The East-West Arc, Re-thinking Growth in the London Region

The East-West Arc spans 30 local councils comprising the growth corridor from Oxford through Milton Keynes and Northampton to Cambridge. Its population of over three million is the fastest growing region in the UK . It forms the northern fringe of the greater London city region to which it is profitably tied, just north of the Green Belt. History, knowledge, technology, agriculture and nature combine in a rich tapestry that has long contributed to the commonwealth of the United Kingdom. In a globalizing world where distances of all kinds are slashed, the Arc is more than a key part of the greater London region. It is a gateway north to the Midlands and the Northern Powerhouse. The Oxford-Milton Keynes-Cambridge Gateway is one of the most innovative and dynamic areas of the UK. Its potential is recognised by the government as a once-in-a-generation opportunity for the region to become a ‘knowledge-intensive growth cluster, competing globally’. Yet that potential is capped by inadequate infrastructure and expensive housing, as well as ecological constraints. As HS2, along with the train and expressway linking Oxford and Cambridge become realities, this vital region can be seen better as a gateway in all directions, thus helping to rebalance growth across the UK. The day-long symposium on the East-West Arc held at the University of Westminster in June of 2018 addressed these challenges from a range of perspectives. Traversing the Arc from south to north is the proposed high-speed rail line HS2, as well as the planned east-west expressway and east-west rail line linking Oxford to Cambridge through Milton Keynes. These transport links, taken together, are intended to enhance connectivity, mobility and productivity across the region. This will further boost growth while presenting financing and environmental challenges along with its benefits. The National Infrastructure Commission (NIC) report from 2017, Partnering for Prosperity: A new deal for the Cambridge-Milton Keynes-Oxford Arc, set out one vision and approach to infrastructure-led development linked to place making. It also set out new thinking on the housing challenge in the region that is equivalent to a new city the size of Birmingham. Other impacts of growth also need to be addressed, such as last mile connectivity and multi-modal transport, social inequities, land consumption of agriculture and forests, greater flood risk, pollution, and loss of ecological function and integrity of historical region including its villages and towns. These are but a few of the impacts that need to be addressed by an assessment of growth scenarios and their impacts, in advance of the foreseen major infrastructure projects. Government has long recognised the strategic importance of the Arc, and not just to the region itself, comprised of three recently-formed regional growth boards in Milton Keynes, Oxford and Cambridge. Central to the Arc is its relationship to London, the west of England and the synergies with the Midlands and further north. This greater London Region contains the UK’s primary transport hubs and corridors, including the main north-south road and rail routes, together with key international gateways such as Heathrow and Birmingham airports and the seaports of Harwich, Felixstowe and the Thames Gateway in the east. While the long history of this greater region has unfolded piece meal, it is now interconnected into a functioning mega-region that needs a coherent strategy founded by cogent analysis. In this context, it is critical to envision the East-West Arc as gateway that enables in all directions, and not merely as a self-contained sub-region or as a northern fringe of London

Effectiveness and safety of betrixaban extended prophylaxis for venous thromboembolism compared with standard-duration prophylaxis intervention in acute medically ill patients : a systematic literature review and network meta-analysis

Aims: To determine the clinical effectiveness and safety of venous thromboembolism (VTE) prophylaxis using US- and Europe-approved anticoagulants relative to extended-duration VTE prophylaxis with betrixaban. Low molecular weight heparins (LMWHs), unfractionated heparin (UFH), fondaparinux sodium and placebo were each compared to betrixaban, as standard-duration VTE prophylaxis for hospitalized, non-surgical patients with acute medical illness at risk of VTE. Materials and methods: A systematic literature review was conducted up to June 2019 to identify randomized controlled trials (RCTs) of VTE prophylaxis in hospitalized, non-surgical patients with acute medical illness at risk of VTE. Studies that reported the occurrence of VTE events (including death) and, where possible, major bleeding, from treatment initiation to 20–50 days thereafter were retrieved and extracted. A Bayesian fixed effect network meta-analysis was used to estimate efficacy and safety of betrixaban compared with standard-duration VTE prophylaxis. Results: Seven RCTs were analyzed which compared betrixaban, LMWHs, UFH, fondaparinux sodium, or placebo. There were significantly higher odds (median odds [95% credible interval]) of VTE with LMWHs (1.38 [1.12–1.70]), UFH (1.60 [1.05–2.46]), and placebo (2.37 [1.55–3.66]) compared with betrixaban. There were significantly higher odds of VTE-related death with placebo (7.76 [2.14–34.40]) compared with betrixaban. No significant differences were observed for the odds of major bleeding with all comparators, VTE-related death with any active standard-duration VTE prophylaxis, or of VTE with fondaparinux sodium, compared with betrixaban. Limitations and conclusions: In this indirect comparison, betrixaban was shown to be an effective regimen with relative benefits compared with LMWHs and UFH. This indicates that betrixaban could reduce the burden of VTE in at-risk hospitalized patients with acute medical illness who need extended prophylaxis, though without direct comparative evidence, stronger conclusions cannot be drawn

Maintaining families' well-being in everyday life

The aim of this paper is to discuss how everyday life changes for the family in the event of chronic illness or disability. It changes physically due to loss of body function and socially due to time and other constraints related to treatment or lack of mobility. Equally important, there is a psychological impact due to the uncertainty of the future. The article will explore how family participation can help to maintain well-being in everyday life. The family should therefore focus on their own needs as much as on the needs of the family members who are ill. In order to maintain well-being in everyday life, it is crucial for the family to create routines and spend time doing things that they enjoy. By doing this, the family will create a rhythm of well-being regardless of the critical family situation. Family members and professional caregivers also need to come together at the beginning and during the illness or disability event to discuss changes that could be made day-to-day for all those involved, thereby making for an easier transition into care giving

Biological measurement beyond the quantum limit

Quantum noise places a fundamental limit on the per photon sensitivity attainable in optical measurements. This limit is of particular importance in biological measurements, where the optical power must be constrained to avoid damage to the specimen. By using non-classically correlated light, we demonstrated that the quantum limit can be surpassed in biological measurements. Quantum enhanced microrheology was performed within yeast cells by tracking naturally occurring lipid granules with sensitivity 2.4 dB beyond the quantum noise limit. The viscoelastic properties of the cytoplasm could thereby be determined with a 64% improved measurement rate. This demonstration paves the way to apply quantum resources broadly in a biological context

Education and older adults at the University of the Third Age

This article reports a critical analysis of older adult education in Malta. In educational gerontology, a critical perspective demands the exposure of how relations of power and inequality, in their myriad forms, combinations, and complexities, are manifest in late-life learning initiatives. Fieldwork conducted at the University of the Third Age (UTA) in Malta uncovered the political nature of elder-learning, especially with respect to three intersecting lines of inequality - namely, positive aging, elitism, and gender. A cautionary note is, therefore, warranted at the dominant positive interpretations of UTAs since late-life learning, as any other education activity, is not politically neutral.peer-reviewe

The Latent Class Structure of ADHD is stable across informants

Previous studies have looked at the structure of attention-deficit/ hyperactivity disorder (ADHD) using latent class analysis (LCA) of Child Behavior Checklist (CBCL) or Diagnostic and Statistical Manual of Mental Disorders (DSM) symptom structure. These studies have identified distinct classes of children with inattentive, hyperactive, or combined subtypes and have used these classes to refine genetic analyses. The objective of the current report is to determine if the latent class structure of ADHD subtypes is consistent across informant using the Conners' Rating Scales (CRS). LCA was applied to CRS forms from mother, father, and teacher reports of 1837, 1329 and 1048 latency aged Dutch twins, respectively. The optimal solution for boys was a 5-class solution for mothers, a 3-class solution for fathers, and a 4-class solution for teachers. For girls, a 4-class solution for mothers and a 3-class for fathers and teachers was optimal. Children placed into a class by one informant had markedly increased odds ratio of being placed into the same or similar class by the other informants. Results from LCA using Dutch twins with the CRS show stability across informants suggesting that more stable phenotypes may be accessible for genotyping using a multi-informant approach