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Sample records for medicine london uk

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. Acheiving speech intelligibility at Paddington Station, London, UK

    NASA Astrophysics Data System (ADS)

    Goddard, Helen M.

    2002-11-01

    Paddington Station in London, UK is a large rail terminus for long distance electric and diesel powered trains. This magnificent train shed has four arched spans and is one of the remaining structural testaments to the architect Brunel. Given the current British and European legislative requirements for intelligible speech in public buildings AMS Acoustics were engaged to design an electroacoustic solution. In this paper we will outline how the significant problems of lively natural acoustics, the high operational noise levels and the strict aesthetic constraints were addressed. The resultant design is radical, using the most recent dsp controlled line array loudspeakers. In the paper we detail the acoustic modeling undertaken to predict both even direct sound pressure level coverage and STI. Further it presents the speech intelligibility measured upon handover of the new system. The design has proved to be successful and given the nature of the space, outstanding speech intelligibility is achieved.

  6. Carbon dioxide and methane emission dynamics in central London (UK)

    NASA Astrophysics Data System (ADS)

    Helfter, Carole; Nemitz, Eiko; Barlow, Janet F.; Wood, Curtis R.

    2013-04-01

    London, with a population of 8.2 million, is the largest city in Europe. It is heavily built-up (typically 8% vegetation cover within the central boroughs) and boasts some of the busiest arteries in Europe despite efforts to reduce traffic in the city centre with the introduction of a congestion charging scheme in 2007. We report on two substantial pollution monitoring efforts in the heart of London between October 2006 and present. Fluxes of carbon dioxide (CO2) and water (H2O) were measured continuously by eddy-covariance in central London from October 2006 until May 2008 from a 190 m telecommunication tower (BT tower; 51° 31' 17.4'' N 0° 8' 20.04'' W). The eddy-covariance system consisted of a Gill R3-50 ultrasonic anemometer operated at 20 Hz and a LI-COR 6262 infrared gas analyser. Air was sampled 0.3 m below the sensor head of the ultrasonic anemometer - which was itself mounted on a 3 m mast to the top of a 15 m lattice tower situated on the roof of the tower (instrument head at 190 m above street level) - and pulled down 45 m of 12.7 mm OD Teflon tubing. In addition, meteorological variables (temperature, relative humidity, pressure, precipitation, wind speed and direction) were also measured with a multi-sensor (Weather Transmitter WXT510, Vaisala). Eddy-covariance measurements at the BT tower location were reinstated in July 2011 and include methane (CH4), CO2 and H2O concentrations measured by a Picarro fast methane analyser (G2301-f). CO2 emissions were found to be mainly controlled by fossil fuel combustion (e.g. traffic, commercial and domestic heating). 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 in two large city centre green spaces (Hyde Park and Regent's Park) explained the seasonal variability. Annual estimates of net exchange of CO2 obtained by eddy-covariance agreed well with up-scaled data from the UK

  7. 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).

  8. The licensing of medicines in the UK.

    PubMed

    2009-04-01

    Before a medicinal product* can be marketed in the UK, a marketing authorisation (formerly called a 'product licence') is needed. Such an authorisation can be granted in the European Union (EU), via the European Medicines Agency (EMEA), European Commission (EC) and member state's competent authorities or, specifically in the UK, via the Medicines and Healthcare product Regulatory Agency (MHRA) on behalf of the UK licensing authority.2(-)4 Also, a change to the authorisation is needed if the licensing status of a medicine is changed; for example, from a prescription-only medicine (POM) to a pharmacy medicine (P). Here we look at the procedures involved in the licensing of medicines (including herbal and homoeopathic products) for use in the UK.

  9. UK nuclear medicine survey 2003-2004.

    PubMed

    Hart, David; Wall, Barry F

    2005-11-01

    This survey was designed to assess the trends in the frequencies of nuclear medicine procedures in the UK and to determine their contributions to the annual collective effective dose to the UK population. The average activities administered by nuclear medicine departments were compared with guidance on diagnostic reference levels issued by the Administration of Radioactive Substances Advisory Committee. The survey was carried out by e-mailing a questionnaire to every known nuclear medicine centre in the UK. The total number of procedures performed annually has increased by 36% over the last 10 years to a level of about 11 procedures per 1000 head of population in the financial year 2003-2004. Seventy-three per cent of all nuclear medicine administrations are for planar imaging, with single-photon emission computed tomography and positron emission tomography contributing 16% and 2%, respectively. Non-imaging diagnostic procedures represent 7% of all nuclear medicine administrations, and therapy 2%. Bone scans continue to be the most frequent procedure. The UK annual collective effective dose from diagnostic nuclear medicine is about 1600 man Sv, resulting in an annual per caput dose of nearly 0.03 mSv. Bone scans are the largest contributor to the collective dose, but myocardium scans are close behind. Planar imaging is responsible for 62% of the total collective effective dose from diagnostic nuclear medicine in the UK, with single-photon emission computed tomography, positron emission tomography and non-imaging contributing 33%, 5% and 0.3%, respectively. The practice of nuclear medicine is still expanding in the UK with single-photon emission computed tomography imaging of the myocardium rapidly approaching bone scans as the main contributor to population exposure. The activities administered for most procedures have remained substantially unchanged and adhere closely to those recommended by the Administration of Radioactive Substances Advisory Committee.

  10. Pseudoislets as primary islet replacements for research: report on a symposium at King's College London, London UK.

    PubMed

    Persaud, Shanta J; Arden, Catherine; Bergsten, Peter; Bone, Adrian J; Brown, James; Dunmore, Simon; Harrison, Moira; Hauge-Evans, Astrid; Kelly, Catriona; King, Aileen; Maffucci, Tania; Marriott, Claire E; McClenaghan, Neville; Morgan, Noel G; Reers, Christina; Russell, Mark A; Turner, Mark D; Willoughby, Emma; Younis, Mustafa Y G; Zhi, Z L; Jones, Peter M

    2010-01-01

    Laboratory-based research aimed at understanding processes regulating insulin secretion and mechanisms underlying β-cell dysfunction and loss in diabetes often makes use of rodents, as these processes are in many respects similar between rats/mice and humans. Indeed, a rough calculation suggests that islets have been isolated from as many as 150,000 rodents to generate the data contained within papers published in 2009 and the first four months of 2010. Rodent use for islet isolation has been mitigated, to a certain extent, by the availability of a variety of insulin-secreting cell lines that are used by researchers world-wide. However, when maintained as monolayers the cell lines do not replicate the robust, sustained secretory responses of primary islets which limits their usefulness as islet surrogates. On the other hand, there have been several reports that configuration of MIN6 β-cells, derived from a mouse insulinoma, as three-dimensional cell clusters termed ‘pseudoislets’ largely recapitulates the function of primary islet β-cells. The Diabetes Research Group at King’s College London has been using the MIN6 pseudoislet model for over a decade and they hosted a symposium on “Pseudoislets as primary islet replacements for research”, which was funded by the UK National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), in London on 15th and 16th April 2010. This small, focused meeting was conceived as an opportunity to consolidate information on experiences of working with pseudoislets between different UK labs, and to introduce the theory and practice of pseudoislet culture to laboratories working with islets and/or β-cell lines but who do not currently use pseudoislets. This short review summarizes the background to the development of the cell line-derived pseudoislet model, the key messages arising from the symposium and emerging themes for future pseudoislet research.

  11. Betel nut use among first and second generation Bangladeshi women in London, UK.

    PubMed

    Núñez-de la Mora, Alejandra; Jesmin, Fahmida; Bentley, Gillian R

    2007-10-01

    This study evaluated the effects of socio-economic variables and migration history on the prevalence of betel nut and smokeless tobacco use in both UK- and Bangladeshi born migrant women resident in London. No significant difference in betel nut use prevalence was found among women of different generations. However, in all groups betel nut users were significantly older and less educated than non-users. Among first generation women there was no effect of either length of time living in the UK or age at migration on use of betel nut, even after controlling for current age. No significant differences in prevalence use due to language spoken, occupation, marital status or borough of residence in London were found. We conclude that, although there are some indications of a change in behavior among younger individuals, betel nut chewing is a practice very much present among Bangladeshi women born and brought up in a bicultural context.

  12. European Association of Urology - 32nd Annual Congress (March 24-28, 2017 - London, UK).

    PubMed

    Sharman, R

    2017-04-01

    The European Association of Urology (EAU) Congress is Europe's biggest urological event and this year's meeting, in London, UK, brought together more than 13,000 participants from over 100 countries to discuss the latest research in this field. With 5 days' worth of lectures, debates, learning courses, presentations and live surgeries the congress provided plenty of opportunity to learn from the 1,400 experts presenting, as well as to network with international peers.

  13. Modelling lead bioaccessibility in urban topsoils based on data from Glasgow, London, Northampton and Swansea, UK.

    PubMed

    Appleton, J D; Cave, M R; Wragg, J

    2012-12-01

    Predictive linear regression (LR) modelling between bioaccessible Pb and a range of total elemental compositions and soil properties was executed for the Glasgow, London, Northampton and Swansea urban areas in order to assess the potential for developing a national urban bioaccessible Pb dataset for the UK. LR indicates that total Pb is the only highly significant independent variable for estimating the bioaccessibility of Pb. Bootstrap resampling shows that the relationship between total Pb and bioaccessible Pb is broadly the same in the four urban areas. The median bioaccessible fraction ranges from 38% in Northampton to 68% in London and Swansea. Results of this study can be used as part of a lines of evidence approach to localised risk assessment but should not be used to replace bioaccessibility testing at individual sites where local conditions may vary considerably from the broad overview presented in this study.

  14. The Controlling Cancer Summit, 17-19 May 2016, London, UK.

    PubMed

    Babina, Irina S

    2016-10-01

    The Controlling Cancer Summit, London, UK, 17-19 May 2016 The Controlling Cancer Summit is an intimate informal meeting that annually gathers international academic and clinical researchers to network and debate the current advancements and challenges of oncology research. This year, it focused not only on diagnostic/prognostic biomarkers and genetic influences in cancer but also novel and sometimes unconventional therapeutic interventions. This report will summarize the meeting highlights that contribute to our comprehension of cancer biology and new innovative ways to target this disease.

  15. Medical nanotechnology in the UK: a perspective from the London Centre for Nanotechnology.

    PubMed

    Horton, Michael A; Khan, Abid

    2006-03-01

    Nanotechnology research is booming worldwide, and the general belief is that medical and biological applications will form the greatest sector of expansion over the next decade, driven by an attempt to bring radical solutions to areas of unmet medical need. What is true in the United States is also being fulfilled in Europe. This, though, is generally at a significantly lower investment level, even if for "large" capital infrastructure and interdisciplinary centers. Against this, the United Kingdom and its European partners are following the maxim "small is beautiful" and are attempting to identify and develop academic research and commercial businesses in areas that traditional nanotechnology developments involving engineering or physics find challenging. Thus in London-University College London (UCL) in a major joint project with Imperial College and linked to other UK and European centers of excellence-we are building upon our internationally competitive medical research (the two universities together form one of the largest centers of biomedical research outside the United States) to focus on and develop medical nanotechnology as a major sector of our research activity. A novel approach to commercialization has been the establishment with government and private equity funds of a "BioNanotechnology Centre" that will act as a portal for UK industry to access specialist skills to solve issues relating to developing nanotechnology-based medical applications, for example, for environmental screening, diagnostics, and therapy. This article reviews our academic and business strategy with examples from our current biomedical research portfolio.

  16. Continuous bioprocessing: the real thing this time? 10(th) Annual bioProcessUK Conference, December 3-4, 2013, London, UK.

    PubMed

    Farid, Suzanne S; Thompson, Bill; Davidson, Andrew

    2014-01-01

    The Annual bioProcessUK Conference has acted as the key networking event for bioprocess scientists and engineers in the UK for the past 10 years. The following article is a report from the sessions that focused on continuous bioprocessing during the 10(th) Annual bioProcessUK Conference (London, December 2013). These sessions were organized by the 'EPSRC Centre for Innovative Manufacturing in Emergent Macromolecular Therapies' hosted at University College London. A plenary lecture and workshop provided a forum for participants to debate topical issues in roundtable discussions with industry and academic experts from institutions such as Genzyme, Janssen, Novo Nordisk, Pfizer, Merck, GE Healthcare and University College London. The aim of these particular sessions was to understand better the challenges and opportunities for continuous bioprocessing in the bioprocessing sector.

  17. 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.

  18. Determinants of fine particle (PM 2.5) personal exposure levels in transport microenvironments, London, UK

    NASA Astrophysics Data System (ADS)

    Adams, H. S.; Nieuwenhuijsen, M. J.; Colvile, R. N.

    A series of field studies were carried out in London, UK, during 1999-2000 in which over 400 fine particle (PM 2.5) personal exposure level measurements were taken for journeys in bicycle, bus, car and underground rail transport microenvironments. This was the first comprehensive PM 2.5 personal exposure study of transport users. Both a fixed-route multi-transport mode study and a study of cyclists' commuter journeys were undertaken. Subsequent to these field studies regression modelling of possible influencing factors of these exposure levels was carried out. Meteorological variables, traffic density, mode and route were considered; the relationships of personal exposure levels with fixed site monitor (FSM) concentrations, and of the FSM concentrations with the potential predictor variables, were also investigated. This analysis of the determinants of transport user exposure to PM 2.5 in London, UK, showed that wind speed had a significant influence on personal exposure levels, though explained only up to 20% of the variability of road transport user exposure levels. The occurrence of higher wind speeds was strongly associated with a decrease in personal exposure levels; a 1.5-2.0 fold difference in exposure level concentrations was estimated between the 10th and 90th percentiles of wind speed. Route was a significant factor, whilst mode was not a significant factor in the street microenvironment (between bicycle, bus and car modes); models incorporating route and mode, as well as wind speed, explained approximately 35% of the variability in PM 2.5 exposure levels. Personal exposure levels were reasonably correlated with urban background FSM concentrations, for fixed-route road mode (bicycle, bus and car) exposure level concentrations, r=0.27 ( p<0.01) and for commuter cyclists' exposure level concentrations r=0.58 ( p<0.01).

  19. Summary of the EMA Joint Regulators/Industry QbD workshop (London, UK; 28-29 January 2014).

    PubMed

    Cook, Graham; France, Georges; Holte, Øyvind; Lorenti, Giampiero; Tainsh, David

    2016-01-01

    This paper summarizes the discussions and insights gained from the key themes that emerged during the Quality by Design (QbD) Workshop held at the European Medicines Agency (EMA) offices in London, UK, on 28-29 January 2014. Industry and regulators shared practical experiences from six case studies (five approved small molecule products and one phase 3 biotechnological product) based on QbD submissions by five companies (AstraZeneca, GlaxoSmithKline, Novartis, NovoNordisk, and Pfizer).The case studies covered a range of different development, regulatory submission, and post-approval aspects of QbD and were developed through confidential discussions between the company representatives and regulators. Key themes that emerged from the workshop discussions were: 1. presentation of information in submissions (development story and the presentation of information in marketing authorization applications; risk assessment and criticality); 2. development aspects (design space; use of models; control strategy); and 3. post-approval aspects (lifecycle management; dossier-quality system interactions; handling of deviations). Many aspects of QbD for biotechnological products are similar to small molecules, but there are some important differences highlighted in this paper.The final section of the paper discusses some proposals for future developments to address the issues that were identified. This paper summarizes the discussions and insights gained from the key themes that emerged during the Quality by Design (QbD) Workshop held at the European Medicines Agency offices in London, UK, on 28-29 January 2014. Industry and regulators shared practical experiences from six case studies (five approved small-molecule products and one phase 3 biotechnological product) based on QbD submissions by five companies (AstraZeneca, GlaxoSmithKline, Novartis, NovoNordisk, and Pfizer).The case studies covered a range of different development, regulatory submission, and post-approval aspects of

  20. 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…

  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. Measurement of NO(x) fluxes from a tall tower in Central London, UK and comparison with emissions inventories.

    PubMed

    Lee, James D; Helfter, Carole; Purvis, Ruth M; Beevers, Sean D; Carslaw, David C; Lewis, Alastair C; Møller, Sarah J; Tremper, Anja; Vaughan, Adam; Nemitz, Eiko G

    2015-01-20

    Direct measurements of NOx concentration and flux were made from a tall tower in central London, UK as part of the Clean Air for London (ClearfLo) project. Fast time resolution (10 Hz) NO and NO2 concentrations were measured and combined with fast vertical wind measurements to provide top-down flux estimates using the eddy covariance technique. Measured NOx fluxes were usually positive and ranged from close to zero at night to 2000-8000 ng m(-2) s(-1) during the day. Peak fluxes were usually observed in the morning, coincident with the maximum traffic flow. Measurements of the NOx flux have been scaled and compared to the UK National Atmospheric Emissions Inventory (NAEI) estimate of NOx emission for the measurement footprint. The measurements are on average 80% higher than the NAEI emission inventory for all of London. Observations made in westerly airflow (from parts of London where traffic is a smaller fraction of the NOx source) showed a better agreement on average with the inventory. The observations suggest that the emissions inventory is poorest at estimating NOx when traffic is the dominant source, in this case from an easterly direction from the BT Tower. Agreement between the measurements and the London Atmospheric Emissions Inventory (LAEI) are better, due to the more explicit treatment of traffic flow by this more detailed inventory. The flux observations support previous tailpipe observations of higher NOx emitted from the London vehicle diesel fleet than is represented in the NAEI or predicted for several EURO emission control technologies. Higher-than-anticipated vehicle NOx is likely responsible for the significant discrepancies that exist in London between observed NOx and long-term NOx projections.

  3. Monitoring CO2 and CH4 concentrations along an urban-rural transect in London, UK

    NASA Astrophysics Data System (ADS)

    Boon, Alex; Broquet, Gregoire; Clifford, Debbie; Chevallier, Frederic; Butterfield, David

    2013-04-01

    Cities are important sources of carbon dioxide (CO2) and methane (CH4). Anthropogenic CO2 is released in the combustion of fossil fuels for heating, electricity and transport. The major sources of CH4 in city environments are natural gas leakage, landfill sites and transport emissions. Monitoring of urban greenhouse gas concentrations is crucial for cities aiming to reduce emissions through measures such as changes to the transport infrastructure and green planning. We present measurements of CO2 and CH4 concentrations using Cavity Ring-Down Spectroscopy (CRDS) at four sites located in and around London, UK. Two sites were located in the inner city, one in the suburban fringe and the fourth in a rural location close to the city. This study was funded by Astrium Services Ltd as part of a pilot scheme to monitor city-scale GHG emissions and presented a unique opportunity to study changes in greenhouse gas concentrations across an urban to rural 'transect'. The CHIMERE chemistry-transport model is used to estimate CO2 and CH4 concentrations throughout the four month measurement period during the summer of 2012. Comparisons are made between the measured and modelled CO2 and CH4 concentrations and the representativity of the study sites for future urban greenhouse gas monitoring is considered. This study also examines the ability of a variety of measurement and modelling techniques to partition anthropogenic and biogenic CO2 sources.

  4. Fine particle (PM2.5) personal exposure levels in transport microenvironments, London, UK.

    PubMed

    Adams, H S; Nieuwenhuijsen, M J; Colvile, R N; McMullen, M A; Khandelwal, P

    2001-11-12

    In order to investigate a specific area of short-term, non-occupational, human exposure to fine particulate air pollution, measurements of personal exposure to PM2.5 in transport microenvironments were taken in two separate field studies in central London, UK. A high flow gravimetric personal sampling system was used; operating at 16 l min(-1); the sampler thus allowed for sufficient sample mass collection for accurate gravimetric analysis of short-term travel exposure levels over typical single commute times. In total, samples were taken on 465 journeys and 61 volunteers participated. In a multi-transport mode study, carried out over 3-week periods in the winter and in the summer, exposure levels were assessed along three fixed routes at peak and off-peak times of the day. Geometric means of personal exposure levels were 34.5 microg m(-3) (G.S.D.= 1.7, n(s) = 40), 39.0 microg m(-3) (G.S.D. = 1.8, n(s) = 36), 37.7 microg m(-3) (G.S.D. = 1.5, n(s) = 42), and 247.2 microg m(-3) (G.S.D. = 1.3, n(s) = 44) for bicycle, bus, car and Tube (underground rail system) modes, respectively, in the July 1999 (summer) measurement campaign. Corresponding levels in the February 2000 (winter) measurement campaign were 23.5 microg m(-3) (G.S.D. = 1.8, n(s) = 56), 38.9 microg m(-3) (G.S.D. = 2.1, n(s) = 32), 33.7 microg m(-3) (G.S.D. = 2.4, n(s) = 12), and 157.3 microg m(-3) (G.S.D. = 3.3, n(s) = 12), respectively. In a second study, exposure levels were measured for a group of 24 commuters travelling by bicycle, during August 1999, in order to assess how representative the fixed route studies were to a larger commuter population. The geometric mean exposure level was 34.2 microg m(-3) (G.S.D. = 1.9, n(s) = 105). In the fixed-route study, the cyclists had the lowest exposure levels, bus and car were slightly higher, while mean exposure levels on the London Underground rail system were 3-8 times higher than the surface transport modes. There was significant between-route variation

  5. Cervical screening among migrant women: a qualitative study of Polish, Slovak and Romanian women in London, UK

    PubMed Central

    Jackowska, Marta; von Wagner, Christian; Wardle, Jane; Juszczyk, Dorota; Luszczynska, Aleksandra; Waller, Jo

    2012-01-01

    Objective To explore awareness of and participation in cervical screening services in women from Poland, Slovakia and Romania living in London, UK. Methods Three qualitative studies were carried out in London in 2008–2009: an interview study of professionals working with Central and Eastern European migrants (n=11); a focus group study including three Polish, one Slovak and one Romanian focus group; and an interview study of Polish (n=11), Slovak (n=7) and Romanian (n=2) women. Results Awareness of the cervical screening programme was good, but understanding of the purpose of screening was sometimes limited. Some women were fully engaged with the UK screening programme; others used screening both in the UK and their countries of origin; and a third group only had screening in their home countries. Women welcomed the fact that screening is free and that reminders are sent, but some were concerned about the screening interval and the age of the first invitation. Conclusions Migrant women from Poland, Slovakia and Romania living in London vary in their level of participation in the National Health Service Cervical Screening Programme. More needs to be done to address concerns regarding screening services, and to ensure that language is not a barrier to participation. PMID:22219504

  6. 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.

  7. Environmental and genetic determinants of vitamin D status among older adults in London, UK.

    PubMed

    Jolliffe, David A; Hanifa, Yasmeen; Witt, Karolina D; Venton, Timothy R; Rowe, Marion; Timms, Peter M; Hyppönen, Elina; Walton, Robert T; Griffiths, Christopher J; Martineau, Adrian R

    2016-11-01

    Despite the high prevalence of vitamin D deficiency among older adults in the UK, studies investigating the determinants of vitamin D status in this group are lacking. We conducted a cross-sectional study in 222 older adults living in sheltered accommodation in London, UK, who were screened for participation in a clinical trial of vitamin D supplementation for the prevention of acute respiratory infection. Details of potential demographic and lifestyle determinants of vitamin D status were collected by questionnaire and blood samples were taken for analysis of serum 25-hydroxyvitamin D (25[OH]D) concentration and DNA extraction. Fifteen single nucleotide polymorphisms (SNP) in 6 genes (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, VDR) previously reported to associate with circulating 25(OH)D concentration were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration. Mean serum 25(OH)D concentration was 42.7nmol/L (SD 22.0); 144/222 (64.9%) participants had serum 25(OH)D concentrations <50nmol/L. The following factors were independently associated with lower serum 25(OH)D concentration: non-white ethnicity (-8.6nmol/L, 95% CI -14.9 to -2.3, P=0.008); lack of vitamin D supplement consumption (-17.1nmol/L, 95% CI -23.3 to -10.9, P<0.001) vs. taking a daily supplement; sampling in Q1/January-March (-12.2nmol/L, 95% CI -21.5 to -2.9, P=0.01), and sampling in Q4/October-December (-10.3nmol/L, 95% CI -20.2 to -0.4, P=0.04) vs. sampling in Q3/July-September. None of the 15 SNP investigated independently associated with serum 25(OH)D concentration after correcting for multiple comparisons. In conclusion, vitamin D deficiency was highly prevalent among the older adults in this study; non-White ethnicity, lack of vitamin D supplement consumption and sampling in winter and spring independently associated with lower vitamin D status.

  8. Sources of greenhouse gases and carbon monoxide in central London (UK)

    NASA Astrophysics Data System (ADS)

    Helfter, Carole; Tremper, Anja; Zazzeri, Giulia; Barlow, Janet F.; Nemitz, Eiko

    2015-04-01

    Biosphere-atmosphere exchange of carbon dioxide (CO2) has been on the scientific agenda for several decades and new technology now also allows for high-precision, continuous monitoring of fluxes of methane (CH4) and nitrous oxide (N2O). Compared to the natural environment, flux measurements in the urban environment, which is home to over 50% of the population globally, are still rare despite high densities of anthropogenic sources of pollutants. We report on over three years of measurements atop a 192 m tower in central London (UK), Europe's largest city, which started in October 2011. Fluxes of methane, carbon monoxide (CO) and carbon dioxide are measured by eddy-covariance (EC) at the British Telecom tower (51° 31' 17.4' N 0° 8' 20.04' W). In addition to the long-term measurements, EC fluxes of nitrous oxide (N2O) were measured in February 2014. All four trace gases exhibit diurnal trends consistent with anthropogenic activities with minimum emissions at night and early afternoon maxima. Segregating emissions by wind direction reveals heterogeneous source distributions with temporal patterns and source strengths that differ between compounds. The lowest emissions for CO, CO2 and CH4 were recorded for NW winds. The highest emissions of methane were in the SE sector, in the NE for CO2 and in the W for CO. Fluxes of all 3 gases exhibited marked seasonal trends characterised by a decrease in emissions in summer (63% reduction for CO, 36% for CO2 and 22% for CH4). Monthly fluxes of CO and CO2 were linearly correlated to air temperature (R2 = 0.7 and 0.59 respectively); a weaker dependence upon temperature was also observed for CH4 (R2 = 0.31). Diurnal and seasonal emissions of CO and CO2 are mainly controlled by local fossil fuel combustion and vehicle cold starts are thought to account for 20-30% of additional emissions of CO during the winter. Fugitive emissions of CH4 from the natural gas distribution network are thought to be substantial, which is consistent

  9. Receptor modelling of both particle composition and size distribution from a background site in London, UK

    NASA Astrophysics Data System (ADS)

    Beddows, D. C. S.; Harrison, R. M.; Green, D. C.; Fuller, G. W.

    2015-09-01

    Positive matrix factorisation (PMF) analysis was applied to PM10 chemical composition and particle number size distribution (NSD) data measured at an urban background site (North Kensington) in London, UK, for the whole of 2011 and 2012. The PMF analyses for these 2 years revealed six and four factors respectively which described seven sources or aerosol types. These included nucleation, traffic, urban background, secondary, fuel oil, marine and non-exhaust/crustal sources. Urban background, secondary and traffic sources were identified by both the chemical composition and particle NSD analysis, but a nucleation source was identified only from the particle NSD data set. Analysis of the PM10 chemical composition data set revealed fuel oil, marine, non-exhaust traffic/crustal sources which were not identified from the NSD data. The two methods appear to be complementary, as the analysis of the PM10 chemical composition data is able to distinguish components contributing largely to particle mass, whereas the number particle size distribution data set - although limited to detecting sources of particles below the diameter upper limit of the SMPS (604 nm) - is more effective for identifying components making an appreciable contribution to particle number. Analysis was also conducted on the combined chemical composition and NSD data set, revealing five factors representing urban background, nucleation, secondary, aged marine and traffic sources. However, the combined analysis appears not to offer any additional power to discriminate sources above that of the aggregate of the two separate PMF analyses. Day-of-the-week and month-of-the-year associations of the factors proved consistent with their assignment to source categories, and bivariate polar plots which examined the wind directional and wind speed association of the different factors also proved highly consistent with their inferred sources. Source attribution according to the air mass back trajectory showed, as

  10. Effects of the urban heat island on the phenology of Odonata in London, UK.

    PubMed

    Villalobos-Jiménez, Giovanna; Hassall, Christopher

    2017-07-01

    Urbanisation is one of the major drivers of ecosystem change and includes increased temperatures in cities leading to an urban heat island (UHI). This study quantified the phenological response of odonates across London, UK, from 1990 to 2012, using a database of 1,031,277 historical sightings. The ordinal flight dates of each species were used to calculate the leading edge, middle and trailing edge of the flight period (P5, P50 and P95, respectively). The results suggest that the phenology of odonates is affected by the UHI only at a community level: no significant changes in the P5 or P50 of the flight period were found, although the P95 shows a mean advance of 4.13 days compared to rural areas, thus suggesting a contraction of the flight period in urban areas. However, only one individual species (Sympetrum striolatum) exhibited an advance in the P95 of the flight period in urban areas compared to rural areas. On the other hand, climate change (minimum temperature) had a much stronger impact on the phenology of odonates at the community level with a significant advance of 6.9 days °C(-1) in the P5 of the flight period, 3.1 days °C(-1) in the P50 and 3.3 days °C(-1) in the P95 flight date. Similarly, a significant advance in P5 was found in 7 of the 15 species tested in response to minimum temperature, and 2 species showed a significant advance in P50 in response to minimum temperature, but no species showed a shift in the P95 flight date due to minimum temperature. As shown in previous studies, life history influences the phenological response of odonates, with spring species and those species lacking an egg diapause being the most responsive to increased temperatures, although summer species and species with obligate egg diapause also respond to the UHI by advancing the P95 by 3.8 and 4.5 days, respectively, compared to rural areas, thus contracting the flight period. The present study shows that the UHI has negligible impacts on emergence patterns

  11. Effects of the urban heat island on the phenology of Odonata in London, UK

    NASA Astrophysics Data System (ADS)

    Villalobos-Jiménez, Giovanna; Hassall, Christopher

    2017-02-01

    Urbanisation is one of the major drivers of ecosystem change and includes increased temperatures in cities leading to an urban heat island (UHI). This study quantified the phenological response of odonates across London, UK, from 1990 to 2012, using a database of 1,031,277 historical sightings. The ordinal flight dates of each species were used to calculate the leading edge, middle and trailing edge of the flight period (P5, P50 and P95, respectively). The results suggest that the phenology of odonates is affected by the UHI only at a community level: no significant changes in the P5 or P50 of the flight period were found, although the P95 shows a mean advance of 4.13 days compared to rural areas, thus suggesting a contraction of the flight period in urban areas. However, only one individual species (Sympetrum striolatum) exhibited an advance in the P95 of the flight period in urban areas compared to rural areas. On the other hand, climate change (minimum temperature) had a much stronger impact on the phenology of odonates at the community level with a significant advance of 6.9 days °C-1 in the P5 of the flight period, 3.1 days °C-1 in the P50 and 3.3 days °C-1 in the P95 flight date. Similarly, a significant advance in P5 was found in 7 of the 15 species tested in response to minimum temperature, and 2 species showed a significant advance in P50 in response to minimum temperature, but no species showed a shift in the P95 flight date due to minimum temperature. As shown in previous studies, life history influences the phenological response of odonates, with spring species and those species lacking an egg diapause being the most responsive to increased temperatures, although summer species and species with obligate egg diapause also respond to the UHI by advancing the P95 by 3.8 and 4.5 days, respectively, compared to rural areas, thus contracting the flight period. The present study shows that the UHI has negligible impacts on emergence patterns of odonates

  12. Pedestrian exposure to air pollution along a major road in Central London, UK

    NASA Astrophysics Data System (ADS)

    Kaur, S.; Nieuwenhuijsen, M. J.; Colvile, R. N.

    Pedestrian exposure to PM 2.5, the loss of reflectance ('blackness') of the PM 2.5 filters, ultrafine particle counts (particle range: 0.02-1 μm) and carbon monoxide (CO) was investigated along a major road running through the DAPPLE study site in Central London, UK. During an intensive 12-day exposure measurement campaign, groups of four volunteers sampled twice in the morning and twice in the afternoon along Marylebone Road. They were randomly designated a walking direction, walking position (kerbside or buildingside) and a side of the major road to walk along. PM 2.5 was sampled using high-flow gravimetric personal samplers, ultrafine particle counts were measured using TSI P-TRAKs and Langans were used to measure CO exposure. PM 2.5 samples were analysed gravimetrically and reflectance was measured using a smoke stain reflectometer to obtain a measure of 'black smoke'. In total 603 acceptable samples were obtained—155 PM 2.5 and reflectance, 120 ultrafine particle count and 173 CO. The average pedestrian exposure along the road was 37.7 μg/m 3, 12.1 m -1×10 -5, 80 009 pt/cm 3 and 1.3 ppm for PM 2.5, loss of reflectance, ultrafine particle counts and CO, respectively. PM 2.5 exposure in the morning was significantly higher than in the afternoon, and there was a significant difference in exposure on the different sides of the road. For both reflectance and ultrafine particle counts, the exposure was significantly different both between the two walking positions on the pavement and the two sides of the street canyon. However there was no significant difference in CO exposure based on walking position, walking direction, canyon side or timing. Filter reflectance was significantly but weakly correlated with PM 2.5 exposure ( r=0.3, N=155), CO exposure ( r=0.2, N=154) and ultrafine particle count exposure ( r=0.7, N=108). PM 2.5 and CO personal exposure measurements were much higher than those recorded at both the local background fixed monitoring station (FMS

  13. Effects of the urban heat island on the phenology of Odonata in London, UK

    NASA Astrophysics Data System (ADS)

    Villalobos-Jiménez, Giovanna; Hassall, Christopher

    2017-07-01

    Urbanisation is one of the major drivers of ecosystem change and includes increased temperatures in cities leading to an urban heat island (UHI). This study quantified the phenological response of odonates across London, UK, from 1990 to 2012, using a database of 1,031,277 historical sightings. The ordinal flight dates of each species were used to calculate the leading edge, middle and trailing edge of the flight period (P5, P50 and P95, respectively). The results suggest that the phenology of odonates is affected by the UHI only at a community level: no significant changes in the P5 or P50 of the flight period were found, although the P95 shows a mean advance of 4.13 days compared to rural areas, thus suggesting a contraction of the flight period in urban areas. However, only one individual species ( Sympetrum striolatum) exhibited an advance in the P95 of the flight period in urban areas compared to rural areas. On the other hand, climate change (minimum temperature) had a much stronger impact on the phenology of odonates at the community level with a significant advance of 6.9 days °C-1 in the P5 of the flight period, 3.1 days °C-1 in the P50 and 3.3 days °C-1 in the P95 flight date. Similarly, a significant advance in P5 was found in 7 of the 15 species tested in response to minimum temperature, and 2 species showed a significant advance in P50 in response to minimum temperature, but no species showed a shift in the P95 flight date due to minimum temperature. As shown in previous studies, life history influences the phenological response of odonates, with spring species and those species lacking an egg diapause being the most responsive to increased temperatures, although summer species and species with obligate egg diapause also respond to the UHI by advancing the P95 by 3.8 and 4.5 days, respectively, compared to rural areas, thus contracting the flight period. The present study shows that the UHI has negligible impacts on emergence patterns of odonates

  14. Assessment of road users' elemental carbon personal exposure levels, London, UK

    NASA Astrophysics Data System (ADS)

    Adams, H. S.; Nieuwenhuijsen, M. J.; Colvile, R. N.; Older, M. J.; Kendall, M.

    Little is known about particulate elemental carbon (EC) personal exposure levels, a key component of diesel exhaust, specifically in transport microenvironments. A method utilizing the optical properties of EC particles has been applied to personal exposure measurement filter samples. In a series of field studies carried out in London, UK, during 1999-2000 over 400 fine particle (PM 2.5) personal exposure level measurements were taken for journeys in bicycle, bus, car and underground rail transport microenvironments, along three main fixed routes. The particulate EC contribution to the PM 2.5 personal exposure was assessed indirectly by means of an optical technique and with the development and use of a size fraction specific and site-specific calibration curve. In this first EC personal exposure study of transport users geometric mean exposure levels in the summer field campaign were 11.2 μg m -3 (GSD=2.7) for cyclists, 13.6 μg m -3 (GSD=1.9) for bus passengers and 21.6 μg m -3 (GSD=2.1) for car drivers; corresponding exposure levels in the winter were 16.4 μg m -3 (GSD=1.8), 18.6 μg m -3 (GSD=2.3) and 27.3 μg m -3 (GSD=2.0), respectively. EC/PM 2.5 ratios were approximately 0.5-0.6 for bicycle and bus modes and 0.7-0.8 for the car mode. EC/PM 2.5 ratios for different routes ranged from approximately 0.7 for Route 1 to 0.4 for Route 3. Cyclists had the lowest exposure to EC, and car occupants the highest exposure. A large difference in exposure levels between a central high traffic density route and the other less central routes was observed. Particulate EC was a very significant proportion of the total PM 2.5 personal exposure and EC personal exposure levels were considerably higher than reported fixed site monitor EC concentrations.

  15. Projecting expenditure on medicines in the UK NHS.

    PubMed

    O'Neill, Phill; Mestre-Ferrandiz, Jorge; Puig-Peiro, Ruth; Sussex, Jon

    2013-10-01

    Expenditure on medicines is a readily identifiable element of health service costs. It is the focus of much attention by payers, not least in the UK even though the cost of medicines represents less than 10 % of total UK National Health Service (NHS) expenditure. Projecting future medicines spending enables the likely cost pressure to be allowed for in planning the scale and allocation of NHS resources. Simple extrapolations of past trends in expenditure fail to account for changes in the rate and mix of new medicines becoming available and in the scope for windfall savings when some medicines lose their patent protection. The objective of this study is to develop and test an improved method to project NHS pharmaceutical expenditure in the UK for the period 2012-2015. We have adopted a product-by-product, bottom-up approach, which means that our projections are built up from individual products to the total market. Our projections of the impact of generic and biosimilars entry on prices and quantities of medicines sold, and of the rate of uptake of newly launched medicines, have been obtained from regression analysis of UK data. To address uncertainty, we have created a baseline and two other illustrative scenarios. We have compared our projections with actual expenditure for 2012. Our projections estimate that, between 2011 and 2015, with no change in policy or price regulation, the UK total medicines bill would increase at an average compound annual growth rate (CAGR) of between 3.1 and 4.1 %. Total NHS spending on branded medicines and total NHS spending on generics are projected to increase at average CAGRs of 0.5-1.8 and 10.0-11.0 %, respectively, over the same time period. For the total market, the actual growth rate for 2012 lay within our projected range. Our methodology provides a useful framework for projecting UK NHS medicines expenditure over the medium term and captures the impacts of existing medicines losing exclusivity and of new medicines being

  16. UK medicines policy: the role of clinical pharmacologists

    PubMed Central

    Webb, David J

    2012-01-01

    Clinical pharmacologists are the only medical specialists whose training focuses specifically on the safe, effective and cost-effective use of medicines, underpinned by an understanding of drug discovery, drug regulation, pharmacology, translational medicine and the performance of clinical trials. This unique perspective has allowed them to provide expertise and leadership in medicines regulation, medicines policy, health technology assessment and drug pricing. Clinical pharmacologists assisted in the creation of the Committee on Safety of Medicines (now the Commission on Human Medicines), the Yellow Card Scheme, the National Institute of Health and Clinical Excellence (NICE) and related organizations in Scotland and Wales, and contributed to clinical guidelines (through the Scottish Intercollegiate Guidelines Network) and the British National Formulary. Their research work has contributed substantially, through translational medicine and therapeutics, to the development of new medicines and, as a result, creation of health and wealth in the UK. Their work in medicines policy has served to protect patients from harms associated with the use of medicines. A reduction in the number of able junior doctors attracted to a career in clinical pharmacology, a reduction in the number of training posts, and an ageing population of academic trainers, puts the future of the specialty, and its contribution to patient safety and UK wealth creation, at substantial risk. Urgent measures are needed to convince the NHS and government that these essential skills should be protected and nurtured. PMID:22360620

  17. Prioritising neonatal medicines research: UK Medicines for Children Research Network scoping survey

    PubMed Central

    Turner, Mark A; Lewis, Sara; Hawcutt, Daniel B; Field, D

    2009-01-01

    Background The dosing regimen and indications for many medicines in current use in neonatology are not well defined. There is a need to prioritise research in this area, but currently there is little information about which drugs are used in UK neonatal units and the research needs in this area as perceived by UK neonatologists. Methods The Neonatal Clinical Studies Group (CSG) of the Medicines for Children Research Network (MCRN) undertook a 2 week prospective scoping survey study to establish which medicines are used in UK neonatal units; how many babies are receiving them; and what clinicians (and other health professionals) believe are important issues for future research. Results 49 out of 116 units responded to at least one element of the survey (42%). 37 units reported the number of neonates who received medicines over a 2 week period. A total of 3924 medicine-patient pairs were reported with 119 different medicines. 70% of medicine-patient pairs involved medicines that were missing either a license or dose for either term or preterm neonates. 4.3% of medicine-patient pairs involved medicines that were missing both license and dose for any neonate. The most common therapeutic gap in need of additional research identified by UK neonatologists was chronic lung disease (21 responding units), followed by patent ductus arteriosus and vitamin supplements (11 responding units for both) Conclusion The research agenda for neonatal medicines can be informed by knowledge of current medicine use and the collective views of the neonatal community. PMID:19674445

  18. Conference Report: Online Information Meeting 2005, Olympia, London (UK), 29 November-1 December 2005

    ERIC Educational Resources Information Center

    Education for Information, 2006

    2006-01-01

    For many years now the Holiday season has been associated with the gathering of information professionals in west London for the annual Online Information Meeting. The Meeting currently is organized by VNU Exhibitions Europe (formerly Imark Communication), though for old-timers it will forever be associated with Learned Information, the…

  19. Conference Report: Online Information Meeting 2005, Olympia, London (UK), 29 November-1 December 2005

    ERIC Educational Resources Information Center

    Education for Information, 2006

    2006-01-01

    For many years now the Holiday season has been associated with the gathering of information professionals in west London for the annual Online Information Meeting. The Meeting currently is organized by VNU Exhibitions Europe (formerly Imark Communication), though for old-timers it will forever be associated with Learned Information, the…

  20. The types of Phasmida in the Natural History Museum, London, UK.

    PubMed

    Brock, Paul D; Marshall, Judith A; Beccaloni, George W; Harman, Allan J E

    2016-10-31

    Type specimens of 437 Phasmida taxa have been located in the Natural History Museum, London (NHMUK, formerly BMNH), including 480 primary types of 372 taxa. Taxa with types are listed alphabetically by their specific or subspecific name, and the number of specimens, sex and locality data are given.

  1. Bilingual Behaviour, Attitudes, Identity and Vitality: Some Data from Japanese Speakers in London, UK

    ERIC Educational Resources Information Center

    Brown, Ivan; Sachdev, Itesh

    2009-01-01

    Although the Japanese community in London is relatively small, its composition is stable and reflects several aspects of Japan's relationship with the international community. Yet there appears to have been no systematic research exploring patterns of bilingual behaviour in relation to social psychological processes amongst Japanese nationals in…

  2. Application of MM5/CMAQ for modelling urban air pollution a case study for London, UK

    NASA Astrophysics Data System (ADS)

    Kitwiroon, N.; Fragkou, E.; Sokhi, R. S.; San Jose, R.; Pérez Camaño, J. L.; Middleton, D.

    2003-04-01

    Urban air pollution has been particularly studied for the last few decades because of its recognised environmental dangers and health implications. The complexity of the urban surface characteristics and turbulence patterns has dictated the use of numerical models by environmental research agencies and regulators in order to predict and manage urban air pollution. However, most of these models are not specifically adapted to urban applications and normally do not include detailed urban parameterisation, such as for surface roughness or urban heat fluxes. Flow structure and dispersion of air pollutants within cities, however, are influenced by urban features such as increased surface roughness. This paper presents a study using MM5 and CMAQ to assess the effect of urban boundary layer features on meteorological parameters, and hence London's air quality. MM5 is a non-hydrostatic (version 3), terrain-following sigma-coordinate model designed to simulate mesoscale and regional-scale atmospheric circulation. This paper employs an improved surface roughness treatment on meteorological profiles and pollution dispersion. A surface roughness scale has been developed for London and the surrounding region. The land cover data was derived from the Centre for Ecology and Hydrology (CEH) data, with a spatial resolution of 25 × 25 m. These z_o values are employed with MM5 for modelling meteorological parameters over London, covering an inner domain area of 49 × 49 km. The outputs of MM5 have been coupled to CMAQ photochemical model to predict concentrations of particles, NO_2 and O_3 for London and the surrounding regions at a spatial resolution of 1 × 1 km. The predicted concentrations have been compared with monitored data obtained from a range of national air quality monitoring sites including Central London (Bloomsbury, Brent), East London (Bexley) and West London (Hillingdon). Comparison of hourly model predictions with measured data is made for pollution levels for

  3. Basic life support education in secondary schools: a cross-sectional survey in London, UK.

    PubMed

    Salciccioli, Justin D; Marshall, Dominic C; Sykes, Mark; Wood, Alexander D; Joppa, Stephanie A; Sinha, Madhurima; Lim, P Boon

    2017-01-06

    Basic life support (BLS) training in schools is associated with improved outcomes from cardiac arrest. International consensus statements have recommended universal BLS training for school-aged children. The current practice of BLS training in London schools is unknown. The aim of this study was to assess current practices of BLS training in London secondary schools. A prospective audit of BLS training in London secondary schools was conducted. Schools were contacted by email, and a subsequent telephone interview was conducted with staff familiar with local training practices. Response data were anonymised and captured electronically. Universal training was defined as any programme which delivers BLS training to all students in the school. Descriptive statistics were used to summarise the results. A total of 65 schools completed the survey covering an estimated student population of 65 396 across 19 of 32 London boroughs. There were 5 (8%) schools that provide universal training programmes for students and an additional 31 (48%) offering training as part of an extracurricular programme or chosen module. An automated external defibrillator (AED) was available in 18 (28%) schools, unavailable in 40 (61%) and 7 (11%) reported their AED provision as unknown. The most common reasons for not having a universal BLS training programme are the requirement for additional class time (28%) and that funding is unavailable for such a programme (28%). There were 5 students who died from sudden cardiac arrest over the period of the past 10 years. BLS training rates in London secondary schools are low, and the majority of schools do not have an AED available in case of emergency. These data highlight an opportunity to improve BLS training and AEDs provision. Future studies should assess programmes which are cost-effective and do not require significant amounts of additional class time. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  4. Basic life support education in secondary schools: a cross-sectional survey in London, UK

    PubMed Central

    Salciccioli, Justin D; Marshall, Dominic C; Sykes, Mark; Wood, Alexander D; Joppa, Stephanie A; Sinha, Madhurima; Lim, P Boon

    2017-01-01

    Objectives Basic life support (BLS) training in schools is associated with improved outcomes from cardiac arrest. International consensus statements have recommended universal BLS training for school-aged children. The current practice of BLS training in London schools is unknown. The aim of this study was to assess current practices of BLS training in London secondary schools. Setting, population and outcomes A prospective audit of BLS training in London secondary schools was conducted. Schools were contacted by email, and a subsequent telephone interview was conducted with staff familiar with local training practices. Response data were anonymised and captured electronically. Universal training was defined as any programme which delivers BLS training to all students in the school. Descriptive statistics were used to summarise the results. Results A total of 65 schools completed the survey covering an estimated student population of 65 396 across 19 of 32 London boroughs. There were 5 (8%) schools that provide universal training programmes for students and an additional 31 (48%) offering training as part of an extracurricular programme or chosen module. An automated external defibrillator (AED) was available in 18 (28%) schools, unavailable in 40 (61%) and 7 (11%) reported their AED provision as unknown. The most common reasons for not having a universal BLS training programme are the requirement for additional class time (28%) and that funding is unavailable for such a programme (28%). There were 5 students who died from sudden cardiac arrest over the period of the past 10 years. Conclusions BLS training rates in London secondary schools are low, and the majority of schools do not have an AED available in case of emergency. These data highlight an opportunity to improve BLS training and AEDs provision. Future studies should assess programmes which are cost-effective and do not require significant amounts of additional class time. PMID:28062467

  5. 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

  6. 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.

  7. The new UK internal medicine curriculum .

    PubMed

    Black, David

    2017-04-01

    Reform of physician education is needed to meet the needs of patients, based on comorbidities, chronic disease management and complexity. The Joint Royal Colleges of Physicians Training Board has developed a new internal medicine curriculum for physician training that aims to not only deliver this expectation, but will simplify competency-based education, smooth the transition to the medical registrar role and hopefully fill some of the current empty funded training posts. However, the change process is complex and requires close working with the General Medical Council and other partners in curriculum delivery. © Royal College of Physicians 2017. All rights reserved.

  8. Working with Secondary School Leadership in a Large-Scale Reform in London, UK: Consultants' Perspectives of Their Role as Agents of School Change and Improvement

    ERIC Educational Resources Information Center

    Cameron, David Hagen

    2010-01-01

    This article uses a cultural and political theoretical framework to examine the relationship between consultants and secondary school leaders within a large-scale consultancy-based reform, the Secondary National Strategy (SNS), in London UK. The SNS follows a cascade model of implementation, in which nationally created initiatives are introduced…

  9. Working with Secondary School Leadership in a Large-Scale Reform in London, UK: Consultants' Perspectives of Their Role as Agents of School Change and Improvement

    ERIC Educational Resources Information Center

    Cameron, David Hagen

    2010-01-01

    This article uses a cultural and political theoretical framework to examine the relationship between consultants and secondary school leaders within a large-scale consultancy-based reform, the Secondary National Strategy (SNS), in London UK. The SNS follows a cascade model of implementation, in which nationally created initiatives are introduced…

  10. Implementation of an improved urban parametrisation into the mesoscale meteorology model METRAS and application to London, UK

    NASA Astrophysics Data System (ADS)

    Grawe, D.; Thompson, H. L.; Salmond, J.; Cai, X.-M.; Schluenzen, K. H.

    2009-09-01

    Urban areas have well documented effects on thermal and dynamic properties of the air as well as its chemical composition. E.g. increased heat storage, anthropogenic heat sources and radiative trapping can cause increased temperatures in the urban canopy, leading to an urban heat island with potentially adverse effects on human health and comfort. A nocturnal heat island may exacerbate the impact of summer heat waves. With growing urbanisation and in a changing climate it can be expected that these effects will increase. In order to mitigate adverse effects of the urban heat island, the strength of the heat island needs to be assessed for current levels of urbanisation, as well as for prospective urbanisation scenarios. For this purpose, the mesoscale meteorology model METRAS (Schlünzen, 2003) has been extended by the urban canopy model BEP (Martilli et al., 2002), which has previously been validated and implemented in other mesoscale meteorology models. BEP parameterises the effects of the urban canopy walls and surfaces on momentum, heat and turbulent kinetic energy and takes into account very detailed specifications of building parameters, such as building height distributions and street axis orientations. The implementation of BEP in METRAS allows the use of a separate numerical grid for BEP, so that for the model simulations presented in this study a very fine vertical grid with 5m cell height (compared to 20m in the METRAS grid) could be used. Greater London forms the largest urban area within the UK and has therefore been selected as the focus area for the validation of results from the improved model and for selected case studies. A domain covering 100km x 100km around London has been set up with a horizontal grid resolution of 1km x 1km. Results of the validation show that the inclusion of BEP improves the performance of METRAS for most cases when compared with measurements in the urban area. This improvement can ultimately be used to provide better

  11. Spatial and temporal variability of urban fluxes of methane, carbon monoxide and carbon dioxide above London, UK

    NASA Astrophysics Data System (ADS)

    Helfter, Carole; Tremper, Anja H.; Halios, Christoforos H.; Kotthaus, Simone; Bjorkegren, Alex; Grimmond, C. Sue B.; Barlow, Janet F.; Nemitz, Eiko

    2016-08-01

    We report on more than 3 years of measurements of fluxes of methane (CH4), carbon monoxide (CO) and carbon dioxide (CO2) taken by eddy-covariance in central London, UK. Mean annual emissions of CO2 in the period 2012-2014 (39.1 ± 2.4 ktons km-2 yr-1) and CO (89 ± 16 tons km-2 yr-1) were consistent (within 1 and 5 % respectively) with values from the London Atmospheric Emissions Inventory, but measured CH4 emissions (72 ± 3 tons km-2 yr-1) were over two-fold larger than the inventory value. Seasonal variability was large for CO with a winter to summer reduction of 69 %, and monthly fluxes were strongly anti-correlated with mean air temperature. The winter increment in CO emissions was attributed mainly to vehicle cold starts and reduced fuel combustion efficiency. CO2 fluxes were 33 % higher in winter than in summer and anti-correlated with mean air temperature, albeit to a lesser extent than for CO. This was attributed to an increased demand for natural gas for heating during the winter. CH4 fluxes exhibited moderate seasonality (21 % larger in winter), and a spatially variable linear anti-correlation with air temperature. Differences in resident population within the flux footprint explained up to 90 % of the spatial variability of the annual CO2 fluxes and up to 99 % for CH4. Furthermore, we suggest that biogenic sources of CH4, such as wastewater, which is unaccounted for by the atmospheric emissions inventories, make a substantial contribution to the overall budget and that commuting dynamics in and out of central business districts could explain some of the spatial and temporal variability of CO2 and CH4 emissions. To our knowledge, this study is unique given the length of the data sets presented, especially for CO and CH4 fluxes. This study offers an independent assessment of "bottom-up" emissions inventories and demonstrates that the urban sources of CO and CO2 are well characterized in London. This is however not the case for CH4 emissions which are

  12. HIV-related discrimination reported by people living with HIV in London, UK.

    PubMed

    Elford, Jonathan; Ibrahim, Fowzia; Bukutu, Cecilia; Anderson, Jane

    2008-03-01

    The objective was to examine the extent to which people living with HIV in London reported being discriminated against because of their infection. In 2004-2005, people living with HIV attending NHS outpatient HIV clinics in north east London were asked: "Have you ever been treated unfairly or differently because of your HIV status-in other words discriminated against?". Of the 1,687 people who returned a questionnaire (73% response rate), data from 1,385 respondents were included in this analysis; 448 heterosexual women and 210 heterosexual men of black African origin, 727 gay/bisexual men (621 white, 106 ethnic minority). Overall, nearly one-third of respondents (29.9%, 414/1,385) said they had been discriminated against because of their HIV infection. Of those who reported experiencing HIV-related discrimination, almost a half (49.6%, 200/403) said this had involved a health care worker including their dentist (n = 102, 25.3%) or primary care physician (n = 70, 17.4%).

  13. Complaints about dog faeces as a symbolic representation of incivility in London, UK: a qualitative study.

    PubMed

    Derges, Jane; Lynch, Rebecca; Clow, Angela; Petticrew, Mark; Draper, Alizon

    2012-12-01

    During a 'Well London' study, residents were asked about their neighbourhood and its environment. Above all other complaints, 'dog poo' was mentioned as a key concern. Despite low rates of infection and disease among the human population resulting from contact with canine faecal matter, the concerns of the public continue to rate it as a serious public health issue. Most public health studies, therefore, seek to identify processes of transmission and disease pathology as a method of addressing the problem. This study approaches the issue through a contextualised analysis of residents' complaints, using anthropological theory to examine the symbolic representation of 'dog poo'. Analysis of the interviews shows that these specific complaints were located among less easily defined or articulated experiences of social and environmental neglect, where neighbours were estranged from one another and local authorities seen as negligent. This approach has important implications for public health, as it provides not only a strong indicator of the level of dissatisfaction within some of London's more disadvantaged neighbourhoods, but also identifies a need for policies that are grounded in cross-disciplinary research into the relationship between health, 'wellbeing' and experiences of marginalisation among urban populations.

  14. The medicines for children agenda in the UK

    PubMed Central

    Stephenson, Terence

    2006-01-01

    Children can expect the medicines prescribed for them to have at least as good an evidence base as in adult practice. Current licensing arrangements in the UK ensure a rigorous assessment of most drugs used for adults, whereas prescribing outside the licence is relatively common for children. Until the evidence base is increased, consensus guidelines or formularies, such as the new British National Formulary for Children, provide some protection for children and prescribers. For the future, there is optimism that the dearth of research on which to base children’s prescribing will be addressed by new initiatives, such as the UK Medicines for Children Research Network and draft EU legislation providing incentives to industry. PMID:16722834

  15. How is stroke thrombolysis portrayed in UK national and London local newspapers? A review and critical discourse analysis.

    PubMed

    Cluckie, Gillian; Rudd, Anthony G; McKevitt, Christopher

    2012-05-01

    thrombolysis for stroke has been licensed in the UK since 2007 and needs to be administered within 4.5 h. Given this time critical factor, the media may have an important role in public awareness. this review aimed to find out how stroke thrombolysis was reported in UK national and London local newspapers and how treatment risks and benefits were communicated. Newspapers published between 1 January 2007 and 31 March 2010 were searched for articles on thrombolysis. Fifty-six articles were included and dispositive analysis, a qualitative analysis method, was used to identify themes. four main themes were identified: inaccurate description of thrombolysis, stroke clinicians' involvement, presentation of risks and benefits and patient stories. Inaccuracies included the presentation of thrombolysis as a treatment for transient ischaemic attack. Clinicians were quoted to suggest that thrombolysis produced complete recovery but were not reported to discuss risks or broader stroke management. The articles reported little or no risks of treatment. Patients' stories were used to reinforce that thrombolysis produces full recovery. this review found that newspaper media provides the public with inaccurate perspectives on thrombolysis. Clinicians may wish to check press articles prior to publishing and to consider the impact of reporting thrombolysis as a treatment which produces complete recovery.

  16. Environmental Risk Factors influencing Bicycle Theft: A Spatial Analysis in London, UK.

    PubMed

    Mburu, Lucy Waruguru; Helbich, Marco

    2016-01-01

    Urban authorities are continuously drawing up policies to promote cycling among commuters. However, these initiatives are counterproductive for the targeted objectives because they increase opportunities for bicycle theft. This paper explores Inner London as a case study to address place-specific risk factors for bicycle theft at the street-segment level while controlling for seasonal variation. The presence of certain public amenities (e.g., bicycle stands, railway stations, pawnshops) was evaluated against locations of bicycle theft between 2013 and 2016 and risk effects were estimated using negative binomial regression models. Results showed that a greater level of risk stemmed from land-use facilities than from area-based socioeconomic status. The presence of facilities such as train stations, vacant houses, pawnbrokers and payday lenders increased bicycle theft, but no evidence was found that linked police stations with crime levels. The findings have significant implications for urban crime prevention with respect to non-residential land use.

  17. Environmental Risk Factors influencing Bicycle Theft: A Spatial Analysis in London, UK

    PubMed Central

    Helbich, Marco

    2016-01-01

    Urban authorities are continuously drawing up policies to promote cycling among commuters. However, these initiatives are counterproductive for the targeted objectives because they increase opportunities for bicycle theft. This paper explores Inner London as a case study to address place-specific risk factors for bicycle theft at the street-segment level while controlling for seasonal variation. The presence of certain public amenities (e.g., bicycle stands, railway stations, pawnshops) was evaluated against locations of bicycle theft between 2013 and 2016 and risk effects were estimated using negative binomial regression models. Results showed that a greater level of risk stemmed from land-use facilities than from area-based socioeconomic status. The presence of facilities such as train stations, vacant houses, pawnbrokers and payday lenders increased bicycle theft, but no evidence was found that linked police stations with crime levels. The findings have significant implications for urban crime prevention with respect to non-residential land use. PMID:27643788

  18. Highlights from Faraday Discussion: Designing New Heterogeneous Catalysts, London, UK, April 2016.

    PubMed

    Fischer, Nico; Manyar, Haresh G; Roldan, Alberto

    2016-06-28

    The Faraday Discussion on the design of new heterogeneous catalysts took place from 4-6 April 2016 in London, United Kingdom. It brought together world leading scientists actively involved in the synthesis, characterisation, modelling and testing of solid catalysts, attracting more than one hundred delegates from a broad spectrum of backgrounds and experience levels - academic and industrial researchers, experimentalists and theoreticians, and students. The meeting was a reflection of how big of an impact the ability to control and design catalysts with specific properties for particular processes can potentially have on the chemical industry, environment, economy and society as a whole. In the following, we give an overview of the topics covered during this meeting and briefly highlight the content of each presentation.

  19. 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.

  20. Discovery of previously unrecognised local faults in London, UK, using detailed 3D geological modelling

    NASA Astrophysics Data System (ADS)

    Aldiss, Don; Haslam, Richard

    2013-04-01

    In parts of London, faulting introduces lateral heterogeneity to the local ground conditions, especially where construction works intercept the Palaeogene Lambeth Group. This brings difficulties to the compilation of a ground model that is fully consistent with the ground investigation data, and so to the design and construction of engineering works. However, because bedrock in the London area is rather uniform at outcrop, and is widely covered by Quaternary deposits, few faults are shown on the geological maps of the area. This paper discusses a successful resolution of this problem at a site in east central London, where tunnels for a new underground railway station are planned. A 3D geological model was used to provide an understanding of the local geological structure, in faulted Lambeth Group strata, that had not been possible by other commonly-used methods. This model includes seven previously unrecognised faults, with downthrows ranging from about 1 m to about 12 m. The model was constructed in the GSI3D geological modelling software using about 145 borehole records, including many legacy records, in an area of 850 m by 500 m. The basis of a GSI3D 3D geological model is a network of 2D cross-sections drawn by a geologist, generally connecting borehole positions (where the borehole records define the level of the geological units that are present), and outcrop and subcrop lines for those units (where shown by a geological map). When the lines tracing the base of each geological unit within the intersecting cross-sections are complete and mutually consistent, the software is used to generate TIN surfaces between those lines, so creating a 3D geological model. Even where a geological model is constructed as if no faults were present, changes in apparent dip between two data points within a single cross-section can indicate that a fault is present in that segment of the cross-section. If displacements of similar size with the same polarity are found in a series

  1. 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.

  2. Challenges of monitoring use of secondary care at local level: a study based in London, UK.

    PubMed Central

    Chenet, L; McKee, M

    1996-01-01

    STUDY OBJECTIVE: To provide those working at district level with practical guidance on using hospital data linked to small geographic areas to explore patterns of care. DESIGN: Examination of the association between age standardised hospital episode rates for the commonest diagnostic categories and deprivation levels (Carstairs index) of the electoral ward of residence. SETTING: An inner London district, Kensington, Chelsea and Westminster, with a population of approximately 325,000. POPULATION: All finished consultant episodes recorded in NHS hospitals for the district population in the year to April 1994. MAIN RESULTS: Many, but not all, disease categories were associated strongly with deprivation, with high episode rates in the most deprived electoral wards. This is partly due to more of those in deprived areas being admitted to hospital and to them being admitted more often. CONCLUSIONS: A wide range of factors needs to be taken into account in interpreting these data. They include the contribution of the private sector and artifacts of both the numerator and denominator. This paper provides a framework for those working at district level to begin to analyse the association between hospitalisation and deprivation locally. It also identifies some of the issues that must be taken into account when seeking to interpret these data. PMID:8935471

  3. Complaints about dog faeces as a symbolic representation of incivility in London, UK: a qualitative study

    PubMed Central

    Derges, Jane; Lynch, Rebecca; Clow, Angela; Petticrew, Mark; Draper, Alizon

    2012-01-01

    During a ‘Well London’ study, residents were asked about their neighbourhood and its environment. Above all other complaints, ‘dog poo’ was mentioned as a key concern. Despite low rates of infection and disease among the human population resulting from contact with canine faecal matter, the concerns of the public continue to rate it as a serious public health issue. Most public health studies, therefore, seek to identify processes of transmission and disease pathology as a method of addressing the problem. This study approaches the issue through a contextualised analysis of residents’ complaints, using anthropological theory to examine the symbolic representation of ‘dog poo’. Analysis of the interviews shows that these specific complaints were located among less easily defined or articulated experiences of social and environmental neglect, where neighbours were estranged from one another and local authorities seen as negligent. This approach has important implications for public health, as it provides not only a strong indicator of the level of dissatisfaction within some of London's more disadvantaged neighbourhoods, but also identifies a need for policies that are grounded in cross-disciplinary research into the relationship between health, ‘wellbeing’ and experiences of marginalisation among urban populations. PMID:23335839

  4. Short-term exposure to traffic-related air pollution and daily mortality in London, UK

    PubMed Central

    Atkinson, Richard W; Analitis, Antonis; Samoli, Evangelia; Fuller, Gary W; Green, David C; Mudway, Ian S; Anderson, Hugh R; Kelly, Frank J

    2016-01-01

    Epidemiological studies have linked daily concentrations of urban air pollution to mortality, but few have investigated specific traffic sources that can inform abatement policies. We assembled a database of >100 daily, measured and modelled pollutant concentrations characterizing air pollution in London between 2011 and 2012. Based on the analyses of temporal patterns and correlations between the metrics, knowledge of local emission sources and reference to the existing literature, we selected, a priori, markers of traffic pollution: oxides of nitrogen (general traffic); elemental and black carbon (EC/BC) (diesel exhaust); carbon monoxide (petrol exhaust); copper (tyre), zinc (brake) and aluminium (mineral dust). Poisson regression accounting for seasonality and meteorology was used to estimate the percentage change in risk of death associated with an interquartile increment of each pollutant. Associations were generally small with confidence intervals that spanned 0% and tended to be negative for cardiovascular mortality and positive for respiratory mortality. The strongest positive associations were for EC and BC adjusted for particle mass and respiratory mortality, 2.66% (95% confidence interval: 0.11, 5.28) and 2.72% (0.09, 5.42) per 0.8 and 1.0 μg/m3, respectively. These associations were robust to adjustment for other traffic metrics and regional pollutants, suggesting a degree of specificity with respiratory mortality and diesel exhaust containing EC/BC. PMID:26464095

  5. Short-term exposure to traffic-related air pollution and daily mortality in London, UK.

    PubMed

    Atkinson, Richard W; Analitis, Antonis; Samoli, Evangelia; Fuller, Gary W; Green, David C; Mudway, Ian S; Anderson, Hugh R; Kelly, Frank J

    2016-01-01

    Epidemiological studies have linked daily concentrations of urban air pollution to mortality, but few have investigated specific traffic sources that can inform abatement policies. We assembled a database of >100 daily, measured and modelled pollutant concentrations characterizing air pollution in London between 2011 and 2012. Based on the analyses of temporal patterns and correlations between the metrics, knowledge of local emission sources and reference to the existing literature, we selected, a priori, markers of traffic pollution: oxides of nitrogen (general traffic); elemental and black carbon (EC/BC) (diesel exhaust); carbon monoxide (petrol exhaust); copper (tyre), zinc (brake) and aluminium (mineral dust). Poisson regression accounting for seasonality and meteorology was used to estimate the percentage change in risk of death associated with an interquartile increment of each pollutant. Associations were generally small with confidence intervals that spanned 0% and tended to be negative for cardiovascular mortality and positive for respiratory mortality. The strongest positive associations were for EC and BC adjusted for particle mass and respiratory mortality, 2.66% (95% confidence interval: 0.11, 5.28) and 2.72% (0.09, 5.42) per 0.8 and 1.0 μg/m(3), respectively. These associations were robust to adjustment for other traffic metrics and regional pollutants, suggesting a degree of specificity with respiratory mortality and diesel exhaust containing EC/BC.

  6. Integrating medicines management into mental health nursing in UK.

    PubMed

    Snowden, Austyn

    2010-06-01

    There is increasing concern that mental health nurses in UK are inadequately trained in medicines management. Recommended solutions entail proposals for further training to improve safety for service users. Although fundamentally important, these organizational approaches lack a conceptual framework to explain how individual practitioners develop competence in medicines management. This is important because applying knowledge of how individuals learn makes strategic interventions more effective. This article presents empirical evidence of how individual mental health nurse prescribers develop competence in prescribing within the context of the therapeutic relationship. It is proposed that these findings can then be extended to inform medicines management training relevant to all mental health nurses, whether prescribers or not. Copyright 2010 Elsevier Inc. All rights reserved.

  7. 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.

  8. Best Evidence Medical Education (BEME): Report of Meeting--3-5 December 1999, London, UK.

    ERIC Educational Resources Information Center

    Medical Teacher, 2000

    2000-01-01

    Discusses a meeting about evidence-based medicine. Presents the format and aim of the meeting and explains what best evidence medical education (BEME) is. Believes medical education specialists are responsible for doing research and disseminating the information to users through workshops, journals, and funding. (YDS)

  9. Why geriatric medicine? A survey of UK specialist trainees in geriatric medicine.

    PubMed

    Fisher, James Michael; Garside, Mark J; Brock, Peter; Gibson, Vicky; Hunt, Kelly; Briggs, Sally; Gordon, Adam Lee

    2017-02-06

    there is concern that there are insufficient numbers of geriatricians to meet the needs of the ageing population. A 2005 survey described factors that influenced why UK geriatricians had chosen to specialise in the field-in the decade since, UK postgraduate training has undergone a fundamental restructure. to explore whether the reasons for choosing a career in geriatric medicine in the UK had changed over time, with the goal of using this knowledge to inform recruitment and training initiatives. an online survey was sent to all UK higher medical trainees in geriatric medicine. survey questions that produced categorical data were analysed with simple descriptive statistics. For the survey questions that produced free-text responses, an inductive, iterative approach to analysis, in keeping with the principles of framework analysis, was employed. two hundred and sixty-nine responses were received out of 641 eligible respondents. Compared with the previous survey, a substantially larger number of respondents regarded geriatric medicine to be their first-choice specialty and a smaller number regretted their career decision. A greater number chose geriatric medicine early in their medical careers. Commitments to the general medical rota and the burden of service provision were considered important downsides to the specialty. there are reasons to be optimistic about recruitment to geriatric medicine. Future attempts to drive up recruitment might legitimately focus on the role of the medical registrar and perceptions that geriatricians shoulder a disproportionate burden of service commitments and obligations to the acute medical take.

  10. Fear of crime, mobility and mental health in inner-city London, UK.

    PubMed

    Whitley, Rob; Prince, Martin

    2005-10-01

    This paper examines the relationship between fear of crime and mental health, and assesses the role interventions may have in helping overcome any negative impact arising from this fear. The data were gathered over a 2-year period in the Gospel Oak neighbourhood of North London using in-depth interviews, focus groups and participant observation. The data are analysed primarily by comparing the impact of fear of crime across sub-groups notably divided by gender, age and mental health status. It was found that fear of crime had a disproportionately negative impact on certain sub-groups, most notably low-income mothers, and to a lesser extent the mentally ill. They experienced what we term "time-space inequalities" as a consequence of fear of crime and other related factors. These inequalities describe variation in the ability to access and utilise different times and spaces within both the immediate and the wider environment. These have negative behavioural and affective consequences that appear to impact on overall mental health. They restrict spatial and temporal movement deterring protective social activity, health-promoting community involvement and use of services. Affective consequences include negative mood and low self-esteem. These inequalities were experienced less in other groups such as mentally healthy men or middle-income women. They appeared to be diminished by interventions that encourage spatial and temporal movement. These include comprehensive local transport, government-issued free travel passes for vulnerable populations and neighbourhood community safety measures such as the installation of CCTV. We suggest that experience of time-space inequalities may be damaging to mental health and that interventions which lessen them may help prevent, ameliorate or shorten episodes of mental illness.

  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. How and Why Do Smokers Start Using E-Cigarettes? Qualitative Study of Vapers in London, UK

    PubMed Central

    Wadsworth, Elle; Neale, Joanne; McNeill, Ann; Hitchman, Sara C.

    2016-01-01

    The aims of the study were to (1) describe how and why smokers start to vape and what products they use; (2) relate findings to the COM-B theory of behaviour change (three conditions are necessary for behaviour change (B): capability (C), opportunity (O), and motivation (M)); and (3) to consider implications for e-cigarette policy research. Semi-structured interviews (n = 30) were conducted in London, UK, with smokers or ex-smokers who were currently using or had used e-cigarettes. E-cigarette initiation (behaviour) was facilitated by: capability (physical capability to use an e-cigarette and psychological capability to understand that using e-cigarettes was less harmful than smoking); opportunity (physical opportunity to access e-cigarettes in shops, at a lower cost than cigarettes, and to vape in “smoke-free” environments, as well as social opportunity to vape with friends and family); and motivation (automatic motivation including curiosity, and reflective motivation, including self-conscious decision-making processes related to perceived health benefits). The application of the COM-B model identified multiple factors that may lead to e-cigarette initiation, including those that could be influenced by policy, such as price relative to cigarettes and use in smoke-free environments. The effects of these policies on initiation should be further investigated along with the possible moderating/mediating effects of social support. PMID:27376312

  13. Entitlement to concessionary public transport and wellbeing: a qualitative study of young people and older citizens in London, UK.

    PubMed

    Jones, Alasdair; Goodman, Anna; Roberts, Helen; Steinbach, Rebecca; Green, Judith

    2013-08-01

    Access to transport is an important determinant of health, and concessionary fares for public transport are one way to reduce the 'transport exclusion' that can limit access. This paper draws on qualitative data from two groups typically at risk of transport exclusion: young people (12-18 years of age, n = 118) and older citizens (60+ years of age, n = 46). The data were collected in London, UK, where young people and older citizens are currently entitled to concessionary bus travel. We focus on how this entitlement is understood and enacted, and how different sources of entitlement mediate the relationship between transport and wellbeing. Both groups felt that their formal entitlement to travel for free reflected their social worth and was, particularly for older citizens, relatively unproblematic. The provision of a concessionary transport entitlement also helped to combat feelings of social exclusion by enhancing recipients' sense of belonging to the city and to a 'community'. However, informal entitlements to particular spaces on the bus reflected less valued social attributes such as need or frailty. Thus in the course of travelling by bus the enactment of entitlements to space and seats entailed the negotiation of social differences and personal vulnerabilities, and this carried with it potential threats to wellbeing. We conclude that the process, as well as the substance, of entitlement can mediate wellbeing; and that where the basis for providing a given entitlement is widely understood and accepted, the risks to wellbeing associated with enacting that entitlement will be reduced.

  14. Attitudes toward transplantation in U.K. Muslim Indo-Asians in west London.

    PubMed

    Alkhawari, Fawzi S; Stimson, Gerry V; Warrens, Anthony N

    2005-06-01

    The worldwide shortage of organs for transplantation makes it important to understand why some oppose donation. Attitudes vary with religion and ethnicity. Accordingly, we undertook a qualitative study of the attitudes of 141 U.K. Muslim Indo-Asians to organ donation. Participants were observed, focus group discussions held and in-depth individual interviews conducted. We identified a high level of alienation from the health care system in general. With respect to organ donation in particular, its importance was generally discounted, often in deference to authority figures within the community who appeared negatively disposed. The culture-specific issues arguing against donation included a sense of the sacredness of the body, a fatalistic approach to illness, a belief that organs took on an independent role as 'witnesses' to an individual's life on Judgement Day and an anxiety that the donor would have no control of the probity of the recipient of an organ. We believe these data suggest a need to improve in a culturally sensitive fashion the provision of health information provided to this community.

  15. Liminal identities: Caribbean men who have sex with men in London, UK.

    PubMed

    Anderson, Moji; Elam, Gillian; Gerver, Sarah; Solarin, Ijeoma; Fenton, Kevin; Easterbrook, Phillippa

    2009-04-01

    Accounts by 10 Caribbean men who have sex with men living in the UK reveal them to be liminal beings with unstable and unresolved identities. They are between social states: aware they are not heterosexual and not publicly recognised, or in some cases self-accepted, as homosexual. Caribbean-born respondents especially suffer from homophobia, expressing regret and disappointment at their sexuality. They may also experience cognitive dissonance - as they are aware of their conflict with the heteronormative order - they cannot resolve. Religion contributes to homophobia and cognitive dissonance particularly for Caribbean-born men, some of whom may believe a fundamental conflict exists between Christianity and homosexuality. Heterosexism and homophobia contribute to and reinforce their liminal state, by preventing transition to publicly recognised homosexual status. Respondents may engage in private and public, internal and external, overt and covert policing of their and other gay men's behaviour: through strategic pretence at heterosexuality and/or condemnation of men engaging in behaviour identifiable as stereotypically homosexual, for example. Narratives point to the need to complexify the conventional understanding of Jamaican heterosexism to explain reported variations in the degree of anti-homosexual hostility in the country.

  16. 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

  17. Methanotrophy in London, UK, Landfill Topsoil: Microbiology, Stable Carbon Isotopes, Seasonal Variation and Laboratory Model Study

    NASA Astrophysics Data System (ADS)

    Sriskantharajah, S.; Fisher, R.; Lowry, D.; Grassineau, N.; Nisbet, E. G.

    2004-12-01

    Landfill is a major source of methane emissions into the atmosphere. Aerobic soil is also a good sink of methane, as it is inhabited by methane consuming bacteria, methanotrophs. Methanotrophic bacteria were cultured from landfill soil samples. Three genera of methanotrophs were cultured: Methylocaldum, Methylosinus and Methylomonas. Interestingly, the only established members of the Methylocaldum genus are all thermophilic, whilst those isolated in this study are mesophilic. This suggests that those Methylocaldum methanotrophs found in landfills may have migrated from hot spring natural settings. Representatives of each genera were inoculated into a simple topsoil model and subjected to variations in temperature, methane concentration and incubation periods. As expected, temperature greatly affected methane oxidation, but methane concentration affected the rate of oxidation far more than expected. The model study implies that the complete combustion of methane to carbon dioxide is greatly affected by temperature and methane availability, whilst the effect on the uptake of methane is not as great. Seasonal variations in methane concentrations within the topsoil were monitored over a one year period from November 2002 to October 2003 and show that methane flow through the topsoil, and consequently methanotrophy, is strongly controlled by meteorology, mainly air temperature and pressure. Generally, methanotrophy was low during colder months and higher at during warmer months, but changes in air pressure complicate this by controlling the rate of flow of methane through the topsoil. δ 13C analyses of methane and carbon dioxide emitted from landfill topsoil showed that there was a great deal of methanotrophic activity during the warmer months of 2003, with most fractionation of residual methane occurring during August. During the heat wave experienced in the UK in August 2003, the δ 13C from borehole samples of methane in the anaerobic zone shifted from -57‰ to -16

  18. Prevalence, determinants and clinical correlates of vitamin D deficiency in adults with inhaled corticosteroid-treated asthma in London, UK.

    PubMed

    Jolliffe, David A; Kilpin, Kate; MacLaughlin, Beverley D; Greiller, Claire L; Hooper, Richard L; Barnes, Neil C; Timms, Peter M; Rajakulasingam, Raj K; Bhowmik, Angshu; Choudhury, Aklak B; Simcock, David E; Hyppönen, Elina; Corrigan, Christopher J; Walton, Robert T; Griffiths, Christopher J; Martineau, Adrian R

    2016-11-05

    Vitamin D deficiency is common in children with asthma, and it associates with poor asthma control, reduced forced expiratory volume in one second (FEV1) and increased requirement for inhaled corticosteroids (ICS). Cross-sectional studies investigating the prevalence, determinants and clinical correlates of vitamin D deficiency in adults with asthma are lacking. We conducted a multi-centre cross-sectional study in 297 adults with a medical record diagnosis of ICS-treated asthma living in London, UK. Details of potential environmental determinants of vitamin D status, asthma control and medication use were collected by questionnaire; blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction, and participants underwent measurement of weight, height and fractional exhaled nitric oxide concentration (FeNO), spirometry and sputum induction for determination of lower airway eosinophil counts (n=35 sub-group). Thirty-five single nucleotide polymorphisms (SNP) in 11 vitamin D pathway genes (DBP, DHCR7, RXRA, CYP2R1, CYP27B1, CYP24A1, CYP3A4 CYP27A1, LRP2, CUBN, VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration, and to determine whether vitamin D status was independently associated with Asthma Control Test (ACT) score, ICS dose, FeNO, forced vital capacity (FVC), FEV1 or lower airway eosinophilia. Mean serum 25(OH)D concentration was 50.6nmol/L (SD 24.9); 162/297 (54.5%) participants were vitamin D deficient (serum 25(OH)D concentration <50nmol/L). Lower vitamin D status was associated with higher body mass index (P=0.014), non-White ethnicity (P=0.036), unemployment (P for trend=0.012), lack of vitamin D supplement use (P<0.001), sampling in Winter or Spring (P for trend <0.001) and lack of a recent sunny holiday abroad (P=0.030), but not with potential genetic determinants. Vitamin D status was not found

  19. Maternal BMI and diabetes in pregnancy: Investigating variations between ethnic groups using routine maternity data from London, UK

    PubMed Central

    Nishikawa, Erin; Seed, Paul T.; Doyle, Pat; Oteng-Ntim, Eugene

    2017-01-01

    Objective To investigate the ethnicity-specific association between body mass index (BMI) and diabetes in pregnancy, with a focus on the appropriateness of using BMI cut-offs to identify pregnant women at risk of diabetes. Study design Analysis of routinely-collected data from a maternity unit in London, UK. Data were available on 53 264 women delivering between 2004 and 2012. Logistic regression was used to explore the association between diabetes in pregnancy and BMI among women of different ethnicities, and adjusted probability estimates were used to derive risk equivalent cut-offs. ROC curve analysis was used to assess the performance of BMI as a predictor of diabetes in pregnancy. Results The prevalence of diabetes in pregnancy was 2.3% overall; highest in South and East Asian women (4.6% and 3.7%). In adjusted analysis, BMI category was strongly associated with diabetes in all ethnic groups. Modelled as a continuous variable with a quadratic term, BMI was an acceptable predictor of diabetes according to ROC curve analysis. Applying a BMI cut-off of 30 kg/m2 would identify just over half of Black women with diabetes in pregnancy, a third of White (32%) and South Asian (35%) women, but only 13% of East Asian women. The ‘risk equivalent’ (comparable to 30 kg/m2 in White women) threshold for South Asian and East Asian women was approximately 21 kg/m2, and 27.5 kg/m2 for Black women. Conclusions This study suggests that current BMI thresholds are likely to be ineffective for diabetes screening in South and East Asian women, as many cases of diabetes will occur at low BMI levels. Our results suggest that East Asian women appear to face a similarly high risk of diabetes to South Asian women. Current UK guidelines recommend diabetes screening should be offered to all pregnant South Asian women; extending this recommendation to include women of East Asian ethnicity may be appropriate. PMID:28640854

  20. Using stable isotope analysis to examine the effect of economic change on breastfeeding practices in Spitalfields, London, UK.

    PubMed

    Nitsch, Erika K; Humphrey, Louise T; Hedges, Robert E M

    2011-12-01

    Breastfeeding patterns were subject to a number of fads in 18th and 19th century Britain. Feeding infants by hand, rather than maternal breastfeeding or wet-nursing, became more prevalent among both the wealthy and poor. Substitute foods may have been a convenient alternative for mothers employed away from the household. This study used stable isotope ratio analysis to examine the weaning schedule in the 18th and 19th century skeletal assemblage from Spitalfields, London, UK. Analysis of 72 juvenile ribs revealed δ(15) N elevations of 2-3‰ above the adult mean for individuals up to the age of two, while elevations of 1-2‰ were observed in δ(13) C for the first year of life. This suggests that the introduction of solid foods took place before the end of the first year, and that breastfeeding had entirely ceased by 2 years of age. The age at death of many of these infants is known from historical records, and can be used to pinpoint the amount of time required for the breast milk signal to be observed in the stable isotope ratios of rib collagen. Results show that a δ(15) N elevation can be detected in the ribs of individuals who died as young as 5-6 weeks. Not all individuals at Spitalfields were breastfed, and there may not have been a single uniformly practiced weaning scheme. There is, however, more evidence for prolonged breastfeeding during the 19th century than the 18th century. 2011 Wiley Periodicals, Inc.

  1. Erosion of cohesive shorelines: the contribution of shore platform downwearing. A case study on the London Clay, Kent coastline, UK.

    NASA Astrophysics Data System (ADS)

    Moses, Cherith

    2017-04-01

    The most rapidly eroding cliffed shorelines in the United Kingdom are composed of semi-consolidated cohesive materials with extensive shore platforms fronting actively eroding cliffs. Research has focussed on understanding and measuring their cliff retreat rates rather than platform downwearing. Yet, irreversible platform downwearing is thought to be a primary cause of beach lowering, a key driver of cliff retreat and contributor of large volumes of fine-grained sediment to the coastal budget. Despite this, few direct measurements of clay platform downwearing exist and current understanding of the erosion mechanisms of cohesive shore platforms is limited. This paper presents downwearing rates, measured over a ten year period across a shore platform in London Clay at Warden Point, Isle of Sheppey, Kent, UK using the specially designed Traversing Erosion Beam. The platform is 300 m wide with a gradient of 0.5 degrees and is backed by 48 m high cliffs. A thin mixed-sediment beach, 8 - 20 m wide and 0.1 m deep, covers the landward edge of the platform. Mean annual downwearing, on the upper to lower mid-shore, 2005 - 2015, is 17.52 ± 2.88 mm/yr. The highest downwearing rate, 29.85 ± 5.21 mm/yr, was recorded on the upper platform. The location of maximum downwearing has varied between measurement periods and is not consistently on one part of the platform. Downwearing is greatest during the winter period and lower during the summer. The results provide evidence of the contribution that platform downwearing makes to cliff erosion and the coastal sediment budget. The findings will assist in the development both of models to enhance prediction of coastal retreat on cohesive shorelines and of strategies for their management and conservation.

  2. Antibiotic resistance and mecA characterization of coagulase-negative staphylococci isolated from three hotels in London, UK.

    PubMed

    Xu, Zhen; Mkrtchyan, Hermine V; Cutler, Ronald R

    2015-01-01

    Antibiotic resistance in bacteria isolated from non-healthcare environments, is a potential problem to public health. In our survey a total of 71 coagulase negative staphylococci (CNS) belonging to 11 different species were isolated from three large hotels in London, UK. The most prevalent species was Staphylococcus haemolyticus, with S. hominis, S. warneri, S. cohnii, and Staphylococcus epidermidis commonly detected. Antimicrobial susceptibilities and carriage of the mecA gene were determined for all of these isolates. Most (85.9%) staphylococci were resistant to multiple antibiotics with all displaying increased susceptibility toward penicillin, fusidic acid, erythromycin, and cefepime. Twenty-one (29.5%) of the isolates were mecA positive, however MIC values to oxacillin, normally associated with the carriage of mecA, varied widely in this group (from 0.06 to 256 mg/L). Fifteen of the twenty-one mecA positive isolates carried SCCmec of these seven were type V, one type I, one type II, and one type IV. Additionally, five of these 15 isolates carried a previously unreported type, 1A, which involves an association between class A mec complex and ccr type 1. The remaining six of the 21 isolates were non-typeable and carried a combination of class A mec complex and ccrC. In addition to this, we also report on new MLST types which were assigned for five S. epidermidis isolates. Four out of these five isolates had MICs between 0.06 and 256 mg/L to oxacillin and would be regarded as clinically susceptible but one isolate had a high oxacillin MIC of 256 mg/L. We demonstrated widespread multiple drug resistance among different staphylococcal species isolated from non-healthcare environments highlighting the potential for these species to act as a reservoir for methicillin and other forms of drug resistance.

  3. A Mixed-Methods Evaluation of a Community-Based Glaucoma Check Service in Hackney, London, UK.

    PubMed

    Holdsworth, Elizabeth; Datta, Jessica; Marks, Dalya; Kuper, Hannah; Lee, Helen; Leamon, Shaun; Lindfield, Robert; Wormald, Richard; Clarke, Jonathan; Elkarmouty, Ahmed; Macdowall, Wendy

    2017-08-01

    To evaluate the uptake, feasibility and acceptability of a general practice-based optometrist-led glaucoma check service. The service targeted people of black Caribbean and black African descent aged 40-65 years, resident in Hackney, London, United Kingdom. The study used a mixed-method design, including analysis of service data, prospective audit of secondary care referrals patient survey, cost-consequence analysis, and interviews with staff involved in developing and implementing the service. A total of 3040 patients were invited to undergo the free check; 595 (19.6%) booked an appointment and 461 (15.2%) attended. Overall, 31 patients (6.8%) were referred to secondary care, of whom 22 attended and were assessed for glaucoma. Four were diagnosed with glaucoma and eight with suspected glaucoma, i.e. 2.6% of patients who underwent the check. The cost per patient identified with suspected or confirmed glaucoma was £9,013. Staff who were interviewed suggested that patients who attended might be those who routinely attended optometrist appointments, however only 62.4% of survey respondents reported having had an eye examination in the previous two years, and 11.4% of women and 16.0% of men reported never having had an eye examination. This study represents one possible configuration for a glaucoma case-finding service, and it contributes to a wider debate about whether screening, targeted or otherwise, should be offered in the UK. Our findings suggest that general practice is an acceptable setting and that such a service may reach some people not previously engaged with primary eye care services.

  4. Evidence-based medicine: UK doctors' attitudes and understanding.

    PubMed

    Davies, Karen S

    2011-09-01

    The aim of this paper is to understand UK doctors' attitudes towards evidence-based medicine (EBM) and their self-perceived understanding of specified EBM terms. An online questionnaire was emailed to doctor's emails (identified from the Internet) and the questionnaire URL was promoted on certain websites and electronic newsletters. This article focuses on the EBM questions posed on this research instrument. Respondents were generally positive towards the practice of EBM; for example, 72.3% of UK doctors agreed that EBM improves patient outcomes. Over 85% of respondents were either able to explain (or had some understanding) all the specified EBM terms. Respondents who had graduated from medical school most recently were more positive towards EBM and had a stronger self-perceived understanding of the EBM terms. This research found that doctors were generally in favour of EBM and their understanding of specialist terms was higher than previous published research. © 2011 The Author. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

  5. Third Annual Open Meeting of the UK Pharmacogenomics and Stratified Medicine Network Conference.

    PubMed

    Bradshaw, Elizabeth H

    2015-07-01

    Third Annual Open Meeting of the UK Pharmacogenetics and Stratified Medicine Network 14 January 2015, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK The third Annual Open Meeting of the UK Pharmacogenetics and Stratified Medicine Network was held on 14 January 2015 in association with the Wellcome Trust on the Wellcome Trust Genome Campus at Hinxton, Cambridge, UK. In the morning, speakers from Cancer Research UK, the Medical Research Council, Genomics England, Innovate UK (formerly TSB) and the Department of Health described the current major projects they are funding. In the afternoon, speakers from various universities around the United Kingdom presented data on pharmacogenetics and stratified medicine research covering diverse disease areas including cancers, warfarin dosing, Gaucher disease and rheumatoid arthritis.

  6. Prevalence, determinants and clinical correlates of vitamin D deficiency in patients with Chronic Obstructive Pulmonary Disease in London, UK.

    PubMed

    Jolliffe, David A; James, Wai Yee; Hooper, Richard L; Barnes, Neil C; Greiller, Claire L; Islam, Kamrul; Bhowmik, Angshu; Timms, Peter M; Rajakulasingam, Raj K; Choudhury, Aklak B; Simcock, David E; Hyppönen, Elina; Walton, Robert T; Corrigan, Christopher J; Griffiths, Christopher J; Martineau, Adrian R

    2017-02-01

    Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD), yet a comprehensive analysis of environmental and genetic determinants of serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with this condition is lacking. We conducted a multi-centre cross-sectional study in 278 COPD patients aged 41-92 years in London, UK. Details of potential environmental determinants of vitamin D status and COPD symptom control and severity were collected by questionnaire, and blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction. All participants performed spirometry and underwent measurement of weight and height. Quadriceps muscle strength (QS) was measured in 134 participants, and sputum induction with enumeration of lower airway eosinophil and neutrophil counts was performed for 44 participants. Thirty-seven single nucleotide polymorphisms (SNP) in 11 genes in the vitamin D pathway (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, CYP27A1, CYP3A4, LRP2, CUBN, RXRA, and VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration and to determine whether vitamin D status or genetic factors independently associated with % predicted forced expiratory volume in one second (FEV1), % predicted forced vital capacity (FVC), the ratio of FEV1 to FVC (FEV1:FVC), daily inhaled corticosteroid (ICS) dose, respiratory quality of life (QoL), QS, and the percentage of eosinophils and neutrophils in induced sputum. Mean serum 25(OH)D concentration was 45.4nmol/L (SD 25.3); 171/278 (61.5%) participants were vitamin D deficient (serum 25[OH]D concentration <50nmol/L). Lower vitamin D status was independently associated with higher body mass index (P=0.001), lower socio-economic position (P=0.037), lack of vitamin D supplement consumption (P<0.001), sampling in Winter or Spring (P for trend=0.006) and

  7. Are fuel poverty reduction schemes associated with decreased excess winter mortality in elders? A case study from London, U.K.

    PubMed

    El Ansari, Walid; El-Silimy, Sally

    2008-12-01

    The London Borough of Newham, London piloted the Warm Zone, a government-led fuel poverty reduction scheme. Fuel poverty is often cited as a factor in excess winter mortality (EWM) in the U.K. This study reported in this paper assessed whether EWM decreased for people aged > or =65 years in Newham as compared to all London, employing data from before and throughout the duration of the Warm Zone project. The paper also discusses the difficulties surrounding the measurement and interpretation of health impact relating to fuel poverty. We calculated and compared the yearly EWM indices for people aged > or =65 years for all of London, and for Newham over 12 years (1993-2005). The yearly EWM ratio for Newham in relation to all London was then calculated and compared. No definitive evidence to support the effect of the War Zone on EMW were noted. Relationships between EWM and fewer poverty reduction schemes are difficult to interpret, as many factors are entangled. These include cold strain and biological, genetic, gender, physiological, thermoregulation, environmental, meteorological, socio-economic, healthcare provision/expenditure, lifestyle and co-morbidity aspects, besides the challenges of sample sizes and whether other fuel poverty reduction schemes were simultaneously in operation. Those in privately owned housing might be ;masked' (underestimated) in their vulnerability to fuel poverty. Redefining the specific criteria for eligibility for fuel poverty grants and tackling heat inefficiency in privately owned homes not eligible for home heating improvement despite fulfilling other criteria for vulnerability requires attention. The implications are discussed.

  8. 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.

  9. Model simulations of cooking organic aerosol (COA) over the UK using estimates of emissions based on measurements at two sites in London

    NASA Astrophysics Data System (ADS)

    Ots, Riinu; Vieno, Massimo; Allan, James D.; Reis, Stefan; Nemitz, Eiko; Young, Dominique E.; Coe, Hugh; Di Marco, Chiara; Detournay, Anais; Mackenzie, Ian A.; Green, David C.; Heal, Mathew R.

    2016-11-01

    Cooking organic aerosol (COA) is currently not included in European emission inventories. However, recent positive matrix factorization (PMF) analyses of aerosol mass spectrometer (AMS) measurements have suggested important contributions of COA in several European cities. In this study, emissions of COA were estimated for the UK, based on hourly AMS measurements of COA made at two sites in London (a kerbside site in central London and an urban background site in a residential area close to central London) for the full calendar year of 2012 during the Clean Air for London (ClearfLo) campaign. Iteration of COA emissions estimates and subsequent evaluation and sensitivity experiments were conducted with the EMEP4UK atmospheric chemistry transport modelling system with a horizontal resolution of 5 km × 5 km. The spatial distribution of these emissions was based on workday population density derived from the 2011 census data. The estimated UK annual COA emission was 7.4 Gg per year, which is an almost 10 % addition to the officially reported UK national total anthropogenic emissions of PM2.5 (82 Gg in 2012), corresponding to 320 mg person-1 day-1 on average. Weekday and weekend diurnal variation in COA emissions were also based on the AMS measurements. Modelled concentrations of COA were then independently evaluated against AMS-derived COA measurements from another city and time period (Manchester, January-February 2007), as well as with COA estimated by a chemical mass balance model of measurements for a 2-week period at the Harwell rural site (˜ 80 km west of central London). The modelled annual average contribution of COA to ambient particulate matter (PM) in central London was between 1 and 2 µg m-3 (˜ 20 % of total measured OA1) and between 0.5 and 0.7 µg m-3 in other major cities in England (Manchester, Birmingham, Leeds). It was also shown that cities smaller than London can have a central hotspot of population density of smaller

  10. 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.

  11. "That's your patient. There's your ventilator": exploring induction to work experiences in a group of non-UK EEA trained anaesthetists in a London hospital: a qualitative study.

    PubMed

    Snelgrove, Huon; Kuybida, Yuriy; Fleet, Mark; McAnulty, Greg

    2015-03-17

    European health systems depend increasingly on the services of health professionals who obtained their primary medical qualification from other countries. There has been a significant increase recently in fully qualified specialist doctors arriving from the European Union to provide short term or longer-term solutions to health human resources needs in the UK National Health System. These doctors often take up senior consultant positions. As a result, the NHS has had to learn to deal with both expatriation and repatriation of EU doctors as a constant dynamic characteristic of its own ability to deliver services. We conducted a qualitative study to explore the acclimatisation experience of EU doctors with qualifications in anaesthesia arriving in the United Kingdom to take up clinical employment in the NHS. The question we ask is: how do specialty registered anaesthetists who trained in other European countries experience the process of acclimatisation to practice in the United Kingdom in a large hospital in London? We did individual interviews with non-UK, EU-qualified doctors with Certification of Completion of specialty Training who were registered with the General Medical Council in the UK and could practice in the NHS as specialist anaesthetists. The doctors were all interviewed whilst working in a large NHS teaching hospital in London, UK. We analysed qualitative data from interview transcripts to identity themes and patterns regarding senior doctor's acclimatisation to the British system. Acclimatisation conceived of as transfer of clinical expertise was problematic for doctors who felt they lacked the right kind of support. Doctors sought different opportunities to share wider perspectives on care deriving from their previous experience. Hospital conceptions of acclimatisation as a highly individual process can offer an idealized view of clinical work and learning in the new system. Socio-cultural theories suggest we create regular learning opportunities for

  12. Travel medicine advice to UK based international motor sport teams.

    PubMed

    Walters, A

    2000-01-01

    International motor sport teams travel extensively. Over the years, the design and build of racing cars has improved so that morbidity and mortality in motor sport has been lessened. Those team members supporting the competitors need to be physically and mentally fit to perform complicated tasks, despite having traveled. This group of travelers has not been studied to any extent previously. An anonymous questionnaire asking some basic travel medicine related questions was distributed to the support team members of a Rally team, and Formula One Grand Prix team. Both teams were based in the UK, and competed in all the rounds of their respective world championships. Ten Rally team members and 18 Formula One team members responded to the questionnaire. The results showed moderate coverage of commonly used vaccinations; appropriate use of antimalarials and insect repellents, but by no means by all team members; little or no problems with traveler's diarrhea; some tendencies to problems related to jet lag, but no real attempt to prevent the problem; and finally some attempt at skin protection against solar damage. Support teams are reasonably well prepared for the combination of, the rigors of frequent travel, and a demanding job. There is a deficit in vaccine coverage, especially of both hepatitis A and B, some education is needed in preventing skin problems later in life due to sun exposure, and further study of jet lag and its implications might be appropriate.

  13. 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.

  14. 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.

  15. 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

  16. Superbugs and Superdrugs-SMi's 12th annual conference--Overcoming resistance. 17-18 March 2010, London, UK.

    PubMed

    Oni, Adekemi

    2010-05-01

    The 12th Annual Superbugs and Superdrugs conference, held in London, included topics covering new therapeutic developments in the field of antimicrobial research. This conference report highlights selected presentations on antimicrobial peptides, addressing bacterial resistance, and new treatments for bacterial infections. Investigational drugs discussed include DPK-060 (DermaGen AB), DAV-132 (Da Volterra), PF-4287881, PNU-100480 and PF-02538084 (all Pfizer Inc), BAL-30072 (Basilea Pharmaceutica International Ltd) and lanbiotics from Novacta.

  17. Lessons for molecular diagnostics in oncology from the Cancer Research UK Stratified Medicine Programme.

    PubMed

    Lindsay, Colin R; Shaw, Emily; Walker, Ian; Johnson, Peter W M

    2015-03-01

    The implementation of stratified medicine in modern cancer care presents substantial opportunity to refine diagnosis and treatment but also numerous challenges. Through experience in a UK tumor profiling initiative, we have gained valuable insights into the complexities and possible solutions for routine delivery of stratified cancer medicine.

  18. ‘Complex’ but coping: experience of symptoms of tuberculosis and health care seeking behaviours - a qualitative interview study of urban risk groups, London, UK

    PubMed Central

    2014-01-01

    Background Tuberculosis awareness, grounded in social cognition models of health care seeking behaviour, relies on the ability of individuals to recognise symptoms, assess their risk and access health care (passive case finding). There is scant published research into the health actions of ‘hard-to-reach’ groups with tuberculosis, who represent approximately 17% of the London TB caseload. This study aimed to analyse patients’ knowledge of tuberculosis, their experiences of symptoms and their health care seeking behaviours. Methods Qualitative interviews were conducted with 17 participants, predominantly homeless and attending a major tuberculosis centre in London, UK. Most had complex medical and social needs including drug and alcohol use or immigration problems affecting entitlement to social welfare. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions. Results Although participants demonstrated some knowledge of tuberculosis their awareness of personal risk was low. Symptoms commonly associated with tuberculosis were either not recognised or were attributed to other causes for which participants would not ordinarily seek health care. Many accessed health care by chance and, for some, for health concerns other than tuberculosis. Conclusions Health education, based on increasing awareness of symptoms, may play a limited role in tuberculosis care for populations with complex health and social needs. The findings support the intensification of outreach initiatives to identify groups at risk of tuberculosis and the development of structured care pathways which support people into prompt diagnosis and treatment. PMID:24943308

  19. 'Complex' but coping: experience of symptoms of tuberculosis and health care seeking behaviours--a qualitative interview study of urban risk groups, London, UK.

    PubMed

    Craig, Gillian M; Joly, Louise M; Zumla, Alimuddin

    2014-06-18

    Tuberculosis awareness, grounded in social cognition models of health care seeking behaviour, relies on the ability of individuals to recognise symptoms, assess their risk and access health care (passive case finding). There is scant published research into the health actions of 'hard-to-reach' groups with tuberculosis, who represent approximately 17% of the London TB caseload. This study aimed to analyse patients' knowledge of tuberculosis, their experiences of symptoms and their health care seeking behaviours. Qualitative interviews were conducted with 17 participants, predominantly homeless and attending a major tuberculosis centre in London, UK. Most had complex medical and social needs including drug and alcohol use or immigration problems affecting entitlement to social welfare. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions. Although participants demonstrated some knowledge of tuberculosis their awareness of personal risk was low. Symptoms commonly associated with tuberculosis were either not recognised or were attributed to other causes for which participants would not ordinarily seek health care. Many accessed health care by chance and, for some, for health concerns other than tuberculosis. Health education, based on increasing awareness of symptoms, may play a limited role in tuberculosis care for populations with complex health and social needs. The findings support the intensification of outreach initiatives to identify groups at risk of tuberculosis and the development of structured care pathways which support people into prompt diagnosis and treatment.

  20. Estimating the influence of different urban canopy cover types on atmospheric particulate matter (PM10) pollution abatement in London UK.

    NASA Astrophysics Data System (ADS)

    Tallis, Matthew; Freer-Smith, Peter; Sinnett, Danielle; Aylott, Matthew; Taylor, Gail

    2010-05-01

    In the urban environment atmospheric pollution by PM10 (particulate matter with a diameter less than 10 x 10-6 m) is a problem that can have adverse effects on human health, particularly increasing rates of respiratory disease. The main contributors to atmospheric PM10 in the urban environment are road traffic, industry and power production. The urban tree canopy is a receptor for removing PM10s from the atmosphere due to the large surface areas generated by leaves and air turbulence created by the structure of the urban forest. In this context urban greening has long been known as a mechanism to contribute towards PM10 removal from the air, furthermore, tree canopy cover has a role in contributing towards a more sustainable urban environment. The work reported here has been carried out within the BRIDGE project (SustainaBle uRban plannIng Decision support accountinG for urban mEtabolism). The aim of this project is to assess the fluxes of energy, water, carbon dioxide and particulates within the urban environment and develope a DSS (Decision Support System) to aid urban planners in sustainable development. A combination of published urban canopy cover data from ground, airborne and satellite based surveys was used. For each of the 33 London boroughs the urban canopy was classified to three groups, urban woodland, street trees and garden trees and each group quantified in terms of ground cover. The total [PM10] for each borough was taken from the LAEI (London Atmospheric Emissions Inventory 2006) and the contribution to reducing [PM10] was assessed for each canopy type. Deposition to the urban canopy was assessed using the UFORE (Urban Forest Effects Model) approach. Deposition to the canopy, boundary layer height and percentage reduction of the [PM10] in the atmosphere was assessed using both hourly meterological data and [PM10] and seasonal data derived from annual models. Results from hourly and annual data were compared with measured values. The model was then

  1. Bringing together values-based and evidence-based medicine: UK Department of Health Initiatives in the 'Personalization' of Care.

    PubMed

    Fulford, K W M Bill

    2011-04-01

    Person-centred medicine depends on combining best research evidence with the unique values (including the preferences, concerns, needs and wishes) of individual patients and their families. The paper gives a brief introduction to values-based practice as a new approach to incorporating patients' values into clinical decision making alongside best research evidence as derived from evidence-based practice. The role of values-based practice as a partner to evidence-based practice is illustrated through a series of policy, training and service development initiatives in mental health from the UK Department of Health in London. These initiatives have supported person-centred developments in key areas of mental health practice including, (1) the use of involuntary treatment; and (2) a shared approach of assessment. Early moves are underway to extend values-based practice to other areas of health care beyond mental health. Values-based practice offers a new approach to incorporating patients' unique values into clinical decision making that is complementary to evidence-based practice as a resource for person-centred medicine. © 2010 Blackwell Publishing Ltd.

  2. Views of senior UK doctors about working in medicine: questionnaire survey.

    PubMed

    Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

    2014-11-01

    We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Questionnaire survey. 3479 contactable UK-trained medical graduates of 1993. UK. Comments made by doctors about their work, and their views about medical careers and training in the UK. Postal and email questionnaires. Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.

  3. Views of senior UK doctors about working in medicine: questionnaire survey

    PubMed Central

    Lambert, Trevor W; Goldacre, Michael J

    2014-01-01

    Summary Objectives We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Design Questionnaire survey Participants 3479 contactable UK-trained medical graduates of 1993. Setting UK. Main outcome measures Comments made by doctors about their work, and their views about medical careers and training in the UK. Method Postal and email questionnaires. Results Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors’ training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Conclusions Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions. PMID:25408920

  4. Trust, autonomy and relationships: the help-seeking preferences of young people in secondary level schools in London (UK).

    PubMed

    Leavey, Gerard; Rothi, Despina; Paul, Rini

    2011-08-01

    Help-seeking among young people is complicated, often determined vicariously by the ability of adults, family or professionals, to recognize, and respond to, their difficulties. We know very little about the complex concerns of teenage young people and how they impact on help-seeking preferences. We aimed to ascertain the help-seeking preferences for a range of mental health problems among adolescents attending schools in an inner-city area of London. In particular we sought to examine the relationship between such adolescents and their family doctor. Using a mixed methods approach we explored help-seeking attitudes of young people. Emotional and mental health problems are not seen by young people as the domain of General practitioners. Moreover, there is a worrying lack of confidence and trust placed in family doctor and other professionals by young people. Young people do not tend easily to trust adults to help them with emotional difficulties.

  5. Evaluation of the source area of rooftop scalar measurements in London, UK using wind tunnel and modelling approaches.

    NASA Astrophysics Data System (ADS)

    Brocklehurst, Aidan; Boon, Alex; Barlow, Janet; Hayden, Paul; Robins, Alan

    2014-05-01

    The source area of an instrument is an estimate of the area of ground over which the measurement is generated. Quantification of the source area of a measurement site provides crucial context for analysis and interpretation of the data. A range of computational models exists to calculate the source area of an instrument, but these are usually based on assumptions which do not hold for instruments positioned very close to the surface, particularly those surrounded by heterogeneous terrain i.e. urban areas. Although positioning instrumentation at higher elevation (i.e. on masts) is ideal in urban areas, this can be costly in terms of installation and maintenance costs and logistically difficult to position instruments in the ideal geographical location. Therefore, in many studies, experimentalists turn to rooftops to position instrumentation. Experimental validations of source area models for these situations are very limited. In this study, a controlled tracer gas experiment was conducted in a wind tunnel based on a 1:200 scale model of a measurement site used in previous experimental work in central London. The detector was set at the location of the rooftop site as the tracer was released at a range of locations within the surrounding streets and rooftops. Concentration measurements are presented for a range of wind angles, with the spread of concentration measurements indicative of the source area distribution. Clear evidence of wind channeling by streets is seen with the shape of the source area strongly influenced by buildings upwind of the measurement point. The results of the wind tunnel study are compared to scalar concentration source areas generated by modelling approaches based on meteorological data from the central London experimental site and used in the interpretation of continuous carbon dioxide (CO2) concentration data. Initial conclusions will be drawn as to how to apply scalar concentration source area models to rooftop measurement sites and

  6. Diversion of prescribed drugs by drug users in treatment: analysis of the UK market and new data from London.

    PubMed

    Fountain, J; Strang, J; Gossop, M; Farrell, M; Griffiths, P

    2000-03-01

    To review the available knowledge about the diversion to the illicit market of drugs prescribed to drug users in treatment in the United Kingdom, and to identify aspects of the London market in more detail. An analysis of the literature and new data in terms of the extent and nature of the market, the practicalities of trade, motives for selling, reasons for demand and the influence of variations in prescribing practice on diversion. Prices of diverted prescription drugs and details of their availability in London are presented. The size of the market is substantial and appears to involve a large number of individuals, each diverting small amounts of their own prescribed drugs. Major motives for selling prescribed drugs are to raise funds to buy other, preferred, drugs and/or to pay for a private prescription. Buyers in treatment appear to be motivated by a desire to supplement their own prescriptions because they are dissatisfied with the particular drug prescribed, dosage and formulation. Drug users in treatment can exploit the variations in prescribing practice--such as how much 'take-home' medication they are allowed and whether tests are conducted to ascertain if they are using it themselves--and divert their prescribed drugs. Prices of prescription drugs on the illicit market can fluctuate on a daily basis according to supply and demand. The results suggest that, to be effective, diversion control must simultaneously involve deterrents from prescribers, drug treatment services, law enforcement agencies and dispensing pharmacists. Finally, some suggestions for further research on this under-studied issue are suggested.

  7. Are medical educators in general practice untapped potential to increase training capacity in sexual and reproductive healthcare? Results of a survey in London, UK

    PubMed Central

    Ma, Richard; Shah, Radhika

    2016-01-01

    Abstract Background Long waiting times for training in sexual and reproductive healthcare (SRH) including long acting reversible contraception (LARC) might lead to attrition from training programmes, leading to reduced capacity for sexual health services, and reduced access to such contraception for women. Setting General practice in London, UK. Question Can medical educators in general practice be used as untapped potential to train other health care professionals in sexual and reproductive healthcare? Method We conducted an online survey to find out the qualifications, skills and willingness of established educators in primary care in London to train other clinicians in sexual and reproductive healthcare, including LARC. Results We received 124 responses from medical educators (10.1% response rate from general practitioner (GP) trainers and 59.0% of clinical supervisors for Foundation Year doctors). 86 (69.9%) had diploma of the Faculty of Sexual and Reproductive Healthcare (DFSRH) qualification and further 18 (14.6%) were interested in obtaining this qualification. Eleven respondents were trained to fit intrauterine contraception only, three for contraceptive implants only and 37 were trained to fit both. 50 (40.3%) of 124 respondents were willing get involved in DFSRH training; 74% of these were willing to teach on any component of DFSRH including LARC. Discussion There is a shortage of training places and long waiting list for clinicians who wish to train in SRH. This survey suggests there is a pool of GP educators with skills and experience in SRH and are willing to train others. This can potentially increase the training capacity and improve overall access to good contraception and LARC for women. PMID:28250840

  8. 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.

  9. Applying quality improvement methods to address gaps in medicines reconciliation at transfers of care from an acute UK hospital

    PubMed Central

    Marvin, Vanessa; Kuo, Shirley; Vaughan, Louella

    2016-01-01

    Objectives Reliable reconciliation of medicines at admission and discharge from hospital is key to reducing unintentional prescribing discrepancies at transitions of healthcare. We introduced a team approach to the reconciliation process at an acute hospital with the aim of improving the provision of information and documentation of reliable medication lists to enable clear, timely communications on discharge. Setting An acute 400-bedded teaching hospital in London, UK. Participants The effects of change were measured in a simple random sample of 10 adult patients a week on the acute admissions unit over 18 months. Interventions Quality improvement methods were used throughout. Interventions included education and training of staff involved at ward level and in the pharmacy department, introduction of medication documentation templates for electronic prescribing and for communicating information on medicines in discharge summaries co-designed with patient representatives. Results Statistical process control analysis showed reliable documentation (complete, verified and intentional changes clarified) of current medication on 49.2% of patients' discharge summaries. This appears to have improved (to 85.2%) according to a poststudy audit the year after the project end. Pharmacist involvement in discharge reconciliation increased significantly, and improvements in the numbers of medicines prescribed in error, or omitted from the discharge prescription, are demonstrated. Variation in weekly measures is seen throughout but particularly at periods of changeover of new doctors and introduction of new systems. Conclusions New processes led to a sustained increase in reconciled medications and, thereby, an improvement in the number of patients discharged from hospital with unintentional discrepancies (errors or omissions) on their discharge prescription. The initiatives were pharmacist-led but involved close working and shared understanding about roles and responsibilities

  10. Quality of Life and Unmet Need in People with Psychosis in the London Borough of Haringey, UK

    PubMed Central

    Lambri, Maria; Chakraborty, Apu; Leavey, Gerard; King, Michael

    2012-01-01

    Objectives. Deinstitutionalization of long-term psychiatric patients produced various community-based residential care facilities. However, inner-city areas have many patients with severe mental illness (SMI) as well as deprivation, unemployment, and crime. This makes meeting their community needs complex. We undertook a needs assessment of service provision and consonance between service users' evaluation of need and by care workers. Design. Cross-sectional study with random sample of SMI service users in four housing settings: rehabilitation units; high-supported; medium-supported; low-supported housing. Setting. London Borough of Haringey. Outcome Measures. 110 SMI service users and 110 keyworkers were interviewed, using Camberwell Assessment of Need; SF-36; Lancashire Quality-of-Life profile; demographic and clinical information. Results. People in “low-support” and “high-support” housing had similar symptom scores, though low support had significantly lower quality of life. Quality of life was positively predicted by self-reported mental-health score and negatively predicted by unmet-need score in whole sample and in medium-support residents. Residents' and care-workers' assessments of need differed considerably. Conclusions. Although patients' housing needs were broadly met, those in low-supported housing fared least well. Attendance to self-reported mental health and unmet social needs to quality of life underpins planning of residential services for those with SMI. Social and personal needs of people in supported housing may be underestimated and overlooked; service providers need to prioritise these if concept of “recovery” is to advance. PMID:23213300

  11. Qualitative investigation of patients' experience of a glaucoma virtual clinic in a specialist ophthalmic hospital in London, UK.

    PubMed

    Kotecha, Aachal; Bonstein, Karen; Cable, Richard; Cammack, Jocelyn; Clipston, Jane; Foster, Paul

    2015-12-15

    To explore how patients felt about delivery of care in a novel technician-delivered virtual clinic compared with delivery of care in a doctor-delivered model. A qualitative investigation using one-to-one interviews before and after patients' appointments at either the standard outpatient glaucoma clinic or the new technician-delivered virtual glaucoma clinic (Glaucoma Screening and Stable Monitoring Service, GSMS). A glaucoma clinic based in a tertiary ophthalmic specialist hospital in London. 43 patients (38 Caucasian, 5 African/Afro-Caribbean) were interviewed prior to their glaucoma appointment; 38 patients were interviewed between 4 and 6 weeks after their appointment. Consecutive patients were identified from patient reception lists and telephoned prior to their appointment inviting them to participate. Trust in the patient-provider relationship emerged as a key theme in patients' acceptance of not being seen in a traditional doctor-delivered service. Patients who were well informed regarding their glaucoma status and low risk of progression to sight loss were more accepting of the GSMS. Patients valued the reassurance received through effective communication with their healthcare practitioner at the time of their appointment. This study suggests that patients are accepting of moving to a model of service delivery whereby the doctor is removed from the consultation as long as they are informed about the status of their condition and reassured by the interaction with staff they meet. This study highlights the importance of patient engagement when introducing new models of service delivery. 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/

  12. Before the ban--an exploratory study of a local khat market in East London, U.K.

    PubMed

    Kassim, Saba; Dalsania, Asha; Nordgren, Johan; Klein, Axel; Hulbert, Josh

    2015-06-12

    Khat is a green leaf with amphetamine-like effects. It is primarily used among people in Africa, the Middle East and in the diaspora communities from these countries. Prior to the prohibition of khat in the UK on 24 June 2014, there was almost no information available on key aspects of the local khat market. A cross-sectional study was conducted in 2012 using snowball sampling, Privileged Access Interviewing and area mapping in order to identify khat sale establishments. Data was collected via face-to-face interviews using mixed methods for data collection. This included information about the establishments selling khat, khat pricing and its use among different ethnic minority groups, in addition to the potential sale of khat to children and risk assessment (e.g., use of pesticides on khat). Five out of seven sellers identified agreed to participate. Sellers described their khat sale establishments as 'community centres' which included, for example, a restaurant basement. The sellers' history of selling khat ranged between 1-15 years and khat's sale took place between 2pm-10pm. Miraa (e.g., Lara) from Kenya was the most popularly used khat variety, sold in pre-wrapped bundles of approximately 250 g costing £3 each and delivered four days a week. Harari (e.g., Owdi) from Ethiopia was sold in 200 g, 400 g and 1 kg bundles, priced between £5 and £20 and delivered two days a week. The primary benefit of khat use was reported to be social interaction. The customers were predominantly adult males of Somali origin. Most sellers claimed a self-imposed ban on sales to children under 18 years old. Khat bundles had no labelling describing variety or weight and sellers had no knowledge of the use of pesticides on khat and did not advertise the risks associated with khat use. Khat selling establishments were businesses that did not adhere to trade standards regulations (e.g., labelling khat bundles). They claimed to provide a community service (facilitating social

  13. Patterns of long bone growth in a mid-19th century documented sample of the urban poor from Bethnal Green, London, UK.

    PubMed

    Ives, Rachel; Humphrey, Louise

    2017-05-01

    Studies of male and female long bone growth in past populations are limited and usually constrained by the lack of personal identification. This article aimed to evaluate long bone growth in a series of mid-19(th) century documented burials associated with the urban poor from Bethnal Green, London, UK. Maximum diaphyseal lengths from 74 males and 70 females (2 months to 12 years) were compared to modern reference data from North America. Diaphyseal lengths were expressed as a percentage of expected length and an average percentage value was calculated across all available long bones. An index of growth progression was introduced to explore differences in the progress of males and females towards their projected adult size. Deviation from the expected growth attainment was evident in both sexes in the archaeological series by 2-4 months of age. Only 19.4% (28/144) of the children had attained an average long bone length >90% of the predicted mean in the reference series. The percentage of expected growth attainment decreased steadily in both sexes during infancy and early childhood. Overall, females deviated further from their expected growth progression than males. Growth faltering in both males and females was established during infancy (<1 year) with no evidence for recovery in older age groups. Early weaning and inadequate artificial feeding, together with impoverished living conditions and limited sanitary provision, most likely impacted on childhood growth. © 2017 Wiley Periodicals, Inc.

  14. Energy exchanges in a Central Business District - Interpretation of Eddy Covariance and radiation flux measurements (London UK)

    NASA Astrophysics Data System (ADS)

    Kotthaus, S.; Grimmond, S.

    2013-12-01

    Global urbanisation brings increasingly dense and complex urban structures. To manage cities sustainably and smartly, currently and into the future under changing climates, urban climate research needs to advance in areas such as Central Business Districts (CBD) where human interactions with the environment are particularly concentrated. Measurement and modelling approaches may be pushed to their limits in dense urban settings, but if urban climate research is to contribute to the challenges of real cities those limits have to be addressed. The climate of cities is strongly governed by surface-atmosphere exchanges of energy, moisture and momentum. Observations of the relevant fluxes provide important information for improvement and evaluation of modelling approaches. Due to the CBD's heterogeneity, a very careful analysis of observations is required to understand the relevant processes. Current approaches used to interpret observations and set them in a wider context may need to be adapted for use in these more complex areas. Here, we present long-term observations of the radiation balance components and turbulent fluxes of latent heat, sensible heat and momentum in the city centre of London. This is one of the first measurement studies in a CBD covering multiple years with analysis at temporal scales from days to seasons. Data gathered at two sites in close vicinity, but with different measurement heights, are analysed to investigate the influence of source area characteristics on long-term radiation and turbulent fluxes. Challenges of source area modelling and the critical aspect of siting in such a complex environment are considered. Outgoing long- and short-wave radiation are impacted by the anisotropic nature of the urban surface and the high reflectance materials increasingly being used as building materials. Results highlight the need to consider the source area of radiometers in terms of diffuse and direct irradiance. Sensible heat fluxes (QH) are positive

  15. The introduction of 10% renewable energy in every building. Possibility or probability? Case study: Granville plus community Centre London, UK

    NASA Astrophysics Data System (ADS)

    Tsitnidis, Petros

    This thesis investigates the ways of producing 10% of the energy consumed in a site from renewable energy sources. It analyses how this can be accomplished by considering the general frame of the subject and referring to the general problem of climate change and its effects on the planet. Special attention is paid to architecture and an attempt is made to answer the question how the built environment can cope with this problem. Reference is also made to the UK's latest guidelines on the issue. The introduction of the 10% renewable energy use in buildings, known as the "Merton Rule", is one of the most pioneering guidelines towards sustainability. The thesis is continued with the post-occupancy assessment on a four year-old building, part of a much older community center complex that has been built with very advanced design and strict environmental targets but suffers from lack of care and management. The building does not achieve optimum performance as there are difficulties with various stakeholders in the buildings management. This thesis, therefore, examines possible solutions and suggests ways of improvement. The study concludes with remarks and suggestions based on simulation and assessment procedures. New ventilation strategies are proposed to be introduced to the building together with a series of ways to reduce the highest internal temperatures of the first floor. Extensive reference is also made to the initial sustainable approach of the design. The interventions proposed have as a target the improvement of the energy performance and the minimization of the carbon footprint of the building. Keywords: environmental design, sustainable architecture, granville plus, Merton Rule.

  16. European Pharmaceutical Pricing and Reimbursement--SMi's 21st Annual Meeting (October 5-6, 2015--London, UK).

    PubMed

    Kibble, A; D'Souza, P

    2015-10-01

    Translating perceived market value for pharmaceutical products into a willingness to pay remains the key factor in ensuring market access and return on investment. How price is managed in the context of new market entrants or new approval settings can create complex challenges, and further complexity is added through diverse global reimbursement structures and the myriad of stakeholders involved at every step of value identification. SMi's 21st Annual Meeting on European Pricing and Reimbursement presented a program focused on the measures being taken by European healthcare systems as they seek to facilitate access to the latest treatments while delivering value for payers and patients. Supporting patient access to life-changing medicines is a challenge, and funders are responding in many different ways; however, while the pharma industry continues to focus its efforts on high cost drugs that treat diseases of the few, the disconnect will be not be resolved. The speakers and delegates at the annual meeting believe success is possible by focusing on value for patients, driven by provider experience, scale and learning. Instead of simply lowering costs, companies, providers and payers can more adequately contribute to the goals of funders as well as the treatment needs of patients.

  17. Screening for latent TB, HIV, and hepatitis B/C in new migrants in a high prevalence area of London, UK: a cross-sectional study.

    PubMed

    Hargreaves, Sally; Seedat, Farah; Car, Josip; Escombe, Rod; Hasan, Samia; Eliahoo, Joseph; Friedland, Jon S

    2014-12-03

    Rising rates of infectious diseases in international migrants has reignited the debate around screening. There have been calls to strengthen primary-care-based programmes, focusing on latent TB. We did a cross-sectional study of new migrants to test an innovative one-stop blood test approach to detect multiple infections at one appointment (HIV, latent tuberculosis, and hepatitis B/C) on registration with a General Practitioner (GP) in primary care. The study was done across two GP practices attached to hospital Accident and Emergency Departments (A&E) in a high migrant area of London for 6 months. Inclusion criteria were foreign-born individuals from a high TB prevalence country (>40 cases per 100,000) who have lived in the UK ≤ 10 years, and were over 18 years of age. All new migrants who attended a New Patient Health Check were screened for eligibility and offered the blood test. We followed routine care pathways for follow-up. There were 1235 new registrations in 6 months. 453 attended their New Patient Health Check, of which 47 (10.4%) were identified as new migrants (age 32.11 years [range 18-72]; 22 different nationalities; time in UK 2.28 years [0-10]). 36 (76.6%) participated in the study. The intervention only increased the prevalence of diagnosed latent TB (18.18% [95% CI 6.98-35.46]; 181.8 cases per 1000). Ultimately 0 (0%) of 6 patients with latent TB went on to complete treatment (3 did not attend referral). No cases of HIV or hepatitis B/C were found. Foreign-born patients were under-represented at these practices in relation to 2011 Census data (Chi-square test -0.111 [95% CI -0.125 to -0.097]; p < 0.001). The one-stop approach was feasible in this context and acceptability was high. However, the number of presenting migrants was surprisingly low, reflecting the barriers to care that this group face on arrival, and none ultimately received treatment. The ongoing UK debate around immigration checks and charging in primary care for new

  18. Associations of short-term exposure to traffic-related air pollution with cardiovascular and respiratory hospital admissions in London, UK

    PubMed Central

    Samoli, Evangelia; Atkinson, Richard W; Analitis, Antonis; Fuller, Gary W; Green, David C; Mudway, Ian; Anderson, H Ross; Kelly, Frank J

    2016-01-01

    Objectives There is evidence of adverse associations between short-term exposure to traffic-related pollution and health, but little is known about the relative contribution of the various sources and particulate constituents. Methods For each day for 2011–2012 in London, UK over 100 air pollutant metrics were assembled using monitors, modelling and chemical analyses. We selected a priori metrics indicative of traffic sources: general traffic, petrol exhaust, diesel exhaust and non-exhaust (mineral dust, brake and tyre wear). Using Poisson regression models, controlling for time-varying confounders, we derived effect estimates for cardiovascular and respiratory hospital admissions at prespecified lags and evaluated the sensitivity of estimates to multipollutant modelling and effect modification by season. Results For single day exposure, we found consistent associations between adult (15–64 years) cardiovascular and paediatric (0–14 years) respiratory admissions with elemental and black carbon (EC/BC), ranging from 0.56% to 1.65% increase per IQR change, and to a lesser degree with carbon monoxide (CO) and aluminium (Al). The average of past 7 days EC/BC exposure was associated with elderly (65+ years) cardiovascular admissions. Indicated associations were higher during the warm period of the year. Although effect estimates were sensitive to the adjustment for other pollutants they remained consistent in direction, indicating independence of associations from different sources, especially between diesel and petrol engines, as well as mineral dust. Conclusions Our results suggest that exhaust related pollutants are associated with increased numbers of adult cardiovascular and paediatric respiratory hospitalisations. More extensive monitoring in urban centres is required to further elucidate the associations. PMID:26884048

  19. Attitudes towards cytology and human papillomavirus self-sample collection for cervical screening among Hindu women in London, UK: a mixed methods study

    PubMed Central

    Cadman, Louise; Ashdown-Barr, Lesley; Waller, Jo; Szarewski, Anne

    2015-01-01

    Objectives To explore the attitudes, views and understanding of women attending a Hindu temple in London, UK towards cervical screening, human papillomavirus (HPV) testing and two HPV self-sample collection devices: the Dacron swab and Evalyn® brush. Methods A mixed methods design comprising a survey and four focus groups was adopted. Focus group discussions were recorded and transcribed verbatim and explored using thematic framework analysis. Results A total of 185 Hindu women completed surveys and 23 attended focus groups. Of the respondents 75% aged 25–64 years reported having cervical screening within the last 5 years; 85% had attended college or university. Familiar barriers to attendance for screening were identified: fear of pain and the test result, embarrassment, screener's attitude, inconvenient appointment times and difficulty with child care. Additional barriers cited included age and country of birth, with older and Indian-born women thought to be less likely to attend for screening. Self-collected sampling had a mixed reception. Women were not confident that their sample would be as good as a clinician sample and expressed concern about the impact that a positive HPV result might have on their relationships. Conclusions Screening attendance in this highly educated group of Hindu women was slightly lower than in the general population (75% of women aged 25–64 years had been screened in the last 5 years compared with 79% in England as a whole). Familiar barriers to screening were identified. Women felt able to collect their own sample for HPV testing with a Dacron swab but lacked confidence that it would be as good as that obtained by a clinician. PMID:24521934

  20. Attitudes towards cytology and human papillomavirus self-sample collection for cervical screening among Hindu women in London, UK: a mixed methods study.

    PubMed

    Cadman, Louise; Ashdown-Barr, Lesley; Waller, Jo; Szarewski, Anne

    2015-01-01

    To explore the attitudes, views and understanding of women attending a Hindu temple in London, UK towards cervical screening, human papillomavirus (HPV) testing and two HPV self-sample collection devices: the Dacron swab and Evalyn(®) brush. A mixed methods design comprising a survey and four focus groups was adopted. Focus group discussions were recorded and transcribed verbatim and explored using thematic framework analysis. A total of 185 Hindu women completed surveys and 23 attended focus groups. Of the respondents 75% aged 25-64 years reported having cervical screening within the last 5 years; 85% had attended college or university. Familiar barriers to attendance for screening were identified: fear of pain and the test result, embarrassment, screener's attitude, inconvenient appointment times and difficulty with child care. Additional barriers cited included age and country of birth, with older and Indian-born women thought to be less likely to attend for screening. Self-collected sampling had a mixed reception. Women were not confident that their sample would be as good as a clinician sample and expressed concern about the impact that a positive HPV result might have on their relationships. Screening attendance in this highly educated group of Hindu women was slightly lower than in the general population (75% of women aged 25-64 years had been screened in the last 5 years compared with 79% in England as a whole). Familiar barriers to screening were identified. Women felt able to collect their own sample for HPV testing with a Dacron swab but lacked confidence that it would be as good as that obtained by a clinician. 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.

  1. Delivery and collection of radioactive packages to and from UK hospital nuclear medicine departments.

    PubMed

    Lawson, Richard S; Davies, Glyn; Hesslewood, Stuart R; Hinton, Paul J; Maxwell, Alan

    2004-12-01

    Under radiation protection legislation in the UK, employers have a duty to maintain appropriate records to account for radioactive materials in their possession and to ensure security of these materials. This applies to radioactive packages, containing items such as technetium generators, which are regularly delivered to hospital nuclear medicine departments. It also applies to the collection of packages, such as those containing used generators for return to the supplier. This article has been written by the professional bodies representing nuclear medicine in the UK in order to provide guidance to hospitals on appropriate procedures that will comply with the legislation. General principles, which should be met by any acceptable protocol, are stated, and practical guidance on how these may be implemented is given. Some example scenarios are outlined.

  2. Impact of UK policy initiatives on use of medicines to aid smoking cessation

    PubMed Central

    West, R; DiMarino, M; Gitchell, J; McNeill, A

    2005-01-01

    Context: Increasing the use of effective smoking cessation aids could in principle have a substantial public health impact. The UK government has undertaken several major policy initiatives to try to increase usage of smoking cessation medicines. It is important to evaluate what effect, if any, these have had to inform future policy in the UK and internationally. Objective: This study used sales data to examine the impact of government initiatives to increase access to smoking cessation medicines. Design: Information about prescription and non-prescription sales (1999–2002) was obtained. Estimates of utilisation were compared with findings from the Office of National Statistics (ONS) omnibus surveys. The effects of policy initiatives (making the medicines reimbursable and making them available on general sale outside pharmacies) were assessed by means of time series analysis. In addition a new nicotine replacement therapy (NRT) product (a nicotine lozenge) was launched and the effect of this on total utilisation was assessed. Results: Making bupropion, and subsequently nicotine replacement therapy (NRT), reimbursable had a major impact in medication usage; the estimated increase in each case was more than 80 000 "treatment weeks" purchased per month. In addition, introduction of a nicotine lozenge increased total utilisation and did not detract from usage of other medicines. According to both the sales and the survey data, the proportion of smokers using medicines to aid smoking cessation more than doubled from 8–9% in 1999 to 17% in 2002. The ONS surveys showed no increase in the proportions of smokers making quit attempts and so the effects were solely on the proportions of quit attempts that were aided by medication. Conclusions: In the UK, making smoking cessation medicines reimbursable led to a large increase in utilisation. While the effect on smoking prevalence would be too small to be detected in national surveys it could have a substantial public

  3. The integration of acupuncture within medicine in the UK--the British Medical Acupuncture Society's 25th anniversary.

    PubMed

    Baldry, Peter

    2005-03-01

    Acupuncture was first used in China, probable about 2000 years ago. When acupuncture first arrived in the West in the 17th century, the principles which the Chinese had used to explain its actions were at variance with current scientific knowledge of the body's structure and function. This led to the rejection of acupuncture by the medical profession in the UK, although individual practitioners adopted it with enthusiasm, usually needling the point of maximal tenderness to treat musculoskeletal pain. Acupuncture was more generally accepted in France and Germany, where the pioneering British physician Felix Mann encountered it in the 1950s. He then taught acupuncture to other medical practitioners and organised regular meetings in London, from which the British Medical Acupuncture Society, BMAS, emerged in 1980. The tradition of biannual scientific meetings has continued since then. The Society has many connections with prominent acupuncturists internationally and is a founder member of the International Council of Medical Acupuncture and Related Techniques (ICMART), and has hosted two world congresses. The Society was involved in standardisation of the meridian nomenclature published in 1990. The Society's scientific journal, Acupuncture in Medicine, was founded in 1981 and has gained international recognition, being indexed on several databases. The Society has established regular teaching courses at different levels, which lead to professional qualifications of Certificate and Diploma. The membership is now open to different health professionals, has grown steadily and now stands at nearly 2500. The Society is administered from offices in Cheshire and London. Many individual members have contributed to the Society's characteristic Western 'medical' approach to acupuncture in which needling is seen as a form of neuromuscular stimulation that owes little to traditional meridians or points. The Society has shown a particular interest in acupuncture for myofascial

  4. Personal exposure of street canyon intersection users to PM 2.5, ultrafine particle counts and carbon monoxide in Central London, UK

    NASA Astrophysics Data System (ADS)

    Kaur, S.; Nieuwenhuijsen, M.; Colvile, R.

    Short-term human exposure to PM 2.5, ultrafine particle counts (particle range: 0.02-1 μm) and carbon monoxide (CO) was investigated at and around a street canyon intersection in Central London, UK. During a four-week field campaign, groups of four volunteers collected samples at three timings (morning, lunch and afternoon), along two different routes (a heavily trafficked route and a backstreet route) via five modes of transport (walking, cycling, bus, car and taxi). PM 2.5 was sampled using high-flow gravimetric personal samplers, ultrafine particle counts were measured using TSI P-TRAKs and Langans were used to measure CO exposure. Three hundred and ninety-four samples were collected—197 PM 2.5, 86 ultrafine particle count and 111 CO. Arithmetic means of PM 2.5 personal exposure were 27.5, 33.5, 34.5, 38.0 and 41.5 μg m -3, ultrafine particle counts were 67 773, 93 968, 101 364, 99 736 and 87 545 pt cm -3 and CO levels were 0.9, 1.1, 0.8, 1.3 and 1.1 ppm for walking, cycling, bus, car and taxi respectively. On the heavily trafficked route, personal exposure was 35.3 μg m -3, 101142 pt cm -3 and 1.3 ppm, and on the backstreet route it was 31.8 μg m -3, 71628 pt cm -3 and 0.6 ppm for PM 2.5, ultrafine particle counts and CO, respectively. Personal exposure levels were high during the morning measurements for all three pollutants (34.6 μg m -3, 106 270 pt cm -3 and 1.5 ppm for PM 2.5, ultrafine particle counts and CO, respectively).There was a moderately strong correlation between personal exposure of ultrafine particle counts and CO ( r=0.7, N=67) but a weaker correlation between PM 2.5 and ultrafine particle counts ( r=0.5, N=83) and a low correlation between PM 2.5 and CO exposure ( r=0.2, N=105). The exposure assessment also revealed that the background and kerbside monitoring stations were not representative of the personal exposure of individuals to PM 2.5 and CO at and around a street canyon intersection.

  5. The emerging landscape of reimbursement of regenerative medicine products in the UK: publications, policies and politics.

    PubMed

    Mahalatchimy, Aurélie; Faulkner, Alex

    2017-10-03

    This paper aims to map the trends and analyze key institutional dynamics that constitute the policies for reimbursement of regenerative medicine (RM), especially in the UK. Two quantitative publications studies using Google Scholar and a qualitative study based on a larger study of 43 semi-structured interviews. Reimbursement has been a growing topic of publications specific to RM and independent from orphan drugs. Risk-sharing schemes receive attention among others for dealing with RM reimbursement. Trade organizations have been especially involved on RM reimbursement issues and have proposed solutions. The policy and institutional landscape of reimbursement studies in RM is a highly variegated and conflictual one and in its infancy.

  6. 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

  7. Opening the gateways to market and adoption of regenerative medicine? The UK case in context.

    PubMed

    Faulkner, Alex

    2016-04-01

    Regenerative medicine is a site for opposing forces of gatekeeping and innovation. This applies both to regulation of market entry and to clinical adoption. Key gateways include the EU's Advanced Therapy Medicinal Products Regulation, technology assessment body NICE and commissioning/service contractor National Health Service England. The paper maps recent gatekeeping flexibilities, describing the range of gateways to market and healthcare adoption seen as alternatives to mainstream routes. The initiatives range from exemptions in pharmaceutical and ATMP regulations, through 'adaptive pathways' and 'risk-based' approaches, to special designation for promising innovation, value-based assessment and commissioner developments. Future developments are considered in the UK's 'accelerated access review'. Caution is urged in assessing the impact of these gateway flexibilities and their market and public health implications.

  8. 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.

  9. Reducing follow-ups: an opportunity to increase the capacity of genitourinary medicine services across the UK.

    PubMed

    Ahmed-Jushuf, I; Griffiths, V

    2007-05-01

    Significant increases in genitourinary (GU) medicine clinic workloads throughout the UK have resulted in an unmet demand for appointments, and increased waiting times. In order to meet the government target of a 48-hour maximum waiting time for all patients, many clinics are modernising current practices to increase capacity and improve access to services. The 'Six Sigma' study group of 12 GU medicine clinics which was formed in 2003 to investigate means of enhancing capacity of GU medicine services, has demonstrated that there is a significant amount of unreleased capacity within UK clinics. In this article, the Six Sigma group present potential actions which other GU medicine clinics in the UK may be able to apply and thereby release additional capacity. Example case studies from the Six Sigma study are also presented, illustrating the applicability of this model throughout the UK. The findings of the Six Sigma project offer GU medicine clinics across the UK the opportunity to increase capacity, without adversely affecting quality of care.

  10. Training in clinical forensic medicine in the UK--perceptions of current regulatory standards.

    PubMed

    Stark, Margaret M; Norfolk, Guy A

    2011-08-01

    As clinical forensic medicine (CFM) is not currently recognised as a speciality in the UK there are no nationally agreed mandatory standards for training forensic physicians in either general forensic (GFM) or sexual offence medicine (SOM). The General Medical Council (GMC), the medical regulator in the UK, has issued clear standards for training in all specialities recommending that "trainees must be supported to acquire the necessary skills and experience through induction, effective educational supervision, an appropriate workload and time to learn". In order to evaluate the current situation in the field of clinical forensic medicine, doctors who have recently (within the last two years) started working in the field "trainees" (n = 38), and trainers (n = 61) with responsibility for clinical and educational supervision of new trainees, were surveyed by questionnaire to gather their perceptions of how the relevant GMC standards are being met in initial on-the-job training. Telephone interviews were performed with eleven doctors working as clinical or medical directors to determine their views. It is clear that currently the quality of training in CFM is sub-standard and inconsistent and that the published standards, as to the minimum requirement for training that must be met by post-graduate medical and training providers at all levels, are not being met. The Faculty of Forensic and Legal Medicine (FFLM) needs to set explicit minimum standards which will comply with the regulator and work to pilot credentialing for forensic physicians. A number of recommendations are made for urgent FFLM development.

  11. Global update: UK.

    PubMed

    Culme-Seymour, Emily J

    2012-11-01

    2012 has been an exciting year in the UK with substantial development on every front - research, clinical, industry and government. In particular, the focus has now moved to encompass far more post-research activities, with the continued enrolment of patients onto two pioneering Phase I clinical trials: ReNeuron's ReN001 stem cell therapy for stroke (PISCES) in Southern General Hospital, Greater Glasgow and Advanced Cell Technology's retinal pigment epithelial cells derived from human embryonic stem cells for Stargardts macular dystrophy and dry age-related macular degeneration at Moorfields Eye Hospital, London. The funding landscape for the sector has evolved from previous years to more fully embrace development and translation, including the provision of £180 million available for biomedical research via the Biomedical Catalyst Fund (joint Technology Strategy Board and Medical Research Council [MRC] funding) and a further £25 million through the UK Research Council's UK Regenerative Medicine Platform initiative, as well as ongoing developments with the Cell Therapy Catapult, which all act to further encourage a pan-UK collaborative environment. Overall, the UK cell therapy community continues to thrive and impact heavily upon the worldwide sector, with an established research base, a solid approach to translation and a small but growing commercial sector that is going from strength to strength.

  12. Nutrition Labeling and Portion Size Information on Children's Menus in Fast-Food and Table-Service Chain Restaurants in London, UK

    ERIC Educational Resources Information Center

    Reeves, Sue; Wake, Yvonne; Zick, Andrea

    2011-01-01

    Objective: To investigate meals, price, nutritional content, and nutrition and portion size information available on children's menus in fast-food and table-service chain restaurants in London, since the United Kingdom does not currently require such information but may be initiating a voluntary guideline. Methods: Children's menus were assessed…

  13. Nutrition Labeling and Portion Size Information on Children's Menus in Fast-Food and Table-Service Chain Restaurants in London, UK

    ERIC Educational Resources Information Center

    Reeves, Sue; Wake, Yvonne; Zick, Andrea

    2011-01-01

    Objective: To investigate meals, price, nutritional content, and nutrition and portion size information available on children's menus in fast-food and table-service chain restaurants in London, since the United Kingdom does not currently require such information but may be initiating a voluntary guideline. Methods: Children's menus were assessed…

  14. Establishing a baseline for the monitoring of medicines availability for children in the UK: 1998–2002

    PubMed Central

    Balakrishnan, Komathi; Tordoff, June; Norris, Pauline; Reith, David

    2007-01-01

    Aim To determine changes in the availability, in terms of licensing and formulations, of medicines for children in the UK between 1998 and 2002. Methods Using the Association of British Pharmaceutical Industry (ABPI) Compendium of Data Sheets and Summaries of Product Characteristics (SPC) 1998 and the Medicines Compendium 2002, licensed medicines available in the UK in the calendar years 1998 and 2002 were examined. Results In 1998, 61% of chemical entities/fixed-dose combinations were licensed in some form for children compared with 64% in 2002. Of the chemical entities/fixed-dose combinations with oral formulations, 250 (33%) in 1998 had an oral formulation suitable for use by children and in 2002 there were 284 (34%). Of the 129 new chemical entities registered in the UK between 1998 and 2002, only 30 (23%) were licensed for under the age of 12 years and 19 (15%) for the neonatal age group. A total of 480 medicines licensed for children were withdrawn from marketing but only cisapride and primidone had no generic or therapeutic alternatives. Conclusion Although there was improvement in the availability of medicines for children in the UK over the 5-year period (1998–2002), considerable inequities still existed between children and adults. PMID:16869822

  15. 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.

  16. Monitoring and reporting of preanalytical errors in laboratory medicine: the UK situation.

    PubMed

    Cornes, Michael P; Atherton, Jennifer; Pourmahram, Ghazaleh; Borthwick, Hazel; Kyle, Betty; West, Jamie; Costelloe, Seán J

    2016-03-01

    Most errors in the clinical laboratory occur in the preanalytical phase. This study aimed to comprehensively describe the prevalence and nature of preanalytical quality monitoring practices in UK clinical laboratories. A survey was sent on behalf of the Association for Clinical Biochemistry and Laboratory Medicine Preanalytical Working Group (ACB-WG-PA) to all heads of department of clinical laboratories in the UK. The survey captured data on the analytical platform and Laboratory Information Management System in use; which preanalytical errors were recorded and how they were classified and gauged interest in an external quality assurance scheme for preanalytical errors. Of the 157 laboratories asked to participate, responses were received from 104 (66.2%). Laboratory error rates were recorded per number of specimens, rather than per number of requests in 51% of respondents. Aside from serum indices for haemolysis, icterus and lipaemia, which were measured in 80% of laboratories, the most common errors recorded were booking-in errors (70.1%) and sample mislabelling (56.9%) in laboratories who record preanalytical errors. Of the laboratories surveyed, 95.9% expressed an interest in guidance on recording preanalytical error and 91.8% expressed interest in an external quality assurance scheme. This survey observes a wide variation in the definition, repertoire and collection methods for preanalytical errors in the UK. Data indicate there is a lot of interest in improving preanalytical data collection. The ACB-WG-PA aims to produce guidance and support for laboratories to standardize preanalytical data collection and to help establish and validate an external quality assurance scheme for interlaboratory comparison. © The Author(s) 2015.

  17. UK: the current state of regulation of complementary and alternative medicine.

    PubMed

    Walker, L A; Budd, S

    2002-03-01

    There is no legislation that restricts the practice of CAM in the UK apart from the practice of chiropractic and osteopathy and limits on advertising the treatments of certain conditions such as cancer and tuberculosis. The UK government has increasingly recognised the need for comprehensive regulation of CAM, though it abandoned its original plan for a single overarching regulatory body. Initiatives to examine and hasten the process of regulation have included setting up a central, well-recognised charitable body to facilitate progress for individual professions, and an authoritative survey of the existing professional organisations. One pathway open to individual professions is statutory self-regulation, which requires a single governing body, a systematic corpus of knowledge, recognised training courses and demonstrated efficacy. The other pathway is voluntary self-regulation. Chiropractic and osteopathy have adopted statutory self-regulation, though this has proved expensive for individual members of these professions. A recent House of Lords report on CAM has recommended that the herbal medicine and acupuncture professions should also develop a system of statutory regulation. Other professions, such as aromatherapy, are in the process of establishing single professional bodies as a first step towards self-regulation. Among the issues that remain to be resolved is the relationship between the CAM professions and statutory registered practitioners who also practise CAM.

  18. Airborne determination of the temporo-spatial distribution of benzene, toluene, nitrogen oxides and ozone in the boundary layer across Greater London, UK

    NASA Astrophysics Data System (ADS)

    Shaw, M. D.; Lee, J. D.; Davison, B.; Vaughan, A.; Purvis, R. M.; Lewis, A. C.; Hewitt, C. N.

    2014-10-01

    Highly spatially resolved mixing ratios of benzene and toluene, nitrogen oxides (NOx) and ozone (O3) were measured in the atmospheric boundary layer above Greater London during the period 24 June to 9 July 2013 using a Dornier 228 aircraft. Toluene and benzene were determined in-situ using a proton transfer reaction mass spectrometer (PTR-MS), NOx by dual channel NOx chemiluminescence and O3 mixing ratios by UV absorption. Average mixing ratios observed over inner London at 360 ± 10 m a.g.l. were 0.20 ± 0.05, 0.28 ± 0.07, 13.2 ± 8.6, 21.0 ± 7.3 and 34.3 ± 15.2 ppbv for benzene, toluene, NO, NO2 and NOx respectively. Linear regression analysis between NO2, benzene and toluene mixing ratios yielded a trimodal distribution indicating that these compounds predominantly share the same or co-located sources within the city and that a significant fraction of NOx is directly emitted as NO2. Average mixing ratios measured at 360 ± 10 m a.g.l. over outer London were always lower than over inner London. Where traffic densities were highest, the toluene / benzene (T / B) concentration ratios were highest (average of 1.8 ± 0.3 ppbv ppbv-1) indicative of strong local sources. Daytime maxima in NOx, benzene and toluene mixing ratios were observed in the morning (~40 ppbv NOx, ~350 pptv toluene and ~200 pptv benzene) and for ozone in the mid-afternoon (~40 ppbv O3) all at 360 ± 10 m a.g.l.

  19. Airborne determination of the temporo-spatial distribution of benzene, toluene, nitrogen oxides and ozone in the boundary layer across Greater London, UK

    NASA Astrophysics Data System (ADS)

    Shaw, M. D.; Lee, J. D.; Davison, B.; Vaughan, A.; Purvis, R. M.; Harvey, A.; Lewis, A. C.; Hewitt, C. N.

    2015-05-01

    Highly spatially resolved mixing ratios of benzene and toluene, nitrogen oxides (NOx) and ozone (O3) were measured in the atmospheric boundary layer above Greater London during the period 24 June to 9 July 2013 using a Dornier 228 aircraft. Toluene and benzene were determined in situ using a proton transfer reaction mass spectrometer (PTR-MS), NOx by dual-channel NOx chemiluminescence and O3 mixing ratios by UV absorption. Average mixing ratios observed over inner London at 360 ± 10 m a.g.l. were 0.20 ± 0.05, 0.28 ± 0.07, 13.2 ± 8.6, 21.0 ± 7.3 and 34.3 ± 15.2 ppbv for benzene, toluene, NO, NO2 and NOx respectively. Linear regression analysis between NO2, benzene and toluene mixing ratios yields a strong covariance, indicating that these compounds predominantly share the same or co-located sources within the city. Average mixing ratios measured at 360 ± 10 m a.g.l. over outer London were always lower than over inner London. Where traffic densities were highest, the toluene / benzene (T / B) concentration ratios were highest (average of 1.8 ± 0.5 ppbv ppbv-1), indicative of strong local sources. Daytime maxima in NOx, benzene and toluene mixing ratios were observed in the morning (~ 40 ppbv NOx, ~ 350 pptv toluene and ~ 200 pptv benzene) and in the mid-afternoon for ozone (~ 40 ppbv O3), all at 360 ± 10 m a.g.l.

  20. The 8th International Conference on Counter-current Chromatography held at Brunel University, London, UK, July 23-25, 2014.

    PubMed

    Ignatova, Svetlana; Sutherland, Ian

    2015-12-18

    The 8th International Conference on Counter-current Chromatography (CCC2014) was held at Brunel University London from July 23rd to 25th, 2014. It has been 14 years since Brunel hosted the first International Conference on CCC (CCC2000) at the beginning of the millennium and therefore, it was a good opportunity to review the progress of this emerging technology and particularly the impact it is having with industry today.

  1. Partnerships in Pharma--An Economist Intelligence Unit Seminar--Building Innovation into Alliances and Business Models. 1 October 2010, London, UK.

    PubMed

    Kibble, Alexandra

    2010-12-01

    The Partnerships in Pharma seminar, held in London, included topics related to building innovation into alliances and business models within the pharmaceutical industry. This conference report highlights selected presentations on strategies for successful partnering, partnering alongside an evolving CRO industry, considering the pharma value chain, and partnerships between industry and academia. Approaches used by Ipsen, Merck Serono, Pfizer and ViiV Healthcare are also described.

  2. Receipt and use of spoken and written over-the-counter medicine information: insights into Australian and UK consumers' experiences.

    PubMed

    Tong, Vivien; Raynor, David K; Aslani, Parisa

    2017-05-24

    To explore Australian and UK consumers' receipt and use of spoken and written medicine information and examine the role of leaflets for consumers of over-the-counter (OTC) medicines. Semistructured interviews were conducted with 37 Australian and 39 UK consumers to explore information received with their most recent OTC medicine purchase, and how information was used at different times post-purchase. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Similarities were evident between the key themes identified from Australian and UK consumers' experiences. Consumers infrequently sought spoken information and reported that pharmacy staff provided minimal spoken information for OTC medicines. Leaflets were not always received or wanted and had a less salient role as an information source for repeat OTC purchases. Consumers tended not to read OTC labels or leaflets. Product familiarity led to consumers tending not to seek information on labels or leaflets. When labels were consulted, directions for use were commonly read. However, OTC medicine information in general was infrequently revisited. As familiarity is not an infallible proxy for safe and effective medication use, strategies to promote the value and use of these OTC medicine information sources are important and needed. Minimal spoken information provision coupled with limited written information use may adversely impact medication safety in self-management. © 2017 Royal Pharmaceutical Society.

  3. 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

  4. Effect of a national focused course on academic medicine for UK candidates applying for a Clinical Academic Programme.

    PubMed

    Khajuria, A; Cheng, K; Levy, J

    2017-03-01

    Background Academic medicine is crucial for healthcare advancement. However, recruitment of junior doctors into academia remains an area of concern globally. In the UK, a national integrated clinical academic pathway was developed to address these issues, with the Academic Foundation Programme as the 'first opportunity for research'. We aimed to evaluate whether a focused course on academic medicine could enhance knowledge, confidence and preparedness of candidates wishing to apply for an academic programme. Methods UK medical students attended a national course conducted by current UK Academic Foundation Programme doctors that comprised lectures on academic medicine and various aspects of the Academic Foundation Programme. An online questionnaire-based cross-sectional study was conducted with participants rating measures including knowledge, preparedness and confidence related to Academic Foundation Programme applications. Outcomes were measured using Likert scales (1=low; 5=high). Results In total, 103 out of 155 attendees from 11 different UK medical schools responded to the survey (66% response rate). Pre and post-course data showed increase in participants' knowledge (median score 2 vs 4, p < 0.0001), understanding of the application process (median score 2 vs 4, p < 0.0001), confidence (median score 2 vs 4, p < 0.0001) and preparedness (median score 2 vs 4, p < 0.0001) in applying for the Academic Foundation Programme. Conclusion To our knowledge this is the first study in the available literature that demonstrates a focused course on academic medicine may enhance UK medical students' knowledge, confidence and preparedness in applying for a clinical academic programme. Further research will ascertain whether such courses can augment trainee numbers undertaking and remaining within academic medicine.

  5. Dental age assessment (DAA) of Afro-Trinidadian children and adolescents. Development of a Reference Dataset (RDS) and comparison with Caucasians resident in London, UK.

    PubMed

    Moze, Kevin; Roberts, Graham

    2012-07-01

    The large number of extant Dental Panoramic Tomographs of Afro-Trinidadian subjects were collected and Tooth Development Stages (TDSs) were assessed for each of the 878 radiographs to provide a Reference Dataset (RDS) of Afro-Trinidadian children and adolescents. The values for each of the 256 TDSs present were statistically significantly different from the values for the same TDSs in the UK Caucasian RDS. A validation study of 50 radiographs of Afro-Trinidadian subjects from 24 boys and 26 girls were assessed to enable calculation of the Dental Age (DA). The DA calculated using the UK Caucasian RDS was statistically significantly different from the chronological age. The same radiographs were used to calculate the Age of Attainment of the individual Tooth Development Stages for females and males in both the UK Caucasian subjects, and the Afro-Trinidadians. The majority of these comparisons showed the TDSs in Afro-Trinidadian subjects to develop earlier than the UK Caucasian subjects by approximately 8 months.

  6. Women in senior post-graduate medicine career roles in the UK: a qualitative study.

    PubMed

    Curtis, Anthony; Eley, Lizzie; Gray, Selena; Irish, Bill

    2016-01-01

    This qualitative study sought to elicit the views, experiences, career journeys and aspirations of women in senior post-graduate medical education roles to identify steps needed to help support career progression. In-depth semi-structured telephone interviews. UK. Purposive sample of 12 women in a variety of senior leadership roles in post-graduate medical education in the UK. Self reported motivating influences, factors that helped and hindered progress, key branch points, and key educational factors and social support impacting on participants' career in postgraduate medicine. Respondents often reported that career journeys were serendipitous, rather than planned, formal or well structured. Senior women leaders reported having a high internal locus of control, with very high levels of commitment to the NHS. All reported significant levels of drive, although the majority indicated that they were not ambitious in the sense of a strong drive for money, prestige, recognition or power. They perceived that there was an under-representation of women in senior leadership positions and that high-quality female mentorship was particularly important in redressing this imbalance. Social support, such a spouse or other significant family member, was particularly valued as reaffirming and supporting women's chosen career ambition. Factors that were considered to have hindered career progression included low self-confidence and self-efficacy, the so-called glass ceiling and perceived self-limiting cultural influences. Factors indirectly linked to gender such as part-time versus working full time were reportedly influential in being overlooked for senior leadership roles. Implications of these findings are discussed in the paper. Social support, mentorship and role modelling are all perceived as highly important in redressing perceived gender imbalances in careers in post-graduate medical education.

  7. Women in senior post-graduate medicine career roles in the UK: a qualitative study

    PubMed Central

    Curtis, Anthony; Eley, Lizzie; Irish, Bill

    2016-01-01

    Objectives This qualitative study sought to elicit the views, experiences, career journeys and aspirations of women in senior post-graduate medical education roles to identify steps needed to help support career progression. Design In-depth semi-structured telephone interviews. Setting UK. Participants Purposive sample of 12 women in a variety of senior leadership roles in post-graduate medical education in the UK. Main outcome measures Self reported motivating influences, factors that helped and hindered progress, key branch points, and key educational factors and social support impacting on participants' career in postgraduate medicine. Results Respondents often reported that career journeys were serendipitous, rather than planned, formal or well structured. Senior women leaders reported having a high internal locus of control, with very high levels of commitment to the NHS. All reported significant levels of drive, although the majority indicated that they were not ambitious in the sense of a strong drive for money, prestige, recognition or power. They perceived that there was an under-representation of women in senior leadership positions and that high-quality female mentorship was particularly important in redressing this imbalance. Social support, such a spouse or other significant family member, was particularly valued as reaffirming and supporting women’s chosen career ambition. Factors that were considered to have hindered career progression included low self-confidence and self-efficacy, the so-called glass ceiling and perceived self-limiting cultural influences. Factors indirectly linked to gender such as part-time versus working full time were reportedly influential in being overlooked for senior leadership roles. Implications of these findings are discussed in the paper. Conclusion Social support, mentorship and role modelling are all perceived as highly important in redressing perceived gender imbalances in careers in post-graduate medical education

  8. Establishing the research priorities of paediatric emergency medicine clinicians in the UK and Ireland.

    PubMed

    Hartshorn, Stuart; O'Sullivan, Ronan; Maconochie, Ian K; Bevan, Catherine; Cleugh, Francesca; Lyttle, Mark D

    2015-11-01

    Paediatric Emergency Research in the UK and Ireland (PERUKI) is a collaborative clinical studies group established in August 2012. It consists of a network of 43 centres from England, Ireland, Northern Ireland, Scotland and Wales, and aims to improve the emergency care of children through the performance of robust collaborative multicentre research within emergency departments. A study was conducted regarding the research priorities of PERUKI, to establish the research agenda for paediatric emergency medicine in the UK and Ireland. A two-stage modified Delphi survey was conducted of PERUKI members via an online survey platform. Stage 1 allowed each member to submit up to 12 individual questions that they identified as priorities for future research. In stage 2, the shortlisted questions were each rated on a seven-point Likert scale of relative importance. Members of PERUKI, including clinical specialists, academics, trainees and research nurses. Stage 1 surveys were submitted by 46/91 PERUKI members (51%). A total of 249 research questions were generated and, following the removal of duplicate questions and shortlisting, 60 questions were carried forward for stage 2 ranking. Stage 2 survey responses were submitted by 58/95 members (61%). For the 60 research questions that were rated, the mean score of 'relative degree of importance' was 4.70 (range 3.36-5.62, SD 0.55). After ranking, the top 10 research priorities included questions on biomarkers for serious bacterial illness, major trauma, intravenous bronchodilators for asthma and decision rules for fever with petechiae, head injury and atraumatic limp. Research priorities of PERUKI members have been identified. By sharing these results with clinicians, academics and funding bodies, future research efforts can be focused to the areas of greatest need. 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.

  9. 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…

  10. 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

  11. Analysis of the potential of near ground measurements of CO2 and CH4 in London, UK for the monitoring of city-scale emissions using an atmospheric transport model

    NASA Astrophysics Data System (ADS)

    Boon, A.; Broquet, G.; Clifford, D. J.; Chevallier, F.; Butterfield, D. M.; Pison, I.; Ramonet, M.; Paris, J. D.; Ciais, P.

    2015-11-01

    Carbon dioxide (CO2) and methane (CH4) mole fractions were measured at four near ground sites located in and around London during the summer of 2012 in view to investigate the potential of assimilating such measurements in an atmospheric inversion system for the monitoring of the CO2 and CH4 emissions in the London area. These data were analysed and compared with simulations using a modelling framework suited to building an inversion system: a 2 km horizontal resolution South of England configuration of the transport model CHIMERE driven by European Centre for Medium-Range Weather Forecasting (ECMWF) meteorological forcing, coupled to a 1 km horizontal resolution emission inventory (the UK National Atmospheric Emission Inventory). First comparisons reveal that local sources have a large impact on measurements and these local sources cannot be represented in the model at 2 km resolution. We evaluate methods to minimise some of the other critical sources of misfits between the observation data and the model simulation that overlap the signature of the errors in the emission inventory. These methods should make it easier to identify the corrections that should be applied to the inventory. Analysis is supported by observations from meteorological sites around the city and a three-week period of atmospheric mixing layer height estimations from lidar measurements. The difficulties of modelling the mixing layer depth and thus CO2 and CH4 concentrations during the night, morning and late afternoon led us to focus on the afternoon period for all further analyses. The misfits between observations and model simulations are high for both CO2 and CH4 (i.e., their root mean square (RMS) is between 8 and 12 parts per million (ppm) for CO2 and between 30 and 55 parts per billion (ppb) for CH4 at a given site). By analysing the gradients between the urban sites and a suburban or rural reference site, we are able to decrease the impact of uncertainties in the fluxes and transport

  12. HIV+ children and their families in the UK: results from a family-clinic based 'look-back' exercise in London.

    PubMed

    Campbell, Tomás; Griffiths, Jayne; Beer, Hannah; Legemah, Precious; Saine, Mbalu

    2014-01-01

    Advances in antiretroviral treatment have resulted in a growing number of HIV+ children surviving into adolescence and adulthood. However, HIV remains a chronic condition compounded by additional psychosocial stressors associated with living with HIV. The gold standard for treatment of HIV+ children and young people is within a family context. This 'look-back' exercise was conducted within an HIV family clinic context in London. HIV+ children's clinical notes were examined with the aim of describing the medical and social context of the families attending the clinic. Results showed that families are living with many psychosocial challenges that may have an impact on their ability to respond effectively to the challenge of living with HIV disease.

  13. National audit of asymptomatic screening in UK genitourinary medicine clinics: case-notes audit.

    PubMed

    McClean, H; Carne, C A; Sullivan, A K; Menon-Johansson, A; Gokhale, R; Sethi, G; Mammen-Tobin, A G; Daniels, D

    2010-07-01

    A national audit of screening of asymptomatic patients seen in UK genitourinary medicine clinics in 2009 was conducted against the national guidelines. Data were aggregated by regions and clinics in regions, allowing practice to be compared within and between regions, as well as to national averages and against national guidelines. The case-notes of 4428 patients were audited. Performance was over 80% against the national guidelines for screening of asymptomatic heterosexual men, men who have sex with men (MSM) and women for chlamydial, gonorrhoeal, syphilis and HIV infections. However, the recommended method of endocervical culture for gonorrhoea was performed in only 65% of women, with a further one-quarter being screened with endocervical or vulvovaginal nucleic acid amplification tests (NAATs). Although significant NAAT use for gonorrhoea was seen in all groups, testing for gonorrhoea by culture is still recommended as a first-line test on invasive samples. Over 80% of MSM, who were not known to be immune, were screened for hepatitis B. Urethral microscopy was performed in 22% of heterosexual men and 17% of MSM, and cervical microscopy in 12% of women.

  14. What is the impact of research champions on integrating research in mental health clinical practice? A quasiexperimental study in South London, UK.

    PubMed

    Oduola, Sherifat; Wykes, Til; Robotham, Dan; Craig, Tom K J

    2017-09-11

    Key challenges for mental health healthcare professionals to implement research alongside clinical activity have been highlighted, such as insufficient time to apply research skills and lack of support and resources. We examined the impact of employing dedicated staff to promote research in community mental health clinical settings. Quasiexperiment before and after study. South London and Maudsley National Health Service Foundation Trust. 4455 patients receiving care from 15 community mental health teams between 1 December 2013 and 31 December 2014. The proportion of patients approached for research participation in clinical services where research champions were present (intervention group), and where research champions were not present (comparison group). Patients in the intervention group were nearly six times more likely to be approached for research participation (Adj. OR=5.98; 95% CI 4.96 to 7.22). Investing in staff that promote and drive research in clinical services increases opportunities for patients to hear about and engage in clinical research studies. However, investment needs to move beyond employing short-term staff. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. A time-series analysis of any short-term effects of meteorological and air pollution factors on preterm births in London, UK.

    PubMed

    Lee, Sue J; Hajat, Shakoor; Steer, Philip J; Filippi, Veronique

    2008-02-01

    Although much is known about the incidence and burden of preterm birth, its biological mechanisms are not well understood. While several studies have suggested that high levels of air pollution or exposure to particular climatic factors may be associated with an increased risk of preterm birth, other studies do not support such an association. To determine whether exposure to various environmental factors place a large London-based population at higher risk for preterm birth, we analyzed 482,568 births that occurred between 1988 and 2000 from the St. Mary's Maternity Information System database. Using an ecological study design, any short-term associations between preterm birth and various environmental factors were investigated using time-series regression techniques. Environmental exposures included air pollution (ambient ozone and PM(10)) and climatic factors (temperature, rainfall, sunshine, relative humidity, barometric pressure, and largest drop in barometric pressure). In addition to exposure on the day of birth, cumulative exposure up to 1 week before birth was investigated. The risk of preterm birth did not increase with exposure to the levels of ambient air pollution or meteorological factors experienced by this population. Cumulative exposure from 0 to 6 days before birth also did not show any significant effect on the risk of preterm birth. This large study, covering 13 years, suggests that there is no association between preterm births and recent exposure to ambient air pollution or recent changes in the weather.

  16. Early virological response to HIV treatment: can we predict who is likely to experience subsequent treatment failure? Results from an observational cohort study, London, UK

    PubMed Central

    Brima, Nataliya; Lampe, Fiona C.; Copas, Andrew; Gilson, Richard; Williams, Ian; Johnson, Margaret A.; Phillips, Andrew N.; Smith, Colette J.

    2017-01-01

    Abstract Introduction: For people living with HIV, the first antiretroviral treatment (ART) regimen offers the best chance for a good virological response. Early identification of those unlikely to respond to first-line ART could enable timely intervention and increase chances of a good initial treatment response. In this study we assess the extent to which the HIV RNA viral load (VL) at 1 and 3 months is predictive of first-line treatment outcome at 6 months. Methods: All previously ART-naive individuals starting ART at two London centres since 2000 with baseline (−180 to 3 days) VL >500 c/mL had a VL measurement between 6 and 12 months after starting ART, and at least one at month 1 (4–60 days) or month 3 (61–120 days) were included. Lack of treatment response was defined as (i) VL >200 copies/mL at 6 months or (ii) VL >200 copies/mL at 6 months or simultaneous switch in drugs from at least two different drug classes before 6 months. The association with VL measurements at 1 and 3 months post-ART; change from pre-ART in these values; and CD4 count measurements at 1 and 3 months were assessed using logistic regression models. The relative fit of the models was compared using the Akaike information criterion (AIC). Results: A total of 198 out of 3258 individuals (6%) experienced lack of treatment response at 6 months (definition i), increasing to 511 (16%) for definition (ii). Those with a 1-month (day 4–60 window) VL of <1000, 1000–9999, 10,000–99,999 and >100,000 copies/ml had a 4%, 8%, 23% and 24% chance, respectively, of subsequently experiencing treatment non-response at 6 months (definition (i)). When considering the 3-month (day 61–120 window) VL, the chances of subsequently experiencing treatment non-response were, respectively, 3%, 25%, 67% and 75%. Results were similar for definition (ii). Conclusions: Whilst 3-month VL provides good discrimination between low and high risk of treatment failure, 1-month VL does not. Presence

  17. Early virological response to HIV treatment: can we predict who is likely to experience subsequent treatment failure? Results from an observational cohort study, London, UK.

    PubMed

    Brima, Nataliya; Lampe, Fiona C; Copas, Andrew; Gilson, Richard; Williams, Ian; Johnson, Margaret A; Phillips, Andrew N; Smith, Colette J

    2017-08-30

    For people living with HIV, the first antiretroviral treatment (ART) regimen offers the best chance for a good virological response. Early identification of those unlikely to respond to first-line ART could enable timely intervention and increase chances of a good initial treatment response. In this study we assess the extent to which the HIV RNA viral load (VL) at 1 and 3 months is predictive of first-line treatment outcome at 6 months. Methods All previously ART-naive individuals starting ART at two London centres since 2000 with baseline (-180 to 3 days) VL >500 c/mL had a VL measurement between 6 and 12 months after starting ART, and at least one at month 1 (4-60 days) or month 3 (61-120 days) were included. Lack of treatment response was defined as (i) VL >200 copies/mL at 6 months or (ii) VL >200 copies/mL at 6 months or simultaneous switch in drugs from at least two different drug classes before 6 months. The association with VL measurements at 1 and 3 months post-ART; change from pre-ART in these values; and CD4 count measurements at 1 and 3 months were assessed using logistic regression models. The relative fit of the models was compared using the Akaike information criterion (AIC). A total of 198 out of 3258 individuals (6%) experienced lack of treatment response at 6 months (definition i), increasing to 511 (16%) for definition (ii). Those with a 1-month (day 4-60 window) VL of <1000, 1000-9999, 10,000-99,999 and >100,000 copies/ml had a 4%, 8%, 23% and 24% chance, respectively, of subsequently experiencing treatment non-response at 6 months (definition (i)). When considering the 3-month (day 61-120 window) VL, the chances of subsequently experiencing treatment non-response were, respectively, 3%, 25%, 67% and 75%. Results were similar for definition (ii). Whilst 3-month VL provides good discrimination between low and high risk of treatment failure, 1-month VL does not. Presence of a VL >10,000 copies/ml after 3 months of ART is a

  18. Animal models and antibody assays for evaluating candidate SARS vaccines: summary of a technical meeting 25-26 August 2005, London, UK.

    PubMed

    Roberts, Anjeanette; Wood, John; Subbarao, Kanta; Ferguson, Morag; Wood, David; Cherian, Thomas

    2006-11-30

    Severe acute respiratory syndrome (SARS) emerged in the Guangdong province of China in late 2002 and spread to 29 countries. By the end of the outbreak in July 2003, the CDC and WHO reported 8437 cases with a 9.6% case fatality rate. The disease was caused by a previously unrecognized coronavirus, SARS-CoV. Drawing on experience with animal coronavirus vaccines, several vaccine candidates have been developed and evaluated in pre-clinical trials. Available data suggest that vaccines should be based on the the 180kDa viral spike protein, S, the only significant neutralization antigen capable of inducing protective immune responses in animals. In the absence of clinical cases of SARS, candidate vaccines should be evaluated for efficacy in animal models, and although it is uncertain whether the United States Food and Drug Administration's "animal rule" would apply to licensure of a SARS vaccine, it is important to develop standardized animal models and immunological assays in preparation for this eventuality. This report summarizes the recommendations from a WHO Technical Meeting on Animal Models and Antibody Assays for Evaluating Candidate SARS Vaccines held on 25-26 August 2005 in South Mimms, UK, provides guidance on the use of animal models, and outlines the steps to develop standard reagents and assays for immunological evaluation of candidate SARS vaccines.

  19. Special issue of selected papers from the second UK-Japan bilateral Workshop and First ERCOFTAC Workshop on Turbulent Flows Generated/Designed in Multiscale/Fractal Ways, London, March 2012

    NASA Astrophysics Data System (ADS)

    Laizet, Sylvain; Sakai, Yasuhiko; Christos Vassilicos, J.

    2013-12-01

    This special issue of Fluid Dynamics Research includes nine papers which are based on nine of the presentations at the Second UK-Japan bilateral Workshop and First ERCOFTAC Workshop on 'Turbulent flows generated/designed in multiscale/fractal ways: fundamentals and applications' held from 26 to 27 March 2012 at Imperial College London, UK. The research area of fractal-generated turbulent flows started with a chapter published in 2001 in one of the conference proceedings which came out of the 1999 Isaac Newton Institute 6 month Programme on Turbulence in Cambridge (UK). However, the first results which formed the basis of much of the work reported in this special issue started appearing from 2007 onwards and progress since then could perhaps be described as not insignificant. Research in this area has resulted in the following six notable advances: (a) the definition of two new length-scales characterizing grid-generated turbulence; (b) enhanced and energy-efficient stirring and scalar transfer by fractal grid and fractal openings/flanges with applications, in particular, to improved turbulence generation for combustion; (c) the non-equilibrium turbulent dissipation law; (d) non-equilibrium axisymmetric wake laws; (e) insights into the dependence of drag forces and vortex shedding on the fractal geometry of fractal objects and simulation methods for the calculation of drag of fractal trees; and (f) the invention and successful proof of concept of fractal spoilers and fractal fences. The present special issue contains papers directly related to these advances and can be seen as a reflection of the current research in the field of fractal-generated turbulent flows and their differences and commonalities with other turbulent flows. The financial support from the Japan Society for the Promotion of Science has been decisive for the organization and success of this workshop. We are also grateful to ERCOFTAC who put in place the EU-wide Special Interest Group on multiscale

  20. 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

  1. 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

  2. Monitoring CO2 and CH4 concentrations in London, UK using a rooftop atmospheric measurement network and an atmospheric chemistry-transport model

    NASA Astrophysics Data System (ADS)

    Boon, Alex; Broquet, Gregoire; Clifford, Debbie; Chevallier, Frederic; Butterfield, David; Pison, Isabelle; Ciais, Phillipe

    2014-05-01

    A rapidly developing research field is the development of monitoring networks and data assimilation systems to provide an optimal estimate of urban greenhouse gases based on both observations and the output of a chemistry-transport model driven by current emissions inventories. A key first step in development of this methodology is to evaluate the ability of the chemistry-transport model to simulate observations at the chosen measurement sites. In this study, funded by Astrium Services SAS, a network comprising four state-of-the-art atmospheric sensors was placed on rooftop sites in and around London during the summer of 2012. Two sites were located in the inner city and two 'background' sites (one suburban and one rural) were positioned to enable examination of the urban increment of GHG concentrations. The chemistry-transport model, CHIMERE, was run at 2 km resolution using temporally and spatially derived emissions inventories from the National Atmospheric Emissions Inventory (NAEI), driven by European Centre for Medium-Range Weather Forecasts (ECMWF) meteorology. Here, we focus on the analysis of the urban increments of total CO2, total CH4 and fossil fuel CO2 during the afternoon hours 12:00 to 17:00, aiming to identify the key sources of misfits between the model and the observations. Results showed there was improved agreement between the observed and modelled urban increments compared with total modelled and observed values for individual sites. This suggests that some of the misfits arose from the selection of appropriate boundary conditions for the model. However, there remained underestimation of the observed values and an inability of the model to simulate observed variability. The observations at the two inner city sites showed evidence of different contributions from local (<2 km-scale) sources, despite their proximity. A simple CO-based method was used to attribute fossil fuel CO2 from observations and showed that there were localised traffic based

  3. Overall satisfaction, sexual function, and the durability of neophallus dimensions following staged female to male genital gender confirming surgery: the Institute of Urology, London U.K. experience

    PubMed Central

    Christopher, Nim A.; De Luca, Francesco; Spilotros, Marco; Ralph, David J.

    2014-01-01

    Background and purpose What factors influence transgender men’s decisions to undergo (and to not undergo) specific genital gender confirming surgeries (GCS) has not been described in the literature. Sexual function outcomes related to clitoral transposition and penile prosthesis placement is also not well described. Durability of neophallus dimensions after phalloplasty has not been described. A better understanding of these factors is necessary for pre-op counseling. We sought to assess patient genital-GCS related satisfaction, regret, pre/post-op sexual function, genital preferences, and genital measurements post-op. Materials and methods We evaluated ten female to male transgender patients who had previously undergone suprapubic pedicle-flap phalloplasty [suprapubic phalloplasty (SP); N=10] and 15 who had undergone radial artery forearm-flap phalloplasty [(RAP); N=15; 5/15 without and 10/15 with cutaneous nerve to clitoral nerve anastomosis] at our center (UK). We queried patients’ surgery related preferences and concerns, satisfaction, and sexual function pre/post-surgery, and accounted for whether patients had undergone clitoral transposition and/or cutaneous-to-clitoral nerve anastomosis. We measured flaccid and (where applicable) erect length and girth using a smart-phone app we designed. Results Mean age at surgery and follow-up for those that underwent SP was 35.1 and 2.23 years, and 34 and 6.8 for those that underwent RAP. Mean satisfaction scores were 9.1/10 and 9/10 for those that underwent SP and RAP, respectively. No patient (0%) regretted starting genital-GCS surgery. All (100%) patients that could achieve orgasm before GCS with clitoral transposition could achieve orgasm after surgery, and the vast majority reported preserved quality of erogenous sensation by our transposition technique. All (100%) RAP and 9/10 SP patients reported masturbation with their phallus. Inflatable penile prosthesis placement was not associated with decreased erogenous

  4. New insights from comprehensive on-road measurements of NOx, NO2 and NH3 from vehicle emission remote sensing in London, UK

    NASA Astrophysics Data System (ADS)

    Carslaw, David C.; Rhys-Tyler, Glyn

    2013-12-01

    In this paper we report the first direct measurements of nitrogen dioxide (NO2) in the UK using a vehicle emission remote sensing technique. Measurements of NO, NO2 and ammonia (NH3) from almost 70,000 vehicles were made spanning vehicle model years from 1985 to 2012. These measurements were carefully matched with detailed vehicle information data to understand the emission characteristics of a wide range of vehicles in a detailed way. Overall it is found that only petrol fuelled vehicles have shown an appreciable reduction in total NOx emissions over the past 15-20 years. Emissions of NOx from diesel vehicles, including those with after-treatment systems designed to reduce emissions of NOx, have not reduced over the same period of time. It is also evident that the vehicle manufacturer has a strong influence on emissions of NO2 for Euro 4/5 diesel cars and urban buses. Smaller-engined Euro 4/5 diesel cars are also shown to emit less NO2 than larger-engined vehicles. It is shown that NOx emissions from urban buses fitted with Selective Catalytic Reduction (SCR) are comparable to those using Exhaust Gas Recirculation for Euro V vehicles, while reductions in NOx of about 30% are observed for Euro IV and EEV vehicles. However, the emissions of NO2 vary widely dependent on the bus technology used. Almost all the NOx emission from Euro IV buses with SCR is in the form of NO, whereas EEV vehicles (Enhanced Environmentally friendly Vehicle) emit about 30% of the NOx as NO2. We find similarly low amounts of NO2 from trucks (3.5-12t and >12t). Finally, we show that NH3 emissions are most important for older generation catalyst-equipped petrol vehicles and SCR-equipped buses. The NH3 emissions from petrol cars have decreased by over a factor of three from the vehicles manufactured in the late 1990s compared with those manufactured in 2012. Tables of emission factors are presented for NOx, NO2 and NH3 together with uncertainties to assist the development of new emission

  5. International Health and Tropical Medicine 08: Proceedings of a Residential Meeting of the Royal Society of Tropical Medicine and Hygiene, 17-19 September 2008, Brighton, UK.

    PubMed

    Newport, Melanie J; Lang, Trudie

    2009-11-01

    The Royal Society of Tropical Medicine and Hygiene held a residential meeting from 17-19 September 2008. Over 250 delegates from a diverse range of backgrounds and experience convened in Brighton, UK for three days of talks and discussions on a wide variety of themes. Topics ranged from tropical and neglected infectious diseases through to other disorders that whilst not traditionally associated with low income countries pose an increasing challenge; chronic diseases, mental health disorders and problems arising from conflict and poverty combined. The meeting represented the change in focus at RSTMH from tropical infectious diseases towards global health in its broadest sense.

  6. Analysis of the potential of near-ground measurements of CO2 and CH4 in London, UK, for the monitoring of city-scale emissions using an atmospheric transport model

    NASA Astrophysics Data System (ADS)

    Boon, Alex; Broquet, Grégoire; Clifford, Deborah J.; Chevallier, Frédéric; Butterfield, David M.; Pison, Isabelle; Ramonet, Michel; Paris, Jean-Daniel; Ciais, Philippe

    2016-06-01

    Carbon dioxide (CO2) and methane (CH4) mole fractions were measured at four near-ground sites located in and around London during the summer of 2012 with a view to investigating the potential of assimilating such measurements in an atmospheric inversion system for the monitoring of the CO2 and CH4 emissions in the London area. These data were analysed and compared with simulations using a modelling framework suited to building an inversion system: a 2 km horizontal resolution south of England configuration of the transport model CHIMERE driven by European Centre for Medium-Range Weather Forecasts (ECMWF) meteorological forcing, coupled to a 1 km horizontal resolution emission inventory (the UK National Atmospheric Emission Inventory). First comparisons reveal that local sources, which cannot be represented in the model at a 2 km resolution, have a large impact on measurements. We evaluate methods to filter out the impact of some of the other critical sources of discrepancies between the measurements and the model simulation except that of the errors in the emission inventory, which we attempt to isolate. Such a separation of the impact of errors in the emission inventory should make it easier to identify the corrections that should be applied to the inventory. Analysis is supported by observations from meteorological sites around the city and a 3-week period of atmospheric mixing layer height estimations from lidar measurements. The difficulties of modelling the mixing layer depth and thus CO2 and CH4 concentrations during the night, morning and late afternoon lead to focusing on the afternoon period for all further analyses. The discrepancies between observations and model simulations are high for both CO2 and CH4 (i.e. their root mean square (RMS) is between 8 and 12 parts per million (ppm) for CO2 and between 30 and 55 parts per billion (ppb) for CH4 at a given site). By analysing the gradients between the urban sites and a suburban or rural reference site, we

  7. System-level and patient-level explanations for non-attendance at diabetic retinopathy screening in Sutton and Merton (London, UK): a qualitative analysis of a service evaluation

    PubMed Central

    Strutton, R; Du Chemin, A; Stratton, I M; Forster, A S

    2016-01-01

    Objectives Non-attendance at diabetic retinopathy screening has financial implications for screening programmes and potential clinical costs to patients. We sought to identify explanations for why patients had never attended a screening appointment (never attendance) in one programme. Design Qualitative analysis of a service evaluation. Setting One South London (UK) diabetic eye screening programme. Participants and procedure Patients who had been registered with one screening programme for at least 18 months and who had never attended screening within the programme were contacted by telephone to ascertain why this was the case. Patients’ general practices were also contacted for information about why each patient may not have attended. Framework analysis was used to interpret responses. Results Of the 296 patients, 38 were not eligible for screening and of the 258 eligible patients, 159 were not contactable (31 of these had phone numbers that were not in use). We obtained reasons from patients/general practices/clinical notes for non-attendance for 146 (57%) patients. A number of patient-level and system-level factors were given to explain non-attendance. Patient-level factors included having other commitments, being anxious about screening, not engaging with any diabetes care and being misinformed about screening. System-level factors included miscommunication about where the patient lives, their clinical situation and practical problems that could have been overcome had their existence been shared between programmes. Conclusions This service evaluation provides unique insight into the patient-level and system-level reasons for never attendance at diabetic retinopathy screening. Improved sharing of relevant information between providers has the potential to facilitate increased uptake of screening. Greater awareness of patient-level barriers may help providers offer a more accessible service. PMID:27194319

  8. Analytical confirmation of synthetic cannabinoids in a cohort of 179 presentations with acute recreational drug toxicity to an Emergency Department in London, UK in the first half of 2015.

    PubMed

    Abouchedid, Rachelle; Hudson, Simon; Thurtle, Natalie; Yamamoto, Takahiro; Ho, James H; Bailey, George; Wood, Michelle; Sadones, Nele; Stove, Christophe P; Dines, Alison; Archer, John R H; Wood, David M; Dargan, Paul I

    2017-06-01

    Synthetic cannabinoid receptor agonists are the largest group of new psychoactive substances reported in the last decade; in this study we investigated how commonly these drugs are found in patients presenting to the Emergency Department with acute recreational drug toxicity. We conducted an observational cohort study enrolling consecutive adult patients presenting to an Emergency Department (ED) in London (UK) January-July 2015 (6 months) with acute recreational drug toxicity. Residual serum obtained from a serum sample taken as part of routine clinical care was analyzed using high-resolution accurate mass-spectrometry with liquid-chromatography (HRAM-LCMSMS). Minimum clinical data were obtained from ED medical records. 18 (10%) of the 179 patient samples were positive for synthetic cannabinoid receptor agonists. The most common was 5F AKB-48 (13 samples, concentration 50-7600 pg/ml), followed by 5F PB-22 (7, 30-400 pg/mL), MDMB-CHMICA (7, 80-8000 pg/mL), AB-CHMINACA (3, 50-1800 pg/mL), Cumyl 5F-PINACA (1, 800 pg/mL) and BB-22 (1, 60 pg/mL). Only 9/18 (50%) in whom synthetic cannabinoid receptor agonists were detected self-reported synthetic cannabinoid receptor agonist use. The most common clinical features were seizures and agitation, both recorded in four (22%) individuals. Fourteen patients (78%) were discharged from the ED, one of the four admitted to hospital was admitted to critical care. Synthetic cannabinoid receptor agonists were found in 10% of this cohort with acute recreational drug toxicity but self-reported in only half of these. This suggests that presentations to the ED with acute synthetic cannabinoid receptor agonist toxicity may be more common than reported.

  9. Prevalence of use of complementary and alternative medicine (CAM) by patients/consumers in the UK: systematic review of surveys.

    PubMed

    Posadzki, Paul; Watson, Leala K; Alotaibi, Amani; Ernst, Edzard

    2013-04-01

    This systematic review aimed to estimate the prevalence of use of complementary and alternative medicine (CAM) in the UK. Five databases were searched for English language, peer-reviewed surveys published between 1 January 2000 and 7 October 2011. In addition, relevant book chapters and files from our own departmental records were searched by hand. Eighty-nine surveys were included, with a total of 97,222 participants. Most studies were of poor methodological quality. Across surveys on CAM in general, the average one-year prevalence of use of CAM was 41.1% and the average lifetime prevalence was 51.8%. In methodologically sound surveys, the equivalent rates were 26.3% and 44%, respectively. In surveys with response rates >70%, average one-year prevalence was nearly threefold lower than in surveys with response rates between 21% and 50%. Herbal medicine was the most popular CAM, followed by homeopathy, aromatherapy, massage and reflexology. Many patients and consumers in the UK use CAM; healthcare professionals should therefore responsibly advise their patients about the use of CAM.

  10. UK Doubles Its "World-Leading" Research in Life Sciences and Medicine in Six Years: Testing the Claim?

    PubMed

    Wooding, Steven; Van Leeuwen, Thed N; Parks, Sarah; Kapur, Shitij; Grant, Jonathan

    2015-01-01

    The UK, like some other countries, carries out a periodic review of research quality in universities and the most recent Research Excellence Framework (REF) reported a doubling (103% increase) in its "world leading" or so-called "4*" research outputs in the areas of life sciences and medicine between 2008 and 2014. This is a remarkable improvement in six years and if validated internationally could have profound implications for health sciences. We compared the reported changes in 4* quality to bibliometric measures of quality for the 56,639 articles submitted to the RAE 2008 and the 50,044 articles submitted to the REF 2014 to Panel A, which assesses the life sciences, including medicine. UK research submitted to the RAE and REF was of better quality than worldwide research on average. While we found evidence for some increase in the quality of top UK research articles, a 10-25% increase in the top 10%ile papers, depending upon the metrics used, we could not find evidence to support a 103% increase in quality. Instead we found that as compared to the RAE, the REF results implied a lower citation %ile threshold for declaring a 4*. There is a wide discrepancy between bibliometric indices and peer-review panel judgements between the RAE 2008 and REF 2014. It is possible that the changes in the funding regime between 2008 and 2014 that significantly increased the financial premium for 4* articles may have influenced research quality evaluation. For the advancement of science and health, evaluation of research quality requires consistency and validity - the discrepancy noted here calls for a closer examination of mass peer-review methods like the REF.

  11. A review of the cultivation and processing of cannabis (Cannabis sativa L.) for production of prescription medicines in the UK.

    PubMed

    Potter, David J

    2014-01-01

    The quality demands of the pharmaceutical industry require prescription medicines to be consistent in their active ingredient content. Achieving this, using raw cannabis as a feedstock, is especially challenging. The plant material is extremely inhomogeneous, and the ratios of active ingredients are affected by a range of factors. These include the genetics of the plant, the growing and storage conditions, the state of maturity at harvest, and the methods used to process and formulate the material. The reasons for this variability are described, with particular emphasis on the botanical considerations. To produce the complex botanical medicine Sativex®, which contains the cannabinoids Δ(9)-tetrahydrocannabinol (THC) and cannabidiol (CBD) and a range of other ingredients, GW Pharmaceuticals had to manage these variables. This medicine, for the treatment of spasticity due to multiple sclerosis, is the first cannabis-based medicine to be approved in the UK. The company's methodology for producing this and other chemotypes is described. Copyright © 2013 John Wiley & Sons, Ltd.

  12. Career choices for geriatric medicine: national surveys of graduates of 1974-2009 from all UK medical schools.

    PubMed

    Maisonneuve, Jenny J; Pulford, Claire; Lambert, Trevor W; Goldacre, Michael J

    2014-07-01

    numbers of elderly people are increasing worldwide. This increases the importance of the specialty of geriatric medicine. Recruitment to the specialty may not be keeping pace with need. to report trends in junior doctors' career choices for geriatric medicine, factors that influence career choice, and associations between early career choices and later specialty destinations. questionnaire surveys of all medical qualifiers from all UK medical schools in selected year-of-qualification cohorts (1974-2009). Survey response rates 1, 3 and 5 years after graduation were, respectively, 65.9% (33,972/51,535), 65.5% (29,400/44,879) and 66.1% (22,600/34,197). geriatric medicine was the career choice of 0.9% of medical graduates (0.4% of men, 1.3% of women) 1 year after qualification; and of 1.5% (1.2% of men, 1.9% of women) after 5 years. There was a modest increase in recent cohorts. Important influences on career choice included enthusiasm for and commitment to the specialty, experience of working in geriatric medicine and self-appraisal of own skills. Early career choices were not highly predictive of later destinations. Of practising geriatricians in our surveys, 9% (20/212) had told us that they wanted to be geriatricians in their first year after graduation, as had 36% when in their third year and 74% in their fifth year. a higher percentage of women than men choose geriatric medicine; in recent years its popularity has increased slightly. Early career choice is not highly predictive of an eventual career in the specialty. Flexibility is needed about when doctors can enter training in geriatric medicine. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Knowledge and beliefs of young people about medicines in the UK.

    PubMed

    MacAdam, Angela; Kaufman, Ela; Williams, Sian

    2017-04-01

    To investigate knowledge and beliefs regarding medicines among young people in the South-East of England. A cross-sectional survey was conducted among young people aged 12-17 years in three state secondary schools which participated in the Pharmacy and Biomedical Sciences Outreach Program (POP) - scientific workshops in south-east England. One hundred questionnaires were successfully completed giving a response rate of 75%. The median knowledge score was 62.3% (±19.8). Increase in knowledge of medicines was positively associated with increase in age and with a positive belief about medicines. One of the questions answered that scored less than 50% was concerning the use of antibiotics. Knowledge of medicines appeared to be adequate among young people and was higher with a positive belief about medicines. However, there was variability in how well different questions were answered suggesting inclusion in the school curriculum would be beneficial in order to reduce the misinformation that was apparent, particularly regarding the potential non-adherence to antibiotics. © 2016 Royal Pharmaceutical Society.

  14. Developing a new specialty – sport and exercise medicine in the UK

    PubMed Central

    Cullen, Michael

    2010-01-01

    Sports physicians have existed since ancient times. However as a recognised specialty, sports medicine is a relatively new discipline and even today very few countries have formal postgraduate training programmes which allow doctors to pursue a career in this discipline. This paper outlines the development of sport and exercise medicine in the United Kingdom, describing the journey leading to specialty recognition in 2005 and the progress being made towards establishing it as an integral component of the National Health Service in the 21st century. PMID:24198537

  15. The medicinal use of cannabis in the UK: results of a nationwide survey.

    PubMed

    Ware, M A; Adams, H; Guy, G W

    2005-03-01

    The use of cannabis for medical purposes is a controversial but an important topic of public and scientific interest. We report on the results of a self-administered questionnaire study conducted in the United Kingdom between 1998 and 2002. The questionnaire consisted of 34 items and included demographic data, disease and medication use patterns and cannabis use profiles. Subjects were self-selected; 3663 questionnaires were distributed and 2969 were returned [1805 (60.9%) women, mean age 52.7 years (SD 12.7)]. Medicinal cannabis use was reported by patients with chronic pain (25%), multiple sclerosis and depression (22% each), arthritis (21%) and neuropathy (19%). Medicinal cannabis use was associated with younger age, male gender and previous recreational use (p < 0.001). While caution must be exercised in interpreting these data, they point to the need for clinical studies of cannabis and cannabinoids with standardised and quality-controlled products.

  16. A survey of the role of the UK physicist in nuclear medicine: a report of a joint working group of the British Institute of Radiology, British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine.

    PubMed

    Tindale, W B; Thorley, P J; Nunan, T O; Lewington, V; Shields, R A; Williams, N R

    2003-01-01

    Guidelines for the provision of physics support to nuclear medicine were published in 1999 by a joint working group of the British Institute of Radiology, the British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine. Following publication of the guidelines, a survey was conducted by the working group to gather data on the actual level of physicist support in UK hospitals of different types and on the activities undertaken by physicists. The data were collected in the 12 months following the publication of guidelines and cover different hospital models and seven UK regions. The results provide evidence that many of the smaller units - small teaching hospitals and, particularly, small district general hospitals - have insufficient physics support. Although, on average, there is good agreement between the guidelines and the survey data for medium and large district general hospitals, there is wide variation in the level of physics provision between hospitals delivering apparently similar services. This emphasizes the need for national guidelines, against which institutions may be bench-marked and which may be used as a recommendation for the staffing levels necessary to ensure services are delivered safely and standards are not compromised. The complexity and variety of workload is an important factor in determining the level of physics support. As services develop, it is vital that this aspect is recognized to ensure that appropriate resources are available for the required physics input, even if any new service represents only a modest clinical throughput in terms of patient numbers.

  17. 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

  18. 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).

  19. News Astronomy: Science and beauty combined Africa: Physics technicians offer valuable skills Conference: ESERA2013 brings researchers together in Cyprus Physics Olympiad: UK team bring home more medals from the Physics Olympics in Copenhagen Physics Tournament: IOC backs Shrewsbury to host IYPT 2014 Conference: MPTL18 looks at the latest multimedia developments Workshop: The selective absorption of light Science on Stage: Illuminating Science Education in London in 2015

    NASA Astrophysics Data System (ADS)

    2013-11-01

    Astronomy: Science and beauty combined Africa: Physics technicians offer valuable skills Conference: ESERA2013 brings researchers together in Cyprus Physics Olympiad: UK team bring home more medals from the Physics Olympics in Copenhagen Physics Tournament: IOC backs Shrewsbury to host IYPT 2014 Conference: MPTL18 looks at the latest multimedia developments Workshop: The selective absorption of light Science on Stage: Illuminating Science Education in London in 2015

  20. 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

  1. The psychological health and well-being of emergency medicine consultants in the UK.

    PubMed

    Fitzgerald, Katherine; Yates, Philip; Benger, Jonathan; Harris, Adrian

    2017-07-01

    To explore the experience of psychological distress and well-being in emergency medicine (EM) consultants. A qualitative, interpretative phenomenological analysis (IPA) study based on 1:1 semistructured interviews with EM consultants working full time in EDs across South West England. Eighteen EM consultants were interviewed across five EDs, the mean (SD) age of participants being 43.17 (5.8) years. The personal meanings that participants attached to their experiences were inductively analysed. The analysis formed three superordinate themes: systemic pressures, physical and mental strain and managing the challenges. Pressures within the ED and healthcare system contributed to participants feeling undervalued and unsatisfied when working in an increasingly uncontrollable environment. Participants described working intensely to meet systemic demands, which inadvertently contributed to a diminishing sense of achievement and self-worth. Consultants perceived their experience of physical and emotional strain as unsustainable, as it negatively impacted; functioning at work, relationships, personal well-being and the EM profession. Participants described how sustainability as an EM consultant could be promoted by social support from consultant colleagues and the ED team, and the opportunity to develop new roles and support ED problem solving at an organisational level. These processes supported a stigma-reducing means of promoting psychological well-being. EM consultants experience considerable physical and mental strain. This strain is dynamically related to consultants' experiences of diminishing self-worth and satisfaction, alongside current sociopolitical demands on EM services. Recognising the psychological experiences and needs of EM consultants and promoting a sustainable EM consultant role could benefit individual psychological well-being and the delivery of emergency care. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  2. Access to complementary medicine in general practice: survey in one UK health authority.

    PubMed

    Wearn, A M; Greenfield, S M

    1998-09-01

    Complementary therapy (CT) has become increasingly popular with the general public and interest from the health professions has been rising. There has been no study focusing on the pattern of availability of CT within urban and inner-city general practice. We aimed to describe the prevalence and pattern of access to complementary therapy in this setting, identifying the characteristics of practices offering CT and the perceived barriers to service provision. We sent a postal questionnaire to all 254 general practices on the Birmingham Family Health Services Authority list. Practices were asked whether they offered any access to CTs, how services were organized and which therapies were available and to identify any barriers to provision. 175 practices (68.9%) responded. Half of the practices offered access to CT. Of these, half offered an in-house service, usually provided by the doctor (81.8%). Of GPs practising therapies themselves, 58% began in or after 1990. Seventeen separate therapies were offered, most commonly acupuncture, osteopathy, chiropractic, hypnotherapy and homoeopathy. Practices significantly more likely to offer access to CT were of larger list size and training or teaching practices. They were equally likely to be fundholders or non-fundholders. Practices offering an in-house service tended to be fundholding, training and of larger list size. Finance was perceived as the major barrier. In the area studied, many patients now have some access to CT within primary care, often within their own practice. In the main, therapies offered are the 'medically acceptable face' of complementary medicine.

  3. 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

  4. 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.

  5. UK Parkinson's Excellence Network: empowering service improvement across the UK.

    PubMed

    Burn, David

    2015-01-01

    Parkinson's UK, together with leading Parkinson's professionals, has set up the UK Parkinson's Excellence Network to bring together the passion and expertise of leading clinicians with the strategic leadership and resources of Parkinson's UK underpinned by the voice of people affected by Parkinson's. Launched in London in February 2015, the Excellence Network aims to drive sustainable improvements in health and social care services. It will provide a more strategic approach to clinical development so that Parkinson's services across health and social care can be transformed to provide the best quality care across the UK.

  6. 'All singing, all dancing': staff views on the integration of family planning and genitourinary medicine in Lothian, UK.

    PubMed

    Higgins, Martin; Chen, Eric Zhong; Gebbie, Ailsa E; Fernando, Imali; Milne, Dona; Cochrane, Rosemary

    2014-10-01

    UK policy documents advocate integrated approaches to sexual health service provision to ensure that everyone can access high-quality treatment. However, there is relatively little evidence to demonstrate any resultant benefits. The family planning and genitourinary medicine services in Lothian have been fully integrated and most care is now delivered from a purpose-built sexual health centre. We wished to study the views of staff on integrated sexual and reproductive care. Staff completed anonymous questionnaires before and after integration, looking at four main aspects: the patient pathway, specific patient groups, their own professional status, and their working environment. The surveys used a mixture of five-point Likert-type scales and open-ended questions. Over 50% of staff completed the surveys on each occasion. Six months after the new building opened, staff attitudes about the integrated service were mixed. Staff reported more stress and less opportunity for specialisation but there was no change in their sense of professional status or development. There were concerns about how well the integrated service met the needs of specific patient groups, notably women. These concerns co-existed with a verdict that overall service quality was no worse following integration. Staff views should form an important part of service redesign and integration projects. Although the results from the Lothian surveys suggest a perceived worsening of some aspects of the service, further evaluation is needed to unpick the different problems that have appeared under the catch-all term of 'integration'. 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.

  7. Naturalness as an ethical stance: idea(l)s and practices of care in western herbal medicine in the UK.

    PubMed

    Nissen, Nina

    2015-01-01

    An association of non-biomedical healthcare with appeals to nature and naturalness, and an invocation of a rhetoric of gentleness, goodness, purity and moral power has been noted previously, and some scholars argue that nature has taken on a meaning broadly opposed to the rational scientific order of modernity. Drawing on an ethnographic study of women's practice and use of western herbal medicine (WHM) in the UK, the intertwining of the perceived naturalness of WHM with distinct care practices points to a further avenue for exploration. To examine patients' and herbalists' discourses of the naturalness of WHM and associated idea(l)s and practices of care, understandings of nature and a feminist ethics of care are utilized as analytical frameworks. The analysis presented suggests that, through WHM, patients and herbalists become embedded in a complex spatio-temporal wholeness and web of care that intertwines past, present and future, self and others, and local and global concerns. In the emerging 'ordinary ethics of care', naturalness constitutes a sign of goodness and of a shared humanity within the organic world, while care, underpinned by idea(l)s of natural and holistic care practices, links human and non-human others. Thus, the naturalness of WHM, as perceived by some patients and herbalists, engages and blends with a continually unfolding field of relationships in the lifeworld(s), where care practices, caring relations and collective wellbeing may constitute an ethical stance that raises deeper questions about the significance of relationality, the values of care/caring and the mutual involvement of nature and human being(s).

  8. A 'novel' model for integrating Sport and Exercise Medicine (SEM) and Musculoskeletal (MSK) management into primary care in the UK.

    PubMed

    Heron, Neil

    2015-01-01

    Musculoskeletal (MSK) symptoms are common within primary care but some general practitioners (GPs)/family physicians do not feel comfortable managing these symptoms, preferring to refer onwards. We aimed to establish a reproducible GP-staffed MSK and sport and exercise medicine (SEM) clinic within primary care, in keeping with recent policy changes within the UK health system. A monthly MSK and SEM clinic was held within a Belfast GP practice, staffed by 1 GP with a specialist interest in MSK/SEM conditions, and its performance was reviewed over two 3-month periods. Parameters audited included diagnoses, patient satisfaction and secondary care referral rates. 83 patients, 36 males and 47 females, were reviewed in the clinic and the main presenting joint was the shoulder. Patient self-reported satisfaction with the service was high. Comparing referral rates between August and October 2013 and the same period in 2014, overall referrals from the practice were reduced by 147, orthopaedic and rheumatology referrals were reduced by 2 and 3, while physiotherapy and X-ray referrals were reduced by 47 and 90, respectively. Comparing the referral rates between January and March 2014 and the same period in 2015, overall outpatient referrals were reduced by 152, orthopaedic and rheumatology referrals were reduced by 9 and 4, while physiotherapy and X-ray referrals were reduced by 41 and 3, respectively. We present a novel, reproducible service model for managing MSK/SEM symptoms in primary care which could be commissioned by local groups. This model can make sound economic sense and deliver high patient satisfaction within primary care, reducing waiting times and the secondary care referral burden.

  9. Investigation of social, demographic and health variations in the usage of prescribed and over-the-counter medicines within a large cohort (South Yorkshire, UK)

    PubMed Central

    Green, Mark A; Little, Emma; Cooper, Richard; Relton, Clare; Strong, Mark

    2016-01-01

    Objectives Prescribed and over-the-counter (non-prescribed) medicine usage has increased in recent years; however, there has been less investigation of the socioeconomic predictors of use. This has been due to a lack of data, especially for over-the-counter medicines. Our study aims to understand how prescribed and over-the-counter medicine patterns vary by demographic, social and health characteristics within a large population cohort. Design Cross-sectional data analysis. Setting South Yorkshire, UK. Participants 27 806 individuals from wave 1 of the Yorkshire Health Study (2010–2012). Measures Individuals self-reported each medicine they were taking and whether each was prescribed or not. The medicines were grouped into 14 categories (eg, cardiovascular system, infection, contraception). Negative binomial regression models were used to analyse the count of medicine usage. We included demographic (age, gender, ethnicity), social (education), health-related (body mass index, smoking, alcohol consumption, physical activity) factors and chronic health conditions (eg, stroke, anxiety and heart disease) in our analyses. Results 49% of men and 62% of women were taking medicine with the majority of this prescribed (88% and 83%, respectively). Health conditions were found to be positively associated with prescribed medicine usage, but mixed in their associated with over-the-counter medicines. Educational attainment was negatively associated with prescribed and positively associated with over-the-counter usage. Conclusions Our study addresses a dearth of evidence to provide new insights into how behaviours in medicine usage vary by demographic, social and health-related factors. Differences in over-the-counter medicine usage by educational attainment may help our understanding of the determinants of health inequalities. PMID:27683515

  10. 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)

  11. 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)

  12. 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.

  13. Cross-cultural differences in GPs' attitudes towards complementary and alternative medicine: a survey comparing regions of the UK and Germany.

    PubMed

    Schmidt, K; Jacobs, P A; Barton, A

    2002-09-01

    To investigate whether there is a difference in general practitioners' attitudes towards CAM in the UK and Germany. A descriptive questionnaire was developed and sent to 97 GPs in the UK and 99 GPs in Germany. The overall response rate was 68%. German GPs showed a (non-significant) overall more positive attitude towards CAM than did British GPs. British GPs made more referrals to complementary practitioners. The most popular CAM therapies that UK GPs referred their patients to were chiropractic treatment, acupuncture and osteopathy. German GPs referred their patients mainly to acupuncture treatment, chiropractic treatment and herbal medicine. A significantly higher number of German GPs reported having practised as a CAM practitioner before and having personally used CAM themselves. Seventy percent of British GPs and 76% of German GPs thought it is safe to prescribe complementary medicine and therapies to patients. There are small national differences in referring patients to various CAM modalities. Both nations have an overall positive attitude toward and a high interest in CAM. Lack of scientific evidence and information on training opportunities were important points that were continuously raised by GPs in both countries.

  14. 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.

  15. Variation in assessment and standard setting practices across UK undergraduate medicine and the need for a benchmark

    PubMed Central

    2015-01-01

    Objectives The principal aim of this study is to provide an account of variation in UK undergraduate medical assessment styles and corresponding standard setting approaches with a view to highlighting the importance of a UK national licensing exam in recognizing a common standard. Methods Using a secure online survey system, response data were collected during the period 13 - 30 January 2014 from selected specialists in medical education assessment, who served as representatives for their respective medical schools. Results Assessment styles and corresponding choices of standard setting methods vary markedly across UK medical schools. While there is considerable consensus on the application of compensatory approaches, individual schools display their own nuances through use of hybrid assessment and standard setting styles, uptake of less popular standard setting techniques and divided views on norm referencing. Conclusions The extent of variation in assessment and standard setting practices across UK medical schools validates the concern that there is a lack of evidence that UK medical students achieve a common standard on graduation. A national licensing exam is therefore a viable option for benchmarking the performance of all UK undergraduate medical students. PMID:26520472

  16. 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

  17. Overseas Chinese students in the UK: patterns and correlates of their use of Western and traditional Chinese medicine.

    PubMed

    Bishop, Felicity L; Lim, Chiw Yeh; Leydon, Geraldine M; Lewith, George T

    2009-02-01

    We explored the correlates of use of TCM and WM by ethnic Chinese students in the UK. A questionnaire assessed key theoretical determinants of health services use. One hundred and seventy ethnic Chinese participants (international students at one university in the South of England) completed this questionnaire (presented in English and Chinese) assessing their demographic characteristics, health status, attitudes towards and use of TCM and WM. Participants were more likely to use WM than TCM when they were in the UK. Different variables predicted use of WM and TCM. The statistical predictors (demographic characteristics, health status, past behaviour, attitudes) explained modest but important proportions of the variance in use of WM (37%) and TCM (29%). In conclusion, this small exploratory study suggests a need for further research on the health care utilisation of this growing body of international students. Improved language support is needed for international students in UK health care settings.

  18. 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

  19. 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

  20. 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

  1. Fair access to medicine? Retrospective analysis of UK medical schools application data 2009-2012 using three measures of socioeconomic status.

    PubMed

    Steven, Kathryn; Dowell, Jon; Jackson, Cathy; Guthrie, Bruce

    2016-01-13

    Medical students have historically largely come from more affluent parts of society, leading many countries to seek to broaden access to medical careers on the grounds of social justice and the perceived benefits of greater workforce diversity. The aim of this study was to examine variation in socioeconomic status (SES) of applicants to study medicine and applicants with an accepted offer from a medical school, comparing the four UK countries and individual medical schools. Retrospective analysis of application data for 22 UK medical schools 2009/10-2011/12. Data were analysed for all 32,964 UK-domiciled applicants aged <20 years to 22 non-graduate medical schools requiring applicants to sit the United Kingdom Clinical Aptitude Test (UKCAT). Rates of applicants and accepted offers were compared using three measures of SES: (1) Postcode-assigned Index of Multiple Deprivation score (IMD); (2) School type; (3) Parental occupation measured by the National Statistics Socio Economic Classification (NS-SEC). There is a marked social gradient of applicants and applicants with accepted offers with, depending on UK country of residence, 19.7-34.5% of applicants living in the most affluent tenth of postcodes vs 1.8-5.7% in the least affluent tenth. However, the majority of applicants in all postcodes had parents in the highest SES occupational group (NS-SEC1). Applicants resident in the most deprived postcodes, with parents from lower SES occupational groups (NS-SEC4/5) and attending non-selective state schools were less likely to obtain an accepted offer of a place at medical school further steepening the observed social gradient. Medical schools varied significantly in the percentage of individuals from NS-SEC 4/5 applying (2.3%-8.4%) and gaining an accepted offer (1.2%-7.7%). Regardless of the measure, those from less affluent backgrounds are less likely to apply and less likely to gain an accepted offer to study medicine. Postcode-based measures such as IMD may be

  2. 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.

  3. Continuous monitoring of carbon dioxide, methane and carbon monoxide west of London, UK: use of long term records and isotopes to identify changes in source emissions in the regional and local atmosphere

    NASA Astrophysics Data System (ADS)

    Fisher, R.; Lowry, D.; Sriskantharajah, S.; Nisbet, E.

    2003-04-01

    The Royal Holloway atmospheric laboratory measures CH4, CO2 and CO continuously, and δ 13C of methane is also measured in spot samples, all to high precision and accuracy. The records date back to 1995 for CH4, 1996 for CO and 1999 for CO2. The collection site is on a campus rooftop, at Egham, on the first hill west of London. This allows sampling both of relatively clean background air from the SW and London air from the east. During still anticyclonal events, gentle daytime SW winds are often replaced by nocturnal easterlies from the urban heat island. Overall, in the past 2-3 years the major pollution events appear to have been less marked than in previous years: this may be meteorological accident (i.e. more wet windy Atlantic-type weather; less anticyclonic and Eurasian air), but may also record improvement in urban air quality. For example, the annual averaged CO concentration recorded at the Egham site dropped from 580 ppb for 1997 to 380 ppb for 2001. The yearly concentration of methane has also decreased since the records began from 2032ppb in 1996 to 1995ppb in 2001. On a daily time scale, by using CH4 emissions as a relative constant the effects of meteorological variability can be removed from the dataset and the periods of excess CO2 and CO calculated. These correspond closely with rush hour traffic periods with minimum excess at 04:00 GMT. Deviations from normal abundance ratios between CO2, CO and CH4 identify distinct emission traits in each gas. High precision isotopic analysis of methane in air samples allows changing source emissions to be identified. The methane record has been compared with the Atlantic background CH4 concentrations and δ 13C recorded at Mace Head. The methane concentration in air arriving at Royal Holloway from the SW is commonly 25-30 ppb greater than at Mace Head and there is a small enrichment in δ 13C (0-0.2 permil). During anticyclonic events the isotopes of CH4 and CO2 can be used to identify local sources and the

  4. A survey of UK dental health professionals using a medicines information service: what questions do they ask and do they get useful answers?

    PubMed

    McEntee, J E; Henderson, S L; Rutter, P M; Rutter, J; Davis, H J; Randall, C J

    2011-07-08

    Dentists prescribe a limited range of medicines but it is important that they consider the effects of all medicines their patients are taking when providing dental care. In the UK, a national medicines information (UKMi) service funded by the National Health Service is available to advise health professionals on prescribing and to support evidence-based practice. This paper presents the results of a survey of 151 dental health professionals who contacted the UKMi service for advice. Enquiries most commonly involved antibiotics (32%), but dental health professionals also asked for advice on legal issues relating to medicines (10%), and on managing patients receiving bisphosphonates (9%), local anaesthetics (6%) and antiplatelet drugs (5%). One hundred and forty-six (97%) enquirers used the advice provided: for managing current patients, planning the care of future patients, for continuing professional development and teaching others. Two thirds of enquirers used the information provided to check if current or proposed management was appropriate, one half to change therapy and over one quarter to identify, manage or avoid adverse effects or drug interactions.

  5. How a Regional Broker Can Improve Industry Demand for University Interaction: A Case Study of the London Technology Network

    ERIC Educational Resources Information Center

    Reid, Peter; Schofield, Matt

    2006-01-01

    UK university research produces highly cited publications (DTI, 2004), but demand from UK business for commercial ideas from academia is weak (HM Treasury, 2003). This paper reviews factors in the development of one regional UK technology broker, the London Technology Network (LTN), which has achieved significant and audited business demand. The…

  6. Aspirin in the 21st century-common mechanisms of disease and their modulation by aspirin: a report from the 2015 scientific conference of the international aspirin foundation, 28 August, London, UK.

    PubMed

    Smith, Tom; Hutchison, Pippa; Schrör, Karsten; Clària, Joan; Lanas, Angel; Patrignani, Paola; Chan, Andrew T; Din, Farhat; Langley, Ruth; Elwood, Peter; Freedman, Andrew; Eccles, Ron

    2015-01-01

    Professor Peter Rothwell of Oxford University chaired the annual Scientific Conference of the International Aspirin Foundation in London on 28 August 2015. It took the form of four sessions. Aspirin has more than one action in its effects on disease. Its acetylation of cyclooxygenase 2 (COX-2) in platelets leads to the blockade of pro-inflammatory chemicals and generation of anti-inflammatory mediators and increase in nitrous oxide (NO) production, which helps to preserve arterial endothelium. But platelets are not its only target. There is now evidence that aspirin has a direct antitumour effect on intestinal mucosal cells that block their potential transformation into cancer cells. Randomised placebo-controlled trials (RCTs) in people with histories of colorectal neoplasia have shown that aspirin reduces the risk of recurrent adenomas and reduces long-term cancer incidence in patients with Lynch syndrome. Among women given aspirin for cardiovascular disease, there were fewer cancers than in those given placebo. Epidemiological evidence has suggested that aspirin treatment after cancer is diagnosed reduces the incidence of metastases and prolongs survival, and long-term studies of anticancer treatment with aspirin are under way to confirm this. Apart from cancer studies, aspirin use is now firmly established as treatment for antiphospholipid syndrome (Hughes syndrome) and is being used to prevent and treat the heightened risk of cardiovascular disease in diabetes mellitus and in patients with HIV.

  7. Regulatory Consequences of "Brexit" for the Development of Medicinal Products.

    PubMed

    Jackson, E L; Feldschreiber, P; Breckenridge, A

    2017-08-01

    The United Kingdom voted in a referendum in June 2016 to leave the European Union (EU) after 45 years of membership. Among the many political, social, and scientific consequences are those for the regulation of health care products. No longer will the efficacy, safety, and quality of medicines in the United Kingdom be subject to an EU regulatory framework. The European Medicines Agency (EMA), which is currently located in London, will move elsewhere in Europe. The pharmaceutical industry will reassess its commitment to the UK health scene. © 2017, ASCPT.

  8. Language Shift and Vitality Perceptions amongst London's Second-Generation Bangladeshis

    ERIC Educational Resources Information Center

    Rasinger, Sebastian M.

    2013-01-01

    With more than 64,500 members, the Bangladeshi community in London is one of the largest in the UK. Originating from a wave of immigration during the 1970s, a considerable part of the community now consists of a second, UK-born generation. This explorative study seeks to address, first, the extent of the intergenerational language shift from…

  9. 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.

  10. Synergy between medicinal chemistry and biological research.

    PubMed

    Moncada, Salvador; Coaker, Hannah

    2014-09-01

    Salvador Moncada studied medicine at the University of El Salvador (El Salvador) before coming to the UK in 1971 to work on a PhD with Professor John Vane at the Institute of Basic Medical Sciences, Royal College of Surgeons (UK). After a short period of research at the University of Honduras (Honduras), he joined the Wellcome Research Laboratories (UK) where he became Head of the Department of Prostaglandin Research and later, Director of Research. He returned to academic life in 1996 as founder and director of the Wolfson Institute for Biomedical Research at University College London (UK). Moncada played a role in the discovery of the mechanism of action of aspirin-like drugs and later led the teams which discover prostacyclin and identified nitric oxide as a biological mediator. In his role as a Director of Research of the Wellcome Laboratories, he oversaw the discovery and development of medicines for epilepsy, migraine, malaria and cancer. Currently, he is working on the regulation of cell proliferation as Director of the Institute of Cancer Sciences at the University of Manchester (UK). Moncada has won numerous awards from the international scientific community and in 2010, he received a knighthood from Her Majesty Queen Elizabeth II for his services to science.

  11. "Every morning before you open the door you have to watch for that brown envelope": complexities and challenges of undertaking oral history with Ethiopian forced migrants in London, UK.

    PubMed

    Palmer, David

    2010-01-01

    The experience, "voice," and perceptions of the "individual refugee" is conspicuous by its virtual absence from academic research. The few studies dealing with black adn minority ethnic experiences from an emic perspective in relation to mental health do not specifically refer to refugees or asylum seekers. This article explores the use of oral history techniques when researching Ethiopian forced migrants in the U.K. Based on two pilot research projects which explored Ethiopian culture and experience in reference to mental health adn well-being, it will focus on some of the complexities and challenges encountered. This article acknowledges the need for an understanding of cultural traditions as well as history and experience when planning and implementing such research as this proved to be an essential part of the research process, ensuring that individual stories and truths were allowed to evolve. The oral history approach for this research therefore ensured that the experiential knowledge of the Ethiopian forced migrant participants was given space, authenticity, and validity.

  12. Ethics and pharmaceutical medicine -- the full report of the Ethical Issues Committee of the Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the UK.

    PubMed

    Bickerstaffe, R; Brock, P; Husson, J-M; Rubin, I; Bragman, K; Paterson, K; Sommerville, A

    2006-02-01

    The practice of pharmaceutical medicine brings with it ethical challenges and dilemmas often very different from those encountered in the practice of clinical medicine. Having established a framework of guiding ethical principles, this report aims to look in some detail at specific areas of possible ethical concern to pharmaceutical physicians, offering practical advice and guidance on good practice. The report covers issues related to pharmaceutical research, including dissemination of research findings, communication with other health professionals and patients and involvement of pharmaceutical physicians and companies in the provision of patient services. The primacy of the interests of patients and the wider public is emphasised, and the possible impact of new developments in pharmaceutical technology is explored. It is hoped that the report will help those working in pharmaceutical medicine and act as a stimulus for wider discussion and debate.

  13. The use of biomedicine, complementary and alternative medicine, and ethnomedicine for the treatment of epilepsy among people of South Asian origin in the UK

    PubMed Central

    Rhodes, Penny J; Small, Neil; Ismail, Hanif; Wright, John P

    2008-01-01

    Background Studies have shown that a significant proportion of people with epilepsy use complementary and alternative medicine (CAM). CAM use is known to vary between different ethnic groups and cultural contexts; however, little attention has been devoted to inter-ethnic differences within the UK population. We studied the use of biomedicine, complementary and alternative medicine, and ethnomedicine in a sample of people with epilepsy of South Asian origin living in the north of England. Methods Interviews were conducted with 30 people of South Asian origin and 16 carers drawn from a sampling frame of patients over 18 years old with epilepsy, compiled from epilepsy registers and hospital databases. All interviews were tape-recorded, translated if required and transcribed. A framework approach was adopted to analyse the data. Results All those interviewed were taking conventional anti-epileptic drugs. Most had also sought help from traditional South Asian practitioners, but only two people had tried conventional CAM. Decisions to consult a traditional healer were taken by families rather than by individuals with epilepsy. Those who made the decision to consult a traditional healer were usually older family members and their motivations and perceptions of safety and efficacy often differed from those of the recipients of the treatment. No-one had discussed the use of traditional therapies with their doctor. The patterns observed in the UK mirrored those reported among people with epilepsy in India and Pakistan. Conclusion The health care-seeking behaviour of study participants, although mainly confined within the ethnomedicine sector, shared much in common with that of people who use global CAM. The appeal of traditional therapies lay in their religious and moral legitimacy within the South Asian community, especially to the older generation who were disproportionately influential in the determination of treatment choices. As a second generation made up of people of

  14. 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.

  15. Survey of prioritizing/triaging of appointments in genitourinary medicine clinics in the UK: a British Co-operative Clinical Group survey.

    PubMed

    Alawattegama, A B; Rajamanoharan, S; Maw, R; Carne, C A

    2006-04-01

    A questionnaire was circulated to all lead genitourinary (GU) medicine physicians in the UK in November 2003 to obtain data on access, waiting times and triaging. Of the 143 responders, 92.3% departments had limited access to some or all GU medicine clinics. Where access was limited, 5.3% had no identifiable process in place to see urgent patients. The mean waiting times in clinics with an open appointment system only for a routine female and male appointment were 2.9 weeks and 2.8 weeks (range 2 days-10 weeks), respectively, and for an urgent appointment, two days (range same day-14 days), for both sexes. The survey has raised concerns that a number of departments did not consider as urgent for prioritizing, patients with documented untreated gonorrhoea, syphilis, or HIV, or contacts of patients with these conditions. This survey has highlighted a need for the national specialist society to provide guidance on prioritizing patients where access is limited.

  16. The Cambridge Bachelor of Medicine (MB)/Doctor of Philosophy (PhD): graduate outcomes of the first MB/PhD programme in the UK.

    PubMed

    Cox, Timothy M; Brimicombe, James; Wood, Diana F; Peters, D Keith

    2012-12-01

    We reviewed outcomes of the Cambridge Bachelor of Medicine (MB)/Doctor of Philosophy (PhD) programme for the period 1989-2010. Of the 90 alumni contacted, 80 (89%; 24 women) completed an anonymous questionnaire. Thirty were academic staff and 35 were in general professional (core) or higher medical training. Of the latter, 11 were specialty registrars, six were academic clinical fellows and three held academic foundation year posts. Eight alumni were overseas, including five in North America. Most (95%) respondents considered that their academic career goals were facilitated by the programme. Sixty-eight of the 80 alumni had conducted further research, 63 (79%) were active in research, and 90% had explicit plans for further full-time research. Twelve graduates had further substantive research support (six clinician scientist awards and three senior fellowships) and two were Wellcome Trust postdoctoral MB/PhD fellows. Alumni included two full university professors, one reader, six senior lecturers, two assistant professors and nine university clinical lecturers. MB/PhD programmes offer an alternative training pathway for clinician-scientists in UK medical schools: the Cambridge programme promotes scientific discovery and sustained academic development within the context of contemporary medicine and clinical practice.

  17. 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,…

  18. 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,…

  19. 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…

  20. Opinions and attitudes of the UK's GDPs and specialists in oral surgery, oral medicine and surgical dentistry on oral cancer screening.

    PubMed

    Kujan, O; Duxbury, A J; Glenny, A M; Thakker, N S; Sloan, P

    2006-03-01

    To survey two broad areas of oral cancer awareness and management of patients at risk of oral cancer by specialists in oral surgery, oral medicine, surgical dentistry and general dental practitioners (GDPs) in the UK. The first of these included knowledge and awareness of aetiological factors, changing patterns of disease, and screening/detection programmes including their effectiveness. The second included oral cancer detection methods, advice on avoidance of high-risk activity and self-examination, and referral pattern of GDPs. A pretested, 44-item questionnaire, a covering letter, a brief outline of the research protocol and return, stamped envelope were mailed in March 2003. A sample of 200 GDPs whose names were obtained from the General Dental Council's main list and 305 dental specialist names obtained from specialist's list in surgical dentistry, oral medicine and oral surgery were selected randomly. Information on oral cancer awareness and practice, screening practice and education was obtained. The response rate was 66.9%. The knowledge of the dental specialists was consistent with that in reports of current aetiological studies on oral cancer. However there were gaps in the GDP's knowledge and ascertainment of oral cancer risk factors. Over 70% of the dental specialists provided counselling advice on the risks of tobacco and alcohol habits compared with 41.2% of GDPs. More GDPs (52.4%) than specialists (35.4%) believed that oral cancer screening on a national basis would be effective in decreasing the mortality of oral cancer. Over 95% of all respondents used a visual examination for oral cancer screening and 89.9% of all respondents strongly believed that visual screening is effective in the early detection of oral cancer. The results showed that GDPs had knowledge gaps in their awareness of oral cancer risk factors and the application of preventive measures. Most dental health providers in the UK perform visual screening of the oral mucosa for their

  1. 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.

  2. A practical approach to Events Medicine provision.

    PubMed

    Smith, Susan P; Cosgrove, Joseph F; Driscoll, Peter J; Smith, Andrew; Butler, John; Goode, Peter; Waldmann, Carl; Vallis, Christopher J; Topham, Fiona; Mythen, Michael Monty

    2016-09-09

    In the past three decades, mass casualty incidents have occurred worldwide at multiple sporting events and other mass gatherings. Organisational safety and healthcare provision can consequently be scrutinised post-event. Within the UK, such incidents in the 1980s provided incentives to improve medical services and subsequent high profile UK-based international sporting events (London Olympics and Paralympics 2012, Glasgow Commonwealth Games 2014, Rugby World Cup 2015) added a further catalyst for developing services. Furthermore in the aftermath of the abandoned France versus Germany association football match at the Stade de France (Paris Terrorist Attacks, November 2015) and the 2016 UK report from HM Coroner on the Hillsborough Inquest, medical cover at sporting events is being further reviewed. Doctors providing spectator cover therefore need to have an awareness of their likely roles at sporting venues. Formal guidance exists in many countries for the provision of such cover but remains generic even though Events Medicine is increasingly recognised as a necessary service. The current evidence base is limited with best practice examples often anecdotally cited by acute care specialists (eg, emergency medicine) who provide cover. This article is therefore intended to present an overview for doctors of the knowledge and skills required to treat ill and injured spectators and enable them to adequately risk-assess venues in cooperation with other health and safety providers, including preparation for a major incident. It also gives guidance on how activity can be adequately assessed and how doctors can have management roles in Events Medicine.

  3. Biomarkers research in Europe: focus on personalized medicine.

    PubMed

    Metodiev, Metodi V

    2011-09-01

    The sixth annual European Biomarkers Summit took place in London, UK, on 18-19 May 2011. It was part of a larger event, organized by Select Biosciences, with meetings on molecular diagnostics, single cell analysis and theranostics for personalized medicine. The Biomarkers Summit featured 17 invited talks from academics and industry researchers, a number of poster presentations and exhibitions from several companies marketing biomarker-related technologies and consumables. The focus was broad, covering various aspects of biomarker discovery, qualification, and applications, and a variety of diseases including cancer, neurodegenerative conditions and infectious diseases. Gene-based, as well as protein-based, platforms for biomarkers identification and analysis were discussed.

  4. The role of the Faculty of Public Health (Medicine) in developing a multidisciplinary public health profession in the UK.

    PubMed

    Griffiths, Sian; Crown, June; McEwen, Jim

    2007-06-01

    The Faculty of Public Health (FPH) started out its life as the Faculty of Community Medicine. Its initial membership was drawn from the ranks of Medical Officers of Health (MOsH), medical administrators and consultants working in communicable disease. Born under the aegis of the three Royal Colleges of Physicians, it was de facto for members of the medical profession. This was despite the intention of some of the prime movers in its creation that its membership should reflect the multidisciplinary nature of specialist public health. As such, whilst the Faculty's establishment was indeed a triumph, the triumph was only partial, since many senior public health professionals were precluded from full membership. Over the years this situation has changed, but the road to the Faculty's current open policy, based on achieving public health excellence rather than holding a professional badge, has not been a smooth one. The fears of many medical members that the specialty would be down graded through opening up its membership posed successive presidents with many, often justifiable, challenges. In this article we, former presidents, reflect on the key events during our successive tenures.

  5. 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.

  6. Commercialization of regenerative medicine: learning from spin-outs.

    PubMed

    French, Anna; Buckler, R Lee; Brindley, David A

    2013-04-01

    Abstract The meeting "Commercialization of Your Regenerative Medicine Research: Lessons from Spin Out Successes" was hosted by the Oxbridge Biotech Roundtable (OBR) (Oxford, UK) at the University of Oxford in February, 2013, and attracted a multi-stakeholder audience spanning academia and industry. The event featured case studies from Gregg Sando, CEO, Cell Medica (London, UK), John Sinden, CSO, Reneuron (Guilford, UK), and Paul Kemp, CEO and CSO, Intercytex (Manchester, UK). OBR is a student-led initiative with over 7000 members across eight different UK and US locations with a mission to foster a conversation about the healthcare and life sciences industry. Here we review the main themes of the meeting and the major questions facing the regenerative medicine industry and its rapidly emerging subsets of cellular and gene therapies. Notably, we discuss the compatibility of regenerative therapies to the existing healthcare infrastructure, biomanufacturing challenges (including scalability and comparability), and the amenability of regenerative therapies to existing reimbursement and investment models. Furthermore, we reiterate key words of advice from seasoned industry leaders intended to accelerate the translation path from lab bench to the marketplace.

  7. 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.

  8. Lipoedema: the first UK patient survey.

    PubMed

    Evans, Suzanne

    2013-04-01

    Lipoedema UK was founded in 2012 by women with lipoedema and clinicians working in the Lymphoedema Service at St George's Hospital in London. Its patron is Professor Peter Mortimer, the UK's leading Lipoedema expert, and its nurse consultant is Sandy Ellis, who diagnoses and treats many women with Lipoedema in the UK and is also the nurse consultant in the St George's team. The charity's objectives are to educate doctors, health professionals and the public about lipoedema and its symptoms, so it may be diagnosed and treated earlier.

  9. Evidence Europe 2017. London, UK - February 22-23, 2017.

    PubMed

    Kibble, A

    2017-03-01

    As the political backdrop changes in both the U.S. and Europe, volatility in the pharma industry is beginning to be felt as the sector becomes sensitive to the uncertainty. U.S. President Trump has stated he will pursue an agenda against high U.S. drug prices and is expected to seek to repeal the Affordable Care Act, while in Europe, Brexit casts further unknowns in regulatory authorization procedures, trade and external reference pricing. With these factors in mind, Terrapin's Evidence Europe meeting provided for a very topical discussion on the use of evidence to define and communicate value in healthcare. With a particular focus on real-world evidence, the conference used presentations, panel briefings and roundtable discussions to foster debate on the challenges faced by industry as it negotiates the current fragile environment. Copyright 2017 Clarivate Analytics.

  10. 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.

  11. 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.

  12. 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 ...

  13. Chance UK

    ERIC Educational Resources Information Center

    McGrath, Gracia

    2003-01-01

    Chance UK is a unique charity in the UK that specialises in mentoring programmes for primary schoolchildren with behavioural problems. It was founded in 1995 by a policeman, Chief Superintendent Paul Mathias, who believed that by stepping in early, young children with behavioural difficulties could be given the chance to develop the necessary…

  14. 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

  15. Analyzing the Roles, Activities, and Skills of Learning Technologists: A Case Study from City University London

    ERIC Educational Resources Information Center

    Fox, Olivia; Sumner, Neal

    2014-01-01

    This article reports on a case study carried out at City University London into the role of learning technologists. The article examines how the role developed by providing points of comparison with a report on the career development of learning technology staff in UK universities in 2001. This case study identified that learning technologists…

  16. Teachers' Experiences of Autonomy in Continuing Professional Development: Teacher Learning Communities in London and Hong Kong

    ERIC Educational Resources Information Center

    Hargreaves, Eleanore; Berry, Rita; Lai, Y. C.; Leung, Pamela; Scott, David; Stobart, Gordon

    2013-01-01

    This paper examines teachers' experiences of autonomy as they undertook Continuing Professional Development (CPD) in the form of Teacher Learning Communities (TLCs) to develop Assessment for Learning (AfL). Participant teacher interview data were used from two parallel TLC projects, one in Hong Kong and one in London, UK. Autonomy was defined in…

  17. Analyzing the Roles, Activities, and Skills of Learning Technologists: A Case Study from City University London

    ERIC Educational Resources Information Center

    Fox, Olivia; Sumner, Neal

    2014-01-01

    This article reports on a case study carried out at City University London into the role of learning technologists. The article examines how the role developed by providing points of comparison with a report on the career development of learning technology staff in UK universities in 2001. This case study identified that learning technologists…

  18. Teachers' Experiences of Autonomy in Continuing Professional Development: Teacher Learning Communities in London and Hong Kong

    ERIC Educational Resources Information Center

    Hargreaves, Eleanore; Berry, Rita; Lai, Y. C.; Leung, Pamela; Scott, David; Stobart, Gordon

    2013-01-01

    This paper examines teachers' experiences of autonomy as they undertook Continuing Professional Development (CPD) in the form of Teacher Learning Communities (TLCs) to develop Assessment for Learning (AfL). Participant teacher interview data were used from two parallel TLC projects, one in Hong Kong and one in London, UK. Autonomy was defined in…

  19. The Wrong Side of the Tracks: Starting School in a Socially Disadvantaged London Borough

    ERIC Educational Resources Information Center

    Alsford, Elizabeth; Ralephata, Andrew; Bolderson, Sarah; Curtin, Martina; Parish, Esther; Klaber, Victoria; Griffin, Sue; Nash, Lisa; Cullen, Rachel; Musoke, Brenda; Bhalla, Sangheeta; Walker, Lindsay; Duffer, Luisa; O'Sullivan, Sylvia; Knowland, Victoria; Cozens, Suzanne; McLaren, Lindsey; Camilleri, Bernard; Halil, Suzan; Furze, Rachael; Leung, Wai; O'Gorman, Ciara; Carver, Verity; Young, Dorothy; Pring, Tim

    2017-01-01

    Substantial evidence exists that social circumstances can affect children's language development. As a result many children in socially deprived areas start school with delayed language, which may persist and adversely affect their attainment. We assessed the language of children in seven reception classes in a London (UK) borough and followed the…

  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. 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

  2. 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.

  3. Resilience of Andean urban ethnobotanies: a comparison of medicinal plant use among Bolivian and Peruvian migrants in the United Kingdom and in their countries of origin.

    PubMed

    Ceuterick, Melissa; Vandebroek, Ina; Pieroni, Andrea

    2011-06-14

    Analysing why and how ethnobotanical traditions 'survive' is important for a better understanding of migrants' health care behaviour. This study investigates the use of traditional medicinal plants among first generation migrants from Bolivia and Peru in London, in relation to practices among their peers in their respective home countries in order to assess changes in traditional health care among newcomer communities. A total of 98 semi-structured interviews were conducted in London (UK), Cochabamba (Bolivia) and Lima (Peru). Voucher specimens of all reported species were collected and identified. By comparing data on active plant uses and their applications, overlap and differences between health care practices before and after migration could be outlined. In London, people can rely on more biomedical alternatives and have access to less traditional herbal remedies as compared to their countries of origin. In general, Peruvians and Bolivians in London continued to use traditional medicine for common, self-limiting ailments that were also widespread in their countries of origin. The same widely used (either readily available cosmopolitan or culturally relevant) plant species appeared in the post-migration group. In general, less freshly available medicinal species were used in London and more edible, primary food species were consumed for medicinal purposes after migration. Bolivian and Peruvian migrants in London clearly proved to be resilient in their use of home-remedies when faced with the changes that come with migration. The observed ethnobotanical coping strategies are characterised by: (1) the preservation of culturally salient species (cultural key stone species); (2) a positive influence of the presence of cultural diversity (cultural edge effect), (3) a creative blending of different kinds of knowledge and resources, noticeable in an increased use of dried, processed alternatives and food species; and (4) a reliance on social networks for the exchange

  4. Standardised versus individualised multiherb Chinese herbal medicine for oligomenorrhoea and amenorrhoea in polycystic ovary syndrome: a randomised feasibility and pilot study in the UK

    PubMed Central

    Flower, Andrew; Prescott, Philip; Wing, Trevor; Moore, Michael; Lewith, George

    2017-01-01

    Objectives To explore feasibility of a randomised study using standardised or individualised multiherb Chinese herbal medicine (CHM) for oligomenorrhoea and amenorrhoea in women with polycystic ovary syndrome (PCOS), to pilot study methods and to obtain clinical data to support sample size calculations. Design Prospective, pragmatic, randomised feasibility and pilot study with participant and practitioner blinding. Setting 2 private herbal practices in the UK. Participants 40 women diagnosed with PCOS and oligomenorrhoea or amenorrhoea following Rotterdam criteria. Intervention 6 months of either standardised CHM or individualised CHM, 16 g daily taken orally as a tea. Main outcome measures Our primary objective was to determine whether oligomenorrhoea and amenorrhoea were appropriate as the primary outcome measures for the main study. Estimates of treatment effects were obtained for menstrual rate, body mass index (BMI), weight and hirsutism. Data were collected regarding safety, feasibility and acceptability. Results Of the 40 participants recruited, 29 (72.5%) completed the study. The most frequently cited symptoms of concern were hirsutism, weight and menstrual irregularity. Statistically significant improvements in menstrual rates were found at 6 months within group for both standardised CHM (mean difference (MD) 0.18±0.06, 95% CI 0.06 to 0.29; p=0.0027) and individualised CHM (MD 0.27±0.06, 95% CI 0.15 to 0.39; p<0.001), though not between group (p=0.26). No improvements were observed for BMI nor for weight in either group. Improvements in hirsutism scores found within group for both groups were not statistically significant between group (p=0.09). Liver and kidney function and adverse events data were largely normal. Participant feedback suggests changing to tablet administration could facilitate adherence. Conclusions A CHM randomised controlled trial for PCOS is feasible and preliminary data suggest that both individualised and standardised

  5. 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…

  6. 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

  7. 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)

  8. Veterinary medicines: product update.

    PubMed

    2014-04-05

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  9. Veterinary medicines: product update.

    PubMed

    2014-03-01

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  10. Veterinary medicines: product update.

    PubMed

    2014-08-02

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  11. Veterinary medicines: product update.

    PubMed

    2014-11-01

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  12. Veterinary medicines: product update.

    PubMed

    2014-09-06

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK, and on other relevant issues.

  13. Veterinary medicines update.

    PubMed

    2017-03-11

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues.

  14. 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

    roadside monitoring sites was higher than at urban background locations. In the PM10 samples this increased oxidative activity appeared to be associated with increased concentrations of copper (Cu), barium (Ba), and bathophenanthroline disulfonate-mobilized iron (BPS Fe) in the roadside samples. In the PM2.5 samples, no simple association could be seen, suggesting that other unmeasured components were driving the increased oxidative potential in this fraction of the roadside samples. These data suggest that two components were contributing to the oxidative potential of roadside PM, namely Cu and BPS Fe in the coarse fraction of PM (PM with an aerodynamic diameter of 2.5 microm to 10 microm; PM(2.5-10)) and an unidentified redox catalyst in PM2.5. The data derived for this baseline study confirmed key observations from a more limited spatial mapping exercise published in our earlier HEI report on the introduction of the London's Congestion Charging Scheme (CCS) in 2003 (Kelly et al. 2011a,b). In addition, the data set in the current report provided robust baseline information on the oxidative potential and metal content of PM found in the London airshed in the period before implementation of the LEZ; the finding that a proportion of the oxidative potential appears in the PM coarse mode and is apparently related to brake wear raises important issues regarding the nature of traffic management schemes. The final goal of this baseline study was to establish the feasibility, in ethical and operational terms, of using the U.K.'s electronic primary-care records to evaluate the effects of the LEZ on human health outcomes. Data on consultations and prescriptions were compiled from a pilot group of general practices (13 distributed across London, with 100,000 patients; 29 situated in the inner London Borough of Lambeth, with 200,000 patients). Ethics approvals were obtained to link individual primary-care records to modeled NOx concentrations by means of post-codes. (To preserve

  15. Incremental validity of WISC-IV(UK) factor index scores with a referred Irish sample: predicting performance on the WIAT-II(UK.).

    PubMed

    Canivez, Gary L; Watkins, Marley W; James, Trevor; Good, Rebecca; James, Kate

    2014-12-01

    Subtest and factor scores have typically provided little incremental predictive validity beyond the omnibus IQ score. This study examined the incremental validity of Wechsler Intelligence Scale for Children - Fourth UK Edition (WISC-IV(UK) ; Wechsler, 2004a, Wechsler Intelligence Scale for Children - Fourth UK Edition, Harcourt Assessment, London, UK) and factor index scores in predicting academic achievement on the Wechsler Individual Achievement Test - Second UK Edition (WIAT-II(UK) ; Wechsler, 2005a, Wechsler Individual Achievement Test-Second UK Edition, Pearson, London, UK), beyond that predicted by the WISC-IV(UK) FSIQ. The sample included 1,014 Irish children (ages 6-0 to 16-9) who were referred for evaluation of learning difficulties. Hierarchical multiple regression analyses were used with the WISC-IV(UK) FSIQ (Block 1) and factor index scores (Block 2) as predictors and WIAT-II(UK) subtest and composite scores as dependent variables. The WISC-IV(UK) FSIQ accounted for statistically significant and generally large portions of WIAT-II(UK) subtest and composite score variance. WISC-IV(UK) factor index scores combined to provide statistically significant increments in prediction of most WIAT-II(UK) subtest and composite scores over and above the FSIQ; however, the effect sizes were mostly small as previously observed (i.e., Canivez, 2013a, Psychol. Assess., 25, 484; Glutting et al., 2006, J. Spec. Educ., 40, 103; Nelson et al., 2013, Psychol. Assess., 25, 618). Individually, the WISC-IV(UK) factor index scores provided small unique contributions to predicting WIAT-II(UK) scores. This, in combination with studies of apportioned variance from bifactor confirmatory factor analysis (Watkins et al., 2013, Int. J. Sch. Educ. Psychol., 1, 102), indicated that the WISC-IV(UK) FSIQ should retain the greatest weight in WISC-IV(UK) interpretation. © 2014 The British Psychological Society.

  16. Commentary: Clinical skills teaching in UK medical education as exemplified by the BM5 curriculum, Faculty of Medicine, University of Southampton

    PubMed Central

    Timm, Anja; Polack, Clare

    2016-01-01

    This commentary seeks to enable comparisons about clinical skills teaching in Germany and the UK. It outlines the British regulatory environment and its impact on programme design. Through the example of the University of Southampton we show how clinical skills teaching is integrated both vertically and horizontally. PMID:27579351

  17. Sport and exercise medicine and the Olympic health legacy

    PubMed Central

    2012-01-01

    London 2012 is the first Olympic and Paralympic Games to explicitly try and develop socioeconomic legacies for which success indicators are specified - the highest profile of which was to deliver a health legacy by getting two million more people more active by 2012. This editorial highlights how specialists in Sport and Exercise Medicine can contribute towards increasing physical activity participation in the UK, as well as how the National Centre for Sport and Exercise Medicine might be a useful vehicle for delivering an Olympic health legacy. Key challenges are also discussed such as acquisition of funding to support new physical activity initiatives, appropriate allocation of resources, and how to assess the impact of legacy initiatives. PMID:22813079

  18. Medicinal Cannabis in California: An Interview with Igor Grant, MD.

    PubMed

    Piomelli, Daniele; Grant, Igor

    2016-01-01

    Dr. Igor Grant, MD, is distinguished professor and chair of psychiatry and director of the HIV Neurobehavioral Research Program and the Center for Medicinal Cannabis Research at the University of California, San Diego. Dr. Grant is a neuropsychiatrist who graduated from the University of British Columbia School of Medicine (1966), and received specialty training in psychiatry at the University of Pennsylvania (1967-1971), and additional training in neurology at the Institute of Neurology (1980-1981), London, U.K. Dr. Grant's academic interests focus on the effects of various diseases on brain and behavior, with an emphasis on translational studies in HIV, and drugs of abuse. He has contributed to ∼700 scholarly publications and is principal investigator of several NIH studies, including an NIDA P50 (Translational Methamphetamine AIDS Research Center-TMARC), and is codirector of the HIV Neurobehavioral Research Center (HNRC).

  19. Quantum Electronics in the UK. A National-Survey Conference.

    DTIC Science & Technology

    1985-10-30

    RD-RI61 623 QUANTUN ELECTRONICS IN THE UK A NTIONL-SURVEY v CONFERENCE(U) OFFICE OF NAVAL RESEARCH LONDON ( ENGLAND ) UNCLSSIIEDP ROMAN 39 OCT 85...IDENTIFICATION NUMBER ORGANiZATION (if applicable) 8( ADDRE SS (City, State, and ZIP Code) 10 SOURCE OF FUNDING NUMBERS PROGRAM PROJECT TASK IWORK UNIT ...ELEMENT NO INO NO ACCESSION NO ’I TITLE (Include Security Classification) Quantum Electronics in the UK : A National-Survey Conference 12 PERSONAL AL.1

  20. 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.

  1. Construct Validity of the Wechsler Intelligence Scale for Children-Fourth UK Edition with a Referred Irish Sample: Wechsler and Cattell-Horn-Carroll Model Comparisons with 15 Subtests

    ERIC Educational Resources Information Center

    Canivez, Gary L.; Watkins, Marley W.; Good, Rebecca; James, Kate; James, Trevor

    2017-01-01

    Background: Irish educational psychologists frequently use the Wechsler Intelligence Scale for Children-Fourth UK Edition (WISC-IV[superscript UK]; Wechsler, 2004, Wechsler Intelligence Scale for Children-Fourth UK Edition, London, UK, Harcourt Assessment) in clinical assessments of children with learning difficulties. Unfortunately, reliability…

  2. 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).

  3. Assessment for Learning and Teacher Learning Communities: UK Teachers' Experiences

    ERIC Educational Resources Information Center

    Hargreaves, Eleanore

    2013-01-01

    In this paper, I explore the experiences of secondary teachers in four London schools [UK] who participated in Teacher Learning Communities, defined as meetings in which professional learning was supported as they learned about Assessment for Learning (AfL). The claim for these communities is that they lead to sustained improvements in teaching…

  4. Assessment for Learning and Teacher Learning Communities: UK Teachers' Experiences

    ERIC Educational Resources Information Center

    Hargreaves, Eleanore

    2013-01-01

    In this paper, I explore the experiences of secondary teachers in four London schools [UK] who participated in Teacher Learning Communities, defined as meetings in which professional learning was supported as they learned about Assessment for Learning (AfL). The claim for these communities is that they lead to sustained improvements in teaching…

  5. A roof over your head; house price peaks in the UK and Ireland

    NASA Astrophysics Data System (ADS)

    Richmond, Peter

    2007-02-01

    We analyse, following recent work of Roehner, changes in house prices for both the UK and Ireland. We conclude that prices in the UK/London have reached a tipping point and relative to inflation are set to fall over the next few years. House prices (again relative to inflation) in Ireland are shown to have broken away from the more moderate rises found in the provinces of mainland UK, and Dublin seems to have emerged as another global ‘hot’ spot. An evolution similar to that in London can be anticipated.

  6. 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.

  7. The UK pharmaceutical market. An overview.

    PubMed

    Towse, A

    1996-01-01

    The National Health Service (NHS) accounts for more than 98% of the UK prescription medicines market, which is the sixth largest pharmaceutical market in the world. Most of this market is driven by the UK's approximately 35,000 general practitioners (GPs). It is an open market, with most leading foreign pharmaceutical companies having a strong presence. While the growth rate of this market has been decelerating, it remains one of the fastest growing components of NHS expenditure. The NHS does not operate any kind of national reimbursement list, but the UK government has adopted several means to keep medicines expenditure under control. These include cash incentives and constraints for GPs relating to expenditure on medicines, individual quarterly updates on GP prescribing, the publication of a list of medicines that cannot be prescribed by GPs, the switching of some prescription-only medicines to over-the-counter medicines, and a co-payment system. The main form of economic regulation in the UK, however, remains the Pharmaceutical Price Regulation Scheme (PPRS). This limits the rate-of-return on capital attributable to medicines sales to the NHS, with the intended rate-of-return being equal to that of UK industry overall. The pharmaceutical industry has generally performed relatively well in the UK market, managing to preserve incentives to innovation. This reflects the fact that UK GPs have been able to maintain their clinical freedom, as well as government recognition of the economic contribution made by the pharmaceutical industry. Current issues of interest in the UK pharmaceutical market context include the future of the PPRS, the debates over the imposition of a national formulary and generic substitution, and over parallel trade, the potential impact of managed-care protocols and computer-based prescribing on pharmaceutical expenditures, and possible political changes.

  8. Why Research--What Research Should Be Done?: Report of a Collaborative Workshop in the UK to Discuss Social Research Priorities on Visual Impairment

    ERIC Educational Resources Information Center

    Brace, Michael; Herriotts, Paul; Mccullagh, Angela; Nzegwu, Femi

    2007-01-01

    This article reports on a workshop held in London UK in November 2006 to discuss future research priorities in the visual impairment sector in the UK. The workshop was held under the auspices of the VISION 2020 UK Social Research Group, a collaborative group of charitable partners who commission social research in the sector. The broad purpose of…

  9. The Practitioner Health Programme: a free and confidential health service for doctors and dentists in London

    PubMed Central

    2008-01-01

    This article describes a free and confidential service available to doctors and dentists living or working in the London area and who are suffering from mental health, addiction or physical health concerns that may be affecting their work. The service is led by an experienced general practitioner and includes free and timely access to specialist services. The service will begin to accept referrals from October 2008. Please consult the web site for details: www.php.nhs.uk PMID:25949562

  10. 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…

  11. 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.…

  12. 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…

  13. 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.

  14. 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.

  15. CONSORT item reporting quality in the top ten ranked journals of critical care medicine in 2011: a retrospective analysis.

    PubMed

    Stevanovic, Ana; Schmitz, Sabine; Rossaint, Rolf; Schürholz, Tobias; Coburn, Mark

    2015-01-01

    Reporting randomised controlled trials is a key element in order to disseminate research findings. The CONSORT statement was introduced to improve the reporting quality. We assessed the adherence to the CONSORT statement of randomised controlled trials published 2011 in the top ten ranked journals of critical care medicine (ISI Web of Knowledge 2011, Thomson Reuters, London UK). Design. We performed a retrospective cross sectional data analysis. Setting. This study was executed at the University Hospital of RWTH, Aachen. Participants. We selected the following top ten listed journals according to ISI Web of Knowledge (Thomson Reuters, London, UK) critical care medicine ranking in the year 2011: American Journal of Respiratory and Critical Care Medicine, Critical Care Medicine, Intensive Care Medicine, CHEST, Critical Care, Journal of Neurotrauma, Resuscitation, Pediatric Critical Care Medicine, Shock and Minerva Anestesiologica. Main outcome measures. We screened the online table of contents of each included journal, to identify the randomised controlled trials. The adherence to the items of the CONSORT Checklist in each trial was evaluated. Additionally we correlated the citation frequency of the articles and the impact factor of the respective journal with the amount of reported items per trial. We analysed 119 randomised controlled trials and found, 15 years after the implementation of the CONSORT statement, that a median of 61,1% of the checklist-items were reported. Only 55.5% of the articles were identified as randomised trials in their titles. The citation frequency of the trials correlated significantly (rs = 0,433; p<0,001 and r = 0,331; p<0,001) to the CONSORT statement adherence. The impact factor showed also a significant correlation to the CONSORT adherence (r = 0,386; p<0,001). The reporting quality of randomised controlled trials in the field of critical care medicine remains poor and needs considerable improvement.

  16. CONSORT Item Reporting Quality in the Top Ten Ranked Journals of Critical Care Medicine in 2011: A Retrospective Analysis

    PubMed Central

    Rossaint, Rolf; Schürholz, Tobias; Coburn, Mark

    2015-01-01

    Introduction Reporting randomised controlled trials is a key element in order to disseminate research findings. The CONSORT statement was introduced to improve the reporting quality. We assessed the adherence to the CONSORT statement of randomised controlled trials published 2011 in the top ten ranked journals of critical care medicine (ISI Web of Knowledge 2011, Thomson Reuters, London UK). Methods Design. We performed a retrospective cross sectional data analysis. Setting. This study was executed at the University Hospital of RWTH, Aachen. Participants. We selected the following top ten listed journals according to ISI Web of Knowledge (Thomson Reuters, London, UK) critical care medicine ranking in the year 2011: American Journal of Respiratory and Critical Care Medicine, Critical Care Medicine, Intensive Care Medicine, CHEST, Critical Care, Journal of Neurotrauma, Resuscitation, Pediatric Critical Care Medicine, Shock and Minerva Anestesiologica. Main outcome measures. We screened the online table of contents of each included journal, to identify the randomised controlled trials. The adherence to the items of the CONSORT Checklist in each trial was evaluated. Additionally we correlated the citation frequency of the articles and the impact factor of the respective journal with the amount of reported items per trial. Results We analysed 119 randomised controlled trials and found, 15 years after the implementation of the CONSORT statement, that a median of 61,1% of the checklist-items were reported. Only 55.5% of the articles were identified as randomised trials in their titles. The citation frequency of the trials correlated significantly (rs = 0,433; p<0,001 and r = 0,331; p<0,001) to the CONSORT statement adherence. The impact factor showed also a significant correlation to the CONSORT adherence (r = 0,386; p<0,001). Conclusion The reporting quality of randomised controlled trials in the field of critical care medicine remains poor and needs considerable

  17. Herald waves of cholera in nineteenth century London.

    PubMed

    Tien, Joseph H; Poinar, Hendrik N; Fisman, David N; Earn, David J D

    2011-05-06

    Deaths from cholera in London, UK, were recorded weekly from 1824 to 1901. Three features of the time series stand out: (i) cholera deaths were strongly seasonal, with peak mortality almost always in the summer, (ii) the only non-summer outbreaks occurred in the spring of 1832, the autumn of 1848 and the winter of 1853, and (iii) extraordinarily severe summer outbreaks occurred in 1832, 1849, 1854 and 1866 (the four 'great' cholera years). The non-summer outbreaks of 1832, 1848 and 1853 appear to have been herald waves of newly invading cholera strains. In addition, a simple mathematical model confirms that a non-summer introduction of a new cholera strain can result in an initial herald wave, followed by a severe outbreak the following summer. Through the analysis of the genomes of nineteenth-century specimens, it may be possible to identify the strains that caused these herald waves and the well-known cholera epidemics that followed.

  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.

    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

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. Attitudes to and knowledge about elderly people: a comparative analysis of students of medicine, English and Computer Science and their teachers.

    PubMed

    Edwards, M J; Aldous, I R

    1996-05-01

    Attitudes to and knowledge about elderly people were assessed in 1091 students and lecturers from the London Hospital Medical College (LHMC), London, UK and the English and Computer Science departments of Queen Mary and Westfield College (QMW), London, UK. General knowledge about elderly people was measured by the Palmore 'Facts about Aging Quiz 1'. Attitudes towards elderly people were measured by the Rosencranz and McNevin Semantic Differential scale. A higher level of knowledge about elderly people was found both in medical students and in medical lecturers compared to their counterparts in the English and Computer Science departments (P < 0.001). The cross-sectional data indicated that medical students developed a significantly increasing knowledge about elderly people as they progressed through their training, in contrast to students of English and Computer Science. Scores on the Rosencranz & McNevin scale indicated that attitudes towards elderly people across all three groups of students and lecturers were similar. The scores obtained for all groups indicated that they held approximately neutral attitudes towards elderly people. A significant correlation (P < 0.001) was found between high levels of knowledge about elderly people, and positive attitudes towards them. The necessity of interventions to improve general attitudes towards and knowledge of elderly people among medical students is questioned. It is suggested that future research should look beyond surveys of general attitudes towards elderly people for the causes of the current lack of interest in geriatric medicine.

  5. An RAS Specialist Meeting, London, 14 October 2005: "Science from La Palma - Looking Beyond 2009"

    NASA Astrophysics Data System (ADS)

    Lennon, D.; Evans, C.; Drew, J.

    2005-12-01

    In 2009 the international agreement setting up the Roque de los Muchachos Observatory on the island of La Palma will have been in existence for a period of 30 years. In 2007 the United Kingdom will have to make a decision on whether or not to withdraw from that agreement and PPARC, through its ownership of the Isaac Newton Group of Telescopes, has the responsibility of deciding on the UK's involvement in the observatory beyond 2009. As part of the decision making process, and in support of the UK's overall strategic re-evaluation in astronomy, the ING was reviewed during 2005. It was therefore thought timely to assess recent scientific achievements from the Roque de los Muchachos, and to consider what role the observatory might have beyond 2009. Under the auspices of the Royal Astronomical Society a Specialist Meeting was held in Burlington House, Piccadilly, London on October 14th 2005 and was attended by approximately 100 astronomers from around the UK.

  6. Geological Society of London Issues Statement on Climate Change

    NASA Astrophysics Data System (ADS)

    Summerhayes, Colin

    2011-02-01

    On 1 November the Geological Society of London (GSL) published a statement (http://www.geolsoc.org.uk/gsl/site//GSL//lang/en/climatechange) about the geological evidence relating to past climates, atmospheric carbon levels, and their interrelationships. The online version also carries a list of recommendations for further reading. The GSL's Geoscientist magazine (http://www.geolsoc.org.uk/gsl/site/GSL/lang/en/page8578.html) reported Bryan Lovell, GSL president, as saying, “Climate change is a defining issue of our time, whose full understanding needs geology's long perspective. Earth scientists can read…the geological record of changes in climate that occurred long before we were around to light so much as a camp fire, let alone burn coal, gas and oil. A dramatic global warming event 55 million years ago gives us a particularly clear indication of what happens when there is a sudden release of 1500 billion tonnes of carbon into Earth's atmosphere. It gets hot, the seas become more acid, and there is widespread extinction of life. We are a third of the way to repeating that ancient natural input of carbon through our own agency. The message from the rocks is that it would be a good idea to stop pulling that carbon trigger.”

  7. Cord blood banking in London: the first 1000 collections.

    PubMed

    Armitage, S; Warwick, R; Fehily, D; Navarrete, C; Contreras, M

    1999-07-01

    The London Cord Blood Bank was established with the aim of collecting, processing and storing 10000 unrelated stem cell donations for the significant number of children in the UK requiring transplantation, for whom a matched unrelated bone marrow donor cannot be found. Collection is performed at two hospitals by dedicated cord blood bank staff after delivery of the placenta. Mothers are interviewed regarding medical, ethnic and behavioural history by nurse counsellors and sign a detailed consent form. Donations are returned to the bank for processing. Volume reduction is undertaken by a simple, closed, semi-automated blood processing system, with excellent recovery of progenitor cells. Units are cryopreserved and stored in the vapour phase of liquid nitrogen. Blood samples from mothers and cord blood donations are tested for the UK mandatory red cell and microbiology markers for blood donors. Donations are typed for HLA-A, B and DR at medium resolution (antigen split) level using sequence-specific oligonucleotide probing and sequence-specific priming techniques. The selection of collection hospitals on the basis of ethnic mix has proven effective, with 41.5% of donations derived from non-European caucasoid donors. Bacterial contamination of collections has been dramatically reduced by implementation of improved umbilical cord decontamination protocols.

  8. 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

  9. Why is U.K. medicine no longer a self-regulating profession? The role of scandals involving "bad apple" doctors.

    PubMed

    Dixon-Woods, Mary; Yeung, Karen; Bosk, Charles L

    2011-11-01

    This article identifies the role played by a series of medical scandals in the U.K., occurring from the mid-1990s onwards, in ending a collegial model of self-regulation of the medical profession that had endured for 150 years. The state's original motive in endorsing professional self-regulation was to resolve the principal-agent problem inherent in the doctor-patient relationship. The profession, in return for its self-regulating privileges, undertook to act as a reliable guarantor for the competence and conduct of each of its members. Though sufficient to ensure that most doctors were "good", the collegial model adopted by the profession left it fatally vulnerable to the problem of "bad apples": those unwilling, incapable or indifferent to delivering on their professional commitments and who betrayed the trust of both patients and peers. Weak administrative systems in the NHS failed to compensate for the defects of the collegium in controlling these individuals. The scandals both provoked and legitimised erosion of the profession's self-regulatory power. Though its vulnerability to bad apples had been present since the founding of the 19th century profession, it was the convergence of social and political conditions at a particular historical moment that transformed the scandals into an unstoppable imperative for reform. Huge public anger, the voice permitted to a coalition of critics, shifts in social attitudes, the opportunity presented for imposing standards for accountability, and the increasing ascendancy of pro-interventionist managerialist and political agendas from the early 1990s onwards were all implicated in the response made to scandals and the shape the reforms took. Scandals need to be understood not as simple determinants of change, but as one performative element in a constellation of socially contingent forces and contexts. The new rebalancing of the "countervailing powers" has dislodged the profession as the senior partner in the regulation of

  10. Integrated Cancer System: a perspective on developing an integrated system for cancer services in London

    PubMed Central

    Haire, K; Burton, C; Park, R; Reynolds, J; Stewart, D

    2012-01-01

    This article explores the potential for integrated cancer systems to improve the quality of care and deliver cost efficiencies and improve outcomes for cancer patients. Currently, patients in the UK still have poorer survival rates than comparable countries such as Canada, Sweden, Norway and Australia. Improving the quality of cancer services is a key policy objective and cancer is a priority outcome measure in both the NHS and Public Health Outcomes Framework. Evidence suggests that better integrated delivery has the potential to improve the quality and reduce the cost of healthcare, and ultimately improve health outcomes. One of the key themes from the Model of Care for Cancer Services1 was that cancer services should be commissioned along pathways and that provider networks should be established to deliver care. London has two integrated cancer systems; one covering north central and east London (London Cancer) and the other covering west and south London (London Cancer Alliance). There a number of areas in cancer care that the current model of service provision has failed to adequately address and which have the potential to improve significantly though implementation of integrated services. These include improving early diagnosis, reducing inequalities in access to treatment and outcomes and maximising research and training across the system. Important drivers for the integration of cancer services are strong clinical leadership, shared informatics systems, focusing on quality of services and improving patient experience. Emerging needs of integrated cancer in London are around strengthening the involvement of primary care, public health and the third sector; working to develop sufficient capacity and expertise in primary care and collaborating more closely with commissioners to develop integrated systems. PMID:25949664

  11. Spatially resolved flux measurements of NOx from London suggest significantly higher emissions than predicted by inventories.

    PubMed

    Vaughan, Adam R; Lee, James D; Misztal, Pawel K; Metzger, Stefan; Shaw, Marvin D; Lewis, Alastair C; Purvis, Ruth M; Carslaw, David C; Goldstein, Allen H; Hewitt, C Nicholas; Davison, Brian; Beevers, Sean D; Karl, Thomas G

    2016-07-18

    To date, direct validation of city-wide emissions inventories for air pollutants has been difficult or impossible. However, recent technological innovations now allow direct measurement of pollutant fluxes from cities, for comparison with emissions inventories, which are themselves commonly used for prediction of current and future air quality and to help guide abatement strategies. Fluxes of NOx were measured using the eddy-covariance technique from an aircraft flying at low altitude over London. The highest fluxes were observed over central London, with lower fluxes measured in suburban areas. A footprint model was used to estimate the spatial area from which the measured emissions occurred. This allowed comparison of the flux measurements to the UK's National Atmospheric Emissions Inventory (NAEI) for NOx, with scaling factors used to account for the actual time of day, day of week and month of year of the measurement. The comparison suggests significant underestimation of NOx emissions in London by the NAEI, mainly due to its under-representation of real world road traffic emissions. A comparison was also carried out with an enhanced version of the inventory using real world driving emission factors and road measurement data taken from the London Atmospheric Emissions Inventory (LAEI). The measurement to inventory agreement was substantially improved using the enhanced version, showing the importance of fully accounting for road traffic, which is the dominant NOx emission source in London. In central London there was still an underestimation by the inventory of 30-40% compared with flux measurements, suggesting significant improvements are still required in the NOx emissions inventory.

  12. Comparability: manufacturing, characterization and controls, report of a UK Regenerative Medicine Platform Pluripotent Stem Cell Platform Workshop, Trinity Hall, Cambridge, 14–15 September 2015

    PubMed Central

    Williams, David J; Archer, Richard; Archibald, Peter; Bantounas, Ioannis; Baptista, Ricardo; Barker, Roger; Barry, Jacqueline; Bietrix, Florence; Blair, Nicholas; Braybrook, Julian; Campbell, Jonathan; Canham, Maurice; Chandra, Amit; Foldes, Gabor; Gilmanshin, Rudy; Girard, Mathilde; Gorjup, Erwin; Hewitt, Zöe; Hourd, Paul; Hyllner, Johan; Jesson, Helen; Kee, Jasmin; Kerby, Julie; Kotsopoulou, Nina; Kowalski, Stanley; Leidel, Chris; Marshall, Damian; Masi, Louis; McCall, Mark; McCann, Conor; Medcalf, Nicholas; Moore, Harry; Ozawa, Hiroki; Pan, David; Parmar, Malin; Plant, Anne L; Reinwald, Yvonne; Sebastian, Sujith; Stacey, Glyn; Thomas, Robert J; Thomas, Dave; Thurman-Newell, Jamie; Turner, Marc; Vitillo, Loriana; Wall, Ivan; Wilson, Alison; Wolfrum, Jacqueline; Yang, Ying; Zimmerman, Heiko

    2016-01-01

    This paper summarizes the proceedings of a workshop held at Trinity Hall, Cambridge to discuss comparability and includes additional information and references to related information added subsequently to the workshop. Comparability is the need to demonstrate equivalence of product after a process change; a recent publication states that this ‘may be difficult for cell-based medicinal products’. Therefore a well-managed change process is required which needs access to good science and regulatory advice and developers are encouraged to seek help early. The workshop shared current thinking and best practice and allowed the definition of key research questions. The intent of this report is to summarize the key issues and the consensus reached on each of these by the expert delegates. PMID:27404768

  13. Comparability: manufacturing, characterization and controls, report of a UK Regenerative Medicine Platform Pluripotent Stem Cell Platform Workshop, Trinity Hall, Cambridge, 14-15 September 2015.

    PubMed

    Williams, David J; Archer, Richard; Archibald, Peter; Bantounas, Ioannis; Baptista, Ricardo; Barker, Roger; Barry, Jacqueline; Bietrix, Florence; Blair, Nicholas; Braybrook, Julian; Campbell, Jonathan; Canham, Maurice; Chandra, Amit; Foldes, Gabor; Gilmanshin, Rudy; Girard, Mathilde; Gorjup, Erwin; Hewitt, Zöe; Hourd, Paul; Hyllner, Johan; Jesson, Helen; Kee, Jasmin; Kerby, Julie; Kotsopoulou, Nina; Kowalski, Stanley; Leidel, Chris; Marshall, Damian; Masi, Louis; McCall, Mark; McCann, Conor; Medcalf, Nicholas; Moore, Harry; Ozawa, Hiroki; Pan, David; Parmar, Malin; Plant, Anne L; Reinwald, Yvonne; Sebastian, Sujith; Stacey, Glyn; Thomas, Robert J; Thomas, Dave; Thurman-Newell, Jamie; Turner, Marc; Vitillo, Loriana; Wall, Ivan; Wilson, Alison; Wolfrum, Jacqueline; Yang, Ying; Zimmerman, Heiko

    2016-07-01

    This paper summarizes the proceedings of a workshop held at Trinity Hall, Cambridge to discuss comparability and includes additional information and references to related information added subsequently to the workshop. Comparability is the need to demonstrate equivalence of product after a process change; a recent publication states that this 'may be difficult for cell-based medicinal products'. Therefore a well-managed change process is required which needs access to good science and regulatory advice and developers are encouraged to seek help early. The workshop shared current thinking and best practice and allowed the definition of key research questions. The intent of this report is to summarize the key issues and the consensus reached on each of these by the expert delegates.

  14. Physical activity in deprived communities in London: examining individual and neighbourhood-level factors.

    PubMed

    Watts, Paul; Phillips, Gemma; Petticrew, Mark; Hayes, Richard; Bottomley, Christian; Yu, Ge; Schmidt, Elena; Tobi, Patrick; Moore, Derek; Frostick, Caroline; Lock, Karen; Renton, Adrian

    2013-01-01

    The objectives of this study were to examine relationships between neighbourhood-level and individual-level characteristics and physical activity in deprived London neighbourhoods. In 40 of the most deprived neighbourhoods in London (ranked in top 11% in London by Index of Multiple Deprivation) a cross-sectional survey (n = 4107 adults aged > = 16 years), neighbourhood audit tool, GIS measures and routine data measured neighbourhood and individual-level characteristics. The binary outcome was meeting the minimum recommended (CMO, UK) 5 × 30 mins moderate physical activity per week. Multilevel modelling was used to examine associations between physical activity and individual and neighbourhood-level characteristics. Respondents living more than 300 m away from accessible greenspace had lower odds of achieving recommended physical activity levels than those who lived within 300 m; from 301-600 m (OR = 0.7; 95% CI 0.5-0.9) and from 601-900 m (OR = 0.6; 95% CI 0.4-0.8). There was substantial residual between-neighbourhood variance in physical activity (median odds ratio = 1.7). Other objectively measured neighbourhood-level characteristics were not associated with physical activity levels. Distance to nearest greenspace is associated with meeting recommended physical activity levels in deprived London neighbourhoods. Despite residual variance in physical activity levels between neighbourhoods, we found little evidence for the influence of other measured neighbourhood-level characteristics.

  15. Mind the gap: financial London and the regional class pay gap.

    PubMed

    Friedman, Sam; Laurison, Daniel

    2017-09-01

    The hidden barriers, or 'gender pay gap', preventing women from earning equivalent incomes to men is well documented. Yet recent research has uncovered that, in Britain, there is also a comparable class-origin pay gap in higher professional and managerial occupations. So far this analysis has only been conducted at the national level and it is not known whether there are regional differences within the UK. This paper uses pooled data from the 2014 and 2015 Labour Force Survey (N = 7,534) to stage a more spatially sensitive analysis that examines regional variation in the class pay gap. We find that this 'class ceiling' is not evenly spatially distributed. Instead it is particularly marked in Central London, where those in high-status occupations who are from working-class backgrounds earn, on average, £10,660 less per year than those whose parents were in higher professional and managerial employment. Finally, we inspect the Capital further to reveal that the class pay gap is largest within Central London's banking and finance sector. Challenging policy conceptions of London as the 'engine room' of social mobility, these findings suggest that class disadvantage within high-status occupations is particularly acute in the Capital. The findings also underline the value of investigating regional differences in social mobility, and demonstrate how such analysis can unravel important and previously unrecognized spatial dimensions of class inequality. © London School of Economics and Political Science 2017.

  16. The Influence of Green Infrastructure on Urban Resilience in Greater London

    NASA Astrophysics Data System (ADS)

    Oh, Yukyung

    2017-04-01

    High population densities and diverse economic activities in urban areas create social issues as well as a range of environmental impacts including air pollution, soil contamination, loss of biodiversity and health problems (Alberti et al., 2003; Dobbs, Escobedo, & Zipperer, 2011; Grimm et al., 2008). The concept of urban resilience has been used for increasing the capacity of the entities and players to adapt to rapid changes, and urban green spaces play a crucial role in increasing urban resilience. Greater London has a good case for increasing urban green spaces and resilience under the London Plan. The relevance of urban open spaces and several socioeconomic indicators would provide researchers and policy makers with the information for managing green coverage. The correlation analysis of two quantitative data such as open space and socioeconomic data of Greater London was conducted with SPSS. The data for open spaces in Greater London was gained through Greenspace Information for Greater London. The data was converted from vector to raster in Geographic Information System (GIS), so as to calculate landscape metrics for open spaces in Greater London through a spatial pattern analysis program, FRAGSTATS 4.2. The socioeconomic data was obtained from "London Borough Profile", London Datastore. In addition, data on total carbon emissions from Industry and Commercial, Domestic, Transport, LULUCF Net Emissions, and per capita emissions were gained from UK local authority and regional carbon dioxide emissions national statistics: 2005-2014 released from Department of Energy and Climate Change. The indicators from open spaces are total area of open space and patch density or contagion of open spaces. The latter indicator allows to figure out the level of fragmentation of open spaces. The socioeconomic indicators cover number of jobs by workplace, jobs density, crime rates per thousand population, and several wellbeing indicators such as life satisfaction

  17. Heavens Open Up for UK Astronomers

    NASA Astrophysics Data System (ADS)

    2002-07-01

    A significant milestone for British and European science occurred today (July 8, 2002) when the Council of the European Southern Observatory (ESO) met in London. At this historical meeting, the United Kingdom was formally welcomed into ESO by the nine other member states. The UK, one of the leading nations in astronomical research, now joins one of the world's major astronomical organisations. UK astronomers will now be able to use the four 8.2-metre and several 1.8-metre telescopes that comprise the Very Large Telescope (VLT) facility located at the Paranal Observatory in the northern part of the Atacama desert in Chile, as well as two 4-m class telescopes and several smaller ones at the ESO La Silla Observatory further south. The UK will also benefit from increased involvement in the design and construction of the Atacama Large Millimetre Array (ALMA), a network of 64 twelve-metre telescopes also sited in Chile, and play a defining role in ESO's 100-metre Overwhelmingly Large Telescope (OWL). Sir Martin Rees , The Astronomer Royal, said, "Joining ESO is good for UK science, and I think good for Europe as well. It offers us access to the VLT's 8-m class telescopes and restores the UK's full competitiveness in optical astronomy. We're now guaranteed full involvement in ALMA and in the next generation of giant optical instruments - projects that will be at the forefront of the research in the next decade and beyond. Moreover, our commitment to ESO should enhance its chances of forging ahead of the US in these technically challenging and high profile scientific projects. UK membership of ESO is a significant and welcome outcome of this government's increasing investment in science". Prof. Ian Halliday , Chief Executive of the Particle Physics and Astronomy Research Council (PPARC), the UK's strategic science investment agency said, "The United Kingdom already participates in Europe's flagship particle physics research and the space science research programmes through

  18. Environmental health impacts: occurrence, exposure and significance, Lancaster University, UK, 9-10 September 2003.

    PubMed

    Martin, Francis L; Semple, Kirk T

    2004-09-01

    Speakers: John Ashby (Syngenta CTL, UK), Peter A. Behnisch (Eurofins GfA, Germany), Paul L. Carmichael (Unilever Colworth, UK), Curtis C.Harris (National Cancer Institute, USA), Kevin C. Jones (Lancaster University, UK), Andreas Kortenkamp (School of Pharmacy, London, UK), Caroline J. Langdon (Reading University, UK), Anthony M. Lynch (GlaxoSmithKline, UK), Francis L. Martin (Lancaster University, UK), Trevor J. McMillan (Lancaster University, UK), David H. Phillips (Institute of Cancer Research, UK), Huw J. Ricketts (University of Cardiff, UK), Michael N. Routledge (University of Leeds, UK), J. Thomas Sanderson (Utrecht University, The Netherlands) and Kirk T. Semple (Lancaster University, UK) The effects of many environmental exposures to either single contaminants or to mixtures still remain to be properly assessed in ecotoxicological and human toxicological settings. Such assessments need to be carried out using relevant biological assays. On a mechanistic basis, future studies need to be able to extrapolate exposure to disease risk. It is envisaged that such an approach would lead to the development of appropriate strategies to either reduce exposures or to initiate preventative measures in susceptible individuals or populations. To mark the opening of a new Institute, the Lancaster Environmental Centre, an environmental health workshop was held over 2 days (9-10 September 2003) at Lancaster University, UK. The fate, behaviour and movement of chemicals in the environment, together with environmental exposures and human health, biomarkers of such exposures, hormone-like compounds and appropriate genetic toxicology methodologies, were discussed.

  19. Experiences of non-UK-qualified doctors working within the UK regulatory framework: a qualitative study

    PubMed Central

    Slowther, A; Lewando Hundt, GA; Purkis, J; Taylor, R

    2012-01-01

    Objective To explore the experience of non-UK-qualified doctors in working within the regulatory framework of the General Medical Council (GMC) document Good Medical Practice. Design Individual interviews and focus groups. Setting United Kingdom. Participants Non-UK-qualified doctors who had registered with the GMC between 1 April 2006 and 31 March 2008, doctors attending training/induction programmes for non-UK-qualified doctors, and key informants involved in training and support for non-UK-qualified doctors. Main outcome measures Themes identified from analysis of interview and focus group transcripts. Results Information and support for non-UK qualified doctors who apply to register to work in the UK has little reference to the ethical and professional standards required of doctors working in the UK. Recognition of the ethical, legal and cultural context of UK healthcare occurs once doctors are working in practice. Non-UK qualified doctors reported clear differences in the ethical and legal framework for practising medicine between the UK and their country of qualification, particularly in the model of the doctor–patient relationship. The degree of support for non-UK-qualified doctors in dealing with ethical concerns is related to the type of post they work in. European doctors describe similar difficulties with working in an unfamiliar regulatory framework to their non-European colleagues. Conclusions Non-UK-qualified doctors experience a number of difficulties related to practising within a different ethical and professional regulatory framework. Provision of information and educational resources before registration, together with in-practice support would help to develop a more effective understanding of GMP and its implications for practice in the UK. PMID:22408082

  20. Women from Africa living with HIV in London: a descriptive study.

    PubMed

    Anderson, J; Doyal, L

    2004-01-01

    There are no studies that have examined the particular needs and experiences of African women living with HIV in the UK at a time when they represent an increasingly large proportion of the UK HIV epidemic. This study explores the illness biographies and daily lives of HIV-positive African women receiving treatment in London. Sixty-two women from 11 African countries attending HIV specialist clinics in five London hospitals participated in self-completion questionnaires and in depth semi-structured interviews. Using a narrative approach, women were asked to talk about their HIV status in the broader context of their life history. Important differences exist within this group based mainly on nationality, income, education level and legal status in the UK. However, marked similarities also emerged which were related in part to their situation as migrants and were compounded by their illness. Stigma, both actual and perceived, had a profound impact on women's lives, making control of information about their situation a matter of acute concern. This had an effect on how women accessed health services and voluntary sector agencies. The resilience of women in dealing with difficulties in their lives was strengthened by religious belief. Such similarities and differences need to be properly understood by health and social care professionals if they are to offer the most appropriate care for this growing population of patients.

  1. Proceedings of the Seventh International Conference on Educational Data Mining (EDM) (7th, London, United Kingdom, July 4-7, 2014)

    ERIC Educational Resources Information Center

    Stamper, John, Ed.; Pardos, Zachary, Ed.; Mavrikis, Manolis, Ed.; McLaren, Bruce M., Ed.

    2014-01-01

    The 7th International Conference on Education Data Mining held on July 4th-7th, 2014, at the Institute of Education, London, UK is the leading international forum for high-quality research that mines large data sets in order to answer educational research questions that shed light on the learning process. These data sets may come from the traces…

  2. 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.

  3. Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

    PubMed Central

    Viney, Rowena; Needleman, Sarah; Griffin, Ann

    2016-01-01

    Objectives Explore trainee doctors’ experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Design Qualitative semistructured focus group and interview study. Setting Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. Participants 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad. Results Most trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work–life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising. Conclusions BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on

  4. Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study.

    PubMed

    Woolf, Katherine; Rich, Antonia; Viney, Rowena; Needleman, Sarah; Griffin, Ann

    2016-11-25

    Explore trainee doctors' experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Qualitative semistructured focus group and interview study. Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad. Most trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work-life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising. BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on trainee-trainer relationships at work and organisational changes to

  5. Social and economic hardship among people living with HIV in London.

    PubMed

    Ibrahim, F; Anderson, J; Bukutu, C; Elford, J

    2008-10-01

    To examine the social and economic circumstances of people living with HIV in London. Between June 2004 and June 2005, 1687 people living with HIV (73% response) receiving treatment and care in north-east London National Health Service out-patient clinics completed a confidential, self-administered questionnaire. The questionnaire sought information on employment, income, education, residency status in the UK and housing. In total, 1604 respondents were included in the analysis: Black African heterosexual women (n=480) and men (224); White (646) and ethnic minority (i.e. non-White) homosexual men (112); White heterosexual men (64) and women (39); and Black Caribbean heterosexual women (26) and men (13). Black African heterosexual men and women consistently reported more difficulties than any other group in relation to employment, income, housing and residency status. Half the Black African heterosexual men (46.8%) and women (51.2%) reported insecure residency status in the UK, significantly more than any other group (P<0.001). Just under half the respondents (46.6%) were employed at the time of the survey; Black African heterosexual women (35.3%) and men (45.4%) were less likely to be employed than White (57.6%) or ethnic minority (53.7%) homosexual men (P<0.001). Forty per cent of Black African heterosexual men and women, 22.9% of ethnic minority homosexual men and 9.6% of White homosexual men did not have enough money to cover their basic needs (P<0.001). In this study of people living with HIV in London, a substantial number faced social and economic hardship, particularly Black African and other ethnic minority respondents. Our findings provide further evidence that in London HIV is associated with poverty, particularly among migrant and ethnic minority populations.

  6. 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.

  7. Multiple large clusters of tuberculosis in London: a cross-sectional analysis of molecular and spatial data.

    PubMed

    Smith, Catherine M; Maguire, Helen; Anderson, Charlotte; Macdonald, Neil; Hayward, Andrew C

    2017-01-01

    Large outbreaks of tuberculosis (TB) represent a particular threat to disease control because they reflect multiple instances of active transmission. The extent to which long chains of transmission contribute to high TB incidence in London is unknown. We aimed to estimate the contribution of large clusters to the burden of TB in London and identify risk factors. We identified TB patients resident in London notified between 2010 and 2014, and used 24-locus mycobacterial interspersed repetitive units-variable number tandem repeat strain typing data to classify cases according to molecular cluster size. We used spatial scan statistics to test for spatial clustering and analysed risk factors through multinomial logistic regression. TB isolates from 7458 patients were included in the analysis. There were 20 large molecular clusters (with n>20 cases), comprising 795 (11%) of all cases; 18 (90%) large clusters exhibited significant spatial clustering. Cases in large clusters were more likely to be UK born (adjusted odds ratio 2.93, 95% CI 2.28-3.77), of black-Caribbean ethnicity (adjusted odds ratio 3.64, 95% CI 2.23-5.94) and have multiple social risk factors (adjusted odds ratio 3.75, 95% CI 1.96-7.16). Large clusters of cases contribute substantially to the burden of TB in London. Targeting interventions such as screening in deprived areas and social risk groups, including those of black ethnicities and born in the UK, should be a priority for reducing transmission.

  8. Multiple large clusters of tuberculosis in London: a cross-sectional analysis of molecular and spatial data

    PubMed Central

    Maguire, Helen; Anderson, Charlotte; Macdonald, Neil; Hayward, Andrew C.

    2017-01-01

    Large outbreaks of tuberculosis (TB) represent a particular threat to disease control because they reflect multiple instances of active transmission. The extent to which long chains of transmission contribute to high TB incidence in London is unknown. We aimed to estimate the contribution of large clusters to the burden of TB in London and identify risk factors. We identified TB patients resident in London notified between 2010 and 2014, and used 24-locus mycobacterial interspersed repetitive units–variable number tandem repeat strain typing data to classify cases according to molecular cluster size. We used spatial scan statistics to test for spatial clustering and analysed risk factors through multinomial logistic regression. TB isolates from 7458 patients were included in the analysis. There were 20 large molecular clusters (with n>20 cases), comprising 795 (11%) of all cases; 18 (90%) large clusters exhibited significant spatial clustering. Cases in large clusters were more likely to be UK born (adjusted odds ratio 2.93, 95% CI 2.28–3.77), of black-Caribbean ethnicity (adjusted odds ratio 3.64, 95% CI 2.23–5.94) and have multiple social risk factors (adjusted odds ratio 3.75, 95% CI 1.96–7.16). Large clusters of cases contribute substantially to the burden of TB in London. Targeting interventions such as screening in deprived areas and social risk groups, including those of black ethnicities and born in the UK, should be a priority for reducing transmission. PMID:28149918

  9. How To: Preparing to Find a Job as a Spanish Teacher in the UK

    ERIC Educational Resources Information Center

    Talero, Gemma Carmen Belmonte

    2016-01-01

    This case study is about the design of the one-day course "How to find a job as a Spanish teacher in the UK," which is taught at the Instituto Cervantes in London. The course came to exist due to a large number of requests from Spaniards who have come to the UK in recent years--many of them wanting to find a job as a Spanish teacher--and…

  10. The ghost of Christmas past: health effects of poverty in London in 1896 and 1991.

    PubMed

    Dorling, D; Mitchell, R; Shaw, M; Orford, S; Smith, G D

    To compare the extent to which late 20th century patterns of mortality in London are predicted by contemporary patterns of poverty and by late 19th century patterns of poverty. To test the hypothesis that the pattern of mortality from causes known to be related to deprivation in early life can be better predicted by the distribution of poverty in the late 19th century than by that in the late 20th century. Data from Charles Booth's survey of inner London in 1896 were digitised and matched to contemporary local government wards. Ward level indices of relative poverty were derived from Booth's survey and the 1991 UK census of population. All deaths which took place within the surveyed area between 1991 and 1995 were identified and assigned to contemporary local government wards. Standardised mortality ratios for various causes of death were calculated for each ward for all ages, under age 65, and over age 65. Simple correlation and partial correlation analysis were used to estimate the contribution of the indices of poverty from 1896 and 1991 in predicting ward level mortality ratios in the early 1990s. Inner London. For many causes of death in London, measures of deprivation made around 1896 and 1991 both contributed strongly to predicting the current spatial distribution. Contemporary mortality from diseases which are known to be related to deprivation in early life (stomach cancer, stroke, lung cancer) is predicted more strongly by the distribution of poverty in 1896 than that in 1991. In addition, all cause mortality among people aged over 65 was slightly more strongly related to the geography of poverty in the late 19th century than to its contemporary distribution. Contemporary patterns of some diseases have their roots in the past. The fundamental relation between spatial patterns of social deprivation and spatial patterns of mortality is so robust that a century of change in inner London has failed to disrupt it.

  11. The Ghost of Christmas Past: health effects of poverty in London in 1896 and 1991

    PubMed Central

    Dorling, Danny; Mitchell, Richard; Shaw, Mary; Orford, Scott; Davey Smith, George

    2000-01-01

    Objectives To compare the extent to which late 20th century patterns of mortality in London are predicted by contemporary patterns of poverty and by late 19th century patterns of poverty. To test the hypothesis that the pattern of mortality from causes known to be related to deprivation in early life can be better predicted by the distribution of poverty in the late 19th century than by that in the late 20th century. Design Data from Charles Booth's survey of inner London in 1896 were digitised and matched to contemporary local government wards. Ward level indices of relative poverty were derived from Booth's survey and the 1991 UK census of population. All deaths which took place within the surveyed area between 1991 and 1995 were identified and assigned to contemporary local government wards. Standardised mortality ratios for various causes of death were calculated for each ward for all ages, under age 65, and over age 65. Simple correlation and partial correlation analysis were used to estimate the contribution of the indices of poverty from 1896 and 1991 in predicting ward level mortality ratios in the early 1990s. Setting Inner London. Results For many causes of death in London, measures of deprivation made around 1896 and 1991 both contributed strongly to predicting the current spatial distribution. Contemporary mortality from diseases which are known to be related to deprivation in early life (stomach cancer, stroke, lung cancer) is predicted more strongly by the distribution of poverty in 1896 than that in 1991. In addition, all cause mortality among people aged over 65 was slightly more strongly related to the geography of poverty in the late 19th century than to its contemporary distribution. Conclusions Contemporary patterns of some diseases have their roots in the past. The fundamental relation between spatial patterns of social deprivation and spatial patterns of mortality is so robust that a century of change in inner London has failed to disrupt it

  12. 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." 

  13. 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…

  14. 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…

  15. 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.

  16. 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)

  17. 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.

  18. 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.

  19. 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…

  20. 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…

  1. 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)

  2. 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.

  3. Survey of community pharmacists' perception of electronic cigarettes in London

    PubMed Central

    Marques Gomes, Ana C N; Nabhani-Gebara, Shereen; Kayyali, Reem; Buonocore, Federico; Calabrese, Gianpiero

    2016-01-01

    Objectives To seek community pharmacists' perception on use, safety and possible effectiveness of e-cigarettes as quit smoking tools, and their future regulation. Setting A survey of a sample of 154 community pharmacies across London, UK. Context E-cigarettes have exclusively established themselves in the market through consumers-led demand. To date, e-cigarettes still remain unregulated and can be easily purchased in shops, over the internet, but more controversially also in pharmacies in the UK. Pharmacists find themselves with a shortage of information on their safety and efficacy, and may experience an ethical dilemma when consulted by patients/customers. Key findings Response rate: 60% (n=92). Independent pharmacies accounted for 90% of the sample. The majority of participants (73%) sell e-cigarettes. A minority of participants (20%) have been presented with adverse effects such as cough and dry mouth. As possible reasons for their use, pharmacists ranked ‘aid in stop smoking’ as the most important (56%), with ‘cheaper alternative’ (43%) and ‘social/recreational use’ (31%) being the least important ones. Safety issues were raised as statements such as ‘e-liquid in cartridges may be toxic’ were agreed by 52% of respondents. The majority of pharmacists (97%) were supportive of e-cigarettes being regulated, expressing current concerns regarding excipients (42%) and nicotine content (34%). Participants indicated that they would require training in the form of information packs (88%), online tutorials (67%), continuous professional development (CPD) workshops (43%) to cover safety, counselling, dosage instructions, adverse effects and role in the smoking cessation care pathway in the future. Conclusions Pharmacists expressed concerns about the safety of e-cigarettes, especially regarding the amounts of excipients and nicotine as these still remain unregulated. Currently, there are no guidelines for pharmacists regarding e-cigarettes. Community

  4. Supporting a UK Success Story: The Impact of University Research and Sport Development

    ERIC Educational Resources Information Center

    Universities UK, 2012

    2012-01-01

    As part of an Olympic and Paralympic themed Universities Week this new report highlights just some of the many ways in which research will help Team Great Britain achieve exceptional results. While most attention will be on the results achieved in London this summer, it is inspiring to look at the research taking place in UK universities that will…

  5. Supporting a UK Success Story: The Impact of University Research and Sport Development

    ERIC Educational Resources Information Center

    Universities UK, 2012

    2012-01-01

    As part of an Olympic and Paralympic themed Universities Week this new report highlights just some of the many ways in which research will help Team Great Britain achieve exceptional results. While most attention will be on the results achieved in London this summer, it is inspiring to look at the research taking place in UK universities that will…

  6. Gypsy, Roma and Traveller Pupils in Schools in the UK: Inclusion and "Good Practice"

    ERIC Educational Resources Information Center

    Bhopal, Kalwant; Myers, Martin

    2009-01-01

    This paper examines inclusionary processes and examples of "good practice" in primary and secondary schools for Gypsy, Roma and Traveller pupils in one inner London Borough in the UK. It will explore the role of the Traveller Education Service (TES) and argue that the support provided by the TES to schools is essential for the…

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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

  12. 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

  13. 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…

  14. 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

  15. 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

  16. 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...

  17. 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

  18. Herald waves of cholera in nineteenth century London

    PubMed Central

    Tien, Joseph H.; Poinar, Hendrik N.; Fisman, David N.; Earn, David J. D.

    2011-01-01

    Deaths from cholera in London, UK, were recorded weekly from 1824 to 1901. Three features of the time series stand out: (i) cholera deaths were strongly seasonal, with peak mortality almost always in the summer, (ii) the only non-summer outbreaks occurred in the spring of 1832, the autumn of 1848 and the winter of 1853, and (iii) extraordinarily severe summer outbreaks occurred in 1832, 1849, 1854 and 1866 (the four ‘great’ cholera years). The non-summer outbreaks of 1832, 1848 and 1853 appear to have been herald waves of newly invading cholera strains. In addition, a simple mathematical model confirms that a non-summer introduction of a new cholera strain can result in an initial herald wave, followed by a severe outbreak the following summer. Through the analysis of the genomes of nineteenth-century specimens, it may be possible to identify the strains that caused these herald waves and the well-known cholera epidemics that followed. PMID:21123253

  19. External and internal noise surveys of London primary schools.

    PubMed

    Shield, Bridget; Dockrell, Julie E

    2004-02-01

    Internal and external noise surveys have been carried out around schools in London, UK, to provide information on typical levels and sources to which children are exposed while at school. Noise levels were measured outside 142 schools, in areas away from flight paths into major airports. Here 86% of the schools surveyed were exposed to noise from road traffic, the average external noise level outside a school being 57 dB L(Aeq). Detailed internal noise surveys have been carried out in 140 classrooms in 16 schools, together with classroom observations. It was found that noise levels inside classrooms depend upon the activities in which the children are engaged, with a difference of 20 dB L(Aeq) between the "quietest" and "noisiest" activities. The average background noise level in classrooms exceeds the level recommended in current standards. The number of children in the classroom was found to affect noise levels. External noise influenced internal noise levels only when children were engaged in the quietest classroom activities. The effects of the age of the school buildings and types of window upon internal noise were examined but results were inconclusive.

  20. Air earth current measurements at Kew, London, 1909 1979

    NASA Astrophysics Data System (ADS)

    Harrison, R. G.; Ingram, W. J.

    2005-07-01

    A vertical conduction current arises from the global ionospheric potential and the integrated electrical resistance between the Earth's surface and the ionosphere. The conduction current density varies with the ionospheric potential and the vertical (columnar) resistance. At the surface, the conduction current density is known as the air-earth current. C.T.R. Wilson developed a measurement technique for the air-earth current in 1906, which was implemented by the British Meteorological Office at its Kew Observatory (51° 28'N, 0° 19'W) near London in 1909. Simultaneous measurements of air-earth current, potential gradient and positive air conductivity were made almost continuously until 1979 using the Wilson method on fine afternoons. A summary of the complete set of monthly mean measurements is presented here for the first time. The data span the nuclear weapons testing period and the UK Clean Air Act of 1956, both of which influenced the measurements obtained. Annual average values of the air earth current density at Kew are 0.97 pA·m -2 (1909-1931), 1.04 pA·m -2 (1932-1949) and 1.41 pA·m -2 (1967-1979).

  1. London 2012: occupational health in the construction programme.

    PubMed

    Waterman, Lawrence

    2007-05-01

    This article explores the approach to occupational health in the UK construction industry in both broad and narrow contexts. The construction programme for the 2012 Olympic Games and Paralympic Games includes the creation of a large urban park in east London containing many sports venues and served by enhanced infrastructure. The Olympic Delivery Authority (ODA), responsible for the construction programme, is developing plans that seek to assure the health of the thousands of workers who will be engaged in this work. Such plans are not being drafted in a vacuum. In addition to considerable consultation with stakeholders the ODA is also drawing on some of the exciting work that has been undertaken in occupational health in recent years. In particular, the move from a focus on technical health services provided by 'experts' to an acceptance that health issues should be managed within employing organizations. Understanding this broad context provides a solid basis for analysing the specific proposals for occupational support during the Olympic Park construction.

  2. Increasing Plasmodium falciparum malaria in southwest London: a 25 year observational study

    PubMed Central

    Williams, J; Chitre, M; Sharland, M

    2002-01-01

    Aims: To identify changes in the presenting number and species of imported malaria in children in southwest London. Methods: A prospective single observer study over 25 years (1975–99) of all cases of paediatric malaria seen at St George's Hospital. Results: A confirmed diagnosis was made in 249 children (56% boys; 44% girls; median age 8.0 years). Of these, 53% were UK residents and 44% were children travelling to the UK. A significant increase was noted in the number of cases over the 25 years (1975–79: mean 4.8 cases/year; 1990–99: mean 13.7 cases/year). Over the 25 years Plasmodium falciparum was seen in 77%, P vivax in 14%, P ovale in 6%, and P malariae in 3% of cases. P falciparum had increased in frequency (1975–79: P falciparum 50%, P vivax 50%; 1990–99: P falciparum 82%, P vivax 6%), associated with an increase in the proportion of children acquiring their infection in sub-Saharan Africa. Median time between arrival in the UK to the onset of fever was: P falciparum, 5 days; P ovale, 25 days; P malariae, 37 days; and P vivax, 62 days. Median time interval between the onset of fever to commencement of treatment was 4 days. This had not improved over the 25 year period. Only 41% of UK resident children presenting to hospital had taken prophylaxis and the overall number of symptomatic children taking no prophylaxis was increasing. Conclusion: Imported childhood P falciparum malaria is increasing in southwest London associated with increasing travel from sub-Saharan Africa. Over the 25 year period there has been no improvement in chemoprophylaxis rates or time to diagnosis. PMID:12023177

  3. Bibliography of the Research Staff of the UK Institute of Oceanographic Sciences, Bidston Observatory (1979-83).

    DTIC Science & Technology

    1984-01-19

    RD-Ri38 597 BIBLIOGRAPHY OF THE RESEARCH STAFF OF THE UK INSTITUTE 1/7 OF OCEANOGRAPHIC S.. (U) OFFICE OF NAVAL RESEARCH LONDON ( ENGLAND ) R DOLAN 19...OFFICEI F N A V A L _ _ _ _ _ _ _ _ __ BIBLIOGRAPHY OF THE RESEARCH STAFF OF THE UK INSTITUTE OF OCEANOGRAPHIC SCIENCES, BIDSTON OBSERVATORY (1979-83...ROBERT DOLAN BRANCH 19 January 1984 OFFICE LONDON ENGLAND mR5 1984 UNITIIW STATESI OF AlMERIICA This document is issued primarily for the informati6n of

  4. 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.

  5. 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

  6. 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).

  7. An outbreak of illness among schoolchildren in London: toxic poisoning not mass hysteria.

    PubMed Central

    Aldous, J C; Ellam, G A; Murray, V; Pike, G

    1994-01-01

    STUDY OBJECTIVE--To determine the cause of an outbreak of acute gastrointestinal illness that occurred shortly after lunch in children attending a school in London, UK. DESIGN--A questionnaire survey of children at the affected school was carried out on the day after the incident. Microbiological, environmental, and toxicological investigations were also undertaken. SETTING--A school in London, UK. PARTICIPANTS--Altogether 374/468 (80%) of the children who had eaten lunch at the school on the day of the incident completed a questionnaire. MAIN RESULTS--There was a significant association between illness and the consumption of raw cucumber (relative risk = 6.1; 95% confidence interval 2.2, 16). Microbiological investigation of the foods served at lunch did not show any pathogens and toxicological investigations suggested that the cucumbers were contaminated by a pesticide. CONCLUSIONS--Although the outbreak displayed several typical features of mass psychogenic illness, the most probable cause was a toxic chemical present in cucumber served at lunch. Those responsible for investigating outbreaks of illness should be aware of the possible toxicological causes and the appropriate modes of investigation. They should be wary of too readily attributing a psychogenic cause to unusual outbreaks of acute illness in schoolchildren. PMID:8138768

  8. Health Technology Assessment in the UK.

    PubMed

    Raftery, James; Powell, John

    2013-10-12

    In this Review, we discuss the UK's Health Technology Assessment programme, which is 20 years old in 2013. We situate the programme in the context of the UK landscape for evidence-based medicine, including in relation to the National Institute for Health and Care Excellence and as guidance to the National Health Service. We identify features that might be of value to other health systems as they confront the challenges of rapid innovation and rising costs. We use examples of recent studies to show the strengths and weaknesses of the programme. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Pathways, Networks and Systems Medicine Conferences

    SciTech Connect

    Nadeau, Joseph H.

    2013-11-25

    The 6th Pathways, Networks and Systems Medicine Conference was held at the Minoa Palace Conference Center, Chania, Crete, Greece (16-21 June 2008). The Organizing Committee was composed of Joe Nadeau (CWRU, Cleveland), Rudi Balling (German Research Centre, Brauschweig), David Galas (Institute for Systems Biology, Seattle), Lee Hood (Institute for Systems Biology, Seattle), Diane Isonaka (Seattle), Fotis Kafatos (Imperial College, London), John Lambris (Univ. Pennsylvania, Philadelphia),Harris Lewin (Univ. of Indiana, Urbana-Champaign), Edison Liu (Genome Institute of Singapore, Singapore), and Shankar Subramaniam (Univ. California, San Diego). A total of 101 individuals from 21 countries participated in the conference: USA (48), Canada (5), France (5), Austria (4), Germany (3), Italy (3), UK (3), Greece (2), New Zealand (2), Singapore (2), Argentina (1), Australia (1), Cuba (1), Denmark (1), Japan (1), Mexico (1), Netherlands (1), Spain (1), Sweden (1), Switzerland (1). With respect to speakers, 29 were established faculty members and 13 were graduate students or postdoctoral fellows. With respect to gender representation, among speakers, 13 were female and 28 were male, and among all participants 43 were female and 58 were male. Program these included the following topics: Cancer Pathways and Networks (Day 1), Metabolic Disease Networks (Day 2), Day 3 ? Organs, Pathways and Stem Cells (Day 3), and Day 4 ? Inflammation, Immunity, Microbes and the Environment (Day 4). Proceedings of the Conference were not published.

  10. 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.

  11. Listening to those on the frontline: service users’ experiences of London tuberculosis services

    PubMed Central

    Boudioni, Markella; McLaren, Susan; Belling, Ruth; Woods, Leslie

    2011-01-01

    Aim: To explore tuberculosis (TB) service users’ experiences and satisfaction with care provision. Background: Thirty-nine percent of all new UK TB cases occur in London. Prevalence varies considerably between and within boroughs. Overall, research suggests inadequate control of London’s TB transmission; TB has become a health care priority for all London Primary Care Trusts. Service users’ experiences and satisfaction with care provision have not been explored adequately previously. Methods: A qualitative research design, using semi-structured face-to-face interviews was used. Ten service users, purposively selected in key risk groups across London, were interviewed. All interviews were digitally recorded with users’ permission, transcribed verbatim, and analyzed thematically. Results: Participants were treated in local hospitals for 6–12 months. Treatment was administered by TB nurses to inpatients and outpatients receiving directly observed therapy in consultation with medical staff and home visits for complex cases. Two participants did not realize the importance of compliance. Overall, they were satisfied with many TB services’ aspects, communication, and service organization. Early access, low suspicion index amongst some GPs, and restricted referral routes were identified as service barriers. Other improvement areas were information provision on drug side effects, diet, nutritional status, and a few health professionals’ attitudes. The effects on people varied enormously from minimal impact to psychological shock; TB also affected social and personal aspects of their life. With regard to further support facilities, some positive views on managed accommodation by TB-aware professionals for those with accommodation problems were identified. Conclusion: This first in-depth study of TB service users’ experiences across London offers valuable insights into service users’ experiences, providing information and recommendations for a strategic

  12. UK malaria treatment guidelines.

    PubMed

    Lalloo, David G; Shingadia, Delane; Pasvol, Geoffrey; Chiodini, Peter L; Whitty, Christopher J; Beeching, Nicholas J; Hill, David R; Warrell, David A; Bannister, Barbara A

    2007-02-01

    ); quinine is highly effective but poorly tolerated in prolonged dosage and is always supplemented by additional treatment, usually with oral doxycycline. ALL patients treated for P. falciparum malaria should be admitted to hospital for at least 24 h, since patients can deteriorate suddenly, especially early in the course of treatment. Severe falciparum malaria, or infections complicated by a relatively high parasite count (more than 2% of red blood cells parasitized), should be treated with intravenous therapy until the patient is well enough to continue with oral treatment. In the UK, the treatment of choice for severe or complicated malaria is currently an infusion of intravenous quinine. This may exacerbate hypoglycaemia that can occur in malaria; patients treated with intravenous quinine therefore require careful monitoring. Intravenous artesunate reduces high parasite loads more rapidly than quinine and is more effective in treating severe malaria in selected situations. It can also be used in patients with contra-indications to quinine. Intravenous artesunate is unlicensed in the EU. Assistance in obtaining artesunate may be sought from specialist tropical medicine centres, on consultation, for named patients. Patients with severe or complicated malaria should be managed in a high dependency or intensive care environment. They may require haemodynamic support and management of acute respiratory distress syndrome, disseminated intravascular coagulation, renal impairment/failure, seizures, and severe intercurrent infections including gram-negative bacteraemia/septicaemia. Falciparum malaria in pregnancy is more likely to be severe and complicated: the placenta contains high levels of parasites. Stillbirth or early delivery may occur and diagnosis can be difficult if parasites are concentrated in the placenta and scanty in the blood. The treatment of choice for falciparum malaria in pregnancy is quinine; doxycycline is contraindicated in pregnancy but clindamycin can be

  13. The dangers of an adventurous partner: Cordylobia anthropophaga infestation in London.

    PubMed

    Whitehorn, J S; Whitehorn, C; Thakrar, N A; Hall, M J R; Godfrey-Faussett, P; Bailey, R

    2010-05-01

    We describe a case of cutaneous myiasis caused by Cordylobia anthropophaga acquired in the UK from contact with another person's clothes. We propose that this diagnosis should be considered in both returning travellers and also their household contacts. Copyright 2009 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  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. 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.

  16. 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

  17. 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…

  18. 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…

  19. An audit of HIV treatment outcomes in a UK inner city cohort.

    PubMed

    Bird, E; Cormack, I; Rodgers, M; Phillips, D; Elgalib, A

    2016-10-01

    We describe the demographics and treatment outcomes of a HIV-infected cohort from Croydon University Hospital, London, UK. We showed that the Croydon Cohort had good viral load suppression (98.6% with viral load < 100 copies/ml and 99.0% with viral load < 200 copies/ml) despite being a potentially challenging cohort in a deprived area of London. The viral load outcomes are better than the Public Health England data from 2014 and the latest British HIV Association audit using data from 2009.

  20. Factors contributing to incidents in medicine administration. Part 2.

    PubMed

    Fry, Margaret Mary; Dacey, Caroline

    The lack of empirical research on nurses' views of the factors contributing to medication errors, and particularly of studies conducted in the UK, formed the starting point for this study. Part 2 of this two-part article aims to inform the wider nursing population about the views of nurses working in the medicine directorate of a large London teaching hospital, and to explore the reporting of medication incidents and the effect of this on the practice of the nurses involved. Quantitative results of a self-administered questionnaire indicated that this group of nurses felt that the most important factors contributing to medication incidents were interruptions by patients and relatives/visitors and telephone calls during the process of administration. Suggested ways of reducing errors were 'protected' medicine rounds, unique or distinct packaging of medications and regular revision sessions on mathematical calculations. These nurses' views confirmed that factors identified in the literature as contributing to medication incidents were problematic for them too. Simple changes to practice could help to reduce the number of such incidents.

  1. Survey of community pharmacists' perception of electronic cigarettes in London.

    PubMed

    Marques Gomes, Ana C N; Nabhani-Gebara, Shereen; Kayyali, Reem; Buonocore, Federico; Calabrese, Gianpiero

    2016-11-10

    To seek community pharmacists' perception on use, safety and possible effectiveness of e-cigarettes as quit smoking tools, and their future regulation. A survey of a sample of 154 community pharmacies across London, UK. E-cigarettes have exclusively established themselves in the market through consumers-led demand. To date, e-cigarettes still remain unregulated and can be easily purchased in shops, over the internet, but more controversially also in pharmacies in the UK. Pharmacists find themselves with a shortage of information on their safety and efficacy, and may experience an ethical dilemma when consulted by patients/customers. Response rate: 60% (n=92). Independent pharmacies accounted for 90% of the sample. The majority of participants (73%) sell e-cigarettes. A minority of participants (20%) have been presented with adverse effects such as cough and dry mouth. As possible reasons for their use, pharmacists ranked 'aid in stop smoking' as the most important (56%), with 'cheaper alternative' (43%) and 'social/recreational use' (31%) being the least important ones. Safety issues were raised as statements such as 'e-liquid in cartridges may be toxic' were agreed by 52% of respondents. The majority of pharmacists (97%) were supportive of e-cigarettes being regulated, expressing current concerns regarding excipients (42%) and nicotine content (34%). Participants indicated that they would require training in the form of information packs (88%), online tutorials (67%), continuous professional development (CPD) workshops (43%) to cover safety, counselling, dosage instructions, adverse effects and role in the smoking cessation care pathway in the future. Pharmacists expressed concerns about the safety of e-cigarettes, especially regarding the amounts of excipients and nicotine as these still remain unregulated. Currently, there are no guidelines for pharmacists regarding e-cigarettes. Community pharmacists look forward to regulations so to conduct their duties in a

  2. UK Secondary Schools under Surveillance: What Are the Implications for Race? A Critical Race and Butlerian Analysis

    ERIC Educational Resources Information Center

    Chadderton, Charlotte

    2012-01-01

    Since September 11th 2001, and the London bombings of July 2005, the "war on terror" has led to the subjection of populations to new regimes of control and reinforced state sovereignty. This involves, in countries such as the UK and the US, the limiting of personal freedoms, increased regulation of immigration and constant surveillance,…

  3. UK Secondary Schools under Surveillance: What Are the Implications for Race? A Critical Race and Butlerian Analysis

    ERIC Educational Resources Information Center

    Chadderton, Charlotte

    2012-01-01

    Since September 11th 2001, and the London bombings of July 2005, the "war on terror" has led to the subjection of populations to new regimes of control and reinforced state sovereignty. This involves, in countries such as the UK and the US, the limiting of personal freedoms, increased regulation of immigration and constant surveillance,…

  4. "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…

  5. 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.

  6. Industrial Genotoxicology Group (IGG): Aneuploidy, White House Hotel, London, UK, 16 May 1997.

    PubMed

    1998-07-01

    Aneuploidy has important consequences for human health. There is a requirement to detect aneugens that may not be fully satisfied by the current test batter. New cytogenetic techniques look promising.

  7. Highlights from Faraday Discussion 184: Single-Molecule Microscopy and Spectroscopy, London, UK, September 2015.

    PubMed

    Gellings, E; Faez, S; Piatkowski, L

    2016-02-07

    The 2015 Faraday Discussion on single-molecule microscopy and spectroscopy brought together leading scientists involved in various topics of single-molecule research. It attracted almost a hundred delegates from a broad spectrum of backgrounds and experience levels - from experimentalists to theoreticians, from biologists to materials scientists, from masters students to Nobel Prize Laureates. The meeting was merely a reflection of how big of an impact the ability to detect individual molecules has had on science over the past quarter of a century. In the following we give an overview of the topics covered during this meeting and briefly highlight the content of each presentation.

  8. Large-scale structure in the universe. Proceedings. Conference, London (UK), 25 - 26 Mar 1998.

    NASA Astrophysics Data System (ADS)

    1999-01-01

    The following topics were dealt with: Universe: large-scale structure, early Universe: quantum fluctuations, microwave background radiation studies, the Sloan Digital Sky Survey, the 2dF Galaxy Redshift Survey, galaxy clustering evolution, the CNOC2 Field Galaxy Redshift Survey, quasar clustering.

  9. Type catalogue of Terebridae (Mollusca, Gastropoda, Conoidea) in the Natural History Museum, London, U.K.

    PubMed

    Salvador, Andreia; Pickering, Joan

    2017-04-04

    The type collection of Terebridae in the Natural History Museum consists of 248 lots. In order to clarify the type status of this material, an annotated alphabetic list by species is provided. The format includes the original citation for each species, type locality, collector, label data, registration number, number of specimens, type status and remarks. Due to the actions of previous workers, fixation of lectotype by inference of holotype is given for 168 species. A bibliography of relevant publications is also provided.

  10. Geostrategies of Interlingualism: Language Policy and Practice in the International Maritime Organisation, London, UK

    ERIC Educational Resources Information Center

    McEntee-Atalianis, Lisa J.

    2006-01-01

    Fettes (2004) asserts that "politico-strategies" of languages are no longer viable frameworks for "national and community policy". Rather, he proposes the development of "geostrategies of interlingualism", i.e. linguistic strategies which promote international communication equitably and efficiently, whilst respecting…

  11. A dynamic approach to urban road deposited sediment pollution monitoring (Marylebone Road, London, UK)

    NASA Astrophysics Data System (ADS)

    Crosby, C. J.; Fullen, M. A.; Booth, C. A.; Searle, D. E.

    2014-06-01

    The use of mineral magnetic measurements (χLF, χARM and SIRM) as a potential pollution proxy using road deposited sediment (RDS) is explored as an alternative means of monitoring pollution on a busy city road. Comparison of sediment-related analytical data by correlation analysis between mineral magnetic, particle size and geochemical properties is reported. Mineral magnetic concentration parameters (χLF, χARM and SIRM) reveal significant (p < 0.001; n = 61) associations with PM1.0, PM2.5 and PM10. Significant associations were also found with mineral magnetic concentrations (χLF and SIRM) and specific concentrations of the elements Fe, Ni, Cu, Zn and Mn (p < 0.001; n = 61). Inter-geochemical correlation analysis found strong associations (p < 0.001; n = 61) between Fe, Ni, Cu, Zn and Mn and suggest anthropogenic enrichment influences. Low χFD% measurements imply an influence of multi-domain mineralogy, indicative of anthropogenic combustion processes. SEM micrographs also support this, as all samples contain Fe spherules indicative of vehicular combustion processes. This study advocates rapid and simple initial assessment of urban pollution episodes using mineral magnetic measurements as a dynamic explorative technology.

  12. Response of London's urban heat island to a marine air intrusion in an easterly wind regime

    NASA Astrophysics Data System (ADS)

    Chemel, C.; Sokhi, R. S.

    2010-09-01

    the urban boundary layer and the intensity of the UHI are also examined through numerical simulations. The advection of cooler air from the North Sea reduces the UHI on the windward suburbs and displaces it several kilometres to the west, in good agreement with observations. Passive tracers are released within the urban area to investigate the impact of the marine air intrusion on transport characteristics above London's atmosphere. Cooler air advection across London was found to efficiently cleanse the urban area of passive tracers. Implications for urban air quality are discussed in the light of results from this case study. This study has been conducted as part the Clean Air for London (ClearfLo) project, funded by the UK National Environment Research Council (NERC).

  13. CAP in the UK

    NASA Astrophysics Data System (ADS)

    Haley, P.

    2008-06-01

    This poster highlights some of the experiential learning activities used by The SHARE Initiative (TSI) in the UK. Past, present and future projects are described and the possibility of linking up internationally with other projects is invited. Digital media, scientific heritage and solar physics are three areas which Paul Haley (Director - TSI) is particularly keen to develop. Operating as a community interest company TSI outreaches astronomy activities directly into rural areas in the UK.

  14. Promoting SETI in the UK

    NASA Astrophysics Data System (ADS)

    Penny, Alan

    2013-10-01

    MEETING REPORT What does the UK presently do in the search for extraterrestrial intelligence and what are the plans for the future? Alan Penny reports on a meeting of UK academics active in SETI, held as sessions in the recent National Astronomy Meeting in Scotland - and the formation of the UK SETI Research Network to promote UK academic work.

  15. 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...

  16. 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).…

  17. 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 ...

  18. 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 ...

  19. 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).…

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. Spatial and temporal associations of road traffic noise and air pollution in London: Implications for epidemiological studies.

    PubMed

    Fecht, Daniela; Hansell, Anna L; Morley, David; Dajnak, David; Vienneau, Danielle; Beevers, Sean; Toledano, Mireille B; Kelly, Frank J; Anderson, H Ross; Gulliver, John

    2016-03-01

    Road traffic gives rise to noise and air pollution exposures, both of which are associated with adverse health effects especially for cardiovascular disease, but mechanisms may differ. Understanding the variability in correlations between these pollutants is essential to understand better their separate and joint effects on human health. We explored associations between modelled noise and air pollutants using different spatial units and area characteristics in London in 2003-2010. We modelled annual average exposures to road traffic noise (LAeq,24h, Lden, LAeq,16h, Lnight) for ~190,000 postcode centroids in London using the UK Calculation of Road Traffic Noise (CRTN) method. We used a dispersion model (KCLurban) to model nitrogen dioxide, nitrogen oxide, ozone, total and the traffic-only component of particulate matter ≤2.5μm and ≤10μm. We analysed noise and air pollution correlations at the postcode level (~50 people), postcodes stratified by London Boroughs (~240,000 people), neighbourhoods (Lower layer Super Output Areas) (~1600 people), 1km grid squares, air pollution tertiles, 50m, 100m and 200m in distance from major roads and by deprivation tertiles. Across all London postcodes, we observed overall moderate correlations between modelled noise and air pollution that were stable over time (Spearman's rho range: |0.34-0.55|). Correlations, however, varied considerably depending on the spatial unit: largest ranges were seen in neighbourhoods and 1km grid squares (both Spearman's rho range: |0.01-0.87|) and was less for Boroughs (Spearman's rho range: |0.21-0.78|). There was little difference in correlations between exposure tertiles, distance from road or deprivation tertiles. Associations between noise and air pollution at the relevant geographical unit of analysis need to be carefully considered in any epidemiological analysis, in particular in complex urban areas. Low correlations near roads, however, suggest that independent effects of road noise and

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. Finding a VOICE for UK clinical pharmacology

    PubMed Central

    Aronson, Jeffrey K

    2012-01-01

    At a James Black Conference held in Oxford on 20–22 June 2011, a group of senior clinical pharmacologists and their junior colleagues, other medical specialists, and pharmacists discussed an agenda for UK clinical pharmacology for the next 5 years, addressing the following broad questions. How should UK clinical pharmacology be further developed and delivered as a discipline in universities, the NHS, pharmaceutical companies, and regulatory authorities? How should teaching and training in UK clinical pharmacology and therapeutics be delivered and assessed? What topics should be priorities for research in UK academic clinical pharmacology? How should clinical pharmacology contribute to UK drugs policy? How should pharmacology and clinical pharmacology be further integrated, to the benefit of both? Numerous recommendations emerged, under the collective acronym VOICE, standing for Visibility, Outreach, Integration, Coverage and Emissaries. Visibility The visibility of the discipline needs to be increased. This could be done, for example, by increased activities in acute general medicine/toxicology, through activities of Medicines and Therapeutics Committees, participation in grand rounds, teaching and training, and monitoring therapeutic interventions, and by offering bolt-on training for other specialists (for example, short courses, MSc courses, and training programmes). Outreach Methods of increasing outreach include roadshows in schools/medical schools, national special study modules, public education, press coverage, and social marketing. Integration Closer collaborations with pharmacologists, clinical pharmacists, other prescribers, and pharmaceutical companies (e.g. through joint training programmes) are desirable. Coverage Attention to neglected areas, such as general practice, paediatrics, obstetrics, geriatrics, anaesthetics, cancer, and immunology. Emissaries Trainees to spread the word. PMID:22360150

  12. Finding a VOICE for UK clinical pharmacology.

    PubMed

    Aronson, Jeffrey K

    2012-06-01

    At a James Black Conference held in Oxford on 20-22 June 2011, a group of senior clinical pharmacologists and their junior colleagues, other medical specialists, and pharmacists discussed an agenda for UK clinical pharmacology for the next 5 years, addressing the following broad questions. How should UK clinical pharmacology be further developed and delivered as a discipline in universities, the NHS, pharmaceutical companies, and regulatory authorities? How should teaching and training in UK clinical pharmacology and therapeutics be delivered and assessed? What topics should be priorities for research in UK academic clinical pharmacology? How should clinical pharmacology contribute to UK drugs policy? How should pharmacology and clinical pharmacology be further integrated, to the benefit of both? Numerous recommendations emerged, under the collective acronym VOICE, standing for Visibility, Outreach, Integration, Coverage and Emissaries. VISIBILITY: The visibility of the discipline needs to be increased. This could be done, for example, by increased activities in acute general medicine/toxicology, through activities of Medicines and Therapeutics Committees, participation in grand rounds, teaching and training, and monitoring therapeutic interventions, and by offering bolt-on training for other specialists (for example, short courses, MSc courses, and training programmes). OUTREACH: Methods of increasing outreach include roadshows in schools/medical schools, national special study modules, public education, press coverage, and social marketing. INTEGRATION: Closer collaborations with pharmacologists, clinical pharmacists, other prescribers, and pharmaceutical companies (e.g. through joint training programmes) are desirable. COVERAGE: Attention to neglected areas, such as general practice, paediatrics, obstetrics, geriatrics, anaesthetics, cancer, and immunology. EMISSARIES: Trainees to spread the word.

  13. Congressional Science Fellow tackles science policy for U.K.

    NASA Astrophysics Data System (ADS)

    Moses, Julie J.

    After an AGU Congressional Science Fellowship in 1997-1998,I decided to pursue science policy further. I spied an ad in the Sunday Washington Post advertising for someone with a science degree, who also had knowledge of the United Kingdom, and science policy experience on Capitol Hill. In addition to my Ph.D. from the University of California at Los Angeles and the Congressional Science Fellowship, I had spent two years in the U.K. as a post-doc at Queen Mary and Westfield College in London.I applied for the job, which was at the British Embassy in Washington, D.C., and was hired. The UK Foreign Office has a tradition of hiring many of its embassy staff locally; they consider knowledge of local politics and issues very use ful for their interests. Now I cover hard science issues, including space and the Internet for Her Majesty's Government.

  14. [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.

  15. Integrated traditional Chinese medicine.

    PubMed

    Robinson, Nicola

    2006-05-01

    To experience the integration of traditional Chinese medicine (TCM) in China was 'the chance of a lifetime; thanks to the support of the Winston Churchill Memorial Trust. The scale and range of TCM available in terms of health care provision, education and research is unique in the world. This holistic integrative medicine is part of Chinese culture. Regulation and training of practitioners has similarities with current structures emerging in the UK in preparation for the statutory regulation for acupuncture and herbal medicine. China's research activity is a critical component of informing the debate on evidence-based practice and now real opportunities for collaboration and dissemination are beginning to emerge.

  16. Prevalence of nasopharyngeal carriage of pneumococcus in preschool children attending day care in London.

    PubMed

    Roche, Anita; Heath, Paul T; Sharland, Mike; Strachan, David; Breathnach, Aodhan; Haigh, John; Young, Yvonne

    2007-12-01

    To estimate the prevalence of nasopharyngeal (NP) carriage of pneumococcus (Streptococcus pneumoniae) and describe the antibiotic resistance patterns and serotypes in young children attending group day care in London. Cross-sectional survey of attendees at a sample of registered child day care centres (CDCCs) in a London borough. Urban setting with a socially and culturally diverse population. 19 CDCCs (13% of total) participated between March and November 2003. A single NP swab was required from each child, and parents completed a questionnaire about their child's health and attendance at day care. WHO methodology for pneumococcal carriage studies was followed. 30% of parents consented. 234 swabs were collected from children aged 6 months to 5 years. 53% were boys and 81% were white. 120 children (51%, 95% CI 45% to 58%) carried pneumococci in their nasopharynx. None of the isolates were resistant to penicillin (upper CL 3%). 21 isolates were resistant to erythromycin (17.5%, 95% CI 11% to 25.5%). 68 isolates (57%) were serotypes included in the 7-valent conjugate vaccine. Non-white children had a lower prevalence of carriage (27% vs 58%). The prevalence of pneumococcal NP carriage was high. The penicillin resistance rate is lower than in many other countries and may reflect a decrease in community antibiotic prescribing in the UK. Monitoring circulating serotypes is important in the context of recent changes to the vaccination policy. Further study is required to explore the association with ethnicity and risk factors for antibiotic resistance.

  17. Key Barriers to Community Cohesion: Views from Residents of 20 London Deprived Neighbourhoods.

    PubMed

    Bertotti, Marcello; Adams-Eaton, Faye; Sheridan, Kevin; Renton, Adrian

    2012-04-01

    The notion of community has been central to the political project of renewal of New Labour in the UK. The paper explores how the discourses of community are framed within New Labour and discusses these in the light of the results from research which focuses on how people within urban deprived areas construct their community. It draws upon the results of one part of a larger research project (the 'Well London' programme) which aimed to capture the views of residents from 20 disadvantaged neighbourhoods throughout London using an innovative qualitative method known as the 'World Café'. Our results show the centrality of young people to the development of cohesive communities, the importance of building informal relationships between residents alongside encouraging greater participation to policy making, and the need to see these places as fragile and temporary locations but with considerable social strengths. Government policies are only partially addressing these issues. They pay greater attention to formally encouraging citizens to become more involved in policy making, largely ignore the contribution young people could make to the community cohesion agenda, and weakly define the shared norms and values that are crucial in building cohesive communities. Thus, the conclusion is that whilst an emphasis of the government on 'community' is to be welcome, more needs to be done in terms of considering the 'voices' of the community as well as enabling communities to determine and act upon their priorities.

  18. "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.

  19. The Dependence on Smokeless Tobacco in the South Asian Communities in East London

    PubMed Central

    Khaja, Amjad Hussain; Zwiad, Abdulsalam Ali; Tarakji, Bassel; Gazal, Giath; Albaba, Feras; KalajI, Nader; Petro, Waleed

    2016-01-01

    Background & Objective: The purpose of the study was to understand the dependency on smokeless tobacco. Methods: The major aspect of the interview was to study the type of chewing tobacco used, frequency of purchase of chewing tobacco, change in attitude and behavior after the use of chewing tobacco. This study was done in 2005 in London. Of the 110 respondents interviewed 88 were used for the data analysis. Study Design: An exploratory study was conducted in East London, United Kingdom. The selected sample was interviewed through a questionnaire, based on the Severson Smokeless Tobacco Dependence Scale. Results: Cross tabulations report that in a sample of 88 South Asian UK resident men 46.6% used leaf (paan), 43.2% used processed form of chewing tobacco and 10.2% used gutka. Older age (67%) respondents were more likely than the younger age (30%) respondents to chew tobacco. The frequency of purchase of chewing tobacco is reported high (67.2%) in the older age group than the younger age group (50%). Conclusion: This current study used an amended form of the Severson Smokeless Tobacco Scale questionnaire to study the dependency on smokeless tobacco. The study could be developed in the selection of the sample, which would include both males and females to study the dependency on smokeless tobacco. PMID:26234985

  20. The role of one large greenspace in mitigating London's nocturnal urban heat island.

    PubMed

    Doick, Kieron J; Peace, Andrew; Hutchings, Tony R

    2014-09-15

    The term urban heat island (UHI) describes a phenomenon where cities are on average warmer than the surrounding rural area. Trees and greenspaces are recognised for their strong potential to regulate urban air temperatures and combat the UHI. Empirical data is required in the UK to inform predictions on cooling by urban greenspaces and guide planning to maximise cooling of urban populations. We describe a 5-month study to measure the temperature profile of one of central London's large greenspaces and also in an adjacent street to determine the extent to which the greenspace reduced night-time UHI intensity. Statistical modelling displayed an exponential decay in the extent of cooling with increased distance from the greenspace. The extent of cooling ranged from an estimated 20 m on some nights to 440 m on other nights. The mean temperature reduction over these distances was 1.1 °C in the summer months, with a maximum of 4 °C cooling observed on some nights. Results suggest that calculation of London's UHI using Met Stations close to urban greenspace can underestimate 'urban' heat island intensity due to the cooling effect of the greenspace and values could be in the region of 45% higher. Our results lend support to claims that urban greenspace is an important component of UHI mitigation strategies. Lack of certainty over the variables that govern the extent of the greenspace cooling influence indicates that the multifaceted roles of trees and greenspaces in the UK's urban environment merit further consideration. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  1. Birthweight by gestational age and its effect on perinatal mortality in white and in Punjabi births: experience at a district general hospital in West London 1967-1975.

    PubMed

    Dawson, I; Golder, R Y; Jonas, E G

    1982-11-01

    At Hillingdon Hospital in West London two main ethnic groups: 'UK' (i.e. white European) and 'Indian' (i.e. Punjabi) account for the bulk of obstetric work load. Birthweight by gestational age graphs were calculated for some 6000 Indian and 18000 UK infants born between 1967 and 1975 inclusive. A mean weight difference at term favoured UK male babies by 240 g and UK female babies by 230 g. Though the crude perinatal results in the two populations were not significantly different, the perinatal mortality of infants less than 2500 g in birthweight was lower in the Indian than the UK population, particularly in the 1500-2400 g group. This is attributed to a levelling off in intrauterine growth from 36 to 37 weeks gestation onwards in Indian compared with UK pregnancies, so that they were more mature than UK births of the same weight. However light-for-dates births, defined as birthweights below the 10th centile of weight-for-gestational age on their own ethnic and sex specific standards pose problems, irrespective of ethnic background.

  2. Medical student fitness to practise committees at UK medical schools

    PubMed Central

    Aldridge, Jocelyne; Bray, Sally A; David, Timothy J

    2009-01-01

    Background The aim was to explore the structures for managing student fitness to practise hearings in medical schools in the UK. We surveyed by email the named fitness to practise leads of all full members of the UK Medical Schools Council with a medical undergraduate programme. We asked whether student fitness to practise cases were considered by a committee/panel dedicated to medicine, or by one which also considered other undergraduate health and social care students. Findings All 31 medical schools responded. 19 medical schools had a fitness to practise committee dealing with medical students only. Three had a committee that dealt with students of medicine and dentistry. One had a committee that dealt with students of medicine and veterinary medicine. Eight had a committee that dealt with students of medicine and two or more other programmes, such as dentistry, nursing, midwifery, physiotherapy, dietetics, social work, pharmacy, psychology, audiology, speech therapy, operating department practice, veterinary medicine and education. Conclusion All 31 UK medical schools with undergraduate programmes have a fitness to practise committee to deal with students whose behaviour has given rise to concern about their fitness to practise. The variation in governance structures for student fitness to practise committees/panels can in part be explained by variations in University structures and the extent to which Universities co-manage undergraduate medicine with other courses. PMID:19500404

  3. Air quality and public health impacts of UK airports. Part II: Impacts and policy assessment

    NASA Astrophysics Data System (ADS)

    Yim, Steve H. L.; Stettler, Marc E. J.; Barrett, Steven R. H.

    2013-03-01

    The potential adverse human health impacts of emissions from UK airports have become a significant issue of public concern. We produce an inventory of UK airport emissions - including emissions from aircraft landing and takeoff operations, aircraft auxiliary power units (APUs) and ground support equipment (GSE) - with quantified uncertainty. Emissions due to more than 95% of UK passenger enplanements are accounted for. We apply a multi-scale air quality modelling approach to assess the air quality impacts of UK airports. Using a concentration-response function we estimate that 110 (90% CI: 72-160) early deaths occur in the UK each year (based on 2005 data) due to UK airport emissions. We estimate that up to 65% of the health impacts of UK airports could be mitigated by desulphurising jet fuel, electrifying GSE, avoiding use of APUs and use of single engine taxiing. Two plans for the expansion of UK airport capacity are examined - expansion of London Heathrow and new hub airport in the Thames Estuary. Even if capacity is constrained, we find that the health impacts of UK airports still increases by 170% in 2030 due to an increasing and aging population, increasing emissions, and a changing atmosphere. We estimate that if Heathrow were to be expanded as per previous UK Government plans, UK-wide health impacts in 2030 would increase by 4% relative to the 2030 constrained case, but this increase could become a 48% reduction if emissions mitigation measures were employed. We calculate that 24% of UK-wide aviation-attributable early deaths could be avoided in 2030 if Heathrow were replaced by a new airport in Thames Estuary because the location is downwind of London, where this reduction occurs notwithstanding the increase in aircraft emissions. A Thames hub airport would (isolated from knock-on effects at other airports) cause 60-70% fewer early deaths than an expanded Heathrow, or 55-63% fewer early deaths than an unexpanded Heathrow. Finally, replacing Heathrow by a

  4. Non-European nurses' perceived barriers to UK nurse registration.

    PubMed

    Allan, Helen; Westwood, Sue

    2016-05-11

    Aim To conduct a scoping project to identify perceived barriers to UK nurse registration as experienced by internationally educated nurses working as healthcare assistants in the UK. Method Eleven internationally educated nurses working as healthcare assistants in two London hospitals attended two facilitated focus groups. Qualitative thematic analysis was used to analyse the data. Findings Study participants articulated frustration with UK English language testing requirements and a sense of injustice and unfairness relating to: double standards for nurses educated within and outside of the European Union (EU) and European Economic Area (EEA); and what was perceived, by some, as arbitrary English language testing with unnecessarily high standards. Differences among study participants related to issues of competency and accountability regarding English language skills and passing English language skills tests, with many feeling they were playing 'a game' where the rules kept changing. Conclusion Language testing barriers are impeding UK nurse registration for some internationally educated nurses from outside the EU and EEA who, as a result, are working as healthcare assistants. The provision of English language training by employers would improve their prospects of achieving nurse registration.

  5. 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.

  6. 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.

  7. 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.

  8. Comparing the academic performance of graduate-entry and undergraduate medical students at a UK medical school.

    PubMed

    Knight, James; Stead, Anthony P; Geyton, Thomas Oliver

    2017-01-01

    The aim of the study was to assess whether graduate-entry (GE) medicine is a valid route to medical school in the United Kingdom. We set out to analyze the academic performance of GE students when compared with undergraduate (UG) students by assessing the representation of high achievers and students with fail grades within the two cohorts. Using the Freedom of Information Act, we requested examination result data for the academic year 2013-2014 at St. George's Medical School, London, UK. We analyzed the number of students gaining distinction (top 7.5%) and those in the first two deciles. There were 389 GE and 548 UG students in the clinical years. A total of 61.3% of the first or second decile places were awarded to GEs, with 38.7% going to UGs (P < 0.0005). The proportion of GEs achieving the first or second decile was 30.1% compared to 12.8% of UGs (P < 0.01). The proportion of GEs awarded distinction was 12.3% compared to 2.9% of UGs (P < 0.02). The total number of students failing a year at the first attempt was 103. The failure rate within each group was 12.1% for GE and 10.2% for UG. Our study found that GE students were overrepresented in the high-achieving groups when compared to UG students. GE students were significantly more likely to be placed in the first or second decile or attain a distinction award. However, GE and UG have a similar failure rate. This study shows that GE programs are a valid entry route to medical courses in the UK.

  9. A Portable Low-Cost High Density Sensor Network for Air Quality at London Heathrow Airport

    NASA Astrophysics Data System (ADS)

    Popoola, O. A.; Mead, M. I.; Bright, V. B.; North, R.; Stewart, G.; Kaye, P. H.; Jones, R. L.

    2013-12-01

    The growing demand for air travel in the UK has led to calls for ways to address the effects of increasing activities in airports in London. London Heathrow airport (LHR) is the largest airport in the UK and in recent years has been operating close to full capacity resulting in consideration of building a third runway to ease the burden at the airport. Such an expansion would be subject to meeting several criteria including local air quality challenges. Air quality issues associated with the airport include particulates (e.g. PM2.5, PM10), carbon monoxide (CO), oxides of nitrogen (NO, NO2), sulphur dioxide (SO2) and volatile organic compounds (VOCs), and these are associated with different sources including aircraft activities and road traffic within and outside of the airport. Although it is well known that airports contribute to poor air quality, part of the challenge is to quantify contributions from these different sources. The work presented here shows the utility of low-cost high density sensor networks in addressing this challenge. We have shown in previous studies the application of low-cost electrochemical sensor network instruments in monitoring air quality pollutants including CO, NO and NO2 in an urban environment. In this paper we extend this to include modified versions of these instruments which incorporate additional species such as O3, SO2, VOCs, CO2 as well as size-speciated particulates (0.38 to 17.4 μm). Meteorological data including temperature, relative humidity, wind speed and direction are also recorded. For this paper, we focus on LHR, although the technique has much wider applicability. A network of 30 sensor nodes is being deployed for over 16 months in and around LHR as part of NERC funded Sensor Network for Air Quality (SNAQ) project. We present here some of the early results from the deployment showing source attribution associated with different operational modes at LHR. Regional pollution episodes influenced by macro meteorology are

  10. Volatile organic compound fluxes and concentrations in London (ClearfLo)

    NASA Astrophysics Data System (ADS)

    Valach, Amy; Langford, Ben; Nemitz, Eiko; MacKenzie, Rob; Hewitt, Nick

    2014-05-01

    Volatile organic compounds (VOCs) from anthropogenic sources such as fuel combustion or evaporative emissions can directly and indirectly affect human health. Some VOCs, such as benzene and 1,3- butadiene are carcinogens. These and other VOCs contribute to the formation of ozone (O3) and aerosol particles, which have effects on human health and the radiative balance of the atmosphere. Although in the UK VOC emissions are subject to control under European Commission Directive 2008/50/EC and emission reducing technologies have been implemented, urban air pollution remains a concern. Urban air quality is likely to remain a priority since currently >50% of the global population live in urban areas with trends in urbanization and population migration predicted to increase. The ClearfLo project is a large multi-institutional consortium funded by the UK Natural Environment Research Council (NERC) and provides integrated measurements of meteorology, gas phase and particulate composition of the atmosphere over London. Both long term and IOP measurements were made at street and elevated locations at a range of sites across London and its surroundings during 2011 and 2012. Mixing ratios of a selection of nine VOCs were measured using a high sensitivity proton transfer reaction-mass spectrometer (PTR-MS) at a ground level urban background (North Kensington) and kerbside (Marylebone Road) site during the winter IOP. VOC fluxes were measured by virtually disjunct eddy covariance (vDEC) at an elevated urban site (King's College Strand) in Aug-Dec 2012. Our results for the first IOP showed that most of the selected compound concentrations depended on traffic emissions, although there was a marked difference between the urban background and kerbside sites. We identified some temperature effects on VOC concentrations. We also present the first analyses of VOC flux measurements over London. Preliminary analyses indicate most compounds associated with vehicle emissions closely

  11. 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…

  12. 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…

  13. 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.

  14. A tale of two cities: Comparison of impacts on CO2 emissions, the indoor environment and health of home energy efficiency strategies in London and Milton Keynes

    NASA Astrophysics Data System (ADS)

    Shrubsole, C.; Das, P.; Milner, J.; Hamilton, I. G.; Spadaro, J. V.; Oikonomou, E.; Davies, M.; Wilkinson, P.

    2015-11-01

    Dwellings are a substantial source of global CO2 emissions. The energy used in homes for heating, cooking and running electrical appliances is responsible for a quarter of current total UK emissions and is a key target of government policies for greenhouse gas abatement. Policymakers need to understand the potential impact that such decarbonization policies have on the indoor environment and health for a full assessment of costs and benefits. We investigated these impacts in two contrasting settings of the UK: London, a predominantly older city and Milton Keynes, a growing new town. We employed SCRIBE, a building physics-based health impact model of the UK housing stock linked to the English Housing Survey, to examine changes, 2010-2050, in end-use energy demand, CO2 emissions, winter indoor temperatures, airborne pollutant concentrations and associated health impacts. For each location we modelled the existing (2010) housing stock and three future scenarios with different levels of energy efficiency interventions combined with either a business-as-usual, or accelerated decarbonization of the electricity grid approach. The potential for CO2 savings was appreciably greater in London than Milton Keynes except when substantial decarbonization of the electricity grid was assumed, largely because of the lower level of current energy efficiency in London and differences in the type and form of the housing stock. The average net impact on health per thousand population was greater in magnitude under all scenarios in London compared to Milton Keynes and more beneficial when it was assumed that purpose-provided ventilation (PPV) would be part of energy efficiency interventions, but more detrimental when interventions were assumed not to include PPV. These findings illustrate the importance of considering ventilation measures for health protection and the potential variation in the impact of home energy efficiency strategies, suggesting the need for tailored policy

  15. Tuberculosis in London: the importance of homelessness, problem drug use and prison.

    PubMed

    Story, A; Murad, S; Roberts, W; Verheyen, M; Hayward, A C

    2007-08-01

    The control of tuberculosis (TB) is founded on early case detection and complete treatment of disease. In the UK, TB is concentrated in subgroups of the population in large urban centres. The impact of homelessness, imprisonment and problem drug use on TB control in London is reviewed. A cohort study was undertaken of all patients with TB in Greater London to determine the point prevalence of disease in different groups and to examine risk factors for smear positivity, drug resistance, treatment adherence, loss to follow-up and use of directly observed therapy (DOT). Data were collected on 97% (1941/1995) of eligible patients. The overall prevalence of TB was 27 per 100,000. An extremely high prevalence of TB was seen in homeless people (788/100,000), problem drug users (354/100,000) and prisoners (208/100,000). Multivariate analysis showed that problem drug use was associated with smear positive disease (OR 2.2, p<0.001), being part of a known outbreak of drug resistant TB (OR 3.5, p = 0.001) and loss to follow-up (OR 2.7, p<0.001). Imprisonment was associated with being part of the outbreak (OR 10.3, p<0.001) and poor adherence (OR 3.9, p<0.001). Homelessness was associated with infectious TB (OR 1.6, p = 0.05), multidrug resistance (OR 2.1, p = 0.03), poor adherence (OR 2.5, p<0.001) and loss to follow-up (OR 3.8, p<0.001). In London, homeless people, prisoners and problem drug users collectively comprise 17% of TB cases, 44% of smear positive drug resistant cases, 38% of poorly compliant cases and 44% of cases lost to follow-up. 15% of these patients start treatment on DOT but 46% end up on DOT. High levels of infectious and drug resistant disease, poor adherence and loss to follow-up care indicate that TB is not effectively controlled among homeless people, prisoners and problem drug users in London.

  16. Tuberculosis in London: the importance of homelessness, problem drug use and prison

    PubMed Central

    Story, A; Murad, S; Roberts, W; Verheyen, M; Hayward, A C

    2007-01-01

    Background The control of tuberculosis (TB) is founded on early case detection and complete treatment of disease. In the UK, TB is concentrated in subgroups of the population in large urban centres. The impact of homelessness, imprisonment and problem drug use on TB control in London is reviewed. Methods A cohort study was undertaken of all patients with TB in Greater London to determine the point prevalence of disease in different groups and to examine risk factors for smear positivity, drug resistance, treatment adherence, loss to follow‐up and use of directly observed therapy (DOT). Results Data were collected on 97% (1941/1995) of eligible patients. The overall prevalence of TB was 27 per 100 000. An extremely high prevalence of TB was seen in homeless people (788/100 000), problem drug users (354/100 000) and prisoners (208/100 000). Multivariate analysis showed that problem drug use was associated with smear positive disease (OR 2.2, p<0.001), being part of a known outbreak of drug resistant TB (OR 3.5, p = 0.001) and loss to follow‐up (OR 2.7, p<0.001). Imprisonment was associated with being part of the outbreak (OR 10.3, p<0.001) and poor adherence (OR 3.9, p<0.001). Homelessness was associated with infectious TB (OR 1.6, p = 0.05), multidrug resistance (OR 2.1, p = 0.03), poor adherence (OR 2.5, p<0.001) and loss to follow‐up (OR 3.8, p<0.001). In London, homeless people, prisoners and problem drug users collectively comprise 17% of TB cases, 44% of smear positive drug resistant cases, 38% of poorly compliant cases and 44% of cases lost to follow‐up. 15% of these patients start treatment on DOT but 46% end up on DOT. Conclusions High levels of infectious and drug resistant disease, poor adherence and loss to follow‐up care indicate that TB is not effectively controlled among homeless people, prisoners and problem drug users in London. PMID:17289861

  17. 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)

  18. 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)

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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.

  14. Assessing public health risk in the London polonium-210 incident, 2006.

    PubMed

    Maguire, H; Fraser, G; Croft, J; Bailey, M; Tattersall, P; Morrey, M; Turbitt, D; Ruggles, R; Bishop, L; Giraudon, I; Walsh, B; Evans, B; Morgan, O; Clark, M; Lightfoot, N; Gilmour, R; Gross, R; Cox, R; Troop, P

    2010-06-01

    Mr Alexander Litvinenko died in a London hospital on 23 November 2006, allegedly from poisoning with the radionuclide polonium-210 ((210)Po). Associated circumstances required an integrated response to investigate the potential risk of internal contamination for individuals exposed to contaminated environments. Descriptive study. Contaminated locations presenting a potential risk to health were identified through environmental assessment by radiation protection specialists. Individuals connected with these locations were identified and assessed for internal contamination with (210)Po. In total, 1029 UK residents were identified, associated with the 11 most contaminated locations. Of these, 974 were personally interviewed and 787 were offered urine tests for (210)Po excretion. Overall, 139 individuals (18%) showed evidence of probable internal contamination with (210)Po arising from the incident, but only 53 (7%) had assessed radiation doses of 1mSv or more. The highest assessed radiation dose was approximately 100mSv. Although internal contamination with (210)Po was relatively frequent and was most extensive among individuals associated with locations judged a priori to pose the greatest risk, a high degree of assurance could be given to UK and international communities that the level of health risk from exposure to the radionuclide in this incident was low. Copyright 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Simulating secondary organic aerosol from missing diesel-related intermediate-volatility organic compound emissions during the Clean Air for London (ClearfLo) campaign

    NASA Astrophysics Data System (ADS)

    Ots, Riinu; Young, Dominique E.; Vieno, Massimo; Xu, Lu; Dunmore, Rachel E.; Allan, James D.; Coe, Hugh; Williams, Leah R.; Herndon, Scott C.; Ng, Nga L.; Hamilton, Jacqueline F.; Bergström, Robert; Di Marco, Chiara; Nemitz, Eiko; Mackenzie, Ian A.; Kuenen, Jeroen J. P.; Green, David C.; Reis, Stefan; Heal, Mathew R.

    2016-05-01

    We present high-resolution (5 km × 5 km) atmospheric chemical transport model (ACTM) simulations of the impact of newly estimated traffic-related emissions on secondary organic aerosol (SOA) formation over the UK for 2012. Our simulations include additional diesel-related intermediate-volatility organic compound (IVOC) emissions derived directly from comprehensive field measurements at an urban background site in London during the 2012 Clean Air for London (ClearfLo) campaign. Our IVOC emissions are added proportionally to VOC emissions, as opposed to proportionally to primary organic aerosol (POA) as has been done by previous ACTM studies seeking to simulate the effects of these missing emissions. Modelled concentrations are evaluated against hourly and daily measurements of organic aerosol (OA) components derived from aerosol mass spectrometer (AMS) measurements also made during the ClearfLo campaign at three sites in the London area. According to the model simulations, diesel-related IVOCs can explain on average ˜ 30 % of the annual SOA in and around London. Furthermore, the 90th percentile of modelled daily SOA concentrations for the whole year is 3.8 µg m-3, constituting a notable addition to total particulate matter. More measurements of these precursors (currently not included in official emissions inventories) is recommended. During the period of concurrent measurements, SOA concentrations at the Detling rural background location east of London were greater than at the central London location. The model shows that this was caused by an intense pollution plume with a strong gradient of imported SOA passing over the rural location. This demonstrates the value of modelling for supporting the interpretation of measurements taken at different sites or for short durations.

  16. Combined Ground and Space-Based Measurements of Air Quality during the London Olympic Games 2012

    NASA Astrophysics Data System (ADS)

    Graves, R. R.; Leigh, R. J.; Singh Anand, J.; McNally, M.; Lawrence, J.; Remedios, J.; Monks, P. S.

    2012-12-01

    During July and August 2012 the Summer Olympic Games were held in London. During this period, unusually high levels of traffic and visitors to the city were expected, it is important to understand the effect this had on the air quality in London during this period. To this end three novel CityScan instruments were installed in London from the 20th July though to the end of September; affording the unique opportunity to monitor the spatial and vertical structure of nitrogen dioxide within the boundary layer in unprecedented detail. The deployment was included as part of the large NERC funded ClearfLo project (Clean Air for London) involving many other institutions and complementary measurement techniques. CityScan is a Hemispherical Scanning Imaging Differential Optical Absorption Spectrometer (HSI-DOAS) which is has been optimised to measure concentrations of nitrogen dioxide. CityScan has a 95° field of view (FOV) between the zenith and 5° below the horizon. Across this FOV there are 128 resolved elements which are measured concurrently, the spectrometer is rotated azimuthally 1° per second providing full hemispherical coverage every 6 minutes. CityScan measures concentrations of nitrogen dioxide over specific lines of sight and due to the extensive field of view of the instrument this produces measurements which are representative over city-wide scales. Nitrogen dioxide is an important air pollutant which is produced in all combustion processes and can reduce lung function; especially in sensitised individuals. These instruments aim to bridge the gap in spatial scales between point source measurements of air quality and satellite measurements of air quality offering additional information on emissions, transport and the chemistry of nitrogen dioxide. More information regarding the CityScan technique can be found at http://www.leos.le.ac.uk/aq/index.html. The first of the three CityScan instruments was located in North Kensington, the second in Soho and third

  17. Provision of health promotion programmes to people with serious mental illness: a mapping exercise of four South London boroughs.

    PubMed

    O'Brien, C; Gardner-Sood, P; Corlett, S K; Ismail, K; Smith, S; Atakan, Z; Greenwood, K; Joseph, C; Gaughran, F

    2014-03-01

    People with serious mental illness (SMI) are at increased risk of developing various physical health diseases, contributing to significantly reduced life expectancies compared with the general population. In light of this, the Department of Health have set the physical health of people with mental health problems as a priority for improvement. Additionally, the UK government encourages the NHS and local authorities to develop health promotion programmes (HPPs) for people with SMI. To document how many and what types of HPPs were available to people with SMI across four South London boroughs, UK. We found 145 HPPs were available to people with SMI across the four boroughs, but with an inequitable distribution. We also found that certain HPPs set admission criteria that were likely to act as a barrier to improving health. A more integrated approach of documenting and providing information regarding the provision of HPPs for or inclusive of people with SMI is needed. People with serious mental illness (SMI) such as schizophrenia, schizoaffective disorders and bipolar disorder are at increased risk of developing diabetes, cardiovascular disease and respiratory disease, contributing to significantly reduced life expectancies. As a result, emphasis has been placed on developing Health Promotion Programmes (HPPs) to modify the risk of poor physical health in SMI. We examined how many and what types of HPPs are available for or inclusive of people with SMI across four borough in South London, UK. A cross-sectional mapping study was carried out to identify the number of HPPs available to people with SMI. We found 145 HPPs available to people with SMI existed across the four boroughs but with an inequitable distribution, which in some boroughs we anticipate may not meet need. In some cases, HPPs set admission conditions which were likely to further impede access. We recommend that accurate and readily available information on the provision of HPPs for or inclusive of people

  18. 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…

  19. 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…

  20. Herbal medicines for osteoarthritis.

    PubMed

    2012-01-01

    Osteoarthritis is one of the leading causes of pain and disability. In the UK, up to 8.5 million people are affected by joint pain that may be attributed to the condition. Non-surgical treatment options include lifestyle measures (e.g. exercise); local therapy involving heat or cold; manual therapy; transcutaneous electrical nerve stimulation (TENS); topical capsaicin; simple analgesics; NSAIDs; opioids; and intra-articular corticosteroid injections. Studies have reported widespread use of complementary and alternative therapies such as herbal medicines by patients with arthritis. Here we review the efficacy and safety of herbal medicines for symptoms of osteoarthritis.

  1. Epidemiology of U.K. military burns.

    PubMed

    Foster, Mark Anthony; Moledina, Jamil; Jeffery, Steve L A

    2011-01-01

    The authors review the etiology of U.K. military burns in light of increasing hybrid warfare. Analysis of the nature of these injured personnel will provide commanders with the evidence to plan for on-going and future operations. Case notes of all U.K. Armed Forces burn injured patients who were evacuated to the Royal Centre for Defence Medicine were reviewed. Demographics, burn severity, pattern, and mortality details were included. There were 134 U.K. military personnel with burns requiring return to the United Kingdom during 2001-2007. The median age was 27 (20-62) years. Overall, 60% of burns seen were "accidental." Burning waste, misuse or disrespect of fuel, and scalds were the most prevalent noncombat burns. Areas commonly burned were the face, legs, and hands. During 2006-2007 in the two major conflicts, more than 59% (n = 36) of the burned patients evacuated to the United Kingdom were injured during combat. Burns sustained in combat represent 5.8% of all combat casualties and were commonly associated with other injuries. Improvised explosive device, minestrike, and rocket-propelled grenade were common causes. The mean TBSA affected for both groups was 5% (1-70). The majority of combat burn injuries have been small in size. Greater provision of flame retardant equipment and clothing may reduce the extent and number of combat burns in the future. The numbers of noncombat burns are being reduced by good military discipline.

  2. 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.

  3. 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.

  4. Audit of the job satisfaction levels of the UK radiography and physics workforce in UK radiotherapy centres 2012.

    PubMed

    Hutton, D; Beardmore, C; Patel, I; Massey, J; Wong, H; Probst, H

    2014-07-01

    Workforce planning reports identify a staff shortfall that jeopardizes the ability of UK radiotherapy centres to meet future demands. Obtaining an understanding of the work experiences of radiotherapy professionals will support the development of strategies to increase job satisfaction, productivity and effectiveness. A quantitative survey assessed job satisfaction, attitudes to incident reporting, stress and burnout, opportunities for professional development, workload, retention and turnover. Clinical oncologists were not included, as the Royal College of Radiologists, London, UK, had recently assessed their members' satisfaction. All questions were taken from validated instruments or adapted from the "UK National Health Service Staff Survey". The survey yielded 658 completed responses (approximately 16% response rate), from public and private sectors. Over a third (36%) of respondents were classified as satisfied for job satisfaction with 11% dissatisfied and the remaining 53% ambivalent. A significant proportion of clinical staff (37.5%) report high emotional exhaustion. Presenteeism was an issue with 42.4% attending work despite feeling unable to fulfil their role. Radiotherapy professionals are prone to the effects of compassion fatigue and burnout. Attention must be paid to workload and its impact on practitioners' job satisfaction. Professional development that is supported and informed by a performance development review is a simple and effective means of enhancing satisfaction. Individuals have a responsibility to themselves and their colleagues as their behaviours and attitudes influence job satisfaction. This work identifies areas for future research to enhance the professional resilience of practitioners, in order to provide high-quality treatments.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. The future of the London Buy-To-Let property market: Simulation with temporal Bayesian Networks.

    PubMed

    Constantinou, Anthony C; Fenton, Norman

    2017-01-01

    In 2015 the British government announced a number of major tax reforms for individual landlords. To give landlords time to adjust, some of these tax measures are being introduced gradually from April 2017, with full effect in tax year 2020/21. The changes in taxation have received much media attention since there has been widespread belief that the new measures were sufficiently skewed against landlords that they could signal the end of the Buy-To-Let (BTL) investment era in the UK. This paper assesses the prospective performance of BTL investments in London from the investor's perspective, and examines the impact of incoming tax reforms using a novel Temporal Bayesian Network model. The model captures uncertainties of interest by simulating the impact of changing circumstances and the interventions available to an investor at various time-steps of a BTL investment portfolio. The simulation results suggest that the new tax reforms are likely to have a detrimental effect on net profits from rental income, and this hits risk-seeking investors who favour leverage much harder than risk-averse investors who do not seek to expand their property portfolio. The impact on net profits also poses substantial risks for lossmaking returns excluding capital gains, especially in the case of rising interest rates. While this makes it less desirable or even non-viable for some to continue being a landlord, based on the current status of all factors taken into consideration for simulation, investment prospects are still likely to remain good within a reasonable range of interest rate and capital growth rate variations. The results also suggest that the recent trend of property prices in London increasing faster than rents will not continue for much longer; either capital growth rates will have to decrease, rental growth rates will have to increase, or we shall observe a combination of the two events.

  10. The future of the London Buy-To-Let property market: Simulation with temporal Bayesian Networks

    PubMed Central

    Fenton, Norman

    2017-01-01

    In 2015 the British government announced a number of major tax reforms for individual landlords. To give landlords time to adjust, some of these tax measures are being introduced gradually from April 2017, with full effect in tax year 2020/21. The changes in taxation have received much media attention since there has been widespread belief that the new measures were sufficiently skewed against landlords that they could signal the end of the Buy-To-Let (BTL) investment era in the UK. This paper assesses the prospective performance of BTL investments in London from the investor’s perspective, and examines the impact of incoming tax reforms using a novel Temporal Bayesian Network model. The model captures uncertainties of interest by simulating the impact of changing circumstances and the interventions available to an investor at various time-steps of a BTL investment portfolio. The simulation results suggest that the new tax reforms are likely to have a detrimental effect on net profits from rental income, and this hits risk-seeking investors who favour leverage much harder than risk-averse investors who do not seek to expand their property portfolio. The impact on net profits also poses substantial risks for lossmaking returns excluding capital gains, especially in the case of rising interest rates. While this makes it less desirable or even non-viable for some to continue being a landlord, based on the current status of all factors taken into consideration for simulation, investment prospects are still likely to remain good within a reasonable range of interest rate and capital growth rate variations. The results also suggest that the recent trend of property prices in London increasing faster than rents will not continue for much longer; either capital growth rates will have to decrease, rental growth rates will have to increase, or we shall observe a combination of the two events. PMID:28654698

  11. Prevalence of nasopharyngeal carriage of pneumococcus in preschool children attending day care in London

    PubMed Central

    Roche, Anita; Heath, Paul T; Sharland, Mike; Strachan, David; Breathnach, Aodhan; Haigh, John; Young, Yvonne

    2007-01-01

    Objective To estimate the prevalence of nasopharyngeal (NP) carriage of pneumococcus (Streptococcus pneumoniae) and describe the antibiotic resistance patterns and serotypes in young children attending group day care in London. Design and subjects Cross‐sectional survey of attendees at a sample of registered child day care centres (CDCCs) in a London borough. Setting Urban setting with a socially and culturally diverse population. Methods and outcomes 19 CDCCs (13% of total) participated between March and November 2003. A single NP swab was required from each child, and parents completed a questionnaire about their child's health and attendance at day care. WHO methodology for pneumococcal carriage studies was followed. Results 30% of parents consented. 234 swabs were collected from children aged 6 months to 5 years. 53% were boys and 81% were white. 120 children (51%, 95% CI 45% to 58%) carried pneumococci in their nasopharynx. None of the isolates were resistant to penicillin (upper CL 3%). 21 isolates were resistant to erythromycin (17.5%, 95% CI 11% to 25.5%). 68 isolates (57%) were serotypes included in the 7‐valent conjugate vaccine. Non‐white children had a lower prevalence of carriage (27% vs 58%). Conclusion: The prevalence of pneumococcal NP carriage was high. The penicillin resistance rate is lower than in many other countries and may reflect a decrease in community antibiotic prescribing in the UK. Monitoring circulating serotypes is important in the context of recent changes to the vaccination policy. Further study is required to explore the association with ethnicity and risk factors for antibiotic resistance. PMID:17768150

  12. 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.

  13. Epidemiology of internal contamination with polonium-210 in the London incident, 2006.

    PubMed

    Fraser, G; Giraudon, I; Cohuet, S; Bishop, L; Maguire, H; Thomas, H L; Mandal, S; Anders, K; Sanchez-Padilla, E; Charlett, A; Evans, B; Gross, R

    2012-02-01

    More than 700 UK residents were tested for possible contamination with polonium-210 ((210)Po) following the alleged poisoning of Mr Alexander Litvinenko in London in November 2006. This paper describes the epidemiology of internal contamination with the radionuclide in this group. 11 locations in London had been identified as sufficiently environmentally contaminated with (210)Po to present a health risk to people associated with them. Public health consultant teams identified individuals at risk and offered 24-h urine testing for (210)Po excretion. Prevalence of internal contamination was estimated, and a retrospective cohort analysis was completed for each location. Overall 139 individuals (prevalence 0.19 (95% CI 0.13 to 0.27)) showed evidence of internal contamination with (210)Po, although none with uptakes likely to cause adverse health effects. Substantial prevalence was seen among specific hotel service staff, customers, staff and other users of a hotel bar, office and hospital staff, staff of one restaurant and residents of and visitors to the family home. Increased risks of contamination were seen for a hotel bar in association with occupational, behavioural and temporal factors. Occupational and guest exposure to contaminated areas of hotels were also associated with increased contamination risk. Nurses were more likely to become contaminated than other staff involved in direct patient care. Uptake of trace amounts of radionuclide in this incident was frequent. Occupational, behavioural and temporal gradients in contamination risk were mostly consistent with a priori site risk assessments. Utility of the investigation methods and findings for future accidental or deliberate environmental contamination incidents are discussed.

  14. Trauma and current symptoms of PTSD in a South East London community.

    PubMed

    Frissa, Souci; Hatch, Stephani L; Gazard, Billy; Fear, Nicola T; Hotopf, Matthew

    2013-08-01

    This study aimed to estimate the prevalence of symptoms of post-traumatic stress disorder (PTSD) and its association with traumatic events in a representative sample of an inner city population in the UK. A representative community sample of 1,698 adults, aged 16 years and over, from two south London boroughs were interviewed face to face with structured survey questionnaires. The prevalence of current symptoms of PTSD was 5.5 %. Women were more likely to screen positive (6.4 %) than men (3.6 %), and symptoms of PTSD were high in the unemployed (12.5 %), in those not working because of health reasons (18.2 %) and in the lowest household income group (14.8 %). Most (78.2 %) of the study population had lifetime trauma and more than a third (39.7 %) reported childhood trauma. There was an independent association between childhood as well as lifetime trauma and current symptoms of PTSD and a gradient association between an increase in cumulative traumatic events and the likelihood of reporting symptoms of current PTSD (OR 1.8, 95 % CI (1.6-2.1)). Although we observed the highest prevalence of current symptoms of PTSD in those migrated for asylum or political reason (13.6 %), compared to the non-migrants, the prevalence of exposure to most traumatic life events was higher in the non-migrant group. The present study demonstrates the high prevalence of exposure to trauma in a South East London community and the cumulative effect on current symptoms of PTSD. As PTSD is a condition which is associated with disability and co-morbidity, the association of current PTSD with common adversities in the community should be noted.

  15. Cycling to work in London and inhaled dose of black carbon.

    PubMed

    Nwokoro, Chinedu; Ewin, Clare; Harrison, Clare; Ibrahim, Mubin; Dundas, Isobel; Dickson, Iain; Mushtaq, Naseem; Grigg, Jonathan

    2012-11-01

    Modelling studies suggest that urban cycling is associated with an increased inhaled dose of fossil fuel-derived black carbon (BC). Using the amount of black material in airway macrophages as a marker of long-term inhaled BC, we sought to compare inhaled BC dose in London (UK) cyclists and non-cyclists. Airway macrophage carbon was assessed in 28 (58%) out of 48 healthy adults (14 cyclists and 14 non-cyclists) who attended for induced sputum. Short-term (24 h) exposure to BC was assessed on a representative working day in 27 out of 28 subjects. Serum interleukin (IL)-1β, IL-2, IL-6, IL-8, granulocyte-macrophage colony-stimulating factor and tumour necrosis factor (TNF)-α were assessed in 26 out of the 28 subjects. Cyclists were found to have increased airway macrophage carbon when compared with non-cyclists (mean ± se 1.81 ± 0.21 versus 1.11 ± 0.07 μm(2); p<0.01). Short-term monitoring showed no difference in 24 h BC exposure between the two groups. However, cyclists were exposed to higher concentrations of BC during commuting (p<0.01). Airway macrophage carbon was associated with monitored commute BC (n=28; r=0.47, p<0.05). TNF-α was found to be increased in cyclists (p<0.05), but no other cytokines were increased. Commuting to work by bicycle in London is associated with increased long-term inhaled dose of BC. Whether cycling per se increases inhaled BC dose remains unclear.

  16. Radiotherapy in the UK

    SciTech Connect

    Ramsay, S.

    1993-10-09

    What is wrong with radiation treatment in the UK Is it bad practice or merely bad publicity Between 1982 and 1991, 1,000 patients receiving isocentric radiation therapy at the North Staffordshire Royal Infirmary received a substantial underdose of radiation; the clinical report on this incident was published last week. The operator had been using a correction factor for tumor-to-skin distance, unaware that this factor had already been applied by the computer system. Although the report pointed out that it is not surprising that the clinicians were not alerted to the undertreatment, is also noted that there were no resources at the hospital to audit the outcome of radiotherapy.

  17. 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.

  18. 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

  19. Chemical composition and sources of organic aerosols over London from the ClearfLo 2012 campaigns

    NASA Astrophysics Data System (ADS)

    Finessi, Emanuela; Holmes, Rachel; Hopkins, James; Lee, James; Harrison, Roy; Hamilton, Jacqueline

    2014-05-01

    Air quality in urban areas represents a major public health issue with around one third of the European population concentrated in cities and numbers expected to increase at global scale, particularly in developing countries. Particulate matter (PM) represents a primary threat for human health as numerous studies have confirmed the association between increased levels of cardiovascular and respiratory diseases with the exposure to PM. Despite considerable efforts made in improving air quality and progressively stricter emissions regulations, the PM concentrations have not changed much over the past decades for reasons that remain unclear, and highlight that studies on PM source apportionment are required for the formulation of effective policy. We investigated the chemical composition of organic aerosol (OA) collected during two intensive field campaigns held in winter and summer 2012 in the frame of the project Clean air for London (http://www.clearflo.ac.uk/). PM samples were collected both at a city background site (North Kensington) and at a rural site 50 km southeast of London (Detling) with 8 to 24 hours sampling schedule and analysed using off-line methods. Thermal-optical analysis was used to quantify OC-EC components while a suite of soft ionization mass spectrometric techniques was deployed for detailed chemical characterization. Liquid chromatography mass Spectrometry (LC-MSn) was mostly used for the simultaneous detection and quantification of various tracers for both primary and secondary OA sources. Well-established markers for wood burning primary OA like levoglucosan and azelaic acid were quantified together with various classes of nitroaromatics including methyl-nitrocatechols that are potential tracers for wood burning secondary OA. In addition, oxidation products of biogenic VOCs such as isoprene and monoterpenes were also quantified for both seasons and sites. A non-negligible contribution from biogenic SOA to urban OA was found in summertime

  20. Investigating the annual behaviour of submicron secondary inorganic and organic aerosols in London

    NASA Astrophysics Data System (ADS)

    Young, D. E.; Allan, J. D.; Williams, P. I.; Green, D. C.; Flynn, M. J.; Harrison, R. M.; Yin, J.; Gallagher, M. W.; Coe, H.

    2015-06-01

    For the first time, the behaviour of non-refractory inorganic and organic submicron particulate through an entire annual cycle is investigated using measurements from an Aerodyne compact time-of-flight aerosol mass spectrometer (cToF-AMS) located at a UK urban background site in North Kensington, London. We show that secondary aerosols account for a significant fraction of the submicron aerosol burden and that high concentration events are governed by different factors depending on season. Furthermore, we demonstrate that on an annual basis there is no variability in the extent of secondary organic aerosol (SOA) oxidation, as defined by the oxygen content, irrespective of amount. This result is surprising given the changes in precursor emissions and contributions as well as photochemical activity throughout the year; however it may make the characterisation of SOA in urban environments more straightforward than previously supposed. Organic species, nitrate, sulphate, ammonium, and chloride were measured during 2012 with average concentrations (±1 standard deviation) of 4.32 (±4.42), 2.74 (±5.00), 1.39 (±1.34), 1.30 (±1.52), and 0.15 (±0.24) μg m-3, contributing 44, 28, 14, 13, and 2 % to the total non-refractory submicron mass (NR-PM1) respectively. Components of the organic aerosol fraction are determined using positive matrix factorisation (PMF), in which five factors are identified and attributed as hydrocarbon-like OA (HOA), cooking OA (COA), solid fuel OA (SFOA), type 1 oxygenated OA (OOA1), and type 2 oxygenated OA (OOA2). OOA1 and OOA2 represent more and less oxygenated OA with average concentrations of 1.27 (±1.49) and 0.14 (±0.29) μg m-3 respectively, where OOA1 dominates the SOA fraction (90%). Diurnal, monthly, and seasonal trends are observed in all organic and inorganic species due to meteorological conditions, specific nature of the aerosols, and availability of precursors. Regional and transboundary pollution as well as other individual

  1. Investigating the annual behaviour of submicron secondary inorganic and organic aerosols in London

    NASA Astrophysics Data System (ADS)

    Young, D. E.; Allan, J. D.; Williams, P. I.; Green, D. C.; Flynn, M. J.; Harrison, R. M.; Yin, J.; Gallagher, M. W.; Coe, H.

    2014-07-01

    For the first time, the behaviour of non-refractory inorganic and organic submicron particulate through an entire annual cycle is investigated using measurements from an Aerodyne compact time-of-flight aerosol mass spectrometer (cToF-AMS) located at a UK urban background site in North Kensington, London. We show secondary aerosols account for a significant fraction of the submicron aerosol burden and that high concentration events are governed by different factors depending on season. Furthermore, we demonstrate that on an annual basis there is no variability in the extent of secondary organic aerosol (SOA) oxidation, as defined by the oxygen content, irrespective of amount. This result is surprising given the changes in precursor emissions and contributions as well as photochemical activity throughout the year; however it may make the characterisation of SOA in urban environments more straightforward than previously supposed. Organic species, nitrate, sulphate, ammonium, and chloride were measured during 2012 with average concentrations (±one standard deviation) of 4.32 (±4.42), 2.74 (±5.00), 1.39 (±1.34), 1.30 (±1.52) and 0.15 (±0.24) μg m-3, contributing 43, 28, 14, 13 and 2% to the total submicron mass, respectively. Components of the organic aerosol fraction are determined using positive matrix factorisation (PMF) where five factors are identified and attributed as hydrocarbon-like OA (HOA), cooking OA (COA), solid fuel OA (SFOA), type 1 oxygenated OA (OOA1), and type 2 oxygenated OA (OOA2). OOA1 and OOA2 represent more and less oxygenated OA with average concentrations of 1.27 (±1.49) and 0.14 (±0.29) μg m-3, respectively, where OOA1 dominates the SOA fraction (90%). Diurnal, monthly, and seasonal trends are observed in all organic and inorganic species, due to meteorological conditions, specific nature of the aerosols, and availability of precursors. Regional and transboundary pollution as well as other individual pollution events influence London

  2. The management for tuberculosis control in Greater London in comparison with that in Osaka City: lessons for improvement of TB control management in Osaka City urban setting.

    PubMed

    Ohkado, Akihiro; Williams, Gini; Ishikawa, Nobukatsu; Shimouchi, Akira; Simon, Carter

    2005-07-01

    The tuberculosis (TB) notification in Osaka City has been persistently high compared with other urban areas in Japan. Although the TB notification in Greater London has kept much lower level compared with that in Osaka City, it has been also persistently high compared with other urban areas in the UK. Nonetheless, the contexts of the two cities relating TB control programme as well as the epidemiological situation greatly vary; there must be some lessons to be learnt from each other to improve each TB control programme to tackle against TB more effectively. Comparing the epidemiological situation of TB in both cities, it is obvious that Osaka City suffers TB more than Greater London in terms of the TB notification rate. Concerning the context of the TB control programme, Osaka City has centralised approach with strong local government commitment; Greater London, on the other hand, has an approach that is greatly fragmented but coordinated through voluntary TB Networks. This paper aims to draw some constructive and practical lessons from Greater London TB control management for further improvement of Osaka City TB control management through literature review and interview to health professionals. TB epidemiology in Greater London shows distinct features in the extent of TB in new entrants and TB co-infected with HIV in comparison with those in Osaka City. TB epidemiology in Osaka City is to a great extent specifically related to homeless people whereas in Greater London, this relationship occurs to a lesser extent. Both areas have relatively high TB-notification rates compared with national figures, and they have "TB hot spots" where remarkably high TB-notification rates exist. TB control in Greater London is characterised with decentralised and devolved services to local government health authorities supplemented with co-ordinating bodies across sectors as well as across Greater London. Sector-wide TB Network as well as London TB Group (LTBG) and London TB Nurses

  3. An observational study of retail availability and in-store marketing of e-cigarettes in London: potential to undermine recent tobacco control gains?

    PubMed Central

    Hsu, Robert; Myers, Allison E; Ribisl, Kurt M; Marteau, Theresa M

    2013-01-01

    Objectives E-cigarette companies and vendors claim the potential of e-cigarettes to help smokers reduce or quit tobacco use. E-cigarettes also have the potential to renormalise smoking. The purpose of this study was to describe the availability and in-store marketing of e-cigarettes in London, UK stores selling tobacco and alcohol. Design Observational study. Setting Small and large stores selling alcohol and tobacco in London, UK. Primary and secondary outcome measures The number of stores selling e-cigarettes, the number of stores with an interior or exterior e-cigarette advertisement, the number of stores with an e-cigarette point-of-sale movable display, store size, deprivation index score for store's corresponding lower super output area. Results Audits were completed in 108 of 128 selected stores. 62 of the audited stores (57%) sold e-cigarettes. E-cigarette availability was unrelated to store size. There was a statistically non-significant trend towards increased availability in more deprived areas (p=0.069). 31 of the 62 stores (50%) selling e-cigarettes had a point-of-sale movable display, with all but one found in small stores. Two small stores had interior advertisements and eight had exterior advertisements. No advertisements were observed in large stores. Conclusions This audit revealed widespread availability of e-cigarettes and in-store marketing in London, UK. Even if e-cigarettes prove to be an effective cessation aid, their sale and use are resulting in an increasing public presence of cigarette-like images and smoking behaviour. After decades of work to denormalise smoking, these findings raise the question of whether e-cigarettes are renormalising smoking. PMID:24366581

  4. "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

  5. "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.

  6. 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.

  7. 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…

  8. 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…

  9. 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

  10. 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:…

  11. 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…

  12. 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…

  13. 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…

  14. 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)

  15. 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…

  16. 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…

  17. 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)

  18. 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.

  19. 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…

  20. 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.

  1. 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,…

  2. 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…

  3. 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)

  4. 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:…

  5. 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…

  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. Type 2 diabetes mellitus in people with severe mental illness: inequalities by ethnicity and age. Cross-sectional analysis of 588 408 records from the UK.

    PubMed

    Das-Munshi, J; Ashworth, M; Dewey, M E; Gaughran, F; Hull, S; Morgan, C; Nazroo, J; Petersen, I; Schofield, P; Stewart, R; Thornicroft, G; Prince, M J

    2017-07-01

    To investigate whether the association of severe mental illness with Type 2 diabetes varies by ethnicity and age. We conducted a cross-sectional analysis of data from an ethnically diverse sample of 588 408 individuals aged ≥18 years, registered to 98% of general practices (primary care) in London, UK. The outcome of interest was prevalent Type 2 diabetes. Relative to people without severe mental illness, the relative risk of Type 2 diabetes in people with severe mental illness was greatest in the youngest age groups. In the white British group the relative risks were 9.99 (95% CI 5.34, 18.69) in those aged 18-34 years, 2.89 (95% CI 2.43, 3.45) in those aged 35-54 years and 1.16 (95% CI 1.04, 1.30) in those aged ≥55 years, with similar trends across all ethnic minority groups. Additional adjustment for anti-psychotic prescriptions only marginally attenuated the associations. Assessment of estimated prevalence of Type 2 diabetes in severe mental illness by ethnicity (absolute measures of effect) indicated that the association between severe mental illness and Type 2 diabetes was more marked in ethnic minorities than in the white British group with severe mental illness, especially for Indian, Pakistani and Bangladeshi individuals with severe mental illness. The relative risk of Type 2 diabetes is elevated in younger populations. Most associations persisted despite adjustment for anti-psychotic prescriptions. Ethnic minority groups had a higher prevalence of Type 2 diabetes in the presence of severe mental illness. Future research and policy, particularly with respect to screening and clinical care for Type 2 diabetes in populations with severe mental illness, should take these findings into account. © 2016 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  8. Entrepreneurship and UK Doctoral Graduates

    ERIC Educational Resources Information Center

    Hooley, Tristram; Bentley, Kieran; Marriott, John

    2011-01-01

    This paper discusses the experience of UK doctoral graduates in pursuing entrepreneurial careers: there is evidence that this applies to a substantial number--about 10%--of doctoral graduates. The nature of their experience was explored using 37 interviews with doctoral entrepreneurs. The research was funded by Vitae (www.vitae.ac.uk), an…

  9. Entrepreneurship and UK Doctoral Graduates

    ERIC Educational Resources Information Center

    Hooley, Tristram; Bentley, Kieran; Marriott, John

    2011-01-01

    This paper discusses the experience of UK doctoral graduates in pursuing entrepreneurial careers: there is evidence that this applies to a substantial number--about 10%--of doctoral graduates. The nature of their experience was explored using 37 interviews with doctoral entrepreneurs. The research was funded by Vitae (www.vitae.ac.uk), an…

  10. The secret garden? Elite metropolitan geographies in the contemporary UK.

    PubMed

    Cunningham, Niall; Savage, Mike

    2015-05-01

    There is an enduring, indeed increasing awareness of the role of spatial location in defining and reinforcing inequality in this country and beyond. In the UK, much of the debate around these issues has focussed on the established trope of a long-standing 'north-south divide', a divide which appears to have deepened in recent decades with the inexorable de-industrialisation of northern Britain presented in stark counterpoint to the burgeoning concentration of wealth in London and the south-east, driven by the financial and ancillary services sectors. Due to a lack of available data, such debates have tended to focus solely on economic inequalities between places, and until now there was little understanding of how these disparities played out in the social and cultural domains. This paper significantly advances our understanding of the true meaning of spatial inequality in the UK by broadening that definition to encompass not only the economic, but also the social and cultural arenas, using data available from the BBC's Great British Class Survey experiment. We argue that these data shine a light not only on the economic inequalities between different parts of the country which existing debates have already uncovered but to understand how these are both reinforced and mediated across the social and cultural dimensions. Fundamentally, we concur with a great many others in seeing London and the south-east as a vortex for economic accumulation but it is also much more than that; it is a space where the coming together of intense economic, social and cultural resources enables the crystallisation of particular and nuanced forms of elite social class formations, formations in which place is not incidental but integral to their very existence.

  11. The secret garden? Elite metropolitan geographies in the contemporary UK

    PubMed Central

    Cunningham, Niall; Savage, Mike

    2015-01-01

    There is an enduring, indeed increasing awareness of the role of spatial location in defining and reinforcing inequality in this country and beyond. In the UK, much of the debate around these issues has focussed on the established trope of a long-standing ‘north-south divide’, a divide which appears to have deepened in recent decades with the inexorable de-industrialisation of northern Britain presented in stark counterpoint to the burgeoning concentration of wealth in London and the south-east, driven by the financial and ancillary services sectors. Due to a lack of available data, such debates have tended to focus solely on economic inequalities between places, and until now there was little understanding of how these disparities played out in the social and cultural domains. This paper significantly advances our understanding of the true meaning of spatial inequality in the UK by broadening that definition to encompass not only the economic, but also the social and cultural arenas, using data available from the BBC's Great British Class Survey experiment. We argue that these data shine a light not only on the economic inequalities between different parts of the country which existing debates have already uncovered but to understand how these are both reinforced and mediated across the social and cultural dimensions. Fundamentally, we concur with a great many others in seeing London and the south-east as a vortex for economic accumulation but it is also much more than that; it is a space where the coming together of intense economic, social and cultural resources enables the crystallisation of particular and nuanced forms of elite social class formations, formations in which place is not incidental but integral to their very existence. PMID:26640301

  12. Realising the potential for an Olympic legacy; teaching medical students about sport and exercise medicine and exercise prescribing.

    PubMed

    Jones, Paul R; Brooks, John H M; Wylie, Ann

    2013-11-01

    Physicians are increasingly being called upon to promote physical activity (PA) among patients. However, a paucity of exercise medicine teaching in the UK undergraduate medical curricula prevents students from acquiring the necessary knowledge and skills to do so. To address this issue, King's College London School of Medicine introduced an exercise medicine strand of teaching. This study evaluated the acceptability of exercise promotion behaviour change lectures and explored the knowledge and attitudes of the students who received it. Students were invited to complete a 6-item online questionnaire prior to and after exercise medicine lectures. The questionnaire assessed beliefs regarding the importance of PA in disease prevention and management, in addition to their confidence in advising patients on PA recommendations. A focus group (n=7) explored students' attitudes towards and knowledge of PA promotion and exercise prescribing. In total, 121 (15%) first-year and second-year MBBS students completed the questionnaire. Students' beliefs regarding the importance of PA in managing disease and their confidence in PA promotion among patients increased after the teaching (p<0.001). More students were able to correctly identify the Chief Medical Officer recommended adult PA guidelines (p<0.05). Students were enthusiastic about the exercise medicine teaching, strongly supportive of its continued inclusion in the curriculum and advocated its importance for patients and themselves as future doctors. Behaviour change teaching successfully improved students' knowledge of and confidence regarding PA promotion. These improvements are a step forward and may increase the rates and success of physician PA counselling in the future.

  13. Use of non‐invasive ventilation in UK emergency departments

    PubMed Central

    Browning, J; Atwood, B; Gray, A

    2006-01-01

    Aim To describe the current use of non‐invasive ventilation in UK emergency departments. Methods A structured questionnaire was sent to all UK emergency departments assessing 25,000 new patients annually. Results 222 of 233 departments completed the questionnaire. 148 currently use non‐invasive ventilation (NIV). Most used NIV for either cardiogenic pulmonary oedema (n = 128) or chronic obstructive pulmonary disease (n = 115). Only 49 departments have protocols for NIV use and 23 audited practice. Conclusion NIV is commonly used in UK emergency departments. Practices vary significantly. One solution would be the development of guidelines on when and how to use NIV in emergency medicine practice. PMID:17130599

  14. UK goes to the Planets

    NASA Astrophysics Data System (ADS)

    Heward, A.

    UK goes to the Planets Anita Heward UK Goes to the Planets Co-ordinator (anitaheward@btinternet.com) "UK goes to the Planets" is a campaign to promote the UK's involvement in missions to explore the Solar System. The campaign is run by a consortium of representatives from the research institutions and commercial companies that are involved in these missions. Since the end of 2002, the consortium has met every few months to discuss how to capitalise on the promotional opportunity offered by this busy time in planetary exploration. The main aim is to encourage collaboration between organisations in order to produce the most comprehensive and cost-effective outreach activities and highlight the UK-wide involvement in planetary science. Activities to date have included press and media events, as well as the development of a website, publications, educational materials and exhibitions. This talk will review the achievements of the past four years and look ahead to future plans.

  15. Speeches to mark the accession of the UK to ESO: Lord Sainsbury, Arno Freytag, Catherine Cesarsky

    NASA Astrophysics Data System (ADS)

    2002-09-01

    To mark the occasion of the the tenth member state joining ESO, the UK invited ESO to hold its 98th Council meeting in London on 8-9 July 2002. The hosts provided a wonderful venue for the meeting in Trinity House, overlooking the Tower of London. An excursion to the historic Greenwich Observatory and a banquet at Lancaster House helped to make it an especially memorable occasion. A landmark decision made at the meeting was the approval for the construction and operation of the Atacama Large Millimeter Array (ALMA). The speeches given at the banquet by Lord Sainsbury, A. Freytag and C. Cesarsky are printed below, followed by an article by Prof. Gerry Gilmore on the British astronomers' perspective.

  16. Mental health needs, service use and costs among Somali refugees in the UK.

    PubMed

    McCrone, P; Bhui, K; Craig, T; Mohamud, S; Warfa, N; Stansfeld, S A; Thornicroft, G; Curtis, S

    2005-05-01

    To assess the mental health needs and service use of Somali refugees living in London. Subjects (n = 143) were sampled from conventional and non-conventional sites. Needs and service use were measured using the Camberwell Assessment of Need and the Client Service Receipt Inventory, respectively. Comparisons between sites were made and cost predictors identified. Basic needs occurred frequently but were often not fully addressed. The mean number of needs was around four out of a possible 22. The most used services were GPs, other clinicians and refugee services. Higher non-inpatient costs were associated with length of stay in the UK and lower costs with being at risk of suicide and having panic disorder or agoraphobia. Somali refugees living in London have a relatively high level of need but a low level of service use. Refugee characteristics could only account for a limited amount of cost variation. Copyright Blackwell Munksgaard 2005.

  17. Currently available medical engineering degrees in the UK. Part 1: Undergraduate degrees.

    PubMed

    Joyce, T

    2009-05-01

    This paper reviews mechanical-engineering-based medical engineering degrees which are currently provided at undergraduate level in the UK. At present there are 14 undergraduate degree programmes in medical engineering, offered by the University of Bath, University of Birmingham, University of Bradford, Cardiff University, University of Hull, Imperial College London, University of Leeds, University of Nottingham, University of Oxford, Queen Mary University of London, University of Sheffield, University of Southampton, University of Surrey, and Swansea University. All these undergraduate courses are delivered on a full-time basis, both 3 year BEng and 4 year MEng degrees. Half of the 14 degree courses share a core first 2 years with a mechanical engineering stream. The other seven programmes include medical engineering modules earlier in their degrees. Within the courses, a very wide range of medical-engineering-related modules are offered, although more common modules include biomaterials, biomechanics, and anatomy and physiology.

  18. 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.

  19. In-Street Wind Direction Variability in the Vicinity of a Busy Intersection in Central London

    NASA Astrophysics Data System (ADS)

    Balogun, Ahmed A.; Tomlin, Alison S.; Wood, Curtis R.; Barlow, Janet F.; Belcher, Stephen E.; Smalley, Robert J.; Lingard, Justin J. N.; Arnold, Sam J.; Dobre, Adrian; Robins, Alan G.; Martin, Damien; Shallcross, Dudley E.

    2010-09-01

    We present results from fast-response wind measurements within and above a busy intersection between two street canyons (Marylebone Road and Gloucester Place) in Westminster, London taken as part of the DAPPLE (Dispersion of Air Pollution and Penetration into the Local Environment; www.dapple.org.uk uk" TargetType="URL"/> ) 2007 field campaign. The data reported here were collected using ultrasonic anemometers on the roof-top of a building adjacent to the intersection and at two heights on a pair of lamp-posts on opposite sides of the intersection. Site characteristics, data analysis and the variation of intersection flow with the above-roof wind direction ( θ ref ) are discussed. Evidence of both flow channelling and recirculation was identified within the canyon, only a few metres from the intersection for along-street and across-street roof-top winds respectively. Results also indicate that for oblique roof-top flows, the intersection flow is a complex combination of bifurcated channelled flows, recirculation and corner vortices. Asymmetries in local building geometry around the intersection and small changes in the background wind direction (changes in 15- min mean θ ref of 5°-10°) were also observed to have profound influences on the behaviour of intersection flow patterns. Consequently, short time-scale variability in the background flow direction can lead to highly scattered in-street mean flow angles masking the true multi-modal features of the flow and thus further complicating modelling challenges.

  20. South Asian and Middle Eastern patients' perspectives on medicine-related problems in the United Kingdom.

    PubMed

    Alhomoud, Faten; Dhillon, Soraya; Aslanpour, Zoe; Smith, Felicity

    2015-08-01

    There has been little research which specifically examines medicine use among South Asian (SA) and Middle Eastern (ME) groups, although evidence suggests that medicine-related needs may be poorly met for these groups. To describe medicine-related problems (MRPs) experienced by SA and ME patients from their perspectives and identify possible contributory factors that may be specific to their cultures. The data were collected in seven pharmacies in London, United Kingdom (UK). The study was a qualitative study. Patients were from SA and ME origins, aged over 18 and prescribed three or more regular medicines. Patients were identified when presenting with a prescription. The data were collected in 80 face-to-face semi-structured interviews using Gordon's MRPs tool. Interviews were audiotaped, transcribed verbatim and analysed thematically using Gordon's coding frame and Nvivo 10 software. Describing MRPs experienced by SA and ME patients from their perspectives and identifying possible contributory factors that may be specific to their cultures. Results Eighty participants (61 % male) had mean (SD) age 58 (13.4) years and a mean (SD) of 8 (4) medicines. Interviews revealed that several factors contributed to the development of MRPs; some appeared to be specific to SA and ME cultures and others were similar to the general population. The factors that were reported to be specific to SA and ME groups comprised religious practices and beliefs, use of non-prescription medicines, extent of family support, and travelling abroad--to patient's homeland or to take religious journeys. Illiteracy, language and communication barriers, lack of translated resources, perceptions of healthcare providers, and difficulty consulting a doctor of the same gender may also contribute to the problems. Many of these factors could be expected to influence patient's safety, adherence, and informed decision-making. This study demonstrated that SA and ME patients have their own problems and needs