Case 3: North Middlesex University Hospital Trust and MiddlesexUniversity: a blended learning language skills programme

A case study is presented of a blended learning course, English Language and Communication for Clinical Practice, which was provided for North Middlesex University Hospital by the Academic Writing and Language Team at Middesex Universit

Stuck in the slow lane: reconceptualising the links between gender, transport and social exclusion

This article draws upon primary research undertaken with over 3,000 women in the North East of England to explore the links between women, transport and the labour market. The research, funded by the ESF, advances the idea of spatiality as a social construction and builds on seminal studies relating to women and poverty to consider the way in which a gender division of transport constrains women's mobility and restricts their employment opportunities. It is likely to contribute to important debates, concerning strategies to tackle worklessness and the most effective spatial level at which to configure public transport networks

Financing water resource infrastructure, 1987 September 1

The contents of this paper were drafted from a workgroup report to an Engineering Foundation Conference entitled Financing and Amortizing Water Resources Infrastructure held at Palm Coast, Florida, March 29-April 3, 1987. A slightly different version of this paper appeared in the conference proceedings

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

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

Dissimilarity of the gut-lung axis and dysbiosis of the lower airways in ventilated preterm infants

Background: Chronic lung disease of prematurity (CLD), also called bronchopulmonary dysplasia, is a major consequence of preterm birth but the role of the microbiome in its development remains unclear. We, therefore, assessed the progression of the bacterial community in ventilated preterm infants over time in the upper and lower airways, and assessed the gut-lung axis by comparing the upper and lower airways bacterial communities with the stool findings. Finally, we assessed if the bacterial communities were associated with lung inflammation to suggest dysbiosis. Methods: We serially sampled multiple anatomical sites including the upper airway (nasopharyngeal aspirates, NPA), lower airways (tracheal aspirate fluid, TAF, and bronchoalveolar lavage fluid, BAL) and the gut (stool) of ventilated preterm-born infants. Bacterial DNA load was measured in all samples and sequenced using the V3-V4 region of the 16S rRNA gene Results: From 1,102 (539 NPA, 276 TAF, 89 BAL, 198 stool) samples from 55 preterm infants, 352 (32%) amplified suitably for 16s RNA gene sequencing. Bacterial load was low at birth, quickly increased with time but was associated with predominant operational taxonomic units (OTUs) in all sample types. There was dissimilarity in bacterial communities between the upper and lower airways and the gut with a separate dysbiotic inflammatory process occurring in the lower airways of infants. Individual OTUs were associated with increased inflammatory markers. Conclusions: Taken together, these findings suggest that targeted treatment of the predominant organisms, including those not routinely treated such as Ureaplasma spp., may decrease the development of CLD in preterm-born infants

Large-scale genome-wide association studies and meta-analyses of longitudinal change in adult lung function.

BACKGROUND: Genome-wide association studies (GWAS) have identified numerous loci influencing cross-sectional lung function, but less is known about genes influencing longitudinal change in lung function. METHODS: We performed GWAS of the rate of change in forced expiratory volume in the first second (FEV1) in 14 longitudinal, population-based cohort studies comprising 27,249 adults of European ancestry using linear mixed effects model and combined cohort-specific results using fixed effect meta-analysis to identify novel genetic loci associated with longitudinal change in lung function. Gene expression analyses were subsequently performed for identified genetic loci. As a secondary aim, we estimated the mean rate of decline in FEV1 by smoking pattern, irrespective of genotypes, across these 14 studies using meta-analysis. RESULTS: The overall meta-analysis produced suggestive evidence for association at the novel IL16/STARD5/TMC3 locus on chromosome 15 (P  =  5.71 × 10(-7)). In addition, meta-analysis using the five cohorts with ≥3 FEV1 measurements per participant identified the novel ME3 locus on chromosome 11 (P  =  2.18 × 10(-8)) at genome-wide significance. Neither locus was associated with FEV1 decline in two additional cohort studies. We confirmed gene expression of IL16, STARD5, and ME3 in multiple lung tissues. Publicly available microarray data confirmed differential expression of all three genes in lung samples from COPD patients compared with controls. Irrespective of genotypes, the combined estimate for FEV1 decline was 26.9, 29.2 and 35.7 mL/year in never, former, and persistent smokers, respectively. CONCLUSIONS: In this large-scale GWAS, we identified two novel genetic loci in association with the rate of change in FEV1 that harbor candidate genes with biologically plausible functional links to lung function

Lighting for cycling in the UK : a review

While UK governments have recently sought to increase cycling activity, it remains a minority interest. One reason for this is the perceived danger of cycling on roads filled with traffic. There is statistical evidence to support this perception; for equal exposure, cyclists are more likely to be seriously injured than either drivers or pedestrians. Lighting has a role to play in reducing the hazards of cycling by enhancing the visibility and conspicuity of cyclists. Unfortunately, it is not at all clear that the current lighting regulations and recommendations for cycling and cyclists are the best that can be achieved or are even adequate for these purposes. A number of actions are suggested that should enable lighting’s contribution to the safety of cyclists to be realized