Changes needed to medicine in the UK before senior UK-trained doctors, working outside the UK, will return: questionnaire surveys undertaken between 2004 and 2015.

PubMed

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

2017-12-01

To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Questionnaire survey. UK-trained medical graduates. Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned. Comments from doctors working abroad about changes needed to UK medicine before they would return. Eleven years after graduation, 290 (6%) of respondents were working in medicine abroad; 277 (6%) were doing so 17/19 years after graduation. Eleven years after graduation, 53% of doctors working abroad indicated that they did not intend to return, and 71% did so 17/19 years after graduation. These respondents reported a number of changes which would need to be made to UK medicine in order to increase the likelihood of them returning. The most frequently mentioned changes cited concerned 'politics/management/funding', 'pay/pension', 'posts/security/opportunities', 'working conditions/hours', and 'factors outside medicine'. Policy attention to factors including funding, pay, management and particularly the clinical-political interface, working hours, and work-life balance may pay dividends for all, both in terms of persuading some established doctors to return and, perhaps more importantly, encouraging other, younger doctors to believe that the UK and the National Health Service can offer them a satisfying and rewarding career.

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

Changes needed to medicine in the UK before senior UK-trained doctors, working outside the UK, will return: questionnaire surveys undertaken between 2004 and 2015

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2017-01-01

Objective To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Design Questionnaire survey. Setting UK-trained medical graduates. Participants Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned. Main outcome measures Comments from doctors working abroad about changes needed to UK medicine before they would return. Results Eleven years after graduation, 290 (6%) of respondents were working in medicine abroad; 277 (6%) were doing so 17/19 years after graduation. Eleven years after graduation, 53% of doctors working abroad indicated that they did not intend to return, and 71% did so 17/19 years after graduation. These respondents reported a number of changes which would need to be made to UK medicine in order to increase the likelihood of them returning. The most frequently mentioned changes cited concerned ‘politics/management/funding’, ‘pay/pension’, ‘posts/security/opportunities’, ‘working conditions/hours’, and ‘factors outside medicine’. Conclusions Policy attention to factors including funding, pay, management and particularly the clinical–political interface, working hours, and work–life balance may pay dividends for all, both in terms of persuading some established doctors to return and, perhaps more importantly, encouraging other, younger doctors to believe that the UK and the National Health Service can offer them a satisfying and rewarding career. PMID:29230305

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

Eddy Covariance Measurements Assessing NOx Emission in London, UK

NASA Astrophysics Data System (ADS)

Drysdale, W. S.; Lee, J. D.; Purvis, R.; Squires, F. A.; Vaughan, A. R.; Metzger, S.

2017-12-01

NOx (the sum of NO + NO2) is emitted during most combustion processes. NO2is a well known air pollutant detrimental to human health, and is regulated in many cities. London often finds itself in breach of these emission regulations. Emission inventories are used in air quality forecast models to predict current and future air pollution levels and to guide abatement strategy. It is therefore crucial that inventories accurately predict emissions; validation can be carried out using direct measurements. Measurements of NO and NO2 at 5 Hz have been made at the BT Tower, 190 m above street level in central London. Eddy covariance calculations have been performed using both classical and "continuous wavelet transformation" method, producing half hour and 1 minute resolved NOx fluxes respectively. We present a first look at these flux data measured in early 2017. A strong diurnal profile for NOx flux is observed, with an increase from 5am to 7am, and remaining constant around 1400 ng m2 m-1 throughout the day, before decreasing to background levels towards midnight. Data is also compared to previous NOx flux measurements over two periods, June-July 2012 and March-April 2013 to examine how emissions have changed over this period. A significant decrease in NOx emissions ( 64%, a mean flux of 2400 ng m2 s-1 in 2012 to a mean 870 ng m2 s-1 in 2017) is observed. When the fluxes are separated by wind flow from the east and west, there is negligible difference in 2017, where 2012 saw lower fluxes from the east, especially in the afternoon. By coupling the measurements with a footprint model we compare the data to emission estimates from the UK's National Atmospheric Emission Inventory (NAEI). In 2012-13 emissions were measured to be twice as high than the NAEI predicted and the latest data shows a much better agreement.

Uses of the Twins UK genetic database.

PubMed

Spector, Tim D

2007-11-01

Tim Spector is a Professor of Genetic Epidemiology at King's College London and Director of the Twin Research and Genetic Epidemiology Unit at St Thomas' Hospital, London. Professor Spector graduated from St Bartholomew's Hospital Medical School, London, in 1982. After working in General Medicine, he completed a MSc in Epidemiology, and his MD degree at the University of London in 1989. He founded the UK Twins Registry of 10,000 twins in 1993, which is one of the largest collections of genotype and phenotype information on twins worldwide, whose breadth of research has expanded to cover a wide range of common complex traits many of which were previously thought to be mainly due to aging and the environment. He has published over 350 research articles on common diseases. He has written several original articles on the genetics of a wide range of diseases and traits including back pain, acne, inflammation, obesity, memory, musical ability and sexuality. He is the principal investigator of the EU Euroclot and Treat OA study, and a partner in five others. He has written several books, focusing on osteoporosis and genetics and, in 2003, he published a popular book on genetics: Your Genes Unzipped.

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…

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.

Robin Ganellin gives his views on medicinal chemistry and drug discovery. Interview by Stephen L. Carney.

PubMed

Ganellin, C Robin

2004-02-15

Robin Ganellin was born in East London and studied chemistry at Queen Mary College, London, receiving a PhD in 1958 under Professor Michael Dewar for his research on tropylium chemistry. He joined Smith Kline & French Laboratories (SK&F) in the UK in 1958 and was one of the co-inventors of the revolutionary drug cimetidine (Tagamet(R)) He subsequently became Vice-President for Research at the company's Welwyn facility. In 1986 he was awarded a DSc from London University for his work on the medicinal chemistry of drugs acting at histamine receptors and was also made a Fellow of the Royal Society and appointed to the SK&F Chair of Medicinal Chemistry at University College London, where he is now Emeritus Professor of Medicinal Chemistry. Professor Ganellin has been honoured extensively, including such awards as the Royal Society of Chemistry Award for Medicinal Chemistry, their Tilden Medal and Lectureship and their Adrien Albert Medal and Lectureship, Le Prix Charles Mentzer de France, the ACS Division of Medicinal Chemistry Award, the Society of Chemical Industry Messel Medal and the Society for Drug Research Award for Drug Discovery. He is a past Chairman of the Society for Drug Research, was President of the Medicinal Chemistry Section of IUPAC, and is currently Chairman of the IUPAC Subcommittee on Medicinal Chemistry and Drug Development.

UK nuclear medicine survey, 1992-93.

PubMed

Elliott, A T; Elliott, F M; Shields, R A

1996-01-01

A postal survey of UK nuclear medicine departments was undertaken to collate information on equipment, numbers of procedures and staffing levels for the years 1992 and 1993. It was estimated that there are 235 sites undertaking nuclear medicine, the total number of procedures performed being some 490,000 in 1993 compared with 430,000 in 1989. Informal investigation suggests that the increase is due to greater usage of myocardial perfusion and lung ventilation/perfusion studies. Wide variations were noted in staffing levels, with only 22% of departments having medical cover of half-time equivalent or better: over 30% of departments have less than one consultant session per week. Approximately 20% of departments claimed to have no physics input, with a further 20% having less than one session per week.

Prioritisation of veterinary medicines in the UK environment.

PubMed

Boxall, Alistair B A; Fogg, Lindsay A; Kay, Paul; Blackwel, Paul A; Pemberton, Emma J; Croxford, Andy

2003-05-15

A wide range of veterinary medicines is used to treat animals in the UK. Whilst the environmental impact of selected substances (particulary the sheep dip chemicals, anthelmintics and fish farm chemicals) has been well studied, limited information is available in the public domain on the other groups of substances (e.g. antifungals, coccidiostats, antiprotozoals, hormones and growth promoters). There is therefore a need to identify other substances that may impact the environment in order to design national monitoring programmes, target experimental work and develop pollution prevention methodologies. In this study, a simple two-stage prioritisation scheme was developed and applied to veterinary medicines in use in the UK. In the first stage, those substances that have high potential to enter the environment in significant amounts were identified on the basis of amounts used in the UK, treatment type and metabolism. In stage 2, the hazard of the identified substances to terrestrial and aquatic organisms was assessed. Using the approach, a total of 56 substances or groups were assigned to a 'high priority' category. For eleven of these substances, sufficient data were available to characterise their risk, these were: oxytetracycline, chlortetracycline, tetracycline, sulphadiazine, amoxicillin, diazinon, tylosin, dihydrostreptomycin, apramycin, cypermethrin and sarafloxicin. For the remaining 45 substances, full datasets were not available and it is recommended that in the first instance, attempts are made to fill these data gaps.

Pharmaceutical Pricing and Market Access Outlook Europe 2010-HealthNetwork Communications' fourth annual conference. 24-25 March 2010, London, UK.

PubMed

Ogbighele, Erhimuvi

2010-05-01

The HealthNetwork Communications' Fourth Annual Conference on Pharmaceutical Pricing and Market Access Outlook Europe 2010, held in London, included topics covering the challenges facing the pharmaceutical industry, specifically related to pricing and reimbursement, and demonstrating the value of a pharmaceutical. This conference report highlights selected presentations on a global perspective on pricing and reimbursement, with an analysis of the specific, unique challenges in the six major markets, Europe, the US, Canada, Germany, the UK and Japan, and a discussion of the benefits of risk-sharing schemes.

Industry perceptions of barriers to commercialization of regenerative medicine products in the UK.

PubMed

Plagnol, Anke C; Rowley, Emma; Martin, Paul; Livesey, Finbarr

2009-07-01

Regenerative medicine is an emerging field with the potential to provide widespread improvement in healthcare and patient wellbeing via the delivery of therapies that can restore, regenerate or repair damaged tissue. As an industry, it could significantly contribute to economic growth if products are successfully commercialized. However, to date, relatively few products have reached the market owing to a variety of barriers, including a lack of funding and regulatory hurdles. The present study analyzes industry perceptions of the barriers to commercialization that currently impede the success of the regenerative medicine industry in the UK. The analysis is based on 20 interviews with leading industrialists in the field. The study revealed that scientific research in regenerative medicine is thriving in the UK. Unfortunately, lack of access to capital, regulatory hurdles, lack of clinical evidence leading to problems with reimbursement, as well as the culture of the NHS do not provide a good environment for the commercialization of regenerative medicine products. Policy interventions, including increased translational government funding, a change in NHS and NICE organization and policies, and regulatory clarity, would likely improve the general outcomes for the regenerative medicine industry in the UK.

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

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

Regional methods for mapping major faults in areas of uniform low relief, as used in the London Basin, UK

NASA Astrophysics Data System (ADS)

Haslam, Richard; Aldiss, Donald

2013-04-01

Most of the London Basin, south-eastern UK, is underlain by the Palaeogene London Clay Formation, comprising a succession of rather uniform marine clay deposits up to 150 m thick, with widespread cover of Quaternary deposits and urban development. Therefore, in this area faults are difficult to delineate (or to detect) by conventional geological surveying methods in the field, and few are shown on the geological maps of the area. However, boreholes and excavations, especially those for civil engineering works, indicate that faults are probably widespread and numerous in the London area. A representative map of fault distribution and patterns of displacement is a pre-requisite for understanding the tectonic development of a region. Moreover, faulting is an important influence on the design and execution of civil engineering works, and on the hydrogeological characteristics of the ground. This paper reviews methods currently being used to map faults in the London Basin area. These are: the interpretation of persistent scatterer interferometry (PSI) data from time-series satellite-borne radar measurements; the interpretation of regional geophysical fields (Bouguer gravity anomaly and aeromagnetic), especially in combination with a digital elevation model; and the construction and interpretation of 3D geological models. Although these methods are generally not as accurate as large-scale geological field surveys, due to the availability of appropriate data in the London Basin they provide the means to recognise and delineate more faults, and with more confidence, than was possible using traditional geological mapping techniques. Together they reveal regional structures arising during Palaeogene crustal extension and subsidence in the North Sea, followed by inversion of a Mesozoic sedimentary basin in the south of the region, probably modified by strike-slip fault motion associated with the relative northward movement of the African Plate and the Alpine orogeny. This

Who applies and who gets admitted to UK graduate entry medicine? - an analysis of UK admission statistics

PubMed Central

2011-01-01

Background Graduate-entry medicine is a recent development in the UK, intended to expand and broaden access to medical training. After eight years, it is time to evaluate its success in recruitment. Objectives This study aimed to compare the applications and admissions profiles of graduate-entry programmes in the UK to traditional 5 and 6-year courses. Methods Aggregate data on applications and admissions were obtained from the Universities and Colleges Admission Service covering 2003 to 2009. Data were extracted, grouped as appropriate and analysed with the Statistical Package for the Social Sciences. Results Graduate-entry attracts 10,000 applications a year. Women form the majority of applicants and admissions to graduate-entry and traditional medicine programmes. Graduate-entry age profile is older, typically 20's or 30's compared to 18 or 19 years in traditional programmes. Graduate-entry applications and admissions were higher from white and black UK ethnic communities than traditional programmes, and lower from southern and Chinese Asian groups. Graduate-entry has few applications or admissions from Scotland or Northern Ireland. Secondary educational achievement is poorer amongst graduate-entry applicants and admissions than traditional programmes. Conclusions Graduate-entry has succeeded in recruiting substantial additional numbers of older applicants to medicine, in which white and black groups are better represented and Asian groups more poorly represented than in traditional undergraduate programmes. PMID:21943332

HIV in East London: ethnicity, gender and risk. Design and methods.

PubMed

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

2006-06-09

While men who have sex with men remain the group at greatest risk of acquiring HIV infection in the UK, the number of new diagnoses among heterosexuals has risen steadily over the last five years. In the UK, three-quarters of heterosexual men and women diagnosed with HIV in 2004 probably acquired their infection in Africa. This changing epidemiological pattern is particularly pronounced in East London because of its ethnically diverse population. The objective of the study was to examine the social, economic and behavioural characteristics of patients with HIV infection currently receiving treatment and care in hospitals in East London. The research focused on ethnicity, gender, sexuality, education, employment, housing, HIV treatment, stigma, discrimination, religion, migration and sexual risk behaviour. People diagnosed with HIV infection attending outpatient treatment clinics at St Bartholomew's, the Royal London, Whipp's Cross, Homerton, Newham and Barking hospitals (all in East London) over a 4-6 month period were invited to participate in the study in 2004-2005. Those who agreed to participate completed a confidential, self-administered pen-and-paper questionnaire. During the study period, 2680 patients with HIV attended the outpatient clinics in the six participating hospitals, of whom 2299 were eligible for the study and 1687 completed a questionnaire. The response rate was 73% of eligible patients and 63% of all patients attending the clinics during the survey period. A clinic-based study has allowed us to survey nearly 1700 patients with HIV from diverse backgrounds receiving treatment and care in East London. The data collected in this study will provide valuable information for the planning and delivery of appropriate clinical care, social support and health promotion for people living with HIV not only in East London but in other parts of the capital as well as elsewhere in the UK.

Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2017-01-01

Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be ‘better’ elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work–life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to

Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation.

PubMed

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

2018-01-01

Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be 'better' elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work-life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to address

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.

Contrasting VOC Composition in London, UK and Beijing, China

NASA Astrophysics Data System (ADS)

Dunmore, R.; Hopkins, J. R.; Shaw, M.; Squires, F. A.; Lee, J. D.; Lewis, A. C.; Hamilton, J. F.

2017-12-01

With an increasing fraction of the world's population now living in megacities, urban air quality in those locations has the potential to be one of the largest controllable factors for public health. Both London and Beijing are classified as megacities, with the latter almost twice as densely populated. The key drivers and trajectory of air pollution are unique to each location; London has substantially reduced PM10 concentrations over the past two decades but continues to have high urban NO2. Beijing has had well-reported high levels of PM, is now in a phase of gradual decline, and has proportionately low NO2. Both locations however, continue to emit a mix of gas phase pollutants with the potential to form photochemical ozone. Whilst the abundance of NOx in each city is relatively straightforward to quantify, the VOC mixtures that are present differ between these two cities and this has consequential impacts on the downwind ozone formation potential. This work reports a comprehensive assessment of VOC speciation, reactivity and abundance in the two cities using a common set of inter-comparable measurement approaches. Hourly observations of VOCs over the range C2 - C13+ were made using two gas chromatography (GC) instruments; a PLOT column based GC for the most volatile fraction (C2-C7) and a comprehensive two-dimensional GC (GCxGC) for VOCs with more than 7 carbons. London has atmospheric VOC concentrations that in mass and reactivity terms are dominated by longer chain VOCs from diesel fuel. The VOC mixture in ambient Beijing air is dominated by short chain VOCs, a mix of both alkenes from incomplete combustion sources and alkanes and aromatics from petrochemical sources. The substantial difference in the fleet proportions of gasoline and diesel powered vehicles between the two cities is clearly reflected in ambient VOCs. In summertime, isoprene was a notable contributor to VOC reactivity in both cities despite both being highly urbanised locations. The absolute

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…

Current research into brain barriers and the delivery of therapeutics for neurological diseases: a report on CNS barrier congress London, UK, 2017.

PubMed

Greenwood, John; Hammarlund-Udenaes, Margareta; Jones, Hazel C; Stitt, Alan W; Vandenbroucke, Roosmarijn E; Romero, Ignacio A; Campbell, Matthew; Fricker, Gert; Brodin, Birger; Manninga, Heiko; Gaillard, Pieter J; Schwaninger, Markus; Webster, Carl; Wicher, Krzysztof B; Khrestchatisky, Michel

2017-11-07

This is a report on the CNS barrier congress held in London, UK, March 22-23rd 2017 and sponsored by Kisaco Research Ltd. The two 1-day sessions were chaired by John Greenwood and Margareta Hammarlund-Udenaes, respectively, and each session ended with a discussion led by the chair. Speakers consisted of invited academic researchers studying the brain barriers in relation to neurological diseases and industry researchers studying new methods to deliver therapeutics to treat neurological diseases. We include here brief reports from the speakers.

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.

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.

A high HIV-1 strain variability in London, UK, revealed by full-genome analysis: Results from the ICONIC project.

PubMed

Yebra, Gonzalo; Frampton, Dan; Gallo Cassarino, Tiziano; Raffle, Jade; Hubb, Jonathan; Ferns, R Bridget; Waters, Laura; Tong, C Y William; Kozlakidis, Zisis; Hayward, Andrew; Kellam, Paul; Pillay, Deenan; Clark, Duncan; Nastouli, Eleni; Leigh Brown, Andrew J

2018-01-01

The ICONIC project has developed an automated high-throughput pipeline to generate HIV nearly full-length genomes (NFLG, i.e. from gag to nef) from next-generation sequencing (NGS) data. The pipeline was applied to 420 HIV samples collected at University College London Hospitals NHS Trust and Barts Health NHS Trust (London) and sequenced using an Illumina MiSeq at the Wellcome Trust Sanger Institute (Cambridge). Consensus genomes were generated and subtyped using COMET, and unique recombinants were studied with jpHMM and SimPlot. Maximum-likelihood phylogenetic trees were constructed using RAxML to identify transmission networks using the Cluster Picker. The pipeline generated sequences of at least 1Kb of length (median = 7.46Kb, IQR = 4.01Kb) for 375 out of the 420 samples (89%), with 174 (46.4%) being NFLG. A total of 365 sequences (169 of them NFLG) corresponded to unique subjects and were included in the down-stream analyses. The most frequent HIV subtypes were B (n = 149, 40.8%) and C (n = 77, 21.1%) and the circulating recombinant form CRF02_AG (n = 32, 8.8%). We found 14 different CRFs (n = 66, 18.1%) and multiple URFs (n = 32, 8.8%) that involved recombination between 12 different subtypes/CRFs. The most frequent URFs were B/CRF01_AE (4 cases) and A1/D, B/C, and B/CRF02_AG (3 cases each). Most URFs (19/26, 73%) lacked breakpoints in the PR+RT pol region, rendering them undetectable if only that was sequenced. Twelve (37.5%) of the URFs could have emerged within the UK, whereas the rest were probably imported from sub-Saharan Africa, South East Asia and South America. For 2 URFs we found highly similar pol sequences circulating in the UK. We detected 31 phylogenetic clusters using the full dataset: 25 pairs (mostly subtypes B and C), 4 triplets and 2 quadruplets. Some of these were not consistent across different genes due to inter- and intra-subtype recombination. Clusters involved 70 sequences, 19.2% of the dataset. The initial analysis of genome sequences

A high HIV-1 strain variability in London, UK, revealed by full-genome analysis: Results from the ICONIC project

PubMed Central

Frampton, Dan; Gallo Cassarino, Tiziano; Raffle, Jade; Hubb, Jonathan; Ferns, R. Bridget; Waters, Laura; Tong, C. Y. William; Kozlakidis, Zisis; Hayward, Andrew; Kellam, Paul; Pillay, Deenan; Clark, Duncan; Nastouli, Eleni; Leigh Brown, Andrew J.

2018-01-01

Background & methods The ICONIC project has developed an automated high-throughput pipeline to generate HIV nearly full-length genomes (NFLG, i.e. from gag to nef) from next-generation sequencing (NGS) data. The pipeline was applied to 420 HIV samples collected at University College London Hospitals NHS Trust and Barts Health NHS Trust (London) and sequenced using an Illumina MiSeq at the Wellcome Trust Sanger Institute (Cambridge). Consensus genomes were generated and subtyped using COMET, and unique recombinants were studied with jpHMM and SimPlot. Maximum-likelihood phylogenetic trees were constructed using RAxML to identify transmission networks using the Cluster Picker. Results The pipeline generated sequences of at least 1Kb of length (median = 7.46Kb, IQR = 4.01Kb) for 375 out of the 420 samples (89%), with 174 (46.4%) being NFLG. A total of 365 sequences (169 of them NFLG) corresponded to unique subjects and were included in the down-stream analyses. The most frequent HIV subtypes were B (n = 149, 40.8%) and C (n = 77, 21.1%) and the circulating recombinant form CRF02_AG (n = 32, 8.8%). We found 14 different CRFs (n = 66, 18.1%) and multiple URFs (n = 32, 8.8%) that involved recombination between 12 different subtypes/CRFs. The most frequent URFs were B/CRF01_AE (4 cases) and A1/D, B/C, and B/CRF02_AG (3 cases each). Most URFs (19/26, 73%) lacked breakpoints in the PR+RT pol region, rendering them undetectable if only that was sequenced. Twelve (37.5%) of the URFs could have emerged within the UK, whereas the rest were probably imported from sub-Saharan Africa, South East Asia and South America. For 2 URFs we found highly similar pol sequences circulating in the UK. We detected 31 phylogenetic clusters using the full dataset: 25 pairs (mostly subtypes B and C), 4 triplets and 2 quadruplets. Some of these were not consistent across different genes due to inter- and intra-subtype recombination. Clusters involved 70 sequences, 19.2% of the dataset. Conclusions

Clean Air for London (CLEARFLO) Final Campaign Summary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Worsnop, D. R.; Williams, L. R.; Herndon, S. C.

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 additionalmore » motivation for the Detling measurements was the question of whether coatings on black carbon particles enhance absorption.« less

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.

Contrasting patterns of mortality and hospital admissions during hot weather and heat waves in Greater London, UK

PubMed Central

Kovats, R; Hajat, S; Wilkinson, P

2004-01-01

Background: Epidemiological research has shown that mortality increases during hot weather and heat waves, but little is known about the effect on non-fatal outcomes in the UK. Aims and Methods: The effects of hot weather and heat waves on emergency hospital admissions were investigated in Greater London, UK, for a range of causes and age groups. Time series analyses were conducted of daily emergency hospital admissions, 1 April 1994 to 31 March 2000, using autoregressive Poisson models with adjustment for long term trend, season, day of week, public holidays, the Christmas period, influenza, relative humidity, air pollution (ozone, PM10), and overdispersion. The effects of heat were modelled using the average of the daily mean temperature over the index and previous two days. Results: There was no clear evidence of a relation between total emergency hospital admissions and high ambient temperatures, although there was evidence for heat related increases in emergency admissions for respiratory and renal disease, in children under 5, and for respiratory disease in the 75+ age group. During the heat wave of 29 July to 3 August 1995, hospital admissions showed a small non-significant increase: 2.6% (95% CI –2.2 to 7.6), while daily mortality rose by 10.8% (95% CI 2.8 to 19.3) after adjusting for time varying confounders. Conclusions: The impact of hot weather on mortality is not paralleled by similar magnitude increases in hospital admissions in the UK, which supports the hypothesis that many heat related deaths occur in people before they come to medical attention. This has evident implications for public health, and merits further enquiry. PMID:15477282

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.

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.

A survey to determine the views of renal transplant patients on generic substitution in the UK.

PubMed

Al Ameri, Mubarak N; Whittaker, Clare; Tucker, Arthur; Yaqoob, Magdi; Johnston, Atholl

2011-08-01

Rising healthcare costs promote the generic substitution among patients because it is identifiable costs. A key concern is that patients should be involved in the decision of switching. The aim of this study was to examine renal transplant patients' views on generic substitution in the UK. A total of 163 renal patients were surveyed using 36 multiple-choice questions at Barts and The London Renal Transplant Clinic, in the UK. Transplant recipients over 18 years, able to read and write English and willing to fill in the questionnaire were targeted; 84% of patients were conscious of the availability of generic medicines, 70% understood the terms "generic" and "branded" in relation to medicines and 54% were aware of generic substitution practice. However, 75% did not know if they were taking generics and 84% felt that generics are not equivalent or only equivalent sometimes and they were uncertain that generics had the same quality as branded medicines. Moreover, many patients admitted that they would not accept the generic substitution of ciclosporin when become available in the UK. A number of factors such as patients' education, knowledge, severity of the disease, efficacy of generic medicines and patients' involvement in decisions regarding their health appear to drive patients' attitudes towards generic substitution. © 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation.

The Provision of Prescription-Only Medicines for Use on UK-based Overseas Expeditions.

PubMed

Moore, James K; Ladbrook, Matthew; Goodyer, Larry; Dallimore, Jon

2017-09-01

Expedition teams without accompanying medical professionals traveling overseas from the UK frequently carry medical kits containing prescription-only medicines (POMs). Access to safe, basic POMs whilst on expedition is important, as the quality and availability of medicines in-country may not be acceptable, and delay in treatment may be hazardous. At present, there is no published guidance relating to drug acquisition and administration in these situations. In the UK, a number of different practices are currently in use, with uncertainty and medicolegal concerns currently hampering safe and efficient provision of POMs on overseas expeditions. A guideline is proposed for the management of prescription-only medications in an expedition setting. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Marvelous medicines and dangerous drugs: the representation of prescription medicine in the UK newsprint media.

PubMed

Prosser, Helen

2010-01-01

Using discourse analysis, this study examines the representation of prescription medicines in the UK newsprint media and, specifically, how the meaning and function of medicines are constructed. At the same time, it examines the extent to which the newsprint media represents a resource for health information, and considers how it may encourage or challenge faith in modern medicine and medical authority. As such, it extends analysis around concepts such as the informed patient and examines the representation of patients and doctors and the extent to which patient-doctor identities promoted in the newsprint media reflect a shift away from paternalism to negotiated encounters. Findings show the media constructs a discrete, contradictory, and frequently oversimplified set of characterizations about medicine. Moreover, it discursively constructs realities that justify and sustain medial dominance. Ideological paradigms in discourse assign patients as passive and disempowered while simultaneously privileging "expert" knowledge. This constructs a reality that marginalizes patients' participation in decision-making.

International Conference on Deformation, Yield and Fracture of Polymers (9th) Held in Cambridge, UK on 11-14 April, 1994. Conference Papers

DTIC Science & Technology

1994-01-01

microplasticity and relaxations in polymers using a laser interferometer NN Peschanskaya, PN Yakushev, AB Sinani and VA Bershtein (Ioffe Physical-Technical...Medicine, London, UK) P29 Toughening mechanism of flame-retarded plastics L Utevskii, I Finberg, E Reznik and M Muskatel (Dead Sea Bromine group, Beer...Dead Sea Bromine Group, Beer Sheva, Israel) P31 Stress-relaxation due to environmental effects on polypropylene and fiber reinforced polyester E Gutman

Highlights from the Inaugural International Cancer Microbiome Consortium Meeting (ICMC), 5-6 September 2017, London, UK.

PubMed

Scott, Alasdair J; Merrifield, Claire A; Alexander, James L; Marchesi, Julian R; Kinross, James M

2017-01-01

The International Cancer Microbiome Consortium (ICMC) is a recently launched collaborative between academics and academic-clinicians that aims to promote microbiome research within the field of oncology, establish expert consensus and deliver education for academics and clinicians. The inaugural two-day meeting was held at the Royal Society of Medicine (RSM), London, UK, 5-6 September 2017. Microbiome and cancer experts from around the world first delivered a series of talks during an educational day and then sat for a day of roundtable discussion to debate key topics in microbiome-cancer research. Talks delivered during the educational day covered a broad range of microbiome-related topics. The potential role of the microbiome in the pathogenesis of colorectal cancer was discussed and debated in detail with experts highlighting the latest data in animal models and humans and addressing the question of causation versus association. The impact of the microbiota on other cancers-such as lung and urogenital tract-was also discussed. The microbiome represents a novel target for therapeutic manipulation in cancer and a number of talks explored how this might be realised through diet, faecal microbiota transplant and chemotherapeutics. On the second day, experts debated pre-agreed topics with the aim of producing a consensus statement with a focus on the current state of our knowledge and key gaps for further development. The panel debated the notion of a 'healthy' microbiome and, in turn, the concept of dysbiosis in cancer. The mechanisms of microbiota-induced carcinogenesis were discussed in detail and our current conceptual models were assessed. Experts also considered co-factors in microbiome-induced carcinogenesis to conclude that the tripartite 'interactome' between genetically vulnerable host, environment and the microbiome is central to our current understanding. To conclude, the roundtable discussed how the microbiome may be exploited for therapeutic benefit in

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

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

Sport and exercise medicine and the Olympic health legacy.

PubMed

Tew, Garry A; Copeland, Robert J; Till, Simon H

2012-07-19

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.

Automated external defibrillators in public places: position statement from the Faculty of Sport and Exercise Medicine UK.

PubMed

Iqbal, Zafar; Somauroo, John

2015-11-01

Position statements published by the Faculty of Sport and Exercise Medicine UK are quick reference or information documents and include up to 10 short points of clinical relevance for the Sport and Exercise Medicine community as well as for general practitioners and health professionals. The Faculty of Sport and Exercise Medicine (FSEM) UK has published a statement to create greater awareness that the survival rate from Sudden Cardiac Arrest could improve with prompt access to an automated external defibrillator (AED). 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.

"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

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…

Highlights from the Inaugural International Cancer Microbiome Consortium Meeting (ICMC), 5–6 September 2017, London, UK

PubMed Central

Scott, Alasdair J; Merrifield, Claire A; Alexander, James L; Marchesi, Julian R; Kinross, James M

2017-01-01

The International Cancer Microbiome Consortium (ICMC) is a recently launched collaborative between academics and academic-clinicians that aims to promote microbiome research within the field of oncology, establish expert consensus and deliver education for academics and clinicians. The inaugural two-day meeting was held at the Royal Society of Medicine (RSM), London, UK, 5–6 September 2017. Microbiome and cancer experts from around the world first delivered a series of talks during an educational day and then sat for a day of roundtable discussion to debate key topics in microbiome-cancer research. Talks delivered during the educational day covered a broad range of microbiome-related topics. The potential role of the microbiome in the pathogenesis of colorectal cancer was discussed and debated in detail with experts highlighting the latest data in animal models and humans and addressing the question of causation versus association. The impact of the microbiota on other cancers—such as lung and urogenital tract—was also discussed. The microbiome represents a novel target for therapeutic manipulation in cancer and a number of talks explored how this might be realised through diet, faecal microbiota transplant and chemotherapeutics. On the second day, experts debated pre-agreed topics with the aim of producing a consensus statement with a focus on the current state of our knowledge and key gaps for further development. The panel debated the notion of a ‘healthy’ microbiome and, in turn, the concept of dysbiosis in cancer. The mechanisms of microbiota-induced carcinogenesis were discussed in detail and our current conceptual models were assessed. Experts also considered co-factors in microbiome-induced carcinogenesis to conclude that the tripartite ‘interactome’ between genetically vulnerable host, environment and the microbiome is central to our current understanding. To conclude, the roundtable discussed how the microbiome may be exploited for

Safer Schools in the UK--A Case Study

ERIC Educational Resources Information Center

Hayden, Carol; Holt, Amanda; Martin, Denise; Nee, Claire

2011-01-01

This article reports a research that is based on a European Safer Schools Partnership that included ten countries and specifically the UK case study which was located in London. The initiators of this partnership had been involved in early SSPs in the UK and the educationalists were very much focussed on work that would address problematic…

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.

Reframing sociologies of ethnicity and migration in encounters with Chinese London.

PubMed

Knowles, Caroline

2017-09-01

In this paper I argue that the intersecting sociologies of ethnicity and migration work from a series of interconnected blind spots hindering effective analysis of the current UK situation. Both operate analytically within the limitations of an 'immigrant problem' framework; are overinvested in state agendas; privilege a nation state analysis; are narrowly focused on distributions of migrant bodies, and on receiving, at the expense of sending, contexts. Exploring these limitations with data derived from a modest small-scale qualitative study of young Chinese migrants in London, I argue for a reframing along four dimensions. Firstly, in an era of elite migration, sociology could reach beyond its immigrant problem framework and open up to a broader range of UK migrant ethnicities and circumstances. Secondly, a stronger focus on cities as the scale on which lives are lived, and through which diverse streams of translocal activity are routed, would open new avenues of sociological exploration. Thirdly, including translocal activities connected with distributions of ethnic migrant bodies, such as capital transfers, would broaden its focus, taking migration and ethnicity more centrally into the analysis of globalization as one of its constituting practices. Finally, paying attention to sending, as well as arrival cities, reveals migrants' thinking and shapes the ways in which they live, as my data shows. The Chinese are both one of the UK's neglected minorities, and one of its fastest growing populations. They are a good example of new UK migrants and they bring globalization's realignment with the rising significance of China to the UK. © London School of Economics and Political Science 2017.

Seeing Ourselves as Others See Us: Egyptian Teachers' Views of Science Education in Secondary Schools in London, UK.

ERIC Educational Resources Information Center

Swain, Julian; Monk, Martin; Johnson, Sally

1999-01-01

Explores Egyptian science teachers' views of (1) science education in London secondary schools and (2) how London schools influenced their teaching in Egypt. Explains that the Egyptian teachers were participating in a 12-week in-service course at King's College, London. Discusses the results. (CMK)

Sexually transmitted infection risk exposure among black and minority ethnic youth in northwest London: findings from a study translating a sexually transmitted infection risk-reduction intervention to the UK setting.

PubMed

Gerressu, M; Elam, G; Shain, R; Bonell, C; Brook, G; Champion, J Dimmitt; French, R; Elford, J; Hart, G; Stephenson, J; Imrie, J

2009-08-01

Young black women are disproportionately affected by sexually transmitted infections (STI) in the UK, but effective interventions to address this are lacking. The Young Brent Project explored the nature and context of sexual risk-taking in young people to inform the translation of an effective clinic-based STI reduction intervention (Project SAFE) from the USA to the UK. One-to-one in-depth interviews (n = 37) and group discussions (n = 10) were conducted among men and women aged 15-27 years from different ethnic backgrounds recruited from youth and genitourinary medicine clinic settings in Brent, London. The interviews explored the context within which STI-related risks were assessed, experienced and avoided, the skills needed to recognise risk and the barriers to behaviour change. Concurrent sexual partnerships, mismatched perceptions and expectations, and barriers to condom use contributed to STI risk exposure and difficulties in implementing risk-reduction strategies. Women attempted to achieve monogamy, but experienced complex and fluid sexual relationships. Low risk awareness, flawed partner risk assessments, negative perceptions of condoms and lack of control hindered condom use. Whereas men made conscious decisions, women experienced persuasion, deceit and difficulty in requesting condom use, particularly with older partners. Knowledge of STI and condom use skills is not enough to equip young people with the means to reduce STI risk. Interventions with young women need to place greater emphasis on: entering and maintaining healthy relationships; awareness of risks attached to different forms of concurrency and how concurrency arises; skills to redress power imbalances and building self-esteem.

Abstract‐to‐publication ratio for papers presented at scientific meetings: a quality marker for UK emergency medicine research

PubMed Central

Macmillan, Craig D; Moore, Anthony K; Cook, Ronald J; Pedley, David K

2007-01-01

Objectives To determine the publication rate of abstracts presented by UK emergency physicians at major emergency medicine meetings, and to identify the site of publication of papers. Method All abstracts presented to the annual scientific meetings of both the British Association of Emergency Medicine and the Faculty of Accident and Emergency Medicine between 2001 and 2002 were identified retrospectively from conference programmes. To identify whether the work relating to the abstract had been published in a peer‐reviewed journal, the Medline database (Ovid interface) was searched using the first and last authors as well as key words from the abstract. Results Of the 404 abstracts identified, 124 (30%) had been published as full articles. For abstracts presented in the oral sessions, 83 (57%) resulted in publication. A range of journals accepted papers for publication. Conclusion The abstract‐to‐publication ratio for UK emergency medicine is lower than for other specialties, but broadly similar to emergency medicine in the US and Australia. PMID:17513542

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.

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

2018-04-01

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.

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.

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

Summary Report: U.S.-UK Integration in Helmand

DTIC Science & Technology

2016-02-01

Select a caveat Unlimited distribution Summary Report: U.S.-UK Integration in Helmand Alexander Powell , Larry Lewis, Catherine...October 1993. 3 Benjamin Russell, “Special relationship is safe... ’US has no better partner than UK’, says John Kerry,” The Express (London), 9...Robinson, Eugene. “Clinton’s Remarks Cause Upper Lips to Twitch," Washington Post, 19 October 1993. Russell, Benjamin . “Special relationship is safe

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.

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

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. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Ethnicity, migration status and dental caries experience among adults in East London.

PubMed

Delgado-Angulo, Elsa K; Marcenes, Wagner; Harding, Seeromanie; Bernabé, Eduardo

2018-05-16

To assess the interrelationship between ethnicity, migration status and dental caries experience among adults in East London. We analysed data from 1910 adults (16-65 years) representing 9 ethnic groups, who took part in a community-based health survey in East London. Participants completed a supervised questionnaire and were clinically examined by trained dentists. Dental caries was assessed with the number of decayed, missing and filled teeth (DMFT). The association of ethnicity, nativity status and migration history with DMFT was assessed in negative binomial regression models controlling for demographic, socioeconomic and behavioural factors. White migrants had greater DMFT than UK-born adults, whereas every Asian and Black migrant group had lower DMFT than adults of the same ethnic group born in the UK (albeit significant only for Black Caribbean and Asian Others). Among foreign-born adults, age at arrival (Rate Ratio: 1.03; 95% Confidence Interval: 1.01-1.05) and length of residence (1.04; 95% CI: 1.02-1.06) were positively associated with DMFT. A significant interaction between both factors was also found, with more pronounced differences between older and younger migrants at longer stay in the UK for White Others, Black Caribbean and Asian Others. Large inequalities in caries experience were found between foreign- and UK-born adults, with considerable variation across ethnic groups. Looking beyond cultural explanations, in favour of social and environmental factors, may help to explain those inequalities. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

Trends in use of electroconvulsive therapy in South London from 1949 to 2006.

PubMed

Lambe, Sinéad; Mogg, Andrew; Eranti, Savitha; Pluck, Graham; Hastilow, Sarah; McLoughlin, Declan M

2014-12-01

Electroconvulsive therapy (ECT) remains the most acutely effective treatment for severe depression, but its use has declined since its introduction more than 70 years ago. To provide some historical perspective on changes in ECT practice, the objective of the present study was to identify trends in ECT practice in selected teaching hospitals in South London, UK, between 1949 and 2006. Annual rates of ECT for 1949-1970 were estimated from the contemporary hospital reports of the Maudsley and Bethlem Royal hospitals in South London, UK. Case notes were also retrospectively reviewed to calculate annual rates of ECT administration and extract demographic and clinical information for approximately every 5 years between 1987 and 2006. The annual rate of ECT peaked at 35% of total admission in 1956 and declined gradually thereafter to 10.8% by 1970 and fell below 2.2% from 1991 onward. Depressed and female patients were more likely to receive ECT. Compared to previous years, patients were more severely ill and treatment resistant in 2006, whereas ethnic minorities made up 30% of patients receiving ECT compared to approximately 14% in the preceding years. Currently, ECT seems to be provided increasingly late in more severe illness episodes. The ethnicity of patients receiving ECT in South London may be becoming more representative of the background population, but ECT is being used relatively more frequently for nonaffective disorders in ethnic minorities.

Central and East European migrant men who have sex with men in London: a comparison of recruitment methods.

PubMed

Evans, Alison R; Hart, Graham J; Mole, Richard; Mercer, Catherine H; Parutis, Violetta; Gerry, Christopher J; Imrie, John; Burns, Fiona M

2011-05-17

Following the expansion of the European Union, there has been a large influx of Central and East European (CEE) migrants to the UK. CEE men who have sex with men (MSM) represent a small minority within this population that are none-the-less important to capture in sexual health research among the CEE migrant community. This paper examines the feasibility of recruiting CEE MSM for a survey of sexual behaviour in London using respondent driven sampling (RDS), via gay websites and in GUM clinics. We sought CEE MSM to start RDS chain referral among GUM clinic attendees, our personal contacts and at gay events and venues in central London. We recruited CEE MSM (n = 485) via two popular websites for gay men in Britain (March-May 2009) and at two central London GUM clinics (n = 51) (July 2008-March 2009). We found seventeen men who knew other CEE MSM in London and agreed to recruit contacts into the study. These men recruited only three men into the study, none of whom recruited any further respondents, and RDS was abandoned after 7 months (July 2008-January 2009). Half of the men that we approached to participate in RDS did not know any other CEE MSM in London. Men who agreed to recruit contacts for RDS were rather more likely to have been in the UK for more than one year (94.1% vs 70.0%, p = 0.052). Men recruited through gay websites and from GUM clinics were similar. The Internet was the most successful method for collecting data on sexual risk behaviour among CEE MSM in London. CEE MSM in London were not well networked. RDS may also have failed because they did not fully understand the procedure and/or the financial incentive was not sufficient motivation to take part.

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

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).

Practitioners of Western herbal medicine and their practice in the UK: beginning to sketch the profession.

PubMed

Nissen, Nina

2010-11-01

To profile the profession of Western herbal medicine (WHM) in the UK. A self-completion postal questionnaire sent to a sample of practitioners of WHM in England. A typical practitioner of WHM in the UK is female, aged 41-50, white, and practises part-time from a shared clinic or from home. Motivations to embark on a career in WHM are grounded in an interest in natural healing and the desire to help others. The practice of WHM in the UK responds extensively to women's health needs. Tensions in the practice of WHM are identified between a framework of healthcare that is described as 'traditional' and the influences of evidence-based developments in healthcare. Women, both as practitioners and as patients, and women's health needs play a central role in the contemporary practice of WHM in the UK. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

2017-08-01

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. 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/.

Samuel Holden Parsons Lee (1772-1863): American physician, entrepreneur and selfless fighter of the 1798 Yellow Fever epidemic of New London, Connecticut.

PubMed

Mattie, James K; Desai, Sukumar P

2015-02-01

Samuel Holden Parsons Lee practised medicine at a time when the germ theory of disease had not yet been proposed and antibiotics remained undiscovered. In 1798 he served selflessly as the only physician in town who was willing to battle the Yellow Fever outbreak of New London, Connecticut. Because he practised at the dawn of the age of patent medicine, unfortunately his name also came to be associated with medical quackery. We argue that his contributions have been grossly underestimated. He compounded and vended medications - including bilious pills and bitters - that were gold standards of the day. Moreover, one preparation for treatment of kidney stones led to his sub-specialization in this field and was met with such success that its sale continued for nearly 100 years after his death. While a talented medical man, Lee also had a knack for business, finding success in trading, whaling and real estate. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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.

A survey of oral medicine education, training and practice among dermatologists in the UK and Ireland.

PubMed

Heelan, K; McKenna, D

2016-01-15

Oral mucocutaneous diseases are common and patients with these conditions are frequently assessed by dermatologists. An accurate and comprehensive oral examination is important for a complete dermatological assessment. The aim of this study was to assess education and training, knowledge, and clinical practice of oral medicine among dermatologists in the United Kingdom (UK) and Ireland. A cross-sectional survey was conducted by means of an internet-based survey tool. This was available to British Association of Dermatology (BAD) members in UK and Ireland on the association's website. Members were asked to respond to a 10-part questionnaire that enquired about their knowledge of oral diseases, training in oral medicine, performing an oral examination and oral biopsy. Completed responses were received from 95 dermatologists. The majority of respondents were consultant dermatologists (72%) who were university based. While the majority reported that knowledge of oral diseases was important, only 52% were confident in recognising the normal variants of the oral cavity. Just 55% were confident in recognising oral malignancy and even less (42%) the different forms of oral ulceration. Over three-quarters had never attended an oral medicine clinic or attended an external oral medicine course as part of their training. Two thirds had not been taught normal oral anatomy or how to perform an oral examination. The majority reported that their training in oral medicine was not adequate to perform their job. This study shows that in this, albeit small, group of dermatology specialists and trainees most appear ill-equipped to recognise and diagnose diseases of the oral cavity due to a lack of training in oral medicine.

Knowledge Construction and Personal Relationship: Insights about a UK University Mentoring and Coaching Service

ERIC Educational Resources Information Center

Hargreaves, Eleanore

2010-01-01

This article examines interview data from 12 mentors/coaches and eight of their clients in order to explore a mentoring and coaching service among UK university staff. Both mentors/coaches and clients were administrative or academic employees of the Institute of Education or affiliated colleges at London University, UK. Their roles related to the…

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

PubMed

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

2017-01-01

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. 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. 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. 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.

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

The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

PubMed

Lee, K

2000-09-01

There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

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…

Where are we in perioperative medicine for older surgical patients? A UK survey of geriatric medicine delivered services in surgery.

PubMed

Partridge, Judith S L; Collingridge, Geraint; Gordon, Adam Lee; Martin, Finbarr C; Harari, Danielle; Dhesi, Jugdeep K

2014-09-01

national reports have highlighted deficiencies in care provided to older surgical patients and suggested a role for innovative, collaborative, inter-specialty models of care. The extent of geriatrician-led perioperative services in the UK (excluding orthogeriatric services) has not previously been described. This survey describes current services and explores barriers to further development. an electronic survey was sent to clinical leads for geriatric medicine at all 161 acute NHS health care trusts in the UK. Reminders were sent on three occasions over an 8-week period. The survey examined preoperative and postoperative care and organisational issues. Responses were analysed descriptively. there were 130 respondents (80.7%). One-third (38) of respondents described providing some geriatric medicine input in older surgical patients. Preoperative services existed in 15 (12%), where 14 provided risk assessment and 13 preoperative optimisation. Twenty-six respondents (20%) delivered care postoperatively, of them 10 took a reactive approach, 11 a proactive approach and 5 provided a combination of reactive and proactive care. Barriers to establishing perioperative geriatric medicine services included funding, workforce issues and a lack of inter-specialty collaboration. a national appetite exists to provide geriatrician-led services to older surgical patients yet the majority of existing services remain reactive and do not use comprehensive geriatric assessment as an organising principle. This survey suggests that funding for geriatricians in perioperative care has not yet been universally established. Future efforts should focus on dissemination of experiential knowledge and published resources, collaboration with commissioners and empirical research to overcome the barriers described. © 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.

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.

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…

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

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

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

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

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.

Measuring the Hydraulic Effectiveness of Low Impact Development Practices in a Heavily Urbanised Environment: A Case Study from London, UK

NASA Astrophysics Data System (ADS)

El Hattab, M. H.; Vernon, D.; Mijic, A.

2017-12-01

Low impact development practices (LID) are deemed to have a synergetic effect in mitigating urban storm water flooding. Designing and implementing effective LID practices require reliable real-life data about their performance in different applications; however, there are limited studies providing such data. In this study an innovative micro-monitoring system to assess the performance of porous pavement and rain gardens as retrofitting technologies was developed. Three pilot streets in London, UK were selected as part of Thames Water Utilities Limited's Counters Creek scheme. The system includes a V-notch weir installed at the outlet of each LID device to provide an accurate and reliable quantification over a wide range of discharges. In addition to, a low flow sensor installed downstream of the V-notch to cross-check the readings. Having a flow survey time-series of the pre-retrofitting conditions from the study streets, extensive laboratory calibrations under different flow conditions depicting the exact site conditions were performed prior to installing the devices in the field. The micro-monitoring system is well suited for high-resolution temporal monitoring and enables accurate long-term evaluation of LID components' performance. Initial results from the field validated the robustness of the system in fulfilling its requirements.

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

Government Getting Closer: Higher Education and Devolution in the UK

ERIC Educational Resources Information Center

Court, Stephen

2004-01-01

Since 1997 there has been a series of far-reaching constitutional changes in the UK through the devolution of power from Westminster to new legislatures and executives in Scotland, Wales and Northern Ireland. In addition, an elected assembly in London and the English regional development agencies have been established. This paper examines policy…

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…

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

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.

NREL Wins Prestigious UK "Academy Award" for Engineering | News | NREL

Science.gov Websites

College London (UCL), along with NASA, The European Synchrotron, and the UK National Physical Laboratory impressive company." UCL, NREL, NASA, and their partners were recognized in the category of Safety and Device developed by NREL and NASA to study failure mechanisms in Li-ion batteries and then recorded their

Learning experiences and assessment in the first 2 years of the medical course at King's College London School of Medicine.

PubMed

Papachristodoulou, Despo

2010-01-01

The medical curriculum at King's College London School of Medicine is a 5 year course; an extended program (6 years) and a graduate entry program (4 years) are also available. The first 2 years of the curriculum comprise phases 1 and 2. The curriculum consists of core material that is common to all students and student-selected components (students undertake three such components in the first 2 years). Phase 1 lasts 12 weeks and students learn the principles of tissue and organ structure and function. They are also introduced to the practice of medicine (concepts of health, communication, ethics, inter-professional education and medicine in the community). Phase 2 consists of 36 weekly clinical scenarios that place basic medical science in a clinical context. Phase 2 covers cardiovascular, respiratory, gastrointestinal, renal and musculoskeletal systems; nutrition; endocrinology; head and neck anatomy; neuroscience; genetics; and infections. Teaching continues in pri! mary care and in the hospitals and includes basic and advanced life support. Learning experiences include lectures, tutorials, practical classes, dissection and prosection, communication skills, e-learning, student-led sessions and primary care and hospital visits. Assessment consists of in-course assessment (e.g., presentations, tests and essays) and end-of-year examinations which consist of written papers and an objective structured clinical examination at the end of year 2. The main strengths of the program include the scenario format of learning and the practice of medicine early on. The difficulties arise mainly from the large numbers of students (420 per year).

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.

Safety and security in acute admission psychiatric wards in Ireland and London: a comparative study.

PubMed

Cowman, Seamus; Bowers, Len

2009-05-01

The comparative element of this study is to describe safety and security measures in psychiatric acute admission wards in the Republic of Ireland and London; to describe differences and similarities in terms of safety and security patterns in the Republic of Ireland and London; and to make recommendations on safety and security to mental health services management and psychiatric nurses. Violence is a serious problem in psychiatric services and staff experience significant psychological reactions to being assaulted. Health and Safety Authorities in the UK and Ireland have expressed concern about violence and assault in healthcare, however, there remains a lack of clarity on matters of procedure and policy pertaining to safety and security in psychiatric hospitals. A descriptive survey research design was employed. Questionnaires were circulated to all acute wards in London and in Ireland and the resulting data compared. A total of 124 psychiatric wards from London and 43 wards from Ireland were included in this study and response rates of 70% (London) and 86% (Ireland) were obtained. Differences and similarities in safety and security practices were identified between London and Ireland, with Irish wards having generally higher and more intensive levels of security. There is a lack of coherent policy and procedure in safety and security measures across psychiatric acute admission wards in the Republic of Ireland and London. Given the trends in European Union (EU) regulation, there is a strong argument for the publication of acceptable minimum guidelines for safety and security in mental health services across the EU. There must be a concerted effort to ensure that all policy and procedure in safety and security is founded on evidence and best practice. Mental health managers must establish a review of work safety and security procedures and practices. Risk assessment and environmental audits of all mental health clinical environments should be mandatory.

Sapientia: accelerating rare disease diagnosis and treatment.

PubMed

Furness, Mike

2016-09-01

Congenica (Cambridge, UK) is a world leading developer of genome-based discovery and diagnostic technologies. The UK company is a spin-out from the Wellcome Trust Sanger Institute (Cambridge, UK) and was founded by scientists and clinicians at the leading edge of genomic analysis. Congenica's Sapientia™ technology platform allows whole-genome sequence analysis to be easily interpreted and presented within a clinically actionable diagnostic report. It is based on pioneering research from Wellcome Trust Sanger Institute, National Health Service clinicians and regional genetic testing laboratories and validated by Genomics England Ltd (London, UK). Sapientia used for medical diagnosis in hospitals including Great Ormond Street Hospital (London, UK), Manchester Centre for Genomic Medicine (Manchester, UK), Birmingham Women's Hospital (Birmingham, UK) and for new drug development by pharmaceutical companies. This profile follows the journey from proof of concept to clinical diagnosis.

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.

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.

Evolving Pb isotope signatures of London airborne particulate matter (PM 10)-constraints from on-filter and solution-mode MC-ICP-MS.

PubMed

Noble, Stephen R; Horstwood, Matthew S A; Davy, Pamela; Pashley, Vanessa; Spiro, Baruch; Smith, Steve

2008-07-01

Pb isotope compositions of biologically significant PM(10) atmospheric particulates from a busy roadside location in London UK were measured using solution- and laser ablation-mode MC-ICP-MS. The solution-mode data for PM(10) sampled between 1998-2001 document a dramatic shift to increasingly radiogenic compositions as leaded petrol was phased out. LA-MC-ICP-MS isotope analysis, piloted on a subset of the available samples, is shown to be a potential reconnaissance analytical technique. PM(10) particles trapped on quartz filters were liberated from the filter surface, without ablating the filter substrate, using a 266 nm UV laser and a dynamic, large diameter, low-fluence ablation protocol. The Pb isotope evolution noted in the London data set obtained by both analytical protocols is similar to that observed elsewhere in Western Europe following leaded petrol elimination. The data therefore provide important baseline isotope composition information useful for continued UK atmospheric monitoring through the early 21(st) century.

Communicating geohazard information for emergency responders, a case study from the UK.

NASA Astrophysics Data System (ADS)

Banks, Vanessa; Cooper, Anthony

2016-04-01

SSS11.4/ESSI4.6/HS11.39/NH9.13 Communication of uncertain information in earth sciences: data, models and visualization Communicating geohazard information for emergency responders, a case study from the UK. Cooper, A. H.1, Banks, V.J.1, Cowup, P.2, Curness, J.3, Davis, R.4, Dawson, L3. and Gazzard, L.4 1 British Geological Survey, Keyworth, NG12 5GG, UK 2 London Fire Brigade, 169 Union Street, London, SE1 0LL, UK 3.Coventry University, Priory Street, Coventry, CV1 5FB, UK 4.Avon Fire and Rescue, Temple Back, Bristol, BS1 6EU, UK. In February 2013 a sinkhole opened beneath a Florida Home resulting in the loss of a life and demolition of the affected home. The resulting void was in the order of 15 m deep. Neighbouring homes also had to be demolished. Television footage of this unfortunate incident resonated with an Assistant Commissioner of the London Fire Brigade who questioned whether or not such a feature would be recognised in the UK and if so, how the emergency response would be managed. Stemming from this, the British Geological Survey was invited to work with the Chief Fire Officers Association Urban Search and Rescue working group on geohazards. The aim of this group was to develop national tactical operational guidance on geohazards that would form the basis for regional guidance and training. The project was addressed collaboratively providing opportunities for two students from the Coventry University Disaster Management course, that were on placements with Avon Fire and Rescue, to work with the BGS to develop the guidance. Key to the success of the project was an iterative approach to knowledge exchange with respect to firstly, the characterization of the geohazards, and the processes and uncertainties associated with them and secondly, with respect to emergency responders' needs and priorities. Effective communication was achieved through challenging and rationalising the geoscience language for the end user and through a series of customised

The ‘Compleat Physician’ and Experimentation in Medicines: Everard Maynwaring (c.1629–1713) and the Restoration Debate on Medical Practice in London

PubMed Central

Barry, Jonathan

2018-01-01

Restoration London saw a wave of publications by physicians advocating that the ‘compleat physician’ should be one who experimented and produced his own medicines. Only thus, they argued, could the medical hierarchy be restored and medical authority re-established on a defensible basis. This article seeks to explain the context for this unusual approach, and why it failed to attract mainstream physicians by the end of the century, by considering the sixty-year career of one of its leading advocates, Everard Maynwaring (c.1629–1713), a prolific medical author, and what his own failure to enter the medical establishment may show about the problems inherent in this model for the physician. A university-trained gentleman physician who converted to chymical medicine c.1660, Maynwaring published learned and relatively unpolemical texts to persuade both medical and lay audiences of the superiority of experimental medicine as a mode of learned practice, yet could not easily reconcile this with the advocacy and sale of his own chymical medicines (especially as he focused increasingly on a small group of ‘universal medicines’) without being branded an ‘empirick’. Fragmentary evidence regarding his career suggests he became increasingly marginalised, and as an old man was reduced to advertising his cures like the ‘empiricks’ from whom he had sought to distance both himself and physicians in general. PMID:29553009

Habitual micronutrient intake during and after pregnancy in Caucasian Londoners.

PubMed

Derbyshire, E; Davies, G J; Costarelli, V; Dettmar, P W

2009-01-01

Micronutrient status is of fundamental importance both upon conception and throughout pregnancy. There is an abundance of literature investigating nutrient intakes during individual trimesters of pregnancy but few studies have investigated baseline intakes of nutrients throughout gestation as a continuum. The current investigation set out to measure habitual micronutrient intakes at weeks 13, 25, 35 of pregnancy and 6 weeks postpartum using a prospective background information questionnaire, 4-7-day weighed food diary and postnatal questionnaire. Seventy-two primiparous, Caucasian Londoners were recruited at the study start with 42 completing the first, second, third trimester and postpartum study stages respectively. Study findings indicated that sodium intakes were significantly higher than UK guidelines throughout and after pregnancy (P < 0.001). Intakes of folate, iron, vitamin D, potassium, iodine and selenium were lower than UK recommendations during and after pregnancy, but to varying levels of statistical significance (P < 0.05). Only 23-38% of women met UK recommendations for folate (300 microg day(-1)) through dietary sources. Similarly, only a small percentage of women met dietary guidelines for iron (19-28%). The findings from the current study indicate that public health interventions may be required to help expectant mothers achieve an optimal diet, particularly after birth when dietary recommendations increase for some micronutrients.

An overview of space medicine.

PubMed

Hodkinson, P D; Anderton, R A; Posselt, B N; Fong, K J

2017-12-01

Space medicine is fundamental to the human exploration of space. It supports survival, function and performance in this challenging and potentially lethal environment. It is international, intercultural and interdisciplinary, operating at the boundaries of exploration, science, technology and medicine. Space medicine is also the latest UK specialty to be recognized by the Royal College of Physicians in the UK and the General Medical Council. This review introduces the field of space medicine and describes the different types of spaceflight, environmental challenges, associated medical and physiological effects, and operational medical considerations. It will describe the varied roles of the space medicine doctor, including the conduct of surgery and anaesthesia, and concludes with a vision of the future for space medicine in the UK.Space medicine doctors have a responsibility to space workers and spaceflight participants. These 'flight surgeons' are key in developing mitigation strategies to ensure the safety, health and performance of space travellers in what is an extreme and hazardous environment. This includes all phases from selection, training and spaceflight itself to post-flight rehabilitation and long-term health. The recent recognition of the speciality provides a pathway to train in this fascinating field of medicine and is a key enabler for the UK Government's commercial spaceflight ambition. © Crown copyright 2017.

London's historic pea-soupers''

DOE Office of Scientific and Technical Information (OSTI.GOV)

Urbinato, D.

Americans may think smog was invented in Los Angeles. Not so. In fact, a Londoner coined the term smog'' in 1905 to describe the city's insidious combination of natural fog and coal smoke. By then, the phenomenon was part of London history, and dirty, acrid smoke-filled pea-soupers'' were as familiar to Londoners as Big Ben and Westminster Abby. Smog in London predates Shakespeare by four centuries. Until the 12th century, most Londoners burned wood for fuel. But as the city grew and the forests shrank, wood became scarce and increasingly expensive. Large deposits of sea-coal'' off the northeast coast providedmore » a cheap alternative. Soon, Londoners were burning the soft, bituminous coal to heat their homes and fuel their factories. Sea-coal was plentiful, but it didn't burn efficiently. A lot of its energy was spent making smoke, not heat. Coal smoke drifting through thousands of London chimneys combined with clean natural fog to make smog. If the weather conditions were right, it would last for days. Early on, no one had the scientific tools to correlate smog with adverse health effects, but complaints about the smoky air as an annoyance date back to at least 1272, when King Edward I, on the urging of important noblemen and clerics, banned the burning of sea-coal. Anyone caught burning or selling the stuff was to be tortured or executed. The first offender caught was summarily put to death. This deterred nobody. Of necessity, citizens continued to burn sea-coal in violation of the law, which required the burning of wood few could afford.« less

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.

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.

British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice.

PubMed

Hackett, Geoff; Kirby, Michael; Edwards, David; Jones, Thomas Hugh; Wylie, Kevan; Ossei-Gerning, Nick; David, Janine; Muneer, Asif

2017-12-01

Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but its diagnosis and management can be challenging. To review the available literature on TD and provide evidence-based statements for UK clinical practice. Evidence was derived from Medline, EMBASE, and Cochrane searches on hypogonadism, testosterone (T) therapy, and cardiovascular safety from May 2005 to May 2015. Further searches continued until May 2017. To provide a guideline on diagnosing and managing TD, with levels of evidence and grades of recommendation, based on a critical review of the literature and consensus of the British Society of Sexual Medicine panel. 25 statements are provided, relating to 5 key areas: screening, diagnosis, initiating T therapy, benefits and risks of T therapy, and follow-up. 7 statements are supported by level 1, 8 by level 2, 5 by level 3, and 5 by level 4 evidence. To help guide UK practitioners on effectively diagnosing and managing primary and age-related TD. A large amount of literature was carefully sourced and reviewed, presenting the best evidence available at the time. However, some statements provided are based on poor-quality evidence. This is a rapidly evolving area of research and recommendations are subject to change. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions and take personal values and preferences and individual circumstances into account. Many issues remain controversial, but in the meantime, clinicians need to manage patient needs and clinical expectations armed with the best clinical evidence and the multidisciplinary expert opinion available. Improving the diagnosis and management of TD in adult men should provide somatic, sexual, and psychological benefits and subsequent improvements in quality of life. Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone

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

PubMed Central

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. PMID:26441881

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.

Storageless and caching Tier-2 models in the UK context

NASA Astrophysics Data System (ADS)

Cadellin Skipsey, Samuel; Dewhurst, Alastair; Crooks, David; MacMahon, Ewan; Roy, Gareth; Smith, Oliver; Mohammed, Kashif; Brew, Chris; Britton, David

2017-10-01

Operational and other pressures have lead to WLCG experiments moving increasingly to a stratified model for Tier-2 resources, where “fat” Tier-2s (“T2Ds”) and “thin” Tier-2s (“T2Cs”) provide different levels of service. In the UK, this distinction is also encouraged by the terms of the current GridPP5 funding model. In anticipation of this, testing has been performed on the implications, and potential implementation, of such a distinction in our resources. In particular, this presentation presents the results of testing of storage T2Cs, where the “thin” nature is expressed by the site having either no local data storage, or only a thin caching layer; data is streamed or copied from a “nearby” T2D when needed by jobs. In OSG, this model has been adopted successfully for CMS AAA sites; but the network topology and capacity in the USA is significantly different to that in the UK (and much of Europe). We present the result of several operational tests: the in-production University College London (UCL) site, which runs ATLAS workloads using storage at the Queen Mary University of London (QMUL) site; the Oxford site, which has had scaling tests performed against T2Ds in various locations in the UK (to test network effects); and the Durham site, which has been testing the specific ATLAS caching solution of “Rucio Cache” integration with ARC’s caching layer.

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.

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

Proceedings of the signature series event of the international society for cellular therapy: "Advancements in cellular therapies and regenerative medicine in digestive diseases," London, United Kingdom, May 3, 2017.

PubMed

Ciccocioppo, Rachele; Dos Santos, Claudia C; Baumgart, Daniel C; Cangemi, Giuseppina C; Cardinale, Vincenzo; Ciacci, Carolina; De Coppi, Paolo; Haldar, Debashis; Klersy, Catherine; Nostro, M Cristina; Ott, Michael; Piemonti, Lorenzo; Tomei, Alice A; Uygun, Basak; Vetrano, Stefania; Orlando, Giuseppe

2018-03-01

A summary of the First Signature Series Event, "Advancements in Cellular Therapies and Regenerative Medicine for Digestive Diseases," held on May 3, 2017, in London, United Kingdom, is presented. Twelve speakers from three continents covered major topics in the areas of cellular therapy and regenerative medicine applied to liver and gastrointestinal medicine as well as to diabetes mellitus. Highlights from their presentations, together with an overview of the global impact of digestive diseases and a proposal for a shared online collection and data-monitoring platform tool, are included in this proceedings. Although growing evidence demonstrate the feasibility and safety of exploiting cell-based technologies for the treatment of digestive diseases, regulatory and methodological obstacles will need to be overcome before the successful implementation in the clinic of these novel attractive therapeutic strategies. Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Current Capabilities, Requirements and a Proposed Strategy for Interdependency Analysis in the UK

NASA Astrophysics Data System (ADS)

Bloomfield, Robin; Chozos, Nick; Salako, Kizito

The UK government recently commissioned a research study to identify the state-of-the-art in Critical Infrastructure modelling and analysis, and the government/industry requirements for such tools and services. This study (Cetifs) concluded with a strategy aiming to bridge the gaps between the capabilities and requirements, which would establish interdependency analysis as a commercially viable service in the near future. This paper presents the findings of this study that was carried out by CSR, City University London, Adelard LLP, a safety/security consultancy and Cranfield University, defense academy of the UK.

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. Copyright © 2012 Elsevier Ltd. All rights reserved.

The uk Lidar-sunphotometer operational volcanic ash monitoring network

NASA Astrophysics Data System (ADS)

Adam, Mariana; Buxmann, Joelle; Freeman, Nigel; Horseman, Andrew; Salmon, Christopher; Sugier, Jacqueline; Bennett, Richard

2018-04-01

The Met Office completed the deployment of ten lidars (UV Raman and depolarization), each accompanied by a sunphotometer (polarized model), to provide quantitative monitoring of volcanic ash over UK for VAAC London. The lidars provide range corrected signal and volume depolarization ratio in near-real time. The sunphotometers deliver aerosol optical depth, Ångstrom exponent and degree of linear polarization. Case study analyses of Saharan dust events (as a proxy for volcanic ash) are presented.

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

Beck Exportation: London and Sydney

NASA Astrophysics Data System (ADS)

Cartwright, William; Field, Kenneth

2018-05-01

Henry (Harry) Beck's schematic map of the London Underground is the foundation for most `modern' representations of metropolitan rail systems. From its introduction in the 1930s, it has been the image of the London underground rail transportation system, and, indeed, the image of London itself. Following the launch of the schematic map in 1933 Londoners adopted his representation of the underground as the favoured transportation navigation tool, but also as a physical affirmation that they were citizens of a modern city, a city of electricity and the avant-garde. The London Underground map, as well as being the physical image of the underground rail system, became the signature of the modern city itself. It projected order, systematic transportation and commuter convenience. The map reinforced the general belief that a modern transportation system was at the very heart of what made a city a city. Building upon the success of the map, Beck, and the London Passenger Transport Board, explored how this `take' on the representation of an urban transportation system might be exported to other European, and Antipodean rail networks. This paper provides a dialogue on how Beck's concept for the `metromap' was offered as an alternative navigational diagram to the, then new, Sydney underground system. It then outlines the results of an investigation about how this `Exportation' of Beck's design resulted in the 1939 Sydney metromap that was a clone of the London Underground map.

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

2018-01-01

Vitamin D deficiency is common in children with asthma, and it associates with poor asthma control, reduced forced expiratory volume in one second (FEV 1 ) 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), FEV 1 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

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

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

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.

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…

Foundation Year 2 doctors' reasons for leaving UK medicine: an in-depth analysis of decision-making using semistructured interviews.

PubMed

Smith, Samantha E; Tallentire, Victoria R; Pope, Lindsey M; Laidlaw, Anita H; Morrison, Jill

2018-03-02

To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts. All four regions of Scotland. Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis. Maximum variation between participants was sought. Semistructured interviews were coded using template analysis. Six perspectives, described by Feldman and Ng, were used as the initial coding template. The codes were then configured to form a framework that explores the interplay of factors influencing Foundation Year 2 (F2) doctors' decisions to leave UK medicine. Seventeen participants were interviewed. Six perspectives were explored. Structural influences (countrywide and worldwide issues) included visas, economic and political considerations, structure of healthcare systems and availability of junior doctor jobs worldwide. Organisational influences (the National Health Service (NHS) and other healthcare providers) included staffing and compensation policies, the working environment and the learning environment. Occupational influences (specific to being a junior doctor) comprised the junior doctor contract, role and workload, pursuit of career interests and the structure of training. Work group influences (relationships with colleagues) included support at work, task interdependence and use of locums. Personal life influences consisted of work-life balance, and support in resolving work-life conflict. The underlying theme of 'taking a break' recurred through multiple narratives. F2s give reasons similar to those given by any professional considering a change in their job. However, working within the NHS as an F2 doctor brought specific challenges, such as a need to make a choice of specialty within the F2 year, exposure to workplace bullying and difficulties in raising concerns. Despite these challenges, most F2s did not view their decision to leave as a permanent job

Foundation Year 2 doctors’ reasons for leaving UK medicine: an in-depth analysis of decision-making using semistructured interviews

PubMed Central

Smith, Samantha E; Tallentire, Victoria R; Pope, Lindsey M; Morrison, Jill

2018-01-01

Objectives To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts. Setting All four regions of Scotland. Participants Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis. Maximum variation between participants was sought. Primary and secondary outcome measures Semistructured interviews were coded using template analysis. Six perspectives, described by Feldman and Ng, were used as the initial coding template. The codes were then configured to form a framework that explores the interplay of factors influencing Foundation Year 2 (F2) doctors’ decisions to leave UK medicine. Results Seventeen participants were interviewed. Six perspectives were explored. Structural influences (countrywide and worldwide issues) included visas, economic and political considerations, structure of healthcare systems and availability of junior doctor jobs worldwide. Organisational influences (the National Health Service (NHS) and other healthcare providers) included staffing and compensation policies, the working environment and the learning environment. Occupational influences (specific to being a junior doctor) comprised the junior doctor contract, role and workload, pursuit of career interests and the structure of training. Work group influences (relationships with colleagues) included support at work, task interdependence and use of locums. Personal life influences consisted of work-life balance, and support in resolving work-life conflict. The underlying theme of ‘taking a break’ recurred through multiple narratives. Conclusions F2s give reasons similar to those given by any professional considering a change in their job. However, working within the NHS as an F2 doctor brought specific challenges, such as a need to make a choice of specialty within the F2 year, exposure to workplace bullying and difficulties in raising

Obesity, physical activity and traumatic dental injuries in adolescents from East London.

PubMed

Aswathikutty, Aswathikutty; Marcenes, Wagner; Stansfeld, Stephen A; Bernabé, Eduardo

2017-04-01

Evidence on the interplay between obesity, physical activity and traumatic dental injuries (TDIs) is still inconclusive and heavily based on cross-sectional studies. The aim of this study was to explore the interrelationship of obesity and physical activity at age 11-12 years with TDI at age 15-16-years among schoolchildren from East London. Data were analysed regarding 598 adolescents who participated in phases I and III of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal, school-based study of adolescents in East London. Participants reported their level of physical activity and their height and weight were measured to estimate body mass index Z-scores (according to the UK growth reference) when they were 11-12 years old. Oral clinical examinations were conducted to assess TDI, overjet and lip coverage when participants were 15-16 years old. The associations of obesity and physical activity with TDI were evaluated in crude and adjusted models using binary logistic regression. Overall, 22.6% of adolescents were obese and 7.2% exercised for 7 h or more a week at baseline, while 18.1% of adolescents had experienced TDI by age 15-16 years. Physical activity (7+ hours per week) was significantly associated with TDI (odds ratio: 2.19; 95% confidence interval: 1.08-4.43) in the crude model. However, no significant associations were found between obesity and TDI (1.18; 95% CI: 0.72-1.93) or physical activity and TDI (1.96; 95% CI: 0.94-4.07) in adjusted models. This study found no evidence of any associations of obesity and physical activity with TDI among adolescents from East London. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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…

Observations of the Morning Development of the Urban Boundary Layer Over London, UK, Taken During the ACTUAL Project

NASA Astrophysics Data System (ADS)

Halios, Christos H.; Barlow, Janet F.

2018-03-01

The study of the boundary layer can be most difficult when it is in transition and forced by a complex surface, such as an urban area. Here, a novel combination of ground-based remote sensing and in situ instrumentation in central London, UK, is deployed, aiming to capture the full evolution of the urban boundary layer (UBL) from night-time until the fully-developed convective phase. In contrast with the night-time stable boundary layer observed over rural areas, the night-time UBL is weakly convective. Therefore, a new approach for the detection of the morning-transition and rapid-growth phases is introduced, based on the sharp, quasi-linear increase of the mixing height. The urban morning-transition phase varied in duration between 0.5 and 4 h and the growth rate of the mixing layer during the rapid-growth phase had a strong positive relationship with the convective velocity scale, and a weaker, negative relationship with wind speed. Wind shear was found to be higher during the night-time and morning-transition phases than the rapid-growth phase and the shear production of turbulent kinetic energy near the mixing-layer top was around six times larger than surface shear production in summer, and around 1.5 times larger in winter. In summer under low winds, low-level jets dominated the UBL, and shear production was greater than buoyant production during the night-time and the morning-transition phase near the mixing-layer top. Within the rapid-growth phase, buoyant production dominated at the surface, but shear production dominated in the upper half of the UBL. These results imply that regional flows such as low-level jets play an important role alongside surface forcing in determining UBL structure and growth.

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.

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

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

UK Doubles Its “World-Leading” Research in Life Sciences and Medicine in Six Years: Testing the Claim?

PubMed Central

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

2015-01-01

Background 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. Methods 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. Findings 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*. Interpretation 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. PMID:26204117

Mechanisms of Coagulation Abnormalities and Trauma

DTIC Science & Technology

2011-07-01

Medicine & Dentistry , Queen Mary University of London, London, UK 3 and Department of Anesthesia , University of Alabama at Birmingham, Birmingham, AL 4... local hypoperfusion and fibrin clot formation. Other groups have confirmed these findings in the gut, liver, and lung. Furthermore, skin biopsies from...Brohi,‡ Daniel Frith,‡ Jean-François Pittet,*† and Mitchell J. Cohen* The Departments of *Surgery and † Anesthesia , University of California, San

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.

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.”

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

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…

Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study.

PubMed

Di Forti, Marta; Marconi, Arianna; Carra, Elena; Fraietta, Sara; Trotta, Antonella; Bonomo, Matteo; Bianconi, Francesca; Gardner-Sood, Poonam; O'Connor, Jennifer; Russo, Manuela; Stilo, Simona A; Marques, Tiago Reis; Mondelli, Valeria; Dazzan, Paola; Pariante, Carmine; David, Anthony S; Gaughran, Fiona; Atakan, Zerrin; Iyegbe, Conrad; Powell, John; Morgan, Craig; Lynskey, Michael; Murray, Robin M

2015-03-01

The risk of individuals having adverse effects from drug use (eg, alcohol) generally depends on the frequency of use and potency of the drug used. We aimed to investigate how frequent use of skunk-like (high-potency) cannabis in south London affected the association between cannabis and psychotic disorders. We applied adjusted logistic regression models to data from patients aged 18-65 years presenting to South London and Maudsley NHS Foundation Trust with first-episode psychosis and population controls recruited from the same area of south London (UK) to estimate the effect of the frequency of use, and type of cannabis used on the risk of psychotic disorders. We then calculated the proportion of new cases of psychosis attributable to different types of cannabis use in south London. Between May 1, 2005, and May 31, 2011, we obtained data from 410 patients with first-episode psychosis and 370 population controls. The risk of individuals having a psychotic disorder showed a roughly three-times increase in users of skunk-like cannabis compared with those who never used cannabis (adjusted odds ratio [OR] 2·92, 95% CI 1·52-3·45, p=0·001). Use of skunk-like cannabis every day conferred the highest risk of psychotic disorders compared with no use of cannabis (adjusted OR 5·4, 95% CI 2·81-11·31, p=0·002). The population attributable fraction of first-episode psychosis for skunk use for our geographical area was 24% (95% CI 17-31), possibly because of the high prevalence of use of high-potency cannabis (218 [53%] of 410 patients) in our study. The ready availability of high potency cannabis in south London might have resulted in a greater proportion of first onset psychosis cases being attributed to cannabis use than in previous studies. UK National Institute of Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health, SLaM and the Institute of Psychiatry at King's College London, Psychiatry Research Trust, Maudsley Charity Research Fund, and

Evidence-based medicine in daily surgical decision making: a survey-based comparison between the UK and Germany.

PubMed

Schnitzbauer, Andreas A; Proneth, Andrea; Pengel, Liset; Ansorg, Jörg; Anthuber, Matthias; Bechstein, Wolf O; Schlitt, Hans J; Geissler, Edward K

2015-01-01

Evidence-based medicine (EbM) is a vital part of reasonable and conclusive decision making for clinicians in daily clinical work. To analyze the knowledge and the attitude of surgeons towards EbM, a survey was performed in the UK and Germany. A web-based questionnaire was distributed via mailing lists from the Royal College of Surgeons of England (RCSE) and the Berufsverband Deutscher Chirurgen (BDC). Our primary aim was to get information about knowledge of EbM amongst German and British surgeons. A total of 549 individuals opened the questionnaire, but only 198 questionnaires were complete and valid for analysis. In total, 40,000 recipients were approached via the mailing lists of the BDC and RCSE. The response rate was equally low in both countries. On a scale from 1 (unimportant) to 10 (very important), all participants rated EbM as very important for daily clinical decision making (7.3 ± 1.9) as well as for patients (7.8 ± 1.9) and the national health system (7.8 ± 1.9). On a scale from 1 (unimportant) to 5 (very important), systematic reviews (4.6 ± 0.6) and randomized controlled trials (4.6 ± 0.6) were identified as the highest levels of study designs to enhance evidence in medicine. British surgeons considered EbM to be more important in daily clinical work when compared to data from German surgeons (7.9 ± 1.6 vs. 6.7 ± 2.1, p < 0.001). Subgroup analysis showed different results in some categories; however, a pattern to explain the differences was not evident. Personal requirements expressed in a free text field emphasized the results and reflected concerns such as broad unwillingness and lack of interdisciplinary approaches for patients (n = 59: 25 in the UK and 34 in Germany). The overall results show that EbM is believed to be important by surgeons in the UK and Germany. However, perception of EbM in the respective health system (UK vs. Germany) may be different. Nonetheless, EbM is an important tool to navigate through daily clinical problems

Current status of teaching on spirituality in UK medical schools.

PubMed

Neely, David; Minford, Eunice J

2008-02-01

To investigate the current status of teaching on spirituality in medicine in UK medical schools and to establish if and how medical schools are preparing future doctors to identify patients' spiritual needs. We carried out a national questionnaire survey using a 2-part questionnaire. Section A contained questions relating to the quantity of teaching on spirituality and the topics covered. Section B contained questions relating to teaching on alternative health practices. Medical educators from each of the 32 medical schools in the UK were invited to participate. A response rate of 53% (n = 17) was achieved. A total of 59% (n = 10) of respondents stated that there is teaching on spirituality in medicine in their curricula. On extrapolation, at least 31% and a maximum of 78% of UK medical schools currently provide some form of teaching on spirituality. Of the respondents that teach spirituality, 50% (n = 5) stated that their schools include compulsory teaching on spirituality in medicine, 80% (n = 8) include optional components, and 88% stated that teaching on complementary and alternative medicine is included in the curriculum. Although 59% (n = 10) of respondent medical schools (the actual UK figure lies between 31% and 78%) currently provide some form of teaching on spirituality, there is significant room for improvement. There is little uniformity between medical schools with regard to content, form, amount or type of staff member delivering the teaching. It would be beneficial to introduce a standardised curriculum on spirituality across all UK medical schools.

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

Sexual and HIV risk behaviour in central and eastern European migrants in London.

PubMed

Burns, Fiona M; Evans, Alison R; Mercer, Catherine H; Parutis, Violetta; Gerry, Christopher J; Mole, Richard C M; French, Rebecca S; Imrie, John; Hart, Graham J

2011-06-01

Accession of 10 Central and Eastern European (CEE) countries to the E.U. resulted in the largest migratory influx in peacetime British history. No information exists on the sexual behaviour of CEE migrants within the U.K. The aim of this study was to assess the sexual lifestyles and health service needs of these communities. A survey, delivered electronically and available in 12 languages, of migrants from the 10 CEE accession countries recruited from community venues in London following extensive social mapping and via the Internet. Reported behaviours were compared with those from national probability survey data. 2648 CEE migrants completed the survey. Male CEE migrants reported higher rates of partner acquisition (adjusted OR (aOR) 2.1, 95% CI: 1.3 to 2.1) and paying for sex (aOR 3.2, 95% CI: 2.5 to 4.0), and both male and female CEE migrants reported more injecting drug use (men: aOR 2.2, 95% CI: 1.3 to 3.9; women: aOR 3.0, 95% CI 1.1 to 8.1), than the general population; however, CEE migrants were more likely to report more consistent condom use and lower reported diagnoses of sexually transmitted infections (STI). Just over 1% of respondents reported being HIV positive. Most men and a third of women were not registered for primary care in the U.K. CEE migrants to London report high rates of behaviours associated with increased risk of HIV/STI acquisition and transmission. These results should inform service planning, identify where STI and HIV interventions should be targeted, and provide baseline data to help evaluate the effectiveness of such interventions.

Currently available medical engineering degrees in the UK. Part 2: Postgraduate degrees.

PubMed

Joyce, T

2009-05-01

This paper considers taught medical engineering MSc degrees, based on mechanical engineering, which are provided in the UK. Currently there are 19 institutions which provide such postgraduate degree programmes. These are the University of Aberdeen, University of Bath, University of Bradford, Brunel University, University of Dundee, University of Hull, Imperial College London, Keele University, King's College London, University of Leeds, University of Liverpool, University of Nottingham, University of Oxford, Queen Mary University of London, University of Southampton, University of Strathclyde, University of Surrey, University of Ulster, and University of Warwick. While most courses are delivered on a 1 year full-time basis, other delivery modes are also available. Relatively few modules are offered as distance learning or short courses. A wide range of modules are offered by the various universities for the different taught MSc degrees. Common modules include biomaterials and biomechanics. The medical-engineering-related modules offered by a number of universities are also made available to students on allied MSc programmes and undergraduate degrees in medical engineering.

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

PubMed

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

2016-05-01

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. 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. 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. 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. 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/

The hospital microbiome project: meeting report for the UK science and innovation network UK-USA workshop ‘beating the superbugs: hospital microbiome studies for tackling antimicrobial resistance’, October 14th 2013

PubMed Central

2014-01-01

The UK Science and Innovation Network UK-USA workshop ‘Beating the Superbugs: Hospital Microbiome Studies for tackling Antimicrobial Resistance’ was held on October 14th 2013 at the UK Department of Health, London. The workshop was designed to promote US-UK collaboration on hospital microbiome studies to add a new facet to our collective understanding of antimicrobial resistance. The assembled researchers debated the importance of the hospital microbial community in transmission of disease and as a reservoir for antimicrobial resistance genes, and discussed methodologies, hypotheses, and priorities. A number of complementary approaches were explored, although the importance of the built environment microbiome in disease transmission was not universally accepted. Current whole genome epidemiological methods are being pioneered in the UK and the benefits of moving to community analysis are not necessarily obvious to the pioneers; however, rapid progress in other areas of microbiology suggest to some researchers that hospital microbiome studies will be exceptionally fruitful even in the short term. Collaborative studies will recombine different strengths to tackle the international problems of antimicrobial resistance and hospital and healthcare associated infections.

Epidemiology and clinical features of imported malaria in East London.

PubMed

Francis, Benjamin C; Gonzalo, Ximena; Duggineni, Sirisha; Thomas, Janice M; NicFhogartaigh, Caoimhe; Babiker, Zahir Osman Eltahir

2016-06-01

Malaria is the most common imported tropical disease in the United Kingdom (UK). The overall mortality is low but inter-regional differences have been observed. We conducted a 2-year retrospective review of clinical and laboratory records of patients with malaria attending three acute hospitals in East London from 1 April 2013 through 31 March 2015. Epidemiological and clinical characteristics of imported malaria were described and risk factors associated with severe falciparum malaria were explored. In total, 133 patients with laboratory-confirmed malaria were identified including three requiring critical care admission but no deaths. The median age at presentation was 41 years (IQR 30-50). The majority of patients were males (64.7%, 86/133) and had Black or Black British ethnicity (67.5%, 79/117). West Africa was the most frequent region of travel (70.4%, 76/108). Chemoprophylaxis use was poor (25.3%, 20/79). The interval between arriving in the UK and presenting to hospital was short (median 10 days; IQR 5-15.5, n = 84). July-September was the peak season of presentation (34.6%, 46/133). Plasmodium falciparum was the commonest species (76.7%, 102/133) and 31.4% (32/102) of these patients had parasitaemia >2%. Severe falciparum malaria was documented in 36.3% (37/102) of patients and the October-March season presentation was associated with an increased risk of severity (OR 3.00; 95% CI 1.30-6.93). Black patients appeared to have reduced risk of severe falciparum malaria (OR 0.46; 95% CI 0.16-1.35) but this was not statistically significant. HIV sero-status was determined in only 27.1% (36/133) of cases. Only 8.5% (10/117) of all malaria patients were treated as outpatients. Clinicians need to raise awareness on malaria prevention strategies, improve rates of HIV testing in tropical travellers, and familiarise themselves with ambulatory management of malaria. The relationship between season of presentation, ethnicity and severity of falciparum malaria

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.

From containment to community: Trigger points from the London pandemic (H1N1) 2009 influenza incident response.

PubMed

Balasegaram, S; Glasswell, A; Cleary, V; Turbitt, D; McCloskey, B

2011-02-01

In the UK, during the first wave of pandemic (H1N1) 2009 influenza, a national 'containment' strategy was employed from 25 April to 2 July 2009, with case finding, treatment of cases, contact tracing and prophylaxis of close contacts. The aim of the strategy was to delay the introduction and spread of pandemic flu in the UK, provide a better understanding of the course of the novel disease, and thereby allow more time for the development of treatment and vaccination options. Descriptive study of the management of the containment phase of pandemic (H1N1) 2009 influenza. Analysis of data reported to the London Flu Response Centre (LFRC). The average number of telephone calls and faxes per day from health professionals before 15 June 2009 was 188, but this started to rise from 363 on 12 June, to 674 on 15 June, and peaked on 22 June at 2206 calls. The number of cases confirmed [by pandemic (H1N1) 2009 influenza specific H1 and N1 polymerase chain reaction] in London rose to a peak of 200 cases per day. There were widespread school outbreaks reporting large numbers of absences with influenza-like illnesses. Activity in the LFRC intensified to a point where London was declared a 'hot spot' for pandemic (H1N1) 2009 influenza on 19 June 2009 because of sustained community transmission. The local incident response was modified to the 'outbreak management phase' of the containment phase. The sharp rise in the number of telephone calls and the rise in school outbreaks appeared to be trigger points for community transmission. These indicators should inform decisions on modifying public health strategy in pandemic situations. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Carrington-L5: The UK/US Space Weather Operational Mission.

NASA Astrophysics Data System (ADS)

Bisi, M. M.; Trichas, M.

2015-12-01

Airbus Defence and Space (UK) have carried out a study for an operational L5 space weather mission, in collaboration with RAL, the UK Met Office, UCL and Imperial College London. The study looked at the user requirements for an operational mission, a model instrument payload, and a mission/spacecraft concept. A particular focus is cost effectiveness and timelineness of the data, suitable for operational forecasting needs. The study focussed on a mission at L5 assuming that a US mission to L1 will already occur, on the basis that L5 offers the greatest benefit for SWE predictions. The baseline payload has been selected to address all MOSWOC/SWPC priorities using UK/US instruments, consisting of: a heliospheric imager, coronagraph, EUV imager, magnetograph, magnetometer, solar wind analyser and radiation monitor. The platform is based on extensive re-use from Airbus' past missions to minimize the cost and a Falcon-9 launcher has been selected on the same basis. A schedule analysis shows that the earliest launch could occur in 2020, assuming Phase A KO in 2015. The study team have selected the name "Carrington" for the mission, reflecting the UK's proud history in this domain.

Transmitted antiretroviral drug resistance in treatment naïve HIV-infected persons in London in 2011 to 2013.

PubMed

McFaul, Katie; Lim, Charlotte; Jones, Rachael; Asboe, David; Pozniak, Anton; Sonecha, Sonali; Boffito, Marta; Nwokolo, Nneka

2014-01-01

Previously published UK data on HIV transmitted drug resistance (TDR) shows that it ranges between 3 and 9.4% [1,2]. However, there are no recent data from populations where HIV transmission rates are increasing. The aim of this study was to assess the prevalence of TDR in untreated HIV-infected individuals attending three HIV specialist clinics under the HIV Directorate, Chelsea and Westminster Hospital and based throughout London - the Kobler Clinic, 56 Dean Street and West London Centre for Sexual Health. We included all patients with a HIV diagnosis, no history of antiretroviral therapy (ART) intake, attending one of the three clinics (Kobler (K), 56 Dean Street (DS) and West London (WL)), between 2011 and 2013 who started antiretrovirals. Reverse transcriptase (RT) and protease region sequencing was performed using Vircotype virtual phenotype resistance analysis. Drug resistance mutations were identified according to Stanford University HIV Drug Resistance Database (http://hivdb.stanford.edu/). Among 1705 HIV-1-infected patients enrolled in the study, 1252 were males (919 were MSM), 107 were females and 346 had no gender recorded. Ethnicity was 51.1% white British/Irish/other, 6.1% African, 2.1% Caribbean, 2.8% Asian, 1.3% Indian/Pakistani/Bangladeshi, 4.2%, other, 3.2% not stated, and 29.2% unknown. 547 were from K (84.3% males, 48.3% MSM), 826 were from DS (84.3% males, 71.9% MSM), and 109 from WL (87.2% males, 56.0% MSM), 223 from other sites not specified. 77.5% (1321 of 1705) of patients had baseline viral resistance testing performed. Prevalence of primary resistance in those with a baseline viral resistance test was 13.5% overall: 19.3% in K, 14.9% in DS, and 14.7% in WL. The most common mutations detected were: NRTI: 184V, 215F, 41L; NNRTI 103N, 179D, 90I; PI 90M, 46I, and 82A. Among patients who tested with TDR, 79.1% had one single mutation, 18.7% and 2.2% exhibited dual or triple class-resistant viruses, respectively. This study across a large HIV

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.

Non-London electrodynamics in a multiband London model: Anisotropy-induced nonlocalities and multiple magnetic field penetration lengths

NASA Astrophysics Data System (ADS)

Silaev, Mihail; Winyard, Thomas; Babaev, Egor

2018-05-01

The London model describes strongly type-2 superconductors as massive vector field theories, where the magnetic field decays exponentially at the length scale of the London penetration length. This also holds for isotropic multiband extensions, where the presence of multiple bands merely renormalizes the London penetration length. We show that, by contrast, the magnetic properties of anisotropic multiband London models are not this simple, and the anisotropy leads to the interband phase differences becoming coupled to the magnetic field. This results in the magnetic field in such systems having N +1 penetration lengths, where N is the number of field components or bands. That is, in a given direction, the magnetic field decay is described by N +1 modes with different amplitudes and different decay length scales. For certain anisotropies we obtain magnetic modes with complex masses. That means that magnetic field decay is not described by a monotonic exponential increment set by a real penetration length but instead is oscillating. Some of the penetration lengths are shown to diverge away from the superconducting phase transition when the mass of the phase-difference mode vanishes. Finally the anisotropy-driven hybridization of the London mode with the Leggett modes can provide an effectively nonlocal magnetic response in the nominally local London model. Focusing on the two-component model, we discuss the magnetic field inversion that results from the effective nonlocality, both near the surface of the superconductor and around vortices. In the regime where the magnetic field decay becomes nonmonotonic, the multiband London superconductor is shown to form weakly-bound states of vortices.

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.

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

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.

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.

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…

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,…

Psychosocial risk factors for coronary heart disease in UK South Asian men and women.

PubMed

Williams, E D; Steptoe, A; Chambers, J C; Kooner, J S

2009-12-01

South Asian people in the UK and other western countries have elevated rates of coronary heart disease (CHD). Psychosocial factors contribute to CHD risk, but information about psychosocial risk profiles in UK South Asians is limited. This study aimed to examine the profile of conventional and novel psychosocial risk factors in South Asian compared with white men and women. Using a cross-sectional population study design, psychosocial profiles were assessed in 1130 South Asian and 818 white European healthy men and women aged between 35 and 75 years, who had previously participated in a cardiovascular risk assessment programme in West London. Psychosocial factors potentially contributing to CHD risk were assessed using standardised questionnaires. UK South Asians reported significantly higher psychosocial adversity compared with UK whites. South Asian men and women experienced greater chronic stress, in the form of financial strain, residential crowding, family conflict, social deprivation and discrimination, than white Europeans. They had larger social networks, but reported lower social support and greater depression and hostility. These effects were largely independent of socioeconomic status. UK South Asians experience significant psychosocial adversity compared with UK white Europeans. This is consistent with the heightened vulnerability to CHD observed in this population.

The impact of migration on the sexual health, behaviours and attitudes of Central and East European gay/bisexual men in London.

PubMed

Mole, Richard C M; Parutis, Violetta; Gerry, Christopher J; Burns, Fiona M

2014-02-01

Building on an earlier quantitative study which found that gay/bisexual men from Central and Eastern Europe were at greater risk of sexual ill health following migration to the UK, the aim of this qualitative study is to explore how the process of migration itself may have influenced the migrants' sexual behaviour and attitudes. To address these questions, we conducted 17 in-depth interviews in London with gay/bisexual male migrants from Central and Eastern Europe, drawing on Fisher and Fisher's Information-Motivation-Behavioral Skills model as an interpretive framework. We find that the sexual behaviours of our respondents have been significantly influenced by the process of migration itself. In particular, extricating themselves from the traditional systems of social control in their home societies and having greater access to gay venues in London resulted in their increased sexual activity, particularly in the first phase of migration. High-risk sexual behaviour was found to be a factor of sexual mixing, the use of commercial sex and perceptions of risk in the UK vis-á-vis Central and Eastern Europe, with each of these factors also influenced by the process of migration. Risk-prevention behaviour depended upon the possession of appropriate risk-prevention information, motivation to use condoms and appropriate behavioural skills, with the latter two factors in particular influenced by social mores in the home country and the UK. The interviews suggested a number of migration-related factors that increased the STI and HIV risk for these migrants. A number of potentially important policy recommendations stem from our analysis.

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.

Quantifying UK emissions of carbon dioxide using an integrative measurement strategy

NASA Astrophysics Data System (ADS)

Gonzi, S.; Palmer, P.

2015-12-01

The main objective of the Greenhouse gAs Uk and Global Emissions (GAUGE) programme is to quantify the magnitude and uncertainty of CO2, CH4 and N2O fluxes from the UK. GAUGE builds on the tall tower network established by the UK Government to estimate fluxes from England, Northern Ireland, Scotland, and Wales. The GAUGE measurement programme includes two additional tall tower sites (one in North Yorkshire and one downwind of London); regular measurements of CO2 and CH4 isotopologues; instrumentation installed on a ferry that travels daily along the eastern coast of the UK from Scotland to Belgium; a research aircraft that has been deployed on a campaign basis; and a high-density network over East Anglia that is primarily focused on the agricultural sector. We have also included satellite observations from the Japanese Greenhouse gases Observing SATellite (GOSAT) through ongoing activities within the UK National Centre for Earth Observation. In this presentation, we will present new CO2 flux estimates for the UK inferred from GAUGE measurements using a nested, high-resolution (25 km) version of the GEOS-Chem atmospheric transport model and an ensemble Kalman filter. We will present our current best estimate for CO2 fluxes and a preliminary assessment of the efficacy of individual GAUGE data sources to spatially resolve CO2 flux estimates over the UK. We will also discuss how flux estimates inferred from the different models used within GAUGE can help to assess the role of transport model error and to determine an ensemble CO2 flux estimate for the UK.

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

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

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.

The moral economy of austerity: analysing UK welfare reform.

PubMed

Morris, Lydia

2016-03-01

This paper notes the contemporary emergence of 'morality' in both sociological argument and political rhetoric, and analyses its significance in relation to ongoing UK welfare reforms. It revisits the idea of 'moral economy' and identifies two strands in its contemporary application; that all economies depend on an internal moral schema, and that some external moral evaluation is desirable. UK welfare reform is analysed as an example of the former, with reference to three distinct orientations advanced in the work of Freeden (1996), Laclau (2014), and Lockwood (1996). In this light, the paper then considers challenges to the reform agenda, drawn from third sector and other public sources. It outlines the forms of argument present in these challenges, based respectively on rationality, legality, and morality, which together provide a basis for evaluation of the welfare reforms and for an alternative 'moral economy'. © London School of Economics and Political Science 2016.

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

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

2018-01-01

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 (FEV 1 ), % predicted forced vital capacity (FVC), the ratio of FEV 1 to FVC (FEV 1 :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

The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results

PubMed Central

2012-01-01

Background The Well London program used community engagement, complemented by changes to the physical and social neighborhood environment, to improve physical activity levels, healthy eating, and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomized trial (CRT). The baseline survey data are reported here. Methods The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas (LSOAs); ranked in the 11% most deprived LSOAs in London by the English Indices of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information, and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighborhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating, and mental wellbeing were assessed using standardized, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys. Results There were 4,107 adults and 1,214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighborhoods were broadly similar. There was greater between-cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking, and self-reported anxiety/depression were similar in the Well London adult population and the national Health Survey for England. Levels of physical activity were higher

The Well London program--a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results.

PubMed

Phillips, Gemma; Renton, Adrian; Moore, Derek G; Bottomley, Christian; Schmidt, Elena; Lais, Shahana; Yu, Ge; Wall, Martin; Tobi, Patrick; Frostick, Caroline; Clow, Angela; Lock, Karen; Petticrew, Mark; Hayes, Richard

2012-07-06

The Well London program used community engagement, complemented by changes to the physical and social neighborhood environment, to improve physical activity levels, healthy eating, and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomized trial (CRT). The baseline survey data are reported here. The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas (LSOAs); ranked in the 11% most deprived LSOAs in London by the English Indices of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information, and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighborhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating, and mental wellbeing were assessed using standardized, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys. There were 4,107 adults and 1,214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighborhoods were broadly similar. There was greater between-cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking, and self-reported anxiety/depression were similar in the Well London adult population and the national Health Survey for England. Levels of physical activity were higher in the Well London adult

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,…

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.

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.

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…

The influence of social support on ethnic differences in well-being and depression in adolescents: findings from the prospective Olympic Regeneration in East London (ORiEL) study.

PubMed

Smith, Neil R; Clark, Charlotte; Smuk, Melanie; Cummins, Steven; Stansfeld, Stephen A

2015-11-01

This study examines the extent to which in adolescent positive mental well-being and depressive symptoms vary across ethnic groups, and prospectively examines whether social support is protective against low/poor well-being and depression. A longitudinal survey of 2426 adolescents from the Olympic Regeneration in East London study measured well-being and depressive symptoms at baseline at ages 11-12 and at follow-up two years later at ages 13-14. Social support was assessed at ages 11-12 years by the Multidimensional Scale of Perceived Social Support, by the level of parental support for school, by the frequency of family activities and by friendship choices. Ethnic differences in well-being and depression in Bangladeshi (N = 337) and Black African (N = 249) adolescents compared to their White UK counterparts (N = 380) were estimated adjusted stepwise for socio-demographic factors and domains of social support. Black African and Bangladeshi adolescents scored significantly higher for well-being than their White UK counterparts. There were no significant ethnic differences in the prevalence of depressive symptoms. Lower levels of social support were prospectively associated with lower well-being and higher rates of depression in all ethnic groups. Adjustment for multiple domains of social support did not account for ethnic differences in well-being. Bangladeshi and Black African adolescents in East London may have a positive mental health advantage over their White UK counterparts though social support did not fully explain this difference. Further investigation of the reasons for lower well-being in the White UK group is needed.

Ionizing Radiation in Earth’s Atmosphere and in Space Near Earth

DTIC Science & Technology

2011-05-01

Tulsa OK 35 0.9 1.1 0.0005 0.0012 London UK – Los Angeles CA 39 10.5 11. 0.017 0.046 Chicago IL – London UK 37 7.3 7.7 0.012 0.032 London UK... Chicago IL 39 7.8 8.3 0.013 0.036 Athens Greece – New York NY 41 9.4 9.7 0.019 0.041 Average Solar Activity in 51 years (1958-2008) Houston...0.001 London UK – Los Angeles CA 39 10.5 11. 0.016 0.039 Chicago IL – London UK 37 7.3 7.7 0.011 0.027 London UK – Chicago IL 39 7.8 8.3 0.012

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

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

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

PubMed

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

2015-05-17

The purpose of the study was to understand the dependency on smokeless tobacco. 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. 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. 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%). 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.

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

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…

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.

The North West London Integrated Care Pilot: innovative strategies to improve care coordination for older adults and people with diabetes.

PubMed

Harris, Matthew; Greaves, Felix; Patterson, Sue; Jones, Jessica; Pappas, Yannis; Majeed, Azeem; Car, Josip

2012-01-01

The North West London Integrated Care Pilot (ICP) was launched in June 2011 and brings together more than 100 general practices, 2 acute care trusts, 5 primary care trusts, 2 mental health care trusts, 3 community health trusts, 5 local authorities, and 2 voluntary sector organizations (Age UK and Diabetes UK) to improve the coordination of care for a pilot population of 550 000 people. Specifically, the ICP serves people older than 75 years and those with diabetes. Although still in the early stages of implementation, the ICP has already received national awards for its innovations in design and delivery. This article critically describes the ICP objectives, facilitating processes, and planned impact as well as the organizational and financial challenges that policy makers are facing in the implementation of the pilot program.

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…

Medicine reclassification processes and regulations for proper use of over-the-counter self-care medicines in Japan.

PubMed

Nomura, Kaori; Kitagawa, Yuki; Yuda, Yasukatsu; Takano-Ohmuro, Hiromi

2016-01-01

Japan has actively reclassified substances ranging from prescription drugs to over-the-counter (OTC) drugs in recent years. The sale of most OTC drugs was deregulated several times and pharmacists' supervision was deemed no longer mandatory. Japan established a new OTC evaluation system in 2015 to hear opinions from various stakeholders regarding medicine types to be reclassified. This study aimed to examine the new framework to identify candidate substances for reclassification. Moreover, we examined how to manage the safe, self-care use of OTC drugs in Japan. The necessary regulatory information on OTC approvals as of January 2015 was collected using an Internet search and relevant databases. To highlight the characteristics of OTC drugs in Japan, the UK was selected as a comparison country because it too was actively promoting the reclassification of medicines from prescription to nonprescription status, and because of economic similarity. Japan and the UK have a risk-based classification for nonprescription medicines. Japan has made OTC drugs available with mandatory pharmacists' supervision, face-to-face with pharmacists, or online instruction, which is similar to the "pharmacy medicine" practiced in the UK. Japan recently reformed the reclassification process to involve physicians and the public in the process; some interactions were back to "prescription-only medicine" in the UK. It is expected that the opinion of marketers, medical professionals, and the public will improve the discussion that will greatly contribute to the safe use of drugs. Monitoring the new system will be noteworthy to ensure that OTC drug users are managing their self-care properly and visiting a doctor only when necessary. The supply methods are similar in Japan and the UK; however, the expected growth in the Japanese OTC market by the Cabinet and the industry is still uncertain.

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

Epidemiology of adolescent substance use in London schools.

PubMed

Penney, J; Dargan, P I; Padmore, J; Wood, D M; Norman, I J

2016-06-01

Alcohol and substance use in adolescence can be associated with a range of health, emotional, social, behavioural and legal problems. There has been a change in the recreational drugs available to users in recent years; however, little is known about how this impacts the youngest and most vulnerable population of substance users. To investigate the prevalence of substance use among children aged 15-18 years in London schools. Questionnaire survey. Students aged 15-18 years in three London schools self-completed the questionnaire which collected demographic data (age, gender and ethnicity) and data on frequency of use of alcohol, tobacco and classical recreational drugs and novel psychoactive substances. Completed surveys were available from 533 students (47.8% of those invited to participate). One hundred thirteen (20.4%) students reported lifetime use of at least one recreational drug, cannabis (96, 18.7%) was commonly reported and only 6 (1.1%) reported use of a novel psychoactive substance. A total of 250 (47.8%) reported using alcohol at least once; those from White and Mixed ethnic groups were more likely to report using alcohol than those in other ethnic groups. A total of 382 (74.2%) students reported using tobacco at least once, and students from ethnic minorities were more likely to smoke than their White counterparts. This study supports previous findings that alcohol and drug use are declining in adolescents in UK. There are different patterns of substance use amongst different ethnic groups; this is important to schools and policymakers planning interventions related to substance use in school-aged children. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The 'other' London effect: the diversification of London's suburban grammar schools and the rise of hyper-selective elite state schools.

PubMed

Gamsu, Sol

2018-03-30

This paper examines the rise of a new elite of 'super-state' schools in London, revealing a growing divide within the state sector which problematizes claims that the capital is a 'hotspot' for social mobility (Social Mobility Commission ). Although recent research has revealed a 'London effect' in which students in the capital on Free School Meals outperform their peers in other regions (Greaves, Macmillan and Sibieta ), inequalities between London's schools in access to elite universities have been overlooked. Drawing on a case study of a suburban London grammar school, 'King Henry's School', I show how ethnic-minority suburbanization has combined with an institutional strategy to compete with elite private schools. Strategies of selection have been mobilized alongside elements of elite 'gentlemanly' educational culture in order to reposition the school within the hierarchy of London's schools. The result is a hyper-selective school which provides a conduit to elite universities for upwardly mobile British-Asian students. I show that this strategy has strong parallels with the school's attempts in the early twentieth century to compete with London's fee-paying 'public' schools. The continuing symbolic value of 'traditional' forms of elite educational culture to a school seeking to reposition itself within the field reflects deep structural patterns of inequality in English education. To understand how apparent improvements in social mobility can sit alongside deepening inequalities between state schools, there is a need for a historical sociological approach that takes account of long-term processes of institutional change (Savage ; Inglis ). © London School of Economics and Political Science 2018.

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

'Care and Prevent': rationale for investigating skin and soft tissue infections and AA amyloidosis among people who inject drugs in London.

PubMed

Harris, M; Brathwaite, R; McGowan, Catherine R; Ciccarone, D; Gilchrist, G; McCusker, M; O'Brien, K; Dunn, J; Scott, J; Hope, V

2018-05-08

Skin and soft tissue infections (SSTIs) are a leading cause of morbidity and mortality among people who inject drugs (PWID). International data indicate up to one third of PWID have experienced an SSTI within the past month. Complications include sepsis, endocarditis and amyloid A (AA) amyloidosis. AA amyloidosis is a serious sequela of chronic SSTI among PWID. Though there is a paucity of literature reporting on AA amyloidosis among PWID, what has been published suggests there is likely a causal relationship between AA amyloidosis and injecting-related SSTI. If left untreated, AA amyloidosis can lead to renal failure; premature mortality among diagnosed PWID is high. Early intervention may reverse disease. Despite the high societal and individual burden of SSTI among PWID, empirical evidence on the barriers and facilitators to injecting-related SSTI prevention and care or the feasibility and acceptability of AA amyloidosis screening and treatment referral are limited. This study aims to fill these gaps and assess the prevalence of AA amyloidosis among PWID. Care and Prevent is a UK National Institute for Health Research-funded mixed-methods study. In five phases (P1-P5), we aim to assess the evidence for AA amyloidosis among PWID (P1); assess the feasibility of AA amyloidosis screening, diagnostic and treatment referral among PWID in London (P2); investigate the barriers and facilitators to AA amyloidosis care (P3); explore SSTI protection and risk (P4); and co-create harm reduction resources with the affected community (P5). This paper describes the conceptual framework, methodological design and proposed analysis for the mixed-methods multi-phase study. We are implementing the Care and Prevent protocol in London. The systematic review component of the study has been completed and published. Care and Prevent will generate an estimate of AA amyloidosis prevalence among community recruited PWID in London, with implications for the development of screening

Female perpetrated sexual offences reported to a London sexual assault referral centre.

PubMed

Morgan, Louise; Long, Lisa

2018-02-01

A gender specific approach to understanding female sex offenders is important for developing prevention and treatment strategies, yet research to date is limited. While it is recognised that females often offend with another person, there has been little attempt to look beyond the two groupings of solo and co-offending and study females who offend in larger groups. Furthermore, very few studies have looked at the victims of these crimes and all of these have focussed on child victims only. The present work describes demographic and assault related characteristics of victims of all ages reporting a sexual assault by a female perpetrator to the Havens sexual assault referral centres in London, UK, in a five year period, with the aim of identifying victim, perpetrator and offence patterns in solo, pair and group sexual assaults. 47 cases were identified, just 0.66% of the total cases seen, and victims ranged from 3 to 59 years of age. Female perpetrators actively participated in the sexual and physical violence in many cases and were often involved in other ways, such as facilitating the offence, procuring the victim and filming the assault. Victims of solo perpetrators were mostly children who reported an assault by a teacher or childminder. Victims of pairs were older and all perpetrators were male/female pairs, usually reportedly in a romantic relationship. Victims of groups were more often strangers to the perpetrators and these assaults were often very violent. These findings are discussed in relation to current knowledge and suggestions are made for further research. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Investing in learning and training refugee doctors.

PubMed

Ong, Yong Lock; Trafford, Penny; Paice, Elisabeth; Jackson, Neil

2010-06-01

Medically qualified refugees seek to build a new life and return to clinical medicine. The National Health Service (NHS) in the UK needs to develop a workforce to meet the needs of the communities it serves, and refugee doctors have the potential to contribute to the NHS, using their experience and skills to benefit patients. Fifty-four per cent of refugee doctors in the UK live in London, so in response, the London Deanery (Postgraduate Department of Medical and Dental Education, London University) has undertaken a series of initiatives over the past 8 years assisting refugee doctors back into medical employment. Clinical attachments, supernumerary 6-month posts and general practitioner (GP) training rotations have been offered. The projects, doctors involved, educational provision and outcomes are reported. The obstacles and barriers to returning to substantive posts in medicine are also discussed. Fifty-six per cent of the refugee doctors were known to be working after the schemes, 52 per cent gained substantive posts and 39 per cent entered training grades. Investing in innovative and creative work-based training programmes for refugee doctors is worthwhile, but needs to be adequately resourced if refugee doctors are to bring ultimate benefit to the NHS. © Blackwell Publishing Ltd 2010.

Innovating healthcare delivery to address noncommunicable diseases in low-income settings: the example of hypertension.

PubMed

Piot, Peter; Aerts, Ann; Wood, David A; Lamptey, Peter; Oti, Samuel; Connell, Kenneth; Dorairaj, Prabhakaran; Boufford, Jo I; Caldwell, Aya; Perel, Pablo

2016-07-01

London Dialogue event, The Hospital Club, 24 Endell St, London, WC2H 9HQ, London, UK, 1 December 2015 Hypertension is a global health issue causing almost 10 million deaths annually, with a disproportionate number occurring in low- and middle-income countries. The condition can be managed effectively, but there is a need for innovation in healthcare delivery to alleviate its burden. This paper presents a number of innovative delivery models from a number of different countries, including Kenya, Ghana, Barbados and India. These models were presented at the London Dialogue event, which was cohosted by the Novartis Foundation and the London School of Hygiene & Tropical Medicine Centre for Global Noncommunicable Diseases on 1 December 2015. It is argued that these models are applicable not only to hypertension, but provide valuable lessons to address other noncommunicable diseases.

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.

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

Conference Scene: Induced pluripotent cells: a new path for regenerative medicine. 7 October 2010, BioPark, Welwyn Garden City, Hertfordshire, UK.

PubMed

Crutzen, Hélène S G

2011-01-01

Embryonic stem cells and induced pluripotent stem (iPS) cells, which are embryonic stem-like cells derived from adult tissues, have the broadest differentiation potential. These cells are unique in their ability to self-renew, to be maintained in an undifferentiated state for long periods of culturing and to give rise to many different cell lineages including germ-line cells. They therefore represent an invaluable tool for facilitating research towards the realization of regenerative medicine. The recent developments in embryonic stem cell and iPS cell technology have allowed human cell models to be developed that will hopefully provide novel platforms for disease analysis not only at the basic science level, but also for drug discovery and screening, and other clinical applications. This 1-day conference, chaired by Professor Peter Andrews from the University of Sheffield, UK, and Dr Chris Denning from the University of Nottingham, UK, focused on generation of iPS cells, their differentiation into specific fates and applications to disease modeling. It consisted of 11 talks by UK-based and international researchers, and three posters; Ms Azra Fatima from Cologne University, Germany, won the competition for her poster on the derivation of iPS cells from a patient with arrhythmogenic right ventricular cardiomyopathy.

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…

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.

Inequalities in usage of a public bicycle sharing scheme: socio-demographic predictors of uptake and usage of the London (UK) cycle hire scheme.

PubMed

Ogilvie, F; Goodman, A

2012-07-01

Cycling confers individual and population-level health benefits, but uptake is not always equitable across socio-demographic groups. We sought to examine inequalities in uptake and usage of London's Barclays Cycle Hire (BCH) scheme. We obtained complete BCH registration data, and compared users with the general population. We examined usage levels by explanatory variables including gender, small-area income-deprivation and local cycling prevalence. 100,801 registered individuals made 2.5 million trips between July 2010 and March 2011. Compared with residents and workers in the central London area served by the scheme, registered individuals were more likely to be male and to live in areas of low deprivation and high cycling prevalence. Among those registered, females made 1.63 (95%CI 1.53, 1.74) fewer trips per month than males, and made under a fifth of all trips. Adjusting for the fact that deprived areas were less likely to be close to BCH docking stations, users in the most deprived areas made 0.85 (95%CI 0.63,1.07) more trips per month than those in the least deprived areas. Females and residents in deprived areas are underrepresented among users of London's public bicycle sharing scheme. The scheme's planned expansion into more deprived areas has, however, the potential to create a more equitable uptake of cycling. Copyright © 2012 Elsevier Inc. All rights reserved.

Perceived need of, and interest in, HIV pre-exposure prophylaxis amongst men who have sex with men attending three sexual health clinics in London, UK.

PubMed

Bull, Lauren; Dimitrijevic, Pavle; Beverley, Sophie; Scarborough, Alex; Mandalia, Sundhiya; Dosekun, Olamide; Barber, Tristan; Reeves, Iain; McCormack, Sheena; Rayment, Michael

2018-04-01

HIV pre-exposure prophylaxis (PrEP) has proven efficacy in reducing the risk of HIV infection in men who have sex with men (MSM), but has not yet been commissioned in the UK. The aim of this study was to investigate perceived need and benefit (or experience of) PrEP among HIV-negative MSM attending sexual health clinics. HIV-negative MSM attending three sexual health centres in London, UK were opportunistically invited to complete a questionnaire. Data collected comprised demographic data and sexual and drug use behaviours as well as questions regarding perceptions of risk and need for PrEP. Logistic regression analysis was undertaken to identify variables predicting acceptability of, and intention to use, PrEP. In addition, data were gathered in respondents already taking PrEP. Eight hundred and thirty-nine questionnaires were analysed. The median age of respondents was 35 years (IQR 28-41, range 18-78), 650 (77%) were of white ethnicity and 649 (77%) had a university education. Four hundred and fifty-six (54%) reported at least one episode of condomless anal sex in the preceding three months, 437 (52%) reported recreational drug use in the preceding three months and 311 (37%) had been diagnosed with a sexually transmitted infection within the preceding six months. Four hundred and sixty-three (64%) of 726 strongly agreed with the statement 'I think I would benefit from PrEP'. Multivariate logistic regression analysis demonstrated that having receptive anal intercourse (RAI) without condoms, having an awareness of the risk of unprotected RAI and having belief in the effectiveness of PrEP were independent predictors for someone thinking they would benefit from taking PrEP. Eight percent of respondents (59/724) had already taken or were currently taking PrEP. The results suggest that individuals at risk are likely to perceive themselves as benefiting from PrEP. The majority perceived their risk of acquiring HIV and benefit from PrEP accurately. Overall they appeared

[Four cholera epidemics in nineteenth-century London].

PubMed

Tynkkynen, K

1995-01-01

Asiatic cholera originated in India and spread to Europe in the early years of the nineteenth-century. In Britain the first cases were diagnosed late in 1831. The epidemic, reached London in February 1832. The authorities were poorly prepared for the invasion of a new epidemic and the doctors disagreed bitterly on the measures to be taken. There was little co-operation between the authorities, and the fact that the urban poor mistrusted the medical profession did not improve the situation. All this resulted in several cholera riots. These riots were not, however, as violent as those in several other cities in Europe. The 1832-33 cholera epidemic claimed 4,000 to 7,000 victims in London. It seems probable that several isolated cases of cholera occurred in London in 1852. It was not, however, until September 1853 that it was officially announced by the British authorities that a cholera epidemic was claiming victims not only in London but also in other parts of the country. During this epidemic numerous Londoners lodged complaints against nuisances in the metropolis. Yet, in most cases, the fines imposed on offenders were rather slight, since the authorities were extremely reluctant to interfere with anyone's trade or business. It was during this epidemic that John Snow, a London doctor, succeeded in tracing the epidemic to a single water pump on Broad Street in the Golden Square area. Snow did not, however, succeed in convincing the majority of his colleagues regarding the erroneous nature of the miasma theory during the epidemic of 1853/54, which cost the lives of some 12,000 people in the city area....

International society of blood transfusion working party on red cell immunogenetics and terminology: report of the Seoul and London meetings.

PubMed

Storry, J R; Castilho, L; Chen, Q; Daniels, G; Denomme, G; Flegel, W A; Gassner, C; de Haas, M; Hyland, C; Keller, M; Lomas-Francis, C; Moulds, J M; Nogues, N; Olsson, M L; Peyrard, T; van der Schoot, C E; Tani, Y; Thornton, N; Wagner, F; Wendel, S; Westhoff, C; Yahalom, V

2016-08-01

The Working Party has met twice since the last report: in Seoul, South Korea 2014, and in London, UK 2015, both in association with the International Society of Blood Transfusion (ISBT) Congress. As in previous meetings, matters pertaining to blood group antigen nomenclature were discussed. Eleven new blood group antigens were added to seven blood group systems. This brings the current total of blood group antigens recognized by the ISBT to 346, of which 308 are clustered within 36 blood groups systems. The remaining 38 antigens are currently unassigned to a known blood group system.

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.

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.

Martin Van Butchell (1735-1814): the eccentric, "kook" dentist of old London.

PubMed

Christen, A G; Christen, J A

1999-11-01

This article is a thumbnail sketch of the life and times of Martin Van Butchell (1735-1814), an eccentric, "kook" advertising dentist of Old London. Van Butchell earned these descriptive labels by displaying an unorthodox lifestyle, an outrageous personal appearance and outlandish, extreme and socially unacceptable personal and professional behaviors. While the general populace seemed to be fascinated by his strange ways, dentists and physicians were generally alienated by them. Nevertheless, he was considered a good dentist for his time, and he was extremely popular with his patients. Martin practiced dentistry for 23 years, and he practiced medicine as well, specializing in the treatment of ruptures and anal fistulas. Van Butchell interacted greatly with both John and William Hunter, who became two of the most famous and talented physicians, surgeons, anatomists and biologists of all time. When his first wife, Mary died, Martin arranged for her body to be embalmed and publicly displayed in his dental office for advertising purposes. Her preserved body was shown at the Museum of the Royal College of Surgeons (London), until it was destroyed by a German fire bomb in May, 1941. Mary's remains were on public display for a total of 166 years.

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.…

The Opticians Act 1989 and UK optometry.

PubMed

Taylor, S P

1991-04-01

The build-up to the original 1958 Opticians Act is used as an introduction to the more recent developments in UK optics that have culminated in the introduction of the Opticians Act 1989. The changes introduced as a result of the Health and Social Security Act 1984 and the Health and Medicines Act 1988 are briefly described before discussing the sectional arrangement of the new Act. This new legislation pulls together much of the law relating to optometry and dispensing optics in the UK and provides a single accessible source.

Carrington-L5: The UK/US Operational Space Weather Monitoring Mission

NASA Astrophysics Data System (ADS)

Trichas, Markos; Gibbs, Mark; Harrison, Richard; Green, Lucie; Eastwood, Jonathan; Bentley, Bob; Bisi, Mario; Bogdanova, Yulia; Davies, Jackie; D'Arrigo, Paolo; Eyles, Chris; Fazakerley, Andrew; Hapgood, Mike; Jackson, David; Kataria, Dhiren; Monchieri, Emanuele; Windred, Phil

2015-06-01

Airbus Defence and Space (UK) has carried out a study to investigate the possibilities for an operational space weather mission, in collaboration with the Met Office, RAL, MSSL and Imperial College London. The study looked at the user requirements for an operational mission, a model instrument payload, and a mission/spacecraft concept. A particular focus is cost effectiveness and timelineness of the data, suitable for 24/7 operational forecasting needs. We have focussed on a mission at L5 assuming that a mission to L1 will already occur, on the basis that L5 (Earth trailing) offers the greatest benefit for the earliest possible warning on hazardous SWE events and the most accurate SWE predictions. The baseline payload has been selected to cover all UK Met Office/NOAA's users priorities for L5 using instruments with extensive UK/US heritage, consisting of: heliospheric imager, coronograph, magnetograph, magnetometer, solar wind analyser and radiation monitor. The platform and subsystems are based on extensive re-use from past Airbus Defence and Space spacecraft to minimize the development cost and a Falcon-9 launcher has been selected on the same basis. A schedule analysis shows that the earliest launch could be achieved by 2020, assuming Phase A kick-off in 2015-2016. The study team have selected the name "Carrington" for the mission, reflecting the UK's proud history in this domain.

The changing oxidizing environment in London - trends in ozone precursors and their contribution to ozone production

NASA Astrophysics Data System (ADS)

von Schneidemesser, E.; Vieno, M.; Monks, P. S.

2014-01-01

Ground-level ozone is recognized to be a threat to human health (WHO, 2003), have a deleterious impact on vegetation (Fowler et al., 2009), is also an important greenhouse gas (IPCC, 2007) and key to the oxidative ability of the atmosphere (Monks et al., 2009). Owing to its harmful effect on health, much policy and mitigation effort has been put into reducing its precursors - the nitrogen oxides (NOx) and non-methane volatile organic compounds (NMVOCs). The non-linear chemistry of tropospheric ozone formation, dependent mainly on NOx and NMVOC concentrations in the atmosphere, makes controlling tropospheric ozone complex. Furthermore, the concentration of ozone at any given point is a complex superimposition of in-situ produced or destroyed ozone and transported ozone on the regional and hemispheric-scale. In order to effectively address ozone, a more detailed understanding of its origins is needed. Here we show that roughly half (5 μg m-3) of the observed increase in urban (London) ozone (10 μg m-3) in the UK from 1998 to 2008 is owing to factors of local origin, in particular, the change in NO : NO2 ratio, NMVOC : NOx balance, NMVOC speciation, and emission reductions (including NOx titration). In areas with previously higher large concentrations of nitrogen oxides, ozone that was previously suppressed by high concentrations of NO has now been "unmasked", as in London and other urban areas of the UK. The remaining half (approximately 5 μg m-3) of the observed ozone increase is attributed to non-local factors such as long-term transport of ozone, changes in background ozone, and meteorological variability. These results show that a two-pronged approach, local action and regional-to-hemispheric cooperation, is needed to reduce ozone and thereby population exposure, which is especially important for urban ozone.

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

Report of Charrette : re-connect New London 2010.

DOT National Transportation Integrated Search

2011-03-01

"Members of Re-New London Council Board informally met with Dr. Norman Garrick in November 2009. A lively discussion regarding the : New London landscape in general and leverage points for revitalization ensued. Norman related his observations as he ...

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.

Report of Charrette re-connect New London 2010.

DOT National Transportation Integrated Search

2011-03-01

Members of Re-New London Council Board informally met with Dr. Norman Garrick in November 2009. A lively discussion regarding the : New London landscape in general and leverage points for revitalization ensued. Norman related his observations as he e...

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

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).

Inequalities in access to genitourinary medicine clinics in the UK: results from a mystery shopper survey.

PubMed

Foley, Elizabeth; Furegato, Martina; Hughes, Gwenda; Board, Christopher; Hayden, Vanessa; Prescott, Timothy; Shone, Eleanor; Patel, Rajul

2017-11-01

This study investigated whether access to genitourinary medicine (GUM) clinics meets UK-recommended standards. In January 2014 and 2015, postal questionnaires about appointment and service characteristics were sent to lead clinicians of UK GUM clinics. In February 2014 and 2015, researchers posing as symptomatic and asymptomatic 'patients' contacted clinics by telephone, requesting to be seen. Clinic and patient characteristics associated with the offer of an appointment within 48 hours were examined using unadjusted and UK country and patient gender adjusted multivariable logistic regression analyses. In March 2015, a convenience sample (one in four) of clinics was visited by researchers with the same clinical symptoms. Ability to achieve a same-day consultation and waiting time were assessed. In 2015, 90.8% of clinics offered symptomatic 'patients' an appointment within 48 hours when contacted by telephone, compared with 95.5% in 2014 (aOR=0.46 (0.26 to 0.83); p<0.01). The decline was greatest in women (96.0% to 90.1%; p<0.05), and clinics in England (96.2% to 90.7%; p<0.01). For asymptomatic patients, the proportion offered an appointment within 48 hours increased from 50.7% in 2014 to 74.5% in 2015 (aOR=3.06 (2.23 to 4.22); p<0.001), and in both men (58.2% to 90.8%; p<0.001) and women (49.0% to 59.6%; p<0.01). In adjusted analysis, asymptomatic women were significantly less likely to be offered an appointment than asymptomatic men (aOR=0.33 (0.23 to 0.45); p value<0.001). 95% of clinics were able to see symptomatic patients attending in person. Access to GUM services has worsened for those with symptoms suggestive of an acute STI and is significantly poorer for asymptomatic women. This evidence may support the reintroduction of process targets. 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/.

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

From One Medicine to Two:

PubMed Central

Woods, Abigail

2017-01-01

summary This article offers a novel perspective on the evolving identities and relationships of human medicine and veterinary medicine in England during the decades that followed the 1791 foundation of the London Veterinary College. Contrary to the impressions conveyed by both medical and veterinary historians, it reveals that veterinary medicine, as initially defined, taught and studied at the college, was not a domain apart from human medicine but rather was continuous with it. It then shows how this social, cultural, and epistemological continuity fractured over the period 1815 to 1835. Under the impetus of a movement for medical reform, veterinarians began to advance an alternative vision of their field as an autonomous, independent domain. They developed their own societies and journals and a uniquely veterinary epistemology that was rooted in the experiences of veterinary practice. In this way, "one medicine" became "two," and the professions began to assume their modern forms and relations. PMID:29081431

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

PubMed Central

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

2014-01-01

Objective: 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. Methods: 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”. Results: 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. Conclusion: 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. Advances in knowledge: This work identifies areas for future research to enhance the professional resilience of practitioners, in order to provide high-quality treatments. PMID:24786316

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

Air pollution and the incidence of ischaemic and haemorrhagic stroke in the South London Stroke Register: a case-cross-over analysis.

PubMed

Butland, B K; Atkinson, R W; Crichton, S; Barratt, B; Beevers, S; Spiridou, A; Hoang, U; Kelly, F J; Wolfe, C D

2017-07-01

Few European studies investigating associations between short-term exposure to air pollution and incident stroke have considered stroke subtypes. Using information from the South London Stroke Register for 2005-2012, we investigated associations between daily concentrations of gaseous and particulate air pollutants and incident stroke subtypes in an ethnically diverse area of London, UK. Modelled daily pollutant concentrations based on a combination of measurements and dispersion modelling were linked at postcode level to incident stroke events stratified by haemorrhagic and ischaemic subtypes. The data were analysed using a time-stratified case-cross-over approach. Conditional logistic regression models included natural cubic splines for daily mean temperature and daily mean relative humidity, a binary term for public holidays and a sine-cosine annual cycle. Of primary interest were same day mean concentrations of particulate matter <2.5 and <10 µm in diameter (PM 2.5 , PM 10 ), ozone (O 3 ), nitrogen dioxide (NO 2 ) and NO 2 +nitrogen oxide (NO X ). Our analysis was based on 1758 incident strokes (1311 were ischaemic and 256 were haemorrhagic). We found no evidence of an association between all stroke or ischaemic stroke and same day exposure to PM 2.5 , PM 10 , O 3 , NO 2 or NO X . For haemorrhagic stroke, we found a negative association with PM 10 suggestive of a 14.6% (95% CI 0.7% to 26.5%) fall in risk per 10 µg/m 3 increase in pollutant. Using data from the South London Stroke Register, we found no evidence of a positive association between outdoor air pollution and incident stroke or its subtypes. These results, though in contrast to recent meta-analyses, are not inconsistent with the mixed findings of other UK studies. 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/.

Taylor Elected to Royal Society of London

Science.gov Websites

SLAC, 28 May 1997 Taylor Elected to Royal Society of London Richard Taylor, physics professor at statements must be verified by facts. Taylor will travel to London in the near future for his induction, part Isaac Newton and Michael Faraday. Taylor, a Canadian citizen, received his Ph.D. at Stanford in 1962 and

Advances in sports nutrition, exercise and medicine: Olympic issues, the legacy and beyond.

PubMed

Carmont, Mike

2012-07-19

In the run up to the London 2012 Olympics, this editorial introduces the cross-journal article collection Advances in Sports Nutrition, Exercise and Medicine http://www.biomedcentral.com/series/asnem.

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

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

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.

Career progression of men and women doctors in the UK NHS: a questionnaire study of the UK medical qualifiers of 1993 in 2010/2011

PubMed Central

Svirko, Elena; Goldacre, Michael J

2014-01-01

Summary Objectives To report the career progression of a cohort of UK medical graduates in mid-career, comparing men and women. Design Postal and questionnaire survey conducted in 2010/2011, with comparisons with earlier surveys. Setting UK. Participants In total, 2507 responding UK medical graduates of 1993. Main outcome measures Doctors’ career specialties, grade, work location and working pattern in 2010/2011 and equivalent data in earlier years. Results The respondents represented 72% of the contactable cohort; 90% were working in UK medicine and 7% in medicine outside the UK; 87% were in the UK NHS (87% of men and 86% of women). Of doctors in the NHS, 70.6% of men and 52.0% of women were in the hospital specialties and the great majority of the others were in general practice. Within hospital specialties, a higher percentage of men than women were in surgery, and a higher percentage of women than men were in paediatrics, obstetrics and gynaecology, clinical oncology, pathology and psychiatry. In the NHS, 63% of women and 8% of men were working less-than-full-time (in general practice, 19% of men and 83% of women; and in hospital specialties, 3% of men and 46% of women). Among doctors who had always worked full-time, 94% of men and 87% of women GPs were GP principals; in hospital practice, 96% of men and 93% of women had reached consultant level. Conclusions The 1993 graduates show a continuing high level of commitment to the NHS. Gender differences in seniority lessened considerably when comparing doctors who had always worked full-time. PMID:25408921

Bringing diagnostics to developing countries: an interview with Rosanna Peeling.

PubMed

Peeling, Rosanna

2015-01-01

Interview with Professor Rosanna Peeling, PhD by Claire Raison (Commissioning Editor) Professor Rosanna Peeling is Chair of Diagnostic Research at the London School of Hygiene and Tropical Medicine (London, UK) and founded the International Diagnostics Centre at the institution. Professor Peeling previously worked for the WHO in Geneva, Switzerland, and continues to work on innovations for molecular diagnostics for point-of-care use in developing countries, addressing challenges posed by lack of funding and resources, regulatory issues and under-developed healthcare systems in these locations. Here, she discusses her career, recent progress in the field and how connectivity will affect global healthcare.

Schistosomiasis presenting in travellers: a 15 year observational study at the Hospital for Tropical Diseases, London.

PubMed

Coltart, Cordelia E M; Chew, Anastasia; Storrar, Neill; Armstrong, Margaret; Suff, Natalie; Morris, Leila; Chiodini, Peter L; Whitty, Christopher J M

2015-03-01

Schistosomiasis in returning travellers is one of the most common imported tropical infections with potentially serious complications, which are preventable if diagnosed early. A review was undertaken of consecutive cases of schistosomiasis presenting at the Hospital for Tropical Diseases, London, UK from 1997 to 2012. All 1020 schistosomiasis cases were from Africa and Schistosoma haematobium was the predominant species in those with microscopy confirmed schistosomiasis (74.2%, 204/252). The number of cases of imported schistosomiasis is decreasing steadily as a proportion of travellers seen. The majority of cases were in travellers originating from non-endemic settings (81.8%, 707/864). The most common symptom was of genitourinary complaints (22.6%, 230/1020), predominantly haematuria (17.8%, 181/1020); 36.1% (368) of cases were asymptomatic. Overall 42% had eosinophilia, and 62% of ova positive S. haematobium cases had haematuria on urine dip. Thus, no single screening tool was sufficient to identify or rule out schistosomiasis when used alone. Serology testing was a more sensitive tool in travellers than in other patients (p=0.007). The prevalence of schistosomiasis in presenting travellers is decreasing. The predominant presenting species has shifted from S. mansoni to S. haematobium. No single test can reliably diagnose schistosomiasis, with eosinophilia and urine dip having low sensitivity. Clinicians need to continue to undertake a wide spectrum of diagnostic tests to ensure cases of schistosomiasis are not missed. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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.

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.

Community Engagement using World Café: The Well London Experience

PubMed Central

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

2016-01-01

The Well London programme was launched across twenty boroughs in London during late 2007 to improve the health and well-being of residents living in some of the most deprived communities in London. Well London employed a multi-stage community engagement process which informed the overall project strategy for each intervention area. In this article we establish and describe the key principles that guided the design of this innovative community engagement process. Principles included building collaborative partnerships, working with whole-systems, privileging community knowledge and working with the deficit of experience in each area. The article then describes in detail how these principles were operationalised throughout the preparation and delivery of forty World Cafes, which were the first open community activities of the Well London community engagement process. Finally, this article reflects on and summarises the lessons learned when employing innovative, inclusive and transparent community engagement for health promotion. PMID:27857453

Community Engagement using World Café: The Well London Experience.

PubMed

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

2010-01-01

The Well London programme was launched across twenty boroughs in London during late 2007 to improve the health and well-being of residents living in some of the most deprived communities in London. Well London employed a multi-stage community engagement process which informed the overall project strategy for each intervention area. In this article we establish and describe the key principles that guided the design of this innovative community engagement process. Principles included building collaborative partnerships, working with whole-systems, privileging community knowledge and working with the deficit of experience in each area. The article then describes in detail how these principles were operationalised throughout the preparation and delivery of forty World Cafes, which were the first open community activities of the Well London community engagement process. Finally, this article reflects on and summarises the lessons learned when employing innovative, inclusive and transparent community engagement for health promotion.

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.

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

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…

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…

The development and implementation of the structured training programme for caregivers of inpatients after stroke (TRACS) intervention: the London Stroke Carers Training Course.

PubMed

Forster, Anne; Dickerson, Josie; Melbourn, Anne; Steadman, Jayne; Wittink, Margreet; Young, John; Kalra, Lalit; Farrin, Amanda

2015-03-01

To describe the content and delivery of the adapted London Stroke Carers Training Course intervention evaluated in the Training Caregivers after Stroke (TRACS) trial. The London Stroke Carers Training Course is a structured training programme for caregivers of inpatients who are likely to return home after their stroke. The course was delivered by members of the multidisciplinary team while the patient was in the stroke unit with one recommended 'follow through' session after discharge home. The intervention consists of 14 training components (six mandatory) that were identified as important knowledge/skills that caregivers would need to be able to care for the stroke patient after discharge home. Following national training days, the London Stroke Carers Training Course was disseminated to intervention sites by the cascade method of implementation. The intervention was adapted for implementation across a range of stroke units. Training days were well attended (median 2.5 and 2.0 attendees per centre for the first and second days, respectively) and the feedback positive, demonstrating 'face validity' for the intervention. However cascading of this training to other members of the multidisciplinary team was not consistent, with 7/18 centres recording no cascade training. The adapted London Stroke Carers Training Course provided a training programme that could be delivered in a standardised, structured way in a variety of stroke unit settings throughout the UK. The intervention was well received by stroke unit staff, however, the cascade method of implementation was not as effective as we would have wished. © The Author(s) 2014.

Effect of 7 July 2005 terrorist attacks in London on suicide in England and Wales.

PubMed

Salib, Emad; Cortina-Borja, Mario

2009-01-01

A reduction in suicide in England and Wales has been reported after the attacks of 11 September 2001 in the USA. It may be plausible therefore to expect a much greater impact on suicide in the UK in response to the events of 7 July 2005, caused by the first suicide terrorist attack by Islamic extremists on British soil. To examine the effect of the 7 July 2005 terrorist attacks in London on suicide rates in England and Wales. Analysis of number of suicide (ICD-10 codes X60-X84) and undetermined injury deaths (ICD-10 codes Y10-Y34) reported in England and Wales in the 12 weeks before and after 7 July 2005. We used Shewhart Control Charts based on Poisson rates to explore adjusted daily and weekly suicide rates and rate differences with respect to 7 July 2005. A brief but significant reduction in daily suicide rate was observed a few days after the terrorist attack in London on 7 July 2005. Further reduction was also observed on the 21 July 2005, coinciding with the second wave of attacks. No similar reduction in suicide was seen during the same period in the previous 4 years. Poisson regression models with indicator variables for each day in July 2005 revealed a reduction of 40% of the expected daily rate for these 2 days only. We found no evidence of any longer-term effect on suicide. The study findings are contrary to our expectation and only weakly support Durkheim's theory that periods of national threat lower the suicide rate through the impact on social cohesion. It is possible that previous experience of IRA terrorism in the UK may have limited the effect of the 7 July 2005 attacks on suicide in England and Wales. The shock value of suicide terrorism and its psychological potency appear to diminish over time as the tactic becomes overused.

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

Aerosol trace metals, particle morphology and total gaseous mercury in the atmosphere of Oxford, UK

NASA Astrophysics Data System (ADS)

Witt, M. L. I.; Meheran, N.; Mather, T. A.; de Hoog, J. C. M.; Pyle, D. M.

2010-04-01

An investigation of atmospheric trace metals was conducted in Oxford, UK, a small city ˜60 miles northwest of London, in 2007 and 2008. Concentrations of Sr, Mo, Cd, Pb, V, Cr, Mn, Fe, Co, Ni, Cu and Zn in aerosol were measured in bulk and size segregated samples. In addition, total gaseous mercury (TGM) concentrations were monitored semi-continuously by cold vapour-atomic fluorescence spectroscopy. Metal concentrations in Oxford were intermediate between previously reported levels of UK rural and urban areas for most metals studied and levels of Cd, Ni and Pb were within European guidelines. Metal concentrations appeared to be influenced by higher traffic volume on a timescale of hours. The influence of traffic on the aerosols was also suggested by the observation of carbonaceous particles via scanning electron microscopy (SEM). Air mass back trajectories suggest air masses arriving in Oxford from London and mainland Europe contained the highest metal concentrations. Aerosol samples collected over Bonfire Weekend, a period of intense firework use and lighting of bonfires in the UK, showed metal concentrations 6-46 times higher than at other times. Strontium, a tracer of firework release, was present at higher concentrations and showed a change in its size distribution from the coarse to fine mode over Bonfire Weekend. The presence of an abundance of spherical Sr particles was also confirmed in SEM images. The average TGM concentration in Oxford was 3.17 ng m -3 (st. dev. 1.59) with values recorded between 1.32 and 23.2 ng m -3. This is a higher average value than reported from nearby rural locations, although during periods when air was arriving from the west, similar concentrations to these rural areas were seen in Oxford. Comparison to meteorological data suggests that TGM in Oxford's air is highest when wind is arriving from the east/southeast. This may be due to emissions from London/mainland Europe with a possible contribution from emissions from a local

UK role 4 military infection services: past, present and future.

PubMed

Dufty, Ngozi E; Bailey, M S

2013-09-01

NATO describes 'Role 4' military medical services as those provided for the definitive care of patients who cannot be treated within a theatre of operations and these are usually located in a military force's country of origin and may include the involvement of civilian medical services. The UK Defence Medical Services have a proud history of developing and providing clinical services in infectious diseases and tropical medicine, sexual health and HIV medicine, and medical microbiology and virology. These UK Role 4 Military Infection Services have adapted well to recent overseas deployments, but new challenges will arise due to current military cutbacks and a greater diversity of contingency operations in the future. Further evidence-based development of these services will require leadership by military clinicians and improved communication and support for 'reach-back' services.

UK audit of quantitative thyroid uptake imaging.

PubMed

Taylor, Jonathan C; Murray, Anthony W; Hall, David O; Barnfield, Mark C; O'Shaugnessy, Emma R; Carson, Kathryn J; Cullis, James; Towey, David J; Kenny, Bob

2017-07-01

A national audit of quantitative thyroid uptake imaging was conducted by the Nuclear Medicine Software Quality Group of the Institute of Physics and Engineering in Medicine in 2014/2015. The aims of the audit were to measure and assess the variability in thyroid uptake results across the UK and to compare local protocols with British Nuclear Medicine Society (BNMS) guidelines. Participants were invited through a combination of emails on a public mailbase and targeted invitations from regional co-ordinators. All participants were given a set of images from which to calculate quantitative measures and a spreadsheet for capturing results. The image data consisted of two sets of 10 anterior thyroid images, half of which were acquired after administration of Tc-pertechnetate and the other half after administration of I-iodide. Images of the administration syringes or thyroid phantoms were also included. In total, 54 participants responded to the audit. The median number of scans conducted per year was 50. A majority of centres had at least one noncompliance in comparison with BNMS guidelines. Of most concern was the widespread lack of injection-site imaging. Quantitative results showed that both intersite and intrasite variability were low for the Tc dataset. The coefficient of quartile deviation was between 0.03 and 0.13 for measurements of overall percentage uptake. Although the number of returns for the I dataset was smaller, the level of variability between participants was greater (the coefficient of quartile deviation was between 0.17 and 0.25). A UK-wide audit showed that thyroid uptake imaging is still a common test in the UK. It was found that most centres do not adhere to all aspects of the BNMS practice guidelines but that quantitative results are reasonably consistent for Tc-based scans.

Breast cancer awareness and barriers to symptomatic presentation among women from different ethnic groups in East London

PubMed Central

Forbes, L J L; Atkins, L; Thurnham, A; Layburn, J; Haste, F; Ramirez, A J

2011-01-01

Background: During 2001 to 2005, 1-year breast cancer survival was low in ethnically diverse East London. We hypothesised that this was due to low breast cancer awareness and barriers to symptomatic presentation, leading to late stage at diagnosis in women from ethnic minorities. We examined ethnic differences in breast cancer awareness and barriers to symptomatic presentation in East London. Methods: We carried out a population-based survey of 1515 women aged 30+ using the Cancer Research UK Breast Cancer Awareness Measure. We analysed the data using logistic regression adjusting for age group and level of deprivation. Results: South Asian and black women had lower breast cancer awareness than white women. South Asian women, but not black women, reported more emotional barriers to seeking medical help than white women. White women were more likely than non-white women to report worry about wasting the doctor's time as a barrier to symptomatic presentation. Conclusion: Interventions to promote early presentation of breast cancer for South Asian and black women should promote knowledge of symptoms and skills to detect changes, and tackle emotional barriers to symptomatic presentation and for white women tackle the idea that going to the doctor to discuss a breast symptom will waste the doctor's time. PMID:21989188

'Why not you?' Discourses of widening access on UK medical school websites.

PubMed

Alexander, Kirsty; Fahey Palma, Tania; Nicholson, Sandra; Cleland, Jennifer

2017-06-01

In the UK, applications to medicine from those in lower socio-economic groups remain low despite significant investments of time, interest and resources in widening access (WA) to medicine. This suggests that medical schools' core messages about WA may be working to embed or further reinforce marginalisation, rather than to combat this. Our objective was to investigate how the value of WA is communicated by UK medical schools through their websites, and how this may create expectations regarding who is 'suitable' for medicine. We conducted a critical discourse analysis of the webpages of UK medical schools in relation to WA. Our conceptual framework was underpinned by a Foucauldian understanding of discourse. Analysis followed an adapted version of Hyatt's analytical framework. This involved contextualising the data by identifying drivers, levers and warrants for WA, before undertaking a systematic investigation of linguistic features to reveal the discourses in use, and their assumptions. Discourses of 'social mobility for the individual' justified WA as an initiative to support individuals with academic ability and commitment to medicine, but who were disadvantaged by their background in the application process. This meritocratic discourse communicated the benefits of WA as flowing one way, with medical schools providing opportunities to applicants. Conversely, discourses justifying WA as an initiative to benefit patient care were marginalised and largely excluded. Alternative strengths typically attributed to students from lower socio-economic groups were not mentioned, which implies that these were not valued. Current discourses of WA on UK medical school websites do not present non-traditional applicants as bringing gains to medicine through their diversity. This may work as a barrier to attracting larger numbers of diverse applicants. Medical schools should reflect upon their website discourses, critically evaluate current approaches to encouraging

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.

How fair is access to more prestigious UK universities?

PubMed

Boliver, Vikki

2013-06-01

Now that most UK universities have increased their tuition fees to £9,000 a year and are implementing new Access Agreements as required by the Office for Fair Access, it has never been more important to examine the extent of fair access to UK higher education and to more prestigious UK universities in particular. This paper uses Universities and Colleges Admissions Service (UCAS) data for the period 1996 to 2006 to explore the extent of fair access to prestigious Russell Group universities, where 'fair' is taken to mean equal rates of making applications to and receiving offers of admission from these universities on the part of those who are equally qualified to enter them. The empirical findings show that access to Russell Group universities is far from fair in this sense and that little changed following the introduction of tuition fees in 1998 and their initial increase to £3,000 a year in 2006. Throughout this period, UCAS applicants from lower class backgrounds and from state schools remained much less likely to apply to Russell Group universities than their comparably qualified counterparts from higher class backgrounds and private schools, while Russell Group applicants from state schools and from Black and Asian ethnic backgrounds remained much less likely to receive offers of admission from Russell Group universities in comparison with their equivalently qualified peers from private schools and the White ethnic group. © London School of Economics and Political Science 2013.

PLAB and UK graduates' performance on MRCP(UK) and MRCGP examinations: data linkage study.

PubMed

McManus, I C; Wakeford, Richard

2014-04-17

To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Doctors in training for internal medicine or general practice in the United Kingdom. 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18,532, 14,094, and 14,376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14,235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all P<0.001). PLAB2 marks correlated with MRCP(UK) PACES and MRCGP CSA (r=0.274, 0.321; both P<0.001). PLAB graduates had significantly lower MRCP(UK) and MRCGP assessments (Glass's Δ=0.94, 0.91, 1.40, 1.01, and 1.82 for MRCP(UK) Part 1, Part 2, and PACES and MRCGP AKT and CSA), and were more likely to fail assessments and to progress more slowly than UK medical graduates. IELTS scores correlated

PLAB and UK graduates’ performance on MRCP(UK) and MRCGP examinations: data linkage study

PubMed Central

Wakeford, Richard

2014-01-01

Objectives To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Design Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Setting Doctors in training for internal medicine or general practice in the United Kingdom. Participants 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18 532, 14 094, and 14 376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14 235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Main outcome measures Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. Results PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all P<0.001). PLAB2 marks correlated with MRCP(UK) PACES and MRCGP CSA (r=0.274, 0.321; both P<0.001). PLAB graduates had significantly lower MRCP(UK) and MRCGP assessments (Glass’s Δ=0.94, 0.91, 1.40, 1.01, and 1.82 for MRCP(UK) Part 1, Part 2, and PACES and MRCGP AKT and CSA), and were more likely to fail assessments

EELAB: an innovative educational resource in occupational medicine.

PubMed

Zhou, A Y; Dodman, J; Hussey, L; Sen, D; Rayner, C; Zarin, N; Agius, R

2017-07-01

Postgraduate education, training and clinical governance in occupational medicine (OM) require easily accessible yet rigorous, research and evidence-based tools based on actual clinical practice. To develop and evaluate an online resource helping physicians develop their OM skills using their own cases of work-related ill-health (WRIH). WRIH data reported by general practitioners (GPs) to The Health and Occupation Research (THOR) network were used to identify common OM clinical problems, their reported causes and management. Searches were undertaken for corresponding evidence-based and audit guidelines. A web portal entitled Electronic, Experiential, Learning, Audit and Benchmarking (EELAB) was designed to enable access to interactive resources preferably by entering data about actual cases. EELAB offered disease-specific online learning and self-assessment, self-audit of clinical management against external standards and benchmarking against their peers' practices as recorded in the research database. The resource was made available to 250 GPs and 224 occupational physicians in UK as well as postgraduate OM students for evaluation. Feedback was generally very favourable with physicians reporting their EELAB use for case-based assignments. Comments such as those suggesting a wider range of clinical conditions have guided further improvement. External peer-reviewed evaluation resulted in accreditation by the Royal College of GPs and by the Faculties of OM (FOM) of London and of Ireland. This innovative resource has been shown to achieve education, self-audit and benchmarking objectives, based on the participants' clinical practice and an extensive research database. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

The experiences of implementing generic medicine policy in eight countries: A review and recommendations for a successful promotion of generic medicine use

PubMed Central

Hassali, Mohamed Azmi; Alrasheedy, Alian A.; McLachlan, Andrew; Nguyen, Tuan Anh; AL-Tamimi, Saleh Karamah; Ibrahim, Mohamed Izham Mohamed; Aljadhey, Hisham

2013-01-01

Generic medicines are clinically interchangeable with original brand medicines and have the same quality, efficacy and safety profiles. They are, nevertheless, much cheaper in price. Thus, while providing the same therapeutic outcomes, generic medicines lead to substantial savings for healthcare systems. Therefore, the quality use of generic medicines is promoted in many countries. In this paper, we reviewed the role of generic medicines in healthcare systems and the experiences of promoting the use of generic medicines in eight selected countries, namely the United States (US), the United Kingdom (UK), Sweden, Finland, Australia, Japan, Malaysia and Thailand. The review showed that there are different main policies adopted to promote generic medicines such as generic substitution in the US, generic prescribing in the UK and mandatory generic substitution in Sweden and Finland. To effectively and successfully implement the main policy, different complementary policies and initiatives were necessarily introduced. Barriers to generic medicine use varied between countries from negative perceptions about generic medicines to lack of a coherent generic medicine policy, while facilitators included availability of information about generic medicines to both healthcare professionals and patients, brand interchangeability guidelines, regulations that support generic substitution by pharmacists, and incentives to both healthcare professionals and patients. PMID:25561861

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.

Validation of an instrument to measure patients' experiences of medicine use: the Living with Medicines Questionnaire.

PubMed

Krska, Janet; Katusiime, Barbra; Corlett, Sarah A

2017-01-01

Medicine-related burden is an increasingly recognized concept, stemming from the rising tide of polypharmacy, which may impact on patient behaviors, including nonadherence. No instruments currently exist which specifically measure medicine-related burden. The Living with Medicines Questionnaire (LMQ) was developed for this purpose. This study validated the LMQ in a sample of adults using regular prescription medicines in the UK. Questionnaires were distributed in community pharmacies and public places in southeast England or online through UK health websites and social media. A total of 1,177 were returned: 507 (43.1%) from pharmacy distribution and 670 (56.9%) online. Construct validity was assessed by principal components analysis and item reduction undertaken on the original 60-item pool. Known-groups analysis assessed differences in mean total scores between participants using different numbers of medicines and between those who did or did not require assistance with medicine use. Internal consistency was assessed by Cronbach's alpha. Free-text comments were analyzed thematically to substantiate underlying dimensions. A 42-item, eight-factor structure comprising intercorrelated dimensions (patient-doctor relationships and communication about medicines, patient-pharmacist communication about medicines, interferences with daily life, practical difficulties, effectiveness, acceptance of medicine use, autonomy/control over medicines and concerns about medicine use) was derived, which explained 57.4% of the total variation. Six of the eight subscales had acceptable internal consistency (α>0.7). More positive experiences were observed among patients using eight or fewer medicines compared to nine or more, and those independent with managing/using their medicines versus those requiring assistance. Free-text comments, provided by almost a third of the respondents, supported the domains identified. The resultant LMQ-2 is a valid and reliable multidimensional measure of

International differences in sport medicine access and clinical management

PubMed Central

Heron, Neil; Malliaropoulos, Nikolaos G.

2012-01-01

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

Turbulent Flow at 190 m Height Above London During 2006-2008: A Climatology and the Applicability of Similarity Theory

NASA Astrophysics Data System (ADS)

Wood, C. R.; Lacser, A.; Barlow, J. F.; Padhra, A.; Belcher, S. E.; Nemitz, E.; Helfter, C.; Famulari, D.; Grimmond, C. S. B.

2010-10-01

Flow and turbulence above urban terrain is more complex than above rural terrain, due to the different momentum and heat transfer characteristics that are affected by the presence of buildings (e.g. pressure variations around buildings). The applicability of similarity theory (as developed over rural terrain) is tested using observations of flow from a sonic anemometer located at 190.3 m height in London, U.K. using about 6500 h of data. Turbulence statistics—dimensionless wind speed and temperature, standard deviations and correlation coefficients for momentum and heat transfer—were analysed in three ways. First, turbulence statistics were plotted as a function only of a local stability parameter z/Λ (where Λ is the local Obukhov length and z is the height above ground); the σ i / u * values ( i = u, v, w) for neutral conditions are 2.3, 1.85 and 1.35 respectively, similar to canonical values. Second, analysis of urban mixed-layer formulations during daytime convective conditions over London was undertaken, showing that atmospheric turbulence at high altitude over large cities might not behave dissimilarly from that over rural terrain. Third, correlation coefficients for heat and momentum were analyzed with respect to local stability. The results give confidence in using the framework of local similarity for turbulence measured over London, and perhaps other cities. However, the following caveats for our data are worth noting: (i) the terrain is reasonably flat, (ii) building heights vary little over a large area, and (iii) the sensor height is above the mean roughness sublayer depth.

Estimated costs of production and potential prices for the WHO Essential Medicines List

PubMed Central

Hill, Andrew M; Barber, Melissa J

2018-01-01

Introduction There are persistent gaps in access to affordable medicines. The WHO Model List of Essential Medicines (EML) includes medicines considered necessary for functional health systems. Methods A generic price estimation formula was developed by reviewing published analyses of cost of production for medicines and assuming manufacture in India, which included costs of formulation, packaging, taxation and a 10% profit margin. Data on per-kilogram prices of active pharmaceutical ingredient exported from India were retrieved from an online database. Estimated prices were compared with the lowest globally available prices for HIV/AIDS, tuberculosis (TB) and malaria medicines, and current prices in the UK, South Africa and India. Results The estimation formula had good predictive accuracy for HIV/AIDS, TB and malaria medicines. Estimated generic prices ranged from US$0.01 to US$1.45 per unit, with most in the lower end of this range. Lowest available prices were greater than estimated generic prices for 214/277 (77%) comparable items in the UK, 142/212 (67%) in South Africa and 118/298 (40%) in India. Lowest available prices were more than three times above estimated generic price for 47% of cases compared in the UK and 22% in South Africa. Conclusion A wide range of medicines in the EML can be profitably manufactured at very low cost. Most EML medicines are sold in the UK and South Africa at prices significantly higher than those estimated from production costs. Generic price estimation and international price comparisons could empower government price negotiations and support cost-effectiveness calculations. PMID:29564159

Medicine reclassification processes and regulations for proper use of over-the-counter self-care medicines in Japan

PubMed Central

Nomura, Kaori; Kitagawa, Yuki; Yuda, Yasukatsu; Takano-Ohmuro, Hiromi

2016-01-01

Objectives Japan has actively reclassified substances ranging from prescription drugs to over-the-counter (OTC) drugs in recent years. The sale of most OTC drugs was deregulated several times and pharmacists’ supervision was deemed no longer mandatory. Japan established a new OTC evaluation system in 2015 to hear opinions from various stakeholders regarding medicine types to be reclassified. This study aimed to examine the new framework to identify candidate substances for reclassification. Moreover, we examined how to manage the safe, self-care use of OTC drugs in Japan. Methods The necessary regulatory information on OTC approvals as of January 2015 was collected using an Internet search and relevant databases. To highlight the characteristics of OTC drugs in Japan, the UK was selected as a comparison country because it too was actively promoting the reclassification of medicines from prescription to nonprescription status, and because of economic similarity. Results Japan and the UK have a risk-based classification for nonprescription medicines. Japan has made OTC drugs available with mandatory pharmacists’ supervision, face-to-face with pharmacists, or online instruction, which is similar to the “pharmacy medicine” practiced in the UK. Japan recently reformed the reclassification process to involve physicians and the public in the process; some interactions were back to “prescription-only medicine” in the UK. Conclusion It is expected that the opinion of marketers, medical professionals, and the public will improve the discussion that will greatly contribute to the safe use of drugs. Monitoring the new system will be noteworthy to ensure that OTC drug users are managing their self-care properly and visiting a doctor only when necessary. The supply methods are similar in Japan and the UK; however, the expected growth in the Japanese OTC market by the Cabinet and the industry is still uncertain. PMID:27555801

Police deaths in New York and London during the twentieth century

PubMed Central

Kyriacou, D N; Monkkonen, E H; Peek‐Asa, C; Lucke, R E; Labbett, S; Pearlman, K S; Hutson, H R

2006-01-01

Objectives To describe the incidences and causes of occupational police deaths in New York City in the United States and Greater London in the United Kingdom during the twentieth century. To assess the relation between overall societal violence and violence directed toward police officers in these metropolitan areas. Design and setting Ecological study of New York and London from 1900 through 1999. Main outcome measures Intentional and unintentional occupational police mortality rates for New York and London were estimated for each decade. The general population homicide rates of both New York and London were assessed for their correlation with their respective intentional occupational police mortality rates. Results During the 20th century, 585 police officers in New York and 160 police officers in London died while participating in law enforcement activities. New York had markedly greater intentional police mortality rates compared to London throughout most of the 20th century, but these differences decreased significantly by the end of the century. Intentional gunshot wounds comprised 290 police deaths in New York, but only 14 police deaths in London. In New York, gun shot wounds (both intentional and unintentional) accounted for more occupational police deaths (51.6%) than did all other injury mechanisms combined. In London, motor vehicle collision was the most common cause (47.5%) of occupational police death. There were no apparent correlations between the general population homicide rates and intentional police mortality rates in either New York (r2 = 0.05, 95% CI −0.77 to 0.81) or London (r2 = 0.34, 95% CI −0.61 to 0.89). Conclusions During the 20th century, both intentional and unintentional occupational police mortality rates were significantly greater in New York compared to London. These differences are likely from several socioeconomic, cultural, and occupational factors. The declines in police deaths in New York during the latter part of

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…

Medical students' perceptions of their ethics teaching

PubMed Central

Johnston, Carolyn; Haughton, Peter

2007-01-01

The teaching of ethics in UK medical schools has recently been reviewed, from the perspective of the teachers themselves. A questionnaire survey of medical undergraduates at King's College London School of Medicine provides useful insight into the students' perception of ethics education, what they consider to be the value of learning ethics and law, and how engaged they feel with the subject. PMID:17601871

Interview with Alexander Cohen.

PubMed

Cohen, Alexander Ander

2017-05-01

Ander Cohen speaks to Adam Price-Evans, Commissioning Editor of Future Cardiology: Alexander (Ander) Cohen MBBS (Hons), MSc, MD, FRACP is a vascular physician and epidemiologist at Guy's and St Thomas' Hospital, King's College (London, UK). He graduated with honors in medicine and honors in surgery from the University of Melbourne, Australia, and became a fellow of the Royal Australasian College of Physicians in 1990. He was awarded an MSc in Epidemiology from the London School of Hygiene and Tropical Medicine, University of London in 1991 with a thesis on the metabolic syndrome in South-Asian populations. In 1998, he was awarded an MD with a thesis on the epidemiology of venous thromboembolism and thromboprophylaxis. In addition to his clinical work, he is involved in designing, managing and analyzing clinical trials from Phase I to IV. He is the Chairman and a member of many international steering committees for multicenter trials, epidemiological and pharmacoeconomic studies, and was previously the Director of Clinical Research and an Epidemiologist in Thrombosis Research at King's College Hospital.

'I count myself as being in a different world': African gay and bisexual men living with HIV in London. An exploratory study.

PubMed

Paparini, Sara; Doyal, Lesley; Anderson, Jane

2008-05-01

The experiences of men from African backgrounds living with HIV who are gay/bisexual have so far been overlooked in the research on HIV in the UK. Little is known about the ways that HIV impacts on this population. We report on an exploratory qualitative study with 8 gay/bisexual men from 7 different African countries living with HIV in London, based on in depth semi structured interviews and a thematic analysis. HIV testing and diagnosis, disclosure to others, social and sexual networks, sexual relationships and practices, use of health services and coping mechanisms emerged as key themes. Men with insecure residency status in the UK and those without work had additional challenges to meet. Men described the constant juggling required to balance the complex and sometimes contradictory realities of life as a gay/bisexual man, an African and an HIV positive person. Actual and perceived stigma was a key barrier to accessing appropriate practical and emotional support from families, social network or religious organisations.

Report on the Infinium 450k methylation array analysis workshop: April 20, 2012 UCL, London, UK.

PubMed

Morris, Tiffany; Lowe, Robert

2012-08-01

A new platform for DNA methylome analysis is Illumina's Infinium HumanMethylation450. This technology is an extension of the previous HumanMethylation27 BeadChip and allows the methylation status of 12 samples per chip and 4 to 8 chips (total of 48 to 96 samples) to be assessed simultaneously for more than 480,000 cytosines across the genome. The platform incorporates two different probe types using different assay designs (InfiniumI and InfiniumII). Although this has allowed the assessment of more CpG sites, it has also introduced technical variation between the two probe types, which has complicated the analysis process. Many groups are working on normalization methods and analysis pipelines while many others are struggling to make sense of their new data sets. This motivated the organization of a meeting held at University College London that focused solely on the analysis methods and problems related to this new platform. The meeting was attended by 125 computational and bench scientists from 11 countries. There were 10 speakers, a small poster session and a discussion session.

33 CFR 110.52 - Thames River, New London, Conn.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Thames River, New London, Conn. 110.52 Section 110.52 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.52 Thames River, New London, Conn. (a) Area No...

33 CFR 110.52 - Thames River, New London, Conn.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Thames River, New London, Conn. 110.52 Section 110.52 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.52 Thames River, New London, Conn. (a) Area No...

33 CFR 110.52 - Thames River, New London, Conn.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Thames River, New London, Conn. 110.52 Section 110.52 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.52 Thames River, New London, Conn. (a) Area No...

33 CFR 110.52 - Thames River, New London, Conn.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Thames River, New London, Conn. 110.52 Section 110.52 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.52 Thames River, New London, Conn. (a) Area No...

33 CFR 110.52 - Thames River, New London, Conn.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Thames River, New London, Conn. 110.52 Section 110.52 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.52 Thames River, New London, Conn. (a) Area No...

Prevalence, correlates and patterns of waterpipe smoking among secondary school students in southeast London: a cross-sectional study.

PubMed

Jawad, Mohammed; Power, Gerald

2016-02-01

Waterpipe smoking is growing worldwide, but little is known of its epidemiology in the UK due to its absence from national health surveys. We sought to address this by calculating the prevalence of waterpipe smoking among secondary school students in southeast London. We conducted a pooled secondary analysis of routine health surveillance surveys among 11-17 year olds in convenience-sampled secondary schools from three ethnically-diverse areas of southeast London. We calculated ever (lifetime) waterpipe use, and compared its sociodemographic correlates to ever (lifetime) cigarette use. In one area we collected data on patterns of waterpipe use. Of 2,098 respondents (mean age 14.1 ± 1.7 years, 55.7 % male, 46.6 % of black ethnicity), ever waterpipe use was 39.6 % (95 % CI 37.6-41.7 %) and was higher than that for ever cigarette use (32.4 %; 95 % CI 30.5-34.4). While waterpipe users were significantly and independently more likely to be male and of non-white ethnicities, at least 30 % of all age, gender and ethnic sub-groups had tried waterpipe smoking. In contrast, cigarette users were more likely to be older and of white ethnicity. In one of the three areas, over a quarter of waterpipe users were occasional or regular waterpipe smokers, and most were introduced to and currently used waterpipe in waterpipe-serving premises or friends' homes. Waterpipe smoking prevalence was high in southeast London, and users exhibited a different sociodemographic profile to cigarette users. Waterpipe should be included in national health surveys of young people. National surveillance is warranted to help develop suitable interventions to prevent uptake and promote cessation.

Education in the attic: an insight into the educational services of the Old Operating Theatre Museum and Herb Garret, London Bridge.

PubMed

Edge, Stevie

2009-01-01

Hidden for almost a century in the attic of St Thomas' Church the oldest operating theatre in Britain is now part of a museum. This precious building now houses a collection of pre-anaesthetic tools, items relating to medicine in the home and various Apothecary displays. The museum aims to preserve the theatre and items relating to medicine, in order to contribute to the understanding of the development of medical knowledge, with particular reference to St Thomas' hospital. An independent museum with a long history of educational provision: this article explores some of the education services of The Old Operating Theatre Museum and Herb Garret at London Bridge.

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)

Pathways, Networks and Systems Medicine Conferences

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nadeau, Joseph H.

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),more » 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.« less

Mutual learning and research messages: India, UK, and Europe

PubMed Central

Kalra, Gurvinder; Bhugra, Dinesh

2010-01-01

India and UK have had a long history together, since the times of the British Raj. Most of what Indian psychiatry is today, finds its roots in ancient Indian texts and medicine systems as much as it is influenced by the European system. Psychiatric research in India is growing. It is being influenced by research in the UK and Europe and is influencing them at the same time. In addition to the sharing of ideas and the know-how, there has also been a good amount of sharing of mental health professionals and research samples in the form of immigrants from India to the UK. The Indian mental health professionals based in UK have done a good amount of research with a focus on these Indian immigrants, giving an insight into cross-cultural aspects of some major psychiatric disorders. This article discusses the impact that research in these countries has had on each other and the contributions that have resulted from it. PMID:21836716

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

Developing technology for surgery in the UK: a multidisciplinary meeting of engineers and surgeons.

PubMed

Taylor, G W

2007-03-01

There is an increasing necessity for surgeons and engineers to work together in order to target future technological developments at clinical need and cost-effectiveness. This is a report of two linked meetings with these objectives, held at the Institute of Mechanical Engineers, London, UK. The two meetings were organized by the same faculty members and held on consecutive days. Delegates included surgeons, academic mechanical engineers, researchers and industrial representatives. The programme was made up of varied presentations by surgeons and engineers as well as open discussion of the topics covered. Delegates were updated on the current state of surgical robotics in the UK in four surgical specialties; urology, neurosurgery, orthopaedics and ENT. This included clinical and experimental evidence, together with discussion of future advances. Minimally invasive surgery, real-time imaging and the development of more compact and cost effective surgical robots were identified as key areas for future research. Copyright 2006 John Wiley & Sons, Ltd.

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

THE LONDON EXTERNAL DEGREE SYSTEM, ORIGINS AND PRESENT PROBLEMS.

ERIC Educational Resources Information Center

CHARNLEY, A.H.

FORMAL RESPONSIBILITY FOR BRITISH ADULTS PURSUING DEGREE COURSES BY HOME STUDY RESTS LARGELY WITH THE UNIVERSITY OF LONDON. ALTHOUGH ABOUT 1,000 STUDENTS ARE BEING TAUGHT AT INSTITUTIONS COOPERATING WITH THE UNIVERSITY OF LONDON, THE MAJOR GROUPS ARE THE HOME STUDENTS (OVER 20,000) AND THE OVERSEAS STUDENTS (OVER 4,000). BRITISH EXTERNAL STUDENTS…

Fear of Crime among Elderly Jews in Boston and London.

ERIC Educational Resources Information Center

Ginsberg, Yona

1985-01-01

Examines the impact of fear of crime on the daily behavior of elderly Jews in racially mixed, deteriorating neighborhoods in Boston and London. Results showed the Boston elderly retreated behind locked doors, while the London elderly continued their daily routine. (JAC)

The 2005 London terror attacks: An investigation of changes in psychological wellbeing and social capital pre- and post-attacks (2003-07)-A UK panel study.

PubMed

Giordano, Giuseppe N; Lindström, Martin

2016-12-01

The London public transport suicide bombings, which occurred on 7th July 2005, were described as the worst single terrorist atrocity on British soil to date. Past acts of terrorism have been associated with deterioration in population mental health. They may also negatively impact levels of social capital, which is considered a buffer against poor mental health outcomes. By employing panel data from the British Household Panel Survey and following the same individuals (N T =9287) three times over a five-year period (2003, 2005 and 2007), the aim of this longitudinal multilevel study was to investigate: (i) the impact of terrorism on individual-level social capital (generalised trust and social participation) across the UK; and (ii) the buffering effects of social capital on psychological wellbeing (GHQ-12). By comparing 2005 and 2007 covariate values (including the two social capital proxies) against their pre-terror baseline (2003) measurements in two separate multilevel logistic regression models, we examined the immediate and longer-term effects of the 2005 attacks on our GHQ-12 outcome. Compared to baseline, generalised trust dropped from 44% to 36% immediately post-terror attacks in 2005, while local participation increased from 45.8% to 47.5%. Social capital levels started to return to baseline levels by 2007, yet both proxies maintained independent buffering effects against poor GHQ-12 scores in years 2005 and 2007. From this empirical evidence, it seems that though generalised trust levels are negatively affected by acts of terrorism, the accompanying increase in local active participation may aid in the re-establishment of societal norms and beliefs in later years. Decision makers should be aware that such atrocities may negatively impact on populations' generalised trust in the shorter-term. To safeguard against losing this buffer against poor mental health outcomes, local active participation should be encouraged.

Art in wartime: The First Wounded, London Hospital, August 1914.

PubMed

Park, M P; Park, R H R

2011-06-01

John Lavery's The First Wounded, London Hospital, August 1914 records a memorable event in the First World War. This painting and the archives of the Royal London Hospital provide a fascinating insight into the nursing and medical care of these early war casualties.

Inner London's Education Authority: Reflections on ILEA Twenty-Five Years after Closure

ERIC Educational Resources Information Center

Mitchell, Peter

2015-01-01

It is 25 years since the Inner London Education Authority (ILEA) was abolished and management of education in central London transferred to 13 London boroughs. The author reflects on the experience of being an ex-ILEA head teacher, and of managing one of the new local education authorities in the immediate post-ILEA period. He begins by commenting…

London Challenge: Surveys of Pupils and Teachers, 2005. Research Report RR718

ERIC Educational Resources Information Center

Ridley, Kate; Knight, Sarah; Scott, Emma; Benton, Tom; Woodthorpe, Adrian

2006-01-01

The London Challenge is a Department for Education and Skills (DfES) initiative, which aims to raise levels of attainment in London secondary schools and to create a world class education system in the capital. In 2005, London Challenge commissioned the National Foundation for Educational Research (NFER) to carry out a survey of Year 7 pupils,…

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

Sexual behaviours, HIV testing, and the proportion of men at risk of transmitting and acquiring HIV in London, UK, 2000-13: a serial cross-sectional study.

PubMed

Aghaizu, Adamma; Wayal, Sonali; Nardone, Anthony; Parsons, Victoria; Copas, Andrew; Mercey, Danielle; Hart, Graham; Gilson, Richard; Johnson, Anne M

2016-09-01

HIV incidence in men who have sex with men (MSM) in the UK has remained unchanged over the past decade despite increases in HIV testing and antiretroviral therapy (ART) coverage. In this study, we examine trends in sexual behaviours and HIV testing in MSM and explore the risk of transmitting and acquiring HIV. In this serial cross-sectional study, we obtained data from ten cross-sectional surveys done between 2000 and 2013, consisting of anonymous self-administered questionnaires and oral HIV antibody testing in MSM recruited in gay social venues in London, UK. Data were collected between October and January for all survey years up to 2008 and between February and August thereafter. All men older than 16 years were eligible to take part and fieldworkers attempted to approach all MSM in each venue and recorded refusal rates. Data were collected on demographic and sexual behavioural characteristics. We analysed trends over time using linear, logistic, and quantile regression. Of 13 861 questionnaires collected between 2000 and 2013, we excluded 1985 (124 had completed the survey previously or were heterosexual reporting no anal intercourse in the past year, and 1861 did not provide samples for antibody testing). Of the 11 876 eligible MSM recruited, 1512 (13%) were HIV positive, with no significant trend in HIV positivity over time. 35% (531 of 1505) of HIV-positive MSM had undiagnosed infection, which decreased non-linearly over time from 34% (45 of 131) to 24% (25 of 106; p=0·01), while recent HIV testing (ie, in the past year) increased from 26% (263 of 997) to 60% (467 of 777; p<0·0001). The increase in recent testing in undiagnosed men (from 29% to 67%, p<0·0001) and HIV-negative men (from 26% to 62%, p<0·0001) suggests that undiagnosed infection might increasingly be recently acquired infection. The proportion of MSM reporting unprotected anal intercourse (UAI) in the past year increased from 43% (513 of 1187) to 53% (394 of 749; p<0·0001) and

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.

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.

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.

'Our community is the worst': the influence of cultural beliefs on stigma, relationships with family and help-seeking in three ethnic communities in London.

PubMed

Shefer, Guy; Rose, Diana; Nellums, Laura; Thornicroft, Graham; Henderson, Claire; Evans-Lacko, Sara

2013-09-01

Existing knowledge about the cultural beliefs of black and minority ethnic (BME) communities in the UK regarding stigma and mental illness is limited. Data were collected in 10 focus groups, five with service users and five with laypersons, from BME communities in London. Thematic analysis identified that cultural beliefs regarding mental illness reflect four different voices present within the BME communities. The study revealed that cultural beliefs influencing both relationships with family and, consequently, help-seeking for individuals with mental illness must be considered in the development of anti-stigma interventions and when engaging communities around mental health.

Wealth, health and frailty in industrial-era London.

PubMed

DeWitte, Sharon N; Hughes-Morey, Gail; Bekvalac, Jelena; Karsten, Jordan

2016-05-01

Socioeconomic status is a powerful predictor of mortality in living populations, as status affects exposure or access to a variety of factors that impact health and survival, such as diet, healthcare, infectious disease and pollution. This study examines the effect of socioeconomic status on mortality and survival in London during a period spanning the early 18th through mid-19th centuries. During this period, London experienced rapid industrialization and heightened class distinctions. This study examines whether low-socioeconomic status was associated with reduced survival at a time when the distinctions between social strata were peaking. The samples for this study are drawn from three skeletal assemblages in London that represent lower and higher social strata. The upper socioeconomic status sample (n = 394) is from Chelsea Old Church and St Bride's Fleet Street (crypt assemblage). The low socioeconomic status sample (n = 474) is from St. Bride's Lower Churchyard (also known as St Bride's Farringdon Street). The effect of status on mortality and survival is assessed using hazard analysis and Kaplan-Meier analysis. The results reveal elevated mortality and reduced survival for lower socioeconomic status children, but no strong effect of status on adult mortality or survival. These results might indicate strong selective mortality operating during childhood or the effects of migration in the industrial-era population of London.

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.

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

PubMed

MacDougall, Margaret

2015-10-31

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. 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. 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. 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.

Ethnic variation in the prevalence of visual impairment in people attending diabetic retinopathy screening in the United Kingdom (DRIVE UK).

PubMed

Sivaprasad, Sobha; Gupta, Bhaskar; Gulliford, Martin C; Dodhia, Hiten; Mann, Samantha; Nagi, Dinesh; Evans, Jennifer

2012-01-01

To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom). The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London) or August 2009 (West Yorkshire) were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks ("Black/African/Caribbean/Black British") and South Asians ("Asians originating from the Indian subcontinent"). We examined the prevalence of visual impairment in the better eye using three cut-off points (a) loss of vision sufficient for driving (approximately <6/9) (b) visual impairment (<6/12) and (c) severe visual impairment (<6/60), standardising the prevalence of visual impairment in the minority ethnic groups to the age-structure of the white population. Data on visual acuity and were available on 50,331 individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI) 3.2% to 3.5%) and 0.39% severely visually impaired (0.33% to 0.44%). Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively) compared to white people (3.3%, 95% CI 3.1% to 3.5%). Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire. Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK.

Fritz London and the scale of quantum mechanisms

NASA Astrophysics Data System (ADS)

Monaldi, Daniela

2017-11-01

Fritz London's seminal idea of ;quantum mechanisms of macroscopic scale;, first articulated in 1946, was the unanticipated result of two decades of research, during which London pursued quantum-mechanical explanations of various kinds of systems of particles at different scales. He started at the microphysical scale with the hydrogen molecule, generalized his approach to chemical bonds and intermolecular forces, then turned to macrophysical systems like superconductors and superfluid helium. Along this path, he formulated a set of concepts-the quantum mechanism of exchange, the rigidity of the wave function, the role of quantum statistics in multi-particle systems, the possibility of order in momentum space-that eventually coalesced into a new conception of systems of equal particles. In particular, it was London's clarification of Bose-Einstein condensation that enabled him to formulate the notion of superfluids, and led him to the recognition that quantum mechanics was not, as it was commonly assumed, relevant exclusively as a micromechanics.

Real-world effects of medications for chronic obstructive pulmonary disease: protocol for a UK population-based non-interventional cohort study with validation against randomised trial results.

PubMed

Wing, Kevin; Williamson, Elizabeth; Carpenter, James R; Wise, Lesley; Schneeweiss, Sebastian; Smeeth, Liam; Quint, Jennifer K; Douglas, Ian

2018-03-25

Chronic obstructive pulmonary disease (COPD) is a progressive disease affecting 3 million people in the UK, in which patients exhibit airflow obstruction that is not fully reversible. COPD treatment guidelines are largely informed by randomised controlled trial results, but it is unclear if these findings apply to large patient populations not studied in trials. Non-interventional studies could be used to study patient groups excluded from trials, but the use of these studies to estimate treatment effectiveness is in its infancy. In this study, we will use individual trial data to validate non-interventional methods for assessing COPD treatment effectiveness, before applying these methods to the analysis of treatment effectiveness within people excluded from, or under-represented in COPD trials. Using individual patient data from the landmark COPD Towards a Revolution in COPD Health (TORCH) trial and validated methods for detecting COPD and exacerbations in routinely collected primary care data, we will assemble a cohort in the UK Clinical Practice Research Datalink (selecting people between 1 January 2004 and 1 January 2017) with similar characteristics to TORCH participants and test whether non-interventional data can generate comparable results to trials, using cohort methodology with propensity score techniques to adjust for potential confounding. We will then use the methodological template we have developed to determine risks and benefits of COPD treatments in people excluded from TORCH. Outcomes are pneumonia, COPD exacerbation, mortality and time to treatment change. Groups to be studied include the elderly (>80 years), people with substantial comorbidity, people with and without underlying cardiovascular disease and people with mild COPD. Ethical approval has been granted by the London School of Hygiene & Tropical Medicine Ethics Committee (Ref: 11997). The study has been approved by the Independent Scientific Advisory Committee of the UK Medicines and

The Benefits of Residential Fieldwork for School Science: Insights from a five-year initiative for inner-city students in the UK

NASA Astrophysics Data System (ADS)

Amos, Ruth; Reiss, Michael

2012-03-01

There is considerable international interest in the value of residential fieldwork for school students. In the UK, pressures on curriculum time, rising costs and heightened concern over students' safety are curtailing residential experiences. Collaboration between several key fieldwork providers across the UK created an extensive programme of residential courses for 11-14-year-olds in London schools from 2004 to 2008. Some 33,000 students from 849 schools took part. This paper draws on the evaluation of the programme that gathered questionnaire, interview and observational data from 2,706 participating students, 70 teachers and 869 parents/carers from 46 schools, mainly in deprived areas of the city. Our findings revealed that students' collaborative skills improved and interpersonal relationships were strengthened and taken back to school. Gains were strongest in social and affective domains, together with behavioural improvements for some students. Individual cognitive gains were revealed more convincingly during face-to-face interviews, rather than through survey items. Students from socially deprived backgrounds benefitted from exposure to learning environments which promoted authentic practical inquiry. Over the 5-year programme, combined physical adventure and real-world experiences proved to be popular with students and their teachers, and opened up opportunities for learning and doing science in ways not often accessible in urban school environments. Further programmes have been implemented in other parts of the UK as a result of the London experience, which build upon the provision of mixed curriculum-adventure course design. The popularity and apparent success of these combination courses suggest that providers need to consider the value of developing similar programmes in the future.

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…

"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

Royal london hospital set P28 plans 30th anniversary reunion.

PubMed

Sibthorpe, Fran

2013-04-03

Members of Set P28 at the Royal London Hospital who began their training in February 1980 are planning a reunion on July 27 in London. The venue will be announced later. Email fran-joy@hotmail.com for details.

Building a Hypertextual Digital Library in the Humanities: A Case Study on London.

ERIC Educational Resources Information Center

Crane, Gregory; Smith, David A.; Wulfman, Clifford E.

This paper describes the creation of a new humanities digital library collection: 11,000,000 words and 10,000 images representing books, images, and maps on pre-twentieth century London and its environs. The London collection contained far more dense and precise information than the materials from the Greco-Roman world. The London collection thus…

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

Cannabis-based medicines--GW pharmaceuticals: high CBD, high THC, medicinal cannabis--GW pharmaceuticals, THC:CBD.

PubMed

2003-01-01

GW Pharmaceuticals is undertaking a major research programme in the UK to develop and market distinct cannabis-based prescription medicines [THC:CBD, High THC, High CBD] in a range of medical conditions. The cannabis for this programme is grown in a secret location in the UK. It is expected that the product will be marketed in the US in late 2003. GW's cannabis-based products include selected phytocannabinoids from cannabis plants, including D9 tetrahydrocannabinol (THC) and cannabidiol (CBD). The company is investigating their use in three delivery systems, including sublingual spray, sublingual tablet and inhaled (but not smoked) dosage forms. The technology is protected by patent applications. Four different formulations are currently being investigated, including High THC, THC:CBD (narrow ratio), THC:CBD (broad ratio) and High CBD. GW is also developing a specialist security technology that will be incorporated in all its drug delivery systems. This technology allows for the recording and remote monitoring of patient usage to prevent any potential abuse of its cannabis-based medicines. GW plans to enter into agreements with other companies following phase III development, to secure the best commercialisation terms for its cannabis-based medicines. In June 2003, GW announced that exclusive commercialisation rights for the drug in the UK had been licensed to Bayer AG. The drug will be marketed under the Sativex brand name. This agreement also provides Bayer with an option to expand their license to include the European Union and certain world markets. GW was granted a clinical trial exemption certificate by the Medicines Control Agency to conduct clinical studies with cannabis-based medicines in the UK. The exemption includes investigations in the relief of pain of neurological origin and defects of neurological function in the following indications: multiple sclerosis (MS), spinal cord injury, peripheral nerve injury, central nervous system damage, neuroinvasive

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).…

The Olympic Regeneration in East London (ORiEL) study: protocol for a prospective controlled quasi-experiment to evaluate the impact of urban regeneration on young people and their families

PubMed Central

Smith, Neil R; Clark, Charlotte; Fahy, Amanda E; Tharmaratnam, Vanathi; Lewis, Daniel J; Thompson, Claire; Renton, Adrian; Moore, Derek G; Bhui, Kamaldeep S; Taylor, Stephanie J C; Eldridge, Sandra; Petticrew, Mark; Greenhalgh, Tricia; Stansfeld, Stephen A; Cummins, Steven

2012-01-01

Introduction Recent systematic reviews suggest that there is a dearth of evidence on the effectiveness of large-scale urban regeneration programmes in improving health and well-being and alleviating health inequalities. The development of the Olympic Park in Stratford for the London 2012 Olympic and Paralympic Games provides the opportunity to take advantage of a natural experiment to examine the impact of large-scale urban regeneration on the health and well-being of young people and their families. Design and methods A prospective school-based survey of adolescents (11–12 years) with parent data collected through face-to-face interviews at home. Adolescents will be recruited from six randomly selected schools in an area receiving large-scale urban regeneration (London Borough of Newham) and compared with adolescents in 18 schools in three comparison areas with no equivalent regeneration (London Boroughs of Tower Hamlets, Hackney and Barking & Dagenham). Baseline data will be completed prior to the start of the London Olympics (July 2012) with follow-up at 6 and 18 months postintervention. Primary outcomes are: pre–post change in adolescent and parent mental health and well-being, physical activity and parental employment status. Secondary outcomes include: pre–post change in social cohesion, smoking, alcohol use, diet and body mass index. The study will account for individual and environmental contextual effects in evaluating changes to identified outcomes. A nested longitudinal qualitative study will explore families’ experiences of regeneration in order to unpack the process by which regeneration impacts on health and well-being. Ethics and dissemination The study has approval from Queen Mary University of London Ethics Committee (QMREC2011/40), the Association of Directors of Children's Services (RGE110927) and the London Boroughs Research Governance Framework (CERGF113). Fieldworkers have had advanced Criminal Records Bureau clearance. Findings

The Olympic Regeneration in East London (ORiEL) study: protocol for a prospective controlled quasi-experiment to evaluate the impact of urban regeneration on young people and their families.

PubMed

Smith, Neil R; Clark, Charlotte; Fahy, Amanda E; Tharmaratnam, Vanathi; Lewis, Daniel J; Thompson, Claire; Renton, Adrian; Moore, Derek G; Bhui, Kamaldeep S; Taylor, Stephanie J C; Eldridge, Sandra; Petticrew, Mark; Greenhalgh, Tricia; Stansfeld, Stephen A; Cummins, Steven

2012-01-01

Recent systematic reviews suggest that there is a dearth of evidence on the effectiveness of large-scale urban regeneration programmes in improving health and well-being and alleviating health inequalities. The development of the Olympic Park in Stratford for the London 2012 Olympic and Paralympic Games provides the opportunity to take advantage of a natural experiment to examine the impact of large-scale urban regeneration on the health and well-being of young people and their families. A prospective school-based survey of adolescents (11-12 years) with parent data collected through face-to-face interviews at home. Adolescents will be recruited from six randomly selected schools in an area receiving large-scale urban regeneration (London Borough of Newham) and compared with adolescents in 18 schools in three comparison areas with no equivalent regeneration (London Boroughs of Tower Hamlets, Hackney and Barking & Dagenham). Baseline data will be completed prior to the start of the London Olympics (July 2012) with follow-up at 6 and 18 months postintervention. Primary outcomes are: pre-post change in adolescent and parent mental health and well-being, physical activity and parental employment status. Secondary outcomes include: pre-post change in social cohesion, smoking, alcohol use, diet and body mass index. The study will account for individual and environmental contextual effects in evaluating changes to identified outcomes. A nested longitudinal qualitative study will explore families' experiences of regeneration in order to unpack the process by which regeneration impacts on health and well-being. The study has approval from Queen Mary University of London Ethics Committee (QMREC2011/40), the Association of Directors of Children's Services (RGE110927) and the London Boroughs Research Governance Framework (CERGF113). Fieldworkers have had advanced Criminal Records Bureau clearance. Findings will be disseminated through peer-reviewed publications, national and

The use of AEDs by police officers in the City of London. Automated external defibrillators.

PubMed

Ross, P; Nolan, J; Hill, E; Dawson, J; Whimster, F; Skinner, D

2001-08-01

The Guidelines 2000 for cardiopulmonary resuscitation recommend shock delivery to victims in ventricular fibrillation within 5 min of call receipt by the Emergency Medical Services. In an effort to achieve this goal, in some parts of the United States, police officers have been trained to use automated external defibrillators (AEDs). We undertook a 3-year pilot evaluation of the use of AEDs by City of London police (CPOL) officers. Over a period of 3 years, 147 CPOL officers were trained in the use of an AED. Four AEDs were placed on rapid response vehicles covering the City of London. An overall call-response interval target was set at 8 min. The CPOL attended 1103 (90%) of the total of 1232 calls to which they were summoned. The mean interval between the first call received and arrival of the CPOL on scene was 8.9+/-4.0 min. The CPOL applied AEDs to 25 victims, 13 of whom were initially in ventricular fibrillation; at least one shock was delivered to all 13. The interval between call reception and delivery of the first shock was 5.5+/-2.5 min. The mean interval between switching on the AED and delivery of the first shock was 24+/-12 s. Two (15%) of these victims survived to hospital discharge. This study has confirmed the feasibility of training police officers in the UK to use AEDs as first responders. The call received to arrival on scene interval should be reduced by improvements in communication between LAS and CPOL.

Psychological and behavioural reactions to the bombings in London on 7 July 2005: cross sectional survey of a representative sample of Londoners

PubMed Central

Rubin, G James; Brewin, Chris R; Greenberg, Neil; Simpson, John; Wessely, Simon

2005-01-01

Objectives To assess the impact of the bombings in London on 7 July on stress levels and travel intentions in London's population. Design A cross sectional telephone survey using random digit dialling was conducted to contact a representative sample of adults. Respondents were asked to participate in an interview enquiring about current levels of stress and travel intentions. Setting Interviews took place between 18 and 20 July. Participants 1010 participants (10% of the eligible people we contacted) completed the interviews. Main outcome measures Main outcomes were presence of substantial stress, measured by using an identical tool to that used to assess the emotional impact of 11 September 2001 in the US population, and intention to travel less on tubes, trains, and buses, or into central London, once the transport network had returned to normal. Results 31% of Londoners reported substantial stress and 32% reported an intention to travel less. Among other things, having difficulty contacting friends or family by mobile phone (odds ratio 1.7, 95% confidence interval 1.1 to 2.7), having thought you could have been injured or killed (3.8, 2.4 to 6.2), and being Muslim (4.0, 2.5 to 6.6) were associated with a greater presence of substantial stress, whereas being white (0.3, 0.2 to 0.4) and having previous experience of terrorism (0.6, 0.5 to 0.9) were associated with reduced stress. Only 12 participants (1%) felt that they needed professional help to deal with their emotional response to the attacks. Conclusions Although the psychological needs of those intimately caught up in the attacks will require further assessment, we found no evidence of a widespread desire for professional counselling. The attacks have inflicted disproportionately high levels of distress among non-white and Muslim Londoners. PMID:16126821

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.

Case studies of transport for London.

DOT National Transportation Integrated Search

2009-01-01

This project was motivated by the election of Ken Livingston as Mayor of London in : 2000. Mayor Livingston campaigned on a platform of improving transportation service through : such innovative means as congestion pricing. Mayor Livingston relied on...

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

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

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

2008-03-20

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. 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. 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. 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 Pakistani origin born in the UK reach

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. Copyright © 2010 The Foundation for Professionals in Services for Adolescents. All rights reserved.

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.

Paul Ehrlich: the Nobel Prize in physiology or medicine 1908.

PubMed

Piro, Anna; Tagarelli, Antonio; Tagarelli, Giuseppe; Lagonia, Paolo; Quattrone, Aldo

2008-01-01

We wish to commemorate Paul Ehrlich on the centennial of his being awarded the Nobel Prize in Physiology or Medicine in 1908. His studies are now considered as milestones in immunology: the morphology of leukocytes; his side-chain theory where he defined the cellular receptor for first time; and his clarification of the difference between serum therapy and chemotherapy. Ehrlich also invented the first chemotherapeutic drug: compound 606, or Salvarsan. We have used some original documents from the Royal Society of London, where Ehrlich was a fellow, and from Leipzig University, where he took a degree in medicine.

Factors influencing the decisions of senior UK doctors to retire or remain in medicine: national surveys of the UK-trained medical graduates of 1974 and 1977

PubMed Central

Smith, Fay; Lachish, Shelly; Goldacre, Michael J

2017-01-01

Objective To report attitudes to retirement of late-career doctors. Design Questionnaires sent in 2014 to all UK medical graduates of 1974 and 1977. Setting United Kingdom. Participants 3695 medical graduates. Main outcome measures Factors which influenced doctors’ decisions to retire and factors which encouraged doctors to remain in work. Results The response rate was 85% (3695/4369). 55% of respondents overall were still working in medicine (whether they had not retired or had retired and returned; 61% of men, 43% of women). Of the retirees, 67% retired when they had originally planned to, and 28% had changed their retirement plans. Fifty per cent of retired doctors cited ‘increased time for leisure/other interests’ as a reason; 43% cited ‘pressure of work’. Women (21%) were more likely than men (11%) to retire for family reasons. Women (27%) were more likely than men (9%) to retire because of the retirement of their spouse. General practitioners (GPs) were more likely than doctors in other specialties to cite ‘pressure of work’. Anaesthetists and GPs were more likely than doctors in other specialties to cite the ‘possibility of deteriorating skill/competence’. Radiologists, surgeons, obstetricians and gynaecologists, and anaesthetists were most likely to cite ‘not wanting to do out-of-hours work’. Doctors who were still working were asked what would encourage them to stay in medicine for longer. Factors cited most frequently were ‘reduced impact of work-related bureaucracy’ (cited by 45%) and ‘workload reduction/shorter hours’ (42%). Men (30%) were more motivated than women (20%) by ‘financial incentivisation’. Surgeons were most motivated by ‘reduction of on-call or emergency commitments’. Conclusions Retention policy should address ways of optimising the clinical contribution of senior doctors while offering reduced workloads in the areas of bureaucracy and working hours, particularly in respect of emergency commitments

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.

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

PREFACE: Sensors and Their Applications XVII

NASA Astrophysics Data System (ADS)

Bilas, V.; McConnell, G.; Kyriacou, P.

2013-06-01

This volume records the Proceedings of the seventeenth conference in the biennial Sensors and Their Applications series that took place at Rixos Libertas, Dubrovnik, Croatia from 16-18 September 2013. The conference is organised by the Instrument Science and Technology Group of the Institute of Physics. The conference was the first organised by the Institute of Physics to be held outside of the UK and Ireland, thus continuing the collaborative and adventurous nature of the meeting. The conference proceedings record the continuing health, diversity and activity of the sensors community worldwide, bringing together contributions from academics and industrial researchers to provide excellent networking opportunities. It is interesting to note some continuing themes such as Optical Sensors and Electromagnetic Sensors, as well as trends in Environmental Sensing and Glacial Monitoring that reflect our changing world, and Sensors in Biology and Medicine that have a growing importance with an ageing population. The conference also accounts for research specialisms and unique strengths from the local community in Croatia, including demining and metal detector sensing. We should like to thank all of our colleagues and friends in the sensor community who have supported this event by contributing manuscripts. Our thanks go also to members of the Technical Programme Committee for their support, and in particular for refereeing the submitted manuscripts. We are also pleased to express our thanks to the Conference Department of the Institute of Physics for their invaluable support in organising this event. We are especially grateful to Dawn Stewart for her responsive and day-to-day handling of this conference, as well as Claire Garland for help in planning and managing this international event. We hope that the conference authors, participants and a wider audience will find these proceedings to be of interest and to serve as a useful reference text. V Bilas, G McConnell and P

Risk and presenting features of prostate cancer amongst African-Caribbean, South Asian and European men in North-east London.

PubMed

Chinegwundoh, Frank; Enver, Mohamed; Lee, Angela; Nargund, Vinod; Oliver, Tim; Ben-Shlomo, Yoav

2006-12-01

To determine whether there are ethnic differences in the incidence and presenting features of all patients with prostate cancer presenting in North-east London, UK. All newly diagnosed men with prostate cancer between 1999 and 2000 who were resident in the East London and City Health Authority were identified from various sources. Key clinical features were extracted from hospital records. The age-adjusted incidence rates for European, South Asian and African-Caribbean patients were calculated using census denominator data. For men aged >50 years the annual age-adjusted incidence rates (95% confidence interval) were 213 (186-240), 647 (504-789) and 199 (85-310) for the European, African-Caribbean and South Asian patients, respectively. African-Caribbean men had a three times greater risk (risk ratio 3.07, 2.40-3.93, P < 0.001) than European men. South Asian men had a lower risk of prostate cancer but this could have been compatible with chance. There was no evidence of marked ethnic differences for prostate-specific antigen levels, clinical staging and Gleason scores. The greater risk of prostate cancer for African-Caribbean men in South-east England is consistent with data from the USA and the Caribbean. Future work needs to determine whether this risk differs according to country of origin, and which genetic and/or environmental risk factors might be important in explaining these observations.

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

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

The commercialization of traditional medicine in modern Cambodia.

PubMed

Ros, Bandeth; Lê, Gillian; McPake, Barbara; Fustukian, Suzanne

2018-01-01

Globally, traditional medicine has long been used to address relatively common illness, mental ill health and during childbirth and post-natal care. However, traditional medicine is primarily provided by the private sector and it is unclear how far expenditures on traditional medicine contribute to household impoverishment. A life history method was used to understand the health seeking experience of 24 households over the last 60 years in Cambodia, a country with high out-of-pocket expenditures for health. The life histories suggest that traditional medicine in Cambodia has been undergoing a process of commercialization, with significant impacts on poor households. In the earlier lives of respondents, payments for traditional medicine were reported to have been flexible, voluntary or appropriate to patients' financial means. In contrast, contemporary practitioners appear to seek immediate cash payments that have frequently led to considerable debt and asset sales by traditional medicine users. Given traditional medicine's popularity as a source of treatment in Cambodia and its potential to contribute to household impoverishment, we suggest that it needs to be included in a national conversation about achieving Universal Health Coverage in the country. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

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.

Accelerated Innovation Deployment (AID) Demonstration : KYTC—Roundabout Installation Project in London, Kentucky.

DOT National Transportation Integrated Search

2017-11-01

This document serves as the final report on the construction and opening of the Roundabout Project in London, Kentucky (Kentucky Item Number 11904.1). This project (hereafter referred to as the London Roundabout) was constructed on the authority o...

Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study.

PubMed

Aung, Nyein Chan; Rechel, Bernd; Odermatt, Peter

2010-10-12

An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London. We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis. The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews. Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced

Medical education, global health and travel medicine: a modern student's experience.

PubMed

Tissingh, Elizabeth Khadija

2009-01-01

Today's medical student will practice medicine in a globalised world, where an understanding of travel medicine and global health will be vital. Students at UK medical schools are keen to learn more about these areas and yet receive little specific training. Tomorrow's doctors should be taught about global health and travel medicine if they are to be prepared to work in tomorrow's world.

Sugar-free medicines are counterproductive.

PubMed

Sundar, S

2012-09-01

Sugar in food and drinks is responsible for the poor dental health of many children and adults. On the other hand, there is no evidence that the small amount of sugar in medicines has been responsible for any dental problems. A recent British Heart Foundation survey found that nearly one in three UK children are eating sweets, chocolate and crisps three or more times a day. Hence it is futile administering sugar-free medicine to a child consuming lot of sweets. Moreover, sugar in medicines makes them palatable and bitter medicines inevitably affect compliance with the prescribed treatment. Poor compliance leads to inadequate treatment of illness and consequently increases the risk of complications from illness. Hence sugar-free medicines promoted as a public health policy could have actually caused more harm than any meaningful net benefit. There is an urgent need for a healthy debate and a fresh look at the policy of promoting sugar-free medicines.

A two-center study of Muslim women's views of breast cancer and breast health practices in Pakistan and the UK.

PubMed

Banning, Maggie; Hafeez, Haroon

2010-09-01

Breast health awareness practices of Pakistani Muslim women in the UK and Pakistan is unknown. Focus group interviews were used to investigate the impact of culture and psychosocial issues on breast health awareness involving 44 women in Lahore and London. Women based in Lahore were more inquisitive about breast cancer and held more developed views compared with British Pakistani Muslim women. Women concurred that concise and relevant breast health education is needed irrespective of faith to improve cultural sensitivity and awareness in both Pakistani communities (both men and women).

Genomics education for medical professionals - the current UK landscape.

PubMed

Slade, Ingrid; Subramanian, Deepak N; Burton, Hilary

2016-08-01

Genomics education in the UK is at an early stage of development, and its pace of evolution has lagged behind that of the genomics research upon which it is based. As a result, knowledge of genomics and its applications remains limited among non-specialist clinicians. In this review article, we describe the complex landscape for genomics education within the UK, and highlight the large number and variety of organisations that can influence, direct and provide genomics training to medical professionals. Postgraduate genomics education is being shaped by the work of the Health Education England (HEE) Genomics Education Programme, working in conjunction with the Joint Committee on Genomics in Medicine. The success of their work will be greatly enhanced by the full cooperation and engagement of the many groups, societies and organisations involved with medical education and training (such as the royal colleges). Without this cooperation, there is a risk of poor coordination and unnecessary duplication of work. Leadership from an organisation such as the HEE Genomics Education Programme will have a key role in guiding the formulation and delivery of genomics education policy by various stakeholders among the different disciplines in medicine. © 2016 Royal College of Physicians.

Interpretation of medical information acts by UK occupational physicians.

PubMed

Batty, Lucia; Glozier, Nick; Holland-Elliott, Kevin

2009-05-01

Difficulties arise in applying the Data Protection Act 1998 and the Access to Medical Reports Act 1988 in occupational health practice. There is no guidance on detailed aspects of applying these Acts in practice and consistent advice has proved difficult to obtain. To audit the understanding and practice of UK occupational physicians to see if a consensus view existed. A postal questionnaire sent to all UK-based Society of Occupational Medicine (SOM) members between December 2005 and June 2006. Responses were analysed using the SPSS 13.0 software. Responses were received from 726 SOM members, a response rate of 48%. The study revealed wide variation and a limited consensus in practice. Significant differences existed between doctors with a Diploma in Occupational Medicine and those with higher Faculty qualifications, between part-time and full-time practitioners and between doctors who qualified pre- and post-1974. The audit revealed wide variation in responding to clinical scenarios in relation to both the Access to Medical Reports and the Data Protection Acts. The findings have implications for clinical practice, policy and research. The majority of respondents reported that national guidance is needed.

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

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

Making clinical academic careers more attractive: views from questionnaire surveys of senior UK doctors.

PubMed

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

2015-08-01

To report on doctors' reasons, as expressed to our research group, for choosing academic careers and on factors that would make a career in clinical academic medicine more attractive to them. Postal, email and web questionnaires. UK. A total of 6936 UK-trained doctors who graduated in 1996, 1999 and 2000. Open-ended comments about a career in clinical academic medicine. Of doctors who provided reasons for pursuing a long-term career in clinical academic medicine, the main reasons were enjoyment of academic work and personal satisfaction, whether expressed directly in those terms, or in terms of intellectual stimulation, enjoyment of research, teaching and the advancement of medicine, and the job being more varied than and preferable to clinical work alone. Doctors' suggestions for making clinical academic medicine more attractive included improved pay and job security, better funding of research, greater availability of academic posts, more dedicated time for research (and less service work) and more support and mentoring. Women were more likely than men to prioritise flexible working hours and part-time posts. Medical schools could provide more information, as part of student teaching, about the opportunities for and realities of a career in clinical academic medicine. Women, in particular, commented that they lacked the role models and information which would encourage them to consider seriously an academic career. Employers could increase academic opportunities by allowing more time for teaching, research and study and should assess whether job plans make adequate allowance for academic work.

The 2nd Annual Clinical Scientist Trainee Symposium, August 22, 2017, London, Canada.

PubMed

Yin, Charles; Blom, Jessica N; Lewis, James F

2018-03-27

Clinician scientists play a critical role in bridging research and clinical practice. Unfortunately, the neglect of research training in medical schools has created clinicians who are unable to translate evidence from literature to practice. Furthermore, the erosion of research training in medical education has resulted in clinicians who lack the skills required for successful scientific investigation. To counteract this, the Schulich School of Medicine & Dentistry has made an effort to engage trainees, at all levels, in the research process. The 2nd Annual Clinician Scientist Trainee Symposium was held in London, Ontario, Canada on August 22, 2017. Organized each year since 2016 by the Schulich Research Office, the symposium features research being conducted by trainees in Schulich's Clinical Research Training Program. The focus this year was on the current state of clinician-scientist training in Canada and visions for the path ahead.

Evaluating methane inventories by isotopic analysis in the London region.

PubMed

Zazzeri, G; Lowry, D; Fisher, R E; France, J L; Lanoisellé, M; Grimmond, C S B; Nisbet, E G

2017-07-07

A thorough understanding of methane sources is necessary to accomplish methane reduction targets. Urban environments, where a large variety of methane sources coexist, are one of the most complex areas to investigate. Methane sources are characterised by specific δ 13 C-CH 4 signatures, so high precision stable isotope analysis of atmospheric methane can be used to give a better understanding of urban sources and their partition in a source mix. Diurnal measurements of methane and carbon dioxide mole fraction, and isotopic values at King's College London, enabled assessment of the isotopic signal of the source mix in central London. Surveys with a mobile measurement system in the London region were also carried out for detection of methane plumes at near ground level, in order to evaluate the spatial allocation of sources suggested by the inventories. The measured isotopic signal in central London (-45.7 ±0.5‰) was more than 2‰ higher than the isotopic value calculated using emission inventories and updated δ 13 C-CH 4 signatures. Besides, during the mobile surveys, many gas leaks were identified that are not included in the inventories. This suggests that a revision of the source distribution given by the emission inventories is needed.

Aircraft trace gas measurements during the London 2012 Olympics: Air quality and emission fluxes derived from sampling upwind and downwind of a megacity

NASA Astrophysics Data System (ADS)

Allen, G.; O'Shea, S.; Muller, J.; Jones, B.; O'Sullivan, D.; Lee, J. D.; Bauguitte, S.; Gallagher, M. W.; Percival, C.; Barratt, B.; McQuaid, J. B.; Illingworth, S.

2013-12-01

This study presents airborne in situ and remote sensing measurements recorded during July and August 2012, across the period of the London 2012 Summer Olympics and simultaneous with the Clear air for London (ClearfLo) ground-based measurement and modelling campaign. Through long-term (2-year) and intensive observation periods (Winter 2011 and Summer 2012), the ClearfLo programme aims to better understand emissions, as well as the chemical, dynamical and micro-meteorological processes which modulate air quality in the London urban environment - an important risk factor for both acute and chronic health effects. The work presented here focuses on two contrasting case studies within the summer ClearfLo period: 30 July 2012 and 9 August 2012, representing relatively clean background and polluted background cases, respectively, and characterised by well-mixed Atlantic westerly maritime inflow in the former and stagnant air (high pressure) in the latter. Measurements of CO, CO2, CH4, N2O, O3, HCN, and other gases measured on board the UK Facility for Airborne Atmospheric Measurement (FAAM) BAe-146 aircraft will be presented and interpreted, with emphasis on observed concentration gradients and tracer-tracer correlations as well as airmass vertical structure and airmass history upwind and downwind of central London in each case. By applying a simple advective model and making use of vertically resolved thermodynamic and composition data, we are able to derive emission strengths for these gases that are representative of the total enclosed surface area. Example emissions for these two cases range between 6x105 kg(C)/hr and 9x105 kg(C)/hr for CO2, and ~0.6x105 kg(C)/hr for CH4. This airborne sampling methodology highlights the unique utility of aircraft measurements to routinely and climatologically characterise emissions from area sources such as cities, and points to future missions to target localised hotspots and distributed point sources.

The current status of diabetes professional educational standards and competencies in the UK--a position statement from the Diabetes UK Healthcare Professional Education Competency Framework Task and Finish Group.

PubMed

Walsh, N; George, S; Priest, L; Deakin, T; Vanterpool, G; Karet, B; Simmons, D

2011-12-01

Diabetes is a significant health concern, both in the UK and globally. Management can be complex, often requiring high levels of knowledge and skills in order to provide high-quality and safe care. The provision of good, safe, quality care lies within the foundations of healthcare education, continuing professional development and evidence-based practice, which are inseparable and part of a continuum during the career of any health professional. Sound education provides the launch pad for effective clinical management and positive patient experiences. This position paper reviews and discusses work undertaken by a Working Group under the auspices of Diabetes UK with the remit of considering all health professional educational issues for people delivering care to people with diabetes. This work has scoped the availability of education for those within the healthcare system who may directly or indirectly encounter people with diabetes and reviews alignment to existing competency frameworks within the UK's National Health Service. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

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.

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.

Michael Fisher at King's College London

NASA Astrophysics Data System (ADS)

Domb, Cyril

1991-09-01

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.

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.

Imported dengue fever in East London: a 6-year retrospective observational study.

PubMed

Riddell, Anna; Babiker, Zahir Osman Eltahir

2017-05-01

Dengue fever (DF) is a frequently imported arthropod-borne infection in the United Kingdom but its broad range of clinical presentations makes it potentially unrecognized by clinicians. We conducted a 6-year retrospective case note review of laboratory confirmed DF patients in East London in the period from 1 January 2010 through 31 December 2015. Epidemiological, clinical and laboratory features of imported DF were described. Risk factors associated with viraemic DF presentations were assessed. Forty-four patients (4 from primary care clinics and 40 from three acute hospitals) were confirmed to have DF through RNA and/or IgM detection. In total, 86.4% (38/44) had primary infection compared to 13.6% (6/44) with secondary infection. Viraemic DF presentations accounted for 59.1% (26/44) of cases. The median age was 34 years (IQR 25-43). Most patients were males (68.2%, 30/44) and of non-white ethnicity (81.8%, 36/44). South Asia was the most frequent travel destination (52.3%, 23/44) followed by Southeast Asia (20.5%, 9/44). July-September was the peak season of presentation (43.2%, 19/44). The median interval between arrival in the UK and laboratory testing was 7 days (IQR 4-13). Arriving from abroad ≤ 7 days before molecular testing (age-adjusted odds ratios [OR] 16.98, 95% CI 2.43-118.75, P  =   0.004) and travel to South or Southeast Asia regions (age-adjusted OR 4.41, 95% CI 1.07-18.21, P  =   0.040) were associated with detectable viraemia at presentation. Only one DF patient met the WHO severity criteria. HIV serostatus was determined in 61.4% (27/44) of cases. Clinicians need to improve DF recognition as well as rates of HIV testing in tropical travellers. Region of travel and time since arrival from DF endemic settings may help clinicians optimize requests for molecular testing. Further research on the clinical and public health aspects of imported DF is needed. © International Society of Travel Medicine, 2017. Published by Oxford University

Operation Ajax: A Case Study on Analyst-Policymaker Tensions and the Challenges of Estimative Intelligence

DTIC Science & Technology

2015-05-21

London, UK: Granada , 1982). 140 Woodhouse, 117. 141 Ibid., 118. This comment is interesting, because Roosevelt recounted that Smith ultimately...1951. Foreign Relations of the United States, 1952-1954, Vol X, 71-73. Woodhouse, C. M. Something Ventured. London, UK: Granada , 1982

The Prolonged Downfall of the Democratic Republic of Afghanistan

DTIC Science & Technology

2014-05-22

Afghanistan (London, UK: Pluto Press, 2001); Gilles Dorronsoro, Revolution Unending: Afghanistan, 1979 to the Present, trans. John King (New York, NY...2 (May 2007): 235-61. Griffin, Michael. Reaping the Whirlwind: The Taliban Movement in Afghanistan. London, UK: Pluto Press, 2001. Jalali, Ali

75 FR 54024 - Drawbridge Operation Regulations; Shaw Cove, New London, CT, Maintenance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-03

... Operation Regulations; Shaw Cove, New London, CT, Maintenance AGENCY: Coast Guard, DHS. ACTION: Notice of... temporary deviation from the regulation governing the operation of the Amtrak Bridge across Shaw Cove, mile...-9826. SUPPLEMENTARY INFORMATION: The Amtrak Bridge, across Shaw Cove at mile 0.0, at New London...

Droughts and Dragons: Geography, Rainfall, and Eighteenth-Century London's Water Systems.

PubMed

Van Lieshout, Carry

By the end of the eighteenth century the majority of households in London received a piped water supply. This article examines the geographical, technological, and environmental challenges that London's private water companies faced as they created and expanded the large technological networks necessary to provide the growing city's water supply. It identifies geography and drought as the main drivers of innovation in London's water supply neworks, and argues that the main impediment to expansion for the majority of the water companies was overcoming the differences in elevation between their intake points and customer bases, with major improvements often made as a result of water shortages. The timing and the success or failure of a company's technological improvements proved pivotal in the subsequent development of the water market.

Alienating evidence based medicine vs. innovative medical device marketing: a report on the evidence debate at a Wounds conference.

PubMed

Madden, Mary

2012-06-01

Wound care management is one of the largest segments of the UK medical technology sector with a turnover exceeding £1bn in 2009 (BIS, 2010). Using data derived from participant observation, this article examines the antagonistic relationship expressed by wound care clinicians towards evidence based medicine in the context of the 2010 United Kingdom (UK) Wounds UK conference/trade show, where evidence based medicine is positioned in opposition to clinical knowledge, as an obstacle to innovation and as a remover of solutions rather than a provider of them. The article is written in the context of the trend towards increasing marketization and privatization in the UK National Health Service (NHS). Copyright © 2012 Elsevier Ltd. All rights reserved.

The Francis Crick Institute.

PubMed

Peters, Keith; Smith, Jim

2017-04-01

The Francis Crick Institute Laboratory, opened in 2016, is supported by the Medical Research Council, Cancer Research UK, the Wellcome Trust, and University College London, King's College London and Imperial College London. The emphasis on research training and early independence of gifted scientists in a multidisciplinary environment provides unique opportunities for UK medical science, including clinical and translational research. © Royal College of Physicians 2017. All rights reserved.

The use of health foods, spices and other botanicals in the Sikh community in London.

PubMed

Sandhu, Davinder S; Heinrich, Michael

2005-07-01

Attitudes and practice concerning complementary and alternative medicine (CAM) are currently an area of considerable interest. However, little is known about the overall importance of such practices, for example, in immigrant communities such as the Sikh (Punjabi) British. The use of CAM in immigrants belonging to the Sikh religion in London was studied. The primary objective was to analyse the extent to which traditional medicine is used and understood by this population. Traditional Sikh medicine is important to this group of informants and a total of 42 species were recorded and identified tentatively. The most frequently mentioned species were Allium cepa (onion -- gunda), Allium sativum (garlic -- lasan, thon), Capsicum frutescens (cayenne pepper -- lalmirch), Cinnamomum verum (cinnamom--dhal chini), Citrus limon (lemon -- nimbu), Foeniculum vulgare (fennel -- saunf), Elettaria cardamomum (cardamom -- elaichi) and Zingiber officinale (ginger -- adrak). The study also highlights the rapid change this tradition is undergoing in a diaspora situation. In depth studies on the use of CAM among other immigrant communities and among ethnic groups are urgent and may help to manage better the treatment of minor ailments as well as chronic diseases. Specifically, more research on traditional and herbal remedies amongst the numerous ethnic groups in urban Britain and how this impacts on the use of biomedicine (e.g. as it is provided by the NHS) is essential.

Aircraft observations of the urban CO2 dome in London and calculated daytime CO2 fluxes at the urban-regional scale

NASA Astrophysics Data System (ADS)

Font, Anna; Morgui, Josep Anton; Grimmond, Sue; Barratt, Benjamin

2013-04-01

dispersed downwind, with peak concentrations displaced from the urban centre along the main wind direction. The urban-regional surface CO2 flux was calculated for four days in October 2011 by either the Integrative Mass Boundary Layer (IMBL) or the Column Integration method (CIM), dependent on meteorological conditions. The diurnal CO2 flux in London obtained from the aircraft observations ranged from 36 to 71 μmol CO2 m-2 s-1 during the day time. This compared well with continuous measurements of CO2 exchange by an eddy-covariance system located in central London. The day-to-day variability observed in the calculated CO2 fluxes responded to the spatial variability of the influence area and emissions that observations were sensitive to. This study provides an example how aircraft surveys in urban areas can be used to estimate CO2 surface fluxes at the urban-regional scale. It also presents an important cross-validation of two independent measurement-based methods to infer the contribution of urban areas to climate change in terms of CO2 emissions that complement bottom-up emissions inventories. References Committee on Methods for Estimating Greenhouse Gas Emissions (2010), The National Academia Press. DECC (2012), http://www.decc.gov.uk/en/content/cms/statistics/indicators/ni186/ni186.aspx

Association between depressive symptoms and objectively measured daily step count in individuals at high risk of cardiovascular disease in South London, UK: a cross-sectional study.

PubMed

Ludwig, Vera M; Bayley, Adam; Cook, Derek G; Stahl, Daniel; Treasure, Janet L; Asthworth, Mark; Greenough, Anne; Winkley, Kirsty; Bornstein, Stefan R; Ismail, Khalida

2018-04-12

Depressive symptoms are common but rarely considered a risk factor for unhealthy lifestyles associated with cardiovascular disease (CVD). This study investigates whether depressive symptoms are associated with reduced physical activity (PA) in individuals at high risk of developing CVD. Secondary analysis of the cross-sectional baseline data from a randomised controlled trial of an intensive lifestyle intervention. 135 primary care practices in South London, UK. 1742 adults, 49-74 years, 86% male at high (≥20%) risk of developing CVD in the next 10 years as defined via QRISK2 score. The main explanatory variable was depressive symptoms measured via the Patient Health Questionnaire-9 (PHQ-9). The main outcome was daily step count measured with an accelerometer (ActiGraph GT3X) stratified by weekdays and weekend days. The median daily step count of the total sample was 6151 (IQR 3510) with significant differences (P<0.001) in mean daily step count between participants with low (PHQ-9 score: 0-4), mild (PHQ-9 score: 5-9) and moderate to severe depressive symptoms (PHQ-9 score: ≥10). Controlling for age, gender, ethnicity, education level, body mass index (BMI), smoking, consumption of alcohol, day of the week and season, individuals with mild depressive symptoms and those with moderate to severe depressive symptoms walked 13.3% (95% CI 18.8% to 7.9%) and 15.6% (95% CI 23.7% to 6.5%) less than non-depressed individuals, respectively. Furthermore, male gender, white ethnicity, higher education level, lower BMI, non-smoking, moderate alcohol intake, weekdays and summer season were independently associated with higher step count. People at high risk of CVD with depressive symptoms have lower levels of PA. ISRCTN84864870; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The influence of academic discourses on medical students' identification with the discipline of family medicine.

PubMed

Rodríguez, Charo; López-Roig, Sofía; Pawlikowska, Teresa; Schweyer, François-Xavier; Bélanger, Emmanuelle; Pastor-Mira, Maria Angeles; Hugé, Sandrine; Spencer, Sarah; Lévasseur, Gwenola; Whitehead, Ian; Tellier, Pierre-Paul

2015-05-01

To understand the influence of academic discourses about family medicine on medical students' professional identity construction during undergraduate training. The authors used a multiple case study research design involving international medical schools, one each from Canada, France, Spain, and the United Kingdom (UK). The authors completed the fieldwork between 2007 and 2009 by conducting 18 focus groups (with 132 students) and 67 semistructured interviews with educators and by gathering pertinent institutional documents. They carried out discursive thematic analyses of the verbatim transcripts and then performed within- and cross-case analyses. The most striking finding was the diverging responses between those at the UK school and those at the other schools. In the UK case, family medicine was recognized as a prestigious academic discipline; students and faculty praised the knowledge and skills of family physicians, and students more often indicated their intent to pursue family medicine. In the other cases, family medicine was not well regarded by students or faculty. This was expressed overtly or through a paradoxical academic discourse that stressed the importance of family medicine to the health care system while decrying its lack of innovative technology and the large workload-to-income ratio. Students at these schools were less likely to consider family medicine. These results stress the influence of academic discourses on medical students' ability to identify with the practice of family medicine. Educators must consider processes of professional identity formation during undergraduate medical training as they develop and reform medical education.

How Representative Are Research Tissue Biobanks of the Local Populations? Experience of the Infectious Diseases Biobank at King's College, London, UK.

PubMed

Kozlakidis, Zisis; Mant, Christine; Peters, Barry; Post, Frank; Fox, Julie; Philpott-Howard, John; Tong, William C-Y; Edgeworth, Jonathan; Peakman, Mark; Malim, Michael; Cason, John

2011-09-01

Biobanks have a primary responsibility to collect tissues that are a true reflection of their local population and thereby promote translational research, which is applicable to the community. The Infectious Diseases BioBank (IDB) at King's College London is located in the southeast of the city, an area that is ethnically diverse. Transplantation programs have frequently reported a low rate of donation among some ethnic minorities. To determine whether patients who volunteered peripheral venous blood samples to the IDB were representative of the local community, we compared local government demographic data to characteristics of patients who have donated to the IDB. There was a good match between these statistics, indicating that the IDB's volunteer population of human immunodeficiency virus patients was similar to local demographics.

How Representative Are Research Tissue Biobanks of the Local Populations? Experience of the Infectious Diseases Biobank at King's College, London, UK

PubMed Central

Kozlakidis, Zisis; Mant, Christine; Peters, Barry; Post, Frank; Fox, Julie; Philpott-Howard, John; Tong, William C.-Y.; Edgeworth, Jonathan; Peakman, Mark; Malim, Michael

2011-01-01

Biobanks have a primary responsibility to collect tissues that are a true reflection of their local population and thereby promote translational research, which is applicable to the community. The Infectious Diseases BioBank (IDB) at King's College London is located in the southeast of the city, an area that is ethnically diverse. Transplantation programs have frequently reported a low rate of donation among some ethnic minorities. To determine whether patients who volunteered peripheral venous blood samples to the IDB were representative of the local community, we compared local government demographic data to characteristics of patients who have donated to the IDB. There was a good match between these statistics, indicating that the IDB's volunteer population of human immunodeficiency virus patients was similar to local demographics. PMID:21977243

Ammonia in London: is it increasing and what is the relevance of urban ammonia for air quality impacts?

NASA Astrophysics Data System (ADS)

Braban, Christine; Tang, Sim; Poskitt, Janet; Van Dijk, Netty; Leeson, Sarah; Dragosits, Ulli; Hutchings, Torben; Twigg, Marsailidh; Di Marco, Chiara; Langford, Ben; Tremper, Anja; Nemitz, Eiko; Sutton, Mark

2017-04-01

Emissions of ammonia affect both rural and urban air quality primarily via reaction of ammonia in the atmosphere forming secondary ammonium salts in particulate matter (PM). Urban ammonia emissions come from a variety of sources including biological decomposition, human waste, industrial processes and combustion engines. In the UK, the only long-term urban ammonia measurement is a UK National Ammonia Monitoring Network site at London Cromwell Road, recording monthly average concentrations. Short term measurements have also been made in the past decade at Marylebone Road, North Kensington and on the BT Tower. Cromwell Road is a kerbside site operational since 1999. The Cromwell Road data indicates that ammonia concentrations may be increasing since 2010-2012 after a long period of decreasing. Data from the National Atmospheric Emissions Inventory indicates ammonia emissions from diesel fleet exhausts increasing over this time period but an overall net decrease in ammonia emissions. With changes in engine and exhaust technology to minimise pollutant emissions and the importance of ammonia as a precursor gas for secondary PM, there is a challenge to understand urban ammonia concentrations and subsequent impacts on urban air quality. In this paper the long term measurements are assessed in conjunction with the short-term measurements.The challenges to assess the relative importance of local versus long range ammonia emission are discussed.

Neighbourhoods and self rated health: a comparison of public sector employees in London and Helsinki

PubMed Central

Stafford, M.; Martikainen, P.; Lahelma, E.; Marmot, M.

2004-01-01

Study objective: Mortality and morbidity vary across neighbourhoods and larger residential areas. Effects of area deprivation on health may vary across countries, because of greater spatial separation of people occupying high and low socioeconomic positions and differences in the provision of local services and facilities. Neighbourhood variations in health and the contribution of residents' characteristics and neighbourhood indicators were compared in London and Helsinki, two settings where inequality and welfare policies differ. Design: Data from two cohorts were used to investigate associations between self rated health and neighbourhood indicators using a multilevel approach. Setting: London and Helsinki. Participants: From the Whitehall II study (London, aged 39–63) and the Helsinki health study (aged 40–60). Main results: Socioeconomic segregation was higher in London than in Helsinki. Age and sex adjusted differences in self rated health between neighbourhoods were also greater in London. Independent of individual socioeconomic position, neighbourhood unemployment, proportion of residents in manual occupations, and proportion of single households were associated with health. In pooled data, residence in a neighbourhood with highest unemployment was associated with an odds ratio of less than good self rated health of 1.51 (95% CI 1.30 to 1.75). High rates of single parenthood were associated with health in London but not in Helsinki. Conclusions: Neighbourhood socioeconomic context was associated with health in both countries, with some evidence of greater neighbourhood effects in London. Greater socioeconomic segregation in London may have emergent effects at the neighbourhood level. Local and national social policies may reduce, or restrict, inequality and segregation between areas. PMID:15310804

Where did the acute medical trainees go? A review of the career pathways of acute care common stem acute medical trainees in London.

PubMed

Gowland, Emily; Ball, Karen Le; Bryant, Catherine; Birns, Jonathan

2016-10-01

Acute care common stem acute medicine (ACCS AM) training was designed to develop competent multi-skilled acute physicians to manage patients with multimorbidity from 'door to discharge' in an era of increasing acute hospital admissions. Recent surveys by the Royal College of Physicians have suggested that acute medical specialties are proving less attractive to trainees. However, data on the career pathways taken by trainees completing core acute medical training has been lacking. Using London as a region with a 100% fill rate for its ACCS AM training programme, this study showed only 14% of trainees go on to higher specialty training in acute internal medicine and a further 10% to pursue higher medical specialty training with dual accreditation with internal medicine. 16% of trainees switched from ACCS AM to emergency medicine or anaesthetics during core ACCS training, and intensive care medicine proved to be the most popular career choice for ACCS AM trainees (21%). The ACCS AM training programme therefore does not appear to be providing what it was set out to do and this paper discusses the potential causes and effects. © Royal College of Physicians 2016. All rights reserved.

Participation in medicine by graduates of medical schools in the United Kingdom up to 25 years post graduation: national cohort surveys.

PubMed

Goldacre, Michael J; Lambert, Trevor W

2013-05-01

To determine--as a guide to assess outcomes of medical education, and for medical workforce planning--whether the great majority of graduates from UK medical schools eventually practice medicine. The authors estimated the level of participation in medicine, in selected years after graduation, of nine cohorts (graduating between 1974 and 2002, inclusive) of graduates from medical schools in the United Kingdom. Their estimation is based on survey-garnered data combined with national employment data, and it uses the statistical method of capture-recapture analysis. This method provides both a lower likely limit and an upper likely limit of the percentage of doctors practicing in medicine. The lower and upper limits depend, essentially, on a range of assumptions about nonresponders. The authors estimate that at least 90% of graduates from UK medical schools work in medicine for many years after graduation. Women are only slightly less likely than men to follow a medical career. To illustrate, of the doctors who lived in the United Kingdom before medical school, at 10 years after graduation, between 95.6% and 98.8% of men were in medicine, as were between 91.9% and 93.3% of women. UK medical graduates from homes outside the United Kingdom were less likely to work in the National Health Service and more likely to pursue a career outside the United Kingdom, but were not appreciably less likely than graduates from UK homes to work in medicine. UK-trained doctors rarely give up a medical career within 25 years of graduation.

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…

London Took the Lead: Institutes for Women.

ERIC Educational Resources Information Center

Hughes, Mary

1992-01-01

The creation in London of single-sex institutes for the education of women offered increased educational opportunities but did not widen their horizons. For working class women, educational policy regarding these institutes tended to support their domestic roles. (SK)

Parish apprenticeship and the old poor law in London.

PubMed

Levene, Alysa

2010-01-01

This article offers an examination of the patterns and motivations behind parish apprenticeship in late eighteenth- and early nineteenth-century London. It stresses continuity in outlook from parish officials binding children, which involved placements in both the traditional and industrializing sectors of the economy. Evidence on the ages, employment types, and locations of 3,285 pauper apprentices bound from different parts of London between 1767 and 1833 indicates a variety of local patterns. The analysis reveals a pattern of youthful age at binding, a range of employment experiences, and parish-specific links to particular trades and manufactures.

Diabetes UK Position Statement. Competency frameworks in diabetes.

PubMed

Simmons, D; Deakin, T; Walsh, N; Turner, B; Lawrence, S; Priest, L; George, S; Vanterpool, G; McArdle, J; Rylance, A; Terry, G; Little, P

2015-05-01

The quality, skills and attitudes of staff working in the healthcare system are central to multidisciplinary learning and working, and to the delivery of the quality of care patients expect. Patients want to know that the staff supporting them have the right knowledge and attitudes to work in partnership, particularly for conditions such as diabetes where 95% of all care is delivered by the person with diabetes themselves. With the current changes in the NHS structures in England, and the potential for greater variation in the types of 'qualified provider', along with the recent scandal at Mid-Staffordshire Hospital, staff need to be shown to be competent and named/accredited or recognized as such. This will help to restore faith in an increasingly devolved delivery structure. The education and validation of competency needs to be consistently delivered and assured to ensure standards are maintained for different roles and disciplines across each UK nation. Diabetes UK recommends that all NHS organizations prioritize healthcare professional education, training and competency through the implementation of a National Diabetes Competency Framework and the phased approach to delivery to address this need. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

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.

Prescriptions and proscriptions: moralising sleep medicines.

PubMed

Gabe, Jonathan; Coveney, Catherine M; Williams, Simon J

2016-05-01

The pharmaceuticalisation of sleep is a contentious issue. Sleep medicines get a 'bad press' due to their potential for dependence and other side effects, including studies reporting increased mortality risks for long-term users. Yet relatively little qualitative social science research has been conducted into how people understand and negotiate their use/non-use of sleep medicines in the context of their everyday lives. This paper draws on focus group data collected in the UK to elicit collective views on and experiences of prescription hypnotics across different social contexts. Respondents, we show, drew on a range of moral repertoires which allowed them to present themselves and their relationships with hypnotics in different ways. Six distinct repertoires about hypnotic use are identified in this regard: the 'deserving' patient, the 'responsible' user, the 'compliant' patient, the 'addict', the 'sinful' user and the 'noble' non user. These users and non-users are constructed drawing on cross-cutting themes of addiction and control, ambivalence and reflexivity. Such issues are in turn discussed in relation to recent sociological debates on the pharmaceuticalisation/de-pharmaceuticalisation of everyday life and the consumption of medicines in the UK today. © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

To Moscow with love: partial reconstruction of Vygotsky's trip to London.

PubMed

van der Veer, René; Zavershneva, Ekaterina

2011-12-01

The Russian psychologist Lev Vygotsky (1896-1934) left the Soviet Union only once to attend a conference on the education of the deaf in London. So far almost nothing was known about this trip, which took place in a period when Vygotsky was still completely unknown as a psychologist, both inside his own country and abroad. Making use of a newly discovered notebook, it proved possible to partially reconstruct Vygotsky's journey and stay in London. Vygotsky's very personal remarks show him to have been a very sensitive and spirited man, who was prey to strong emotions during the conference and afterwards. Rather surprisingly, Vygotsky's own paper about the education of the deaf was never presented during the conference and the stay in London appears to have had a limited value for his own scientific development.

Mapping allergenic pollen vegetation in UK to study environmental exposure and human health.

PubMed

McInnes, Rachel N; Hemming, Deborah; Burgess, Peter; Lyndsay, Donna; Osborne, Nicholas J; Skjøth, Carsten Ambelas; Thomas, Sam; Vardoulakis, Sotiris

2017-12-01

Allergenic pollen is produced by the flowers of a number of trees, grasses and weeds found throughout the UK. Exposure to such pollen grains can exacerbate pollen-related asthma and allergenic conditions such as allergic rhinitis (hay fever). Maps showing the location of these allergenic taxa have many applications: they can be used to provide advice on risk assessments; combined with health data to inform research on health impacts such as respiratory hospital admissions; combined with weather data to improve pollen forecasting systems; or as inputs to pollen emission models. In this study we present 1km resolution maps of 12 taxa of trees, grass and weeds found in the UK. We have selected the main species recorded by the UK pollen network. The taxa mapped in this study were: Alnus (alder), Fraxinus (ash), Betula (birch), Corylus (hazel), Quercus (oak), Pinus (pine) and Salix (willow), Poaceae (grass), Artemisia (mugwort), Plantago (plantain), Rumex (dock, sorrels) and Urtica (nettle). We also focus on one high population centre and present maps showing local level detail around the city of London. Our results show the different geographical distributions of the 12 taxa of trees, weeds and grass, which can be used to study plants in the UK associated with allergy and allergic asthma. These maps have been produced in order to study environmental exposure and human health, although there are many possible applications. This novel method not only provides maps of many different plant types, but also at high resolution across regions of the UK, and we uniquely present 12 key plant taxa using a consistent methodology. To consider the impact on human health due to exposure of the pollen grains, it is important to consider the timing of pollen release, and its dispersal, as well as the effect on air quality, which is also discussed here. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Making clinical academic careers more attractive: views from questionnaire surveys of senior UK doctors

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2015-01-01

Summary Objectives To report on doctors’ reasons, as expressed to our research group, for choosing academic careers and on factors that would make a career in clinical academic medicine more attractive to them. Design Postal, email and web questionnaires. Setting UK. Participants A total of 6936 UK-trained doctors who graduated in 1996, 1999 and 2000. Main outcome measures Open-ended comments about a career in clinical academic medicine. Results Of doctors who provided reasons for pursuing a long-term career in clinical academic medicine, the main reasons were enjoyment of academic work and personal satisfaction, whether expressed directly in those terms, or in terms of intellectual stimulation, enjoyment of research, teaching and the advancement of medicine, and the job being more varied than and preferable to clinical work alone. Doctors’ suggestions for making clinical academic medicine more attractive included improved pay and job security, better funding of research, greater availability of academic posts, more dedicated time for research (and less service work) and more support and mentoring. Women were more likely than men to prioritise flexible working hours and part-time posts. Conclusions Medical schools could provide more information, as part of student teaching, about the opportunities for and realities of a career in clinical academic medicine. Women, in particular, commented that they lacked the role models and information which would encourage them to consider seriously an academic career. Employers could increase academic opportunities by allowing more time for teaching, research and study and should assess whether job plans make adequate allowance for academic work. PMID:26380103

Investigation of the emissions and profiles of a wide range of VOCs during the Clean air for London project

NASA Astrophysics Data System (ADS)

Holmes, Rachel; Lidster, Richard; Hamilton, Jacqueline; Lee, James; Hopkins, James; Whalley, Lisa; Lewis, Alistair

2014-05-01

The majority of the World's population live in polluted urbanized areas. Poor air quality is shortening life expectancy of people in the UK by an average 7-8 months and costs society around £20 billion per year.[1] Despite this, our understanding of atmospheric processing in urban environments and its effect on air quality is incomplete. Air quality models are used to predict how air quality changes given different concentrations of pollution precursors, such as volatile organic compounds (VOCs). The urban environment of megacities pose a unique challenge for air quality measurements and modelling, due to high population densities, pollution levels and complex infrastructure. For over 60 years the air quality in London has been monitored, however the existing measurements are limited to a small group of compounds. In order to fully understand the chemical and physical processes that occur in London, more intensive and comprehensive measurements should be made. The Clean air for London (ClearfLo) project was conducted to investigate the air quality, in particular the boundary layer pollution, of London. A relatively new technique, comprehensive two dimensional gas chromatography (GC×GC) [2] was combined with a well-established dual channel GC (DC-GC) [3] system to provide a more comprehensive measurement of VOCs. A total of 78 individual VOCs (36 aliphatics, 19 monoaromatics, 21 oxygenated and 2 halogenated) and 10 groups of VOCs (8 aliphatic, 1 monoaromatic and 1 monoterpene) from C1-C13+ were quantified. Seasonal and diurnal profiles of these VOCs have been found which show the influence of emission source and chemical processing. Including these extra VOCs should enhance the prediction capability of air quality models thus informing policy makers on how to potentially improve air quality in megacities. References 1. House of Commons Environmental Audit Committee, Air Quality: A follow-up report, Ninth Report of session 2012-12. 2. Lidster, R.T., J.F. Hamilton

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.

Complementary and alternative medicine use in children with cystic fibrosis.

PubMed

Giangioppo, Sandra; Kalaci, Odion; Radhakrishnan, Arun; Fleischer, Erin; Itterman, Jennifer; Lyttle, Brian; Price, April; Radhakrishnan, Dhenuka

2016-11-01

To estimate the overall prevalence of complementary and alternative medicine use among children with cystic fibrosis, determine specific modalities used, predictors of use and subjective helpfulness or harm from individual modalities. Of 53 children attending the cystic fibrosis clinic in London, Ontario (100% recruitment), 79% had used complementary and alternative medicine. The most commonly used modalities were air purifiers, humidifiers, probiotics, and omega-3 fatty acids. Family complementary and alternative medicine use was the only independent predictor of overall use. The majority of patients perceived benefit from specific modalities for cystic fibrosis symptoms. Given the high frequency and number of modalities used and lack of patient and disease characteristics predicting use, we recommend that health care providers should routinely ask about complementary and alternative medicine among all pediatric cystic fibrosis patients and assist patients in understanding the potential benefits and risks to make informed decisions about its use. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychoanalysis of Jack London's "The Call of the Wild" and "White Fang"

ERIC Educational Resources Information Center

Yang, Hongyan

2015-01-01

"The Call of the Wild" and "White Fang" both are masterpieces of Jack London. The protagonists Buck and White Fang are the incarnation of Jack himself to some extent for the two novels reveal a great deal of the writer. This essay aims at psychoanalyzing Jack London's creative process, the Oedipus complex and the confliction…

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.

Diabetes Complications at Presentation and One Year by Glycated Haemoglobin at Diagnosis in a Multiethnic and Diverse Socioeconomic Population: Results from the South London Diabetes Study.

PubMed

Azam, Mohsin; Marwood, Lindsey; Ismail, Khalida; Evans, Tyrrell; Sivaprasad, Sobha; Winkley, Kirsty; Amiel, Stephanie Anne

2015-01-01

Background. WHO's recommendation of HbA1c ≥ 48 mmol/mol (6.5%) as diagnostic for type 2 diabetes mellitus (T2DM) was adopted by three UK London boroughs in May 2012. The South London Diabetes (SOUL-D) study has recruited people with newly diagnosed T2DM since 2008. We compared participants diagnosed before May 2012 with HbA1c < 48 mmol/mol to those with diagnostic HbA1c ≥ 48 mmol/mol. Methods. A prospective cohort study of newly diagnosed T2DM participants from 96 primary care practices, comparing demographic and biomedical variables between those with diagnostic HbA1c < 48 mmol/mol or HbA1c ≥ 48 mmol/mol at recruitment and after one year. Results. Of 1488 participants, 22.8% had diagnostic HbA1c < 48 mmol/mol. They were older and more likely to be white (p < 0.05). At recruitment and one year, there were no between-group differences in the prevalence of diabetic complications, except that those diagnosed with HbA1c < 48 mmol/mol had more sensory neuropathy at recruitment (p = 0.039) and, at one year, had new myocardial infarction (p = 0.012) but less microalbuminuria (p = 0.012). Conclusions. Use of HbA1c ≥ 48 mmol/mol as the sole T2DM diagnostic criterion may miss almost a quarter of those previously diagnosed in South London yet HbA1c < 48 mmol/mol may not exclude clinically important diabetes.

Prevalence of dementia in African-Caribbean compared with UK-born White older people: two-stage cross-sectional study.

PubMed

Adelman, Simon; Blanchard, Martin; Rait, Greta; Leavey, Gerard; Livingston, Gill

2011-08-01

Preliminary studies in the UK, all using screening instruments of unknown cultural validity, indicate that there may be an increased prevalence of dementia in African-Caribbean people, possibly related to vascular risk factors and potentially amenable to preventative measures. To determine the prevalence of dementia in older people of African-Caribbean country of birth compared with their White UK-born counterparts. A total of 218 people of African-Caribbean country of birth and 218 White UK-born people aged ≥60 years were recruited from five general practices in North London. Those who screened positive for cognitive impairment using a culturally valid instrument were offered a standardised diagnostic interview. Two independent assessors diagnosed dementia according to standard operationalised criteria. African-Caribbean participants were 2 years younger, and those with dementia nearly 8 years younger than their White counterparts. The prevalence of dementia was significantly higher in the African-Caribbean (9.6%) than the White group (6.9%) after adjustment for the confounders age and socioeconomic status (odds ratio (OR) = 3.1, 95%CI 1.3-7.3, P = 0.012). There is an increased prevalence of dementia in older people of African-Caribbean country of birth in the UK and at younger ages than in the indigenous White population. These findings have implications for service provision and preventive interventions. Further research is needed to explore the role of vascular risk factors and social adversity in the excess of dementia in this population.

A Descriptive Analysis of the Use of Workplace-Based Assessments in UK Surgical Training.

PubMed

Shalhoub, Joseph; Santos, Cristel; Bussey, Maria; Eardley, Ian; Allum, William

2015-01-01

Workplace-based assessments (WBAs) were introduced formally in the UK in 2007. The aim of the study was to describe the use of WBAs by UK surgical trainees and examine variations by training region, specialty, and level of training. The database of the Intercollegiate Surgical Curriculum Programme was examined for WBAs between August 2007 and July 2013, with in-depth analysis of 2 periods: August 2011 to July 2012 and August 2012 to July 2013. The numbers of validated WBAs per trainee per year increased more than 7-fold, from median 6 per trainee in 2007 to 2008, to 39 in 2011 to 2012, and 44 in 2012 to 2013. In the period 2011 to 2012, 58.4% of core trainees completed the recommended 40 WBAs, with only 38.1% of specialty trainees achieving 40 validated WBAs. In the period 2012 to 2013, these proportions increased to 67.7% and 57.0% for core and specialty trainees, respectively. Core trainees completed more WBAs per year than specialty trainees in the same training region. London core trainees completed the highest numbers of WBAs in both the periods 2011 to 2012 (median 67) and 2012 to 2013 (median 74). There was a peak in WBAs completed by London specialty trainees in the period 2012 to 2013 (median 63). The most validated WBAs were completed by ST1/CT1 (specialty surgical training year, core surgical training year), with a gradual decrease in median WBAs to ST4, followed by a plateau; in the period 2012 to 2013, there was an increase in WBAs at ST8. Core surgical trainees complete ~50% "operative" (procedure-based assessment/direct observation of procedural skills) and ~50% "nonoperative" assessments (case-based discussion/clinical evaluation exercise). During specialty training, procedure-based assessments represented ~46% of WBAs, direct observation of procedural skills 11.2%, case-based discussion ~23%, and clinical evaluation exercise ~15%. UK surgical trainees are, on an average, undertaking 1 WBA per week. Variation exists in use of WBAs between training

Near miss incidents in police custody suites in London in 2003: a feasibility study.

PubMed

Best, David; Havis, Siobhan; Payne-James, J J; Stark, Margaret M

2006-02-01

Potentially preventable deaths in police custody include those which involve illicit drugs, alcohol and deliberate self-harm. Near miss incidents (NMI) that did not result in death have a crucial role in understanding risk factors in custody. Such research has not previously been undertaken. A program of research has been developed to study NMI, in order to better identify those at risk in police custody. For the purposes of this research, NMI have been defined as 'an unplanned and unforeseeable or unforeseen event that could have resulted, but did not result, in human death or may have resulted in injury or other adverse outcomes'. It was intended that the definition although broad, would not include simple accidents (e.g. slipping on urine in a cell) or trivial injury. The two aims of the study are (a) to determine whether it is realistic to attempt to assess NMI with the intention of identifying information of use in enhancing detainee care and (b) to assess how frequently NMIs occur and whether there are specific patterns. Pilot interviews were conducted with three forensic physicians practising in London, UK to create a structured questionnaire for all forensic physicians working in London. The questionnaire provided the basis of a retrospective recall survey of all forensic physicians working in London as Forensic Medical Examiners. The questionnaire was designed to assess the numbers of NMI, patterns in occurrence and relevant learning points within the previous 6 months. A covering letter, background questionnaire (exploring the background of the medical practitioner), copies of the survey, and reply paid envelopes were sent to each Forensic Medical Examiner (n=134) in London, contracted to provide forensic medical services for the Metropolitan Police Service. Data about all incidents were anonymized. Ninety six (73%) Forensic Medical Examiners responded. Of these 18% were Principal grade, the remainder were Senior (24%), Standard (35%) and Assistant (23

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.

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

Strategy to reduce E. coli bacteraemia based on cohort data from a London teaching hospital.

PubMed

Hsu, Desmond; Melzer, Mark

2018-04-01

In 2017, National Health Service Improvement set a 10% reduction target for Escherichia coli bacteraemia by 2018, followed by a 50% reduction in healthcare-associated Gram-negative bacteraemias by 2022. We analysed consecutive cases of E. coli bacteraemia and devised a strategy to achieve these targets. From December 2012 to November 2013, demographic, clinical and microbiological data were prospectively collected on all patients with bacteraemia at the Royal London Hospital in East London, UK. There were 594 significant bacteraemic episodes and 207 (34.8%) were E. coli . Twenty-four (11.6%) of the E. coli isolates were extended spectrum beta-lactamase producers, 22 (10.6%) gentamicin resistant and 2 (1.0%) amikacin resistant. The three most common sites of infection were pyelonephritis 105 (56.7%), catheter-associated urinary tract infection 22 (10.6%), and other medical devices and procedures that cause bacteraemia 32 (15.5%). In the pyelonephritis group, trimethoprim resistance in urinary isolates was 16/47 (34.0%) compared with 3/47 (6.4%) for nitrofurantoin. Twelve months postbacteraemia, recurrent bacteraemia rates were 10/105 (9.5%). There were 44 medical device-associated E. coli bacteraemias, and 22 (50%) were urinary catheter associated. There were 10 patients with E. coli bacteraemia caused by procedures, seven genitourinary or biliary tract instrumentation and three postgastrointestinal surgery. E. coli bacteraemias related to urosepsis could have been prevented by better empirical treatment and targeted prophylaxis. Urinary catheter quality improvement programmes should contribute to a further reduction. For patients undergoing high-risk urinary or biliary tract procedures or device manipulation, we advocate single-dose amikacin prophylaxis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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.

A survey of the clinical use of SeHCAT in the UK.

PubMed

Smith, Michael J; Perkins, Alan C

2013-04-01

The radiopharmaceutical 23-(Se)selena-25-homotaurocholic acid (SeHCAT), introduced 30 years ago, serves as a convenient and reliable diagnostic test for bile acid malabsorption. Recent advances in understanding the pathophysiology of bile acid diarrhoea have led to increased use of SeHCAT; however, some questions on its applicability remain unanswered. To obtain a better understanding of the application of this diagnostic test, a national survey was carried out within the UK. A web-based semistructured questionnaire was used. Invitations to participate were sent to the lead contacts of the 227 Nuclear Medicine Departments in the UK known to the British Nuclear Medicine Society. Information was sought on workload, trends in referrals, acquisition protocols, patient preparation, results, normal ranges and interpretation. For those not using SeHCAT, questions on reasons for not using the test and intentions to commence its use in the future were asked. Responses from 129 UK centres were included in analysis. Seventy-three of these (57%) used SeHCAT in diagnosis, and most of them reported an increase in referrals over the last 3 years. Several departments have started using SeHCAT recently in response to demand from clinicians. There was considerable variability in the practical implementation of the technique and the 'normal' range used for reporting. The findings from the survey have provided a better understanding of how diagnosis using SeHCAT is carried out in the UK. An important finding was the wide variation in the normal reference values used for diagnostic reporting. Establishing greater consistency in the interpretation and reporting of the results of this test would be of considerable clinical value.

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

PubMed

Krakowka, Kathryn

2017-11-01

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

Community organizing and community health: piloting an innovative approach to community engagement applied to an early intervention project in south London

PubMed Central

Bolton, Matthew; Moore, Imogen; Ferreira, Ana; Day, Crispin; Bolton, Derek

2016-01-01

Background The importance of community engagement in health is widely recognized, and key themes in UK National Institute for Health and Clinical Excellence (NICE) recommendations for enhancing community engagement are co-production and community control. This study reports an innovative approach to community engagement using the community-organizing methodology, applied in an intervention of social support to increase social capital, reduce stress and improve well-being in mothers who were pregnant and/or with infants aged 0–2 years. Methods Professional community organizers in Citizens-UK worked with local member civic institutions in south London to facilitate social support to a group of 15 new mothers. Acceptability of the programme, adherence to principles of co-production and community control, and changes in the outcomes of interest were assessed quantitatively in a quasi-experimental design. Results The programme was found to be feasible and acceptable to participating mothers, and perceived by them to involve co-production and community control. There were no detected changes in subjective well-being, but there were important reductions in distress on a standard self-report measure (GHQ-12). There were increases in social capital of a circumscribed kind associated with the project. Conclusions Community organizing provides a promising model and method of facilitating community engagement in health. PMID:25724610

Tracer concentration profiles measured in central London as part of the REPARTEE campaign

NASA Astrophysics Data System (ADS)

Martin, D.; Petersson, K. F.; White, I. R.; Henshaw, S. J.; Nickless, G.; Lovelock, A.; Barlow, J. F.; Dunbar, T.; Wood, C. R.; Shallcross, D. E.

2011-01-01

There have been relatively few tracer experiments carried out that have looked at vertical plume spread in urban areas. In this paper we present results from two tracer (cyclic perfluorocarbon) experiments carried out in 2006 and 2007 in central London centred on the BT Tower as part of the REPARTEE (Regent's Park and Tower Environmental Experiment) campaign. The height of the tower gives a unique opportunity to study vertical dispersion profiles and transport times in central London. Vertical gradients are contrasted with the relevant Pasquill stability classes. Estimation of lateral advection and vertical mixing times are made and compared with previous measurements. Data are then compared with a simple operational dispersion model and contrasted with data taken in central London as part of the DAPPLE campaign. This correlates dosage with non-dimensionalised distance from source. Such analyses illustrate the feasibility of the use of these empirical correlations over these prescribed distances in central London.

UK-born ethnic minority women and their experiences of feeding their newborn infant.

PubMed

Twamley, Katherine; Puthussery, Shuby; Harding, Seeromanie; Baron, Maurina; Macfarlane, Alison

2011-10-01

to explore the factors that impact on UK-born ethnic minority women's experiences of and decisions around feeding their infant. in-depth semi-structured interviews. 34 UK-born women of Black African, Black Caribbean, Pakistani, Bangladeshi, Indian and Irish parentage and 30 health-care professionals. women and health-care professionals were recruited primarily from hospitals serving large numbers of ethnic minority women in London and Birmingham. despite being aware of the benefits of exclusive breast feeding, many women chose to feed their infant with formula. The main barriers to breast feeding were the perceived difficulties of breast feeding, a family preference for formula feed, and embarrassment about breast feeding in front of others. Reports from women of South Asian parentage, particularly those who lived with an extended family, suggested that their intentions to breast feed were compromised by the context of their family life. The lack of privacy in these households and grandparental pressure appeared to be key issues. Unlike other participants, Irish women reported an intention to feed their infant with formula before giving birth. The key facilitators to breast feeding were the self-confidence and determination of women and the supportive role of health-care professionals. these findings point to common but also culturally specific mechanisms that may hinder both the initiation and maintenance of breast feeding in UK-born ethnic minority women. They signal potential benefits from the inclusion of family members in breast-feeding support programmes. Copyright © 2010 Elsevier Ltd. All rights reserved.

Why are children still being infected with HIV? Experiences in the prevention of mother‐to‐child transmission of HIV in south London

PubMed Central

McDonald, C; Lambert, J; Nayagam, D; Welz, T; Poulton, M; Aleksin, D; Welch, J

2007-01-01

Objectives To evaluate the effectiveness of interventions to prevent mother‐to‐child transmission of HIV at a large teaching hospital in South East London, and to assess reasons for the small numbers of transmissions that continue to occur. Design A database of all pregnant women diagnosed as HIV positive between 1993 and 2005 was reviewed, with detailed (retrospective) case‐note review of all mother–infant pairs where HIV transmission occurred. Setting King's College Hospital, London, UK, a teaching hospital serving an ethnically diverse and socially deprived population. Results 296 pregnancies to 274 women were recorded. 9 of 296 (3.0%) women were lost to follow‐up before the end of the pregnancy. Of 287 pregnancies followed up until after delivery, 6 (2.1%) resulted in HIV infection in the infant. More recently, between 2000 and 2004, this transmission rate was even lower, at 3 in 231 (1.3%). Each of these six women had complications, including late presentation to services and defaulting follow‐up appointments, which were likely to increase the risk of HIV transmission. Four of the six transmissions occurred in utero. Conclusion The overall transmission rate of 2% attests to the efforts of the multidisciplinary care team in managing this population which is often hard to reach. Clearly, good systems are needed to trace those women who default. Further data are needed regarding in utero transmissions. PMID:17005542

Impact of London's road traffic air and noise pollution on birth weight: retrospective population based cohort study

PubMed Central

Smith, Rachel B; Fecht, Daniela; Gulliver, John; Beevers, Sean D; Dajnak, David; Blangiardo, Marta; Ghosh, Rebecca E; Hansell, Anna L; Kelly, Frank J; Anderson, H Ross

2017-01-01

Abstract Objective To investigate the relation between exposure to both air and noise pollution from road traffic and birth weight outcomes. Design Retrospective population based cohort study. Setting Greater London and surrounding counties up to the M25 motorway (2317 km2), UK, from 2006 to 2010. Participants 540 365 singleton term live births. Main outcome measures Term low birth weight (LBW), small for gestational age (SGA) at term, and term birth weight. Results Average air pollutant exposures across pregnancy were 41 μg/m3 nitrogen dioxide (NO2), 73 μg/m3 nitrogen oxides (NOx), 14 μg/m3 particulate matter with aerodynamic diameter <2.5 μm (PM2.5), 23 μg/m3 particulate matter with aerodynamic diameter <10 μm (PM10), and 32 μg/m3 ozone (O3). Average daytime (LAeq,16hr) and night-time (Lnight) road traffic A-weighted noise levels were 58 dB and 53 dB respectively. Interquartile range increases in NO2, NOx, PM2.5, PM10, and source specific PM2.5 from traffic exhaust (PM2.5 traffic exhaust) and traffic non-exhaust (brake or tyre wear and resuspension) (PM2.5 traffic non-exhaust) were associated with 2% to 6% increased odds of term LBW, and 1% to 3% increased odds of term SGA. Air pollutant associations were robust to adjustment for road traffic noise. Trends of decreasing birth weight across increasing road traffic noise categories were observed, but were strongly attenuated when adjusted for primary traffic related air pollutants. Only PM2.5 traffic exhaust and PM2.5 were consistently associated with increased risk of term LBW after adjustment for each of the other air pollutants. It was estimated that 3% of term LBW cases in London are directly attributable to residential exposure to PM2.5>13.8 μg/m3during pregnancy. Conclusions The findings suggest that air pollution from road traffic in London is adversely affecting fetal growth. The results suggest little evidence for an independent exposure-response effect of traffic related noise on birth weight

Inflammatory bowel disease and exercise: results of a Crohn's and Colitis UK survey.

PubMed

Chan, D; Robbins, H; Rogers, S; Clark, S; Poullis, A

2014-01-01

Over 250 000 people in the UK are affected with inflammatory bowel disease (IBD) and approximately 10 000 new cases are diagnosed every year. These chronic bowel conditions have been shown to affect both work and recreational activity. In the general population, regular exercise has numerous benefits to health and well-being and there are additional benefits for those with IBD. However, people with IBD face significant challenges in trying to take regular exercise. With the renewed focus on sport brought about by the recent London Olympics, Crohn's and Colitis UK surveyed its members to explore their sport and fitness habits. 918 members participated in the survey, which is the largest survey of its kind, investigating the exercise habits of people with IBD. The survey showed widespread uptake of exercise in those with IBD, with a large number feeling better for it. However, it also identified a considerable number of respondents who reported a significant negative impact of IBD on their ability to take up, enjoy and derive benefit from sporting activities. Asking questions about sporting leisure activity in clinical consultations may identify those in need of help and support and possibly identify factors to be dealt with, in order to enable them to take part in these beneficial activities.

Major Greenwood's early career and the first departments of medical statistics.

PubMed

Farewell, Vern; Johnson, Tony

2014-06-15

Major Greenwood was the foremost medical statistician of the first half of the 20th century in the UK and is often credited with founding the first department of medical statistics at the Lister Institute in London in 1910. Here, we examine in detail his career prior to this appointment, including his association with Karl Pearson. We also examine the remit of the Department of Medical Statistics at the London Hospital of which he was the founding Director in 1908, some 2 years earlier than his appointment at the Lister Institute. Supporting information consisting of further details about Major Greenwood's early career, biographical articles and obituaries for him, and a list of his publications to 1910 by year, is also provided. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

Sustaining International CBRN Centers of Excellence with a Focus on Nuclear Security and Safeguards: Initial Scoping Session London, 23-24 September 2013 SUMMARY REPORT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anderson, Roger G.; Frazar, Sarah L.

2013-12-12

This report provides a summary-level description of the key information, observations, ideas, and recommendations expressed during the subject meeting. The report is organized to correspond to the meeting agenda provided in Appendix 1 and includes references to several of the participants listed in Appendix 2 .The meeting venue was Lloyd’s Register in the City of London. Lloyd’s Register graciously accommodated the request of The Pacific Northwest Laboratory (PNNL) with whom it works on various safeguards activities commissioned by NNSA. PNNL and NNSA also shared the goal of the meeting/study with the United Kingdom (UK) Foreign and Commonwealth Office (FCO) andmore » the Department of Energy and Climate Change with whom they coordinated the participant list.« less

New glossary of terms used in regenerative medicine: standardization continues to emerge as regenerative medicine matures.

PubMed

Sheridan, Ben; Harris, Neil

2009-07-01

Regenerative medicine is an evolving, cross-disciplinary, international field that, as a result, uses terms that are either not widely understood, or may have a number of different meanings. Many stakeholders have identified this lack of clarity as a potential barrier to effective communication within the field. To address this, BSI British Standards, supported by the UK Department for Innovation, Universities and Skills (DIUS), was commissioned to develop guidance on the definitions of terms used within regenerative medicine. The resulting document aims to provide clear consensus terminology to improve communication and facilitate a common understanding for a broad range of potential users.

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.

Stuart London's standard of living: re-examining the Settlement of Tithes of 1638 for rents, income, and poverty.

PubMed

Baer, William C

2010-01-01

The Settlement of Tithes of 1638 can be tested for biases in its London rents. Even so, it proves to be a relatively good source for seventeenth-century London, and for calculating associated median and mean rents, as well as a Gini coefficient of inequality for the distribution of resources. Through other evidence in the Settlement, rent/income ratios for London can be approximated, and from them estimates made of London's median income. Median rents and income also allow estimates of the percentage of Londoners in poverty. Though the last is inevitably disputable, the estimate holds up well to testing by other evidence.

The varying influence of socioeconomic deprivation on breast cancer screening uptake in London.

PubMed

Jack, Ruth H; Robson, Tony; Davies, Elizabeth A

2016-06-01

We assessed the relationship between screening uptake and socioeconomic deprivation for London women aged 50-52 invited to their first routine screening appointment between 2006 and 2009. We examined uptake for London overall and within six screening areas, using deprivation quintile, based on post code of residence. After adjustment for age, area and ethnicity, overall uptake decreased with increasing deprivation (adjusted odds ratio (OR) = 0.95, P < 0.001). However, in two screening areas with lower uptake, women living in deprived areas had higher uptake than women from affluent areas. These potential inequalities in early diagnosis across London require further investigation. © Crown copyright 2015.

Consensus statement on an updated core communication curriculum for UK undergraduate medical education.

PubMed

Noble, Lorraine M; Scott-Smith, Wesley; O'Neill, Bernadette; Salisbury, Helen

2018-04-22

Clinical communication is a core component of undergraduate medical training. A consensus statement on the essential elements of the communication curriculum was co-produced in 2008 by the communication leads of UK medical schools. This paper discusses the relational, contextual and technological changes which have affected clinical communication since then and presents an updated curriculum for communication in undergraduate medicine. The consensus was developed through an iterative consultation process with the communication leads who represent their medical schools on the UK Council of Clinical Communication in Undergraduate Medical Education. The updated curriculum defines the underpinning values, core components and skills required within the context of contemporary medical care. It incorporates the evolving relational issues associated with the more prominent role of the patient in the consultation, reflected through legal precedent and changing societal expectations. The impact on clinical communication of the increased focus on patient safety, the professional duty of candour and digital medicine are discussed. Changes in the way medicine is practised should lead rapidly to adjustments to the content of curricula. The updated curriculum provides a model of best practice to help medical schools develop their teaching and argue for resources. Copyright © 2018 Elsevier B.V. All rights reserved.

The role played by Gerhard Adler in the development of analytical psychology internationally and in the UK.

PubMed

Casement, Ann

2014-02-01

The Jungian analyst Gerhard Adler left Berlin and re-settled in London in 1936. He was closely involved with the professionalization of analytical psychology internationally and in the UK, including the formation of the International Association for Analytical Psychology (IAAP) and The Society of Analytical Psychology (SAP).The tensions that arose within the latter organization led to a split that ended in the formation of the Association of Jungian Analysts (AJA). A further split at AJA resulted in the creation of another organization, the Independent Group of Analytical Psychologists (IGAP). Adler's extensive publications include his role as an editor of Jung's Collected Works and as editor of the C.G. Jung Letters. © 2014, The Society of Analytical Psychology.

London through Rose-Colored Graphics: Visual Rhetoric and Information Graphic Design in Charles Booth's Maps of London Poverty

ERIC Educational Resources Information Center

Kimball, Miles A.

2006-01-01

In this article, I examine a historical information graphic--Charles Booth's maps of London poverty (1889-1902)--to analyze the cultural basis of ideas of transparency and clarity in information graphics. I argue that Booth's maps derive their rhetorical power from contemporary visual culture as much as from their scientific authority. The visual…

ICU fire evacuation preparedness in London: a cross-sectional study.

PubMed

Murphy, G R F; Foot, C

2011-05-01

Hospital fires present a sporadic but significant threat to patients and staff. This is especially so within an intensive care unit (ICU) setting, due to the complexity of moving acutely unwell patients reliant on invasive monitoring and organ support. Despite an average of 500 in-hospital fires reported to the UK department of health per annum, causing 65 injuries and 1-2 fatalities, the readiness of ICUs for urgent evacuation has not been assessed. A cross-sectional survey of all 50 adult and paediatric ICUs within the London Postgraduate Deanery was conducted; neonatal units were excluded. The senior nurse at each unit was asked to complete a 90-question structured questionnaire, covering unit patient characteristics, design, equipment, training, and their evacuation plan. Thirty-five of 50 (70%) responded within 2 months of the study. Significant weaknesses were reported in unit design, equipment, and planning. Unit design was compromised by inadequate fire doors (20%), ventilation cut-outs (17%), and escape routes (up to 60%). The ability to evacuate multiple patients simultaneously may be limited by a lack of portable monitoring equipment (49% of beds) and emergency drug supplies (20% of beds). Evacuation plans were often limited in their scope (96% expected to remain on their floor; 14% had plans to obtain medications after evacuation), and not rehearsed (60%). Staff training, while well provided for permanent staff, is less so for temporary staff (34%). Forward planning for an urgent evacuation can be improved.

Undergraduate teaching on biological weapons and bioterrorism at medical schools in the UK and the Republic of Ireland: results of a cross-sectional study.

PubMed

Green, Stephen T; Cladi, Lorenzo; Morris, Paul; Forde, Donall

2013-06-20

To determine if individual undergraduate schools of medicine in the UK and the Republic of Ireland provide any teaching to medical students about biological weapons, bioterrorism, chemical weapons and weaponised radiation, if they perceive them to be relevant issues and if they figure them in their future plans. A cross-sectional study utilising an internet-based questionnaire sent to key figures responsible for leading on the planning and delivery of undergraduate medical teaching at all schools of medicine in the UK and Ireland. All identified undergraduate schools of medicine in the UK and Ireland between August 2012 and December 2012. Numerical data and free text feedback about relevant aspects of undergraduate teaching. Of the 38 medical schools approached, 34 (28 in UK, 6 in Ireland) completed the questionnaire (89.47%). 4 (all in UK) chose not to complete it. 6/34 (17.65%) included some specific teaching on biological weapons and bioterrorism. 7/34 (20.59%) had staff with bioterrorism expertise (mainly in microbiological and syndromic aspects). 4/34 (11.76%) had plans to introduce some specific teaching on bioterrorism. Free text responses revealed that some felt that because key bodies (eg, UK's General Medical Council) did not request teaching on bioterrorism, then it should not be included, while others regarded this field of study as a postgraduate subject and not appropriate for undergraduates, or argued that the curriculum was too congested already. 4/34 (11.76%) included some specific teaching on chemical weapons, and 3/34 (8.82%) on weaponised radiation. This study provides evidence that at the present time there is little teaching at the undergraduate level in the UK and Ireland on the subjects of biological weapons and bioterrorism, chemical weapons and weaponised radiation and signals that this situation is unlikely to change unless there were to be high-level policy guidance.

Limited urban growth: London's street network dynamics since the 18th century.

PubMed

Masucci, A Paolo; Stanilov, Kiril; Batty, Michael

2013-01-01

We investigate the growth dynamics of Greater London defined by the administrative boundary of the Greater London Authority, based on the evolution of its street network during the last two centuries. This is done by employing a unique dataset, consisting of the planar graph representation of nine time slices of Greater London's road network spanning 224 years, from 1786 to 2010. Within this time-frame, we address the concept of the metropolitan area or city in physical terms, in that urban evolution reveals observable transitions in the distribution of relevant geometrical properties. Given that London has a hard boundary enforced by its long standing green belt, we show that its street network dynamics can be described as a fractal space-filling phenomena up to a capacitated limit, whence its growth can be predicted with a striking level of accuracy. This observation is confirmed by the analytical calculation of key topological properties of the planar graph, such as the topological growth of the network and its average connectivity. This study thus represents an example of a strong violation of Gibrat's law. In particular, we are able to show analytically how London evolves from a more loop-like structure, typical of planned cities, toward a more tree-like structure, typical of self-organized cities. These observations are relevant to the discourse on sustainable urban planning with respect to the control of urban sprawl in many large cities which have developed under the conditions of spatial constraints imposed by green belts and hard urban boundaries.

The sexual attitudes and lifestyles of London's Eastern Europeans (SALLEE Project): design and methods.

PubMed

Evans, Alison R; Parutis, Violetta; Hart, Graham; Mercer, Catherine H; Gerry, Christopher; Mole, Richard; French, Rebecca S; Imrie, John; Burns, Fiona

2009-10-30

Since May 2004, ten Central and Eastern European (CEE) countries have joined the European Union, leading to a large influx of CEE migrants to the United Kingdom (UK). The SALLEE project (sexual attitudes and lifestyles of London's Eastern Europeans) set out to establish an understanding of the sexual lifestyles and reproductive health risks of CEE migrants. CEE nationals make up a small minority of the population resident in the UK with no sampling frame from which to select a probability sample. There is also difficulty estimating the socio-demographic and geographical distribution of the population. In addition, measuring self-reported sexual behaviour which is generally found to be problematic, may be compounded among people from a range of different cultural and linguistic backgrounds. This paper will describe the methods adopted by the SALLEE project to address these challenges. The research was undertaken using quantitative and qualitative methods: a cross-sectional survey of CEE migrants based on three convenience samples (recruited from community venues, sexual health clinics and from the Internet) and semi-structured in-depth interviews with a purposively selected sample of CEE migrants. A detailed social mapping exercise of the CEE community was conducted prior to commencement of the survey to identify places where CEE migrants could be recruited. A total of 3,005 respondents took part in the cross-sectional survey, including 2,276 respondents in the community sample, 357 in the clinic sample and 372 in the Internet sample. 40 in-depth qualitative interviews were undertaken with a range of individuals, as determined by the interview quota matrix. The SALLEE project has benefited from using quantitative research to provide generalisable data on a range of variables and qualitative research to add in-depth understanding and interpretation. The social mapping exercise successfully located a large number of CEE migrants for the community sample and is

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

PubMed

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

2014-02-13

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

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

Parish apprenticeship and the old poor law in London1

PubMed Central

Levene, Alysa

2010-01-01

This article offers an examination of the patterns and motivations behind parish apprenticeship in late eighteenth- and early nineteenth-century London. It stresses continuity in outlook from parish officials binding children, which involved placements in both the traditional and industrializing sectors of the economy. Evidence on the ages, employment types, and locations of 3,285 pauper apprentices bound from different parts of London between 1767 and 1833 indicates a variety of local patterns. The analysis reveals a pattern of youthful age at binding, a range of employment experiences, and parish-specific links to particular trades and manufactures. PMID:20939134

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

Diabetes Complications at Presentation and One Year by Glycated Haemoglobin at Diagnosis in a Multiethnic and Diverse Socioeconomic Population: Results from the South London Diabetes Study

PubMed Central

Azam, Mohsin; Marwood, Lindsey; Ismail, Khalida; Evans, Tyrrell; Sivaprasad, Sobha; Winkley, Kirsty; Amiel, Stephanie Anne

2015-01-01

Background. WHO's recommendation of HbA1c ≥ 48 mmol/mol (6.5%) as diagnostic for type 2 diabetes mellitus (T2DM) was adopted by three UK London boroughs in May 2012. The South London Diabetes (SOUL-D) study has recruited people with newly diagnosed T2DM since 2008. We compared participants diagnosed before May 2012 with HbA1c < 48 mmol/mol to those with diagnostic HbA1c ≥ 48 mmol/mol. Methods. A prospective cohort study of newly diagnosed T2DM participants from 96 primary care practices, comparing demographic and biomedical variables between those with diagnostic HbA1c < 48 mmol/mol or HbA1c ≥ 48 mmol/mol at recruitment and after one year. Results. Of 1488 participants, 22.8% had diagnostic HbA1c < 48 mmol/mol. They were older and more likely to be white (p < 0.05). At recruitment and one year, there were no between-group differences in the prevalence of diabetic complications, except that those diagnosed with HbA1c < 48 mmol/mol had more sensory neuropathy at recruitment (p = 0.039) and, at one year, had new myocardial infarction (p = 0.012) but less microalbuminuria (p = 0.012). Conclusions. Use of HbA1c ≥ 48 mmol/mol as the sole T2DM diagnostic criterion may miss almost a quarter of those previously diagnosed in South London yet HbA1c < 48 mmol/mol may not exclude clinically important diabetes. PMID:26090473

Recent TB transmission, clustering and predictors of large clusters in London, 2010–2012: results from first 3 years of universal MIRU-VNTR strain typing

PubMed Central

Hamblion, Esther L; Le Menach, Arnaud; Anderson, Laura F; Lalor, Maeve K; Brown, Tim; Abubakar, Ibrahim; Anderson, Charlotte; Maguire, Helen; Anderson, Sarah R

2016-01-01

Background The incidence of TB has doubled in the last 20 years in London. A better understanding of risk groups for recent transmission is required to effectively target interventions. We investigated the molecular epidemiological characteristics of TB cases to estimate the proportion of cases due to recent transmission, and identify predictors for belonging to a cluster. Methods The study population included all culture-positive TB cases in London residents, notified between January 2010 and December 2012, strain typed using 24-loci multiple interspersed repetitive units-variable number tandem repeats. Multivariable logistic regression analysis was performed to assess the risk factors for clustering using sociodemographic and clinical characteristics of cases and for cluster size based on the characteristics of the first two cases. Results There were 10 147 cases of which 5728 (57%) were culture confirmed and 4790 isolates (84%) were typed. 2194 (46%) were clustered in 570 clusters, and the estimated proportion attributable to recent transmission was 34%. Clustered cases were more likely to be UK born, have pulmonary TB, a previous diagnosis, a history of substance abuse or alcohol abuse and imprisonment, be of white, Indian, black-African or Caribbean ethnicity. The time between notification of the first two cases was more likely to be <90 days in large clusters. Conclusions Up to a third of TB cases in London may be due to recent transmission. Resources should be directed to the timely investigation of clusters involving cases with risk factors, particularly those with a short period between the first two cases, to interrupt onward transmission of TB. PMID:27417280

Atmospheric ethanol in London and the potential impacts of future fuel formulations.

PubMed

Dunmore, Rachel E; Whalley, Lisa K; Sherwen, Tomás; Evans, Mathew J; Heard, Dwayne E; Hopkins, James R; Lee, James D; Lewis, Alastair C; Lidster, Richard T; Rickard, Andrew R; Hamilton, Jacqueline F

2016-07-18

There is growing global consumption of non-fossil fuels such as ethanol made from renewable biomass. Previous studies have shown that one of the main air quality disadvantages of using ethanol blended fuels is a significant increase in the production of acetaldehyde, an unregulated and toxic pollutant. Most studies on the impacts of ethanol blended gasoline have been carried out in the US and Brazil, with much less focus on the UK and Europe. We report time resolved measurements of ethanol in London during the winter and summer of 2012. In both seasons the mean mixing ratio of ethanol was around 5 ppb, with maximum values over 30 ppb, making ethanol currently the most abundant VOC in London air. We identify a road transport related source, with 'rush-hour' peaks observed. Ethanol is strongly correlated with other road transport-related emissions, such as small aromatics and light alkanes, and has no relationship to summer biogenic emissions. To determine the impact of road transport-related ethanol emission on secondary species (i.e. acetaldehyde and ozone), we use both a chemically detailed box model (incorporating the Master Chemical Mechanism, MCM) and a global and nested regional scale chemical transport model (GEOS-Chem), on various processing time scales. Using the MCM model, only 16% of the modelled acetaldehyde was formed from ethanol oxidation. However, the model significantly underpredicts the total levels of acetaldehyde, indicating a missing primary emission source, that appears to be traffic-related. Further support for a primary emission source comes from the regional scale model simulations, where the observed concentrations of ethanol and acetaldehyde can only be reconciled with the inclusion of large primary emissions. Although only constrained by one set of observations, the regional modelling suggests a European ethanol source similar in magnitude to that of ethane (∼60 Gg per year) and greater than that of acetaldehyde (∼10 Gg per year). The

Vegaphobia: derogatory discourses of veganism and the reproduction of speciesism in UK national newspapers.

PubMed

Cole, Matthew; Morgan, Karen

2011-03-01

This paper critically examines discourses of veganism in UK national newspapers in 2007. In setting parameters for what can and cannot easily be discussed, dominant discourses also help frame understanding. Discourses relating to veganism are therefore presented as contravening commonsense, because they fall outside readily understood meat-eating discourses. Newspapers tend to discredit veganism through ridicule, or as being difficult or impossible to maintain in practice. Vegans are variously stereotyped as ascetics, faddists, sentimentalists, or in some cases, hostile extremists. The overall effect is of a derogatory portrayal of vegans and veganism that we interpret as 'vegaphobia'. We interpret derogatory discourses of veganism in UK national newspapers as evidence of the cultural reproduction of speciesism, through which veganism is dissociated from its connection with debates concerning nonhuman animals' rights or liberation. This is problematic in three, interrelated, respects. First, it empirically misrepresents the experience of veganism, and thereby marginalizes vegans. Second, it perpetuates a moral injury to omnivorous readers who are not presented with the opportunity to understand veganism and the challenge to speciesism that it contains. Third, and most seriously, it obscures and thereby reproduces exploitative and violent relations between human and nonhuman animals. © London School of Economics and Political Science 2011.

Urban organic aerosols measured by single particle mass spectrometry in the megacity of London

NASA Astrophysics Data System (ADS)

Dall'Osto, M.; Harrison, R. M.

2011-02-01

During the month of October 2006, as part of the REPARTEE-I experiment (Regent's Park and Tower Environmental Experiment) an Aerosol Time-Of-Flight Mass Spectrometer (ATOFMS) was deployed at an urban background location in the city of London, UK. Fifteen particle types were classified, some of which were accompanied by Aerosol Mass Spectrometer (AMS) quantitative aerosol mass loading measurements (Dall'Osto et al., 2009a, b). In this manuscript the origins and properties of four particle types associated with locally generated aerosols, independent of the air mass type advected into London, are examined. One particle type, originating from lubricating oil (referred to as Ca-EC), was associated with morning rush hour traffic emissions. A second particle type, composed of both inorganic and organic species (called Na-EC-OC), was found enhanced in particle number concentration during evening time periods, and is likely to originate from a source operating at this time of day, or more probably from condensation of semi-volatile species, and contains both primary and secondary components. A third class, internally mixed with organic carbon and sulphate (called OC), was found to spike both in the morning and evenings. The fourth class (SOA-PAH) exhibited maximum frequency during the warmest part of the day, and a number of factors point towards secondary production from traffic-related volatile aromatic compounds. Single particle mass spectra of this particle type showed an oxidized polycyclic aromatic compound signature. Finally, a comparison of ATOFMS particle class data is made with factors obtained by Positive Matrix Factorization from AMS data.. Both the Ca-EC and OC particle types correlate with the AMS HOA primary organic fraction (R2 = 0.65 and 0.50 respectively), and Na-EC-OC, but not SOA-PAH, which correlates weakly with the AMS OOA secondary organic aerosol factor (R2 = 0.35). A detailed analysis was conducted to identify ATOFMS particle type(s) representative

The impact of market oriented reforms on choice and information: a case study of cataract surgery in outer London and Stockholm.

PubMed

Fotaki, M

1999-05-01

In the early 1990s, a set of market-oriented reforms was introduced into health care systems of the UK and Sweden, two exemplary cases of reliance on planned budgeting and integrated provision of services. In the pursuit of increased efficiency, several County Councils in Sweden have followed the public competition model, while in the UK internal market reforms were introduced. It was expected that the separation of functions of planners and purchasers from those of providers, which were to be freely chosen by the former, would achieve higher allocative efficiency but also enhance users' satisfaction with care. This paper uses cataract surgery as a case study to trace the impact of competition among providers on choice and information. Qualitative research methods were employed to record the perception of changes in their type and amount as it was given to both purchasers and patients. A set of open ended and standardised questionnaires was designed to elicit the views of all actors involved and to measure the likely transformations. Four study sites from Outer London were selected representing the diversity of responses, and the only existing large provider of eye services to Stockholm County Council was used. The analysis of the data showed that the quasi-market reforms have resulted in a change of attitude of providers. Some improvements in the amount and type of information given to purchasers and patients could also be detected, although as far as direct users were concerned, the demand has not been fully satisfied. However, the impact on choice available to patients and purchasers alike seemed to be adverse, an effect that was particularly strong in the UK case.

Non- medical prescribing in Australasia and the UK: the case of podiatry.

PubMed

Borthwick, Alan M; Short, Anthony J; Nancarrow, Susan A; Boyce, Rosalie

2010-01-05

The last decade has witnessed a rapid transformation in the role boundaries of the allied health professions, enabled through the creation of new roles and the expansion of existing, traditional roles. A strategy of health care 'modernisation' has encompassed calls for the redrawing of professional boundaries and identities, linked with demands for greater workforce flexibility. Several tasks and roles previously within the exclusive domain of medicine have been delegated to, or assumed by, allied health professionals, as the workforce is reshaped to meet the challenges posed by changing demographic, social and political contexts. The prescribing of medicines by non-medically qualified healthcare professionals, and in particular the podiatry profession, reflects these changes. Using a range of key primary documentary sources derived from published material in the public domain and unpublished material in private possession, this paper traces the development of contemporary UK and Australasian podiatric prescribing, access, supply and administration of medicines. Documentary sources include material from legislative, health policy, regulatory and professional bodies (including both State and Federal sources in Australia). Tracing a chronological, comparative, socio-historical account of the emergence and development of 'prescribing' in podiatry in both Australasia and the UK enables an analysis of the impact of health policy reforms on the use of, and access to, medicines by podiatrists. The advent of neo-liberal healthcare policies, coupled with demands for workforce flexibility and role transfer within a climate of demographic, economic and social change has enabled allied health professionals to undertake an expanding number of tasks involving the sale, supply, administration and prescription of medicines. As a challenge to medical dominance, these changes, although driven by wider healthcare policy, have met with resistance. As anticipated in the theory of

'Home from home': risk perceptions, malaria and the use of chemoprophylaxis among UK South Asians.

PubMed

Joshi, Mary Sissons; Lalvani, Ajit

2010-08-01

Malaria is a serious disease hazard facing travellers to tropical countries. On average around 2000 cases of malaria are annually imported into the UK, with an over-representation of ethnic minority members. The current research examined adherence to chemoprophylaxis among UK South Asians travelling to malarial regions in South Asia and East Africa. Four hundred South Asians were interviewed with a questionnaire investigating use of malaria prophylaxis, knowledge of malaria, risk perceptions and reasons for inadequate or zero adherence to chemoprophylaxis. Two hundred interviews were conducted in 1994, and a further 200 interviews in 2004. Participants were recruited from areas of known ethnic density in Leicester, London and Oxford. In 1994, although 49% embarked on taking anti-malaria tablets, only 22% took tablets for 2 or more weeks upon return to the UK (and only 6% for the medically advisory period of 4 weeks). In 2004, 32% embarked on taking tablets but only 9% took tablets for 2 or more weeks upon returning to the UK (and only 2.5% for 4 weeks). Good adherence was associated with greater knowledge about the symptoms and transmission of malaria, and being more likely to define the trip as a 'holiday' rather than as a visit to 'family and friends'. Zero adherence was associated with a failure to recognise the potential severity and critical nature of malaria. Common reasons for partial and zero adherence were the perception that the personal risk of getting malaria was low and an erroneous belief in immunity. The specific cognitions available to ethnic minority members travelling 'home' contribute to a very low use of chemoprophylaxis, thus placing them at a heightened risk of acquiring malaria. Health messages need to stress that malaria is a serious health hazard and that emigres visiting malarial regions cannot rely on personal immunity.

Heat protection behaviour in the UK: results of an online survey after the 2013 heatwave.

PubMed

Khare, Swarna; Hajat, Shakoor; Kovats, Sari; Lefevre, Carmen E; de Bruin, Wändi Bruine; Dessai, Suraje; Bone, Angie

2015-09-10

The Heatwave Plan for England provides guidance for personal and home protection measures during heatwaves. Although studies in the USA, Australia and Europe have surveyed heat-related behaviours during heatwaves, few have been conducted in the UK. This study assesses personal and housing (at-home) behaviour and housing characteristics of the UK population during the 2013 heatwave. This paper analyses data from 1497 respondents of an online survey on heat protection measures and behaviour. Participants were asked questions about their behaviour during the 2013 heatwave, the characteristics of their current housing as well as about any negative health outcomes experienced due to the hot weather. We used multinomial logit regression to analyse personal and home heat protection behaviour and logistic regression to analyse characteristics of participants' current home (installed air conditioner, curtains etc.). We stratified the outcomes by age, sex, ethnicity, income, education and regional location. In 2013, for all heat-related illness (except tiredness), a higher proportion of those in the younger age groups reported symptoms compared with those in the older age groups. Women, higher income groups and those with higher education levels were found to be more likely to report always/often taking personal heat protective measures. The elderly were less likely to take some personal and home protective measures but were more likely to live in insulated homes and open windows at night to keep their home cool. Our study has found a high level of awareness of the actions to take during heatwaves in the UK, and has identified important demographic indicators of sections of the UK population that might benefit from additional or more targeted information. The health agencies should attempt to provide better information about heatwaves to those vulnerable (elderly, those at risk living in London, low income earners) or identify any barriers that might be preventing them from

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.

Entrepreneurship Education and Veterinary Medicine: Enhancing Employable Skills

ERIC Educational Resources Information Center

Henry, Colette; Treanor, Lorna

2010-01-01

Purpose: This paper has the purpose of exploring the potential for entrepreneurship education within veterinary medicine. It aims to examine some of the key themes in the entrepreneurship education literature, discuss the make-up of the UK veterinary sector, consider veterinary curricula requirements and illustrate how entrepreneurship education…

Conscientious objection in medical students: a questionnaire survey.

PubMed

Strickland, Sophie Lm

2012-01-01

To explore attitudes towards conscientious objections among medical students in the UK. Medical students at St George's University of London, Cardiff University, King's College London and Leeds University were emailed a link to an anonymous online questionnaire, hosted by an online survey company. The questionnaire contained nine questions. A total of 733 medical students responded. Nearly half of the students in this survey stated that they believed in the right of doctors to conscientiously object to any procedure. Demand for the right to conscientiously object is greater in Muslim medical students when compared with other groups of religious medical students. Abortion continues to be a contentious issue among medical students and this may contribute to the looming crisis in abortion services over the coming years. This project sheds some light on how future doctors view some of their ethical rights and obligations. Using empirical evidence, it reveals that conscientious objection is an issue in the UK medical student body today. These data could help anticipate problems that may arise when these medical students qualify and practise medicine in the community. Clearer guidance is needed for medical students about the issue of conscientious objection at medical school.

School bullying and traumatic dental injuries in East London adolescents.

PubMed

Agel, M; Marcenes, W; Stansfeld, S A; Bernabé, E

2014-12-01

To explore the association between school bullying and traumatic dental injuries (TDI) among 15-16-year-old school children from East London. Data from phase III of the Research with East London Adolescents Community Health Survey (RELACHS), a school-based prospective study of a representative sample of adolescents, were analysed. Adolescents provided information on demographic characteristics, socioeconomic measures and frequency of bullying in school through self-administered questionnaires and were clinically examined for overjet, lip coverage and TDI. The association between school bullying and TDI was assessed using binary logistic regression models. The prevalence of TDI was 17%, while lifetime and current prevalence of bullying was 32% and 11%, respectively. The prevalence of TDI increased with a growing frequency of bullying; from 16% among adolescents who had never been bullied at school, to 21% among those who were bullied in the past but not this school term, to 22% for those who were bullied this school term. However, this association was not statistically significant either in crude or adjusted regression models. There was no evidence of an association between frequency of school bullying and TDI in this sample of 15-16-year-old adolescents in East London.

Engaging the Somali community in the road safety agenda: a process evaluation from the London borough of Hounslow.

PubMed

Christie, Nicola; Sleney, Judith; Ahmed, Fatima; Knight, Elisabeth

2012-08-01

In the UK the most disadvantaged in society are more likely than those more affluent to be injured or killed in a road traffic collision and therefore it is a major cause of health inequality. There is a strong link between ethnicity, deprivation and injury. Whilst national road traffic injury data does not collect ethnic origin the London accident and analysis group does in terms of broad categories such as 'white', 'black' and 'Asian'. Analysis of this data revealed the over-representation of child pedestrian casualties from a 'black' ethnic origin. This information led road safety practitioners in one London borough to map child pedestrian casualties against census data which identified the Somali community as being particularly at risk of being involved in a road traffic collision. Working with the community they sought to discuss and address road safety issues and introduced practical evidence based approaches such as child pedestrian training. The process evaluation of the project used a qualitative approach and showed that engaging with community partners and working across organisational boundaries was a useful strategy to gain an understanding of the Somali community. A bottom approach provided the community with a sense of control and involvement which appears to add value in terms of reducing the sense of powerlessness that marginalised communities often feel. In terms of evaluation, small projects like these, lend themselves to a qualitative process evaluation though it has to be accepted that the strength of this evidence may be regarded as weak. Where possible routine injury data needs to take into account ethnicity which is a known risk factor for road casualty involvement which needs to be continually monitored.

The development of the specialism of emergency medicine: media and cultural influences.

PubMed

Timmons, Stephen; Nairn, Stuart

2015-01-01

In this article we analyse, via a critical review of the literature, the development of a relatively new medical specialism in the United Kingdom, that of emergency medicine. Despite the high media profile of emergency care, it is a low-status specialism within UK medicine. The creation of a specialist College in 2008 means that, symbolically, recognition as a full specialism has now been achieved. In this article, we will show, using a sociology of professions approach, how emergency medicine defined itself as a specialism, and sought to carve out a distinctive jurisdiction. While, in the context of the UK National Health Service, the state was clearly an important factor in the development of this profession, we wish to develop the analysis further than is usual in the sociology of professions. We will analyse the wider cultural context for the development of this specialism, which has benefited from its high profile in the media, through both fictional and documentary sources. © The Author(s) 2014.

Diversity in Adoption of Linguistic Features of London English by Chinese and Bangladeshi Adolescents

ERIC Educational Resources Information Center

Pennington, Martha C.; Lau, Lawrence; Sachdev, Itesh

2011-01-01

This comparative study, conducted in multicultural London, investigates the occurrence in interviews with a researcher and in constructed same-sex peer conversations of five linguistic features characteristic of London English in the speech of two groups of British-born adolescents: ethnic Bangladeshis and ethnic Chinese of Cantonese heritage. The…

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

ERIC Educational Resources Information Center

Aldrich, Richard

2009-01-01

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

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.

Dietary intake in Black British adults; an observational assessment of nutritional composition and the role of traditional foods in UK Caribbean and West African diets.

PubMed

Goff, Louise M; Timbers, Louise; Style, Hannah; Knight, Annemarie

2015-08-01

Acculturation to the UK diet may contribute to the increased burden of non-communicable diseases in Black British communities. The present study aimed to assess nutritional composition and the contribution that traditional foods make to dietary intake in a group of UK-residing Caribbean and West African adults and to explore differences according to ethnicity and duration of residence. Observational study. Dietary intake was assessed using multiple, standardised triple-pass 24 h recalls and analysed using a nutritional composition database. Associations between sociodemographic variables and duration of residence with dietary intake were assessed using ANCOVA. London, UK, October 2011-December 2012. UK adults of Caribbean (n 50) or West African (n 83) ancestry, aged 18-75 years. The Caribbean participants were older and more likely to be born in the UK. After adjusting for age, sex and ethnicity, those who had been resident in the UK for the longest duration had significantly higher intakes of energy (P<0·001), fat (P=0·002) and Na (P=0·03). The West African participants sourced significantly more energy (P=0·04), fat (P=0·02), saturated fat (P=0·02) and Na (P=0·001) from traditional cultural foods compared with the Caribbean diet, which was more reliant on 'Westernised' foods such as sugar-sweetened beverages. These results are novel in demonstrating dietary acculturation in UK adults of Caribbean and West African ancestry. We have provided detailed data regarding the role of traditional foods, presenting dietary information that may guide in individualising care for patients from these communities and improve the cultural sensitivity of public health strategies.

Active Citizenship & Adult Learning In Inner London. Research Paper in Continuing Education Number 2.

ERIC Educational Resources Information Center

Payne, John

The impact of the abolition of the Inner London Educational Authority (ILEA) on adult education in London (England) was explored. Specifically, the impact of abolition, that might support the concept and practice of active citizenship, was studied on three areas of adult education: environmental education, antiracist work, and work with voluntary…

Scintillometer measurements above the urban area of London

NASA Astrophysics Data System (ADS)

Pauscher, Lukas; Salmond, Jennifer; Grimmond, C. S. B.; Foken, Thomas

2010-05-01

The spatial heterogeneity of urban surfaces presents a particular challenge to the measurement of turbulent fluxes. This is particularly true close to the urban surface (in the roughness sub-layer (RSL)) where the mosaic of roof top and street canyon surfaces present a complex three dimensional source area. Scintillometery, which offers the ability to make path-averaged measurements of turbulent fluxes of heat and momentum, provides an alternative approach to obtaining more spatially representative data sets in the RSL. In this study three Scintec small aperture scintillometers (SLS 20) were used to measure the sensible heat flux (QH) at a densely built up site at Strand Campus, King's College London, UK. Two different surfaces (courtyard and rooftop) characteristic of the urban environment were investigated simultaneously. One of the SLS was aligned just atop a courtyard (z/zH= 0.9), while the other two were set up in two different heights (z/zH= 1 and z/zH= 1.25) above a rooftop line. Where zH is the mean building height and z is the measurement height above ground level. Special consideration was given to the estimation of the displacement height and the influence of the Monin-Obukov function used for the analysis. To estimate the contribution of the different surface types to the observed fluxes a footprint analysis was carried out for the two rooftop SLS and the eddy covariance system. Fluxes from the two SLS above the rooftop generally agreed well with each other and exhibited a pronounced diurnal cycle. They also showed similar patterns and magnitudes as those measured by an eddy covariance system located close by. In contrast, diurnal flux patterns derived from the measurements atop the courtyard showed marked differences, especially during day time when fluxes often remained smaller.

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…

The Epidemiology of Injuries in Football at the London 2012 Paralympic Games.

PubMed

Webborn, Nick; Cushman, Daniel; Blauwet, Cheri A; Emery, Carolyn; Derman, Wayne; Schwellnus, Martin; Stomphorst, Jaap; Van de Vliet, Peter; Willick, Stuart E

2016-06-01

The epidemiology of injury in Paralympic football has received little attention. A study of all sports at the London 2012 Paralympic Games identified football 5-a-side as the sport with the highest injury rate, meriting further detailed analysis, which may facilitate the development of strategies to prevent injuries. To examine the injury rates and risk factors associated with injury in Paralympic football. Secondary analysis of a prospective cohort study of injuries to football 5-a-side and football 7-a-side athletes. London 2012 Paralympic Games. Participants included 70 football 5-a-side athletes and 96 football 7-a-side athletes. Athletes from all but one country chose to participate in this study. The Paralympic Injury and Illness Surveillance System was used to track injuries during the Games, with data entered by medical staff. Injury incidence rate (IR) and injury incidence proportion (IP). The overall IR for football 5-a-side was 22.4 injuries/1000 athlete-days (95% confidence interval [CI], 14.1-33.8) with an IP of 31.4 injuries per 100 athletes (95% CI, 20.9-43.6). In 5-a-side competition, 62.5% of injuries were associated with foul play. The overall IR for football 7-a-side was 10.4 injuries/1000 athlete-days (95% CI, 5.4-15.5), with an IP of 14.6 injuries per 100 athletes (95% CI, 7.5-21.6). The most commonly injured body region in both sports was the lower extremity. To our knowledge, this study is the first to examine IR and risk factors associated with injury in Paralympic football. Future studies are needed to determine mechanisms of injury and independent risk factors for injury, thus informing prevention strategies. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Dentists with enhanced skills (Special Interest) in Endodontics: gatekeepers views in London.

PubMed

Ghotane, Swapnil G; Al-Haboubi, Mustafa; Kendall, Nick; Robertson, Claire; Gallagher, Jennifer E

2015-09-21

Dentists with a special interest hold enhanced skills enabling them to treat cases of intermediate complexity. The aim of this study was to explore primary dental care practitioners' views of dentists with a special interest (DwSIs) in Endodontics in London, with reference to an educational and service initiative established by (the former) London Deanery in conjunction with the NHS. A cross-sectional postal survey of primary care dentists working across different models of care within London was conducted, with a target to achieve views of at least 5 % of London's dentists. The questionnaire instrument was informed by qualitative research and the dental literature and piloted prior to distribution; data were analysed using SPSS v19 and STATA v12.0. Six per cent of London's primary care dentists (n = 243) responded to the survey; 53 % were male. Just over one third (37 %; n = 90) were aware of the DwSI service being provided. Most practitioners reported that having access to a DwSI in Endodontics would support the care of their patients (89 %; n = 215), would carry out more endodontic treatment in the NHS primary dental care if adequately reimbursed (93 %; n = 220), and had more time (76 %; n = 180). Female respondents appeared to be less confident in doing endodontic treatment (p = 0.001). More recently qualified respondents reported greater need for training/support for performing more endodontic treatment in the NHS primary dental care (p = 0.001), were more dissatisfied with access to endodontic service in the NHS primary dental care (p = 0.007) and more interested to train as a DwSI in endodontics (p = 0.001) compared with respondents having a greater number of years of clinical experience since qualification. The findings lend support to the concept of developing dentists with enhanced skills as well as ensuring additional funding, time and support to facilitate more routine endodontics through the NHS primary care to meet

Interview with Sanofi's Dr Tunde Falode.

PubMed

Falode, Tunde

2017-01-01

Dr Tunde Falode speaks to Elena Conroy, Commissioning Editor: Dr Tunde Falode is General Manager for the Diabetes and Cardiovascular Business Unit in the UK and Ireland at Sanofi, a global pharmaceutical company. Following graduation from the University of Jos Medical School in Nigeria, he secured a basic surgical training post through Guy's and St Thomas' hospitals in London, eventually specializing in cardiac and thoracic surgery, before changing his career path. In addition to his current role at Sanofi, he recently completed his specialist training in pharmaceutical medicine and has a keen interest in sports.

Household hazardous waste data for the UK by direct sampling.

PubMed

Slack, Rebecca J; Bonin, Michael; Gronow, Jan R; Van Santen, Anton; Voulvoulis, Nikolaos

2007-04-01

The amount of household hazardous waste (HHW) disposed of in the United Kingdom (UK) requires assessment. This paper describes a direct analysis study carried out in three areas in southeast England involving over 500 households. Each participating householder was provided with a special bin in which to place items corresponding to a list of HHW. The amount of waste collected was split into nine broad categories: batteries, home maintenance (DIY), vehicle upkeep, pesticides, pet care, pharmaceuticals, photographic chemicals, household cleaners, and printer cartridges. Over 1 T of waste was collected from the sample households over a 32-week period, which would correspond to an estimated 51,000 T if extrapolated to the UK population for the same period or over 7,000 T per month. Details of likely disposal routes adopted by householders were also sought, demonstrating the different pathways selected for different waste categories. Co-disposal with residual household waste dominated for waste batteries and veterinary medicines, hence avoiding classification as hazardous waste under new UK waste regulations. The information can be used to set a baseline for the management of HHW and provides information for an environmental risk assessment of the disposal of such wastes to landfill.

Using maps and funnel plots to explore variation in place of death from cancer within London, 2002-2007.

PubMed

Madden, P; Coupland, Vh; Møller, H; Davies, Ea

2011-06-01

London has a high proportion of hospital deaths, which health policy seeks to reduce. We explore variation and trends in place of death from cancer within London between 2002 and 2007. Mortality data based on death certificates were used to define deaths from cancer at home, hospice, hospital and nursing home and examine trends over time for London. Proportions of deaths in each place were presented in maps for 31 London primary care trusts (PCTs). Funnel plots were used to identify consistent performance outside the control limits of three standard deviations. There was little overall change in place of death for London, but consistent variation between PCTs. Outer London PCTs had higher proportions of home deaths and inner London PCTs higher proportions of hospice deaths. Funnel plots identified consistent high outlying performance for home, hospice and hospital deaths. No PCT showed a change of 10% or more in home deaths, but five showed decreasing hospital deaths and three increasing hospice deaths. Maps and funnel plots appear useful for identifying areas with differing performance for home, hospital, nursing home and hospice deaths. These methods may help further investigation of how local services may successfully support deaths outside hospital. © The Author(s) 2011

Getting to the core of medicine: Developing undergraduate forensic medicine and pathology teaching.

PubMed

Jones, Richard Martin

2017-11-01

Teaching and learning of forensic medicine and pathology in the undergraduate medical curriculum has been in decline for decades in the UK, and yet graduates are expected to be able to recognise, and protect, those who are most vulnerable in society - i.e. at risk of abuse or neglect - a matter highly relevant to the role of the forensic medical practitioner. When Cardiff University School of Medicine created a new 'learner-centred' undergraduate curriculum, championing case-based discussion in small groups, and earlier clinical contact, residual teaching on 'the pathology of trauma' disappeared. An opportunity to create a new course for the year 3 core curriculum, however, led to re-emergence of forensic medicine and pathology, with a focus on identification, and protection, of the 'vulnerable patient'. This paper describes the development process of the first two iterations of that course, and the influence of 'listening to the student voice'. Forensic medicine and pathology remain relevant in undergraduate medical education; effective, and ethical, safeguarding of the vulnerable is an essential 'core' skill of the modern medical graduate, and forensic medical practitioners can play an integral role in the preparation of medical students for their future clinical practice. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Evolution of primary care databases in UK: a scientometric analysis of research output.

PubMed

Vezyridis, Paraskevas; Timmons, Stephen

2016-10-11

To identify publication and citation trends, most productive institutions and countries, top journals, most cited articles and authorship networks from articles that used and analysed data from primary care databases (CPRD, THIN, QResearch) of pseudonymised electronic health records (EHRs) in UK. Descriptive statistics and scientometric tools were used to analyse a SCOPUS data set of 1891 articles. Open access software was used to extract networks from the data set (Table2Net), visualise and analyse coauthorship networks of scholars and countries (Gephi) and density maps (VOSviewer) of research topics co-occurrence and journal cocitation. Research output increased overall at a yearly rate of 18.65%. While medicine is the main field of research, studies in more specialised areas include biochemistry and pharmacology. Researchers from UK, USA and Spanish institutions have published the most papers. Most of the journals that publish this type of research and most cited papers come from UK and USA. Authorship varied between 3 and 6 authors. Keyword analyses show that smoking, diabetes, cardiovascular diseases and mental illnesses, as well as medication that can treat such medical conditions, such as non-steroid anti-inflammatory agents, insulin and antidepressants constitute the main topics of research. Coauthorship network analyses show that lead scientists, directors or founders of these databases are, to various degrees, at the centre of clusters in this scientific community. There is a considerable increase of publications in primary care research from EHRs. The UK has been well placed at the centre of an expanding global scientific community, facilitating international collaborations and bringing together international expertise in medicine, biochemical and pharmaceutical research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Safety of vaginal delivery among dichorionic diamniotic twins over 10 years in a UK teaching hospital.

PubMed

Rzyska, Ewelina; Ajay, Bini; Chandraharan, Edwin

2017-01-01

To determine whether vaginal delivery among dichorionic diamniotic twins remains a safe option following full implementation of the European Working Time Directive in the UK. A retrospective study was conducted using data for women with dichorionic diamniotic twin pregnancies who attended a teaching hospital in London, UK, for delivery between January 4, 2000, and December 23, 2010. Among 892 women, 474 (53.1%) attempted vaginal delivery, 220 (46.4%) of whom achieved spontaneous vaginal delivery of both twins. Instrumental vaginal delivery was performed among 89 women (18.8%), and 165 (34.8%) women underwent emergency cesarean delivery. Delivery of the second twin by emergency cesarean (n=31) was predominantly for fetal distress (13 [41.9%]) or abnormal lie (10 [32.3%]). A 5-minute Apgar score of 9 or 10 was recorded for 384 (83.7%) of 459 first twins and 369 (82.9%) of 445 second twins, irrespective of the mode of delivery. Vaginal delivery among dichorionic diamniotic twins had a good success rate and a low intrapartum emergency cesarean delivery rate. Training in cardiotocography and intrapartum procedures might further reduce the need for emergency cesarean delivery. © 2016 International Federation of Gynecology and Obstetrics.

An Introduction to ESERO-UK, the UK Space Education Office

ERIC Educational Resources Information Center

Clements, Allan; Mather, Edward

2012-01-01

This article introduces the UK branch of the European Space Education Resource Office (ESERO-UK), also known as the UK Space Education Office. It is a teaching project designed to use space to enthuse primary and secondary students to study science, technology, engineering and mathematics (STEM) subjects. The office is funded by the European Space…

Time-dependent London approach: Dissipation due to out-of-core normal excitations by moving vortices

DOE PAGES

Kogan, V. G.

2018-03-19

The dissipative currents due to normal excitations are included in the London description. The resulting time-dependent London equations are solved for a moving vortex and a moving vortex lattice. It is shown that the field distribution of a moving vortex loses its cylindrical symmetry. It experiences contraction that is stronger in the direction of the motion than in the direction normal to the velocity v. The London contribution of normal currents to dissipation is small relative to the Bardeen-Stephen core dissipation at small velocities, but it approaches the latter at high velocities, where this contribution is no longer proportional tomore » v 2. Here, to minimize the London contribution to dissipation, the vortex lattice is oriented so as to have one of the unit cell vectors along the velocity. This effect is seen in experiments and predicted within the time-dependent Ginzburg-Landau theory.« less

Time-dependent London approach: Dissipation due to out-of-core normal excitations by moving vortices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kogan, V. G.

The dissipative currents due to normal excitations are included in the London description. The resulting time-dependent London equations are solved for a moving vortex and a moving vortex lattice. It is shown that the field distribution of a moving vortex loses its cylindrical symmetry. It experiences contraction that is stronger in the direction of the motion than in the direction normal to the velocity v. The London contribution of normal currents to dissipation is small relative to the Bardeen-Stephen core dissipation at small velocities, but it approaches the latter at high velocities, where this contribution is no longer proportional tomore » v 2. Here, to minimize the London contribution to dissipation, the vortex lattice is oriented so as to have one of the unit cell vectors along the velocity. This effect is seen in experiments and predicted within the time-dependent Ginzburg-Landau theory.« less

Time-dependent London approach: Dissipation due to out-of-core normal excitations by moving vortices

NASA Astrophysics Data System (ADS)

Kogan, V. G.

2018-03-01

The dissipative currents due to normal excitations are included in the London description. The resulting time-dependent London equations are solved for a moving vortex and a moving vortex lattice. It is shown that the field distribution of a moving vortex loses its cylindrical symmetry. It experiences contraction that is stronger in the direction of the motion than in the direction normal to the velocity v . The London contribution of normal currents to dissipation is small relative to the Bardeen-Stephen core dissipation at small velocities, but it approaches the latter at high velocities, where this contribution is no longer proportional to v2. To minimize the London contribution to dissipation, the vortex lattice is oriented so as to have one of the unit cell vectors along the velocity. This effect is seen in experiments and predicted within the time-dependent Ginzburg-Landau theory.

The fissured East Yorkshire Chalk, UK - a 'sustainable' aquifer under stress ?

NASA Astrophysics Data System (ADS)

Elliot, T.; Younger, P. L.; Chadha, D. S.

2003-04-01

, G., Custodio, E., Elliot, T., Manzano, M. &Sauter, M. (2002) Assessments of the sensitivity to climate change of flow and natural water quality in four major carbonate aquifers of Europe. In Hiscock, K.M, Rivett, M.O., Davison, R.M. (Eds.), Sustainable Groundwater Development. Geological Society Special Publication No 193, The Geological Society, London, UK. pp.303-323.

Characterizing Students' Mechanistic Reasoning about London Dispersion Forces

ERIC Educational Resources Information Center

Becker, Nicole; Noyes, Keenan; Cooper, Melanie

2016-01-01

Characterizing how students construct causal mechanistic explanations for chemical phenomena can provide us with important insights into the ways that students develop understanding of chemistry concepts. Here, we present two qualitative studies of undergraduate general chemistry students' reasoning about the causes of London dispersion forces in…

Retrospective audit of the acute management of stroke in two district general hospitals in the uk.

PubMed

Faluyi, O O; Omodara, J A; Tay, K H; Muhiddin, K

2008-06-01

There is some evidence to suggest that the standard of acute medical care provided to patients with cerebrovascular disease is a major determinant of the eventual outcome. Consequently, the Royal College of Physicians (RCP) of London issues periodic guidelines to assist healthcare providers in the management of patients presenting with stroke. An audit of the acute management of stroke in two hospitals belonging to the same health care trust in the UK. Retrospective review of 98 randomly selected case-notes of patients managed for cerebrovascular disease in two acute hospitals in the UK between April and June 2004. The pertinent guidelines of RCP (London) are highlighted while audit targets were set at 70%. 84% of patients presenting with cerebrovascular disease had a stroke rather than a TIA, anterior circulation strokes were commonest. All patients with stroke were admitted while those with TIAs were discharged on the same day but most patients with TIA were not followed up by Stroke specialists. Most CT-imaging of the head was done after 24 hours delaying the commencement of anti-platelets for patients with ischaemic stroke or neurosurgical referral for haemorrhagic stroke. Furthermore, there was a low rate of referral for carotid ultrasound in patients with anterior circulation strokes. Anti-platelets and statins were commenced for most patients with ischaemic stroke while diabetes was well controlled in most of them. However, ACE-inhibitors and diuretics such as indapamide were under-utilized for secondary prevention in such patients. Warfarin anti-coagulation was underutilized in patients with ischaemic stroke who had underlying chronic atrial fibrillation. While there was significant multi-disciplinary team input, dysphagia and physiotherapy assessments were delayed. Similarly, occupational therapy input and psychological assesment were omitted from the care of most patients. Hospital service provision for the management of cerebrovascular disease needs to

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

PubMed Central

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

2016-01-01

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

Rasch analysis of the London Handicap Scale in stroke patients: a cross-sectional study.

PubMed

Park, Eun-Young; Choi, Yoo-Im

2014-07-31

Although activity and participation are the target domains in stroke rehabilitation interventions, there is insufficient evidence available regarding the validity of participation measurement. The purpose of this study was to investigate the psychometric properties of the London Handicap Scale in community-dwelling stroke patients, using Rasch analysis. Participants were 170 community-dwelling stroke survivors. The data were analyzed using Winsteps (version 3.62) with the Rasch model to determine the unidimensionality of item fit, the distribution of item difficulty, and the reliability and suitability of the rating process for the London Handicap Scale. Data of 16 participants did not fit the Rasch model and there were no misfitting items. The person separation value was 2.42, and the reliability was .85; furthermore, the rating process for the London Handicap Scale was found to be suitable for use with stroke patients. This was the first trial to investigate the psychometric properties of the London Handicap Scale using Rasch analysis; the results supported the suitability of this scale for use with stroke patients.

An exploration of attitudes towards female genital mutilation (FGM) in men and women accessing FGM clinical services in London: a pilot study.

PubMed

Larsson, Martina; Cohen, Pollyanna; Hann, Gayle; Creighton, Sarah M; Hodes, Deborah

2018-03-21

This pilot study researched the attitudes towards and the knowledge of female genital mutilation (FGM) in adult women with FGM and their partners. The participant population consisted of English-speaking women and men over 18 years old attending specialist FGM clinics in two London hospitals. The participants completed a questionnaire on the attitudes and the knowledge of FGM, which were adapted with permission from the United Nations Children's Fund and the United States Agency for International Development household surveys. 54 participants (51 women, 3 men) took part in the surveys. 89% of participants thought that FGM should be stopped (95%CI: 0.81-0.97) and 72% said they knew FGM is illegal in the United Kingdom (UK). 15% reported that FGM caused no danger, or were unaware of any danger to women's health. This study demonstrates the opposition to FGM by participants, but some lack of knowledge regarding the legal and health implications. The exploration of attitudes in diaspora community groups is often cited as key to safeguarding girls from FGM. This is one of the first UK studies of individuals from FGM-practising communities, and we recommend use of the study questionnaires for a multicentre, cross-community study. Impact statement What is already known about this subject? Women and children are affected by female genital mutilation (FGM) globally and in the United Kingdom (UK). The majority of knowledge on practices and the attitudes towards FGM comes from UNICEF and USAID research in Africa and there is scant data on FGM practices in diaspora communities in the UK. What do the results of this study add? This study provides an appropriate questionnaire and protocol for use in community-based national research to improve healthcare for women by collecting up-to-date data on the attitudes towards FGM among the members of FGM-practising communities in the UK. What are the implications of these findings for clinical practice and further research? The

A pilot study of an online universal school-based intervention to prevent alcohol and cannabis use in the UK

PubMed Central

Newton, Nicola C; Conrod, Patricia J; Rodriguez, Daniel M; Teesson, Maree

2014-01-01

Objectives The online universal Climate Schools intervention has been found to be effective in reducing the use of alcohol and cannabis among Australian adolescents. The aim of the current study was to examine the feasibility of implementing this prevention programme in the UK. Design A pilot study examining the feasibility of the Climate Schools programme in the UK was conducted with teachers and students from Year 9 classes at two secondary schools in southeast London. Teachers were asked to implement the evidence-based Climate Schools programme over the school year with their students. The intervention consisted of two modules (each with six lessons) delivered approximately 6 months apart. Following completion of the intervention, students and teachers were asked to evaluate the programme. Results 11 teachers and 222 students from two secondary schools evaluated the programme. Overall, the evaluations were extremely positive. Specifically, 85% of students said the information on alcohol and cannabis and how to stay safe was easy to understand, 84% said it was easy to learn and 80% said the online cartoon-based format was an enjoyable way to learn health theory topics. All teachers said the students were able to recall the information taught, 82% said the computer component was easy to implement and all teachers said the teacher's manual was easy to use to prepare class activities. Importantly, 82% of teachers said it was likely that they would use the programme in the future and recommend it to others. Conclusions The Internet-based universal Climate Schools prevention programme to be both feasible and acceptable to students and teachers in the UK. A full evaluation trial of the intervention is now required to examine its effectiveness in reducing alcohol and cannabis use among adolescents in the UK before implementation in the UK school system. PMID:24840248

Undergraduate teaching on biological weapons and bioterrorism at medical schools in the UK and the Republic of Ireland: results of a cross-sectional study

PubMed Central

Green, Stephen T; Cladi, Lorenzo; Morris, Paul; Forde, Donall

2013-01-01

Objective To determine if individual undergraduate schools of medicine in the UK and the Republic of Ireland provide any teaching to medical students about biological weapons, bioterrorism, chemical weapons and weaponised radiation, if they perceive them to be relevant issues and if they figure them in their future plans. Design A cross-sectional study utilising an internet-based questionnaire sent to key figures responsible for leading on the planning and delivery of undergraduate medical teaching at all schools of medicine in the UK and Ireland. Setting All identified undergraduate schools of medicine in the UK and Ireland between August 2012 and December 2012. Outcome measures Numerical data and free text feedback about relevant aspects of undergraduate teaching. Results Of the 38 medical schools approached, 34 (28 in UK, 6 in Ireland) completed the questionnaire (89.47%). 4 (all in UK) chose not to complete it. 6/34 (17.65%) included some specific teaching on biological weapons and bioterrorism. 7/34 (20.59%) had staff with bioterrorism expertise (mainly in microbiological and syndromic aspects). 4/34 (11.76%) had plans to introduce some specific teaching on bioterrorism. Free text responses revealed that some felt that because key bodies (eg, UK's General Medical Council) did not request teaching on bioterrorism, then it should not be included, while others regarded this field of study as a postgraduate subject and not appropriate for undergraduates, or argued that the curriculum was too congested already. 4/34 (11.76%) included some specific teaching on chemical weapons, and 3/34 (8.82%) on weaponised radiation. Conclusions This study provides evidence that at the present time there is little teaching at the undergraduate level in the UK and Ireland on the subjects of biological weapons and bioterrorism, chemical weapons and weaponised radiation and signals that this situation is unlikely to change unless there were to be high-level policy guidance. PMID

Impact of London's road traffic air and noise pollution on birth weight: retrospective population based cohort study.

PubMed

Smith, Rachel B; Fecht, Daniela; Gulliver, John; Beevers, Sean D; Dajnak, David; Blangiardo, Marta; Ghosh, Rebecca E; Hansell, Anna L; Kelly, Frank J; Anderson, H Ross; Toledano, Mireille B

2017-12-05

Objective  To investigate the relation between exposure to both air and noise pollution from road traffic and birth weight outcomes. Design  Retrospective population based cohort study. Setting  Greater London and surrounding counties up to the M25 motorway (2317 km 2 ), UK, from 2006 to 2010. Participants  540 365 singleton term live births. Main outcome measures  Term low birth weight (LBW), small for gestational age (SGA) at term, and term birth weight. Results  Average air pollutant exposures across pregnancy were 41 μg/m 3 nitrogen dioxide (NO 2 ), 73 μg/m 3 nitrogen oxides (NO x ), 14 μg/m 3 particulate matter with aerodynamic diameter <2.5 μm (PM 2.5 ), 23 μg/m 3 particulate matter with aerodynamic diameter <10 μm (PM 10 ), and 32 μg/m 3 ozone (O 3 ). Average daytime (L Aeq,16hr ) and night-time (L night ) road traffic A-weighted noise levels were 58 dB and 53 dB respectively. Interquartile range increases in NO 2 , NO x , PM 2.5 , PM 10 , and source specific PM 2.5 from traffic exhaust (PM 2.5 traffic exhaust ) and traffic non-exhaust (brake or tyre wear and resuspension) (PM 2.5 traffic non-exhaust ) were associated with 2% to 6% increased odds of term LBW, and 1% to 3% increased odds of term SGA. Air pollutant associations were robust to adjustment for road traffic noise. Trends of decreasing birth weight across increasing road traffic noise categories were observed, but were strongly attenuated when adjusted for primary traffic related air pollutants. Only PM 2.5 traffic exhaust and PM 2.5 were consistently associated with increased risk of term LBW after adjustment for each of the other air pollutants. It was estimated that 3% of term LBW cases in London are directly attributable to residential exposure to PM 2.5 >13.8 μg/m 3 during pregnancy. Conclusions  The findings suggest that air pollution from road traffic in London is adversely affecting fetal growth. The results suggest little evidence for an independent exposure

Views of UK medical graduates about flexible and part-time working in medicine: a qualitative study.

PubMed

Evans, J; Goldacre, M J; Lambert, T W

2000-05-01

To report on the views of doctors about flexible and part-time working in medicine. As part of ongoing studies of doctors' careers, postal questionnaires were sent in 1995 and 1996 to all doctors who qualified from UK medical schools in 1977, 1988 and 1993. Structured questions about recipients' careers were accompanied by a form which invited free-text comment. Comments about flexible and part-time working were extracted for analysis. All respondents who commented on flexible and part-time working. Most doctors who commented believed there were insufficient opportunities to meet demand. They also commonly commented that there was not enough information about flexible training opportunities. Some men, as well as women, expressed a wish to work part-time. The most frequently cited reasons for part-time working were to balance career with family responsibilities, and to reduce work-related stress. Cited disadvantages of part-time working were mainly financial and included the problems of paying for childcare and professional subscriptions when on a reduced income. Some respondents perceived negative attitudes towards doctors in part-time jobs. It is well-recognised that more flexible medical career structures are needed so that doctors can vary their time commitment according to their needs at particular stages in their lives. Until recently, needs have not been adequately met. Changes in arrangements for flexible training accompanying the implementation of the specialist registrar grade may have begun to alleviate some of the problems, but others, such as negative attitudes towards part-time work, may take time to change.

Inequalities in the use of dental services among adults in inner South East London.

PubMed

Al-Haboubi, Mustafa; Klass, Charlotte; Jones, Kate; Bernabé, Eduardo; Gallagher, Jennifer E

2013-06-01

Improving access to National Health Service (NHS) dentistry is a public health issue that has been a focus for successive governments and policy makers in the UK. To inform this process, commissioners of services need to understand trends in service use and demands of the local population. This study explored inequalities in dental services use among adults in a socially deprived, ethnically diverse metropolitan area of London; satisfaction with services; and public views for improvement of services. Data from 695 adults were analysed for this study (56% of the eligible sample). Inequalities in dental services use and satisfaction with care according to sociodemographic factors were assessed in unadjusted and fully adjusted models. The proportion of participants who reported attending the dentist in the last 24 months was 69%, with inequalities according to social grade, ethnicity, sex and age but not according to borough of residence. The most common areas identified by respondents for service improvement were availability of dentists, affordability of care, and accommodation of services. Among those who visited the dentist in the last 24 months, 90% were satisfied with the quality of care provided. However, there were inequalities in satisfaction with care according to borough and reason for the last dental visit. © 2013 Eur J Oral Sci.

Early risk assessment for viral haemorrhagic fever: experience at the Hospital for Tropical Diseases, London, UK.

PubMed

Woodrow, Charles J; Eziefula, Alice C; Agranoff, Dan; Scott, Geoffrey M; Watson, Julie; Chiodini, Peter L; Lockwood, Diana N J; Grant, Alison D

2007-01-01

To implement a policy of systematic screening for viral haemorrhagic fever (VHF) among travellers returning from African countries with fever, commencing at initial clinical contact. A protocol based on UK Advisory Committee on Dangerous Pathogens guidance was developed collaboratively by medical, nursing and laboratory staff. Audit was carried out to quantify resource demands and effects on time to diagnose malaria, the main differential diagnosis. A protocol is now implemented for all patients presenting to HTD with fever, with clear guidelines for interaction with clinical and laboratory staff at each stage. The protocol required moderate amounts of clinical and laboratory staff time and resulted in some additional hospital admissions. The time to a diagnosis of malaria increased from a median of 90 (range 50-125) min in patients without VHF risk to a median of 140 (range 101-225) min (p=0.0025) in those assessed as at risk. Although all acute medical services need to have robust procedures for early detection of patients with serious transmissible conditions, few implement such a policy. Our protocol requires increased human and other resources but has no important impact on the rapidity of diagnosis of malaria, and is now embedded in local practice.

Discrimination and common mental disorder among migrant and ethnic groups: findings from a South East London Community sample.

PubMed

Hatch, S L; Gazard, B; Williams, D R; Frissa, S; Goodwin, L; Hotopf, M

2016-05-01

Few studies have examined discrimination and mental health in the UK, particularly by migrant status and in urban contexts with greater demographic diversity. This study aims to (1) describe the prevalence of discrimination experiences across multiple life domains; (2) to describe associations between discrimination experiences and common mental disorder (CMD); (3) to determine whether or not the relationship between discrimination and CMD varies by migrant status and ethnicity. Data on major, anticipated and everyday discrimination and CMD symptoms were collected from an ethnically diverse prospective sample of 1052 participants followed up from 2008 to 2013 in the South East London Community Health study, a population-based household survey. With few exceptions, discrimination was most prevalent among those in the Black Caribbean group. However, those in the White Other ethnic group had similar or greater reporting major and anticipated discrimination to Black or mixed ethnic minority groups. The effects of discrimination on CMD were most pronounced for individuals who had recently migrated to the UK, an ethnically heterogeneous group, and for Black and Mixed ethnic minority groups in partially adjusted models. Prior CMD accounted for differences between the Mixed and White British ethnic groups, but the strength of the association for the most recent migrant group and the Black ethnic groups remained two or more times greater than the reference groups. The strength of the relationship suggests a need for more consideration of migration status along with ethnicity in examining the impact of discrimination on mental disorder in community and clinical samples.

Establishing an emergency department syndromic surveillance system to support the London 2012 Olympic and Paralympic Games.

PubMed

Elliot, Alex J; Hughes, Helen E; Hughes, Thomas C; Locker, Thomas E; Shannon, Tony; Heyworth, John; Wapling, Andy; Catchpole, Mike; Ibbotson, Sue; McCloskey, Brian; Smith, Gillian E

2012-12-01

The London 2012 Olympic and Paralympic Games is a mass gathering event that will present a major public health challenge. The Health Protection Agency, in collaboration with the College of Emergency Medicine, has established the Emergency Department Sentinel Syndromic Surveillance System (EDSSS) to support the public health surveillance requirements of the Games. This feasibility study assesses the usefulness of EDSSS in monitoring indicators of disease in the community. Daily counts of anonymised attendance data from six emergency departments across England were analysed by patient demographics (age, gender, partial postcode), triage coding and diagnosis codes. Generic and specific syndromic indicators were developed using aggregations of diagnosis codes recorded during each attendance. Over 339,000 attendances were recorded (26 July 2010 to 25 July 2011). The highest attendances recorded on weekdays between 10:00 and 11:00 and on weekends between 12:00 and 13:00. The mean daily attendance per emergency department was 257 (range 38-435). Syndromic indicators were developed including: respiratory, gastrointestinal, cardiac, acute respiratory infection, gastroenteritis and myocardial ischaemia. Respiratory and acute respiratory infection indicators peaked during December 2010, concomitant with national influenza activity, as monitored through other influenza surveillance systems. The EDSSS has been established to provide an enhanced surveillance system for the London 2012 Olympics. Further validation of the data will be required; however, the results from this initial descriptive study demonstrate the potential for identifying unusual and/or severe outbreaks of infectious disease, or other incidents with public health impact, within the community.

Bangladeshi women's experiences of infant feeding in the London Borough of Tower Hamlets.

PubMed

Rayment, Juliet; McCourt, Christine; Vaughan, Lisa; Christie, Janice; Trenchard-Mabere, Esther

2016-07-01

This study examined the main factors that influence Bangladeshi women living in London's decisions to partially breastfeed their children, including the influence of older women within the community. Fifty-seven women of Bangladeshi origin living in the London Borough of Tower Hamlets took part in seven discussion groups between April and June 2013. Five groups were held with women of child-bearing age and two groups with older women in the community. A further eight younger women and three older women took part in one-on-one interviews. Interviews were also carried out with eight local health care workers, including public health specialists, peer support workers, breastfeeding coordinators and a health visitor. The influences on women's infant feeding choices can be understood through a 'socio-ecological model', including public health policy; diverse cultural influences from Bangladesh, London and the Bangladeshi community in London; and the impacts of migration and religious and family beliefs. The women's commitment to breastfeeding was mediated through the complexity of their everyday lives. The tension between what was 'best' and what was 'possible' leads them not only to partially breastfeed but also to sustain partial breastfeeding in a way not seen in other socio-cultural groups in the United Kingdom. © 2015 John Wiley & Sons Ltd.

Space, Emotions and the Everyday: The Affective Ecology of 1980s London.

PubMed

Brooke, Stephen

2017-03-01

This article explores the relationship between emotions, space and politics in 1980s London, using the Greater London Council, childcare, and racial harassment as particular foci. It brings together political history, the history of emotions, and geography to offer a new way of thinking about political culture, as well as contributing to the history of the 1980s. It is based upon archival sources. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

77 FR 67566 - Regulated Navigation Area; Thames River Degaussing Range Replacement Operations; New London, CT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

... establishing a regulated navigation area (RNA) on the navigable waters of the Thames River in New London Harbor, New London, CT. The RNA will establish speed and wake restrictions and allow the Coast Guard to prohibit all vessel traffic through the RNA during degaussing range replacement operations, both planned...

Pain medicine--a new credential in Canada.

PubMed

Morley-Forster, Patricia; Karpinski, Jolanta

2015-06-01

In 2010, Pain Medicine was formally recognized as a subspecialty in Canada by the Royal College of Physicians and Surgeons of Canada, a national organization with oversight of the medical education of specialists in Canada. The first trainees began their training at the Western University, London, Canada in July, 2014. This article traces the process of Pain Medicine's development as a discipline in Canada and outlines its multiple entry routes, 2-year curriculum, and assessment procedures. The application for specialty status was initiated in 2007 with the understanding that while Anesthesiology would be the parent specialty, the curriculum would train clinicians in a multidisciplinary setting. To receive recognition as a Royal College subspecialty, Pain Medicine had to successfully pass through three phases, each stage requiring formal approval by the Committee on Specialties. The multiple entry routes to this 2-year subspecialty program are described in this article as are the objectives of training, the curriculum, assessment of competency and the practice-eligibility route to certification. The process of accreditation of new training programs across Canada is also discussed. The new Pain Medicine training program in Canada will train experts in the prevention, diagnosis, treatment and rehabilitation of the spectrum of acute pain, cancer pain and non-cancer pain problems. These physicians will become leaders in education, research, advocacy and administration of this emerging field. Wiley Periodicals, Inc.

Adherence to UK national guidance for discharge information: an audit in primary care.

PubMed

Hammad, Eman A; Wright, David John; Walton, Christine; Nunney, Ian; Bhattacharya, Debi

2014-12-01

Poor communication of clinical information between healthcare settings is associated with patient harm. In 2008, the UK National Prescribing Centre (NPC) issued guidance regarding the minimum information to be communicated upon hospital discharge. This study evaluates the extent of adherence to this guidance and identifies predictors of adherence. This was an audit of discharge summaries received by medical practices in one UK primary care trust of patients hospitalized for 24 h or longer. Each discharge summary was scored against the applicable NPC criteria which were organized into: 'patient, admission and discharge', 'medicine' and 'therapy change' information. Of 3444 discharge summaries audited, 2421 (70.3%) were from two teaching hospitals and 906 (26.3%) from three district hospitals. Unplanned admissions accounted for 2168 (63.0%) of the audit sample and 74.6% (2570) of discharge summaries were electronic. Mean (95% CI) adherence to the total NPC minimum dataset was 71.7% [70.2, 73.2]. Adherence to patient, admission and discharge information was 77.3% (95% CI 77.0, 77.7), 67.2% (95% CI 66.3, 68.2) for medicine information and 48.9% (95% CI 47.5, 50.3) for therapy change information. Allergy status, co-morbidities, medication history and rationale for therapy change were the most frequent omissions. Predictors of adherence included quality of the discharge template, electronic discharge summaries and smaller numbers of prescribed medicines. Despite clear guidance regarding the content of discharge information, omissions are frequent. Adherence to the NPC minimum dataset might be improved by using comprehensive electronic discharge templates and implementation of effective medicines reconciliation at both sides of the health interface. © 2014 The British Pharmacological Society.

Infant Mortality and Income in 4 World Cities: New York, London, Paris, and Tokyo

PubMed Central

Rodwin, Victor G.; Neuberg, Leland G.

2005-01-01

Objectives. We investigated the association between average income or deprivation and infant mortality rate across neighborhoods of 4 world cities. Methods. Using a maximum likelihood negative binomial regression model that controls for births, we analyzed data for 1988–1992 and 1993–1997. Results. In Manhattan, for both periods, we found an association (.05% significance level) between income and infant mortality. In Tokyo, for both periods, and in Paris and London for period 1, we found none (5% significance level). For period 2, the association just missed statistical significance for Paris, whereas for London it was significant (5% level). Conclusions. In stark contrast to Tokyo, Paris, and London, the association of income and infant mortality rate was strongly evident in Manhattan. PMID:15623865

Physical employment standards for U.K. fire and rescue service personnel.

PubMed

Blacker, S D; Rayson, M P; Wilkinson, D M; Carter, J M; Nevill, A M; Richmond, V L

2016-01-01

Evidence-based physical employment standards are vital for recruiting, training and maintaining the operational effectiveness of personnel in physically demanding occupations. (i) Develop criterion tests for in-service physical assessment, which simulate the role-related physical demands of UK fire and rescue service (UK FRS) personnel. (ii) Develop practical physical selection tests for FRS applicants. (iii) Evaluate the validity of the selection tests to predict criterion test performance. Stage 1: we conducted a physical demands analysis involving seven workshops and an expert panel to document the key physical tasks required of UK FRS personnel and to develop 'criterion' and 'selection' tests. Stage 2: we measured the performance of 137 trainee and 50 trained UK FRS personnel on selection, criterion and 'field' measures of aerobic power, strength and body size. Statistical models were developed to predict criterion test performance. Stage 3: matter experts derived minimum performance standards. We developed single person simulations of the key physical tasks required of UK FRS personnel as criterion and selection tests (rural fire, domestic fire, ladder lift, ladder extension, ladder climb, pump assembly, enclosed space search). Selection tests were marginally stronger predictors of criterion test performance (r = 0.88-0.94, 95% Limits of Agreement [LoA] 7.6-14.0%) than field test scores (r = 0.84-0.94, 95% LoA 8.0-19.8%) and offered greater face and content validity and more practical implementation. This study outlines the development of role-related, gender-free physical employment tests for the UK FRS, which conform to equal opportunities law. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study.

PubMed

Woolf, Katherine; Cave, Judith; Greenhalgh, Trisha; Dacre, Jane

2008-08-18

To explore ethnic stereotypes of UK medical students in the context of academic underachievement of medical students from ethnic minorities. Qualitative study using semistructured one to one interviews and focus groups. A London medical school. 27 year 3 medical students and 25 clinical teachers, purposively sampled for ethnicity and sex. Data were analysed using the theory of stereotype threat (a psychological phenomenon thought to negatively affect the performance of people from ethnic minorities in educational contexts) and the constant comparative method. Participants believed the student-teacher relationship was vital for clinical learning. Teachers had strong perceptions about "good" clinical students (interactive, keen, respectful), and some described being aggressive towards students whom they perceived as quiet, unmotivated, and unwilling. Students had equally strong perceptions about "good" clinical teachers (encouraging, interested, interactive, non-aggressive). Students and teachers had concordant and well developed perceptions of the "typical" Asian clinical medical student who was considered over-reliant on books, poor at communicating with patients, too quiet during clinical teaching sessions, and unmotivated owing to being pushed into studying medicine by ambitious parents. Stereotypes of the "typical" white student were less well developed: autonomous, confident, and outgoing team player. Direct discrimination was not reported. Asian clinical medical students may be more likely than white students to be perceived stereotypically and negatively, which may reduce their learning by jeopardising their relationships with teachers. The existence of a negative stereotype about their group also raises the possibility that underperformance of medical students from ethnic minorities may be partly due to stereotype threat. It is recommended that clinical teachers be given opportunities and training to encourage them to get to know their students as

Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study