London’s approaches to tackling climate change after the 21st century are multifaceted and relatively systematic.The aim of this research paper is to analyse London’s actions in response to climate change and to dra...London’s approaches to tackling climate change after the 21st century are multifaceted and relatively systematic.The aim of this research paper is to analyse London’s actions in response to climate change and to draw out what valuable lessons London has for the world in terms of its response to climate change.This paper provides an in-depth analysis of London’s policies and actions on climate mitigation in the areas of“greenhouse gas emissions”and“energy infrastructure”,and climate adaptation actions in the areas of“city green belt and urban afforestation”,“UHI and thermal crisis management”and“water supply infrastructure and sustainable drainage”.It then examines the positive aspects of these actions to determine what London has to say about climate change to the rest of the world and other cities.This paper also discovers that to effectively mitigate and adapt to climate change,London has not only established carbon reduction targets,but also created a large academic research network,represented by the LCCP.At the same time,London has developed a scientific climate change adaptation planning framework(P2R2)that focuses on four key areas:Economic,environmental,health,and infrastructure sectors,and three types of risks:Flooding,heat,and water supply,and emphasizes the dynamics and flexibility of each adaptation strategy.展开更多
Atmospheric particles in central London during July 1996 have been apportioned to sources by two complimentary techniques: (1) morphological characteristics, determined using high power light microscopy; (2) chemical...Atmospheric particles in central London during July 1996 have been apportioned to sources by two complimentary techniques: (1) morphological characteristics, determined using high power light microscopy; (2) chemical composition determined by energy dispersive spectroscopy. During the study period, the majority of particles were found to be either biological in origin, or from vehicle related combustion processes. Trends in the latter group of particles are explored further. Numbers of particles per cubic metre were determined at an hourly resolution over a period of six days, and were found to be significantly correlated with other traffic pollutants such as benzene and 1,3 butadiene, although there is no relationship with mass of PM10 as measured by a nearby UK Government monitoring station. We suggest in this paper that numbers of particles from car exhausts are more representative of traffic pollution than current estimates which use monitoring by mass.展开更多
AIM:It is difficult for Optometrists and General Practitioners to know which patients are at risk. The East London glaucoma prediction score (ELGPS) is a web based risk calculator that has been developed to determine ...AIM:It is difficult for Optometrists and General Practitioners to know which patients are at risk. The East London glaucoma prediction score (ELGPS) is a web based risk calculator that has been developed to determine Glaucoma risk at the time of screening. Multiple risk factors that are available in a low tech environment are assessed to provide a risk assessment. This is extremely useful in settings where access to specialist care is difficult. Use of the calculator is educational. It is a free web based service. Data capture is user specific. METHODS:The scoring system is a web based questionnaire that captures and subsequently calculates the relative risk for the presence of Glaucoma at the time of screening. Three categories of patient are described:Unlikely to have Glaucoma; Glaucoma Suspect and Glaucoma. A case review methodology of patients with known diagnosis is employed to validate the calculator risk assessment. RESULTS:Data from the patient records of 400 patients with an established diagnosis has been captured and used to validate the screening tool. The website reports that the calculated diagnosis correlates with the actual diagnosis 82% of the time. Biostatistics analysis showed:Sensitivity = 88% ; Positive predictive value = 97%; Specificity = 75%. CONCLUSION:Analysis of the first 400 patients validates the web based screening tool as being a good method of screening for the at risk population. The validation is ongoing. The web based format will allow a more widespread recruitment for different geographic, population and personnel variables.展开更多
Background People with schizophrenia have a high premature mortality risk.Obesity is a key potential underlying risk factor that is relatively unevaluated to date.Aims In this study,we investigated the associations of...Background People with schizophrenia have a high premature mortality risk.Obesity is a key potential underlying risk factor that is relatively unevaluated to date.Aims In this study,we investigated the associations of routinely recorded body size with all-cause mortality and deaths from common causes in a large cohort of people with schizophrenia spectrum disorders.Methods We assembled a retrospective observational cohort using data from a large mental health service in South London.We followed all patients over the age of 18 years with a clinical diagnosis of schizophrenia spectrum disorders from the date of their first recorded body mass index(BMI)between 1 January 2007 and 31 March 2018.Results Of 11900 patients with a BMI recording,1566 died.The Cox proportional hazards regression models,after adjusting for sociodemographic,socioeconomic variables and comorbidities,indicated that all-cause mortality was only associated with underweight status compared with healthy weight status(hazard ratio(HR):1.33,95%confidence interval(CI):1.01 to 1.76).Obesity(HR:1.24,95%CI:1.01 to 1.52)and morbid obesity(HR:1.54,95%CI:1.03 to 2.42)were associated with all-cause mortality in the 18–45 years age range,and obesity was associated with lower risk(HR:0.66,95%CI:0.50 to 0.87)in those aged 65+years.Cancer mortality was raised in underweight individuals(HR:1.93,95%CI:1.03 to 4.10)and respiratory disease mortality raised in those with morbid obesity(HR:2.17,95%CI:1.02 to 5.22).Conclusions Overall,being underweight was associated with higher mortality in this disorder group;however,this was potentially accounted for by frailty in older age groups,and obesity was a risk factor for premature mortality in younger ages.The impact of obesity on life expectancy for people with schizophrenia spectrum disorders is clear from our findings.A deeper biological understanding of the relationship between these diseases and schizophrenia will help improve clinical practice.展开更多
Background Experiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers(HCWs).This may have serious consequences for the overall well-being of HCWs...Background Experiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers(HCWs).This may have serious consequences for the overall well-being of HCWs,which in turn may adversely affect patient safety and the productivity of the institution.Aims We designed a study to assess the prevalence of generalised anxiety disorder(GAD),depression and work-related stress experienced by the National Health Service staff in a large tertiary London hospital treating patients with COVID-19 during the current active phase of the COVID-19 era.Methods An anonymous survey was designed with demographic data and three questionnaires.The Generalised Anxiety Disorder-7(GAD-7)and Patient Health Questionnaire-9 were used to assess anxiety and depression,respectively.The Health and Safety Executive Management Standards Indicator Tool was used to assess work-related stress.Staff from multiple specialties embracing cardiothoracic surgery,cardiology,respiratory medicine,endocrinology,oncology,imaging,anaesthesia and intensive care at our hospital were asked to complete the questionnaire between 25 May and 15 June 2020.Results A total of 302 staff members(106 males and 196 females)completed the survey.The overall prevalence of GAD and depression was 41.4%and 42.7%,respectively.The prevalence of GAD and depression was significantly higher in females than in males and was statistically significant.Nurses were four times more likely to report moderate to severe levels of anxiety and depression as compared with doctors.Work-related stress was also observed to be prevalent in our surveyed population with the following standards:relationships,role,control and change showing a need for improvement.Conclusions Our study presents early evidence suggestive of a high prevalence of GAD,depression and work-related stress in HCWs.It is imperative that coherent strategies are implemented to improve the healthcare work environment during this pandemic and mitigate further injury to the mental health status of the healthcare population.展开更多
This work focuses on examining the possible advantages for the urban sustainability,derived from the integration of transport,land use and energy systems.The main aim is to develop a GIS-based method that can help dec...This work focuses on examining the possible advantages for the urban sustainability,derived from the integration of transport,land use and energy systems.The main aim is to develop a GIS-based method that can help decision makers,either public or private,improve the economic,social and environmental sustainability of urban areas through an integrated transformation approach.As a result,it was possible to provide a spatial analysis technique based on seven synthetic variables and on the application of a cluster method able to identify the portions of urban areas where investments and urban integrated transformation processes can be more suitable,according to the dynamic relationships among transport,land use and energy systems.The methodology was applied to the Greater London area and led to significant results:the cluster classes follow the transport railway network evolution within the study area boundary.The paper is organized as follows:in Section 1 the integration of transport,land use and energy planning is investigated;following the introduction,in Section 2,the GIS-based method is presented,followed by a description of the application to the Greater London area;in Section 4,findings of the methodology are explained.In the last section,results and future developments are discussed.展开更多
文摘London’s approaches to tackling climate change after the 21st century are multifaceted and relatively systematic.The aim of this research paper is to analyse London’s actions in response to climate change and to draw out what valuable lessons London has for the world in terms of its response to climate change.This paper provides an in-depth analysis of London’s policies and actions on climate mitigation in the areas of“greenhouse gas emissions”and“energy infrastructure”,and climate adaptation actions in the areas of“city green belt and urban afforestation”,“UHI and thermal crisis management”and“water supply infrastructure and sustainable drainage”.It then examines the positive aspects of these actions to determine what London has to say about climate change to the rest of the world and other cities.This paper also discovers that to effectively mitigate and adapt to climate change,London has not only established carbon reduction targets,but also created a large academic research network,represented by the LCCP.At the same time,London has developed a scientific climate change adaptation planning framework(P2R2)that focuses on four key areas:Economic,environmental,health,and infrastructure sectors,and three types of risks:Flooding,heat,and water supply,and emphasizes the dynamics and flexibility of each adaptation strategy.
文摘Atmospheric particles in central London during July 1996 have been apportioned to sources by two complimentary techniques: (1) morphological characteristics, determined using high power light microscopy; (2) chemical composition determined by energy dispersive spectroscopy. During the study period, the majority of particles were found to be either biological in origin, or from vehicle related combustion processes. Trends in the latter group of particles are explored further. Numbers of particles per cubic metre were determined at an hourly resolution over a period of six days, and were found to be significantly correlated with other traffic pollutants such as benzene and 1,3 butadiene, although there is no relationship with mass of PM10 as measured by a nearby UK Government monitoring station. We suggest in this paper that numbers of particles from car exhausts are more representative of traffic pollution than current estimates which use monitoring by mass.
文摘AIM:It is difficult for Optometrists and General Practitioners to know which patients are at risk. The East London glaucoma prediction score (ELGPS) is a web based risk calculator that has been developed to determine Glaucoma risk at the time of screening. Multiple risk factors that are available in a low tech environment are assessed to provide a risk assessment. This is extremely useful in settings where access to specialist care is difficult. Use of the calculator is educational. It is a free web based service. Data capture is user specific. METHODS:The scoring system is a web based questionnaire that captures and subsequently calculates the relative risk for the presence of Glaucoma at the time of screening. Three categories of patient are described:Unlikely to have Glaucoma; Glaucoma Suspect and Glaucoma. A case review methodology of patients with known diagnosis is employed to validate the calculator risk assessment. RESULTS:Data from the patient records of 400 patients with an established diagnosis has been captured and used to validate the screening tool. The website reports that the calculated diagnosis correlates with the actual diagnosis 82% of the time. Biostatistics analysis showed:Sensitivity = 88% ; Positive predictive value = 97%; Specificity = 75%. CONCLUSION:Analysis of the first 400 patients validates the web based screening tool as being a good method of screening for the at risk population. The validation is ongoing. The web based format will allow a more widespread recruitment for different geographic, population and personnel variables.
基金the National Institute for Health Research(NIHR)Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King’s College Londonthe National Institute for Health Research(NIHR)Applied Research Collaboration South London(NIHR ARC South London)at King’s College Hospital NHS Foundation Trust+5 种基金the DATAMIND HDR UK Mental Health Data Hub(MRC grant MR/W014386)JC is part-funded by:King's College London-K C Wong Postdoctoral Fellowships,Shanghai Youth Top-notch Talent Support Program,Shanghai Municipal Education CommissionGaofeng Clinical Medicine Grant Support,Shanghai Key Laboratory of Psychotic Disorders(13dz2260500)Shanghai Clinical Research Centre for Mental Health(19MC1911100)Program of Shanghai Academic/Technology Research Leader(21XD1423300)Shanghai Pujiang Program(21PJD063)GP is funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.
文摘Background People with schizophrenia have a high premature mortality risk.Obesity is a key potential underlying risk factor that is relatively unevaluated to date.Aims In this study,we investigated the associations of routinely recorded body size with all-cause mortality and deaths from common causes in a large cohort of people with schizophrenia spectrum disorders.Methods We assembled a retrospective observational cohort using data from a large mental health service in South London.We followed all patients over the age of 18 years with a clinical diagnosis of schizophrenia spectrum disorders from the date of their first recorded body mass index(BMI)between 1 January 2007 and 31 March 2018.Results Of 11900 patients with a BMI recording,1566 died.The Cox proportional hazards regression models,after adjusting for sociodemographic,socioeconomic variables and comorbidities,indicated that all-cause mortality was only associated with underweight status compared with healthy weight status(hazard ratio(HR):1.33,95%confidence interval(CI):1.01 to 1.76).Obesity(HR:1.24,95%CI:1.01 to 1.52)and morbid obesity(HR:1.54,95%CI:1.03 to 2.42)were associated with all-cause mortality in the 18–45 years age range,and obesity was associated with lower risk(HR:0.66,95%CI:0.50 to 0.87)in those aged 65+years.Cancer mortality was raised in underweight individuals(HR:1.93,95%CI:1.03 to 4.10)and respiratory disease mortality raised in those with morbid obesity(HR:2.17,95%CI:1.02 to 5.22).Conclusions Overall,being underweight was associated with higher mortality in this disorder group;however,this was potentially accounted for by frailty in older age groups,and obesity was a risk factor for premature mortality in younger ages.The impact of obesity on life expectancy for people with schizophrenia spectrum disorders is clear from our findings.A deeper biological understanding of the relationship between these diseases and schizophrenia will help improve clinical practice.
文摘Background Experiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers(HCWs).This may have serious consequences for the overall well-being of HCWs,which in turn may adversely affect patient safety and the productivity of the institution.Aims We designed a study to assess the prevalence of generalised anxiety disorder(GAD),depression and work-related stress experienced by the National Health Service staff in a large tertiary London hospital treating patients with COVID-19 during the current active phase of the COVID-19 era.Methods An anonymous survey was designed with demographic data and three questionnaires.The Generalised Anxiety Disorder-7(GAD-7)and Patient Health Questionnaire-9 were used to assess anxiety and depression,respectively.The Health and Safety Executive Management Standards Indicator Tool was used to assess work-related stress.Staff from multiple specialties embracing cardiothoracic surgery,cardiology,respiratory medicine,endocrinology,oncology,imaging,anaesthesia and intensive care at our hospital were asked to complete the questionnaire between 25 May and 15 June 2020.Results A total of 302 staff members(106 males and 196 females)completed the survey.The overall prevalence of GAD and depression was 41.4%and 42.7%,respectively.The prevalence of GAD and depression was significantly higher in females than in males and was statistically significant.Nurses were four times more likely to report moderate to severe levels of anxiety and depression as compared with doctors.Work-related stress was also observed to be prevalent in our surveyed population with the following standards:relationships,role,control and change showing a need for improvement.Conclusions Our study presents early evidence suggestive of a high prevalence of GAD,depression and work-related stress in HCWs.It is imperative that coherent strategies are implemented to improve the healthcare work environment during this pandemic and mitigate further injury to the mental health status of the healthcare population.
文摘This work focuses on examining the possible advantages for the urban sustainability,derived from the integration of transport,land use and energy systems.The main aim is to develop a GIS-based method that can help decision makers,either public or private,improve the economic,social and environmental sustainability of urban areas through an integrated transformation approach.As a result,it was possible to provide a spatial analysis technique based on seven synthetic variables and on the application of a cluster method able to identify the portions of urban areas where investments and urban integrated transformation processes can be more suitable,according to the dynamic relationships among transport,land use and energy systems.The methodology was applied to the Greater London area and led to significant results:the cluster classes follow the transport railway network evolution within the study area boundary.The paper is organized as follows:in Section 1 the integration of transport,land use and energy planning is investigated;following the introduction,in Section 2,the GIS-based method is presented,followed by a description of the application to the Greater London area;in Section 4,findings of the methodology are explained.In the last section,results and future developments are discussed.