    2017-08-09

    This study aims to identify the patterns and prevalence of violence-related skull trauma (including the cranium and mandible) among a large sample of skeletons from medieval London (1050-1550 AD). In total, data from 399 skulls, representing six different sites from across medieval London, were analyzed for evidence of trauma and assessed for the likelihood that it was caused by violence. The sites include the three parish cemeteries of St Nicholas Shambles (GPO75), St Lawrence Jewry (GYE92), and St Benet Sherehog (ONE94); the two monastic houses of London Blackfriars (PIC87) and St Mary Graces (MIN86); and the early inmate cemetery from the medieval hospital of St Mary Spital (NRT85). The overall findings suggest that violence affected all aspects of medieval London society, but how that violence was characterized largely depended on sex and burial location. Specifically, males from the lay cemeteries appear to have been the demographic most affected by violence-related skull injuries, particularly blunt force trauma to the cranial vault. Using both archaeological and historical evidence, the results suggest that violence in medieval London may have been more prevalent than in other parts of medieval England, particularly rural environments, but similar to other parts of medieval Europe. However, more studies focusing on medieval trauma, and violence specifically, need to be carried out to further strengthen these results. In particular, males from the lay cemeteries were disproportionately affected by violence-related trauma, especially blunt force trauma. It perhaps indicates a means of informal conflict resolution as those of lower status did not always have the newly established medieval legal system available to them. © 2017 Wiley Periodicals, Inc.

  9. Renaissance plays as a useful source for the comparison between English and Croatian early modern medicine.

    PubMed

    Atalic, Bruno

    2012-01-01

    This paper evaluates the differences between English and Croatian views of early modern medicine through the respective Renaissance plays. As Renaissance made no particular distinction between arts and sciences, plays of that time provide a very common source of medical narrative. During Renaissance both languages produced high literary achievements, which makes them exemplars among their Germanic and Slavic counterparts, and justifies this comparison, regardless of their significant differences. One should bear in mind that while England was a unified kingdom, with London as the major cultural centre, Croatia's division among the neighbouring powers produced several prominent cultural centres such as Zadar, Šibenik, Split, Hvar, Korčula, and the most important one, Dubrovnik. One should also bear in mind that the golden age of Croatian Renaissance plays had finished as early as 1567 with the death of Marin DrŽić, before it even started in England with the foundation of the first permanent theatrical companies in 1576. Along these lines, this paper compares their early modern attitudes toward medicine in general and men and women practitioners in particular. In this respect, it evaluates the influences of the origin, patronage, and religion of their authors. Special attention is given to William Shakespeare (1564-1616) and Marin DrŽić (1508-1567) as the exemplars of English and Croatian Renaissance literature.

  10. National Case-Studies. England.

    ERIC Educational Resources Information Center

    McClelland, Vincent Alan

    1993-01-01

    Presents a discussion of the role of educational research in teacher education in England, looking at its recent history, examining the effects of England's new national curriculum, and discussing the politics of change in the English educational system. (SM)

  11. Health effects of the London bicycle sharing system: health impact modelling study.

    PubMed

    Woodcock, James; Tainio, Marko; Cheshire, James; O'Brien, Oliver; Goodman, Anna

    2014-02-13

    To model the impacts of the bicycle sharing system in London on the health of its users. Health impact modelling and evaluation, using a stochastic simulation model. Central and inner London, England. Total population operational registration and usage data for the London cycle hire scheme (collected April 2011-March 2012), surveys of cycle hire users (collected 2011), and London data on travel, physical activity, road traffic collisions, and particulate air pollution (PM2.5, (collected 2005-12). 578,607 users of the London cycle hire scheme, aged 14 years and over, with an estimated 78% of travel time accounted for by users younger than 45 years. Change in lifelong disability adjusted life years (DALYs) based on one year impacts on incidence of disease and injury, modelled through medium term changes in physical activity, road traffic injuries, and exposure to air pollution. Over the year examined the users made 7.4 million cycle hire trips (estimated 71% of cycling time by men). These trips would mostly otherwise have been made on foot (31%) or by public transport (47%). To date there has been a trend towards fewer fatalities and injuries than expected on cycle hire bicycles. Using these observed injury rates, the population benefits from the cycle hire scheme substantially outweighed harms (net change -72 DALYs (95% credible interval -110 to -43) among men using cycle hire per accounting year; -15 (-42 to -6) among women; note that negative DALYs represent a health benefit). When we modelled cycle hire injury rates as being equal to background rates for all cycling in central London, these benefits were smaller and there was no evidence of a benefit among women (change -49 DALYs (-88 to -17) among men; -1 DALY (-27 to 12) among women). This sex difference largely reflected higher road collision fatality rates for female cyclists. At older ages the modelled benefits of cycling were much larger than the harms. Using background injury rates in the youngest age

  12. Multiple sclerosis distribution in England and Wales and parts of Europe

    PubMed Central

    Stocks, Percy

    1971-01-01

    Scotland and Ireland have the highest death rates from multiple sclerosis and high rates are recorded in an area extending south-eastward from Britain through central Europe. The rates tend to diminish with rising latitude and longitude. In England and Wales the county boroughs with notably high rates during 1958-67 were mostly textile towns with cotton and wool mills, situated in the area recording the lowest average levels of sunshine. In the London area mortality from multiple sclerosis was high in those western boroughs and adjacent counties most exposed to the noise of aircraft using the airports of London. The geographical pattern in England suggests that noise and vibration of particular kinds may be a factor in causation along with a climatic factor, but this hypothesis is speculative until further evidence is found to support it. PMID:5285941

  13. Fritz London's Legacy at Duke University

    NASA Astrophysics Data System (ADS)

    Meyer, Horst

    2006-03-01

    When 3He became available in small quantities after WWII Fritz London, Professor at Duke University since 1939, became very interested in its properties in the liquid and solid phases, as contrasted with those of 4He. His influence and that of his colleague Walter Gordy led to the appointment of William Fairbank in 1952, who was able to verify experimentally the prediction on the Fermi degeneracy of liquid 3He below 1K, a few weeks before London's death in 1954. With his students and associates, Fairbank carried out a number of important experiments which became classics, several of which will be described. At Duke he also started planning other experiments inspired by London's predictions. After W. Fairbank's departure for Stanford in 1959, further research on liquid and solid 3He and 3He-4He mixtures was carried out by his successors at Duke University and some of the results in the sixties will be briefly described.

  14. Educational Assessment in England

    ERIC Educational Resources Information Center

    Isaacs, Tina

    2010-01-01

    This profile explains the assessment system in England, concentrating on those aspects that are related to government policy. It begins by putting the system in context; it then describes the national educational structure, curriculum and assessment arrangements. The government agencies responsible for carrying out education policies are…

  15. Melmark New England

    ERIC Educational Resources Information Center

    Cancro, Lorraine

    2009-01-01

    This article features Melmark New England, a private, nonprofit, community based organization dedicated to serving children and adolescents with autism spectrum disorders, acquired brain injury, neurological diseases and disorders, and severe challenging behaviors. The Melmark parent corporation, a Pennsylvania based provider of services for those…

  16. Local Music in England.

    ERIC Educational Resources Information Center

    Ewbank, Alison

    1986-01-01

    Discusses issues regarding the choice of many young musicians in England to reject their school music education as irrelevant to, and restrictive on, the music they wish to play; presents the general process of how local production works and what its cultural roots and reference points are. Cites specific references. (JD)

  17. Melmark New England

    ERIC Educational Resources Information Center

    Cancro, Lorraine

    2009-01-01

    This article features Melmark New England, a private, nonprofit, community based organization dedicated to serving children and adolescents with autism spectrum disorders, acquired brain injury, neurological diseases and disorders, and severe challenging behaviors. The Melmark parent corporation, a Pennsylvania based provider of services for those…

  18. New Developments in England

    ERIC Educational Resources Information Center

    Smith, Nicola

    2012-01-01

    Early years education in England has undergone a number of radical changes in the last decade. More recently, a change in government after the 2010 UK general election has meant that early years practitioners have experienced a period of uncertainty and change in policy in line with the ambitions and philosophy of the new Conservative/Liberal…

  19. Suicide on the London Underground System.

    PubMed

    Farmer, R; O'Donnell, I; Tranah, T

    1991-09-01

    Over the past 50 years there has been an increase in the numbers of people jumping/falling in front of trains on the London Underground system. Case-fatality rates have fallen from 70% in the 1950s to 55% today. The proportion certified as suicide has fallen while the proportions certified as accidents or open verdicts have risen. There is unusual clustering of events at some stations which are adjacent to psychiatric units. The hypothesis that ease of access to London Underground stations may sometimes be a determinant of suicide is investigated.

  20. Funding for Geography in Higher Education in England (Editorial).

    ERIC Educational Resources Information Center

    Gardner, Rita

    1997-01-01

    Summarizes the key points in the 1996 Higher Education Funding Council for England (HEFCE) Consultation paper and reviews responses to the document. The paper proposed dividing education into four broad levels of resource funding each with a standard price: clinical medicine, laboratory-based, part laboratory-based, and mainly classroom-based.…

  1. Geomorphology of New England

    USGS Publications Warehouse

    Denny, C.S.

    1982-01-01

    Widely scattered terrestrial deposits of Cretaceous or Tertiary age and extensive nearshore and fluvial Coastal Plain deposits now largely beneath the sea indicate that the New England region has been above sea level during and since the Late Cretaceous. Estimates of rates of erosion based on sediment load in rivers and on volume of sediments in the Coastal Plain suggest that if the New England highlands had not been uplifted in the Miocene, the area would now be largely a lowland. If the estimated rates of erosion and uplift are of the right order of magnitude, then it is extremely unlikely that any part of the present landscape dates back before Miocene time. The only exception would be lowlands eroded in the early Mesozoic, later buried beneath Mesozoic and Cenozoic deposits, and exhumed by stream and glacial erosion during the later Cenozoic. Many of the rocks in the New England highlands are similar to those that underlie the Piedmont province in the central and southern Appalachians, where the relief over large areas is much less than in the highlands of New England. These comparisons suggest that the New England highlands have been upwarped in late Cenozoic time. The uplift took place in the Miocene and may have continued into the Quaternary. The New England landscape is primarily controlled by the underlying bedrock. Erosion and deposition during the Quaternary, related in large part to glaciation, have produced only minor changes in drainage and in topography. Shale and graywacke of Ordovician, Cambrian, and Proterozoic age forming the Taconic highlands, and akalic plutonic rocks of Mesozoic age are all highland makers. Sandstone and shale of Jurassic and Triassic age, similar rocks of Carboniferous age, and dolomite, limestone, and shale of Ordovician and Cambrian age commonly underlie lowlands. High-grade metapelites are more resistant than similar schists of low metamorphic grade and form the highest mountains in New England. Feldspathic rocks tend to

  2. Jack London and the San Francisco earthquake

    USGS Publications Warehouse

    Sachs, J.S.

    1982-01-01

    After it was over, it seemed to many, and especially to eyewitnesses like Jack London, that the earthquake and fire had devastated San Francisco. However people were confident that, like the phoeniz, San Francisco would rise from the ashes and regain her palce as the "Imperial City of the West." 

  3. Stage Voice Training in the London Schools.

    ERIC Educational Resources Information Center

    Rubin, Lucille S.

    This report is the result of a six-week study in which the voice training offerings at four schools of drama in London were examined using interviews of teachers and directors, observation of voice classes, and attendance at studio presentations and public performances. The report covers such topics as: textbooks and references being used; courses…

  4. Preventing suicide on the London Underground.

    PubMed

    Clarke, R V; Poyner, B

    1994-02-01

    A field study was carried out to investigate the possibility of preventing suicide on the London Underground. Four groups of potentially valuable measures were identified with the objectives of: (i) reducing public access to the tracks; (ii) improving surveillance by station staff; (iii) facilitating emergency stops; and (iv) reducing injury. These strategies are discussed.

  5. E. B. Nicholson and the London Institution

    ERIC Educational Resources Information Center

    Manley, K. A.

    1973-01-01

    This article provides a history of the London Institution from 1805 to 1912, with special emphasis on E. B. Nicholson's term of office. The last years of the Institution are considered, its financial difficulties being traced back to the terms of its original foundation, and to the changing situation of its members. (47 references) (Author/SJ)

  6. A resilient NHS for London 2012.

    PubMed

    Wapling, Andy; Mooney, Tom

    2011-02-01

    London will host the Olympic and Paralympic Games in 2012. Hosting the Games brings with it both opportunities and challenges for the capital and country. The National Health Service (NHS) in London has a crucial role to play in the delivery of a safe and secure Games. It must also protect its business as usual services and be prepared to respond to any enhanced or additional threats and hazards that may be created by the presence of the Games. NHS London leads a programme of work to ensure that the NHS fulfils its responsibilities during the Games. The programme's Health Resilience workstream has adopted a structured planning process to assess risks, identify gaps in the capability of the NHS, and ensure those gaps are addressed prior to the Games. It acknowledges that training, exercising and testing play vital roles in capability. This work aims to ensure that London's health services will respond in a timely, proportionate and appropriate manner to any incident during the Games. This paper gives an overview of the Olympic context within which this resilience work is taking place, and details the planning processes and relationships employed in planning for such a major event.

  7. Michael Fisher at King's College London

    NASA Astrophysics Data System (ADS)

    Domb, Cyril

    Michael Fisher spent the first 16 years of his academic life in the Physics Department of King's College, London, starting as an undergraduate and ending as a full professor. A survey is undertaken of his activities and achievements during the various periods of this phase of his career.

  8. Movement and Character. Lecture, London, 1946

    ERIC Educational Resources Information Center

    Montesorri, Maria

    2013-01-01

    Dr. Montessori's words from the 1946 London Lectures describe principles of intelligence and character, the work of the hand, and movement with a purpose as being integral to self-construction. The perfection of movement is spiritual, says Dr. Montessori. Repetition of practical life exercises are exercises in movement with the dignity of human…

  9. Black Pupils' Achievement in Inner London.

    ERIC Educational Resources Information Center

    Mabey, Christine

    1986-01-01

    This paper looks at the relationship between reading attainment and examination achievement of Black Afro-Caribbean students who formed part of a cohort of inner London schoolchildren included in a longitudinal study. The findings of the research are discussed in terms of policy implications for education. (Author/CT)

  10. Ensuring equine biosecurity at London 2012.

    PubMed

    Slater, Josh

    2013-02-02

    The London 2012 Olympic and Paralympic Equestrian Games were the highest profile event in the 2012 equestrian calendar and were the culmination of four years of detailed and meticulous biosecurity planning to ensure that all horses arrived, competed and returned home safely and in good health. Josh Slater, Anthony Greenleaves and Andy Paterson describe how this was achieved.

  11. Implementation of an Open Source Library Management System: Experiences with Koha 3.0 at the Royal London Homoeopathic Hospital

    ERIC Educational Resources Information Center

    Bissels, Gerhard

    2008-01-01

    Purpose: The purpose of this paper is to describe the selection process and criteria that led to the implementation of the Koha 3.0 library management system (LMS) at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper is a report based on…

  12. Implementation of an Open Source Library Management System: Experiences with Koha 3.0 at the Royal London Homoeopathic Hospital

    ERIC Educational Resources Information Center

    Bissels, Gerhard

    2008-01-01

    Purpose: The purpose of this paper is to describe the selection process and criteria that led to the implementation of the Koha 3.0 library management system (LMS) at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper is a report based on…

  13. Two Years on: Koha 3.0 in Use at the CAMLIS Library, Royal London Homoeopathic Hospital

    ERIC Educational Resources Information Center

    Bissels, Gerhard; Chandler, Andrea

    2010-01-01

    Purpose: The purpose of this paper is to describe the further development of the Koha 3.0 library management system (LMS) and the involvement of external software consultants at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper takes the…

  14. Two Years on: Koha 3.0 in Use at the CAMLIS Library, Royal London Homoeopathic Hospital

    ERIC Educational Resources Information Center

    Bissels, Gerhard; Chandler, Andrea

    2010-01-01

    Purpose: The purpose of this paper is to describe the further development of the Koha 3.0 library management system (LMS) and the involvement of external software consultants at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper takes the…

  15. 32. VIEW OF PHOTO CAPTIONED 'SUBMARINE BASE, NEW LONDON, CONN. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    32. VIEW OF PHOTO CAPTIONED 'SUBMARINE BASE, NEW LONDON, CONN. OCTOBER 3, 1932. COMPLETION OF ERECTION OF STEELWORK FOR ELEVATOR. LOOKING NORTH. CONTRACT NO. Y-1539-ELEVATOR, SUBMARINE ESCAPE TANK.' - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

  16. 30. VIEW OF PHOTO CAPTIONED 'SUBMARINE BASE, NEW LONDON, CONNECTICUT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    30. VIEW OF PHOTO CAPTIONED 'SUBMARINE BASE, NEW LONDON, CONNECTICUT. 2 JUNE 1930. SUBMARINE TRAINING TANK - STEELWORK 98% COMPLETE; BRICKWORK 95% COMPLETE, PIPING 10% IN PLACE. LOOKING NORTH. CONTRACT NO. Y-1539-ELEVATOR, SUBMARINE ESCAPE TANK.' - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

  17. Recognising and Developing Urban Teachers: Chartered London Teacher Status

    ERIC Educational Resources Information Center

    Bubb, Sara; Porritt, Vivienne

    2008-01-01

    Chartered London Teacher (CLT) status is a unique scheme designed by London Challenge to recognise and reward teachers' achievements and provide a framework for professional development. As well as having the prestige of being a Chartered London Teacher for life, educators receive a one-time payment of 1,000 British pounds from the school budget…

  18. 113. New York, New Haven & Hartford Railroad: New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    113. New York, New Haven & Hartford Railroad: New London Station. New London, New London Co., CT. Sec. 4209, MP 123.00. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  19. 114. New York, New Haven & Hartford Railroad: New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    114. New York, New Haven & Hartford Railroad: New London Station. New London, New London Co., CT. Sec. 4209, MP 123.00. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  20. 33 CFR 110.147 - New London Harbor, Conn.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false New London Harbor, Conn. 110.147... ANCHORAGE REGULATIONS Anchorage Grounds § 110.147 New London Harbor, Conn. (a) The anchorage grounds—(1... Thames River southward of New London, bounded by lines connecting points which are the following bearings...

  1. 112. New York, New Haven & Hartford Railroad: New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    112. New York, New Haven & Hartford Railroad: New London Station. New London, New London Co., CT. Sec. 4209, MP 123.00. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  2. Health effects of the London bicycle sharing system: health impact modelling study

    PubMed Central

    Tainio, Marko; Cheshire, James; O’Brien, Oliver; Goodman, Anna

    2014-01-01

    Objective To model the impacts of the bicycle sharing system in London on the health of its users. Design Health impact modelling and evaluation, using a stochastic simulation model. Setting Central and inner London, England. Data sources Total population operational registration and usage data for the London cycle hire scheme (collected April 2011-March 2012), surveys of cycle hire users (collected 2011), and London data on travel, physical activity, road traffic collisions, and particulate air pollution (PM2.5, (collected 2005-12). Participants 578 607 users of the London cycle hire scheme, aged 14 years and over, with an estimated 78% of travel time accounted for by users younger than 45 years. Main outcome measures Change in lifelong disability adjusted life years (DALYs) based on one year impacts on incidence of disease and injury, modelled through medium term changes in physical activity, road traffic injuries, and exposure to air pollution. Results Over the year examined the users made 7.4 million cycle hire trips (estimated 71% of cycling time by men). These trips would mostly otherwise have been made on foot (31%) or by public transport (47%). To date there has been a trend towards fewer fatalities and injuries than expected on cycle hire bicycles. Using these observed injury rates, the population benefits from the cycle hire scheme substantially outweighed harms (net change −72 DALYs (95% credible interval −110 to −43) among men using cycle hire per accounting year; −15 (−42 to −6) among women; note that negative DALYs represent a health benefit). When we modelled cycle hire injury rates as being equal to background rates for all cycling in central London, these benefits were smaller and there was no evidence of a benefit among women (change −49 DALYs (−88 to −17) among men; −1 DALY (−27 to 12) among women). This sex difference largely reflected higher road collision fatality rates for female cyclists. At older ages the modelled

  3. Irish women who seek abortions in England.

    PubMed

    Francome, C

    1992-01-01

    In 1991, 4158 women from Ireland and 1766 from Northern Ireland traveled to England for abortions. This situation has been ignored by Irish authorities. The 1992 case of the 14-year old seeking an abortion in England finally caught legal attention. This study attempts to help define who these abortion seekers are. Questionnaires from 200 Irish abortion seeking women attending private Marie Stopes clinics in London and the British Pregnancy Advisory Services clinic in Liverpool between September 1988 and December 1990 were analyzed. Findings pertain to demographic characteristics, characteristics of first intercourse, family discussion of sexual activity, and contraceptive use. From this limited sample, it appears that Irish women are sexually reserved and without access to modern methods of birth control and abortion. Sex is associated with shame and guilt. 23% had intercourse before the age of 18 years and 42% after the age of 20. 76% were single and 16% were currently married. 95% were Catholic; 33% had been to church the preceding Sunday and 68% within the past month. Basic information about menstruation is also limited and procedures such as dilatation and curettage may be performed selectively. 28% of married women were uninformed about menstruation prior to its onset. Only 24% had been using birth control around the time of pregnancy. The reason for nonuse was frequently the unexpectedness of intercourse. 62% of adults and 66% of women believe in legalizing abortion in Ireland. British groups have tried to break through the abortion information ban by sending telephone numbers of abortion clinics to Irish firms for distribution to employees. On November 25, 1992, in the general election, there was approval of constitutional amendments guaranteeing the right to travel for abortions and to receive information on abortion access. The amendment to allow abortion to save the life of the mother was not accepted.

  4. Lessons for control of heroin-associated anthrax in Europe from 2009-2010 outbreak case studies, London, UK.

    PubMed

    Abbara, Aula; Brooks, Tim; Taylor, Graham P; Nolan, Marianne; Donaldson, Hugo; Manikon, Maribel; Holmes, Alison

    2014-07-01

    Outbreaks of serious infections associated with heroin use in persons who inject drugs (PWIDs) occur intermittently and require vigilance and rapid reporting of individual cases. Here, we give a firsthand account of the cases in London during an outbreak of heroin-associated anthrax during 2009-2010 in the United Kingdom. This new manifestation of anthrax has resulted in a clinical manifestation distinct from already recognized forms. During 2012-13, additional cases of heroin-associated anthrax among PWIDs in England and other European countries were reported, suggesting that anthrax-contaminated heroin remains in circulation. Antibacterial drugs used for serious soft tissue infection are effective against anthrax, which may lead to substantial underrecognition of this novel illness. The outbreak in London provides a strong case for ongoing vigilance and the use of serologic testing in diagnosis and serologic surveillance schemes to determine and monitor the prevalence of anthrax exposure in the PWID community.

  5. Lessons for Control of Heroin-Associated Anthrax in Europe from 2009–2010 Outbreak Case Studies, London, UK

    PubMed Central

    Abbara, Aula; Brooks, Tim; Taylor, Graham P.; Nolan, Marianne; Donaldson, Hugo; Manikon, Maribel

    2014-01-01

    Outbreaks of serious infections associated with heroin use in persons who inject drugs (PWIDs) occur intermittently and require vigilance and rapid reporting of individual cases. Here, we give a firsthand account of the cases in London during an outbreak of heroin-associated anthrax during 2009–2010 in the United Kingdom. This new manifestation of anthrax has resulted in a clinical manifestation distinct from already recognized forms. During 2012–13, additional cases of heroin-associated anthrax among PWIDs in England and other European countries were reported, suggesting that anthrax-contaminated heroin remains in circulation. Antibacterial drugs used for serious soft tissue infection are effective against anthrax, which may lead to substantial underrecognition of this novel illness. The outbreak in London provides a strong case for ongoing vigilance and the use of serologic testing in diagnosis and serologic surveillance schemes to determine and monitor the prevalence of anthrax exposure in the PWID community. PMID:24959910

  6. Educator Perceptions of Children Who Present with Social, Emotional and Behavioural Difficulties: A Literature Review with Implications for Recent Educational Policy in England and Internationally

    ERIC Educational Resources Information Center

    Armstrong, David

    2014-01-01

    In support of their recommendations, recent policy pronouncements in England on behaviour (DFE (Department for Education). 2010. "The Importance of Teaching-The Schools White Paper". London: TSO) and on reform of special educational needs and disabilities make reference, respectively, to educator perceptions of poor behaviour by children…

  7. Educator Perceptions of Children Who Present with Social, Emotional and Behavioural Difficulties: A Literature Review with Implications for Recent Educational Policy in England and Internationally

    ERIC Educational Resources Information Center

    Armstrong, David

    2014-01-01

    In support of their recommendations, recent policy pronouncements in England on behaviour (DFE (Department for Education). 2010. "The Importance of Teaching-The Schools White Paper". London: TSO) and on reform of special educational needs and disabilities make reference, respectively, to educator perceptions of poor behaviour by children…

  8. Are Londoners Prepared for an Emergency? A Longitudinal Study Following the London Bombings

    PubMed Central

    Rubin, James; Amlôt, Richard; Simpson, John; Wessely, Simon

    2008-01-01

    The UK government sees increasing individual preparedness as a priority, but the level of preparedness of people in the UK for a large-scale emergency is not known. The London bombings of July 7, 2005, affected many Londoners and may have altered their sense of vulnerability to a future terrorist attack. We used a longitudinal study design to assess individual preparedness within the same sample of Londoners at 2 points in time: immediately after the bombings (T1) and 7 to 8 months later (T2). A demographically representative sample of 1,010 Londoners participated in a phone interview at T1. Subsequently, at T2, 574 of the same people participated in a follow-up phone interview. At T1 51% of Londoners had made 4 or more relevant emergency plans; 48% had gathered 4 or more relevant supplies in case of emergency. There was evidence of increased preparedness at T2, by which time 90% had made 4 or more emergency plans. Ethnicity, low social status, and having felt a sense of threat during the bombings predicted increased preparedness between T1 and T2. Women in general, and women of low social status in particular, perceived themselves to be unprepared in the event of a future terrorist attack. In summary, Londoners show moderate levels of emergency preparedness, which increased following the London bombings. Although we cannot know whether this association is causal, the prospective nature of the study increases the likelihood that it is. However, preparedness is still patchy, and there are important demographic associations with levels of preparedness and perception of vulnerability. These findings have implications for future development of individual and community emergency preparedness policy. PMID:19117430

  9. Launch of the London Centre for Nanotechnology.

    PubMed

    Aeppli, Gabriel; Pankhurst, Quentin

    2006-12-01

    Is nanomedicine an area with the promise that its proponents claim? Professors Gabriel Aeppli and Quentin Pankhurst explore the issues in light of the new London Centre for Nanotechnology (LCN)--a joint enterprise between Imperial College and University College London--opened on November 7, 2006. The center is a multidisciplinary research initiative that aims to bridge the physical, engineering and biomedical sciences. In this interview, Professor Gabriel Aeppli, LCN co-Director, and Deputy Director Professor Quentin Pankhurst discuss the advent and future role of the LCN with Nanomedicine's Morag Robertson. Professor Aeppli was formerly with NEC, Bell Laboratories and MIT and has more than 15 years' experience in the computer and telecommunications industry. Professor Pankhurst is a physicist with more than 20 years' experience of working with magnetic materials and nanoparticles, who now works closely with clinicians and medics on innovative healthcare applications. He also recently formed the new start-up company Endomagnetics Inc.

  10. The 2015 Pregnancy Summit, London, UK.

    PubMed

    Johansson, Cherynne

    2016-01-01

    Pregnancy Summit, Cineworld, The O2, London, UK, 29 September to 1 October 2015 The 2015 Pregnancy Summit was held over 3 days from 29 September to 1 October at Cineworld, The O2, London, UK. The event brings together a multidisciplinary faculty of international researchers and clinicians to discuss both scientific and clinical aspects of pregnancy-related issues in an informal setting. The goal of the meeting was to provide delegates with an update of recent advances in management of pregnancy-related conditions, to present research data and to discuss the current attitudes and practices in relevant topics. An extensive range of topics were discussed, from preeclampsia and treatment of hypertension, to the psychological impact of termination of pregnancy and feticide. This report will summarize a selection of the lectures presented.

  11. Mortality and temperature in Sofia and London

    PubMed Central

    Pattenden, S; Nikiforov, B; Armstrong, B

    2003-01-01

    Study objective: Heat and cold have been associated with increased mortality, independently of seasonal trends, but details are little known. This study explores associations between mortality and temperature in two European capitals—Sofia and London—using four years of daily deaths, air pollution, and weather data. Design: Generalised additive models were used to permit non-linear modelling of confounders such as season and humidity, and to show the shape of mortality-temperature relations—using both two day and two week average temperatures separately. Models with linear terms for heat and cold were used to estimate lags of effect, linear effects, and attributable fractions. Participants: 44 701 all age all cause deaths in Sofia (1996–1999) and 256 464 in London (1993–1996). Main results: In London, for each degree of extreme cold (below the 10th centile of the two week mean temperature), mortality increased by 4.2% (95% CI 3.4 to 5.1), and in Sofia by 1.8% (0.6 to 3.9). For each degree rise above the 95th centile of the two day mean, mortality increased by 1.9% (1.4 to 2.4) in London, and 3.5% (2.2 to 4.8) in Sofia. Cold effects appeared after lags of around three days and lasted—particularly in London—at least two weeks. Main heat effects occurred more promptly. There were inverse associations at later lags for heat and cold in Sofia. Conclusions: Average temperatures over short periods do not adequately model cold, and may be inadequate for heat if they ignore harvesting effects. Cold temperatures in London, particularly, seem to harm the general population and the effects are not concentrated among persons close to death. PMID:12883072

  12. Infrared technology and applications; Proceedings of the Meeting, London, England, June 26-28, 1990

    SciTech Connect

    Lettington, A.H.

    1990-01-01

    Industrial infrared spectroscopy, detectors, applied thermography, optical manufacturing techniques, and optical design and testing are covered. Papers on various aspects of ductile grinding and diamond machining are presented, and focus is placed on thermal signature applications of a high-speed spectroradiometer, and industrial applications of the photothermal effect. Uncooled infrared thermal detector arrays are covered as well as submicron thin-film MOM diodes for the detection of 10-micron infrared laser radiation. Infrared thermal-imaging construction-fault location, industrial and research applications of thermography, and the control of materials by infrared thermography are considered. The optical design of a dual-magnification infrared telescope is presented, and image restoration in thermo-dynamic applications of infrared digital imagery is investigated along with a measurement method for wide-angle afocal telescopes.

  13. ICAS, Congress, 15th, London, England, September 7-12, 1986, Proceedings. Volumes 1 and 2

    SciTech Connect

    Santini, P.; Staufenbiel, R.

    1986-01-01

    Current progress in aeronautics is discussed in reviews and reports of theoretical and experimental investigations. Topics examined include airfoil design, transport aircraft, CAD-CAM, testing of composite structures, shock/boundary-layer interaction, unconventional designs, manufacturing procedures, buckling and postbuckling behavior of composites, active-control technology, computational aerodynamics, multielement airfoils for high angles of attack, navigation, and regulations. Consideration is given to stability and control, maintenance, crash testing, model testing, wind-tunnel methods, airbreathing-engine technology, wind shear, metallic materials, aeroelasticity and structural dynamics, safety, boundary-layer studies, engine control, advanced propfan and turbofan aircraft, noise, hypersonics, landing gear, and propulsion-airframe integration.

  14. Satellite communications and broadcasting; Proceedings of the International Conference, London, England, Dec. 2-4, 1986

    NASA Astrophysics Data System (ADS)

    Papers are presented on private satellite networks in the U.S.; the competitive market for international satellite services; private satellite networks in Europe; and various applications for satellites, in particular data broadcasting and business communications. Topics discussed include the worldwide regulation of satellite broadcasting and communications; the capabilities of Eutelsat II; trends in satellite technology; and the role of insurance in space industries. Consideration is given to the use of the ASTRA satellite for TV broadcasting; the services provided by Intelsat; the evolution of American television due to satellites; consumer satellite Television Receive Only marketing in Europe; and satellite programming.

  15. Environmental Education Research. Seminar Report (London, England, United Kingdom, December 3, 1991).

    ERIC Educational Resources Information Center

    Council for Environmental Education, London (England).

    The seminar aimed to improve the degree and quality of Environmental Education Research (EER) in the context of global environmental change with particular emphasis on the role of the social sciences. The report is divided into six sections and appendices. Section 1, an introduction, includes the seminar background, aim, objectives, and chair's…

  16. Fibre optics '90; Proceedings of the Meeting, London, England, Apr. 24-26, 1990

    NASA Astrophysics Data System (ADS)

    McGeehin, P.

    The present conference on fiber optics emphasizes the use of components, devices, and materials for hostile environments, and also encompasses applications of optoelectronics in sensors, communications, 'white light' interferometry, the properties of monomode optical fibers, and coherent optical systems. Specific issues addressed include erbium-doped fiber amplifiers in communications, the use of optical amplification in communication, optical fibers in the adverse space environment, the effects of temperature variations on loose-tube and tight-buffered optical fiber cables, and radiation effects in polarization-maintaining fibers. Also addressed are methods to test the effects of high-ionizing-radiation dose rates on optical fiber data links, sensors for meteorological data acquisition, sensor technology for smart structure development, radiative ignition by loose agglomerates of fine fibers, and a multipurpose evanescent mode-coupling-based device.

  17. Materials 88: Materials and Engineering Design Held in London, England, on 9-13 May 1988

    DTIC Science & Technology

    1988-01-01

    Journal Jan /Feb 1987. the solution in producing graduates as "materials engineers" who will possess the dual attitudes of (9) C. Edeleanu, 29th SAMPE...which we need in a world of ever-increasing complexity and speed. (12) W.J. Plumbridge, Metals and Materials, Jan . 1988, 4, 1, 31. 1.7 Diition of function...Krajcinovic 1984, Lemaitre and Chaboche load carrying capacity in solids has long 1985, Bazant 1986, Murakami 1987, been recognized, as found in

  18. Integration in Education: The Way Forward. 1981 Education Act Conference Report (London, England, July 6, 1985).

    ERIC Educational Resources Information Center

    Orton, Christine

    The report presents major presentations given at a 1-day conference on integration of the handicapped in British schools attended by parents, teachers, social workers, psychologists, and education officers. In the first presentation, M. Vaughan presents philosophical and practical arguments which support eliminating the segregation of children…

  19. Direct broadcasting by satellite in Europe; Proceedings of the Symposium, London, England, January 13, 1982

    NASA Astrophysics Data System (ADS)

    1982-04-01

    The system characteristics of direct broadcasting are discussed, as are the costs and economics of broadcast satellite systems. Attention is also given to other services that may be associated with direct broadcasting, to L-SAT direct broadcast applications, and to the effects of impairments. Other topics discussed are reception problems and options, the ground station market, and the business opportunities presented by direct broadcasting.

  20. Integration--Living with ERA. Report of the CSIE Day Conference (London, England, November 8, 1991).

    ERIC Educational Resources Information Center

    Centre for Studies on Integration in Education, London (England).

    This report summarizes a conference which addressed the 1988 British Education Reform Act (ERA). Two of the major planks in ERA, the National Curriculum and Local Management of Schools (LMS), were discussed in detail by speakers and delegates with a view to developing integration and building inclusive schools. Summaries are provided of the talks…

  1. Integration in Education: The Way Forward. 1981 Education Act Conference Report (London, England, July 6, 1985).

    ERIC Educational Resources Information Center

    Orton, Christine

    The report presents major presentations given at a 1-day conference on integration of the handicapped in British schools attended by parents, teachers, social workers, psychologists, and education officers. In the first presentation, M. Vaughan presents philosophical and practical arguments which support eliminating the segregation of children…

  2. Royal Society, Discussion on Rotation in the Solar System, London, England, March 8, 9, 1984, Proceedings

    NASA Astrophysics Data System (ADS)

    Hide, R.

    1984-11-01

    The classical mechanics of rotation (R) in the present solar system and during its evolution is examined in theoretical studies and reviews of observational data. Topics discussed include R in the early solar system, R/magnetic-field interactions, the R of the sun, long-term changes in the R of the earth, tidal friction in the earth-moon system, the R of the atmospheres of the earth and planets, R and internal structures of the major planets and their inner satellites, the R of the Uranian system, the R of Hyperion, asteroid R rates, R of cometary nuclei, and the R of the earth inner core. Graphs, diagrams, tables, and photographs are provided.

  3. Integration--Living with ERA. Report of the CSIE Day Conference (London, England, November 8, 1991).

    ERIC Educational Resources Information Center

    Centre for Studies on Integration in Education, London (England).

    This report summarizes a conference which addressed the 1988 British Education Reform Act (ERA). Two of the major planks in ERA, the National Curriculum and Local Management of Schools (LMS), were discussed in detail by speakers and delegates with a view to developing integration and building inclusive schools. Summaries are provided of the talks…

  4. Royal Society, Discussion on New Coal Chemistry, London, England, May 21, 22, 1980, Proceedings

    NASA Astrophysics Data System (ADS)

    1981-03-01

    A discussion of new coal chemistry is presented. The chemical and physical structure of coal is examined in the first section, including structural studies of coal extracts, metal and metal complexes in coal and coal microporosity. The second section presents new advances in applied coal technology. The development of liquid fuels and chemicals from coal is given especial emphasis, with papers on the Sasol Synthol process, the Shell-Koppers gasification process, liquefaction and gasification in Germany, the Solvent Refined Coal process, the Exxon Donor Solvent liquefaction process and the Mobil Methanol-to-Gasoline process. Finally, some developments that will be part of the future of coal chemistry in the year 2000 are examined in the third section, including coal-based chemical complexes and the use of coal as an alternative source to oil for chemical feedstocks.

  5. Military microwaves '84; Proceedings of the Conference, London, England, October 24-26, 1984

    NASA Astrophysics Data System (ADS)

    The present conference on microwave frequency electronic warfare and military sensor equipment developments consider radar warning receivers, optical frequency spread spectrum systems, mobile digital communications troposcatter effects, wideband bulk encryption, long range air defense radars (such as the AR320, W-2000 and Martello), multistatic radars, and multimode airborne and interceptor radars. IR system and subsystem component topics encompass thermal imaging and active IR countermeasures, class 1 modules, and diamond coatings, while additional radar-related topics include radar clutter in airborne maritime reconnaissance systems, microstrip antennas with dual polarization capability, the synthesis of shaped beam antenna patterns, planar phased arrays, radar signal processing, radar cross section measurement techniques, and radar imaging and pattern analysis. Attention is also given to optical control and signal processing, mm-wave control technology and EW systems, W-band operations, planar mm-wave arrays, mm-wave monolithic solid state components, mm-wave sensor technology, GaAs monolithic ICs, and dielectric resonator and wideband tunable oscillators.

  6. Military microwaves '80; Proceedings of the Second Conference, London, England, October 22-24, 1980

    NASA Astrophysics Data System (ADS)

    Topics related to communications are discussed, taking into account recent developments in military telemetry, a tactical radio relay for the 80s, selectivity predictions for troposcatter links, microwave communications to remotely piloted vehicles, design aspects for ESM systems, improved angular discrimination for digital ESM systems, suspended substrate stripline filters and multiplexers, and wide-open and scanning ESM systems. Active electronic counter measures are considered along with instrumentation and radar, mm-wave circuit technology, air defense radars, solid state transmitters, radar test equipment, radar, satellite systems and technology, transmit-receive devices for radars, polarization control, and guided weapons. Attention is also given to microwave tubes, radomes, aspects of receiver technology, special antennas, and mm-wave targets, clutter and propagation.

  7. Scales of Hydrogen-Bonding Workshop Held in London, England on 1-3 July 1987

    DTIC Science & Technology

    1987-07-03

    UNDERSTANDING OF THE HYDROGEN-BOND INTERACTION Pierre-Charles Maria and Jean-Francois Gal Laboratoire de Chimie Physique Organique , Universite de Nice - Parc...Faculte des Sciences 2 Rue de Ia Houssiniere 44072 Nantes cedex 03 FRANCE Dr Pierre-Charles Maria Laboratorie de Chimie Physique Organic Dr Jean

  8. Planetary nebulae; Proceedings of the Symposium, University College, London, England, August 9-13, 1982

    NASA Astrophysics Data System (ADS)

    Flower, D. R.

    Reviews of recent observational and theoretical studies of planetary nebulae (PN) are presented. The areas covered include observations of PN, physical processes in PN, chemical abundances in PN, the origin of PN, central stars of PN, and PN in a galactic and extragalactic context. Numerous individual investigations are reported in abstract form, and a complete index of the galactic and extragalactic objects, galaxies, Seyfert galaxies, and related objects mentioned in the reviews and abstracts or shown in the figures and diagrams is provided. Important points from the Symposium discussion are summarized for each contribution. For individual items see A83-49127 to A83-49159

  9. International Conference on Future Energy Concepts, 3rd, London, England, January 27-30, 1981, Proceedings

    NASA Astrophysics Data System (ADS)

    Electric cars are considered along with questions regarding solar energy as alternative or complementary energy concept, aspects of high temperature heat storage, wind turbine response and system integration, the development of the coal fired combined cycle and gas turbine cycle for power generation, the performance characteristics of a variable speed heat pump, and the economics of satellite solar power system operation. Attention is also given to the generation and transmission of electricity from wave energy schemes, the effect of building construction on the value of solar radiation to reduce heat needs, the performance optimization of photovoltaic converters using a microprocessor, power transmission from offshore wind generation systems, and the properties of the polyol fuel cell. Other subjects explored are related to the performance of a Wells turbine for use in a wave energy system, the combustion of low-grade fuels in a fluidized bed, coal gasification for combined cycle power generation, the cost of power recovery from waste heat, and energy from biomass.

  10. Applications of infrared technology; Proceedings of the Meeting, London, England, June 9, 10, 1988

    NASA Astrophysics Data System (ADS)

    Williams, T. L.

    1988-01-01

    Recent developments in thermal imaging and other infrared systems relating to military, industrial, medical, and scientific applications are reviewed. Papers are presented on a new thermal imager using a linear pyroelectric detector array; multichannel near infrared spectroradiometer; technological constraints on the use of thermal imagery for remote sensing; and infrared optical system of the improved stratospheric and mesospheric sounder. Other topics discussed include infrared thermography development for composite material evaluation; infrared process linescanner, and optical infrared starting radiometer.

  11. Wittgenstein, medicine and neuropsychiatry.

    PubMed

    Teive, Hélio A G; Silva, Guilherme Ghizoni; Munhoz, Renato P

    2011-08-01

    A historical review is presented of the link between Ludwig Wittgenstein, considered the most important philosopher of the 20th century, and medicine, particularly neurology and psychiatry. Wittgenstein worked as a porter at Guy's Hospital in London, and then as a technician at the Royal Victoria Infirmary in Newcastle. He wrote about his important insights into language, and neuroscience. It has been suggested that he had Asperger syndrome and a possible movement disorder (mannerisms).

  12. Lower New England, USA

    NASA Image and Video Library

    1973-06-22

    SL2-103-967 (22 June 1973) --- This view of lower New England, (41.5N, 72.0W) shows a rare cloud-free area stretching from northern Long Island across the states of Connecticut, Rhode Island and Massachusetts. The total area covered by this photo is more than 25,000 square miles and includes all of Rhode Island, most of Massachusetts and Connecticut, part of New York and the coastal waters of the Atlantic Ocean. Cape Cod, Boston and the offshore islands are distinctive features. Photo credit: NASA

  13. Earthquakes in New England

    USGS Publications Warehouse

    Fratto, E. S.; Ebel, J.E.; Kadinsky-Cade, K.

    1990-01-01

    New England has a long history of earthquakes. Some of the first explorers were startled when they experienced strong shaking and rumbling of the earth below their feet. they soon learned from the Indians that this was not an uncommon occurrence in the New World. the Plymouth Pilgrims felt their first earthquake in 1638. that first shock rattled dishes, doors, and buildings. The shaking so frightened those working in the fields that they threw down their tools and ran panic-stricken through the countryside. 

  14. Military sports and rehabilitation medicine.

    PubMed

    Dharm-Datta, S; Nicol, E

    2007-06-01

    This article summarises the presentations at the Sports Medicine and Rehabilitation Study Day held by the Haywood Club at The Medical Society of London on 21 September 2006. The event was attended by over 100 serving and retired DMS personnel and included talks on a diverse range of subjects from the newly established speciality of Sports and Exercise medicine, the role of physiotherapy, exercise therapy and podiatry, core stability, tendon disorders, anterior knee pain, and the management of chronic pain.

  15. The 1790 desecration of John Milton's bones, hair and teeth in a London church.

    PubMed

    Christen, Arden G; Christen, Joan A

    2012-01-01

    John Milton (1608-1674), England's epic poet and a champion of civil and religious liberties, has gone down in history as one of the world's greatest philosophers, scholars and authors. Although by age 44 he had become totally blind, he steadfastly continued to write and eventually composed his poetic masterpieces, "Paradise Lost" and "Paradise Regained." In 1674, John Milton died of kidney failure at age 66. He was buried in the "chancel under the clerk's desk" in the parish church of St. Giles-without-Cripplegate (London). Exhumed 116 years after his burial, Milton's corpse received "obscene and scandalous treatment", as portions of his bones, hair and teeth were removed, examined and indiscriminately dispersed to others.

  16. School Choice in London and Paris – A Comparison of Middle-class Strategies

    PubMed Central

    Benson, Michaela; Bridge, Gary; Wilson, Deborah

    2015-01-01

    Education is one major public service in which quasi-markets and other choice-based mechanisms are now established methods of delivery. The types of school people choose, and the extent to which their choices are realized, have a fundamental impact on the outcomes of any mechanism of school choice. In this article, we provide a comparative analysis of the school choice strategies of middle-class families in London and Paris. We draw on approximately 200 in-depth interviews carried out across the two cities. This enables us to investigate the extent to which middle-class school choice strategies transcend the institutional context provided by both the local (state and private) schools market and national education policy in England and France. We discuss these findings in the context of current school choice policy and consider their implications for future policy design. PMID:25750467

  17. School Choice in London and Paris - A Comparison of Middle-class Strategies.

    PubMed

    Benson, Michaela; Bridge, Gary; Wilson, Deborah

    2015-01-01

    Education is one major public service in which quasi-markets and other choice-based mechanisms are now established methods of delivery. The types of school people choose, and the extent to which their choices are realized, have a fundamental impact on the outcomes of any mechanism of school choice. In this article, we provide a comparative analysis of the school choice strategies of middle-class families in London and Paris. We draw on approximately 200 in-depth interviews carried out across the two cities. This enables us to investigate the extent to which middle-class school choice strategies transcend the institutional context provided by both the local (state and private) schools market and national education policy in England and France. We discuss these findings in the context of current school choice policy and consider their implications for future policy design.

  18. Assessing the sources and bioaccessibility of Lead in Soils from London

    NASA Astrophysics Data System (ADS)

    Cave, Mark R.; Wragg, Joanna; Chenery, Simon

    2013-04-01

    The lead content of soil is important since it is toxic to humans and particularly because children tend to more readily absorb lead than do adults: children absorb up to 40% into the bloodstream from ingested or inhaled lead, versus 5-15% in adults. Studies have shown that relatively low concentrations of lead in blood can lead to significant decrease in IQ of children (e.g. Jakubowski, 2011) leading to neuropathy and hypertension in adults. The British Geological Survey has recently completed a systematic high-density geochemical soil survey of the Greater London Area (GLA) in which over 6000 surface soil samples were collected and analysed for 50 elements. The Pb content of the soils range from 11 mg/kg to greater than 10000 mg/kg with mean and median values of 301 and 185 mg/kg, respectively. The ingestion bioaccessible fraction of Pb was measured using an in-vitro bioaccessibility test showing that 68% of the total Pb in London soils is bioaccessible. Measurement of Pb isotopic ratios in selected soils matched with those found in London air particulates and, to a lesser extent, with petrol lead. Self modelling mixture resolution of the 50 element geochemical data set was used to identify geochemically distinct components in the data with Pb being associated with 11 of the components which were of both natural and anthropogenic origin. Relationships between the soil components, the bioaccessible fraction and the Pb isotope ratios provided an indication of the sources of mobile lead in the London soils. References JAKUBOWSKI, M. 2011. Low-level environmental lead exposure and intellectual impairment in children - the current concepts of risk assessment. International Journal of Occupational Medicine and Environmental Health, Vol. 24, 1-7. APPLETON, J D, CAVE, M R, and WRAGG, J. 2012. Modelling lead bioaccessibility in urban topsoils based on data from Glasgow, London, Northampton and Swansea, UK. Environmental Pollution, Vol. 171, 265-272.

  19. Presence of Legionella in London's water supplies.

    PubMed

    Colbourne, J S; Trew, R M

    1986-09-01

    Legionella occurs frequently (52 to 54%) in domestic water and cooling water inside commercial, industrial and health care buildings, and these types of water systems are now regarded as a normal habitat for Legionella. The factors that predispose a particular water system to colonization by these organisms are ill-defined, although it is fairly certain that biological and physicochemical environmental factors play an important role in allowing Legionella to multiply in the circulating water. It has been postulated that the organism may gain access to water systems inside buildings by one of three routes: contact with air through open points such as uncovered storage tanks or vents, ingress of soil or surface water during construction or repair, or intermittent seeding with organisms present in low numbers in the public water supply. Three studies in the USA have found Legionella in 0.4 to 8.8% of drinking-water samples, but these were not representative of the public supply network as a whole. The aim of this study was to determine, over a period of 1 year, the frequency of Legionella in London's drinking water--from the treatment plant through to the consumer's tap. To date, Legionella has not been isolated from raw river water entering London's treatment works or from treated water entering the distribution network. Sixty-two monitoring taps in buildings located in 21 supply areas have been sampled twice for Legionella; only 2 (2.4%) have proved positive during the autumn and winter of 1985/86. The strain found was L. pneumophila serotype 1, subgroup Olda, and the numbers ranged from 10(2) to 10(4)/l. Although the survey is incomplete, it is already clear that the public water supplies in London are not a source of strains of Legionella associated with disease.

  20. Parasuicide in central London 1984-1988.

    PubMed Central

    Fuller, G N; Rea, A J; Payne, J F; Lant, A F

    1989-01-01

    Experience of a central London unit dedicated to the care of patients following parasuicide between 1984 and 1988 is reviewed. There were 1160 admissions, which accounted for 11% of all acute adult medical admissions. The female to male ratio was 1.3, with a peak rate for females below 25 years and for males between 20 and 35. Unemployment was found to be a risk factor for parasuicide in men. Benzodiazepines were the most frequently used drug in parasuicide (35%), followed by paracetamol (13%) and aspirin (9%). PMID:2574238

  1. "Circumcision", culture, and health-care provision in Tower Hamlets, London.

    PubMed

    Cameron, J; Anderson, K R

    1998-11-01

    Tower Hamlets (London, England) has a sizable Somali community whose members maintain close links with their families in Africa. The London Black Women's Health Action Project (LBWAP) was established in Tower Hamlets, in 1982, to address the health needs of Somali women, especially those related to female circumcision. The major focus in the UK has been on protecting girls from undergoing this practice, with little attention to the needs of women who have already been circumcised. Of 200 Somali women interviewed by LBWAP, 61% had been infibulated in their native country by people with no medical training. Among the long-term health consequences were dysmenorrhea, recurrent urinary problems, urethral damage, and painful intercourse. Although deinfibulation can be obtained, both health care professionals and circumcised women tend to be unaware of this service. LBWAP has proposed a study to assess the expressed health care needs of circumcised Somali women and match these desires with actual health care provision. To raise the consciousness of British health care professionals, parallels between female circumcision and the indiscriminate, unnecessary use of episiotomy are being made.

  2. Postcode Lotteries in Public Health - The NHS Health Checks Programme in North West London

    PubMed Central

    2011-01-01

    Background Postcode lotteries in health refer to differences in health care between different geographic areas. These have been previously associated with clinical services. However there has been little documentation of postcode lotteries relating to preventative health care services. This paper describes a postcode lottery effect in relation to the NHS Health Checks Programme (a national cardiovascular screening programme in England) in eight PCTs in the North West sector of London. Methods A descriptive cross-sectional analysis of the Health Checks Programme was carried out in eight PCTs in North West London using a structured data-collecting instrument. Results The analysis found variation in the implementation of the national Health Checks Programme in terms of: the screening approach taken; the allocated budget (which varied from £69,000 to £1.4 million per 100,000 eligible population); payment rates made to providers of Health Checks; tools used to identify and measure risk of cardiovascular disease and diabetes; monitoring and evaluation; and preventative services available following the health check. Conclusions This study identifies a postcode lottery effect related to a national public health programme. Although it is important to allow enough flexibility in the design of the Health Checks Programme so that it fits in with local factors, aspects of the programme may benefit from greater standardisation or stronger national guidance. PMID:21955810

  3. Attitudes towards second hand smoke amongst a highly exposed workforce: survey of London casino workers.

    PubMed

    Pilkington, P A; Gray, S; Gilmore, A B; Daykin, N

    2006-06-01

    To examine knowledge, attitudes and experiences of London casino workers regarding exposure to second hand smoke (SHS) in the workplace. Postal survey of 1568 London casino workers in 25 casinos who were members of the TGWU or GMB Trade Unions. Of the workers, 559 responded to the survey (36% response), 22% of whom were current smokers. Of the respondents, 71% report being nearly always exposed to heavy levels of SHS at work, and most (65%) want all working areas in their casino to be smoke-free. The majority (78%) are bothered by SHS at work, while 91% have wanted to move away from where they are working because of it. Fifty-seven per cent believe their health has suffered as a result of SHS. Of the workers who smoke at work, 59% believe that they would try to quit smoking if no one was allowed to smoke in the casino. The majority of responders are bothered by SHS, and many are concerned about the health impacts. Most want all working areas in their casino to be smoke-free. Despite difficulties in generalizing from this limited sample, these findings add weight to the argument that the legislation on smoking in public places in England should encompass all workplaces, without exemption.

  4. Drakelands Mine, England

    NASA Image and Video Library

    2015-08-21

    The Drakelands Mine (previously known as the Hemerdon Mine) is a historic tungsten and tin mine located northeast of Plymouth, England. Tin and tungsten deposits were discovered in 1867, and the mine operated until 1944. Last year work started to re-open the mine, as it hosts the fourth-largest tungsten and tin deposits in the world. Tungsten has innumerable uses due to its incredible density and high melting temperature. Yet more than 80% of world supply is controlled by China, who has imposed restriction on export of the metal. The image covers an area of 17 by 18.9 km, was acquired June 5, 2013, and is located at 50.4 degrees north, 4 degrees west. http://photojournal.jpl.nasa.gov/catalog/PIA19757

  5. Experiential Approaches to the Global City: London as Social Laboratory

    ERIC Educational Resources Information Center

    Gristwood, Anthony; Woolf, Michael

    2011-01-01

    London is the paramount example of a city that is not bounded by its geography and cannot be grasped in isolation. The U.K.'s national capital and the prime focus for business, finance and creative industries, London also transcends the U.K.'s borders as a hub of the world economy. This paper argues that London, a city riddled by the socioeconomic…

  6. Digital London: Creating a Searchable Web of Interlinked Sources on Eighteenth Century London

    ERIC Educational Resources Information Center

    Shoemaker, Robert

    2005-01-01

    Purpose: To outline the conceptual and technical difficulties encountered, as well as the opportunities created, when developing an interlinked collection of web-based digitised primary sources on eighteenth century London. Design/methodology/approach: As a pilot study for a larger project, a variety of primary sources, including the "Old…

  7. Digital London: Creating a Searchable Web of Interlinked Sources on Eighteenth Century London

    ERIC Educational Resources Information Center

    Shoemaker, Robert

    2005-01-01

    Purpose: To outline the conceptual and technical difficulties encountered, as well as the opportunities created, when developing an interlinked collection of web-based digitised primary sources on eighteenth century London. Design/methodology/approach: As a pilot study for a larger project, a variety of primary sources, including the "Old…

  8. Royden McIntosh Muir and His Anesthetic Links Between South Africa, London, and the United States.

    PubMed

    Gordon, Peter Crichton

    2016-07-01

    New Zealand born, Dr. Royden McIntosh Muir, MBChB(Edin), DA(RCS&RCP), emigrated to Cape Town in 1921 having specialized in anesthesia in London after World War 1 and became one of South Africa's earliest and leading anesthesiologists. He was appointed honorary anesthetist and clinical teacher by the University of Cape Town at South Africa's first medical school in 1922, and lecturer in 1927. Aware of Cape Town's isolation at the southern tip of Africa, he undertook extensive tours studying anesthetic practice at major hospitals in London, the United States and Canada in 1933 and 1938. He became a lifelong friend of Ralph Waters in Madison, who coached him in the use of cyclopropane, and he subsequently introduced cyclopropane into England and South Africa. In the United States, he met Richard von Foregger, founder of the New York based Foregger Company, from whom he later commissioned a purpose-built anesthetic machine marketed by Foregger as "The Muir Midget." Muir was a founder member of the South African Society of Anaesthetists in 1943 and was elected as its second president the following year. Based on what he had seen in academic hospitals in the United States and England, he fought until his retirement for the improved recognition of the specialty in South Africa and the establishment of adequately staffed departments of anesthesia at teaching hospitals in that country.

  9. Healthier central England or North–South divide? Analysis of national survey data on smoking and high-risk drinking

    PubMed Central

    Beard, Emma; Brown, Jamie; West, Robert; Angus, Colin; Kaner, Eileen; Michie, Susan

    2017-01-01

    Objectives This paper compares patterns of smoking and high-risk alcohol use across regions in England, and assesses the impact on these of adjusting for sociodemographic characteristics. Design Population survey of 53 922 adults in England aged 16+ taking part in the Alcohol and Smoking Toolkit Studies. Measures Participants answered questions regarding their socioeconomic status (SES), gender, age, ethnicity, Government Office Region, smoking status and completed the Alcohol Use Disorders Identification Test (AUDIT). High-risk drinkers were defined as those with a score of 8 or more (7 or more for women) on the AUDIT. Results In unadjusted analyses, relative to the South West, those in the North of England were more likely to smoke, while those from the East of England, South East and London were less likely. After adjustment for sociodemographics, smoking prevalence was no higher in North East (RR 0.97, p>0.05), North West (RR 0.98, p>0.05) or Yorkshire and the Humber (RR 1.03, p>0.05) but was less common in the East and West Midlands (RR 0.86, p<0.001; RR 0.91, p<0.05), East of England (RR 0.86, p<0.001), South East (RR 0.92, p<0.05) and London (RR 0.85, p<0.001). High-risk drinking was more common in the North but was less common in the Midlands, London and East of England. Adjustment for sociodemographics had little effect. There was a higher prevalence in the North East (RR 1.67, p<0.001), North West (RR 1.42, p<0.001) and Yorkshire and the Humber (RR 1.35, p<0.001); lower prevalence in the East Midlands (RR 0.69, p<0.001), West Midlands (RR 0.77, p<0.001), East of England (RR 0.72, p<0.001) and London (RR 0.71, p<0.001); and a similar prevalence in the South East (RR 1.10, p>0.05) Conclusions In adjusted analyses, smoking and high-risk drinking appear less common in ‘central England’ than in the rest of the country. Regional differences in smoking, but not those in high-risk drinking, appear to be explained to some extent by sociodemographic

  10. The London low emission zone baseline study.

    PubMed

    Kelly, Frank; Armstrong, Ben; Atkinson, Richard; Anderson, H Ross; Barratt, Ben; Beevers, Sean; Cook, Derek; Green, Dave; Derwent, Dick; Mudway, Ian; Wilkinson, Paul

    2011-11-01

    On February 4, 2008, the world's largest low emission zone (LEZ) was established. At 2644 km2, the zone encompasses most of Greater London. It restricts the entry of the oldest and most polluting diesel vehicles, including heavy-goods vehicles (haulage trucks), buses and coaches, larger vans, and minibuses. It does not apply to cars or motorcycles. The LEZ scheme will introduce increasingly stringent Euro emissions standards over time. The creation of this zone presented a unique opportunity to estimate the effects of a stepwise reduction in vehicle emissions on air quality and health. Before undertaking such an investigation, robust baseline data were gathered on air quality and the oxidative activity and metal content of particulate matter (PM) from air pollution monitors located in Greater London. In addition, methods were developed for using databases of electronic primary-care records in order to evaluate the zone's health effects. Our study began in 2007, using information about the planned restrictions in an agreed-upon LEZ scenario and year-on-year changes in the vehicle fleet in models to predict air pollution concentrations in London for the years 2005, 2008, and 2010. Based on this detailed emissions and air pollution modeling, the areas in London were then identified that were expected to show the greatest changes in air pollution concentrations and population exposures after the implementation of the LEZ. Using these predictions, the best placement of a pollution monitoring network was determined and the feasibility of evaluating the health effects using electronic primary-care records was assessed. To measure baseline pollutant concentrations before the implementation of the LEZ, a comprehensive monitoring network was established close to major roadways and intersections. Output-difference plots from statistical modeling for 2010 indicated seven key areas likely to experience the greatest change in concentrations of nitrogen dioxide (NO2) (at least 3

  11. Effects of Centralizing Acute Stroke Services on Stroke Care Provision in Two Large Metropolitan Areas in England

    PubMed Central

    Morris, Stephen; Hoffman, Alex; Hunter, Rachael M.; Boaden, Ruth; McKevitt, Christopher; Perry, Catherine; Pursani, Nanik; Rudd, Anthony G.; Turner, Simon J.; Tyrrell, Pippa J.; Wolfe, Charles D.A.; Fulop, Naomi J.

    2015-01-01

    Background and Purpose— In 2010, Greater Manchester and London centralized acute stroke care into hyperacute units (Greater Manchester=3, London=8), with additional units providing ongoing specialist stroke care nearer patients’ homes. Greater Manchester patients presenting within 4 hours of symptom onset were eligible for hyperacute unit admission; all London patients were eligible. Research indicates that postcentralization, only London’s stroke mortality fell significantly more than elsewhere in England. This article attempts to explain this difference by analyzing how centralization affects provision of evidence-based clinical interventions. Methods— Controlled before and after analysis was conducted, using national audit data covering Greater Manchester, London, and a noncentralized urban comparator (38 623 adult stroke patients, April 2008 to December 2012). Likelihood of receiving all interventions measured reliably in pre- and postcentralization audits (brain scan; stroke unit admission; receiving antiplatelet; physiotherapist, nutrition, and swallow assessments) was calculated, adjusting for age, sex, stroke-type, consciousness, and whether stroke occurred in-hospital. Results— Postcentralization, likelihood of receiving interventions increased in all areas. London patients were overall significantly more likely to receive interventions, for example, brain scan within 3 hours: Greater Manchester=65.2% (95% confidence interval=64.3–66.2); London=72.1% (71.4–72.8); comparator=55.5% (54.8–56.3). Hyperacute units were significantly more likely to provide interventions, but fewer Greater Manchester patients were admitted to these (Greater Manchester=39%; London=93%). Differences resulted from contrasting hyperacute unit referral criteria and how reliably they were followed. Conclusions— Centralized systems admitting all stroke patients to hyperacute units, as in London, are significantly more likely to provide evidence-based clinical

  12. Healthcare planning for the Olympics in London: a qualitative evaluation.

    PubMed

    Black, Georgia; Kononovas, Kostas; Taylor, Jayne; Raine, Rosalind

    2014-01-01

    Mass gatherings, such as the Olympic and Paralympic Games, represent an enormous logistical challenge for the host city. Health service planners must deliver routine and emergency services and, in recent Games, health legacy initiatives, for the local and visiting population. However there is little evidence to support their planning decisions. We therefore evaluated the strategic health planning programme for the London 2012 Olympic and Paralympic Games to identify generalisable information for future Games. We thematically analysed data from stakeholder interviews and documents. The data were prospectively collected in three phases, before, during and after the Games. We identified five key themes: (1) Systemic Improvement for example in communications, (2) Effective relationships led to efficiencies and permanent gains, such as new relationships with the private sector (3) Difficult relationships led to inefficiencies, for instance, duplication in testing and exercising emergency scenarios, (4) Tendency to over-estimate demand for care, particularly emergency medicine, and (5) Difficulties establishing a health legacy due to its deprioritisation and lack of vision by the programme team. Enduring improvements which are sustained after the Games are possible, such as the establishment of new and productive partnerships. Relationships must be established early on to avoid duplication, delay and unnecessary expense. There should be greater critical evaluation of the likely demand for health services to reduce the wasting of resources. Finally, if a health legacy is planned, then clear definitions and commitment to its measurement is essential.

  13. A new surveillance system for undiagnosed serious infectious illness for the London 2012 Olympic and Paralympic Games.

    PubMed

    Heinsbroek, E; Said, B; Kirkbride, H

    2012-08-02

    A new surveillance system was developed to detect possible new or emerging infections presenting as undiagnosed serious infectious illness (USII) for use during the London 2012 Olympic and Paralympic Games. Designated clinicians in sentinel adult and paediatric intensive care units (ICU/ PICUs) reported USII using an online reporting tool or provided a weekly nil notification. Reported cases were investigated for epidemiological links. A pilot study was undertaken for six months between January and July 2011 to evaluate the feasibility and acceptability of the system. In this six-month period, 5 adults and 13 children were reported by six participating units (3 ICUs, 3 PICUs). Of these 18 patients, 12 were reported within four days after admission to an ICU/PICU. Nine patients were subsequently diagnosed and were thus excluded from the surveillance. Therefore, only nine cases of USII were reported. No clustering was identified.On the basis of the pilot study, we conclude that the system is able to detect cases of USII and is feasible and acceptable to users. USII surveillance has been extended to a total of 19 sentinel units in London and the south-east of England during the London 2012 Olympic and Paralympic Games.

  14. East London Experience with Enteric Fever 2007-2012

    PubMed Central

    Dave, Jayshree; Millar, Michael; Maxeiner, Horst; Freedman, Joanne; Meade, Rachel; Rosmarin, Caryn; Jordan, Matthew; Andrews, Nick; Holliman, Richard; Sefton, Armine

    2015-01-01

    Purpose The clinical presentation and epidemiology for patients with enteric fever at two hospitals in East London during 2007–2012 is described with the aim to identify preventive opportunities and to reduce the cost of treatment. Methods A retrospective analysis of case notes from patients admitted with enteric fever during 2007 to 2012 with a microbiologically confirmed diagnosis was undertaken. Details on clinical presentation, travel history, demographic data, laboratory parameters, treatment, patient outcome and vaccination status were collected. Results Clinical case notes were available for 98/129 (76%) patients including 69 Salmonella enterica serovar Typhi (S. Typhi) and 29 Salmonella enterica serovar Paratyphi (S. Paratyphi). Thirty-four patients (35%) were discharged from emergency medicine without a diagnosis of enteric fever and then readmitted after positive blood cultures. Seventy-one of the 98 patients (72%) were UK residents who had travelled abroad, 23 (23%) were foreign visitors/new entrants to the UK and four (4%) had not travelled abroad. Enteric fever was not considered in the initial differential diagnosis for 48/98 (49%) cases. The median length of hospital stay was 7 days (range 0–57 days). The total cost of bed days for managing enteric fever was £454,000 in the two hospitals (mean £75,666/year). Median time to clinical resolution was five days (range 1–20). Seven of 98 (7%) patients were readmitted with relapsed or continued infection. Six of the 71 (8%) patients had received typhoid vaccination, 34 (48%) patients had not received vaccination, and for 31 cases (44%) vaccination status was unknown. Conclusions Further interventions regarding education and vaccination of travellers and recognition of the condition by emergency medicine clinicians in travellers to South Asia is required. PMID:25790017

  15. Oral health and oral health behaviours of five-year-old children in the Charedi Orthodox Jewish Community in North London, UK.

    PubMed

    Klass, C; Mondkar, A; Wright, D

    2017-03-01

    To report on the oral health status and oral health behaviours of five-year-old Charedi Orthodox Jewish children attending schools in London, UK. Cross-sectional survey. Clinical examinations mirroring the 2015 National Dental Public Health Epidemiology Programme for England for five-year-olds and a parental questionnaire on oral health behaviours. 137 five-year-olds attending Charedi Orthodox Jewish schools in Hackney, North London. Prevalence dmft⟩0 (%) and severity (mean dmft) of dental caries. Of these children 58% had experienced dental caries (95%CI 50,67), the mean number of decayed, missing and filled teeth was 2.38 (95%CI 1.90,2.82) and 23% (95%CI 16,30) had caries affecting their incisors. Only 20% reported that their children had their teeth brushed twice a day and 16% of the children started having their teeth brushed between six months and one year of age. The oral health of five-year-old children in the Charedi Orthodox Jewish community is significantly worse than their counterparts across Hackney, London and England. The establishment of robust baseline data supports the local authority plan to develop targeted oral health improvement programmes tailored to address the health needs and cultural sensitivities of this community. Copyright© 2017 Dennis Barber Ltd.

  16. The First Sports Medicine Books in English.

    ERIC Educational Resources Information Center

    Ryan, Allan J.

    The modern history of sports medicine is chronicled in a discussion of the first writings in English on sports medicine. What may have been the first writing in English is a section on first aid in the ENCYCLOPEDIA OF SPORT, published in England in 1898. It describes injuries commonly sustained in angling, boxing, cricket, cycling, football,…

  17. 33 CFR 110.147 - New London Harbor, Conn.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... emergencies, vessels shall not anchor in New London Harbor or the approaches thereto outside the anchorages... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false New London Harbor, Conn. 110.147 Section 110.147 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY...

  18. Alternative Spaces of Learning in East London: Opportunities and Challenges

    ERIC Educational Resources Information Center

    Sneddon, Raymonde; Martin, Peter

    2012-01-01

    This article emerges from an ongoing exploration into how British minority ethnic communities in the London area create spaces in community-based programs to maintain or develop their languages and literacies. In London, more than one-third of the 850,000 school children speak a language other than English at home (Baker & Eversley, 2000).…

  19. RADIOLOGICAL SURVEY AT THE NEW LONDON HARBOR FACILITIES

    EPA Science Inventory

    A radiological survey done to assess levels of environmental radioactivity in and around navy harbor facilities located on the Thames River near New London, Connecticut. These facilities include the New London Submarine Base at Groton, the Electric Boat Company at Groton, Sound ...

  20. RADIOLOGICAL SURVEY AT THE NEW LONDON HARBOR FACILITIES

    EPA Science Inventory

    A radiological survey done to assess levels of environmental radioactivity in and around navy harbor facilities located on the Thames River near New London, Connecticut. These facilities include the New London Submarine Base at Groton, the Electric Boat Company at Groton, Sound ...

  1. Alternative Spaces of Learning in East London: Opportunities and Challenges

    ERIC Educational Resources Information Center

    Sneddon, Raymonde; Martin, Peter

    2012-01-01

    This article emerges from an ongoing exploration into how British minority ethnic communities in the London area create spaces in community-based programs to maintain or develop their languages and literacies. In London, more than one-third of the 850,000 school children speak a language other than English at home (Baker & Eversley, 2000).…

  2. London air quality: a real world experiment in progress.

    PubMed

    Kelly, Frank J; Kelly, Julia

    2009-07-01

    London currently has the highest nitrogen dioxide (NO2) concentration recorded for any European city and for particulate matter (PM) it has some of the worst hot spots. Therefore overall, for these two pollutants, London is the worst in the UK and amongst the worst in Europe. Exposure to elevated concentrations of air pollutants such as PM and NO2 has well-established heath effects and most countries now have strict guidelines for air quality. London's air quality problems are driven largely by traffic. This, along with the high density of people in an urban area results in air quality guidelines being exceeded on a regular basis and large numbers of people being affected. In an attempt to combat London's air quality problems the Mayor of London introduced a series of measures to decrease traffic emissions. These included both a restriction on the number of vehicles entering central London each day--the Congestions Charging Scheme (CCS), and the discouragement of the most polluting heavy goods vehicles from entering--the London Low Emission Zone (LEZ). Together, it is hoped that these measures will lead to an improvement in air quality and provide a direct health benefit to Londoners. Research underway is charting the progress of this real world experiment.

  3. Practicing Reflexivity in the Study of Italian Migrants in London

    ERIC Educational Resources Information Center

    Seganti, Francesca Romana

    2010-01-01

    This article discusses the centrality of reflexivity in qualitative research through examples from my study on the role new media play in the lives of Italians in London. My hypothesis was that Italians were "in transit" in London and they were using new media to build "temporary" communities. I conducted in-depth interviews…

  4. Education in a Global City: Essays from London

    ERIC Educational Resources Information Center

    Brighouse, Tim, Ed.; Fullick, Leisha, Ed.

    2007-01-01

    This collection of essays by academic and policy experts brings together a wide range of data to offer a clear picture of London's changing education scene. Its mapping of new and developing strategies for successful urban education will be useful to educators and policymakers not only in London but also in other cities operating in similar…

  5. Education in a Global City: Essays from London

    ERIC Educational Resources Information Center

    Brighouse, Tim, Ed.; Fullick, Leisha, Ed.

    2007-01-01

    This collection of essays by academic and policy experts brings together a wide range of data to offer a clear picture of London's changing education scene. Its mapping of new and developing strategies for successful urban education will be useful to educators and policymakers not only in London but also in other cities operating in similar…

  6. Changing the Subject: English in London, 1945-1967

    ERIC Educational Resources Information Center

    Yandell, John

    2014-01-01

    Two recent books, "English Teachers in a Postwar Democracy: Emerging Choice in London Schools, 1945-1965" and "The London Association for the Teaching of English, 1947-67: A History," explore an important period in the development of English as a school subject and in the remaking of the professional identity of English…

  7. Changing the Subject: English in London, 1945-1967

    ERIC Educational Resources Information Center

    Yandell, John

    2014-01-01

    Two recent books, "English Teachers in a Postwar Democracy: Emerging Choice in London Schools, 1945-1965" and "The London Association for the Teaching of English, 1947-67: A History," explore an important period in the development of English as a school subject and in the remaking of the professional identity of English…

  8. London in Space and Time: Peter Ackroyd and Will Self

    ERIC Educational Resources Information Center

    Green, Andrew

    2013-01-01

    This paper explores the treatment of London by two authors who are profoundly influenced by the concept of the power of place and the nature of urban space. The works of Peter Ackroyd, whose writings embody, according to Onega (1997, p. 208) "[a] yearning for mythical closure" where London is "a mystic centre of…

  9. A review of research on chaplains and community-based clergy in the Journal of the American Medical Association, Lancet, and the New England Journal of Medicine: 1998-2000.

    PubMed

    Weaver, Andrew J; Flannelly, Kevin J; Koenig, Harold G; Smith, Fred Douglas

    2004-01-01

    Based on the content analysis of quantitative research appearing in three medical journals, the authors conclude that, despite the shared ideal of providing spiritual care to patients on the part of physicians and chaplains, there is little attention given in these journals demonstrating and promoting this shared perspective. Suggestions for future research that would focus on this common medicine/religion interface and concern are noted.

  10. Age estimation in Portuguese population: The application of the London atlas of tooth development and eruption.

    PubMed

    Pavlović, Strahinja; Palmela Pereira, Cristiana; Vargas de Sousa Santos, Rui Filipe

    2017-03-01

    Chronological age estimation from the dental parameters is becoming increasingly important. The London atlas of tooth development is the most recent developed method and represents a modification of the previous older methods. The aim of this study was to evaluate the accuracy of the London atlas for the dental age estimation in the Portuguese population. The study sample included 736 radiographic images (498 females and 238 males) of Portuguese origin, patients of Dental Clinic of Superior Institute of Health Sciences Egas Moniz and Dental Medicine Faculty, University of Lisbon. The age range of the individuals was between 3 and 24 years. Estimated age was compared with the chronological age using the paired t-test. The results showed that there was no statistically significant difference between left and right side of the jaw (p>0.05). Both sides showed an average overestimation of age by one month approximately. Moreover, the significant difference between chronological and estimated age was not observed in the females. However, the significant difference was observed in a sample coming from males (right: p=0.008; left: p=0.003). Our results showed that the London atlas can be potentially used as a tool for age estimation. However, the difference between sexes clearly suggests that separate charts should be made for each sex. Further studies, which will have as a final goal the development of a new method for age estimation using dental parameters, are needed.

  11. Honor, brotherhood, and the corporate ethos of London's Barber-Surgeons' Company, 1570-1640.

    PubMed

    Chamberland, Celeste

    2009-07-01

    As the largest and most civically active body of medical practitioners in the late Tudor and early Stuart period, surgeons played a vital role in London's urban landscape, but remained precariously vulnerable to abasement due to the regular contact with death and disease necessitated by their work. Based on an analysis of guild records, printed surgical manuals, and conduct literature, this study explores the emergent corporate ethos of London's Barber-Surgeons' Company and addresses the identity formation of surgeons in the late-sixteenth and early-seventeenth centuries. By implementing codes of conduct and uniform standards of practice, punishing transgressions of propriety, and developing legislation to limit the activities of unlicensed and foreign practitioners, Company officers ardently sought social and occupational legitimacy within a milieu characterized by a tremendous emphasis on status and hierarchy. Rooted in methodology drawn from the social history of medicine and cultural anthropology, this study argues that in response to the persistent stigma associated with their work and London's increasingly prevalent culture of credit, surgeons, like other artisanal groups, sought to enhance their social legitimacy and occupational respectability by manipulating contemporary social rituals, reinforcing the honorable associations of their work, and preserving the veneer of brotherhood and camaraderie.

  12. London Trusts proud to describe their work.

    PubMed

    Baillie, Jonathan

    2015-11-01

    'Waste not, Want not' was the title of a recent IHEEM seminar which examined some of the key issues for those responsible for dealing with healthcare waste--from regulatory compliance and correct segregation of waste streams, to the opportunities for more on-site processing. HEJ editor, Jonathan Baillie, reports on the joint presentations given by key environmental and sustainability personnel at two of London's largest NHS Trusts, and their private sector waste management partners. These discussed some of the key initiatives that each Trust and its 'partner' have taken to not only significantly reduce the amount of waste generated on their estate, but also to dispose of it in an environmentally responsible way. These initiatives, the speakers explained, were all part of their organisations' journey on the road to achieving 'Deep Green', a 'nirvana'-like state where their activities have a zero net impact on the environment.

  13. The prevalence of comorbidities among people living with HIV in Brent: a diverse London Borough

    PubMed Central

    Lorenc, Ava; Lorigan, James; Jowata, Mohamade; Brook, Gary; Banarsee, Ricky

    2014-01-01

    Background HIV has changed from a rapidly deteriorating illness to a complex chronic disease, with increasing incidences of comorbidity, including cancer, and liver, lung and cardiovascular diseases. North West London has 6719 individuals living with the human immunodeficiency virus (HIV), 873 of whom reside in the London Borough of Brent. Traditionally, commissioning services have focused on HIV therapy alone without considering how comorbidity affects treatment outcome and total service costs. Setting The setting for the study was NHS Brent Primary Care Trust, London UK. Question What associated comorbidities are present in people in Brent (London, UK) living with HIV, and how common are they? Methods A point-prevalence audit of retrospective data was conducted on all HIV-positive patients in Brent (financial year 2011/12). Data were collected from genito-urinary medicine (GUM) services, community services and general practitioners (GPs) on HIV diagnosis, patient demographics and past/current comorbidities: hepatitis B and C, cardiovascular disease, diabetes and mental health disorders. Results This study identified that 29% of people living with HIV/AIDS (PLWHA) in Brent have at least one comorbidity. The most common was hepatitis, followed by mental health disorders and cardiovascular disease (CVD). Comorbidity was more likely in older male patients (in particular CVD and diabetes) and White patients (except for diabetes which was more common in Asian groups). Discussion/Conclusion Many PLWHA in Brent suffer from a number of other conditions, which appear largely independent of HIV. Findings confirm the need to treat HIV as a long-term condition, including patient education, empowerment and encouraging self-management. The multi-morbidity of many PLWHA suggests a role for both primary care and collaborative, holistic, patient-centred and individualised healthcare. Service providers and commissioners need to consider comorbidities in their treatment of and

  14. Constraining the history of vertical surface motions in SE England.

    NASA Astrophysics Data System (ADS)

    Smith, Philip; England, Richard; Zalasiewicz, Jan

    2015-04-01

    Constraining the history of vertical surface motions in SE England. While there is considerable focus on the effects of rising sea level what is often not considered are ongoing long term changes in surface topography driven by regional tectonics. The London basin is an area at risk from global sea level rise which has a significant long term history of vertical surface motions. Outcrop and borehole sections taken from the onshore and offshore Cenozoic geological record of the UK are used to plot these regional tectonic vertical motions through time. The Cenozoic geological formations useful to the research are dominantly shallow marine sediments and the successions are thickest in the axial regions of the London and Hampshire basins found in the South East of England. Each successive geological formation through time records a component of the tectonic uplift/subsidence history that spans from the end of the Cretaceous, 65Ma through to the present day. Once this history is better understood it can be used to make predictions of the possible vertical tectonic motion in the future. In order to isolate the tectonic uplift or subsidence in a basin and the magnitude of the basement movement, the water depth at the time of deposition, the relative sea-level and the compaction history for the sediments of each formation needs to be constrained. Water depth has been determined so far using a variety of sedimentological, palaeontological and sequence stratigraphic evidence. Palaeo-bathymetry maps have then be contoured from the point data providing the relative palaeo-coastline for each geological formation. The relative sea-level curve will be used from previous work. The third parameter is the decompaction of a formation from its preserved thickness at the present day, to its water saturated and unconsolidated state at the time of deposition. Resolving these parameters and producing a comprehensive burial history for each geological formation in the UK will allow the

  15. [The regulatory framework for complementary and alternative medicines in Europe].

    PubMed

    Knöss, Werner; Stolte, F; Reh, K

    2008-07-01

    Medicinal products from complementary and alternative medicine are in Germany a regular part of the health care system. Herbal, homeopathic, anthroposophic and traditional medicinal products are highly accepted by the population. The German Medicines Act obliged the competent authorities to consider the particular characteristics of complementary and alternative medicines. The European regulatory framework defined the status of herbal medicinal products, traditional herbal medicinal products and homeopathic medicinal products within the directive 2001/83/EC. The committee for herbal medicinal products (HMPC) was established at the European Medicines Agency in London (EMEA); for homeopathic medicinal products there is a specific working group established by the Heads of Medicines Agencies. Harmonisation of medicinal products from complementary and alternative and traditional medicine in Europe was enforced by implementation of directive 2001/83/EC in national legislations of member states. The provisions of this directive will substantially influence the development of the European market during the forthcoming years.

  16. Climate Leaders Collaboration | New England | US EPA

    EPA Pesticide Factsheets

    2017-04-10

    In 2013 EPA New England held a climate leaders summit. A key outgrowth of that summit was the formation of a Climate Leaders Steering Committee and six Action Plan Teams to help New England communities achieve climate resilience.

  17. Ethnic group variations in alcohol-related hospital admissions in England: does place matter?

    PubMed

    Barry, Eleanor; Laverty, Anthony A; Majeed, Azeem; Millett, Christopher

    2015-01-01

    The health burden of alcohol use is socially and geographically patterned in many countries. Less is known about variations in this burden between ethnic groups and whether this differs across place of residence. National cross-sectional study using hospital admission data in England. Alcohol-related admission rates, where an alcohol-related condition was either the primary diagnosis (considered as the reason for admission) or a comorbidity, were calculated using ethnic group specific rates for English regions. In 2010/11 there were a total of 264,870 alcohol-related admissions in England. Admission rates were higher in the North of England than elsewhere (e.g. for primary diagnosis 161 per 100,000 population in the North vs. 62 per 100,000 in the South). These patterns were not uniform across ethnic groups however. For example, admission rates for alcohol-related comorbidity were four times higher among White Irish in London compared with those in the South of England (306 to 76 per 100,000) and four times higher in Indians living in the Midlands compared with those in the South of England (128 to 29 per 100,000). These patterns were similar for admissions with a comorbid alcohol-related condition. Geographical location may be an important determinant of within and between ethnic group variations in alcohol-related hospital admissions in England. While a number of factors were not examined here, this descriptive analysis suggests that this heterogeneity should be taken into account when planning interventions and services for the prevention and management of alcohol misuse.

  18. Comparison of safety equipment between London underground and Beijing subway

    NASA Astrophysics Data System (ADS)

    Chen, T.; Zhang, S. Y.; Zhao, L. Z.; Xia, J. J.; Fu, X. C.; Bao, Z. M.; Chen, Y.; Zhang, X. Z.; Wang, R. J.; Hu, C.; Jing, L. S.; Wang, Y.

    2017-06-01

    The purpose of this paper was to improve the safety equipment’s effectiveness through the comparison. Firstly, the history and safety accident of London Underground and Beijing Subway were shown. Secondly, fire equipment between these two cities was compared including station’s hardware installations and carriage’s hardware installations. Thirdly, the relative software installations were also compared such as emergency drills. The results showed that Beijing Subway’s hardware installations were better than London. However, London Underground’s some installations were more effective than Beijing. Both cities would pay more attention on anti-terrorist in tunnel.

  19. International Instructional Systems: How England Measures Up

    ERIC Educational Resources Information Center

    Creese, Brian; Isaacs, Tina

    2016-01-01

    Although England was not included in the International Instructional Systems Study because it was not a high-performing jurisdiction by the Study's definition, contributors largely were England-based. Analysing the Study's nine overall aspects of instructional systems, this paper finds that England is out of step with many of the high-performing…

  20. Career Guidance in England: Retrospect and Prospect

    ERIC Educational Resources Information Center

    Mulvey, M. Rachel

    2006-01-01

    This paper tackles three challenges: first, to sketch the history of career guidance provision in England over the last 25 years; second, to identify what the current structure of career guidance in England is; and finally, to analyse the key issues and challenges which career guidance in England now faces. Whilst its earlier history in this field…

  1. International Instructional Systems: How England Measures Up

    ERIC Educational Resources Information Center

    Creese, Brian; Isaacs, Tina

    2016-01-01

    Although England was not included in the International Instructional Systems Study because it was not a high-performing jurisdiction by the Study's definition, contributors largely were England-based. Analysing the Study's nine overall aspects of instructional systems, this paper finds that England is out of step with many of the high-performing…

  2. Surveillance of sexually transmitted infections in England and Wales.

    PubMed

    Hughes, G; Paine, T; Thomas, D

    2001-05-01

    Surveillance of sexually transmitted infections (STIs) in England and Wales has, in the past, relied principally on aggregated statistical data submitted by all genitourinary medicine clinics to the Communicable Disease Surveillance Centre, supplemented by various laboratory reporting systems. Although these systems provide comparatively robust surveillance data, they do not provide sufficient information on risk factors to target STI control and prevention programmes appropriately. Over recent years, substantial rises in STIs, the emergence of numerous outbreaks of STIs, and changes in gonococcal resistance patterns have necessitated the introduction of more sophisticated surveillance mechanisms. This article describes current STI surveillance systems in England and Wales, including new systems that have recently been introduced or are currently being developed to meet the need for enhanced STI surveillance data.

  3. Perceived facilitators to change in hospital pharmacy practice in England.

    PubMed

    Auta, Asa; Maz, Julia; Strickland-Hodge, Barry

    2015-12-01

    Traditionally, hospital pharmacists' roles have been associated with dispensing medications prescribed by doctors and offering advice about medicines to patients and other healthcare professionals. In England, significant changes in the structure of hospital pharmacy practice began in the 1970s and currently hospital pharmacists are undertaking a number of advanced roles including prescribing. This study investigated the facilitators to change in hospital pharmacy practice in England in order to identify lessons that might assist in the potential changes needed in other countries for extended clinical roles. The study was conducted in England. A qualitative study using semi-structured interviews was conducted with 28 participants, comprising 22 pharmacists and 6 pharmacy technicians from England. They were recruited through a snowball sampling technique. Transcribed interviews were entered into the QSR NVivo 10 software for data management and analysed thematically. Main outcome measure Pharmacists and pharmacy technicians' perception of the facilitators to hospital pharmacy practice change in England. Three major themes emerged from this study: drivers for change, strategies for change and efficiency. Many of the drivers identified were linked to changes in the structure of hospital pharmacy including education and training; specialisation in practice and career structure. Strategies employed to achieve practice change included broadening the role of pharmacy technicians in order to free-up pharmacists' time; seizing opportunities for extended roles; developing a relationship with the medical profession and professional leadership influence. Participants perceived that the development of pharmacists' clinical roles have resulted in a more efficient healthcare provision where patients were offered seamless services. Changes in the professional structure of pharmacy including education and training, specialisation, career structure and the roles of pharmacy

  4. The Centre for History in Public Health at the London School of Hygiene and Tropical Medicine, University of London (LSHTM)

    ERIC Educational Resources Information Center

    Berridge, Virginia

    2008-01-01

    This article describes the origin of the Centre for History in Public Health and the significance of its location in a leading school of public health. It is in three parts: (1) A brief history of how the AIDS programme became the History Centre; (2) The distinctive approach of the Centre's staff as historians: their contribution and its…

  5. The Centre for History in Public Health at the London School of Hygiene and Tropical Medicine, University of London (LSHTM)

    ERIC Educational Resources Information Center

    Berridge, Virginia

    2008-01-01

    This article describes the origin of the Centre for History in Public Health and the significance of its location in a leading school of public health. It is in three parts: (1) A brief history of how the AIDS programme became the History Centre; (2) The distinctive approach of the Centre's staff as historians: their contribution and its…

  6. Medical student experience of London general practice teaching attachments.

    PubMed

    Schamroth, A J; Haines, A P; Gallivan, S

    1990-07-01

    Forty-eight students kept a log diary of activities during their central London general practice teaching attachments associated with the Department of Primary Health Care of University College and Middlesex School of Medicine. The students each saw on average 96 patients per week, of whom 69% were discussed by the general practitioner with the student after the consultation. Students spent an average of 21.5 hours a week sitting in with the general practitioner. While most of this time was as a passive observer, the students were also able to participate more actively, personally taking histories for a median of 1.25 hours a week and personally examining patients for a median of 1.7 hours a week. During these periods of active involvement each student personally took a mean of 10 short and 2.5 long histories per week and performed a mean of 25.5 short and 1.2 long examinations per week. General practitioners to whom the students were attached spent a mean of 4 hours a week on (patient-oriented) teaching. The tuition was highly rated by the students in terms of both usefulness and stimulation. Students also received a mean of 2.3 hours a week of teaching from other members of the primary health care team, which was somewhat less well received. Areas for improvement were: the relatively few home visits (median of 6 per week) per student; the limited time students spent on self-education (average of 65 minutes per week); and the few practical procedures performed by the students. Students could also be encouraged to play a more active role in examining and interviewing patients.

  7. The Making of Two Readers: Agatha Christie and Jack London.

    ERIC Educational Resources Information Center

    Baghban, Marcia

    1990-01-01

    Looks at the lives of two well-known writers to explore how diverse experiences produce literate adults. Discusses Agatha Christie and Jack London who used reading and writing to earn a living and to gain international reputations. (MG)

  8. The Making of Two Readers: Agatha Christie and Jack London.

    ERIC Educational Resources Information Center

    Baghban, Marcia

    1990-01-01

    Looks at the lives of two well-known writers to explore how diverse experiences produce literate adults. Discusses Agatha Christie and Jack London who used reading and writing to earn a living and to gain international reputations. (MG)

  9. 106. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    106. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  10. 109. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    109. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  11. 108. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    108. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  12. 107. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    107. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  13. 105. Niantic River Bridge. Niantic, New London Co., CT. Sec. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    105. Niantic River Bridge. Niantic, New London Co., CT. Sec. 4209, MP 116.74. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  14. 96. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    96. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  15. 104. Connecticut River Bridge draw span. Old Lyme, New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    104. Connecticut River Bridge draw span. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  16. 98. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    98. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  17. 101. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    101. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  18. 97. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    97. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  19. 102. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    102. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  20. 99. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    99. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  1. 100. Connecticut River Bridge. Old Lyme, New London Co., CT. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    100. Connecticut River Bridge. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  2. 103. Connecticut River Bridge draw span. Old Lyme, New London ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    103. Connecticut River Bridge draw span. Old Lyme, New London Co., CT. Sec. 4209, MP 106.89. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

  3. Mapping School Types in England

    ERIC Educational Resources Information Center

    Courtney, Steven J.

    2015-01-01

    The number and range of school types in England is increasing rapidly in response to a neoliberal policy agenda aiming to expand choice of provision as a mechanism for raising educational standards. In this paper, I seek to undertake a mapping of these school types in order to describe and explain what is happening. I capture this busy terrain…

  4. Deinstitutionalisation in England. Data Brief

    ERIC Educational Resources Information Center

    Emerson, Eric

    2004-01-01

    The implementation of policies associated with deinstitutionalisation has dominated the development of services for people with intellectual disabilities in most, although not all, of the world's richer countries (Braddock, Emerson, Felce & Stancliffe, 2001; Hatton, Emerson & Kiernan, 1995). In England, traditional large-scale institutional care…

  5. Promoting Community Cohesion in England

    ERIC Educational Resources Information Center

    Morris, Andrew B.; McDaid, Maggie; Potter, Hugh

    2011-01-01

    Following serious disturbances in some northern cities in England in 2001, concerns about possible rising inter-communal tension have led to a statutory duty to promote community cohesion being placed on schools. Inspectors from the Office for Standards in Education (Ofsted) are required to make judgements in the leadership and management section…

  6. Mapping School Types in England

    ERIC Educational Resources Information Center

    Courtney, Steven J.

    2015-01-01

    The number and range of school types in England is increasing rapidly in response to a neoliberal policy agenda aiming to expand choice of provision as a mechanism for raising educational standards. In this paper, I seek to undertake a mapping of these school types in order to describe and explain what is happening. I capture this busy terrain…

  7. New England After 3 PM

    ERIC Educational Resources Information Center

    Afterschool Alliance, 2007

    2007-01-01

    Some 20 percent of children in New England have no safe, supervised activities after the school day ends each afternoon. These children are in self-care, missing out on opportunities to learn and explore new interests, and at risk for any number of risky behaviors including substance abuse, crime and teen pregnancy. Policy makers, parents and many…

  8. Vietnam Education in New England.

    ERIC Educational Resources Information Center

    Banit, Thomas

    1990-01-01

    Outlines reasons why teaching about Vietnam is important. Presents the results of a survey designed to find out what New England teachers are teaching about Vietnam. Critiques textbooks on the Vietnam War, and offers teaching strategies for Vietnam War instruction. Recommends the use of maps, films, and videos. (RW)

  9. Educational Aspirations Trajectories in England

    ERIC Educational Resources Information Center

    McCulloch, Andrew

    2017-01-01

    This study used latent class analysis to examine the trajectories followed by young people's educational aspirations in England over the age range from 13 to 16 years and their relationship to educational achievement. The results suggested that young people's aspirations followed six trajectories. Four trajectories showed overall patterns of…

  10. Deinstitutionalisation in England. Data Brief

    ERIC Educational Resources Information Center

    Emerson, Eric

    2004-01-01

    The implementation of policies associated with deinstitutionalisation has dominated the development of services for people with intellectual disabilities in most, although not all, of the world's richer countries (Braddock, Emerson, Felce & Stancliffe, 2001; Hatton, Emerson & Kiernan, 1995). In England, traditional large-scale institutional care…

  11. Contemporary terrorism: risk perception in the London options market.

    PubMed

    Garvey, John; Mullins, Martin

    2008-02-01

    Previous studies have a demonstrated a linkage between terrorist attacks and the operation of financial markets. This article focuses on terrorist events carried out over the last five years and examines how they have been perceived among participants on the London financial market. Data from the London options market suggest a high degree of sensitivity to these events. We argue that this sensitivity reveals a vulnerability in the financial markets should the recent trends in terrorist activity continue.

  12. Weight charts of infants dying of sudden infant death in England.

    PubMed

    Scheimberg, Irene; Ashal, Husna; Kotiloglu-Karaa, Esin; French, Paul; Kay, Philippa; Cohen, Marta C

    2014-01-01

    The organ weights in cases of sudden infant death syndrome (SIDS) and undetermined deaths in previously healthy infants do not correspond to "the normal range" of organ weights in international standard charts for infants currently in use in some institutions. The aim of our study was to ascertain the organ weights of infants dying suddenly and unexpectedly in England and for whom a cause of death was not found, therefore falling under the category of SIDS or undetermined. We collated the organs weights from 2 institutions covering between them the South East and North of England including London, Yorkshire, and Derbyshire. The cases from The Royal London Hospital were autopsied between 1997 and 2013, and the cases from Sheffield Children's Hospital were autopsied between 2006 and 2013. There were 188 babies who had been born at term (62 female and 126 male) and 26 ex-premature babies (15 female and 11 male). Organs of male babies were slightly heavier than those of female babies but as there was no significant differences male and female babies were considered together. Comparison with standard charts (from 1932 and 1962) and with more recent charts confirmed the discrepancy between the older charts commonly in use with more recent measurements, including ours. The main reason for these differences is that babies in the recent charts were previously healthy babies with no long term disease and improved in the health of the population.

  13. Psychiatric morbidity of overseas patients in inner London: A hospital based study

    PubMed Central

    Carranza, Fredy J; Parshall, Alice M

    2005-01-01

    Background Evaluation of the referral, admission, treatment, and outcome of overseas patients admitted to a psychiatric hospital in central London. Ethical, legal and economic implications, and the involvement of consulates in the admission process, are discussed. Method Assessment and review of overseas patients admitted between 1 January 1999 and 31 December 1999. Non-parametric statistical tests were used, and relevant outcomes described. Results 19% of admissions were overseas patients. Mean age was 38 years. 90% were unattached; 84% were white, 71% from European countries. 45% spoke fluent English. Differences in socio-economic status between home country and England were found. 74% were unwell on arrival; 65% travelled to England as tourists. 65% of admissions came via the police. 32% had been ill for more than one year before admission; 68% had psychiatric history. 77% were admitted and 48% discharged under section of the Mental Health Act. 74% had psychotic disorders, all of them with positive symptoms. 55% showed little to moderate improvement in mental state; 10% were on Enhanced Care Programme Approach. Relatives of 48% of patients were contacted. The Hospital repatriated 52% of patients; the Mental Health Team followed up 13% of those discharged. The average length of admission was 43.4 days (range 1–365). Total cost of admissions was GBP350, 600 ($577, 490); average individual cost was GBP11, 116 (range GBP200-81, 000). Conclusions Mentally ill overseas individuals are a vulnerable group that need recognition by health organisations to adapt current practice to better serve their needs. The involvement of consulates needs further evaluation. PMID:15845140

  14. 19th century London dust-yards: A case study in closed-loop resource efficiency

    SciTech Connect

    Velis, Costas A.; Wilson, David C.; Cheeseman, Christopher R.

    2009-04-15

    The material recovery methods used by dust-yards in early 19th century London, England and the conditions that led to their development, success and decline are reported. The overall system developed in response to the market value of constituents of municipal waste, and particularly the high coal ash content of household 'dust'. The emergence of lucrative markets for 'soil' and 'breeze' products encouraged dust-contractors to recover effectively 100% of the residual wastes remaining after readily saleable items and materials had been removed by the thriving informal sector. Contracting dust collection to the private sector allowed parishes to keep the streets relatively clean, without the need to develop institutional capacity, and for a period this also generated useful income. The dust-yard system is, therefore, an early example of organised, municipal-wide solid waste management, and also of public-private sector participation. The dust-yard system had been working successfully for more than 50 years before the Public Health Acts of 1848 and 1875, and was thus important in facilitating a relatively smooth transition to an institutionalised, municipally-run solid waste management system in England. The dust-yards can be seen as early precursors of modern materials recycling facilities (MRFs) and mechanical-biological treatment (MBT) plants; however, it must be emphasised that dust-yards operated without any of the environmental and occupational health considerations that are indispensable today. In addition, there are analogies between dust-yards and informal sector recycling systems currently operating in many developing countries.

  15. 19th century London dust-yards: a case study in closed-loop resource efficiency.

    PubMed

    Velis, Costas A; Wilson, David C; Cheeseman, Christopher R

    2009-04-01

    The material recovery methods used by dust-yards in early 19th century London, England and the conditions that led to their development, success and decline are reported. The overall system developed in response to the market value of constituents of municipal waste, and particularly the high coal ash content of household 'dust'. The emergence of lucrative markets for 'soil' and 'breeze' products encouraged dust-contractors to recover effectively 100% of the residual wastes remaining after readily saleable items and materials had been removed by the thriving informal sector. Contracting dust collection to the private sector allowed parishes to keep the streets relatively clean, without the need to develop institutional capacity, and for a period this also generated useful income. The dust-yard system is, therefore, an early example of organised, municipal-wide solid waste management, and also of public-private sector participation. The dust-yard system had been working successfully for more than 50 years before the Public Health Acts of 1848 and 1875, and was thus important in facilitating a relatively smooth transition to an institutionalised, municipally-run solid waste management system in England. The dust-yards can be seen as early precursors of modern materials recycling facilities (MRFs) and mechanical-biological treatment (MBT) plants; however, it must be emphasised that dust-yards operated without any of the environmental and occupational health considerations that are indispensable today. In addition, there are analogies between dust-yards and informal sector recycling systems currently operating in many developing countries.

  16. Problems of quality designation in diffusely polluted urban streams - the case of Pymme's Brook, north London.

    PubMed

    Faulkner, H; Edmonds-Brown, V; Green, A

    2000-07-01

    Downstream patterns in the biology and bacteriology of Pymme's Brook (north London) between 1985 and 1992, are compared with the local Environment Agency (EA, England and Wales) quality classification of the site, revealing a considerable discrepancy. Although downstream contaminant dispersal patterns showed that at low flow the brook was less successful in absorbing contaminants at polluted surface water outfall (PSWO) entry points than it was at high flow (supporting the low flow strategy of contemporary audit schedules), this effect was found to vary downstream in response to reoxygenation from less polluted outfalls. Additionally, temporal variations in suspended solids, Escherichia coli counts, sediment-bound and soluble pollutant concentrations at low flow, and during two sampled storms, revealed that significant pollutant transfer was concentrated in the 'first flush' of storm events. A downstream survey of sediment-bound lead (Pb) found that concentrations in the bed sediments, which were likely to be mobilised during a first flush, were significantly higher than in solution. So, a complex pattern of downstream contaminant dispersal emerges, which varies with differing antecedent conditions, and through storms. These results indicate that: (1) the new General Quality Assessments (GQA) audit schedule proposed by the EA for England and Wales remains inappropriate for diffusely polluted, urban environments, because it omits routine E. coli counts and sediment-bound heavy metals; and that (2) when audit is based on chemical determinants alone, the choice of site and timing of audit excessively influence quality designations. Pre-audit planning surveys and more reliable alternatives to the use of chemical audit for urban watercourses, are discussed as possible ways forward for the design of quality audit schedules. Implications for the monitoring schedules in operation in other EU countries and the USA are also considered.

  17. Public health in interwar England and Wales: did it fail?

    PubMed

    Gorsky, Martin

    2008-01-01

    British historians initially saw the interwar period as a "golden age" for public health in local government, with unprecedented preventive and curative powers wielded by Medical Officers of Health (MOsH). In the 1980s Lewis and Webster challenged this reading, arguing that MOsH were overstretched, neglectful of their "watchdog" role and incapable of formulating a new philosophy of preventive medicine. The article first details this critique, then reappraises it in the light of recent demographic work. It then provides a case study of public health administration in South-West England. Its conclusion is that some elements of the Lewis/Webster case now deserve to be revised.

  18. Lessons for major system change: centralization of stroke services in two metropolitan areas of England

    PubMed Central

    Ramsay, Angus; Perry, Catherine; Boaden, Ruth; McKevitt, Christopher; Morris, Stephen; Pursani, Nanik; Rudd, Anthony; Tyrrell, Pippa; Wolfe, Charles; Fulop, Naomi

    2016-01-01

    Objectives Our aim was to identify the factors influencing the selection of a model of acute stroke service centralization to create fewer high-volume specialist units in two metropolitan areas of England (London and Greater Manchester). It considers the reasons why services were more fully centralized in London than in Greater Manchester. Methods In both areas, we analysed 316 documents and conducted 45 interviews with people leading transformation, service user organizations, providers and commissioners. Inductive and deductive analyses were used to compare the processes underpinning change in each area, with reference to propositions for achieving major system change taken from a realist review of the existing literature (the Best framework), which we critique and develop further. Results In London, system leadership was used to overcome resistance to centralization and align stakeholders to implement a centralized service model. In Greater Manchester, programme leaders relied on achieving change by consensus and, lacking decision-making authority over providers, accommodated rather than challenged resistance by implementing a less radical transformation of services. Conclusions A combination of system (top-down) and distributed (bottom-up) leadership is important in enabling change. System leadership provides the political authority required to coordinate stakeholders and to capitalize on clinical leadership by aligning it with transformation goals. Policy makers should examine how the structures of system authority, with performance management and financial levers, can be employed to coordinate transformation by aligning the disparate interests of providers and commissioners. PMID:26811375

  19. Lessons for major system change: centralization of stroke services in two metropolitan areas of England.

    PubMed

    Turner, Simon; Ramsay, Angus; Perry, Catherine; Boaden, Ruth; McKevitt, Christopher; Morris, Stephen; Pursani, Nanik; Rudd, Anthony; Tyrrell, Pippa; Wolfe, Charles; Fulop, Naomi

    2016-07-01

    Our aim was to identify the factors influencing the selection of a model of acute stroke service centralization to create fewer high-volume specialist units in two metropolitan areas of England (London and Greater Manchester). It considers the reasons why services were more fully centralized in London than in Greater Manchester. In both areas, we analysed 316 documents and conducted 45 interviews with people leading transformation, service user organizations, providers and commissioners. Inductive and deductive analyses were used to compare the processes underpinning change in each area, with reference to propositions for achieving major system change taken from a realist review of the existing literature (the Best framework), which we critique and develop further. In London, system leadership was used to overcome resistance to centralization and align stakeholders to implement a centralized service model. In Greater Manchester, programme leaders relied on achieving change by consensus and, lacking decision-making authority over providers, accommodated rather than challenged resistance by implementing a less radical transformation of services. A combination of system (top-down) and distributed (bottom-up) leadership is important in enabling change. System leadership provides the political authority required to coordinate stakeholders and to capitalize on clinical leadership by aligning it with transformation goals. Policy makers should examine how the structures of system authority, with performance management and financial levers, can be employed to coordinate transformation by aligning the disparate interests of providers and commissioners. © The Author(s) 2016.

  20. The Black Death in England.

    PubMed

    Sloan, A W

    1981-04-25

    From 1348 to 1350 Europe was devastated by an epidemic of plague, called at the time the Great Mortality and later the Black Death. The epidemic reached southern Europe from the Middle East and spread northward, reaching England in June 1348. Contemporary descriptions leave no doubt of the diagnosis, but estimates of the mortality differ widely owing to lack of contemporary statistics; in England it was probably between one-third and one-half of the population. The Black Death and subsequent plague epidemics in the 14th century had marked social and economic effects, reduced the prestige of the Church and off the medical profession, and were a factor in the social unrest which led to the Renaissance of the Reformation.

  1. The Struggle to Study. Financial Implications for Adults Studying in London. A Research Report Funded by London's Four Open College Networks: ALFA, CAWLOC, GLEAN, and OCSL.

    ERIC Educational Resources Information Center

    Sims, Anne; Goddard, Ty

    The four Open College Networks in London assessed the climate in inner London for adult students who wished to return to education and training. The research focussed on: the extent to which recent legislative changes threatened adult participation in education and training; the abolition of the Inner London Education Authority (ILEA) and…

  2. The Struggle to Study. Financial Implications for Adults Studying in London. A Research Report Funded by London's Four Open College Networks: ALFA, CAWLOC, GLEAN, and OCSL.

    ERIC Educational Resources Information Center

    Sims, Anne; Goddard, Ty

    The four Open College Networks in London assessed the climate in inner London for adult students who wished to return to education and training. The research focussed on: the extent to which recent legislative changes threatened adult participation in education and training; the abolition of the Inner London Education Authority (ILEA) and…

  3. Who is more likely to use doctor-rating websites, and why? A cross-sectional study in London.

    PubMed

    Galizzi, Matteo Maria; Miraldo, Marisa; Stavropoulou, Charitini; Desai, Mihir; Jayatunga, Wikum; Joshi, Mitesh; Parikh, Sunny

    2012-01-01

    To explore the extent to which doctor-rating websites are known and used among a sample of respondents from London. To understand the main predictors of what makes people willing to use doctor-rating websites. A cross-sectional study. The Borough of Hammersmith and Fulham, London, England. 200 individuals from the borough. The likelihood of being aware of doctor-rating websites and the intention to use doctor-rating websites. The use and awareness of doctor-rating websites are still quite limited. White British subjects, as well as respondents with higher income are less likely to use doctor-rating websites. Aspects of the doctor-patient relationship also play a key role in explaining intention to use the websites. The doctor has both a 'complementary' and 'substitute' role with respect to Internet information. Online rating websites can play a major role in supporting patients' informed decisions on which healthcare providers to seek advice from, thus potentially fostering patients' choice in healthcare. Subjects who seek and provide feedback on doctor-ranking websites, though, are unlikely to be representative of the overall patients' pool. In particular, they tend to over-represent opinions from non-White British, medium-low-income patients who are not satisfied with their choice of the healthcare treatments and the level of information provided by their GP. Accounting for differences in the users' characteristics is important when interpreting results from doctor-rating sites.

  4. Why VBAC in Northern New England is still viable: the Northern New England perinatal quality improvement network.

    PubMed

    Lauria, Michele R; Flanagan, Victoria; Capeless, Eleanor

    2012-12-01

    Under the strong leadership of Maternal-Fetal Medicine specialists and the support of the tertiary care centers serving the region, Northern New England (NNE) initiated a collaborative project to improve the availability and safety of trial of labor after cesarean delivery. The project involved over 250 individuals from over 30 organizations and resulted in a strong regional guideline that has been implemented by institutions across the nation. The availability of trial of labor after cesarean in NNE has increased. The work led to the creation of the NNE Perinatal Quality Improvement Network, whose work has improved regional outcomes.

  5. Exploring anterograde associative memory in London taxi drivers.

    PubMed

    Woollett, Katherine; Maguire, Eleanor A

    2012-10-24

    London taxi drivers are renowned for their navigation ability, spending a number of years acquiring 'The Knowledge' of London's complex layout and having to pass stringent examinations to obtain an operating licence. In several studies, this navigation skill has been associated with increased posterior but also decreased anterior hippocampal grey matter volume. Neuropsychologically, gain and loss has also been documented in taxi drivers; while very skilled at navigation in London, they are significantly poorer than controls at learning and recalling new object-location associations. Here we tested a group of London taxi drivers and matched control participants on this object-location associations task, while also subjecting them to a battery of challenging anterograde associative memory tests involving verbal, visual and auditory material both within and across modalities. Our aim was to assess whether their difficulty in previous studies reflected a general problem with associative memory, or was restricted to the spatial domain. We replicated previous findings of poor learning and memory of object-location associations. By contrast, their performance on the other anterograde associative memory tasks was comparable with controls. This resolves an outstanding question in the memory profile of London taxi drivers following hippocampal plasticity, and underlines the close relationship between space and the hippocampus.

  6. A rivalry of foulness: official and unofficial investigations of the London cholera epidemic of 1854.

    PubMed Central

    Paneth, N; Vinten-Johansen, P; Brody, H; Rip, M

    1998-01-01

    Contemporaneous with John Snow's famous study of the 1854 London cholera epidemic were 2 other investigations: a local study of the Broad Street outbreak and an investigation of the entire epidemic, undertaken by England's General Board of Health. More than a quarter-century prior to Koch's description of Vibrio comma, a Board of Health investigator saw microscopic "vibriones" in the rice-water stools of cholera patients that, in his later life, he concluded had been cholera bacilli. Although this finding was potential evidence for Snow's view that cholera was due to a contagious and probably live agent transmitted in the water supply, the Board of Health rejected Snow's conclusions. The Board of Health amassed a huge amount of information which it interpreted as supportive of its conclusion that the epidemic was attributable not so much to water as to air. Snow, by contrast, systematically tested his hypothesis that cholera was water-borne by exploring evidence that at first glance ran contrary to his expectations. Snow's success provides support for using a hypothetico-deductive approach in epidemiology, based on tightly focused hypotheses strongly grounded in pathophysiology. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 PMID:9772861

  7. The impact of thunderstorm asthma on emergency department attendances across London during July 2013.

    PubMed

    Elliot, A J; Hughes, H E; Hughes, T C; Locker, T E; Brown, R; Sarran, C; Clewlow, Y; Murray, V; Bone, A; Catchpole, M; McCloskey, B; Smith, G E

    2014-08-01

    This study illustrates the potential of using emergency department attendance data, routinely accessed as part of a national syndromic surveillance system, to monitor the impact of thunderstorm asthma. The Emergency Department Syndromic Surveillance System (EDSSS) routinely monitors anonymised attendance data on a daily basis across a sentinel network of 35 emergency departments. Attendance data for asthma, wheeze and difficulty breathing are analysed on a daily basis. A statistically significant spike in asthma attendances in two EDSSS emergency departments in London was detected on 23 July 2013, coinciding with a series of large violent thunderstorms across southern England. There was also an increase in the reported severity of these attendances. This preliminary report illustrates the potential of the EDSSS to monitor the impact of thunderstorms on emergency department asthma attendances. Further work will focus on how this system can be used to quantify the impact on emergency departments, thus potentially improving resource planning and also adding to the thunderstorm asthma evidence-base. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Addressing London's modern urban health challenges: learning from other global cities.

    PubMed

    Doyle, Y G; Mills, A J; Korkodilos, M

    2017-03-18

    Around 150 cities have emerged as notable at a global scale. With a global population of fewer than 12%, they generate 46% of world gross domestic product. There is growing interest in how cities can accelerate health improvements through wider social and economic collaboration. A team led by Public Health England in London visited counterparts in New York City and Paris to examine how city health leaders addressed public health challenges. The three cities have similar health challenges but different legal, political and fiscal resources for promoting and protecting health. Consequently, there is no single model that every city could adopt. Organizational structures, interpersonal relationships and individual skills can play an important part in effective delivery of better city health. Lack of access to published evidence on how practice has been influenced by city health policies hampers learning between cities. There is little easily comparable data to guide those interested in such learning. Municipal governments are ideally situated to join researchers to fill this gap in the literature. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Character change of New England snow

    USGS Publications Warehouse

    Huntington, T.G.; Hodgkins, G.A.; Keim, B.D.; Dudley, R.W.

    2004-01-01

    The annual ratio of snow to total precipitation (S/P) for 11 out of 21 US Historical Climatology Network (USHCN) sites in New England decreased significantly from 1949 through 2000. One possible explanation for the observed decrease in S/P ratio is that their temperature increased in New England during the 20th century. The results are consistent with published reports indicating lengthening of the growing season in New England.

  10. Evaluation of the Health Protection Event-Based Surveillance for the London 2012 Olympic and Paralympic Games.

    PubMed

    Severi, E; Kitching, A; Crook, P

    2014-06-19

    The Health Protection Agency (HPA) (currently Public Health England) implemented the Health Protection Event-Based Surveillance (EBS) to provide additional national epidemic intelligence for the 2012 London Olympic and Paralympic Games (the Games). We describe EBS and evaluate the system attributes. EBS aimed at identifying, assessing and reporting to the HPA Olympic Coordination Centre (OCC) possible national infectious disease threats that may significantly impact the Games. EBS reported events in England from 2 July to 12 September 2012. EBS sourced events from reports from local health protection units and from screening an electronic application 'HPZone Dashboard' (DB). During this period, 147 new events were reported to EBS, mostly food-borne and vaccine-preventable diseases: 79 from regional units, 144 from DB (76 from both). EBS reported 61 events to the OCC: 21 of these were reported onwards. EBS sensitivity was 95.2%; positive predictive value was 32.8%; reports were timely (median one day; 10th percentile: 0 days - same day; 90th percentile: 3.6 days); completeness was 99.7%; stability was 100%; EBS simplicity was assessed as good; the daily time per regional or national unit dedicated to EBS was approximately 4 hours (weekdays) and 3 hours (weekends). OCC directors judged EBS as efficient, fast and responsive. EBS provided reliable, reassuring, timely, simple and stable national epidemic intelligence for the Games.

  11. A history of the gardens of the Royal College of Physicians of London.

    PubMed

    Hollman, Arthur

    2009-06-01

    The Royal College of Physicians of London (RCP) was founded in the City of London in 1518 and at that time many of the royal, religious and lay residences had gardens. The gardens were used, among other things, to grow fruit trees, herbs for the kitchen and for strewing on the floor, and for leisure, with lawns, bowling and flowers. So it would have been natural for the RCP Fellows to wish to have a garden of their own. This was not possible until the College moved into its second and third homes in the City in 1614 and 1674 and good street plans of these sites, and of their gardens, have now become available, though we lack any details of the planting. The fourth home in Pall Mall East in 1815 was landlocked. Therefore when the fifth (and current) home in Regent's Park was opened in 1964 it was splendid to have a large garden, carefully designed, planted and recorded. In 2004 a wonderful transformation took place when the College created a modern physic garden showing the development of medicinal plants through the ages and in many parts of the world.

  12. Multifractal to monofractal evolution of the London street network

    NASA Astrophysics Data System (ADS)

    Murcio, Roberto; Masucci, A. Paolo; Arcaute, Elsa; Batty, Michael

    2015-12-01

    We perform a multifractal analysis of the evolution of London's street network from 1786 to 2010. First, we show that a single fractal dimension, commonly associated with the morphological description of cities, does not suffice to capture the dynamics of the system. Instead, for a proper characterization of such a dynamics, the multifractal spectrum needs to be considered. Our analysis reveals that London evolves from an inhomogeneous fractal structure, which can be described in terms of a multifractal, to a homogeneous one, which converges to monofractality. We argue that London's multifractal to monofractal evolution might be a special outcome of the constraint imposed on its growth by a green belt. Through a series of simulations, we show that multifractal objects, constructed through diffusion limited aggregation, evolve toward monofractality if their growth is constrained by a nonpermeable boundary.

  13. Clean Air for London (CLEARFLO) Final Campaign Summary

    SciTech Connect

    Worsnop, D. R.; Williams, L. R.; Herndon, S. C.; Dubey, M.; Ng, N. L.; Thornton, J.; Knighton, B.; Coulter, R.; Prévôt, Ash

    2016-03-01

    This field campaign funded the participation of scientists from seven different research groups and operated over thirty instruments during the Winter Intensive Operating Period (January-February 2012) of the Clean Air for London (ClearfLo) campaign. The campaign took place at a rural site in Detling, UK, 45 kilometers southeast of central London. The primary science questions for the ClearfLo winter IOP (intensive operational periods) were: 1) “what is the urban increment of particulate matter (PM) and other pollutants in the greater London area?” and 2) “what is the contribution of solid fuel use for home heating to wintertime PM?” An additional motivation for the Detling measurements was the question of whether coatings on black carbon particles enhance absorption.

  14. The epidemiology of suicide on the London Underground.

    PubMed

    O'Donnell, I; Farmer, R D

    1994-02-01

    A database containing details of every incident of suicidal behaviour on the London Underground railway system between 1940 and 1990 was assembled from the records of London Underground Ltd and the British Transport Police. The total number of cases was 3240. The mean annual number of suicidal acts on the London Underground system increased from 36.1 (1940-1949) to 94.1 (1980-1989). There were significantly fewer incidents on Sundays than on the other days of the week and the daily rate was highest in the spring. 64% of incidents involved males and the peak age group for both sexes was 25-34 yr. Suicide verdicts were returned for a greater proportion of women than men. Overall case fatality was 55%. However, case fatality rates differed between stations, environmental factors appearing to influence survival. Possible strategies to prevent railway suicides and reduce the lethality of this method are discussed.

  15. Multifractal to monofractal evolution of the London street network.

    PubMed

    Murcio, Roberto; Masucci, A Paolo; Arcaute, Elsa; Batty, Michael

    2015-12-01

    We perform a multifractal analysis of the evolution of London's street network from 1786 to 2010. First, we show that a single fractal dimension, commonly associated with the morphological description of cities, does not suffice to capture the dynamics of the system. Instead, for a proper characterization of such a dynamics, the multifractal spectrum needs to be considered. Our analysis reveals that London evolves from an inhomogeneous fractal structure, which can be described in terms of a multifractal, to a homogeneous one, which converges to monofractality. We argue that London's multifractal to monofractal evolution might be a special outcome of the constraint imposed on its growth by a green belt. Through a series of simulations, we show that multifractal objects, constructed through diffusion limited aggregation, evolve toward monofractality if their growth is constrained by a nonpermeable boundary.

  16. Cosmopolitanism, geographical imaginaries and belonging in North London.

    PubMed

    Devadason, Ranji

    2010-01-01

    Cosmopolitanism has been described as the cultural habitus of globalisation. It is therefore, albeit defined somewhat loosely, often associated with ethnically diverse, global cities. This paper considers the extent to which London engenders cosmopolitan values amongst its residents. It draws on survey data from the LOCAL MULTIDEM study of minorities' political participation to address these themes. The analysis examines perceptions of respect, belonging and geographical imaginaries - amongst established minorities and the ethnic majority - in north London. It is argued that cosmopolitan ethics are transformative and dialectical and, critically, cannot remain the preserve of the privileged in multi-ethnic neighbourhoods. The analysis presented demonstrates that a sense of belonging and cosmopolitan imaginaries are not evenly accessed by different ethnic groups; notably, that Bangladeshi Londoners who are born and bred in the city are less likely to appropriate these discourses than Caribbean, Indian or White residents.

  17. Southeast New England Coastal Watershed Restoration Program

    EPA Pesticide Factsheets

    The Southeast New England Program aims to enhance collaboration among stakeholders and promote innovation in policy, monitoring and best management practices in Rhode Island and southeast Massachusetts.

  18. New England Drinking Water Program | US EPA

    EPA Pesticide Factsheets

    2017-04-10

    Information on Drinking Water in New England. Major Topics covered include: Conservation, Private Wells, Preventing Contamination, Drinking Water Sources, Consumer Confidence Reports, and Drinking Water Awards.

  19. 78 FR 32384 - New England Power Generators Association v. ISO New England Inc.; Notice of Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission New England Power Generators Association v. ISO New England Inc.; Notice of... Federal Power Act (FPA), 16 U.S.C. 824(e), the New England Power Generators Association (Complainant...

  20. 77 FR 5774 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ... National Oceanic and Atmospheric Administration RIN 0648-XA980 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  1. 75 FR 78976 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... National Oceanic and Atmospheric Administration RIN 0648-XA092 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management..., to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  2. 75 FR 49466 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... National Oceanic and Atmospheric Administration RIN 0648-XY17 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee will meet to consider actions affecting New England...

  3. 78 FR 18963 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... National Oceanic and Atmospheric Administration RIN 0648-XC594 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) Recreational Advisory Panel will meet to consider actions affecting New England...

  4. 77 FR 35359 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-13

    ... National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting...), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to consider actions affecting New England...

  5. 75 FR 31425 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-03

    ... National Oceanic and Atmospheric Administration RIN 0648-XW76 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council) VMS/ Enforcement Committee will meet to consider actions affecting New England...

  6. 76 FR 52640 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... National Oceanic and Atmospheric Administration RIN 0648-XA653 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management... to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

  7. Pan-London tuberculosis services: a service evaluation

    PubMed Central

    2012-01-01

    Background London has the largest proportion of tuberculosis (TB) cases of any western European capital, with almost half of new cases drug-resistant. Prevalence varies considerably between and within boroughs with research suggesting inadequate control of TB transmission in London. Economic pressures may exacerbate the already considerable challenges for service organisation and delivery within this context. This paper presents selected findings from an evaluation of London’s TB services’ organisation, delivery, professional workforce and skill mix, intended to support development of a strategic framework for a pan-London TB service. These may also interest health service professionals and managers in TB services in the UK, other European cities and countries and in services currently delivered by multiple providers operating independently. Methods Objectives were: 1) To establish how London’s TB services are structured and delivered in relation to leadership, management, organisation and delivery, coordination, staffing and support; 2) To identify tools/models for calculating skill mix as a basis for identifying skill mix requirements in delivering TB services across London; 3) To inform a strategic framework for the delivery of a pan-London TB service, which may be applicable to other European cities. The multi-method service audit evaluation comprised documentary analysis, semi-structured interviews with TB service users (n = 10), lead TB health professionals and managers (n = 13) representing London’s five sectors and focus groups with TB nurses (n = 8) and non-London network professionals (n = 2). Results Findings showed TB services to be mainly hospital-based, with fewer community-based services. Documentary analysis and professionals’ interviews suggested difficulties with early access to services, low suspicion index amongst some GPs and restricted referral routes. Interviews indicated lack of managed accommodation for

  8. Sources and contributions of wood smoke during winter in London

    NASA Astrophysics Data System (ADS)

    Crilley, Leigh; Bloss, William; Yin, Jianxin; Beddows, David; Harrison, Roy; Zotter, Peter; Prevot, Andre; Green, David

    2014-05-01

    Determining the contribution of wood smoke in large urban centres such as London is becoming increasingly important with the changing nature of domestic heating partly due to the installation of biomass burning heaters to meet renewable energy targets imposed by the EU and also a rise in so-called recreational burning for aesthetic reasons (Fuller et al., 2013). Recent work in large urban centres (London, Paris and Berlin) has demonstrated an increase in the contribution of wood smoke to ambient particles during winter that can at times exceed traffic emissions. In Europe, biomass burning has been identified as a major cause of exceedances of European air quality limits during winter (Fuller et al., 2013). In light of the changing nature of emissions in urban areas there is a need for on-going measurements to assess the impact of biomass burning in cities like London. Therefore we aimed to determine quantitatively the contribution of biomass burning in London and surrounding rural areas. We also aimed to determine whether local emissions or regional sources were the main source of biomass burning in London. Sources of wood smoke during winter in London were investigated at an urban background site (North Kensington) and two surrounding rural sites (Harwell and Detling) by analysing selected wood smoke chemical tracers. Concentrations of levoglucosan, elemental carbon (EC), organic carbon (OC) and K+ were generally well correlated, indicating a similar source of these species at the three sites. Based on the conversion factor for levoglucosan, mean wood smoke mass at Detling, North Kensington and Harwell was 0.78, 0.87 and 1.0 µg m-3, respectively. At all the sites, biomass burning was found to be a source of OC and EC, with the largest source of OC and EC found to be secondary organic aerosols and traffic emissions, respectively. Peaks in levoglucosan concentrations at the sites were observed to coincide with low ambient temperature, suggesting domestic heating as

  9. Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care (CLAHRC) programme nationally and in North West London.

    PubMed

    Caldwell, Sarah E M; Mays, Nicholas

    2012-10-15

    The publication of Best research for best health in 2006 and the "ring-fencing" of health research funding in England marked the start of a period of change for health research governance and the structure of research funding in England. One response to bridging the 'second translational gap' between research knowledge and clinical practice was the establishment of nine Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The goal of this paper is to assess how national-level understanding of the aims and objectives of the CLAHRCs translated into local implementation and practice in North West London. This study uses a variation of Goffman's frame analysis to trace the development of the initial national CLAHRC policy to its implementation at three levels. Data collection and analysis were qualitative through interviews, document analysis and embedded research. Analysis at the macro (national policy), meso (national programme) and micro (North West London) levels shows a significant common understanding of the aims and objectives of the policy and programme. Local level implementation in North West London was also consistent with these. The macro-meso-micro frame analysis is a useful way of studying the transition of a policy from high-level idea to programme in action. It could be used to identify differences at a local (micro) level in the implementation of multi-site programmes that would help understand differences in programme effectiveness.

  10. 2009 New England American College of Sports Medicine Conference

    DTIC Science & Technology

    2010-01-01

    Public Health and University Based Childhood Obesity Program: Application to Service Learning in Exercise Science Wendy Bjerke, MS; Paul Gallo...Regenerative Therapies Herb Stevenson, M.D. Making Sense of the Sports Food Scene Nancy Clark Public Health and University Based Childhood ... Obesity Program: Application to Service Learning in Exercise Science Wendy Bjerke Paul Gallo 9:40- 11:10 Free Communications Inducing

  11. "Persons That Live Remote from London": Apothecaries and the Medical Marketplace in Seventeenth-and Eighteenth-Century Wales

    PubMed Central

    Withey, Alun

    2011-01-01

    Summary This article uses evidence from Welsh apothecary shops as a means to access the mechanisms of the "medical marketplace" in seventeenth- and eighteenth-century Wales. As a country physically remote from large urban medical centers, and with few large towns, Wales has often been overlooked in terms of medical commerce. Nevertheless, evidence suggests that Welsh apothecaries participated in broad and sophisticated networks of trade with London suppliers. Moreover, their shops contained a wide range of medicines from herbal simples to exotic ingredients and chemical preparations, highlighting the availability of such goods far from large urban centers. PMID:21804184

  12. "Persons that live remote from London": apothecaries and the medical marketplace in seventeenth-and eighteenth-century Wales.

    PubMed

    Withey, Alun

    2011-01-01

    This article uses evidence from Welsh apothecary shops as a means to access the mechanisms of the "medical marketplace" in seventeenth- and eighteenth-century Wales. As a country physically remote from large urban medical centers, and with few large towns, Wales has often been overlooked in terms of medical commerce. Nevertheless, evidence suggests that Welsh apothecaries participated in broad and sophisticated networks of trade with London suppliers. Moreover, their shops contained a wide range of medicines from herbal simples to exotic ingredients and chemical preparations, highlighting the availability of such goods far from large urban centers.

  13. Regional variation in hospitalisation and mortality in heart failure: comparison of England and Lombardy using multistate modelling.

    PubMed

    Bottle, Alex; Ventura, Chiara Maria; Dharmarajan, Kumar; Aylin, Paul; Ieva, Francesca; Paganoni, Anna Maria

    2017-07-28

    Heart failure (HF) is a common, serious chronic condition with high morbidity, hospitalisation and mortality. The healthcare systems of England and the northern Italian region of Lombardy share important similarities and have comprehensive hospital administrative databases linked to the death register. We used them to compare admission for HF and mortality for patients between 2006 and 2012 (n = 37,185 for Lombardy, 234,719 for England) with multistate models. Despite close similarities in age, sex and common comorbidities of the two sets of patients, in Lombardy, HF admissions were longer and more frequent per patient than in England, but short- and medium-term mortality was much lower. English patients had more very short stays, but their very elderly also had longer stays than their Lombardy counterparts. Using a three-state model, the predicted total time spent in hospital showed large differences between the countries: women in England spent an average of 24 days if aged 65 at first admission and 19 days if aged 85; in Lombardy these figures were 68 and 27 days respectively. Eight-state models suggested disease progression that appeared similar in each country. Differences by region within England were modest, with London patients spending more time in hospital and having lower mortality than the rest of England. Whilst clinical practice differences plausibly explain these patterns, we cannot confidently disentangle the impact of alternatives such as coding, casemix, and the availability and use of non-hospital settings. We need to better understand the links between rehospitalisation frequency and mortality.

  14. Update in geriatric medicine.

    PubMed

    Cayea, Danelle; Eckstrom, Elizabeth; Christmas, Colleen

    2012-03-01

    With an aging population, internists will provide care to a growing number of older adults, a population at risk of developing multiple chronic medical conditions and geriatric syndromes. For this update in geriatric medicine, we highlight recent key articles focused on preventive strategies and lifestyle changes that reduce the burden of disease and functional decline in older adults. We identified English-language articles published between March 1, 2010 and March 31, 2011 by review of the contents of major geriatrics/general medicine journals and journal watch services including: New England Journal of Medicine, Annals of Internal Medicine, Journal of the American Medical Association, Lancet, Archives of Internal Medicine, British Medical Journal, Journal of the American Geriatrics Society, and the Journals of Gerontology. We also reviewed updates to the Cochrane database of systematic reviews and articles highlighted by the ACP Journal Club and Journal Watch. Inclusion criteria included (1) randomized controlled trials, (2) conditions exclusive or common to older adults, and (3) commonly seen in generalist practices. After abstract review, each author selected five articles, and these were reviewed again by all authors. Through multiple discussions, consensus was reached on the final articles selected for inclusion based on their quality and potential to improve the health of older patients cared for by generalists.

  15. Biomedical practices from a patient perspective. Experiences of Polish female migrants in Barcelona, Berlin and London.

    PubMed

    Main, Izabella

    2016-08-01

    This paper focuses on the diversity in patients' experience of bio-medicine and contrasts it with the normative view characteristic of health professionals. Ethnographic fieldwork among Polish migrant women in London, Barcelona and Berlin included interviews about their experiences with local healthcare and health professionals. Themes drawn from the narratives are differences between the cities in terms of communication between patients and health professionals, respect for patients' choices and dignity, attitudes to pregnancy and birth (different levels of medicalization), and paediatric care. It is argued that patients continuously negotiate among their own views and expectations based on previous experiences and knowledge from personal communication; internet forums and publications; and the offer of medical services in the countries of their settlement. Patients experience pluralism of therapeutic traditions within and outside bio-medicine. In turn, representatives of bio-medicine are rarely aware of other medical practices and beliefs and this leads to various misunderstandings. By highlighting the pluralism of medical practices in European countries and the increasing mobility of patients, this case study has useful implications for medical anthropologists and health professionals in a broader Western context, such as raising sensitivity to different communication strategies and a diversity of curing traditions and expectations.

  16. Forest resources of southern New England

    Treesearch

    Robert T. Brooks; David B. Kittredge; Carol L. Alerich; Carol L. Alerich

    1993-01-01

    An analytical report of the third forest inventory of the three southern New England states of Connecticut, Massachusetts, and Rhode Island. Included is a discussion of forest area, number of trees, timber volume, tree biomass, timber value, forest wildlife habitat, ownership, management opportunities, and the future of forest resources in southern New England.

  17. Leading Indicator: New England's Higher Education Economy

    ERIC Educational Resources Information Center

    Mortenson, Thomas G.

    2003-01-01

    In few places is higher education so ingrained in a region's economic vitality as in New England. Students from all over the world enroll in New England's institutions of learning and research, bringing resources to finance their education and living expenses that reverberate throughout local and state economies. Human capital-based industries…

  18. Provision for Adult Illiteracy in England.

    ERIC Educational Resources Information Center

    Haviland, R. Michael

    The study is intended to begin the process of collecting, coordinating, and disseminating basic information about adult literacy projects and classes in England. Spanning the years 1950 to the present, the data are based on questionnaires sent to all listed adult literacy projects in England. Following a review of the history, background, and…

  19. Political Literacy in Japan and England

    ERIC Educational Resources Information Center

    Davies, Ian; Mizuyama, Mitsuharu; Ikeno, Norio; Parmenter, Lynne; Mori, Chiho

    2013-01-01

    The authors discuss findings from the project "Political Literacy in Japan and England". They do so to follow up on work published in this journal in 2011. The now completed project involved two schools in England and three schools in Japan, and had the aim of exploring what teachers would do in each country when asked to use the same…

  20. New England Takes Stock of Midterm Elections

    ERIC Educational Resources Information Center

    Harney, John O.; Morwick, Carolyn

    2014-01-01

    The recent midterm elections brought New England two new governors. Rhode Island elected its first woman chief executive in Gina Raimondo (D). Massachusetts elected Charlie Baker (R), a former Harvard Pilgrim CEO and official in the Weld and Cellucci administrations. Otherwise, the New England corner offices cautiously welcomed back incumbents:…

  1. Profitable woodlot management in New England

    Treesearch

    Stanley M. Filip; William B. Leak

    1962-01-01

    The woodlot owners of New England have a large stake in the forestry future of the region. In New England there are more than 250,000 woodlots, averaging about 60 acres each. All together they make up about 15 million acres; and they provide a large part of the raw material needed by local wood-using industries.

  2. New England's Vital Resource: The Labor Force.

    ERIC Educational Resources Information Center

    Hoy, John C., Ed.; Bernstein, Melvin H., Ed.

    A collection of analyses and projections is presented that explores the challenges posed by a rapidly evolving economy and the critical issue of manpower policy facing New England and the nation. New England was able to move from traditional industry to high technology because its colleges and universities supplied basic research and trained…

  3. New England Takes Stock of Midterm Elections

    ERIC Educational Resources Information Center

    Harney, John O.; Morwick, Carolyn

    2014-01-01

    The recent midterm elections brought New England two new governors. Rhode Island elected its first woman chief executive in Gina Raimondo (D). Massachusetts elected Charlie Baker (R), a former Harvard Pilgrim CEO and official in the Weld and Cellucci administrations. Otherwise, the New England corner offices cautiously welcomed back incumbents:…

  4. Does accountability for reasonableness work? A protocol for a mixed methods study using an audit tool to evaluate the decision-making of clinical commissioning groups in England.

    PubMed

    Kieslich, Katharina; Littlejohns, Peter

    2015-07-10

    Clinical commissioning groups (CCGs) in England are tasked with making difficult decisions on which healthcare services to provide against the background of limited budgets. The question is how to ensure that these decisions are fair and legitimate. Accounts of what constitutes fair and legitimate priority setting in healthcare include Daniels' and Sabin's accountability for reasonableness (A4R) and Clark's and Weale's framework for the identification of social values. This study combines these accounts and asks whether the decisions of those CCGs that adhere to elements of such accounts are perceived as fairer and more legitimate by key stakeholders. The study addresses the empirical gap arising from a lack of research on whether frameworks such as A4R hold what they promise. It aims to understand the criteria that feature in CCG decision-making. Finally, it examines the usefulness of a decision-making audit tool (DMAT) in identifying the process and content criteria that CCGs apply when making decisions. The adherence of a sample of CCGs to criteria emerging from theories of fair priority setting will be examined using the DMAT developed by PL. The results will be triangulated with data from semistructured interviews with key stakeholders in the CCG sample to ascertain whether there is a correlation between those CCGs that performed well in the DMAT exercise and those whose decisions are perceived positively by interviewees. Descriptive statistical methods will be used to analyse the DMAT data. A combination of quantitative and qualitative content analysis methods will be used to analyse the interview transcripts. Full ethics approval was received by the King's College London Biomedical Sciences, Dentistry, Medicine and Natural and Mathematical Sciences Research Ethics Subcommittee. The results of the study will be disseminated through publications in peer review journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  5. Does accountability for reasonableness work? A protocol for a mixed methods study using an audit tool to evaluate the decision-making of clinical commissioning groups in England

    PubMed Central

    Kieslich, Katharina; Littlejohns, Peter

    2015-01-01

    Introduction Clinical commissioning groups (CCGs) in England are tasked with making difficult decisions on which healthcare services to provide against the background of limited budgets. The question is how to ensure that these decisions are fair and legitimate. Accounts of what constitutes fair and legitimate priority setting in healthcare include Daniels’ and Sabin's accountability for reasonableness (A4R) and Clark's and Weale's framework for the identification of social values. This study combines these accounts and asks whether the decisions of those CCGs that adhere to elements of such accounts are perceived as fairer and more legitimate by key stakeholders. The study addresses the empirical gap arising from a lack of research on whether frameworks such as A4R hold what they promise. It aims to understand the criteria that feature in CCG decision-making. Finally, it examines the usefulness of a decision-making audit tool (DMAT) in identifying the process and content criteria that CCGs apply when making decisions. Methods and analysis The adherence of a sample of CCGs to criteria emerging from theories of fair priority setting will be examined using the DMAT developed by PL. The results will be triangulated with data from semistructured interviews with key stakeholders in the CCG sample to ascertain whether there is a correlation between those CCGs that performed well in the DMAT exercise and those whose decisions are perceived positively by interviewees. Descriptive statistical methods will be used to analyse the DMAT data. A combination of quantitative and qualitative content analysis methods will be used to analyse the interview transcripts. Ethics and dissemination Full ethics approval was received by the King's College London Biomedical Sciences, Dentistry, Medicine and Natural and Mathematical Sciences Research Ethics Subcommittee. The results of the study will be disseminated through publications in peer review journals. PMID:26163034

  6. Connecting Londoners with Their City through Digital Technologies

    ERIC Educational Resources Information Center

    Swift, Frazer

    2013-01-01

    London is one of the most complex, dynamic and diverse cities in the world, with 8 million residents, over 300 languages spoken in its schools, and some 30 million overseas visitors every year. Reaching out to and connecting all these people with the city's heritage while catering to their many interests, motivations and learning needs is a huge…

  7. Battersea: Education in a London Parish since 1750

    ERIC Educational Resources Information Center

    Saint, Andrew

    2010-01-01

    This paper examines the development of educational institutions and buildings in one slice of a big city over a long timescale. The city is London and the slice Battersea, an inner suburb of mixed character and volatile fortunes. The narrative explores the shifts and interactions between state and voluntary provision, local community needs and…

  8. Exploring anterograde associative memory in London taxi drivers

    PubMed Central

    Woollett, Katherine; Maguire, Eleanor A.

    2013-01-01

    London taxi drivers are renowned for their navigation ability, spending a number of years acquiring ‘The Knowledge’ of London’s complex layout and having to pass stringent examinations to obtain an operating licence. In several studies, this navigation skill has been associated with increased posterior but also decreased anterior hippocampal grey matter volume. Neuropsychologically, gain and loss has also been documented in taxi drivers; while very skilled at navigation in London, they are significantly poorer than controls at learning and recalling new object-location associations. Here we tested a group of London taxi drivers and matched control participants on this object-location associations task, while also submitting them to a battery of challenging anterograde associative memory tests involving verbal, visual and auditory material both within and across modalities. Our aim was to assess whether their difficulty in previous studies reflected a general problem with associative memory, or was restricted to the spatial domain. We replicated previous findings of poor learning and memory of object-location associations. By contrast, their performance on the other anterograde associative memory tasks was comparable to controls. This resolves an outstanding question in the memory profile of London taxi drivers following hippocampal plasticity, and underlines the close relationship between space and the hippocampus. PMID:22955143

  9. Intergenerational Learning between Children and Grandparents in East London

    ERIC Educational Resources Information Center

    Kenner, Charmian; Ruby, Mahera; Jessel, John; Gregory, Eve; Arju, Tahera

    2007-01-01

    This study investigates the learning exchange between three- to six-year-old children and their grandparents, in Sylheti/Bengali-speaking families of Bangladeshi origin and monolingual English-speaking families living in east London. The following concepts from sociocultural theory are applied to this new area of intergenerational learning:…

  10. In London, a Working-Class University Wrestles with Change

    ERIC Educational Resources Information Center

    Labi, Aisha

    2012-01-01

    Patrick McGhee, vice chancellor of the University of East London, has a lot in common with many of the 28,000 students at the large urban institution he leads. He was the first in his family to attend university. And he dislikes much about the government's higher-education reform efforts, which he has deemed "misguided, premature, unproven…

  11. The University College London Archive of Stuttered Speech (UCLASS)

    ERIC Educational Resources Information Center

    Howell, Peter; Davis, Stephen; Bartrip, Jon

    2009-01-01

    Purpose: This research note gives details of 2 releases of audio recordings available from speakers who stutter that can be accessed on the Web. Method: Most of the recordings are from school-age children. These are available on the University College London Archive of Stuttered Speech (UCLASS) Web site, and information is provided about how to…

  12. A Community Approach to Youth Work in East London.

    ERIC Educational Resources Information Center

    Cox, Derek M.

    Instituted as part of "Avenues Unlimited" (The Tower Hamlets Youth Project), a community development approach to youth services was attempted in the cosmopolitan inner city slum district of Spitalfields, East London. Efforts began in 1966 with a clean up campaign, a neighborhood club for parents and youth, and other activities by the…

  13. Multicultural Music in the London Borough of Harrow.

    ERIC Educational Resources Information Center

    Murphy, Frank

    1991-01-01

    A project to introduce the music of different cultures into primary and secondary classrooms in London is reported. The six cultures are Indian music and dance, Latin American rock and steel pans, jazz, Indian drums, and Chinese music and movement. The project model is related to multicultural education in general. (Author/LB)

  14. Martha Whiteley of Imperial College, London: A Pioneering Woman Chemist

    ERIC Educational Resources Information Center

    Nicholson, Rafaelle M.; Nicholson, John W.

    2012-01-01

    Martha Whiteley (1866-1956) was one of the most important women chemists in the United Kingdom in the first half of the 20th century. In a male-dominated field, she was an academic on the staff of a co-educational university, Imperial College, London, where she carried out research of her own choosing, rather than assisting a male professor. She…

  15. Multicultural Music in the London Borough of Harrow.

    ERIC Educational Resources Information Center

    Murphy, Frank

    1991-01-01

    A project to introduce the music of different cultures into primary and secondary classrooms in London is reported. The six cultures are Indian music and dance, Latin American rock and steel pans, jazz, Indian drums, and Chinese music and movement. The project model is related to multicultural education in general. (Author/LB)

  16. A fatal case of Lassa fever in London, January 2009.

    PubMed

    Kitching, A; Addiman, S; Cathcart, S; Bischop, L; Krahé, D; Nicholas, M; Coakley, J; Lloyd, G; Brooks, T; Morgan, D; Turbitt, D

    2009-02-12

    In January 2009, the eleventh [corrected] case of Lassa fever imported to the United Kingdom was diagnosed in London. Risk assessment of 328 healthcare contacts with potential direct exposure to Lassa virus - through contact with the case or exposure to bodily fluids - was undertaken. No contacts were assessed to be at high risk of infection and no secondary clinical cases identified.

  17. In London, a Working-Class University Wrestles with Change

    ERIC Educational Resources Information Center

    Labi, Aisha

    2012-01-01

    Patrick McGhee, vice chancellor of the University of East London, has a lot in common with many of the 28,000 students at the large urban institution he leads. He was the first in his family to attend university. And he dislikes much about the government's higher-education reform efforts, which he has deemed "misguided, premature, unproven…

  18. The London Lighthouse. A centre for people with AIDS.

    PubMed

    1988-12-01

    In October last year an Evian Health Award was presented to Mr Christopher Spence, director of London Lighthouse, for pioneering the first independent aids hospice against much opposition. The Lighthouse is now open and although the hospice is the core of its work it also provides a range of other services.

  19. Fit for What? Special Education in London, 1890-1914

    ERIC Educational Resources Information Center

    Read, Jane

    2004-01-01

    This paper presents a case study of the implementation by the London School Board of special education for children designated 'feeble-minded' or 'mentally defective' in the period from 1890 to the passing of the Elementary Education (Defective and Epileptic Children) Act in 1914. Through an analysis of the choice of pedagogy for special schools,…

  20. Martha Whiteley of Imperial College, London: A Pioneering Woman Chemist

    ERIC Educational Resources Information Center

    Nicholson, Rafaelle M.; Nicholson, John W.

    2012-01-01

    Martha Whiteley (1866-1956) was one of the most important women chemists in the United Kingdom in the first half of the 20th century. In a male-dominated field, she was an academic on the staff of a co-educational university, Imperial College, London, where she carried out research of her own choosing, rather than assisting a male professor. She…

  1. Gender Politics and Privatization in the London Borough of Camden.

    ERIC Educational Resources Information Center

    Brush, Lisa D.

    1986-01-01

    This article examines the differential impact of the privatization of social services on women in the London borough of Camden. Concludes that women will suffer greater decline than men in employment, wages, and status as a result of the privatization taking place in Great Britain. (JDH)

  2. Intergenerational Learning between Children and Grandparents in East London

    ERIC Educational Resources Information Center

    Kenner, Charmian; Ruby, Mahera; Jessel, John; Gregory, Eve; Arju, Tahera

    2007-01-01

    This study investigates the learning exchange between three- to six-year-old children and their grandparents, in Sylheti/Bengali-speaking families of Bangladeshi origin and monolingual English-speaking families living in east London. The following concepts from sociocultural theory are applied to this new area of intergenerational learning:…

  3. Battersea: Education in a London Parish since 1750

    ERIC Educational Resources Information Center

    Saint, Andrew

    2010-01-01

    This paper examines the development of educational institutions and buildings in one slice of a big city over a long timescale. The city is London and the slice Battersea, an inner suburb of mixed character and volatile fortunes. The narrative explores the shifts and interactions between state and voluntary provision, local community needs and…

  4. Connecting Londoners with Their City through Digital Technologies

    ERIC Educational Resources Information Center

    Swift, Frazer

    2013-01-01

    London is one of the most complex, dynamic and diverse cities in the world, with 8 million residents, over 300 languages spoken in its schools, and some 30 million overseas visitors every year. Reaching out to and connecting all these people with the city's heritage while catering to their many interests, motivations and learning needs is a huge…

  5. Health economic evaluation in England.

    PubMed

    Raftery, James

    2014-01-01

    The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness.

  6. The social impact of dizziness in London and Siena.

    PubMed

    Bronstein, Adolfo M; Golding, John F; Gresty, Michael A; Mandalà, Marco; Nuti, Daniele; Shetye, Anu; Silove, Yvonne

    2010-02-01

    Although dizziness is a common presenting symptom in general and hospital practice, its social cost is not known. We assessed the social and work life impact of dizziness on patients in two contrasting European cities, Siena and London. First, we developed the 'Social life & Work Impact of Dizziness questionnaire' (SWID), which was validated by administering it to 43 patients with dizziness and 45 normal controls and by correlating the results with the EQ-5D (Europe quality of life) questionnaire. The SWID and EQ-5D scores were worse in patients than controls (p < 0.001) and the two correlated significantly (r = 0.50 p < 0.001). Then two hundred consecutive patients per city attending tertiary specialised 'dizzy patient' clinics, one in London led by a neurologist, one in Siena led by an ear, nose and throat specialist (ENT), were investigated with SWID. Amongst the 400 patients, 27% reported changing their jobs and 21% giving up work as a result of the dizziness. Over 50% of patients felt that their efficiency at work had dropped considerably. The mean number of days off work attributed to the dizziness in the previous 6 months was 7.15 days. Social life was disrupted in 57% of all 400 patients. Factor analysis identified that detrimental effects on work, travel, social and family life combine to create a single factor accounting for much of the overall impact of their dizziness. Significant differences in some measures of handicap between London and Siena emerged, with London patients often faring worse. Reasons for these location differences include, as expected, a higher proportion of neurological patients in London than in Siena. However, factors related to city demographics and social cohesion may also modulate the impact on quality of life and working practice. Regardless of inter-city differences, these findings highlight the high social and economic impact of dizziness.

  7. Deaths of cyclists in london: trends from 1992 to 2006

    PubMed Central

    2010-01-01

    Background Cycling is an increasingly important mode of transport for environmental and health reasons. Cycling fatalities in London were previously investigated in 1994 using routinely collected data. Since then, there have been shifts in the modes of transport used, and in transport policies. We sought to replicate the previous work using data on cyclist deaths in London between 1992 and 2006, specifically investigating whether heavy goods vehicles continued to pose a threat. Methods Observational study based on analysis of time series of police road casualties data, 1992 to 2006, in London, UK. The main outcome measures were cyclists killed in road traffic collisions. Poisson regression and chi-squared test for homogeneity were used to assess time effects. Travel flow data was then used to estimate annual fatality rates per 100,000 cyclists per kilometre. Results From 1992 to 2006 there was a mean of 16 cycling fatalities per year (range 8-21). 146 deaths (60%) were in inner London and 96 in outer London. There was no evidence for a decline over time (p = 0.7) other than a pronounced dip in 2004 when there were 8 fatalities. Freight vehicles were involved in 103 of 242 (43%) of all incidents and the vehicle was making a left turn in over half of these (53%). The fatality rate ranged from 20.5 deaths in 1992 to 11.1 deaths in 2006 per 100,000 estimated cyclists per kilometre (rate ratio 0.54, 95% confidence interval 0.28 to 1.03). Conclusions There is little evidence fatality rates have fallen. Freight vehicles over 3.5 tonnes continue to present a disproportionate threat; they should be removed from urban roads and more appropriate means of delivery of essential goods found. PMID:21078190

  8. Increasing incidence of tuberculosis in England and Wales: a study of the likely causes.

    PubMed Central

    Bhatti, N.; Law, M. R.; Morris, J. K.; Halliday, R.; Moore-Gillon, J.

    1995-01-01

    OBJECTIVE--To examine factors responsible for the recent increase in tuberculosis in England and Wales. DESIGN--Study of the incidence of tuberculosis (a) in the 403 local authority districts in England and Wales, ranked according to Jarman score, and (b) in one deprived inner city district, according to ethnic origin and other factors. SETTING--(a) England and Wales 1980-92, and (b) the London borough of Hackney 1986-93. MAIN OUTCOME MEASURE--Age and sex adjusted rate of tuberculosis. RESULTS--In England and Wales notifications of tuberculosis increased by 12% between 1988 and 1992. The increase was 35% in the poorest 10th of the population and 13% in the next two; and in the remaining 70% there was no increase. In Hackney the increase affected traditionally high risk and low risk ethnic groups to a similar extent. In the "low risk" white and West Indian communities the incidence increased by 58% from 1986-8 (78 cases) to 1991-3 (123), whereas in residents of Indian subcontinent origin the increase was 41% (from 51 cases to 72). Tuberculosis in recently arrived immigrants--refugees (11% of the Hackney population) and Africans (6%)--accounted for less than half of the overall increase, and the proportion of such residents was much higher than in most socioeconomically deprived districts. The local increase was not due to an increase in the proportion of cases notified, to HIV infection, nor to an increase in homeless people. CONCLUSIONS--The national rise in tuberculosis affects only the poorest areas. Within one such area all residents (white and established ethnic minorities) were affected to a similar extent. The evidence indicates a major role for socioeconomic factors in the increase in tuberculosis and only a minor role for recent immigration from endemic areas. PMID:7728031

  9. London through Rose-Colored Graphics: Visual Rhetoric and Information Graphic Design in Charles Booth's Maps of London Poverty

    ERIC Educational Resources Information Center

    Kimball, Miles A.

    2006-01-01

    In this article, I examine a historical information graphic--Charles Booth's maps of London poverty (1889-1902)--to analyze the cultural basis of ideas of transparency and clarity in information graphics. I argue that Booth's maps derive their rhetorical power from contemporary visual culture as much as from their scientific authority. The visual…

  10. Royal Society, Discussion on the Satellite Doppler Tracking and Its Geodetic Applications, London, England, October 10, 11, 1978, Proceedings

    NASA Astrophysics Data System (ADS)

    1980-01-01

    The discussion covers variation of Doppler results with software and time, geodetic satellite Doppler positioning and application to Canadian test adjustments, geoid float techniques in satellite geodesy, and the Russian satellite navigation system. Attention is given to topics on improved accuracy from Doppler satellite positioning, Doppler integration intervals and correlation and to terrestrial-Doppler adjustment and analysis of the primary triangulation of Great Britain.

  11. Grove Fuel Cell Symposium - Progress in Fuel Cell Commercialisation, 2nd, London, England, Sept. 24-27, 1991, Proceedings

    NASA Astrophysics Data System (ADS)

    Appleby, A. J.; Lovering, D. G.

    1992-01-01

    Consideration is given to American fuel cell market development, a gas utility approach to fuel cell commercialization, solid oxide fuel cell developments, proton exchange membrane fuel cell systems engineering, and high temperature fuel cell development. Electric vehicle drive systems, solid polymer fuel cell developments, the role of fuel cells in California clean air initiatives, fuel cell energy recovery from landfill gas, and fuel cells and the city of the future are also considered.

  12. Proceedings of the World Summit on Television for Children. Final Report. (2nd, London, England, March 9-13, 1998).

    ERIC Educational Resources Information Center

    Clarke, Genevieve, Ed.

    This report summarizes the presentations and events of the Second World Summit on Television for Children, to which over 180 speakers from 50 countries contributed, with additional delegates speaking in conference sessions and social events. The report includes the following sections: (1) production, including presentations on the child audience,…

  13. Royal Society, Discussion on Optical Bistability, Dynamical Nonlinearity and Photonic Logic, London, England, March 21, 22, 1984, Proceedings

    NASA Astrophysics Data System (ADS)

    Wherrett, B. S.; Smith, S. D.

    1984-12-01

    An introduction to optically bistable devices and photonic logic is presented, and the impact of technological advances and architectural insights on the design of optical computers is considered along with one-electron theory of nonlinear refraction, nonperturbative many-body theory of the optical nonlinearities in semiconductors, optical bistability in CuCl, multiple quantum well optical nonlinearities, semiconductor nonlinear etalons, and InSb devices involving transphasors with high gain, bistable switches and sequential logic gates. Other subjects explored are related to bistability experimentally observed at three milliwatts in indium arsenide and theoretically predicted for a new class on nonlinear dielectrics, giant nonlinearities and low power optical bistability in cadmium sulfide platelets, bistability in CdHgTe, dynamic effects in optical bistability, and all-optical logic in optical waveguides. Attention is also given to solitons in optical bistability, resonant modulation, guided-wave controlled etalons, and intrinsic polarization bistability in nonlinear media.

  14. Recent developments and applications of infrared analytical instrumentation; Proceedings of the Meeting, London, England, June 7, 8, 1988

    NASA Astrophysics Data System (ADS)

    Willis, H. A.

    1988-01-01

    The technology and applications of IR instruments for the chemical and physical characterization of materials and for remote sensing are discussed in reviews and reports. Topics examined include NIR spectroscopy, hemispherical reflectometers, IR laser optoacoustic detection of gases and vapors, and IR process analyzers with minimal sampling requirements. Consideration is given to computer algorithms for spectral analysis, photoacoustic and photothermal techniques, recent advances in silicide detectors, airborne thermal imaging, and the relative merits of the 3-5-micron and 8-12-micron bands for different applications.

  15. The International Symposium on Applied Military Psychology (18th) Held at London, England on 21-25 June 1982,

    DTIC Science & Technology

    1982-11-30

    just this past year the separate and indeed they often went directly to women’s services were legally abolished, their bunks to recuperate after a work...5* Rep. Sanitfi A.M. Centro Studie Ricerche Medicina Aeronauticae Spaziale Viale P. Gobetti, 2-2A 00185 Roma Dr. Massimiliano Stracca Ispettorato

  16. Elementary Education in England with Special Reference to London, Liverpool, and Manchester. Bulletin, 1913, No. 57. Whole Number 568

    ERIC Educational Resources Information Center

    Kandel, I. L.

    1914-01-01

    With the rapid growth of American cities and the large increase in their industrial population, the problems of the city school administration are becoming more complex and difficult. These problems are different for different cities and can seldom if ever be solved by imitation. Yet a knowledge of the administration of the schools of one large…

  17. Online Information 96. Proceedings of the International Online Information Meeting (20th, London, England, UK, December 3-5, 1996).

    ERIC Educational Resources Information Center

    Raitt, David I., Ed.; Jeapes, Ben, Ed.

    This proceedings volume contains 68 papers. Subjects addressed include: access to information; the future of information managers/librarians; intelligent agents; changing roles of library users; disintermediation; Internet review sites; World Wide Web (WWW) search engines; Java; online searching; future of online education; integrated information…

  18. Online Information 96. Proceedings of the International Online Information Meeting (20th, London, England, UK, December 3-5, 1996).

    ERIC Educational Resources Information Center

    Raitt, David I., Ed.; Jeapes, Ben, Ed.

    This proceedings volume contains 68 papers. Subjects addressed include: access to information; the future of information managers/librarians; intelligent agents; changing roles of library users; disintermediation; Internet review sites; World Wide Web (WWW) search engines; Java; online searching; future of online education; integrated information…

  19. Inner London's Education Authority: Reflections on ILEA Twenty-Five Years after Closure

    ERIC Educational Resources Information Center

    Mitchell, Peter

    2015-01-01

    It is 25 years since the Inner London Education Authority (ILEA) was abolished and management of education in central London transferred to 13 London boroughs. The author reflects on the experience of being an ex-ILEA head teacher, and of managing one of the new local education authorities in the immediate post-ILEA period. He begins by commenting…

  20. Inner London's Education Authority: Reflections on ILEA Twenty-Five Years after Closure

    ERIC Educational Resources Information Center

    Mitchell, Peter

    2015-01-01

    It is 25 years since the Inner London Education Authority (ILEA) was abolished and management of education in central London transferred to 13 London boroughs. The author reflects on the experience of being an ex-ILEA head teacher, and of managing one of the new local education authorities in the immediate post-ILEA period. He begins by commenting…

  1. Building a Hypertextual Digital Library in the Humanities: A Case Study on London.

    ERIC Educational Resources Information Center

    Crane, Gregory; Smith, David A.; Wulfman, Clifford E.

    This paper describes the creation of a new humanities digital library collection: 11,000,000 words and 10,000 images representing books, images, and maps on pre-twentieth century London and its environs. The London collection contained far more dense and precise information than the materials from the Greco-Roman world. The London collection thus…

  2. An Observational Study Using English Syndromic Surveillance Data Collected During the 2012 London Olympics - What did Syndromic Surveillance Show and What Can We Learn for Future Mass-gathering Events?

    PubMed

    Todkill, Dan; Hughes, Helen E; Elliot, Alex J; Morbey, Roger A; Edeghere, Obaghe; Harcourt, Sally; Hughes, Tom; Endericks, Tina; McCloskey, Brian; Catchpole, Mike; Ibbotson, Sue; Smith, Gillian

    2016-12-01

    Introduction In preparation for the London 2012 Olympic Games, existing syndromic surveillance systems operating in England were expanded to include daily general practitioner (GP) out-of-hours (OOH) contacts and emergency department (ED) attendances at sentinel sites (the GP OOH and ED syndromic surveillance systems: GPOOHS and EDSSS). Hypothesis/Problem The further development of syndromic surveillance systems in time for the London 2012 Olympic Games provided a unique opportunity to investigate the impact of a large mass-gathering event on public health and health services as monitored in near real-time by syndromic surveillance of GP OOH contacts and ED attendances. This can, in turn, aid the planning of future events.

  3. Trends in community violence in England and Wales 2005-2009.

    PubMed

    Sivarajasingam, Vaseekaran; Page, Nicholas; Morgan, Peter; Matthews, Kent; Moore, Simon; Shepherd, Jonathan

    2014-03-01

    Injury records from Emergency Departments (EDs) have been studied over the last decade as part of the work of the National Violence Surveillance Network (NVSN) and provide information about local, regional and national violence levels and trends in England and Wales. The purpose of the current study is to evaluate overall, gender, age-specific and regional trends in community violence in England and Wales from an ED perspective from January 2005 to December 2009. Violence-related injury data were collected prospectively in a stratified sample of 77 EDs (Types 1, 3 and 4) in the nine Government Office Regions in England and in Wales. All 77 EDs were recruited on the basis that they had implemented and continued to comply with the provisions of the 1998 Data Protection Act and Caldicott guidance. Attendance date, age and gender of patients who reported injury in violence were identified using assault-related attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends. In total 221,673 (163,384 males: 74%) violence-related attendances were identified. Overall estimated annual injury rate was 6.5 per 1000 resident population (males 9.8 and females 3.4 per 1000). Violence affecting males and females decreased significantly in England and Wales over the 5-year period, with an overall estimated annual decrease of 3% (95% CI: 1.8-4.1%, p<0.05). Attendances decreased significantly for both genders across four out of the five age groups studied. Attendances were found to be highest during the months of May and July and lowest in February. Substantial differences in violence-related ED attendances were identified at the regional level. From this ED perspective overall violence in England and Wales decreased over the period 2005-2009 but increased in East Midlands, London and South West regions. Since 2006, overall trends according to Crime Survey for England and Wales (CSEW), police and ED measures were

  4. How are sexual health clinics in England managing men who have sex with men who refuse to be tested for HIV?

    PubMed

    Hoyos Miller, Juan; Clarke, Emily; Patel, Raj; Kell, Philip; Desai, Monica; Nardone, Anthony

    2017-01-01

    The aim of this study was to ascertain the existence of written policies and common clinical practices in sexual health clinics in England for the management of men who have sex with men who refuse to test for HIV. All sexual health clinics in England ( n = 223) were invited to complete an online questionnaire in August-September 2014. The questionnaire covered the four domains of clinic policies, management practices, training and monitoring. We assess differences by region. Overall, 92 clinics participated. Only three clinics reported having a written policy. In contrast, most reported having a common agreed practice (94% in London vs. 71.6% elsewhere). When encountering a refusal, 72.2% of the London clinics and 53.4% of the clinics from elsewhere offered a less invasive option. Few clinics (17.4%) provided information on home sampling kits and 74.4% informed about other testing options. Eighty-seven per cent of the clinics recorded the occurrence of refusals, but only 37.8% reviewed the collected data. Providing staff with training was more common in London (94.1% vs. 73.8%). Clear policies should be developed to guide professionals when encountering men who have sex with men who refuse an HIV test. Offering less invasive testing options and information on alternative testing options could be easily introduced into routine practice. Efforts should be made to review monitoring data in order to identify implications of test refusals and introduce improvements in management of refusals.

  5. Cervical cancer screening in England.

    PubMed

    Patnick, J

    2000-11-01

    Cervical screening in England is provided free of charge by the National Health Service to all women aged 20-64 years. Computerised call and recall was introduced in 1988 and women receive an invitation every 3-5 years. Smears are taken by the local family doctor, by his/her nurse or at community clinics. Approximately 85% of English women have had a smear in the last 5 years. Quality assurance programmes have recently been established for laboratories and colposcopy clinics and lessons have been learned from previous failures of the service. The incidence has fallen from 16 per 100000 in 1986 to 9.3 per 100000 in 1997. Mortality is currently falling by 7% per year.

  6. Environmental geology of Bath, England

    NASA Astrophysics Data System (ADS)

    Kellaway, G. A.

    1995-10-01

    The hot springs of Bath, England, have been of importance to man for hundreds of years. It was a famous spa in Roman times. Subsequently, the springs were used during the 17th through the 20th centuries and extensive urban and commercial properties were developed at Bath using the water for medical and tourist-oriented activities. With urban and commercial development in the area, man's impact on the environment was substantial and typical environmental problems included pollution, land subsidence, or stability that effected construction, drainage, highways, and canals. During the growth of Bath in the 18th and 19th centuries these environmental problems were described by geologist William Smith and Joseph Townsend. Bath and vicinity provides a unique example of environmental geoscience.

  7. New England style passive solar

    SciTech Connect

    Kriescher, P.

    2000-06-01

    There are homeowners throughout New England who planned for and built homes that allow them to avoid the sting of winter's high heating bills. These climate-responsive homes rely on passive solar heating, cooling and lighting. An example of such a climate-responsive/passive solar house is the home that Arthur and Terry Becker build on 6 beautiful acres (2.4 hectares) of rolling farm and woodland southeast of Andover, Connecticut, in 1981. They worked very closely with their designer, Al Eggan of K.T. Lear and Associates, to ensure that they would never have to pay for home heating oil, and that they would enjoy a level of year-round comfort that they had not experienced in conventionally built homes.

  8. Education in the attic: an insight into the educational services of the Old Operating Theatre Museum and Herb Garret, London Bridge.

    PubMed

    Edge, Stevie

    2009-01-01

    Hidden for almost a century in the attic of St Thomas' Church the oldest operating theatre in Britain is now part of a museum. This precious building now houses a collection of pre-anaesthetic tools, items relating to medicine in the home and various Apothecary displays. The museum aims to preserve the theatre and items relating to medicine, in order to contribute to the understanding of the development of medical knowledge, with particular reference to St Thomas' hospital. An independent museum with a long history of educational provision: this article explores some of the education services of The Old Operating Theatre Museum and Herb Garret at London Bridge.

  9. Exporting Poor Health: The Irish in England

    PubMed Central

    Delaney, Liam; Fernihough, Alan; Smith, James P

    2013-01-01

    The Irish-born population in England typically were in worse health than both the native population and the Irish population in Ireland, a reversal of the commonly observed healthy migrant effect (HIE). Recent birth-cohorts living in England and born in Ireland, however, are healthier than the English population. The substantial Irish migrant health penalty arises principally for cohorts born between 1920 and 1960. This paper attempts to understand the processes that generated these changing migrant health patterns for Irish migrants to England. Our results suggest a strong role for economic selection in driving the dynamics of health differences between the Irish-born migrants and White English populations. PMID:24014181

  10. "Capacity is key": investigating new legal provisions in England and Wales for adult safeguarding.

    PubMed

    Manthorpe, Jill; Samsi, Kritika; Rapaport, Joan

    2013-01-01

    This study aimed to investigate the views and experiences of local Safeguarding Adults Coordinators of the newly implemented Mental Capacity Act 2005. This legislation in England and Wales has both protection and empowerment as its dual goals. Fifteen Safeguarding Adults Coordinators (SACs) employed by local authorities in the London area were interviewed in 2008, and again 2 years later. A total of 12 SACs participated in the 2010 follow-up interviews. The findings are reported here, covering experiences and views on the implementation and uses of the Act. There was overwhelming support for the Act as enhancing people's rights to a life free from abuse, of providing a framework for the assessment of decision-making capacity, and of assisting practitioners in reducing risks and responding to abusive situations. Participants urged better publicity about the Act, more detailed guidance on the new offenses, and greater attention to the interactions with other government policy goals.

  11. Crossing the quality chasm: lessons from health care quality improvement efforts in England

    PubMed Central

    2002-01-01

    The second report from the US Institute of Medicine Crossing the Quality Chasm, highlighted the deficiencies in health care quality in the USA, analyzed the contributory factors, and proposed 13 recommendations for improvements. Clearly, the challenges are enormous. Can anything be learned from the experiences of other countries? This article describes the author's experiences of health care quality improvement efforts in the National Health Service in England and their implications for the USA and for Baylor Health Care System. PMID:16333409

  12. A mathematical model of the London riots and their policing.

    PubMed

    Davies, Toby P; Fry, Hannah M; Wilson, Alan G; Bishop, Steven R

    2013-01-01

    In August 2011, several areas of London experienced episodes of large-scale disorder, comprising looting, rioting and violence. Much subsequent discourse has questioned the adequacy of the police response, in terms of the resources available and strategies used. In this article, we present a mathematical model of the spatial development of the disorder, which can be used to examine the effect of varying policing arrangements. The model is capable of simulating the general emergent patterns of the events and focusses on three fundamental aspects: the apparently-contagious nature of participation; the distances travelled to riot locations; and the deterrent effect of policing. We demonstrate that the spatial configuration of London places some areas at naturally higher risk than others, highlighting the importance of spatial considerations when planning for such events. We also investigate the consequences of varying police numbers and reaction time, which has the potential to guide policy in this area.

  13. Intussusception and the great smog of London, December 1952.

    PubMed

    Black, J

    2003-12-01

    To discuss the possible significance of the increased incidence of intussusception in children in relation to the "Great Smog" of London in December 1952. Cases of intussusception were recorded in two hospitals in East London for the years 1951, 1952, 1953, and 1954. For 1952 the actual dates of admission were recorded. During the year 1952 the total number of cases of intussusception greatly exceeded that in the previous and succeeding years. Immediately during and after the fog there was a clustering of cases, which only occurred during this period. The increased incidence of cases during 1952 is thought to reflect the annual variation in incidence resulting from changes in the prevalence of viruses capable of causing intussusception. The clustering of cases in relation to the fog may reflect a facilitated entry of virus through the wall of the terminal ileum due to the effect of swallowed irritants such as sulphurous acid and smoke particles.

  14. Intussusception and the great smog of London, December 1952

    PubMed Central

    Black, J

    2003-01-01

    Aim: To discuss the possible significance of the increased incidence of intussusception in children in relation to the "Great Smog" of London in December 1952. Methods: Cases of intussusception were recorded in two hospitals in East London for the years 1951, 1952, 1953, and 1954. For 1952 the actual dates of admission were recorded. Results: During the year 1952 the total number of cases of intussusception greatly exceeded that in the previous and succeeding years. Immediately during and after the fog there was a clustering of cases, which only occurred during this period. Conclusions: The increased incidence of cases during 1952 is thought to reflect the annual variation in incidence resulting from changes in the prevalence of viruses capable of causing intussusception. The clustering of cases in relation to the fog may reflect a facilitated entry of virus through the wall of the terminal ileum due to the effect of swallowed irritants such as sulphurous acid and smoke particles. PMID:14670763

  15. Web GIS in practice II: interactive SVG maps of diagnoses of sexually transmitted diseases by Primary Care Trust in London, 1997 – 2003

    PubMed Central

    Boulos, Maged N Kamel; Russell, Chris; Smith, Michael

    2005-01-01

    Background The rates of Sexually transmitted diseases (STDs) in England have been rising steadily since the mid 1990s, making them a major public health concern. In 2003, 672,718 people were diagnosed with an STD in England, and around one third of those cases were diagnosed in London. Results Using GeoReveal v1.1 for Windows, we produced Web-based interactive choropleth maps of diagnoses of STDs by Primary Care Trust (PCT) in London for the years from 1997 to 2003 . These maps are in Scalable Vector Graphics (SVG) format and require a freely available Adobe SVG browser plug-in to be displayed. They are based on data obtained from the House of Commons Hansard Written Answers for 15 October 2004. They show steadily rising rates of STDs in London over the covered seven-year period. Also, one can clearly see on the maps that PCTs located in central London had the highest numbers of STD diagnoses throughout the mapped seven years. A companion bar chart allows users to instantly compare the STD figure of a given PCT for a given year against the average figure for all 25 mapped PCTs for the same year, and also compare those figures across all seven years. The maps offer users a rich set of useful features and functions, including the ability to change the classification method in use, the number of ranges in the map, and the colour theme, among others. Conclusions Wizard-driven tools like GeoReveal have made it very easy to transform complex raw data into valuable decision support information products (interactive Web maps) in very little time and without requiring much expertise. The resultant interactive maps have the potential of further supporting health planners and decision makers in their planning and management tasks by allowing them to graphically interrogate data, instantly spot trends, and make quick and effective visual comparisons of geographically differentiated phenomena between different geographical areas and over time. SVG makes an ideal format for such

  16. Popular opinion leaders in London: a response to Kelly.

    PubMed

    Elford, J; Bolding, G; Sherr, L

    2004-02-01

    Controlled trials conducted in the USA provide clear evidence that peer education can bring about a reduction in high risk sexual behaviour among gay men. HIV prevention interventions that systematically identified, recruited, trained and engaged popular opinion leaders (POLs) made a significant impact on sexual behaviour at a community level in small US towns. However, recent trials conducted in the UK have failed to replicate these findings. A POL intervention in London made no significant impact at a community level on the risk behaviours of gay men. Jeffrey Kelly, one of the authors of the US studies, has identified nine core elements central to the popular opinion leader model. In Kelly's view 'the UK projects were not tests of the popular opinion leader model because they did not employ most of these POL core elements'. The absence of any significant impact of the UK programmes on sexual risk behaviour at a community level was not, therefore, surprising. In fact, the London POL project incorporated all the core elements into its design and succeeded in employing seven out of nine in its delivery. Attempts to employ all the core elements, however, were hampered by problems in recruiting popular opinion leaders as well as barriers to communication. Process evaluation revealed that it was these obstacles which limited diffusion. This in turn explained the absence of any impact of the London POL project on sexual risk behaviour at a community level. The obstacles to successful diffusion in London have provided a valuable opportunity for examining the processes that underlie the POL model. Our study raises the question as to whether social interventions shown to be effective in one setting, place or moment in time can be replicated in another.

  17. Modelling of hydrogen infrastructure for vehicle refuelling in London

    NASA Astrophysics Data System (ADS)

    Joffe, D.; Hart, D.; Bauen, A.

    One of the principal barriers to the widespread use of hydrogen as a road transport fuel is the need for a refuelling infrastructure to be established. The lack of an adequate refuelling infrastructure would severely inhibit an uptake of hydrogen vehicles. On the other hand, without significant penetration of these vehicles, the demand for hydrogen would be insufficient to make a widespread conventional refuelling infrastructure economic. The infrastructure is likely to develop initially in cities, due to the high concentration of vehicles and the anticipated air quality benefits of a switch to hydrogen as a road transport fuel. While trial schemes such as the Clean Urban Transport for Europe (CUTE) bus project will establish initial hydrogen refuelling sites, it is not clear how a transition to a widespread refuelling infrastructure will occur. Indeed, the number of possible different ways and scales of producing and distributing hydrogen means that the possible configurations for such an infrastructure are almost endless. Imperial College London is examining transition strategies for a hydrogen infrastructure for vehicle refuelling in London under a project funded by the UK Engineering and Physical Sciences Research Council (EPSRC). Imperial has five project partners from industry and local government to assist in this study: the Greater London Authority (GLA), BP, BOC, BMW and Air Products. This paper presents initial results from technical modelling of hydrogen infrastructure technologies and how they could be deployed to provide an initial facility for the refuelling of hydrogen fuel-cell buses in London. The results suggest that the choice of H 2 production technology can have significant effects on when the infrastructure would be installed, and the timing of hydrogen production, and bus refuelling.

  18. 33 CFR 110.147 - New London Harbor, Conn.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... (4) Anchorage D. In Long Island Sound approximately two miles west-southwest of New London Ledge...,460 yards; 009°, 2,480 yards; 026°, 1,175 yards; and 008°, 1,075 yards. (3) Anchorage C. In the Thames... Ledge Light: 246°, 2.6 miles; 247°, 2.1 miles; 233°, 2.1 miles; and 235°, 2.6 miles. (5) Anchorage...

  19. Millennium-long recession of limestone facades in London

    NASA Astrophysics Data System (ADS)

    Brimblecombe, Peter; Grossi, Carlota M.

    2008-12-01

    Historical data on the temperature and precipitation data for London has been combined with output from the Hadley Model to estimate the climate of London for the period 1100-2100 CE. This has been converted to other parameters such as freeze-thaw frequency and snowfall relevant to the weathering of stone facades. The pollutant concentrations have been estimated for the same period, with the historical values taken from single box modelling and future values from changes likely given current policy within the metropolis. These values are used in the Lipfert model to show that the recession from karst weathering dominates across the period, while the contributions of sulphur deposition seem notable only across a shorter period 1700-2000 CE. Observations of the late seventeenth century suggest London architects witnessed a notable increase in the recession rate and attributed “fretting quality” to “smoaks of the sea-coal”. The recession rates measured in the late twentieth century lend some support to the estimates from the Lipfert model. The recession looks to increase only slightly, and frost shattering will decrease while salt weathering is likely to increase.

  20. The ClearfLo project - Understanding London's meteorology and composition

    NASA Astrophysics Data System (ADS)

    Belcher, Stephen; Bohnenstengel, Sylvia

    2014-05-01

    ClearfLo is a large multi-institutional project funded by the UK Natural Environment Research Council (NERC). ClearfLo established integrated measurements of meteorology, gaseous and particulate composition/loading of London's (UK) urban atmosphere in 2011 and 2012 to understand the processes underlying poor air quality. A new and unique long-term measurement infrastructure was established in London at street level, urban background and elevated sites and contrasted against rural locations to determine the urban increment in meteorology and pollution. This approach enables understanding the seasonal variations in the meteorology and composition together with the controlling processes. In addition two intensive observation periods (IOPs) provide more detail in winter 2012 and during the Olympics in summer 2012 focusing upon the vertical structure and evolution of the urban boundary layer, chemical controls on nitrogen dioxide and ozone production, in particular the role of volatile organic compounds, and processes controlling the evolution, size, distribution and composition of particulate matter. In this talk we present early analysis of the meteorology and air quality measurements within ClearfLo. In particular we show measurements that indicate the dominant regimes of London's boundary layer.

  1. Place and provision: mapping mental health advocacy services in London.

    PubMed

    Foley, Ronan; Platzer, Hazel

    2007-02-01

    The National Health Service (NHS) Executive for London carried out an investigation in 2002 as part of their wider mental health strategy to establish whether existing mental health advocacy provision in the city was meeting need. The project took a two-part approach, with an emphasis on, (a) mapping the provision of advocacy services and, (b) cartographic mapping of service location and catchments. Data were collected through a detailed questionnaire with service providers in collaboration with the Greater London Mental Health Advocacy Network (GLMHAN) and additional health and government sources. The service mapping identified some key statistics on funding, caseloads and models of service provision with an additional emphasis on coverage, capacity, and funding stability. The questionnaire was augmented by interviews and focus groups with commissioners, service providers and service users and identified differing perspectives and problems, which informed the different perspectives of each of these groups. The cartographic mapping exercise demonstrated a spatially-even provision of mental health advocacy services across the city with each borough being served by at least one local service as well as by London wide specialist schemes. However, at local level, no one borough had the full range of specialist provision to match local demographic need. Ultimately the research assisted the Advisory Group in providing commissioning agencies with clear information on the current status of city-wide mental health advocacy services, and on gaps in existing advocacy provision alongside previously unconsidered geographical and service dimensions of that provision.

  2. Summary of inaugural meeting of the Skin Care in Organ Recipients Group, UK, held at the Royal Society of Medicine, 7 October 2004.

    PubMed

    Eedy, D J

    2005-07-01

    This summarizes a meeting held in London at the Royal Society of Medicine, which was brought together by Prof. Fenella Wojnarowska, Professor of Dermatology at Churchill Hospital, Oxford and cofounder of Skin Care in Organ Recipients, UK (SCOR.UK).

  3. Diesel Exhaust in New England | US EPA

    EPA Pesticide Factsheets

    2017-04-10

    Pollution from diesel engines is a widespread problem across New England and it significantly contributes to air pollution, especially in urban areas. Diesel exhaust is made up of small particles, known as fine particulate matter.

  4. Air Toxics in New England | US EPA

    EPA Pesticide Factsheets

    2017-04-10

    Find general information about air toxics, what EPA is doing to reduce ambient air toxics levels, information on the reductions we have seen to date from large New England manufacturing companies, as well as links to other related websites.

  5. EPA New England Environmental Data Review Supplement

    EPA Pesticide Factsheets

    This document provides Region 1-specific implementation guidance for reviewing and reporting sample results generated for data collection activities and is used in conjunction with the EPA New England Environmental Data Review Program Guidance.

  6. Association between obesity and prescribed medication use in England.

    PubMed

    Kinge, Jonas Minet; Morris, Stephen

    2014-12-01

    We investigate the association between obesity and use of prescribed medications in England. Data were taken from fourteen rounds of the Health Survey for England (1999-2012), which has measures of current prescribed medication use based on therapeutic classifications in the British National Formulary, and nurse-measured height and weight. We find that obesity has a statistically significant and positive association with use of a range of medicines for managing diseases associated with obesity. The mean probability of using any type of medication is 0.40 in those of normal weight, 0.44 in the overweight, 0.52 in obesity class I and 0.60 in obesity class II/III. Significant positive associations were found between obesity and the use of medication for diseases of the cardiovascular system, gastrointestinal system, respiratory system, and central nervous system, as well as for infections, endocrine system disorders, gynaecological/urinary disorders and musculoskeletal and joint disorders. Use of anti-obesity medication is low, even among those with class II/III obesity.

  7. Epidemiology of Toxocariasis in England and Wales.

    PubMed

    Halsby, K; Senyonjo, L; Gupta, S; Ladbury, G; Suvari, M; Chiodini, P; Morgan, D

    2016-11-01

    Toxocara infection occurs through ingestion of parasite eggs excreted by dogs and cats, and can cause severe morbidity. The burden of disease in England and Wales is not well described, and the impact of public health campaigns conducted in the mid-1990s is uncertain. This paper uses data from two extensive databases to explore the trends in this disease in England and Wales from the 1970s to 2009. © 2016 Blackwell Verlag GmbH.

  8. The forests of Southern New England, 2012

    Treesearch

    Brett J. Butler; Susan J. Crocker; Grant M. Domke; Cassandra M. Kurtz; Tonya W. Lister; Patrick D. Miles; Randall S. Morin; Ronald J. Piva; Rachel Riemann; Christopher W. Woodall

    2015-01-01

    This report summarizes the U.S. Forest Service, Forest Inventory and Analysis (FIA) forest inventory data, collected from 2008 to 2012, for Southern New England, defined as Connecticut, Massachusetts, and Rhode Island. Forests cover an estimated 5,128,000 acres or 59 percent of Southern New England—1,736,000 acres in Connecticut (56 percent of the State), 3,028,000...

  9. An evaluation of commissioning arrangements for intrauterine and subdermal contraception services from general practitioners in London, UK.

    PubMed

    Ma, Richard; Brown, Eleanor

    2015-01-01

    General practitioners (GPs) in the UK may be commissioned to provide long-acting reversible contraception (LARC), which may have a role in reducing rates of abortion and unintended pregnancies. Primary care trusts (PCTs) in England had commissioning arrangements with GPs to provide LARC but little is known about such contractual arrangements. We studied the commissioning arrangements in some London PCTs to evaluate the cost and clinical governance of these contracts. We requested commissioning contract specifications and activities for intrauterine contraception (IUC) and subdermal implants (SDI) from responsible officers in each PCT in London relating to activities in three financial years, namely 2009/2010 to 2011/2012. We evaluated each contract using a structure, process and outcome approach. Half (15/31) the PCTs responded and submitted 20 contracts used to commission their GPs to provide IUC, SDI or a combination of these with testing for sexually transmitted infections. The information regarding service activity was inadequate and inconsistent so had to be abandoned. Information from 20 contracts suggested there was a variation in clinical governance and quality assurance mechanisms; there was also a range in the reimbursement for IUC insertion (£77.50 to £105.00), SDI insertion (£25.00 to £81.31) and SDI removal (£30.00 to £100.00) at 2011 prices. It was not clear from non-responders if these PCTs had a service in place. Of those that did commission IUC and SDI services, some specifications were lacking in detail regarding aspects of clinical governance. New commissioners should make explicit references to quality and safety criteria as poor-quality specifications can give rise to serious untoward incidents and litigation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. The tragic 1824 journey of the Hawaiian king and queen to London: history of measles in Hawaii.

    PubMed

    Shulman, Stanford T; Shulman, Deborah L; Sims, Ronald H

    2009-08-01

    The susceptibility of isolated island-based populations to acute infections like measles is well documented, most clearly in Fiji and the Faröe Islands. We review the remarkably tragic 1824 journey of King Kamehameha II and Queen Kamamalu of Hawaii to London and the later enormous impact of measles on Hawaii on first arrival in 1848. The young royalty came to seek an audience with King George IV to negotiate an alliance with England. Virtually the entire royal party developed measles within weeks of arrival, 7 to 10 days after visiting the Royal Military Asylum housing hundreds of soldiers' children. Within the month the king (27) and queen (22) succumbed to measles complications. Their bodies were transported to Hawaii by Right Honorable Lord Byron (Captain George Anson, the poet's cousin). Before 1848 measles was unknown in Hawaii. Several epidemics struck Hawaii in late 1848, beginning with measles and pertussis, then diarrhea and influenza. Measles arrived at this time from California, spreading from Hilo, Hawaii, through all the islands; 10% to 33% of the population died. Subsequent measles epidemics occurred in 1861, 1889 to 1890, 1898, and 1936 to 1937, the latter with 205 deaths. The imported epidemics of infections including measles diminished Hawaii's population from approximately 300,000 at Captain Cook's arrival in 1778 to 135,000 in 1820 and 53,900 in 1876. The measles deaths of the king and queen in London in 1824, likely acquired visiting a large children's home, was a harbinger of the devastating impact of measles upon Hawaiians 24 years later with its first arrival to the Sandwich (Hawaiian) Islands.

  11. Who is more likely to use doctor-rating websites, and why? A cross-sectional study in London

    PubMed Central

    Galizzi, Matteo Maria; Miraldo, Marisa; Stavropoulou, Charitini; Desai, Mihir; Jayatunga, Wikum; Joshi, Mitesh; Parikh, Sunny

    2012-01-01

    Objectives To explore the extent to which doctor-rating websites are known and used among a sample of respondents from London. To understand the main predictors of what makes people willing to use doctor-rating websites. Design A cross-sectional study. Setting The Borough of Hammersmith and Fulham, London, England. Participants 200 individuals from the borough. Main outcome measures The likelihood of being aware of doctor-rating websites and the intention to use doctor-rating websites. Results The use and awareness of doctor-rating websites are still quite limited. White British subjects, as well as respondents with higher income are less likely to use doctor-rating websites. Aspects of the doctor–patient relationship also play a key role in explaining intention to use the websites. The doctor has both a ‘complementary’ and ‘substitute’ role with respect to Internet information. Conclusions Online rating websites can play a major role in supporting patients’ informed decisions on which healthcare providers to seek advice from, thus potentially fostering patients’ choice in healthcare. Subjects who seek and provide feedback on doctor-ranking websites, though, are unlikely to be representative of the overall patients’ pool. In particular, they tend to over-represent opinions from non-White British, medium–low-income patients who are not satisfied with their choice of the healthcare treatments and the level of information provided by their GP. Accounting for differences in the users’ characteristics is important when interpreting results from doctor-rating sites. PMID:23148340

  12. VIS/NIR Spectroscopy to determine the spatial variation of the weathering degree in Paleogene clay soil - London Clay Formation

    NASA Astrophysics Data System (ADS)

    Nasser, Mohammed; Gibson, Andy, ,, Dr; Koor, Nick, ,, Dr; Gale, Professor Andy; Huggett, Jenny, ,, Dr; Branch, Steve

    2017-04-01

    The London Clay Formation (LCF) which underlies much of South-East England is hugely important as a construction medium. However, its geotechnical performance (shear strength, compressive strength, shrink-swell behaviour, etc. ) is greatly affected by its degree of weathering. Despite this importance, little attention has been focussed on a robust method to define and measure its degree of weathering. This is perhaps a result of a well-known colour change from bluish-grey to brown that accompanies 'weathering' and considered to be the result of oxidisation (Chandler and Apted 1988). Through wide experience, this definition is normally effective, but it is perhaps subjective and reliant on the experience of the investigator and the ability to observe samples or exposures. More objective investigation, typically using SEM is not normally economically feasible or expedient for construction works. We propose a simple, robust method to characterise the degree of weathering in the LCF using reflective or Visible-Near-InfraRed-Spectroscopy (VNIRS). 24 samples were extracted from 2 boreholes drilled in the Hampstead area of London to depths of 12 m within the uppermost Claygate Member of the LCF. VNIRS spectra (350-2500 nm) were measured from all samples and compared with XRD, XRF, SEM and PSD results on the same samples. Results show increased magnitude of absorption features related to clay mineralogy around 1400, 1900 and 2200 nm to a depth of 5 m beneath ground level. Beneath this depth, the absorption features show little variation. SEM analyses show corresponding changes in the degradation of pyrite crystals and individual clay (illite/smectite). These preliminary results show that there is a good potential for VNIRS spectroscopy to determine the variation of weathering in the LCF.

  13. NETS: Capturing electricity information in New England

    SciTech Connect

    Abe, J.D.; Alexander, L.R.; Clark, C.F.; Rosen, R.A.

    1999-05-01

    The six New England states share a common electricity market. Five of the six states, representing 95% of retail electricity sales in New England, have enacted electric industry restructuring laws. The other state, Vermont, is presently considering restructuring. Two states, Massachusetts and Rhode Island, have already implemented full retail access in the service territories of their investor-owned utilities. Each New England state has also promulgated, or is in the process of developing, a disclosure standard; some are also developing renewable portfolio standards (RPS) and/or generation performance standards (GPS) that will require the tracking of electricity information. Regulators in New England therefore have a common interest to explore the development of uniform electricity market rules for tracking electricity attributes. This interest served as the impetus for the New England Governors' Conference to hire Environmental Futures, the Tellus Institute, and Synapse Energy Economics to produce the New England Tracking System (NETS) Report. This article provides the policy background that forms the basis for the proposed tracking system and addresses key issues and obstacles identified in the NETS report: the collection and assignment of tracking data to electricity, and identification of an appropriate tracking system administrator. The article concludes by presenting selected comments from the public review process and subsequent next steps. A companion article on page 55 discusses the tracking methodology, detailing how allocations would be made for various wholesale transactions.

  14. Aerospace Medicine

    NASA Technical Reports Server (NTRS)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  15. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  16. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  17. Bath Stone - a Possible Global Heritage Stone from England

    NASA Astrophysics Data System (ADS)

    Marker, Brian

    2014-05-01

    The Middle Jurassic strata of England have several horizons of oolitic and bioclastic limestones that provide high quality dimension stone. One of the most important is found in and near the City of Bath. The Great Oolite Group (Upper Bathonian) contains the Combe Down and Bath Oolites, consisting of current bedded oolites and shelly oolites, that have been used extensively as freestones for construction nearby, for prestigious buildings through much of southern England and more widely. The stone has been used to some extent since Roman times when the city, then known as Aquae Sulis, was an important hot spa. The stone was used to a limited extent through medieval times but from the early 18th century onwards was exploited on a large scale through surface quarrying and underground mining. The City was extensively redeveloped in the 18th to early 19th century, mostly using Bath Stone, when the spas made it a fashionable resort. Buildings from that period include architectural "gems" such as the Royal Crescent and Pulteney Bridge, as well as the renovated Roman Baths. Many buildings were designed by some of the foremost British architects of the time. The consistent use of this stone gives the City an architectural integrity throughout. These features led to the designation of the City as a World Heritage Site. It is a requirement in current City planning policy documents that Bath Stone should be used for new building to preserve the appearance of the City. More widely the stone was used in major houses (e.g. Buckingham Palace and Apsley House in London; King's Pavilion in Brighton); civic buildings (e.g. Bristol Guildhall; Dartmouth Naval College in Devon); churches and cathedrals (e.g. Truro Cathedral in Cornwall); and engineered structures (e.g. the large Dundas Aqueduct on the Kennet and Avon Canal). More widely, Bath Stone has been used in Union Station in Washington DC; Toronto Bible College and the Town Hall at Cape Town, South Africa. Extraction declined in

  18. [Brief introduction of TCM education in New England School of Acupuncture in the USA].

    PubMed

    Yang, Bing

    2012-08-01

    New England School of Acupuncture is the first Chinese Medicine School in the United States. From the aspects of school history, status of students and situation of teachers, curriculum design, clinical practice and scientific research, this present article makes a simple introduction for this school, and briefly compares the Chinese Medicine education between China and west. Different from China, the American education is more lively and vivid, open and flexible, but lacks enough attention on the study of classic and clinical practice. In a word, China and the West could learn from each other and make the best of the both worlds.

  19. Variability in carbon dioxide fluxes for dense urban, suburban and woodland environments in southern England

    NASA Astrophysics Data System (ADS)

    Ward, Helen; Kotthaus, Simone; Grimmond, C. Sue; Bjorkegren, Alex; Wilkinson, Matt; Morrison, Will; Evans, Jon; Morison, James; Christen, Andreas

    2014-05-01

    The net exchange of carbon dioxide between the surface and atmosphere can be measured using the eddy covariance technique. Fluxes from a dense urban environment (central London), a suburban landscape (Swindon) and a woodland ecosystem (Alice Holt) are compared. All sites are located in southern England and experience similar climatic and meteorological conditions, yet have very different land cover. The signatures of anthropogenic and biogenic processes are explored at various (daily, seasonal and annual) timescales. Particular emphasis is placed on identifying the mixture of controls that determine the flux. In summer, there are clear similarities between the suburban and woodland sites, as the diurnal behaviour is dominated by photosynthetic uptake. In winter, however, vegetation is largely dormant and human activity determines the pattern of fluxes at the urban and suburban sites. Emissions from building heating augment the net release of carbon dioxide in cold months. Road use is a major contributor to the total emissions, and the diurnal cycle in the observed fluxes reflects this: in central London roads are busy throughout the day, whereas in Swindon a double-peaked rush-hour signal is evident. The net exchange of carbon dioxide is estimated for each site and set in context with other studies around the world. Central London has the smallest proportion of vegetation and largest emissions amongst study sites in the literature to date. Although Swindon's appreciable vegetation fraction helps to offset the anthropogenic emissions, even in summertime the 24h total flux is usually positive, indicating carbon release. Comparison of these three sites in a similar region demonstrates the effects of increasing urban density and changing land use on the atmosphere. Findings are relevant in terms of characterising the behaviour of urban surfaces and for quantifying the impact of anthropogenic activities.

  20. Public health in interwar England and Wales: did it fail?

    PubMed Central

    Gorsky, Martin

    2008-01-01

    British historians initially saw the interwar period as a «golden age» for public health in local government, with unprecedented preventive and curative powers wielded by Medical Officers of Health (MOsH). In the 1980s Lewis and Webster challenged this reading, arguing that MOsH were overstretched, neglectful of their «watchdog» role and incapable of formulating a new philosophy of preventive medicine. The article first details this critique, then reappraises it in the light of recent demographic work. It then provides a case study of public health administration in South-West England. Its conclusion is that some elements of the Lewis/Webster case now deserve to be revised. PMID:19230339

  1. Endoscope decontamination incidents in England 2003-2004.

    PubMed

    Gamble, H P; Duckworth, G J; Ridgway, G L

    2007-12-01

    An Endoscope Task Force was established following the report of an endoscope decontamination failure in May 2004. The Task Force reviewed endoscope decontamination incidents in England from 2003 to 2004 and made recommendations to prevent further recurrences. Twenty-one incidents were reported from 19 National Health Service (NHS) Trusts, 18 of which matched the Task Force definition of an incident. Eight incidents involved failures to decontaminate auxiliary endoscope channels, seven incidents highlighted problems with automated endoscope reprocessors, and the remaining three involved disinfection practices not recommended by the British Society of Gastroenterology Guidelines. Following an assessment of the risk of transmission from blood-borne viruses, the Task Force recommended that look-back exercises were not indicated. The nature of the incidents suggested that there were problems associated with defining roles and responsibilities for endoscope decontamination, staff training and incompatibility between endoscopes and reprocessors. The Medicines and Healthcare Products Regulatory Agency subsequently issued recommendations to all NHS Trusts carrying out endoscopies.

  2. Opioid-related Policies in New England Emergency Departments.

    PubMed

    Weiner, Scott G; Raja, Ali S; Bittner, Jane C; Curtis, Kevin M; Weimersheimer, Peter; Hasegawa, Kohei; Espinola, Janice A; Camargo, Carlos A

    2016-09-01

    of opioid-related policies varies among New England EDs. The presence of policies recommending use of screening tools and prescribing naloxone for at-risk patients was low, whereas those regarding utilization of the PDMP and referral of patients with opioid abuse to recovery resources were more common. These data provide important benchmarks for future evaluations and recommendations. © 2016 by the Society for Academic Emergency Medicine.

  3. A spatio-temporal model for estimating the long-term effects of air pollution on respiratory hospital admissions in Greater London.

    PubMed

    Rushworth, Alastair; Lee, Duncan; Mitchell, Richard

    2014-07-01

    It has long been known that air pollution is harmful to human health, as many epidemiological studies have been conducted into its effects. Collectively, these studies have investigated both the acute and chronic effects of pollution, with the latter typically based on individual level cohort designs that can be expensive to implement. As a result of the increasing availability of small-area statistics, ecological spatio-temporal study designs are also being used, with which a key statistical problem is allowing for residual spatio-temporal autocorrelation that remains after the covariate effects have been removed. We present a new model for estimating the effects of air pollution on human health, which allows for residual spatio-temporal autocorrelation, and a study into the long-term effects of air pollution on human health in Greater London, England. The individual and joint effects of different pollutants are explored, via the use of single pollutant models and multiple pollutant indices.

  4. Casebooks in Early Modern England:

    PubMed Central

    Kassell, Lauren

    2014-01-01

    summary Casebooks are the richest sources that we have for encounters between early modern medical practitioners and their patients. This article compares astrological and medical records across two centuries, focused on England, and charts developments in the ways in which practitioners kept records and reflected on their practices. Astrologers had a long history of working from particular moments, stellar configurations, and events to general rules. These practices required systematic notation. Physicians increasingly modeled themselves on Hippocrates, recording details of cases as the basis for reasoned expositions of the histories of disease. Medical records, as other scholars have demonstrated, shaped the production of medical knowledge. Instead, this article focuses on the nature of casebooks as artifacts of the medical encounter. It establishes that casebooks were serial records of practice, akin to diaries, testimonials, and registers; identifies extant English casebooks and the practices that led to their production and preservation; and concludes that the processes of writing, ordering, and preserving medical records are as important for understanding the medical encounter as the records themselves. PMID:25557513

  5. The New England forest: baseline for New England forest health monitoring

    Treesearch

    Robert T. Brooks; Thomas S Frieswyk; Douglas M. Griffith; Ellen Cooter; Luther Smith; Luther Smith

    1992-01-01

    The USDA Forest Service along with various cooperators has initiated Forest Health Monitoring (FHM) in New England to assess the condition and stressors of the region's forests, to analyze changes in these data over time, and to identify any relationships between forest condition and stressors. A major component of FHM in New England is 263 permanent plots located...

  6. 75 FR 16096 - New England Power Generators Association Inc., Complainant v. ISO New England Inc., Respondent...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission New England Power Generators Association Inc., Complainant v. ISO New... Generators Association Inc. (Complainant) filed a formal complaint against ISO New England Inc. (Respondent...

  7. "Cultivating health": therapeutic landscapes and older people in northern England.

    PubMed

    Milligan, Christine; Gatrell, Anthony; Bingley, Amanda

    2004-05-01

    While gardening is seen, essentially, as a leisure activity it has also been suggested that the cultivation of a garden plot offers a simple way of harnessing the healing power of nature (The therapeutic garden, Bantam Press, London, 2000). One implication of this is that gardens and gardening activity may offer a key site of comfort and a vital opportunity for an individual's emotional, physical and spiritual renewal. Understanding the extent to which this supposition may be grounded in evidence underpins this paper. In particular, we examine how communal gardening activity on allotments might contribute to the maintenance of health and well being amongst older people. Drawing on recently completed research in northern England, we examine firstly the importance of the wider landscape and the domestic garden in the lives of older people. We then turn our attention to gardening activity on allotments. Based on the findings of our study, we illustrate the sense of achievement, satisfaction and aesthetic pleasure that older people can gain from their gardening activity. However, while older people continue to enjoy the pursuit of gardening, the physical shortcomings attached to the aging process means they may increasingly require support to do so. Communal gardening on allotment sites, we maintain, creates inclusionary spaces in which older people benefit from gardening activity in a mutually supportive environment that combats social isolation and contributes to the development of their social networks. By enhancing the quality of life and emotional well being of older people, we maintain that communal gardening sites offer one practical way in which it may be possible to develop a 'therapeutic landscape'.

  8. Using population segmentation to inform local obesity strategy in England.

    PubMed

    Wills, Jane; Crichton, Nicola; Lorenc, Ava; Kelly, Muireann

    2015-09-01

    Little is known about the views of obese people and how best to meet their needs. Amongst London boroughs Barking and Dagenham has the highest prevalence of adult obesity at 28.7%; the lowest level of healthy eating and of physical activity; and is the 22nd most deprived area of England. The study aimed to gain insight into the attitudes, motivations and priorities of people who are obese or overweight to inform the social marketing of an obesity strategy. Two hundred and ten obese or overweight adults were recruited through visual identification in public thoroughfares to attempt to recruit those seldom seen in primary care. One hundred and eighty-one street-intercept and 52 in-depth interviews were conducted. Thematic analysis was followed by psychographic segmentation. Eleven population segments were identified based on their readiness to change, the value accorded to tackling obesity, identified enabling factors and barriers to weight management and perceived self-efficacy. This population showed considerable variation in its readiness to change and perceived control over obesity but considerable similarity in the exchange value they attributed to tackling their obesity. Even within a relatively homogenous socio-demographic community, there needs to be a range of interventions and messages tailored for different population segments that vary in their readiness to change and confidence about tackling obesity. The dominant emphasis of policy and practice on the health consequences of obesity does not reflect the priorities of this obese population for whom the exchange value of addressing obesity was daily functioning especially in relation to family life.

  9. Venereology at the Polyclinic: Postgraduate Medical Education Among General Practitioners in England, 1899–1914

    PubMed Central

    Hanley, Anne

    2015-01-01

    In 1899 the British Medical Journal enthusiastically announced that a new postgraduate teaching college was to open in London. The aim of the Medical Graduates’ College and Polyclinic (MGC) was to provide continuing education to general practitioners. It drew upon emerging specialisms and in so doing built upon the generalist training received at an undergraduate level. Courses were intended to refresh knowledge and to introduce general practitioners to new knowledge claims and clinical practices. The establishment of postgraduate institutions such as the MGC marked an important stage in the development of medical education in England. Yet these institutions, and the emergence of postgraduate medical education more broadly, have been largely overlooked by historians. Moreover the history of venereological training among medical undergraduates and postgraduates alike has been overlooked. The study of such special subjects characterised postgraduate study. This article examines the dissemination of venereological knowledge among subscribers to MGC as an important case study for the development of institutionalised postgraduate medical education in England at the turn of the twentieth century. PMID:25766540

  10. Vulnerability to the mortality effects of warm temperature in the districts of England and Wales

    NASA Astrophysics Data System (ADS)

    Bennett, James E.; Blangiardo, Marta; Fecht, Daniela; Elliott, Paul; Ezzati, Majid

    2014-04-01

    Warm temperatures adversely affect disease occurrence and death, in extreme conditions as well as when the temperature changes are more modest. Therefore climate change, which is expected to affect both average temperatures and temperature variability, is likely to impact health even in temperate climates. Climate change risk assessment is enriched if there is information on vulnerability and resilience to effects of temperature. Some studies have analysed socio-demographic characteristics that make individuals vulnerable to adverse effects of temperature. Less is known about community-level vulnerability. We used geo-coded mortality and environmental data and Bayesian spatial methods to conduct a national small-area analysis of the mortality effects of warm temperature for all 376 districts in England and Wales. In the most vulnerable districts, those in London and south/southeast England, odds of dying from cardiorespiratory causes increased by more than 10% for 1 °C warmer temperature, compared with virtually no effect in the most resilient districts, which were in the far north. A 2 °C warmer summer may result in 1,552 (95% credible interval 1,307-1,762) additional deaths, about one-half of which would occur in 95 districts. The findings enable risk and adaptation analyses to incorporate local vulnerability to warm temperature and to quantify inequality in its effects.

  11. Emergency call work-load, deprivation and population density: an investigation into ambulance services across England.

    PubMed

    Peacock, Philip J; Peacock, Janet L

    2006-06-01

    Demand for emergency ambulance services has risen steeply over the recent years. This study examined differences in work-load of ambulance services across England and investigated factors linked to high demand. The number of emergency calls received by each ambulance service in 1997 and 2002 and population and area data were used to calculate call rates and population density for each of 27 service areas. Deprivation score and proportion of the population under age 15 and over age 65 were calculated for each service area. There was wide variation in emergency call rates across England, with London having the highest rate both in 1997 (125.6 calls per 1000 persons) and in 2002 (140.1 per 1000). Statistically significant positive associations were observed between call rates and deprivation (1997, r = 0.49; 2002, r = 0.53) and between call rates and population density (1997, r = 0.70; 2002, r = 0.68). Following multivariable regression, the effect of deprivation score was consistently weaker, but the effect of population density was virtually unchanged. We conclude that areas with higher population density have higher call rates, which is not explained by deprivation. Deprivation is associated with higher usage, but its effect is partly due to population density. There is no evidence that these relationships are confounded by age.

  12. Think of your art-eries: Arts participation, behavioural cardiovascular risk factors and mental well-being in deprived communities in London

    PubMed Central

    Renton, A.; Phillips, G.; Daykin, N.; Yu, G.; Taylor, K.; Petticrew, M.

    2012-01-01

    Summary Objectives To investigate the association of participation in arts and cultural activities with health behaviours and mental well-being in low-income populations in London. Study design Cross-sectional, community-based observational study. Methods Data were taken from the cross-sectional baseline survey of the Well London cluster randomized trial, conducted during 2008 in 40 of the most deprived census lower super output areas in London (selected using the English Indices of Multiple Deprivation). Multiple imputation was used to account for missing data in the Well London survey. Descriptive statistics and regression analyses were used to examine the association between participation in arts and cultural activities and physical activity (meeting target of five sessions of at least 30 min of moderate-intensity physical activity per week), healthy eating (meeting target of at least five portions of fruit or vegetables per day) and mental well-being (Hope Scale score; feeling anxious or depressed). Results This study found that levels of arts and cultural engagement in low-income groups in London are >75%, but this is well below the national average for England. Individuals who were more socially disadvantaged (unemployed, living in rented social housing, low educational attainment, low disposable income) were less likely to participate in arts or cultural activities. Arts participation was strongly associated with healthy eating, physical activity and positive mental well-being, with no evidence of confounding by socio-economic or sociodemographic factors. Neither positive mental well-being nor social capital appeared to mediate the relationship between arts participation and health behaviours. Conclusion This study suggests that arts and cultural activities are independently associated with health behaviours and mental well-being. Further qualitative and prospective intervention studies are needed to elucidate the nature of the relationship between health

  13. Think of your art-eries: arts participation, behavioural cardiovascular risk factors and mental well-being in deprived communities in London.

    PubMed

    Renton, A; Phillips, G; Daykin, N; Yu, G; Taylor, K; Petticrew, M

    2012-09-01

    To investigate the association of participation in arts and cultural activities with health behaviours and mental well-being in low-income populations in London. Cross-sectional, community-based observational study. Data were taken from the cross-sectional baseline survey of the Well London cluster randomized trial, conducted during 2008 in 40 of the most deprived census lower super output areas in London (selected using the English Indices of Multiple Deprivation). Multiple imputation was used to account for missing data in the Well London survey. Descriptive statistics and regression analyses were used to examine the association between participation in arts and cultural activities and physical activity (meeting target of five sessions of at least 30 min of moderate-intensity physical activity per week), healthy eating (meeting target of at least five portions of fruit or vegetables per day) and mental well-being (Hope Scale score; feeling anxious or depressed). This study found that levels of arts and cultural engagement in low-income groups in London are >75%, but this is well below the national average for England. Individuals who were more socially disadvantaged (unemployed, living in rented social housing, low educational attainment, low disposable income) were less likely to participate in arts or cultural activities. Arts participation was strongly associated with healthy eating, physical activity and positive mental well-being, with no evidence of confounding by socio-economic or sociodemographic factors. Neither positive mental well-being nor social capital appeared to mediate the relationship between arts participation and health behaviours. This study suggests that arts and cultural activities are independently associated with health behaviours and mental well-being. Further qualitative and prospective intervention studies are needed to elucidate the nature of the relationship between health behaviours, mental well-being and arts participation. If arts

  14. Outcomes of the Bowel Cancer Screening Programme (BCSP) in England after the first 1 million tests

    PubMed Central

    Patnick, Julietta; Nickerson, Claire; Coleman, Lynn; Rutter, Matt D; von Wagner, Christian

    2012-01-01

    Introduction The Bowel Cancer Screening Programme in England began operating in 2006 with the aim of full roll out across England by December 2009. Subjects aged 60–69 are being invited to complete three guaiac faecal occult blood tests (6 windows) every 2 years. The programme aims to reduce mortality from colorectal cancer by 16% in those invited for screening. Methods All subjects eligible for screening in the National Health Service in England are included on one database, which is populated from National Health Service registration data covering about 98% of the population of England. This analysis is only of subjects invited to participate in the first (prevalent) round of screening. Results By October 2008 almost 2.1 million had been invited to participate, with tests being returned by 49.6% of men and 54.4% of women invited. Uptake ranged between 55–60% across the four provincial hubs which administer the programme but was lower in the London hub (40%). Of the 1.08 million returning tests 2.5% of men and 1.5% of women had an abnormal test. 17 518 (10 608 M, 6910 F) underwent investigation, with 98% having a colonoscopy as their first investigation. Cancer (n=1772) and higher risk adenomas (n=6543) were found in 11.6% and 43% of men and 7.8% and 29% of women investigated, respectively. 71% of cancers were ‘early’ (10% polyp cancer, 32% Dukes A, 30% Dukes B) and 77% were left-sided (29% rectal, 45% sigmoid) with only 14% being right-sided compared with expected figures of 67% and 24% for left and right side from UK cancer registration. Conclusion In this first round of screening in England uptake and fecal occult blood test positivity was in line with that from the pilot and the original European trials. Although there was the expected improvement in cancer stage at diagnosis, the proportion with left-sided cancers was higher than expected. PMID:22156981

  15. Heart failure - medicines

    MedlinePlus

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  16. Knowledge and attitudes to prescription charges in New Zealand and England.

    PubMed

    Norris, Pauline T; Wilson, Sarah E; Green, James A; Gu, Jessica; Goddard, Shelby; Deadman, Logan R; Dai, Jennefa; Fastier, Kelsi; Kothapally, Christina; Shi, Wendy; Whyte, Aleisha; Aslam, Haleema; Desai, Raeesa; Wood, Nicole; Sibley, Chris G

    2017-02-22

    Prescription charge regimes vary between countries but there is little research on how much people know about these or support values underlying them. To explore, in New Zealand (NZ) and England, the public's knowledge of, and attitudes to, charges and whether knowledge and attitudes varied by demographic characteristics or by values about entitlement to public goods. A questionnaire was developed and administered to people over 18 recruited in public places in NZ and England. 451 people in NZ and 300 people in England participated. Less than half in each country knew the current prescription charge. In each country 62% of people were unaware of arrangements to protect people from excessive annual charges. Support for free or lower cost medicines for children, people over 65, people on low incomes, people on benefits, and people with chronic health problems was higher in England than in NZ. Support varied by participants' demographic characteristics and, in the case of people on low incomes and people on benefits, by values about universal entitlements. Gaps in knowledge, particularly about mechanisms to protect people from high costs, are concerning and may lead to people paying excessive charges. There was consensus about the elderly, children and the chronically ill being "deserving" of lower prescription charges, but people who did not believe in universal access to public goods appeared to see people on low incomes or benefits as less "deserving". In general, public views resembled those underlying the prescription charge regime in their country. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Controls of carbon dioxide concentrations and fluxes above central London

    NASA Astrophysics Data System (ADS)

    Helfter, C.; Famulari, D.; Phillips, G. J.; Barlow, J. F.; Wood, C. R.; Grimmond, C. S. B.; Nemitz, E.

    2011-03-01

    Eddy-covariance measurements of carbon dioxide fluxes were taken continuously between October 2006 and May 2008 at 190 m height in central London (UK) to quantify emissions and study their controls. Inner London, with a population of 8.2 million (~5000 inhabitants per km2) is heavily built up with 8% vegetation cover within the central boroughs. CO2 emissions were found to be mainly controlled by fossil fuel combustion (e.g. traffic, commercial and domestic heating). The measurement period allowed investigation of both diurnal patterns and seasonal trends. Diurnal averages of CO2 fluxes were found to be correlated with traffic but also exhibited an inverse dependency on atmospheric stability in the near-neutral range, with higher fluxes coinciding with unstable stratification during most seasons and perhaps reflecting how changes in heating-related natural gas consumption and, to a lesser extent, photosynthetic activity controlled the seasonal variability. Despite measurements being taken at ca. 22 times the mean building height, coupling with street level was adequate, especially during daytime. Night-time saw a higher occurrence of stable or neutral stratification, especially in autumn and winter, which resulted in data loss in post-processing and caused the tower to become decoupled from street level. CO2 fluxes observed at night were not always correlated with traffic counts, probably reflecting this decoupling, but also the fact that at night heating was always a larger source than traffic. No significant difference was found between the annual estimate of net exchange of CO2 for the expected measurement footprint and the values derived from the National Atmospheric Emissions Inventory (NAEI), with daytime fluxes differing by only 3%. This agreement with NAEI data also supported the use of the simple flux footprint model which was applied to the London site; this also suggests that individual roughness elements did not significantly affect the measurements due

  18. Controls of carbon dioxide concentrations and fluxes above central London

    NASA Astrophysics Data System (ADS)

    Helfter, C.; Famulari, D.; Phillips, G. J.; Barlow, J. F.; Wood, C. R.; Grimmond, C. S. B.; Nemitz, E.

    2010-10-01

    Eddy-covariance measurements of carbon dioxide fluxes were taken semi-continuously between October 2006 and May 2008 at 190 m height in central London (UK) to quantify emissions and study their controls. Inner London, with a population of 8.2 million (~5000 inhabitants per km2) is heavily built up with 8% vegetation cover within the central boroughs. CO2 emissions were found to be mainly controlled by fossil fuel combustion (e.g. traffic, commercial and domestic heating). The measurement period allowed investigation of both diurnal patterns and seasonal trends. Diurnal averages of CO2 fluxes were found to be highly correlated to traffic. However changes in heating-related natural gas consumption and, to a lesser extent, photosynthetic activity that controlled the seasonal variability. Despite measurements being taken at ca. 22 times the mean building height, coupling with street level was adequate, especially during daytime. Night-time saw a higher occurrence of stable or neutral stratification, especially in autumn and winter, which resulted in data loss in post-processing. No significant difference was found between the annual estimate of net exchange of CO2 for the expected measurement footprint and the values derived from the National Atmospheric Emissions Inventory (NAEI), with daytime fluxes differing by only 3%. This agreement with NAEI data also supported the use of the simple flux footprint model which was applied to the London site; this also suggests that individual roughness elements did not significantly affect the measurements due to the large ratio of measurement height to mean building height.

  19. Religion and HIV diagnosis among Africans living in London.

    PubMed

    Fakoya, I; Johnson, Am; Fenton, Ka; Anderson, J; Nwokolo, N; Sullivan, Ak; Munday, P; Burns, Fm

    2012-11-01

    The aim of the paper was to describe the association of religion with HIV outcomes in newly diagnosed Africans living in London. A survey of newly diagnosed HIV-positive Africans attending 15 HIV treatment centres across London was carried out between April 2004 and February 2006. Confidential self-completed questionnaires were used, linked to clinical records. Bivariate analyses were conducted to ascertain whether religious beliefs were associated with late diagnosis, antiretroviral therapy, and immunological and virological outcome 6 months post diagnosis. A total of 246 Black Africans were eligible and included in the analysis: 62.6% were women, and the median age was 34 years. The median CD4 count at diagnosis was 194 cells/μL (range 0-1334 cells/μL) and 75.6% presented late, as defined as a CD4 count < 350 cells/μL. Most participants were religious: non-Roman Catholic Christians (55.7%), Roman Catholics (35.2%) and Muslims (6.1%). Only 1.2% stated that they did not have a religion. Participants who attended religious services at least monthly were more likely to believe that 'faith alone can cure HIV' than those who attended less frequently (37.7% vs. 15.0%; P = 0.002). A small proportion (5.2%) believed that taking antiretroviral therapy implied a lack of faith in God. Bivariate analysis found no relationship between religiousness (as measured using frequency of attendance at religious services and religious attitudes or beliefs) and late diagnosis, changes in CD4 count/viral load 6 months post diagnosis, or initiation of antiretroviral therapy. Strong religious beliefs about faith and healing are unlikely to act as a barrier to accessing HIV testing or antiretroviral treatment for Black Africans living in London. © 2012 British HIV Association.

  20. Air pollution dispersion models for human exposure predictions in London.

    PubMed

    Beevers, Sean D; Kitwiroon, Nutthida; Williams, Martin L; Kelly, Frank J; Ross Anderson, H; Carslaw, David C

    2013-01-01

    The London household survey has shown that people travel and are exposed to air pollutants differently. This argues for human exposure to be based upon space-time-activity data and spatio-temporal air quality predictions. For the latter, we have demonstrated the role that dispersion models can play by using two complimentary models, KCLurban, which gives source apportionment information, and Community Multi-scale Air Quality Model (CMAQ)-urban, which predicts hourly air quality. The KCLurban model is in close agreement with observations of NO(X), NO(2) and particulate matter (PM)(10/2.5), having a small normalised mean bias (-6% to 4%) and a large Index of Agreement (0.71-0.88). The temporal trends of NO(X) from the CMAQ-urban model are also in reasonable agreement with observations. Spatially, NO(2) predictions show that within 10's of metres of major roads, concentrations can range from approximately 10-20 p.p.b. up to 70 p.p.b. and that for PM(10/2.5) central London roadside concentrations are approximately double the suburban background concentrations. Exposure to different PM sources is important and we predict that brake wear-related PM(10) concentrations are approximately eight times greater near major roads than at suburban background locations. Temporally, we have shown that average NO(X) concentrations close to roads can range by a factor of approximately six between the early morning minimum and morning rush hour maximum periods. These results present strong arguments for the hybrid exposure model under development at King's and, in future, for in-building models and a model for the London Underground.

  1. Popular culture and sporting life in the rural margins of late eighteenth-century England: the world of Robert Anderson, "The Cumberland Bard".

    PubMed

    Huggins, Mike

    2012-01-01

    This study sets out to extend and challenge existing historiography on late eighteenth century British popular culture, customary sports, class and cultural identity, focusing upon the rural geo-political borderland of England. It suggests that prevailing class-based and more London-biased studies need to be balanced with more regionalist-based work, and shows the importance of northern regional leisure variants. The textual and historical analysis draws largely on the published works of a neglected working-class dialect poet, Robert Anderson, living and working in Cumberland, arguing that he represented a strain of ''bardic regionalism,'' a variant of Katie Trumpener’s ''bardic nationalism.''

  2. Public health policy and walking in England-analysis of the 2008 'policy window'.

    PubMed

    Milton, Karen; Grix, Jonathan

    2015-07-05

    Although the government in England has a long-standing interest in walking promotion, this has not been accompanied by a coherent strategic plan or investment to support physical activity behaviour change. However, in 2008 the government announced its intention to invest £7 million into walking promotion. This article utilises Kingdon's Multiple Streams framework as an organising principle through which to interrogate the reasons behind the increased emphasis on walking promotion as part of the public health policy agenda in England. The research adopted a case study design. Data were obtained through document analysis of relevant policies and semi-structured interviews with experts in the walking sector, including both government and non-government representatives. Kingdon's Multiple Streams theory proposes that at certain points in time, 'policy windows' are created through the convergence of a problem, an appropriate solution, and a receptive political environment, and this policy window presents an opportunity for major policy change. The findings of this research suggest that the success of London in securing the 2012 Olympic and Paralympic Games was the primary trigger in the creation of a policy window for walking promotion in recent years. Despite previous interest in walking promotion from the health and transport sectors, it was the recent alignment with the sports agenda that led to increased political commitment. This raises concerns that the research evidence on the health benefits of physical activity and rising levels of inactivity in England, are insufficient to secure government support and investment, and that multi-sector lobbying and joined-up political action may be critical in advancing this agenda.

  3. The psychological and psychiatric effects of terrorism: lessons from London.

    PubMed

    Rubin, G James; Wessely, Simon

    2013-09-01

    The 7 July 2005 bombings in London caused heightened levels of distress among some in the general community. This distress was most notable in Muslims and members of ethnic minority groups. These effects were transient for most. An estimated 30% of those who were more affected by the attacks, including victims and witnesses, developed psychiatric disorders as a result. An outreach program was set up to screen those who were exposed to potentially traumatic events and to offer them evidence-based treatment. This article discusses what lessons might be learned from studies of the general community and the screen-and-treat approach.

  4. Miscellanea: Survey of nameplates in a well known London Street

    PubMed Central

    Bickerton, Richard C; Milton, Catherine M

    1986-01-01

    In 1951 a well known otolaryngologist recorded 798 brass nameplates in a well known London street. In the 35 years since this last survey was conducted the number has decreased by 23. This surprising finding is attributed to the communal entryphone and to the emergence of the shoddy plate. A definition of a plate is proposed, the concentration described, and the geographical distribution of plates summarised. A new phenomenon is encountered, the ghost plate, type A and type B. Further study is required to elucidate the significance of ghost plates. Imagesp1680-a PMID:20742754

  5. Lessons for climate policy from The Great Stink of London

    NASA Astrophysics Data System (ADS)

    Skuce, A.

    2012-12-01

    A rapidly growing population and the introduction of the flush toilet in nineteenth-century London caused a crisis with sewage pollution in the River Thames (Halliday, 1999). There were decades of delays in implementing solutions owing to: inadequate governance institutions; political inertia; difficulties with financing; opposition from vested interests; scientific uncertainties; and technological challenges. Effective counter-measures were started only once the problem arose, quite literally, under the noses of parliamentarians. There are parallels, some of them pointed out earlier by Alley et al (2010), between the sewage crisis in Victorian London and the current problem with climate change. Both involve the unsustainable use of a common resource (a river, the atmosphere) for the unconstrained disposal of human waste products. Alley (2011) estimated that the costs of providing clean water and sanitation are comparable to the expected costs of reducing greenhouse gas emissions. Despite the similarities, the climate change issue is actually much more difficult because of: a) the unequal and uncertain global distribution of cause and effect; b) its long, intergenerational time lines; c) the insufficiency of adequate institutions, conventions or the tools— political, moral or economic—for tackling the climate crisis. This analysis is consistent with the model proposed by Gardiner (2011) in his book A Perfect Moral Storm. The three "storms" he identifies, the global, intergenerational and theoretical storms, combine in a powerful synergy to create a challenge of unprecedented intractability, providing opportunities for what Gardiner calls moral corruption: the obscuring of the buck-passing and procrastination that characterizes climate policy today. In Victorian London, the crucial steps to solve the sewage crises were not taken until the stench from the River Thames during the hot summer of 1858 rendered the House of Commons uninhabitable. A greater stink of a

  6. Two daily smoke maxima in eighteenth century London air

    NASA Astrophysics Data System (ADS)

    Harrison, R. Giles

    Varied electrostatics experiments followed Benjamin Franklin's pioneering atmospheric investigations. In Knightsbridge, Central London, John Read (1726-1814) installed a sensing rod in the upper part of his house and, using a pith ball electrometer and Franklin chimes, monitored atmospheric electricity from 1789 to 1791. Atmospheric electricity is sensitive to weather and smoke pollution. In calm weather conditions, Read observed two daily electrification maxima in moderate weather, around 9 am and 7 pm. This is likely to represent a double diurnal cycle in urban smoke. Before the motor car and steam railways, one source of the double maximum smoke pattern was the daily routine of fire lighting for domestic heating.

  7. Changing geographies of access to medical education in London.

    PubMed

    Brown, Gavin; Garlick, Pamela

    2007-06-01

    This paper highlights the need for health geographers to consider the social and cultural geographies of who gets to train as a doctor. The paper presents a case study of a scheme intended to widen access to medical education for working class students from inner London. This work examines the role of local education markets and cultures of education in shaping the aspirations and achievements of potential future doctors. It employs ethnographic data to consider how 'non-traditional' learners acclimatise to medical school. Our findings indicate that the students who succeed best are those who can see themselves as belonging within the education system, regardless of their social and cultural background.

  8. Space in Pentecostal healing practices among Ghanaian migrants in London.

    PubMed

    Krause, Kristine

    2014-01-01

    In this article I analyze different spatial practices related to Pentecostal healing, drawing on fieldwork with Pentecostal believers who have migrated from Ghana to London, UK. I explore the relationship between space and the manifestation of the Holy Spirit by looking at how points of contact with the divine are created in the personal life of people and at the sites where the casting out of demons takes place. Unlike in other spirit-centered healing traditions, the Christian Holy Spirit is not conceived of as embodied in specific places, but rather is spatially unbound. To manifest, however, the Holy Spirit requires specific spatial qualities and esthetics.

  9. NASA New England Outreach Center

    NASA Technical Reports Server (NTRS)

    2002-01-01

    The NASA New England Outreach Center in Nashua, New Hampshire was established to serve as a catalyst for heightening regional business awareness of NASA procurement, technology and commercialization opportunities. Emphasis is placed on small business participation, with the highest priority given to small disadvantaged businesses, women-owned businesses, HUBZone businesses, service disabled veteran owned businesses, and historically black colleges and universities and minority institutions. The Center assists firms and organizations to understand NASA requirements and to develop strategies to capture NASA related procurement and technology opportunities. The establishment of the NASA Outreach Center serves to stimulate business in a historically underserved area. NASA direct business awards have traditionally been highly present in the West, Midwest, South, and Southeast areas of the United States. The Center guides and assists businesses and organizations in the northeast to target opportunities within NASA and its prime contractors and capture business and technology opportunities. The Center employs an array of technology access, one-on-one meetings, seminars, site visits, and targeted conferences to acquaint Northeast firms and organizations with representatives from NASA and its prime contractors to learn about and discuss opportunities to do business and access the inventory of NASA technology. This stimulus of interaction also provides firms and organizations the opportunity to propose the use of their developed technology and ideas for current and future requirements at NASA. The Center provides a complement to the NASA Northeast Regional Technology Transfer Center in developing prospects for commercialization of NASA technology. In addition, the Center responds to local requests for assistance and NASA material and documents, and is available to address immediate concerns and needs in assessing opportunities, timely support to interact with NASA Centers on

  10. Study of business ethics in occupational medicine.

    PubMed Central

    Philipp, R; Goodman, G; Harling, K; Beattie, B

    1997-01-01

    OBJECTIVE: To investigate the views of specialists in occupational medicine about business ethics in occupational medicine. METHOD: A qualitative study with face to face focus groups and successive reviews of the draft consensus was undertaken of all accredited specialists in occupational medicine who were members of the south Wales and west of England group of the Society of Occupational Medicine, and of all regional specialty advisers and deputies from the Faculty of Occupational Medicine. RESULTS: There was widespread agreement for the need of a code of business ethics. In all, during the four draft stages of preparing a consensus, 72% (28/39) of members of the south Wales and west of England group of the Society of Occupational Medicine, and 31% (20/64) of regional specialty advisers and deputies provided detailed comment for inclusion in it. CONCLUSIONS: Consensus of their views was reached among study participants for issues of business ethics involving advertising, competence, qualifications, fees, commitment, changes in provider contracts, regulation, and supervision of trainees. It provides a basis for further debate. PMID:9196458

  11. Perceptions of heatwave risks to health: interview-based study of older people in London and Norwich, UK.

    PubMed

    Abrahamson, Vanessa; Wolf, Johanna; Lorenzoni, Irene; Fenn, Bridget; Kovats, Sari; Wilkinson, Paul; Adger, W Neil; Raine, Rosalind

    2009-03-01

    Most projections of climate change suggest an increased frequency of heatwaves in England over coming decades; older people are at particular risk. This could result in substantial mortality and morbidity. To determine elderly people's knowledge and perceptions of heat-related risks to health, and of protective behaviours. Semi-structured interviews: 73 men and women, 72-94 years, living in their own homes in London and Norwich, UK. Few respondents considered themselves either old or at risk from the effects of heat, even though many had some form of relevant chronic illness; they did recognize that some medical conditions might increase risks in others. Most reported that they had taken appropriate steps to reduce the effects of heat. Some respondents considered it appropriate for the government to take responsibility for protecting vulnerable people, but many thought state intervention was unnecessary, intrusive and unlikely to be effective. Respondents were more positive about the value of appropriately disseminated advice and solutions by communities themselves. The Heatwave Plan should consider giving greater emphasis to a population-based information strategy, using innovative information dissemination methods to increase awareness of vulnerability to heat among the elderly and to ensure clarity about behaviour modification measures.

  12. Observation of the London moment and trapped flux in precision gyroscopes

    NASA Technical Reports Server (NTRS)

    Xiao, Y. M.; Felson, W.; Wu, C. H.; Keiser, G. M.; Turneaure, J. P.

    1993-01-01

    The London-moment readout has been observed in flight quality gyroscopes and it has been demonstrated that it is possible to reduce magnetic field trapped in these gyroscopes to levels as low as 1.5 x 10 exp -11 T. A preliminary analysis shows that the horizontal component of the London-moment signal is 60 percent of the total expected London-moment signal and is proportional to the gyro spin speed. Experiments were carried out in a unique ground test facility which was designed to provide the conditions necessary to observe the London moment of the spinning gyroscope.

  13. Other Priority Air Toxics in New England | Air Toxics | New ...

    EPA Pesticide Factsheets

    2017-04-10

    The air toxics of greatest concern in New England were selected due to risk modeling for only the inhalation route of exposure and these pollutants exceeded the health benchmarks in one or more of the New England states.

  14. 78 FR 79402 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ...The New England Fishery Management Council's (Council) Joint VMS/Enforcement Committee and Advisory Panel will meet to consider actions affecting New England fisheries in the exclusive economic zone...

  15. 75 FR 2111 - New England Fishery Management Council; Public Hearings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... National Oceanic and Atmospheric Administration RIN 0648-XT75 New England Fishery Management Council... Administration (NOAA), Commerce. ACTION: Monkfish Fishery Management Plan Amendment 5; Public Hearings; Request for Comments. SUMMARY: The New England Fishery Management Council (Council) will hold six...

  16. 76 FR 31304 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... National Oceanic and Atmospheric Administration RIN: 0648-XA462 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  17. 76 FR 31304 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... National Oceanic and Atmospheric Administration RIN 0658-XA461 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management...

  18. 77 FR 71786 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    ... National Oceanic and Atmospheric Administration RIN 0648-XC375 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery...

  19. 78 FR 4391 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... National Oceanic and Atmospheric Administration RIN 0648-XC454 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

  20. 77 FR 70737 - New England Fishery Management Council; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ...; ] DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC366 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England...