Road traffic noise has been associated with hypertension but evidence for the long-term effects on hospital admissions and mortality is limited. We examined the effects of long-term exposure to road ...traffic noise on hospital admissions and mortality in the general population.
The study population consisted of 8.6 million inhabitants of London, one of Europe's largest cities. We assessed small-area-level associations of day- (7:00-22:59) and nighttime (23:00-06:59) road traffic noise with cardiovascular hospital admissions and all-cause and cardiovascular mortality in all adults (≥25 years) and elderly (≥75 years) through Poisson regression models. We adjusted models for age, sex, area-level socioeconomic deprivation, ethnicity, smoking, air pollution, and neighbourhood spatial structure. Median daytime exposure to road traffic noise was 55.6 dB. Daytime road traffic noise increased the risk of hospital admission for stroke with relative risk (RR) 1.05 95% confidence interval (CI): 1.02-1.09 in adults, and 1.09 (95% CI: 1.04-1.14) in the elderly in areas >60 vs. <55 dB. Nighttime noise was associated with stroke admissions only among the elderly. Daytime noise was significantly associated with all-cause mortality in adults RR 1.04 (95% CI: 1.00-1.07) in areas >60 vs. <55 dB. Positive but non-significant associations were seen with mortality for cardiovascular and ischaemic heart disease, and stroke. Results were similar for the elderly.
Long-term exposure to road traffic noise was associated with small increased risks of all-cause mortality and cardiovascular mortality and morbidity in the general population, particularly for stroke in the elderly.
To gain a better understanding on the spatiotemporal variation of ultrafine particles (UFPs) in urban environments, this study reports on the first results of a long-term UFP monitoring network, set ...up in Amsterdam (NL), Antwerp (BE), Leicester (UK) and London (UK). Total number concentrations and size distributions were assessed during 1–2 years at four fixed urban background sites, supplemented with mobile trailer measurements for co-location monitoring and additional short-term monitoring sites. Intra- and interurban spatiotemporal UFP variation, associations with commonly-monitored pollutants (PM, NOx and BC) and impacts of wind fields were evaluated. Although comparable size distributions were observed between the four cities, source-related differences were demonstrated within specific particle size classes. Total and size-resolved particle number concentrations showed clear traffic-related temporal variation, confirming road traffic as the major UFP contributor in urban environments. New particle formation events were observed in all cities. Correlations with typical traffic-related pollutants (BC and NOx) were obtained for all monitoring stations, except for Amsterdam, which might be attributable to UFP emissions from Schiphol airport. The temporal variation in particle number concentration correlated fairly weakly between the four cities (rs = 0.28−0.50, COD = 0.28−0.37), yet improved significantly inside individual cities (rs = 0.59−0.77). Nevertheless, considerable differences were still obtained in terms of particle numbers (20–38% for total particle numbers and up to 49% for size-resolved particle numbers), confirming the importance of local source contributions and the need for careful consideration when allocating UFP monitoring stations in heterogeneous urban environments.
•We evaluated spatiotemporal UFP levels in Amsterdam, Antwerp, Leicester and London.•Size-resolved particle numbers provide valuable information on contributing sources.•Road traffic seems to be a major UFP contributor in the studied urban environments.•New particle formation (NPF) events were observed in all cities.•Consideration is needed when allocating UFP monitoring sites in urban environments.
The higher prevalence of fast food outlets in deprived areas has been associated with the production and maintenance of geographical inequalities in diet. In the UK one type of fast food outlet - the ...‘chicken shop’ - has been the focus of intense public health and media interest. Despite ongoing concerns and initiatives around regulating these establishments, the ‘chicken shop’ is both a commercially successful and ubiquitous feature of disadvantaged urban neighbourhoods. However, little is known about how they are perceived by local residents. We report data from a qualitative study of neighbourhood perceptions in a low SES urban setting. Narrative family interviews, go-along interviews and school video focus group workshops with 66 residents of East London were conducted over two waves. The topic of chicken shops was a prolific theme and a narrative analysis of these accounts revealed that local perceptions of chicken shops are complex and contradictory. Chicken shops were depicted as both potentially damaging for the health of local residents and, at the same time, as valued community spaces. This contradiction was discursively addressed in narrative via a series of rhetorical rebuttals that negated their potential to damage health on the grounds of concepts such as trust, choice, balance, food hygiene and compensatory physical activity. In some instances, chicken shops were described as ‘healthy’ and patronising them constructed as part of a healthy lifestyle. Chicken shops are embedded in the social fabric of neighbourhoods. Successful strategies to improve diet therefore requires context-sensitive environmental interventions.
In recent years the importance of London dispersion forces as the attractive part of the van der Waals potential has been recognized for structural stability, catalysis and chemical reactivity. ...Though known for decades, the determination of the strength of dispersive interactions between certain groups remains a challenging task. Geometrically well‐defined molecular model systems offer the possibility to systematically examine and quantify the London dispersion contribution to interaction energies. The incorporation of control systems in the analysis allows dissecting the interaction of interest from other effects. The knowledge gained from these endeavours will provide the necessary basis to include London dispersion in the design of chemical processes and functional materials.
Various molecular systems for the quantification of London dispersion of different groups have been reviewed. Each has its benefits and drawbacks. In general, the detailed knowledge of the contribution of London dispersion of specific groups will provide valuable guidelines for the design of molecular structures as well as processes.
IntroductionStandards for Reporting of Diagnostic Accuracy Study (STARD) was developed to improve the completeness and transparency of reporting in studies investigating diagnostic test accuracy. ...However, its current form, STARD 2015 does not address the issues and challenges raised by artificial intelligence (AI)-centred interventions. As such, we propose an AI-specific version of the STARD checklist (STARD-AI), which focuses on the reporting of AI diagnostic test accuracy studies. This paper describes the methods that will be used to develop STARD-AI.Methods and analysisThe development of the STARD-AI checklist can be distilled into six stages. (1) A project organisation phase has been undertaken, during which a Project Team and a Steering Committee were established; (2) An item generation process has been completed following a literature review, a patient and public involvement and engagement exercise and an online scoping survey of international experts; (3) A three-round modified Delphi consensus methodology is underway, which will culminate in a teleconference consensus meeting of experts; (4) Thereafter, the Project Team will draft the initial STARD-AI checklist and the accompanying documents; (5) A piloting phase among expert users will be undertaken to identify items which are either unclear or missing. This process, consisting of surveys and semistructured interviews, will contribute towards the explanation and elaboration document and (6) On finalisation of the manuscripts, the group’s efforts turn towards an organised dissemination and implementation strategy to maximise end-user adoption.Ethics and disseminationEthical approval has been granted by the Joint Research Compliance Office at Imperial College London (reference number: 19IC5679). A dissemination strategy will be aimed towards five groups of stakeholders: (1) academia, (2) policy, (3) guidelines and regulation, (4) industry and (5) public and non-specific stakeholders. We anticipate that dissemination will take place in Q3 of 2021.
Everyone in England has the right to primary care without financial charges. Nevertheless, evidence shows that barriers remain for inclusion health populations such as vulnerable migrants, people ...experiencing homelessness, Gypsy, Roma, and Traveller (GRT) communities, and people who sell sex. There is little evidence for what works to improve access. This study was a scoping review of interventions to improve access to mainstream primary care for inclusion health groups in England.
In this scoping review, we searched databases (Embase, Medline, APA PsychInfo, the Cochrane Collaboration Library, Web of Science and CINAHL) and grey literature sources, including the National Health Service and National Institute for Clinical Excellence, for articles published in English between Jan 1, 2010, and Dec 31, 2020, with no limit on study design. Data were extracted according to inclusion criteria, including interventions taking place in England and targeting people with insecure immigration status, people who sell sex, people experiencing homelessness, and GRT communities. Results were presented in a narrative synthesis.
39 studies describing one or more interventions were included: four peer-reviewed articles (one randomised trial, two quality improvement projects, and one mixed-methods study protocol) and 25 grey literature items (38 interventions in total). Interventions mostly targeted people with insecure immigration status (17/38, 45%), and a majority (12/38, 32%) took place in London. The most common types of intervention were training, education, and resources (such as leaflets or websites) for patients or staff (25/38, 66%), and most interventions targeted GP registration processes (28/38, 74%). Interventions commonly involved voluntary and community sector organisations (16/38, 42%). Most interventions were not evaluated to understand their effectiveness (23/38, 61%). Sources with evaluations identified staff training, direct patient advocacy, and involvement of people with lived experience as effective elements.
Interventions to improve access to primary care for inclusion health groups in England were heterogeneous, commonly undertaken at community level, and developed to serve local inclusion health groups. Considerations for policymakers and practitioners include groups and geographical areas less commonly included in interventions, the elements of positive practice identified in evaluations, and the need for evaluation of future interventions.
National Institute for Health and Care Research (NIHR 202050).
Stigma and discrimination are widely recognised as core social determinants of health. There is a gap in understanding how to intervene at societal and systems level to address stigma. This study ...aims to theorise how particular care and support systems shape experiences of stigma as it relates to homelessness, and to then develop systems-level interventions.
We present findings from an ongoing longitudinal ethnographic study, which started June 2022, in south London. Data collection included interviews with people managing, delivering, and using homelessness services (n=41 interviews, two focus groups); participant observation across a range of service settings (>70 h, principally in five sites), and documentary analysis. Participants and research sites gave informed consent. The study was framed by Bourdieu's social practice theory, which structures data collection and analysis around the power and resources individuals have within particular social contexts. We did the analyses using thematic and grounded approaches to qualitative data.
We found that across homeless and health services there was in-depth awareness of stigma and discrimination, but that, collectively, we are “stuck in a rut” in responding to stigma. A proximate challenge was limited clarity and agreement across systems on the nature of the issues involved. A deeper analysis also suggested specific organisational structures and ways of thinking within homelessness and health systems that limit collective discussion and agreement on social and systemic responses to stigma. We also collected data on how stigma was experienced, delineating different forms of stigma and discrimination and where and how they take shape, focusing on enacted, anticipated, and internalised stigma. We also explored how stigma was actively managed and overcome, and how different intersections of systems of inequality produce varying forms of stigma and discrimination.
Our study provides insight into how stigma and discrimination could potentially be addressed systemically within homelessness and health systems. The existing collective awareness of stigma and discrimination offers specific opportunities for generating systemic change. Study limitations include the focus on one geographic area of the UK, although we reflect on how our findings could be generalised to other settings.
UK Research and Innovation.
Recently we have witnessed the mounting of very large development projects (mega‐projects) in European and American cities. There is a striking physical similarity among the schemes and also a ...convergence embodied in private‐sector involvement and market orientation. They differ, however, as to whether they provide affordable units and tie together physical and social goals. This article investigates new mega‐projects in New York, London, and Amsterdam. The dissimilarities among them indicate the extent of variability in contemporary property capitalism. The comparison shows that public‐private partnerships can provide public benefits, but also shows that these large projects are risky for both public and private participants, must primarily be oriented toward profitability, and produce a landscape that does not encourage urbanity. Whether the gains from increased competitiveness are spread throughout the society depends on the size of the direct governmental commitment to public benefits. This is greatest in the Netherlands, where the welfare state, albeit shrunken, lives on; it is least in the United States, where the small size of national expenditures on housing and social welfare means that low‐income people must depend almost wholly on trickle‐down effects to gain from new development.
Résumé
Les très grands projets d'aménagement (mégaprojets) se multiplient dernièrement dans les villes d'Europe et d'Amérique. On est frappé par une similarité physique entre les programmes, mais aussi par une convergence observable dans l'implication du secteur privé et dans une orientation‐marché. Ils diffèrent pourtant par leur capacité ou non à procurer des unités accessibles financièrement et à associer des objectifs physiques et sociaux. L'article étudie de nouveaux mégaprojets à New‐York, Londres et Amsterdam. Les divergences entre eux indiquent l'étendue de la variabilité du capitalisme immobilier contemporain. La comparaison établit que les partenariats public‐privé peuvent produire des bénéfices publics, et montre aussi que ces grands projets sont risqués pour les participants publics et privés, qu'ils doivent surtout rechercher la rentabilité et qu'ils génèrent un paysage peu favorable à l'urbanité. La répartition, sur toute la société, des gains tirés d'une compétitivité accrue dépend de l'ampleur de l'engagement direct des gouvernements à l'égard des bénéfices publics. Le cas le plus flagrant est celui des Pays‐Bas, où l'État‐providence subsiste, bien que diminué; le plus limité est celui des États‐Unis, où la faible ampleur des dépenses nationales de logement et de protection sociale signifie que les populations à bas revenu dépendent presque totalement des effets de propagation pour bénéficier d'un nouvel aménagement.
Tasks that demand externalized attention reliably suppress default network activity while activating the dorsal attention network. These networks have an intrinsic competitive relationship; ...activation of one suppresses activity of the other. Consequently, many assume that default network activity is suppressed during goal-directed cognition. We challenge this assumption in an fMRI study of planning. Recent studies link default network activity with internally focused cognition, such as imagining personal future events, suggesting a role in autobiographical planning. However, it is unclear how goal-directed cognition with an internal focus is mediated by these opposing networks. A third anatomically interposed ‘frontoparietal control network’ might mediate planning across domains, flexibly coupling with either the default or dorsal attention network in support of internally versus externally focused goal-directed cognition, respectively. We tested this hypothesis by analyzing brain activity during autobiographical versus visuospatial planning. Autobiographical planning engaged the default network, whereas visuospatial planning engaged the dorsal attention network, consistent with the anti-correlated domains of internalized and externalized cognition. Critically, both planning tasks engaged the frontoparietal control network. Task-related activation of these three networks was anatomically consistent with independently defined resting-state functional connectivity MRI maps. Task-related functional connectivity analyses demonstrate that the default network can be involved in goal-directed cognition when its activity is coupled with the frontoparietal control network. Additionally, the frontoparietal control network may flexibly couple with the default and dorsal attention networks according to task domain, serving as a cortical mediator linking the two networks in support of goal-directed cognitive processes.
►Spatiotemporal PLS and rsfcMRI analysis identified distributed brain networks.►The default mode network was engaged during goal-directed behavior.►Default activity was co-active, and coupled, with the frontoparietal control network.
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