Equity in new active travel infrastructure: a spatial analysis of London’s new Low Traffic Neighbourhoods

In this article we examine equity in new active travel infrastructure in London, UK. We focus on Low Traffic Neighbourhoods (LTNs) introduced during Covid-19. These area-based schemes mainly involve ‘modal filters’ that restrict through motor traffic from residential streets within a neighbourhood. Such approaches to traffic management are traditional in the Netherlands, but are relatively novel in London and other global cities such as Barcelona. LTNs are often controversial, with one criticism being that they are implemented in affluent areas and hence benefit richer residents. London represents an excellent opportunity to investigate whether these rapidly introduced schemes have so far been equitably distributed. We focused on LTNs introduced between March and September 2020 and still present at the end of October 2020. Having generated datasets representing these new LTN locations and their boundary roads, we matched these to Output Areas (OAs, administrative areas containing around 300 residents). We then examined the extent to which LTN implementation was associated with age, ethnicity, disability, employment and car ownership (using Census 2011 data) and small-area deprivation (using the Index of Multiple Deprivation 2019). We estimated that 3.7% of all Londoners live inside a new LTN, and 8.9% live within 500 m walking distance of a new modal filter. Across London as a whole, people in the most deprived quarter of OAs were 2.5 times more likely to live in a new LTN, compared to Londoners in the least deprived quarter. While overall Black, Asian and Minority Ethnic (BAME) people were slightly more likely than White Londoners to live in a new LTN, this varied by ethnic group. Specifically, Black Londoners were somewhat more likely, and Asian Londoners somewhat less likely than White people to live in a new LTN. Car-free households were more likely to live in a new LTN. We also examined equity within London's districts, which lead on implementation of LTNs. In the median district, people in more deprived areas were more likely to live in an LTN than people in less deprived areas, suggesting that, on average, individual districts have prioritised their more deprived areas. However, in the median district, BAME residents were slightly less likely to live in an LTN than White residents. Across districts implementing LTNs there was wide variation, with some much more or less equitable than others. A third of districts implemented no LTNs at all. Finally, at the micro level, residents living in LTNs were demographically similar to neighbours living in OAs that touched an LTN boundary road. We conclude that LTN implementation has been broadly equitable at the city and micro levels, but the picture is more mixed at the district level, despite districts being encouraged to consider deprivation when planning LTN locations. Equity metrics should be used in policy and research to monitor and improve the distribution of active travel interventions

‘Why has my world become more confusing than it used to be?’ Professional doctoral students reflect on the development of their identity

This article reports on research into the experience of professional doctoral students and is written by the students themselves. We, the authors, are currently studying for the Doctorate in Education at the University of Manchester, UK. We place our work in the context of recent empirical research into the development of doctoral student identity, noting that these literatures are usually authored by programme directors and supervisors. Using a theoretical approach based on the work of Etienne Wenger, we examine how the aims and curriculum of our programme interplay with our professional learning. In interviews with our cohort of students, we explore the complexity and non-linearity of learning. We do not find a simple progression from practitioner to researcher; rather, we find a fluid and complex relationship between those two identities. We consider the extent to which Wenger’s modes of identification are a useful conceptual tool for understanding this interplay and for theorising about our findings. We conclude that there is further scope for the development of our theoretical framework by drawing on other scholarly work on identity development and reflexivit

Equity in new active travel infrastructure: A spatial analysis of London's new Low Traffic Neighbourhoods

In this article we examine equity in new active travel infrastructure in London, UK. We focus on Low Traffic Neighbourhoods (LTNs) introduced during Covid-19. These area-based schemes mainly involve ‘modal filters’ that restrict through motor traffic from residential streets within a neighbourhood. Such approaches to traffic management are traditional in the Netherlands, but are relatively novel in London and other global cities such as Barcelona. LTNs are often controversial, with one criticism being that they are implemented in affluent areas and hence benefit richer residents. London represents an excellent opportunity to investigate whether these rapidly introduced schemes have so far been equitably distributed. We focused on LTNs introduced between March and September 2020 and still present at the end of October 2020. Having generated datasets representing these new LTN locations and their boundary roads, we matched these to Output Areas (OAs, administrative areas containing around 300 residents). We then examined the extent to which LTN implementation was associated with age, ethnicity, disability, employment and car ownership (using Census 2011 data) and small-area deprivation (using the Index of Multiple Deprivation 2019). We estimated that 3.7% of all Londoners live inside a new LTN, and 8.9% live within 500 m walking distance of a new modal filter. Across London as a whole, people in the most deprived quarter of OAs were 2.5 times more likely to live in a new LTN, compared to Londoners in the least deprived quarter. While overall Black, Asian and Minority Ethnic (BAME) people were slightly more likely than White Londoners to live in a new LTN, this varied by ethnic group. Specifically, Black Londoners were somewhat more likely, and Asian Londoners somewhat less likely than White people to live in a new LTN. Car-free households were more likely to live in a new LTN. We also examined equity within London's districts, which lead on implementation of LTNs. In the median district, people in more deprived areas were more likely to live in an LTN than people in less deprived areas, suggesting that, on average, individual districts have prioritised their more deprived areas. However, in the median district, BAME residents were slightly less likely to live in an LTN than White residents. Across districts implementing LTNs there was wide variation, with some much more or less equitable than others. A third of districts implemented no LTNs at all. Finally, at the micro level, residents living in LTNs were demographically similar to neighbours living in OAs that touched an LTN boundary road. We conclude that LTN implementation has been broadly equitable at the city and micro levels, but the picture is more mixed at the district level, despite districts being encouraged to consider deprivation when planning LTN locations. Equity metrics should be used in policy and research to monitor and improve the distribution of active travel interventions

The Contact Structure of Great Britain's Salmon and Trout Aquaculture Industry

We analyse the network structure of the British salmonid aquaculture industry from the perspective of infectious disease control. We combine for the first time live fish transport (or movement) data covering England and Wales with data covering Scotland and include network layers representing potential transmission by rivers, sea water and local transmission via human or animal vectors in the immediate vicinity of each farm or fishery site. We find that 7.2% of all live fish transports cross the England-Scotland border and network analysis shows that 87% of English and Welsh sites and 72% of Scottish sites are reachable from cross-border connections via live fish transports alone. Consequently, from a disease-control perspective, the contact structures of England and Wales and of Scotland should not be considered in isolation. We also show that large epidemics require the live fish movement network and so control strategies targeting movements can be very effective. While there is relatively low risk of widespread epidemics on the live fish transport network alone, the potential risk is substantially amplified by the combined interaction of multiple network layers

Multimodal Imaging Techniques Show Differences in Homing Capacity Between Mesenchymal Stromal Cells and Macrophages in Mouse Renal Injury Models

The question of whether mesenchymal stromal cells (MSCs) home to injured kidneys remains a contested issue. To try and understand the basis for contradictory findings reported in the literature, our purpose here was to investigate whether MSC homing capacity is influenced by administration route, the type of injury model used, and/or the presence of exogenous macrophages. PROCEDURES: To assess the viability, whole-body biodistribution, and intra-renal biodistribution of MSCs, we used a multimodal imaging strategy comprising bioluminescence and magnetic resonance imaging. The effect of administration route (venous or arterial) on the ability of MSCs to home to injured renal tissue, and persist there, was assessed in a glomerular injury model (induced by the nephrotoxicant, Adriamycin) and a tubular injury model induced by ischaemia-reperfusion injury (IRI). Exogenous macrophages were used as a positive control because these cells are known to home to injured mouse kidneys. To assess whether the homing capacity of MSCs can be influenced by the presence of exogenous macrophages, we used a dual-bioluminescence strategy that allowed the whole-body biodistribution of the two cell types to be monitored simultaneously in individual animals. RESULTS: Following intravenous administration, no MSCs were detected in the kidneys, irrespective of whether the mice had been subjected to renal injury. After arterial administration via the left cardiac ventricle, MSCs transiently populated the kidneys, but no preferential homing or persistence was observed in injured renal tissue after unilateral IRI. An exception was when MSCs were co-administered with exogenous macrophages; here, we observed some homing of MSCs to the injured kidney. CONCLUSIONS: Our findings strongly suggest that MSCs do not home to injured kidneys

Murine models of renal ischemia reperfusion injury: An opportunity for refinement using noninvasive monitoring methods

BACKGROUND: Renal ischemia reperfusion injury (R‐IRI) can cause acute kidney injury (AKI) and chronic kidney disease (CKD), resulting in significant morbidity and mortality. To understand the underlying mechanisms, reproducible small‐animal models of AKI and CKD are needed. We describe how innovative technologies for measuring kidney function noninvasively in small rodents allow successful refinement of the R‐IRI models, and offer the unique opportunity to monitor longitudinally in individual animals the transition from AKI to CKD. METHODS: Male BALB/c mice underwent bilateral renal pedicle clamping (AKI) or unilateral renal pedicle clamping with delayed contralateral nephrectomy (CKD) under isoflurane anesthetic. Transdermal GFR monitoring and multispectral optoacoustic tomography (MSOT) in combination with statistical analysis were used to identify and standardize variables within these models. RESULTS: Pre‐clamping anesthetic time was one of the most important predictors of AKI severity after R‐IRI. Standardizing pre‐clamping time resulted in a more predictably severe AKI model. In the CKD model, MSOT demonstrated initial improvement in renal function, followed by significant progressive reduction in function between weeks 2 and 4. Performing contralateral nephrectomy on day 14 enabled the development of CKD with minimal mortality. CONCLUSIONS: Noninvasive monitoring of global and individual renal function after R‐IRI is feasible and reproducible. These techniques can facilitate refinement of kidney injury models and enable the degree of injury seen in preclinical models to be translated to those seen in the clinical setting. Thus, future therapies can be tested in a clinically relevant, noninvasive manner

A cluster randomized trial to reduce HIV risk from outside partnerships in Zambian HIV-Negative couples using a novel behavioral intervention, "Strengthening Our Vows": Study protocol and baseline data.

BACKGROUND: Heterosexual couples contribute to most new HIV infections in areas of generalized HIV epidemics in sub-Saharan Africa. After Couples' Voluntary HIV Counseling and Testing (CVCT), heterosexual concordant HIV negative couples (CNC) in cohabiting unions contribute to approximately 47% of residual new infections in couples. These infections are attributed to concurrent sexual partners, a key driver of the HIV epidemic in Zambia. METHODS/DESIGN: Ten Zambian government clinics in two of the largest cities were randomized in matched pairs to a Strengthening Our Vows (SOV) intervention or a Good Health Package (GHP) comparison arm. SOV addressed preventing HIV infection from concurrent partners and protecting spouses after exposures outside the relationship. GHP focused on handwashing; water chlorination; household deworming; and screening for hypertension, diabetes and schistosomiasis. CNC were referred from CVCT services in government clinics. Follow-up includes post-intervention questionnaires and outcome assessments through 60 months. Longitudinal outcomes of interest include self-report and laboratory markers of condomless sex with outside partners and reported sexual agreements. We present baseline characteristics and factors associated with study arm and reported risk using descriptive statistics. RESULTS: The mean age of men was 32 and 26 for women. On average, couples cohabited for 6 years and had 2 children. Baseline analyses demonstrated some failures of randomization by study arm which will be considered in future primary analyses of longitudinal data. An HIV/STI risk factor composite was not different in the two study arms. Almost one-quarter of couples had an HIV risk factor at baseline. DISCUSSION: In preparation for future biomedical and behavioral interventions in sub-Saharan Africa, it is critical to understand and decrease HIV risk within CNC

Non-invasive imaging reveals conditions that impact distribution and persistence of cells after in vivo administration

Background: Cell-based regenerative medicine therapies are now frequently tested in clinical trials. In many conditions, cell therapies are administered systemically, but there is little understanding of their fate, and adverse events are often under-reported. Currently, it is only possible to assess safety and fate of cell therapies in preclinical studies, specifically by monitoring animals longitudinally using multimodal imaging approaches. Here, using a suite of in vivo imaging modalities to explore the fate of a range of human and murine cells, we investigate how route of administration, cell type and host immune status affect the fate of administered cells. Methods: We applied a unique imaging toolkit combining bioluminescence, optoacoustic and magnetic resonance imaging modalities to assess the safety of different human and murine cell types by following their biodistribution and persistence in mice following administration into the venous or arterial system. Results: Longitudinal imaging analyses (i) suggested that the intra-arterial route may be more hazardous than intravenous administration for certain cell types; (ii) revealed that the potential of a mouse mesenchymal stem/stromal cell (MSC) line to form tumours, depended on administration route and mouse strain; and (iii) indicated that clinically tested human umbilical cord (hUC)-derived MSCs can transiently and unexpectedly proliferate when administered intravenously to mice. Conclusions: In order to perform an adequate safety assessment of potential cell-based therapies, a thorough understanding of cell biodistribution and fate post administration is required. The non-invasive imaging toolbox used here can expose not only the general organ distribution of these therapies, but also a detailed view of their presence within different organs and, importantly, tumourigenic potential. Our observation that the hUC-MSCs but not the human bone marrow (hBM)-derived MSCs persisted for a period in some animals, suggests that therapies with these cells should proceed with caution