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1. Association between household air pollution and nasopharyngeal pneumococcal carriage in Malawian infants (MSCAPE): a nested, prospective, observational study

Author

Dherani, Mukesh K, Pope, Daniel, Tafatatha, Terence, Heinsbroek, Ellen, Chartier, Ryan, Mwalukomo, Thandie, Crampin, Amelia, Mitsi, Elena, German, Esther L, Nikolaou, Elissavet, Solórzano, Carla, Ferreira, Daniela M, Swarthout, Todd D, Hinds, Jason, Mortimer, Kevin, Gordon, Stephen B, French, Neil, and Bruce, Nigel G

Published
2022
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2. A cleaner burning biomass-fuelled cookstove intervention to prevent pneumonia in children under 5 years old in rural Malawi (the Cooking and Pneumonia Study): a cluster randomised controlled trial

Author

Mortimer, Kevin, Ndamala, Chifundo B, Naunje, Andrew W, Malava, Jullita, Katundu, Cynthia, Weston, William, Havens, Deborah, Pope, Daniel, Bruce, Nigel G, Nyirenda, Moffat, Wang, Duolao, Crampin, Amelia, Grigg, Jonathan, Balmes, John, and Gordon, Stephen B

Subjects
Clinical Research, Clinical Trials and Supportive Activities, Pneumonia, Lung, Pediatric, Pneumonia & Influenza, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, Prevention of disease and conditions, and promotion of well-being, Good Health and Well Being, Air Pollution, Indoor, Biomass, Child, Preschool, Cooking, Female, Fires, Follow-Up Studies, Humans, Incidence, Infant, Malawi, Male, Rural Health, Single-Blind Method, Smoke, Wood, Medical and Health Sciences, General & Internal Medicine
Abstract

BackgroundWHO estimates exposure to air pollution from cooking with solid fuels is associated with over 4 million premature deaths worldwide every year including half a million children under the age of 5 years from pneumonia. We hypothesised that replacing open fires with cleaner burning biomass-fuelled cookstoves would reduce pneumonia incidence in young children.MethodsWe did a community-level open cluster randomised controlled trial to compare the effects of a cleaner burning biomass-fuelled cookstove intervention to continuation of open fire cooking on pneumonia in children living in two rural districts, Chikhwawa and Karonga, of Malawi. Clusters were randomly allocated to intervention and control groups using a computer-generated randomisation schedule with stratification by site, distance from health centre, and size of cluster. Within clusters, households with a child under the age of 4·5 years were eligible. Intervention households received two biomass-fuelled cookstoves and a solar panel. The primary outcome was WHO Integrated Management of Childhood Illness (IMCI)-defined pneumonia episodes in children under 5 years of age. Efficacy and safety analyses were by intention to treat. The trial is registered with ISRCTN, number ISRCTN59448623.FindingsWe enrolled 10 750 children from 8626 households across 150 clusters between Dec 9, 2013, and Feb 28, 2016. 10 543 children from 8470 households contributed 15 991 child-years of follow-up data to the intention-to-treat analysis. The IMCI pneumonia incidence rate in the intervention group was 15·76 (95% CI 14·89-16·63) per 100 child-years and in the control group 15·58 (95% CI 14·72-16·45) per 100 child-years, with an intervention versus control incidence rate ratio (IRR) of 1·01 (95% CI 0·91-1·13; p=0·80). Cooking-related serious adverse events (burns) were seen in 19 children; nine in the intervention and ten (one death) in the control group (IRR 0·91 [95% CI 0·37-2·23]; p=0·83).InterpretationWe found no evidence that an intervention comprising cleaner burning biomass-fuelled cookstoves reduced the risk of pneumonia in young children in rural Malawi. Effective strategies to reduce the adverse health effects of household air pollution are needed.FundingMedical Research Council, UK Department for International Development, and Wellcome Trust.

Published
2017

3. Implementation Science to Accelerate Clean Cooking for Public Health.

Author

Rosenthal, Joshua, Balakrishnan, Kalpana, Bruce, Nigel, Chambers, David, Graham, Jay, Jack, Darby, Kline, Lydia, Masera, Omar, Mehta, Sumi, Mercado, Ilse Ruiz, Neta, Gila, Pattanayak, Subhrendu, Puzzolo, Elisa, Petach, Helen, Punturieri, Antonello, Rubinstein, Adolfo, Sage, Michael, Sturke, Rachel, Shankar, Anita, Sherr, Kenny, Smith, Kirk, and Yadama, Gautam

Subjects
Humans, Public Health, Air Pollution, Indoor, Environmental Exposure, Environmental Monitoring, Cooking, Air Pollution, Indoor, Medical And Health Sciences, Environmental Sciences, Toxicology, Medical and Health Sciences
Abstract

Summary: Clean cooking has emerged as a major concern for global health and development because of the enormous burden of disease caused by traditional cookstoves and fires. The World Health Organization has developed new indoor air quality guidelines that few homes will be able to achieve without replacing traditional methods with modern clean cooking technologies, including fuels and stoves. However, decades of experience with improved stove programs indicate that the challenge of modernizing cooking in impoverished communities includes a complex, multi-sectoral set of problems that require implementation research. The National Institutes of Health, in partnership with several government agencies and the Global Alliance for Clean Cookstoves, has launched the Clean Cooking Implementation Science Network that aims to address this issue. In this article, our focus is on building a knowledge base to accelerate scale-up and sustained use of the cleanest technologies in low- and middle-income countries. Implementation science provides a variety of analytical and planning tools to enhance effectiveness of clinical and public health interventions. These tools are being integrated with a growing body of knowledge and new research projects to yield new methods, consensus tools, and an evidence base to accelerate improvements in health promised by the renewed agenda of clean cooking.

Published
2017

4. GRADE: Assessing the quality of evidence in environmental and occupational health

Author

Morgan, Rebecca L, Thayer, Kristina A, Bero, Lisa, Bruce, Nigel, Falck-Ytter, Yngve, Ghersi, Davina, Guyatt, Gordon, Hooijmans, Carlijn, Langendam, Miranda, Mandrioli, Daniele, Mustafa, Reem A, Rehfuess, Eva A, Rooney, Andrew A, Shea, Beverley, Silbergeld, Ellen K, Sutton, Patrice, Wolfe, Mary S, Woodruff, Tracey J, Verbeek, Jos H, Holloway, Alison C, Santesso, Nancy, and Schünemann, Holger J

Subjects
Commerce, Management, Tourism and Services, Human Resources and Industrial Relations, Health Sciences, Clinical Research, Prevention, Aetiology, 2.2 Factors relating to the physical environment, Generic health relevance, Environmental Health, Epidemiologic Research Design, Evidence-Based Medicine, Humans, Occupational Health, Reproducibility of Results, Review Literature as Topic, GRADE, Evidence-based, Risk of bias, Environmental health, Risk assessment, Recommendations, Environmental Sciences
Abstract

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE's applicability to environmental health, and identify priority areas for method assessment and development.

Published
2016

5. Lung function in woodsmoke-exposed Guatemalan children following a chimney stove intervention

Author

Heinzerling, Amy P, Guarnieri, Michael J, Mann, Jennifer K, Diaz, Janet V, Thompson, Lisa M, Diaz, Anaite, Bruce, Nigel G, Smith, Kirk R, and Balmes, John R

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Pediatric, Health Effects of Household Energy Combustion, Prevention, Lung, Health Effects of Indoor Air Pollution, Clinical Research, Aetiology, 2.2 Factors relating to the physical environment, Respiratory, Good Health and Well Being, Air Pollution, Indoor, Carbon Monoxide, Child, Child, Preschool, Cooking, Forced Expiratory Flow Rates, Guatemala, Humans, Incidence, Particulate Matter, Peak Expiratory Flow Rate, Pneumonia, Pregnant Women, Prospective Studies, Rural Population, Smoke, United Nations, Wood, Lung Physiology, Paediatric Lung Disaese, Respiratory System, Cardiovascular medicine and haematology, Clinical sciences
Abstract

RationaleHousehold air pollution (HAP) from solid fuel combustion is a major contributor to the global burden of disease, with considerable impact from respiratory infections in children. The impact of HAP on lung function is unknown.ObjectivesThe Childhood Exposure to Respirable Particulate Matter (CRECER) prospective cohort study followed Guatemalan children who participated in the Randomised Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) trial of a chimney stove intervention to determine the effect of early childhood HAP exposure on growth of lung function.MethodsRESPIRE households with pregnant women or infant children were randomised to receive a chimney stove at the beginning or at the end of the 18-month trial. During CRECER, a subset of these children, as well as children from households with newly installed stoves, were followed with spirometry beginning at age 5. Biomass smoke exposure was measured using personal carbon monoxide tubes. Two-stage regression models were employed to analyse associations with lung function growth.Measurements and main resultsLongitudinal peak expiratory flow (PEF) and FEV1 data were available for 443 and 437 children, respectively, aged 5-8 (mean follow-up 1.3 years). Decreases in PEF growth of 173 mL/min/year (95% CI -341 to -7) and FEV1 of 44 mL/year (95% CI -91 to 4) were observed with stove installation at 18 months compared with stove installation at birth in analyses adjusted for multiple covariates. No statistically significant associations were observed between personal HAP exposure and lung function.ConclusionsA significant decrease in PEF growth and a large non-significant decrease in FEV1 growth were observed with later stove installation. Additional studies including longer follow-up and cleaner stoves or fuels are needed.

Published
2016

7. Lung Function in Rural Guatemalan Women Before and After a Chimney Stove Intervention to Reduce Wood Smoke Exposure: Results From the Randomized Exposure Study of Pollution Indoors and Respiratory Effects and Chronic Respiratory Effects of Early Childhood Exposure to Respirable Particulate Matter Study.

Author

Guarnieri, Michael, Diaz, Esperanza, Pope, Daniel, Eisen, Ellen A, Mann, Jennifer, Smith, Kirk R, Smith-Sivertsen, Tone, Bruce, Nigel G, and Balmes, John R

Subjects
Humans, Environmental Illness, Carbon Monoxide, Spirometry, Incidence, Air Pollution, Indoor, Smoke, Respiration, Wood, Adult, Child, Rural Population, Guatemala, Female, Particulate Matter, Cooking, Lung, Prevention, Health Effects of Indoor Air Pollution, Health Effects of Household Energy Combustion, Clinical Research, Chronic Obstructive Pulmonary Disease, Clinical Trials and Supportive Activities, Aetiology, 2.2 Factors relating to the physical environment, Respiratory, Good Health and Well Being, Clinical Sciences, Respiratory System
Abstract

BackgroundCOPD is the third most frequent cause of death globally, with much of this burden attributable to household biomass smoke exposure in developing countries. As biomass smoke exposure is also associated with cardiovascular disease, lower respiratory infection, lung cancer, and cataracts, it presents an important target for public health intervention.MethodsLung function in Guatemalan women exposed to wood smoke from open fires was measured throughout the Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) stove intervention trial and continued during the Chronic Respiratory Effects of Early Childhood Exposure to Respirable Particulate Matter (CRECER) cohort study. In RESPIRE, early stove households received a chimney woodstove at the beginning of the 18-month trial, and delayed stove households received a stove at trial completion. Personal exposure to wood smoke was assessed with exhaled breath carbon monoxide (CO) and personal CO tubes. Change in lung function between intervention groups and as a function of wood smoke exposure was assessed using random effects models.ResultsOf 306 women participating in both studies, acceptable spirometry was collected in 129 early stove and 136 delayed stove households (n = 265), with a mean follow-up of 5.6 years. Despite reduced wood smoke exposures in early stove households, there were no significant differences in any of the measured spirometric variables during the study period (FEV1, FVC, FEV1/FVC ratio, and annual change) after adjustment for confounding.ConclusionsIn these young Guatemalan women, there was no association between lung function and early randomization to a chimney stove or personal wood smoke exposure. Future stove intervention trials should incorporate cleaner stoves, longer follow-up, or potentially susceptible groups to identify meaningful differences in lung function.

Published
2015

8. Respiratory risks from household air pollution in low and middle income countries

Author

Gordon, Stephen B, Bruce, Nigel G, Grigg, Jonathan, Hibberd, Patricia L, Kurmi, Om P, Lam, Kin-bong Hubert, Mortimer, Kevin, Asante, Kwaku Poku, Balakrishnan, Kalpana, Balmes, John, Bar-Zeev, Naor, Bates, Michael N, Breysse, Patrick N, Buist, Sonia, Chen, Zhengming, Havens, Deborah, Jack, Darby, Jindal, Surinder, Kan, Haidong, Mehta, Sumi, Moschovis, Peter, Naeher, Luke, Patel, Archana, Perez-Padilla, Rogelio, Pope, Daniel, Rylance, Jamie, Semple, Sean, and Martin, William J

Subjects
Climate-Related Exposures and Conditions, Health Effects of Household Energy Combustion, Clinical Research, Lung, Health Effects of Indoor Air Pollution, Prevention, 2.2 Factors relating to the physical environment, Aetiology, Respiratory, Adult, Air Pollution, Indoor, Child, Cooking, Developing Countries, Environmental Exposure, Environmental Restoration and Remediation, Female, Housing, Humans, Income, Male, Respiratory Tract Diseases, Respiratory Tract Neoplasms, Risk Factors, Social Conditions, Socioeconomic Factors, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences
Abstract

A third of the world's population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5-4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.

Published
2014

10. Effects of Woodsmoke Exposure on Airway Inflammation in Rural Guatemalan Women

Author

Guarnieri, Michael J, Diaz, Janet V, Basu, Chandreyi, Diaz, Anaite, Pope, Daniel, Smith, Kirk R, Smith-Sivertsen, Tone, Bruce, Nigel, Solomon, Colin, McCracken, John, and Balmes, John R

Subjects
BRII recipient: Balmes
Abstract

Background: More than two-fifths of the world’s population uses solid fuels, mostly biomass, for cooking. The resulting biomass smoke exposure is a major cause of chronic obstructive pulmonary disease (COPD) among women in developing countries.Objective: To assess whether lower woodsmoke exposure from use of a stove with a chimney, compared to open fires, is associated with lower markers of airway inflammation in young women.Design: We carried out a cross-sectional analysis on a sub-cohort of participants enrolled in a randomized controlled trial in rural Guatemala, RESPIRE.Participants: We recruited 45 indigenous women at the end of the 18-month trial; 19 women who had been using the chimney stove for 18–24 months and 26 women still using open fires.Measurements: We obtained spirometry and induced sputum for cell counts, gene expression of IL-8, TNF-α, MMP-9 and 12, and protein concentrations of IL-8, myeloperoxidase and fibronectin. Exhaled carbon monoxide (CO) and 48-hr personal CO tubes were measured to assess smoke exposure.Results: MMP-9 gene expression was significantly lower in women using chimney stoves. Higher exhaled CO concentrations were significantly associated with higher gene expression of IL-8, TNF-α, and MMP-9. Higher 48-hr personal CO concentrations were associated with higher gene expression of IL-8, TNF- α, MMP-9 and MMP-12; reaching statistical significance for MMP-9 and MMP-12.Conclusions: Compared to using an open wood fire for cooking, use of a chimney stove was associated with lower gene expression of MMP-9, a potential mediator of airway remodeling. Among all participants, indoor biomass smoke exposure was associated with higher gene expression of multiple mediators of airway inflammation and remodeling; these mechanisms may explain some of the observed association between prolonged biomass smoke exposure and COPD.

Published
2014

12. Connecting Legal Discourse with Real World Concerns.

Author

Bruce, Nigel

Abstract

This paper reports on the strategies used by an English-as-a-Second-Language (ESL) teacher to help law students whose first language is Chinese in an English-for-law course learn and understand how to negotiate legal texts and ordinances and connect them with the concerns of people in the real world. The example of the recently enacted Human Organ Transplant Ordinance in Hong Kong is used to show how legal rhetorical objectives can be realized through a series of forensic tasks that connect with the real world concerns of both medical professionals and the lay relatives of transplant recipients. Underlying the paper is a philosophy of ESL teaching that prizes the interdependence of language and content, and the need to raise students' language awareness to maintain clear relevance to their legal studies--an approach aimed at sustaining student interest while raising their awareness of why ordinances are structured the way they are. Real-world case studies are used rather than textbook grammar exercises in order to weave the linguistic agenda into authentic contexts and purposes. Six appendices are included: "Legal Reasoning Moves in an Ordinance-Legislative 'Actions'"; "Circumstances, Conditions, and Exceptions--Hedging the Legal Action"; "First Four Sections of the Human Organ Transplant Ordinance"; an article from the English language Hong Kong press "Medical Bureaucracy Blamed for Fatal Delays, Pre-Transplant Deaths Anger Doctor"; "Two Routes to Amending the Human Organ Transplant Ordinance"; and "LegCo Subcommittee on Human Organ Transplant Ordinance, Extract from the Minutes of the Meeting of 8 Jan. 1999." (KFT)

Published
2000

13. 'Don't Forget the Teachers!' Evaluating the Impact of IT Integration into a University Curriculum.

Author

Bruce, Nigel and Desloge, Pat

Abstract

This paper reports on the findings of two surveys, one year apart, that examined the experiences and attitudes of teachers in a University of Hong Kong English Centre related to the prospect of a curriculum increasingly mediated through information technology (IT). The responses bear witness to the problems teachers experienced in attempting to computerize their pedagogical practices and show how issues of technology, workload, and support can contribute to levels of anxiety and resistance in the workplace. By the end of the second year, a few teachers remained skeptical that computers can enhance language teaching, but any remaining apprehension regarding IT tended to be focused on real administrative and logistical problems of implementation. The paper concludes with recommendations to institutions seeking to pursue the path of integrating IT into well-established curricular practices. (Contains 10 references.) (Author/MES)

Published
1999

14. State and national household concentrations of PM2.5 from solid cookfuel use: Results from measurements and modeling in India for estimation of the global burden of disease

Author

Balakrishnan, Kalpana, Ghosh, Santu, Ganguli, Bhaswati, Sambandam, Sankar, Bruce, Nigel, Barnes, Douglas F, and Smith, Kirk R

Abstract

Abstract Background Previous global burden of disease (GBD) estimates for household air pollution (HAP) from solid cookfuel use were based on categorical indicators of exposure. Recent progress in GBD methodologies that use integrated–exposure–response (IER) curves for combustion particles required the development of models to quantitatively estimate average HAP levels experienced by large populations. Such models can also serve to inform public health intervention efforts. Thus, we developed a model to estimate national household concentrations of PM2.5 from solid cookfuel use in India, together with estimates for 29 states. Methods We monitored 24-hr household concentrations of PM2.5, in 617 rural households from 4 states in India on a cross-sectional basis between November 2004 and March 2005. We then, developed log-linear regression models that predict household concentrations as a function of multiple, independent household level variables available in national household surveys and generated national / state estimates using The Indian National Family and Health Survey (NFHS 2005). Results The measured mean 24-hr concentration of PM2.5 in solid cookfuel using households ranged from 163 μg/m3 (95% CI: 143,183; median 106; IQR: 191) in the living area to 609 μg/m3 (95% CI: 547,671; median: 472; IQR: 734) in the kitchen area. Fuel type, kitchen type, ventilation, geographical location and cooking duration were found to be significant predictors of PM2.5 concentrations in the household model. k-fold cross validation showed a fair degree of correlation (r = 0.56) between modeled and measured values. Extrapolation of the household results by state to all solid cookfuel-using households in India, covered by NFHS 2005, resulted in a modeled estimate of 450 μg/m3 (95% CI: 318,640) and 113 μg/m3 (95% CI: 102,127) , for national average 24-hr PM2.5 concentrations in the kitchen and living areas respectively. Conclusions The model affords substantial improvement over commonly used exposure indicators such as “percent solid cookfuel use” in HAP disease burden assessments, by providing some of the first estimates of national average HAP levels experienced in India. Model estimates also add considerable strength of evidence for framing and implementation of intervention efforts at the state and national levels.

Published
2013

16. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Author

Lim, Stephen S, Vos, Theo, Flaxman, Abraham D, Danaei, Goodarz, Shibuya, Kenji, Adair-Rohani, Heather, AlMazroa, Mohammad A, Amann, Markus, Anderson, H Ross, Andrews, Kathryn G, Aryee, Martin, Atkinson, Charles, Bacchus, Loraine J, Bahalim, Adil N, Balakrishnan, Kalpana, Balmes, John, Barker-Collo, Suzanne, Baxter, Amanda, Bell, Michelle L, Blore, Jed D, Blyth, Fiona, Bonner, Carissa, Borges, Guilherme, Bourne, Rupert, Boussinesq, Michel, Brauer, Michael, Brooks, Peter, Bruce, Nigel G, Brunekreef, Bert, Bryan-Hancock, Claire, Bucello, Chiara, Buchbinder, Rachelle, Bull, Fiona, Burnett, Richard T, Byers, Tim E, Calabria, Bianca, Carapetis, Jonathan, Carnahan, Emily, Chafe, Zoe, Charlson, Fiona, Chen, Honglei, Chen, Jian Shen, Cheng, Andrew Tai-Ann, Child, Jennifer Christine, Cohen, Aaron, Colson, K Ellicott, Cowie, Benjamin C, Darby, Sarah, Darling, Susan, Davis, Adrian, Degenhardt, Louisa, Dentener, Frank, Jarlais, Don C Des, Devries, Karen, Dherani, Mukesh, Ding, Eric L, Dorsey, E Ray, Driscoll, Tim, Edmond, Karen, Ali, Suad Eltahir, Engell, Rebecca E, Erwin, Patricia J, Fahimi, Saman, Falder, Gail, Farzadfar, Farshad, Ferrari, Alize, Finucane, Mariel M, Flaxman, Seth, Fowkes, Francis Gerry R, Freedman, Greg, Freeman, Michael K, Gakidou, Emmanuela, Ghosh, Santu, Giovannucci, Edward, Gmel, Gerhard, Graham, Kathryn, Grainger, Rebecca, Grant, Bridget, Gunnell, David, Gutierrez, Hialy R, Hall, Wayne, Hoek, Hans W, Hogan, Anthony, Hosgood, H Dean, Hoy, Damian, Hu, Howard, Hubbell, Bryan J, Hutchings, Sally J, Ibeanusi, Sydney E, Jacklyn, Gemma L, Jasrasaria, Rashmi, Jonas, Jost B, Kan, Haidong, Kanis, John A, Kassebaum, Nicholas, Kawakami, Norito, Khang, Young-Ho, Khatibzadeh, Shahab, Khoo, Jon-Paul, and Kok, Cindy

Subjects
Tobacco Smoke and Health, Prevention, Tobacco, Burden of Illness, Nutrition, Pediatric, 2.2 Factors relating to the physical environment, 2.3 Psychological, social and economic factors, Aetiology, Respiratory, Cardiovascular, Good Health and Well Being, Clean Water and Sanitation, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Global Health, Humans, Infant, Infant, Newborn, Male, Middle Aged, Mortality, Quality-Adjusted Life Years, Risk Assessment, Risk Factors, Sex Factors, Young Adult, Medical and Health Sciences, General & Internal Medicine
Abstract

BackgroundQuantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time.MethodsWe estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden.FindingsIn 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0·9% (0·4-1·6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania.InterpretationWorldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children.FundingBill & Melinda Gates Foundation.

Published
2012

18. Practising What We Preach: Creating the Conditions for Student Autonomy.

Author

Bruce, Nigel

Abstract

This paper explores the value, in English-as-a-Second-Language medium tertiary education, of extending the notion of student autonomy beyond the context of language learning to the whole curriculum, arguing that autonomy needs to be seen in a broader, more socio-political perspective and that for students to enjoy autonomy requires a transformation in the roles not only of students, but in those of language teachers and subject teachers within the academic curriculum. Greater critical awareness is needed of the educational constraints imposed by prevailing concepts of "skills" as the basis of a tertiary communication curriculum and of knowledge as curricular "capital." It is suggested that underlying these notions are discourses that are adversarial; dualistic; and, ultimately, assimilationist. Although the language education discourse community may preach a critical approach, they often fall short of such critical standards in their own peer-directed public discourse. It is suggested that problem areas in language education include socialization, preoccupation with skills, and the dangers of dualism. (Contains 62 references.) (Author/NAV)

Published
1995

19. Impact of Reduced Maternal Exposures to Wood Smoke from an Introduced Chimney Stove on Newborn Birth Weight in Rural Guatemala

Author

Thompson, Lisa M, Bruce, Nigel, Eskenazi, Brenda, Diaz, Anaite, Pope, Daniel, and Smith, Kirk R

Subjects
Reproductive Medicine, Midwifery, Biomedical and Clinical Sciences, Health Sciences, Health Effects of Household Energy Combustion, Perinatal Period - Conditions Originating in Perinatal Period, Health Effects of Indoor Air Pollution, Prevention, Preterm, Low Birth Weight and Health of the Newborn, Infant Mortality, Pediatric, Conditions Affecting the Embryonic and Fetal Periods, Reproductive health and childbirth, Good Health and Well Being, Adolescent, Adult, Air Pollution, Indoor, Birth Weight, Carbon Monoxide, Cooking, Female, Guatemala, Humans, Infant, Newborn, Maternal Exposure, Pregnancy, Smoke, Wood, Young Adult, carbon monoxide, household air pollution, low birth weight, maternal malnutrition, RESPIRE trial, seasonality, Environmental Sciences, Medical and Health Sciences, Toxicology, Biomedical and clinical sciences, Environmental sciences, Health sciences
Abstract

BackgroundA growing body of evidence indicates a relationship between household indoor air pollution from cooking fires and adverse neonatal outcomes, such as low birth weight (LBW), in resource-poor countries.ObjectiveWe examined the effect of reduced wood smoke exposure in pregnancy on LBW of Guatemalan infants in RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects).MethodsPregnant women (n = 266) either received a chimney stove (intervention) or continued to cook over an open fire (control). Between October 2002 and December 2004 we weighed 174 eligible infants (69 to mothers who used a chimney stove and 105 to mothers who used an open fire during pregnancy) within 48 hr of birth. Multivariate linear regression and adjusted odds ratios (ORs) were used to estimate differences in birth weight and LBW (< 2,500 g) associated with chimney-stove versus open-fire use during pregnancy.ResultsPregnant women using chimney stoves had a 39% reduction in mean exposure to carbon monoxide compared with those using open fires. LBW prevalence was high at 22.4%. On average, infants born to mothers who used a stove weighed 89 g more [95% confidence interval (CI), -27 to 204 g] than infants whose mothers used open fires after adjusting for maternal height, diastolic blood pressure, gravidity, and season of birth. The adjusted OR for LBW was 0.74 (95% CI, 0.33-1.66) among infants of stove users compared with open-fire users. Average birth weight was 296 g higher (95% CI, 109-482 g) in infants born during the cold season (after harvest) than in other infants; this unanticipated finding may reflect the role of maternal nutrition on birth weight in an impoverished region.ConclusionsA chimney stove reduced wood smoke exposures and was associated with reduced LBW occurrence. Although not statistically significant, the estimated effect was consistent with previous studies.

Published
2011

20. Academic Communities and the Need for Boundary Conversations: Towards a Metalingua Franca?

Author

Bruce, Nigel

Abstract

Increasingly, language is seen as the interpretive medium by which knowledge is constructed and communication is carried out within and across disciplines, as well as the way power and authority are exercised, renewed, and protected. This paper explores the prospects of raising awareness of this social and political view of language across the wider educational community, specifically of three communities that should triangulate in this enterprise: subject teachers, their students, and the "mediating" language teachers. The social, educational, and political implications for these communities of talking at cross purposes about language and knowledge are discussed, and the possibilities of their fruitful collaboration is explored. It is suggested that the more that the different communities interact and collaborate, and the more they talk about their intersecting interests, the more a shared discourse may emerge. A description of an interdisciplinary collaboration in developing a classification of micro-skills for offering structured feedback on student writing is described. (Author/JL)

Published
1993

21. Ensuring Access and Quality in Open Learning Programmes: Communication and Study Skills Training for ESL-Medium Higher Education.

Author

Bruce, Nigel J.

Abstract

Tertiary institutions worldwide are catering increasingly to adult, part-time students who are entering higher education for the first time. This paper addresses the compound problems that these students face in attempting to pursue a distance education in a second language. It offers the specific example of Hong Kong and the access and degree programs offered by The University of Hong Kong's School of Professional and Continuing Education. The paper analyzes the types of study and communication problems open learning students may bring with them to their studies, and recommends a policy of communication and study skills training as a means of ensuring both program quality and student access to full degree programs. Contains 7 references. (LB)

Published
1992

22. Prioritising Equality of Outcome in Hong Kong Secondary School Education.

Author

Bruce, Nigel

Abstract

A November 1990 recommendation by the Hong Kong government's education department to adopt a language-streaming policy is discussed. The policy would have children tested and assigned to English-medium or Chinese-medium instruction in the sixth year of elementary school. Implications of this development are examined from the point of view of higher education and from the perspective of providing equal education for all children. Disadvantages to children taught in Chinese and proceeding to higher education are given special attention. Two alternatives are proposed: (1) delaying streaming decisions for an additional 2 years; (2) offering an opportunity for Chinese-medium students to start on their college preparation early; and (3) having students in both streams follow the same curriculum but having Chinese-medium students use the final secondary year to prepare for postsecondary study. It is proposed that because of mandates for higher education to increase enrollment, reduce costs, and compete with other English-speaking countries' universities, the best solution might be for higher education to offer a college-preparatory year for Chinese-medium students. (MSE)

Published
1991

23. EL2-Medium Education in a Largely Monolingual Society: The Case of Hong Kong.

Author

Bruce, Nigel J.

Abstract

English is used as a second-language (EL2) medium of instruction in a wide range of developing countries, notably in East and South Asia, the Middle East, and many parts of Africa, often in the face of a vigorous resurgence of indigenous and regional cultures and languages. A discussion of this situation illustrates some of the social, political, and educational factors that make the implementation of EL2-medium educational policies problematic for developing countries. The discussion then looks into the case of Hong Kong, with its particular linguistic and socio-political situation, and the implications of an EL2-medium education system for an ostensibly egalitarian education policy. The discussion concludes by examining recent attempts by language planners and educators in Hong Kong, in both secondary and higher education, to make the education system more responsive to the sociolinguistic and educational requirements and realities in the territory while retaining a strong EL2-medium profile. (Author/MSE)

Published
1990

24. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study

Author

Shi, Ting, McAllister, David A, O'Brien, Katherine L, Simoes, Eric A F, Madhi, Shabir A, Gessner, Bradford D, Polack, Fernando P, Balsells, Evelyn, Acacio, Sozinho, Aguayo, Claudia, Alassani, Issifou, Ali, Asad, Antonio, Martin, Awasthi, Shally, Awori, Juliet O, Azziz-Baumgartner, Eduardo, Baggett, Henry C, Baillie, Vicky L, Balmaseda, Angel, Barahona, Alfredo, Basnet, Sudha, Bassat, Quique, Basualdo, Wilma, Bigogo, Godfrey, Bont, Louis, Breiman, Robert F, Brooks, W Abdullah, Broor, Shobha, Bruce, Nigel, Bruden, Dana, Buchy, Philippe, Campbell, Stuart, Carosone-Link, Phyllis, Chadha, Mandeep, Chipeta, James, Chou, Monidarin, Clara, Wilfrido, Cohen, Cheryl, de Cuellar, Elizabeth, Dang, Duc-Anh, Dash-yandag, Budragchaagiin, Deloria-Knoll, Maria, Dherani, Mukesh, Eap, Tekchheng, Ebruke, Bernard E, Echavarria, Marcela, de Freitas Lázaro Emediato, Carla Cecília, Fasce, Rodrigo A, Feikin, Daniel R, Feng, Luzhao, Gentile, Angela, Gordon, Aubree, Goswami, Doli, Goyet, Sophie, Groome, Michelle, Halasa, Natasha, Hirve, Siddhivinayak, Homaira, Nusrat, Howie, Stephen R C, Jara, Jorge, Jroundi, Imane, Kartasasmita, Cissy B, Khuri-Bulos, Najwa, Kotloff, Karen L, Krishnan, Anand, Libster, Romina, Lopez, Olga, Lucero, Marilla G, Lucion, Florencia, Lupisan, Socorro P, Marcone, Debora N, McCracken, John P, Mejia, Mario, Moisi, Jennifer C, Montgomery, Joel M, Moore, David P, Moraleda, Cinta, Moyes, Jocelyn, Munywoki, Patrick, Mutyara, Kuswandewi, Nicol, Mark P, Nokes, D James, Nymadawa, Pagbajabyn, da Costa Oliveira, Maria Tereza, Oshitani, Histoshi, Pandey, Nitin, Paranhos-Baccalà, Gláucia, Phillips, Lia N, Picot, Valentina Sanchez, Rahman, Mustafizur, Rakoto-Andrianarivelo, Mala, Rasmussen, Zeba A, Rath, Barbara A, Robinson, Annick, Romero, Candice, Russomando, Graciela, Salimi, Vahid, Sawatwong, Pongpun, Scheltema, Nienke, Schweiger, Brunhilde, Scott, J Anthony G, Seidenberg, Phil, Shen, Kunling, Singleton, Rosalyn, Sotomayor, Viviana, Strand, Tor A, Sutanto, Agustinus, Sylla, Mariam, Tapia, Milagritos D, Thamthitiwat, Somsak, Thomas, Elizabeth D, Tokarz, Rafal, Turner, Claudia, Venter, Marietjie, Waicharoen, Sunthareeya, Wang, Jianwei, Watthanaworawit, Wanitda, Yoshida, Lay-Myint, Yu, Hongjie, Zar, Heather J, Campbell, Harry, and Nair, Harish

Published
2017
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27. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Forouzanfar, Mohammad H, Alexander, Lily, Anderson, H Ross, Bachman, Victoria F, Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M, Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J, KC, Astha, Kyu, Hmwe H, Moradi-Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A, Wagner, Joseph, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw F, Aboyans, Victor, Abraham, Biju, Abraham, Jerry Puthenpurakal, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M E, Aburto, Tania C, Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K, Adsuar, José C, Afshin, Ashkan, Agardh, Emilie E, Al Khabouri, Mazin J, Al Lami, Faris H, Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I, Alegretti, Miguel A, Aleman, Alicia V, Alemu, Zewdie A, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K, Alla, François, Allebeck, Peter, Allen, Peter J, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Ameh, Emmanuel A, Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O, Antonio, Carl Abelardo T, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S Arsic, Artaman, Al, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Atkinson, Charles, Avila, Marco A, Awuah, Baffour, Badawi, Alaa, Bahit, Maria C, Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M, Barker-Collo, Suzanne L, Barquera, Simon, Barregard, Lars, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana C, Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O, Ruvalcaba, Carolina Batis, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Benjet, Corina, Bennett, Derrick A, Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A, Bikbov, Boris, Abdulhak, Aref A Bin, Blore, Jed D, Blyth, Fiona M, Bohensky, Megan A, Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M, Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J, Brenner, Hermann, Briggs, Adam D M, Broday, David M, Brooks, Peter M, Bruce, Nigel G, Brugha, Traolach S, Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N, Bukhman, Gene, Bulloch, Andrew G, Burch, Michael, Burney, Peter G J, Campos-Nonato, Ismael R, Campuzano, Julio C, Cantoral, Alejandra J, Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O, Caso, Valeria, Castañeda-Orjuela, Carlos A, Castro, Ruben E, Catalá-López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K, Chang, Jung-chen, Charlson, Fiona J, Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P, Chimed-Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A, Chuang, Ting-Wu, Chugh, Sumeet S, Cirillo, Massimo, Claßen, Thomas KD, Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M, Contreras, Alejandra G, Cooper, Cyrus, Cooperrider, Kimberly, Cooper, Leslie T, Coresh, Josef, Courville, Karen J, Criqui, Michael H, Cuevas-Nasu, Lucia, Damsere-Derry, James, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I, Davis, Adrian, Davitoiu, Dragos V, Dayama, Anand, de Castro, E Filipa, De la Cruz-Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, del Pozo-Cruz, Borja, Dellavalle, Robert P, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C Des, Dessalegn, Muluken, deVeber, Gabrielle A, Devries, Karen M, Dharmaratne, Samath D, Dherani, Mukesh K, Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E Ray, Driscoll, Tim R, Duan, Leilei, Durrani, Adnan M, Ebel, Beth E, Ellenbogen, Richard G, Elshrek, Yousef M, Endres, Matthias, Ermakov, Sergey P, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A, Farzadfar, Farshad, Fay, Derek F J, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J, Ferri, Cleusa P, Flaxman, Abraham D, Fleming, Thomas D, Foigt, Nataliya, Foreman, Kyle J, Paleo, Urbano Fra, Franklin, Richard C, Gabbe, Belinda, Gaffikin, Lynne, Gakidou, Emmanuela, Gamkrelidze, Amiran, Gankpé, Fortuné G, Gansevoort, Ron T, García-Guerra, Francisco A, Gasana, Evariste, Geleijnse, Johanna M, Gessner, Bradford D, Gething, Pete, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim A M, Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Dantes, Hector Gomez, Gona, Philimon, de Cosio, Teresita Gonzalez, González-Castell, Dinorah, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Guerrant, Richard L, Gugnani, Harish C, Guillemin, Francis, Gunnell, David, Gupta, Rahul, Gupta, Rajeev, Gutiérrez, Reyna A, Hafezi-Nejad, Nima, Hagan, Holly, Hagstromer, Maria, Halasa, Yara A, Hamadeh, Randah R, Hammami, Mouhanad, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Haregu, Tilahun Nigatu, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Simon I, Hedayati, Mohammad T, Heredia-Pi, Ileana B, Hernandez, Lucia, Heuton, Kyle R, Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W, Hoffman, Howard J, Hornberger, John C, Hosgood, H Dean, Hoy, Damian G, Hsairi, Mohamed, Hu, Guoqing, Hu, Howard, Huang, Cheng, Huang, John J, Hubbell, Bryan J, Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa L, Iburg, Kim M, Idrisov, Bulat T, Ikeda, Nayu, Innos, Kaire, Inoue, Manami, Islami, Farhad, Ismayilova, Samaya, Jacobsen, Kathryn H, Jansen, Henrica A, Jarvis, Deborah L, Jassal, Simerjot K, Jauregui, Alejandra, Jayaraman, Sudha, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Fan, Jiang, Guohong, Jiang, Ying, Jonas, Jost B, Juel, Knud, Kan, Haidong, Roseline, Sidibe S Kany, Karam, Nadim E, Karch, André, Karema, Corine K, Karthikeyan, Ganesan, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S, Kemp, Andrew H, Kengne, Andre P, Keren, Andre, Khader, Yousef S, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz A, Khang, Young-Ho, Khatibzadeh, Shahab, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kim, Yunjin, Kimokoti, Ruth W, Kinfu, Yohannes, Kinge, Jonas M, Kissela, Brett M, Kivipelto, Miia, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kose, M Rifat, Kosen, Soewarta, Kraemer, Alexander, Kravchenko, Michael, Krishnaswami, Sanjay, Kromhout, Hans, Ku, Tiffany, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J, Kulkarni, Chanda, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Lai, Taavi, Balaji, Arjun Lakshmana, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lan, Qing, Lansingh, Van C, Larson, Heidi J, Larsson, Anders, Laryea, Dennis O, Lavados, Pablo M, Lawrynowicz, Alicia E, Leasher, Janet L, Lee, Jong-Tae, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S, Lindsay, M Patrice, Lipshultz, Steven E, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Logroscino, Giancarlo, London, Stephanie J, Lopez, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A, Lozano, Rafael, Lunevicius, Raimundas, Ma, Jixiang, Ma, Stefan, Machado, Vasco M P, MacIntyre, Michael F, Magis-Rodriguez, Carlos, Mahdi, Abbas A, Majdan, Marek, Malekzadeh, Reza, Mangalam, Srikanth, Mapoma, Christopher C, Marape, Marape, Marcenes, Wagner, Margolis, David J, Margono, Christopher, Marks, Guy B, Martin, Randall V, Marzan, Melvin B, Mashal, Mohammad T, Masiye, Felix, Mason-Jones, Amanda J, Matsushita, Kunihiro, Matzopoulos, Richard, Mayosi, Bongani M, Mazorodze, Tasara T, McKay, Abigail C, McKee, Martin, McLain, Abigail, Meaney, Peter A, Medina, Catalina, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A, Meltzer, Michele, Memish, Ziad A, Mendoza, Walter, Mensah, George A, Meretoja, Atte, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Misganaw, Awoke, Mishra, Santosh, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A, Mokdad, Ali H, Mola, Glen L, Monasta, Lorenzo, Hernandez, Julio C Montañez, Montico, Marcella, Moore, Ami R, Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N, Mozaffarian, Dariush, Mueller, Ulrich O, Mukaigawara, Mitsuru, Mullany, Erin C, Murthy, Kinnari S, Naghavi, Mohsen, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, KM Venkat, Nash, Denis, Neal, Bruce, Nejjari, Chakib, Neupane, Sudan P, Newton, Charles R, Ngalesoni, Frida N, de Dieu Ngirabega, Jean, Nguyen, Grant, Nguyen, Nhung T, Nieuwenhuijsen, Mark J, Nisar, Muhammad I, Nogueira, José R, Nolla, Joan M, Nolte, Sandra, Norheim, Ole F, Norman, Rosana E, Norrving, Bo, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O, Omer, Saad B, Opio, John Nelson, Orozco, Ricardo, Pagcatipunan, Rodolfo S, Jr., Pain, Amanda W, Pandian, Jeyaraj D, Panelo, Carlo Irwin A, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Caicedo, Angel J Paternina, Patten, Scott B, Paul, Vinod K, Pavlin, Boris I, Pearce, Neil, Pedraza, Lilia S, Pedroza, Andrea, Stokic, Ljiljana Pejin, Pekericli, Ayfer, Pereira, David M, Perez-Padilla, Rogelio, Perez-Ruiz, Fernando, Perico, Norberto, Perry, Samuel A L, Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B, Petzold, Max, Phillips, Michael R, Phua, Hwee Pin, Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V, Polinder, Suzanne, Pond, Constance D, Pope, C Arden, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Powles, John, Prabhakaran, Dorairaj, Prasad, Noela M, Qato, Dima M, Quezada, Amado D, Quistberg, D Alex A, Racapé, Lionel, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Rao, Mayuree, Razavi, Homie, Reddy, K Srinath, Refaat, Amany H, Rehm, Jürgen, Remuzzi, Giuseppe, Ribeiro, Antonio L, Riccio, Patricia M, Richardson, Lee, Riederer, Anne, Robinson, Margaret, Roca, Anna, Rodriguez, Alina, Rojas-Rueda, David, Romieu, Isabelle, Ronfani, Luca, Room, Robin, Roy, Nobhojit, Ruhago, George M, Rushton, Lesley, Sabin, Nsanzimana, Sacco, Ralph L, Saha, Sukanta, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salomon, Joshua A, Salvo, Deborah, Sampson, Uchechukwu K, Sanabria, Juan R, Sanchez, Luz Maria, Sánchez-Pimienta, Tania G, Sanchez-Riera, Lidia, Sandar, Logan, Santos, Itamar S, Sapkota, Amir, Satpathy, Maheswar, Saunders, James E, Sawhney, Monika, Saylan, Mete I, Scarborough, Peter, Schmidt, Jürgen C, Schneider, Ione J C, Schöttker, Ben, Schwebel, David C, Scott, James G, Seedat, Soraya, Sepanlou, Sadaf G, Serdar, Berrin, Servan-Mori, Edson E, Shaddick, Gavin, Shahraz, Saeid, Levy, Teresa Shamah, Shangguan, Siyi, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin H, Shinohara, Yukito, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga D, Silberberg, Donald H, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Skirbekk, Vegard, Sliwa, Karen, Soljak, Michael, Soneji, Samir, Søreide, Kjetil, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stapelberg, Nicolas J C, Stathopoulou, Vasiliki, Steckling, Nadine, Stein, Dan J, Stein, Murray B, Stephens, Natalie, Stöckl, Heidi, Straif, Kurt, Stroumpoulis, Konstantinos, Sturua, Lela, Sunguya, Bruno F, Swaminathan, Soumya, Swaroop, Mamta, Sykes, Bryan L, Tabb, Karen M, Takahashi, Ken, Talongwa, Roberto T, Tandon, Nikhil, Tanne, David, Tanner, Marcel, Tavakkoli, Mohammad, Te Ao, Braden J, Teixeira, Carolina M, Téllez Rojo, Martha M, Terkawi, Abdullah S, Texcalac-Sangrador, José Luis, Thackway, Sarah V, Thomson, Blake, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobollik, Myriam, Tonelli, Marcello, Topouzis, Fotis, Towbin, Jeffrey A, Toyoshima, Hideaki, Traebert, Jefferson, Tran, Bach X, Trasande, Leonardo, Trillini, Matias, Trujillo, Ulises, Dimbuene, Zacharie Tsala, Tsilimbaris, Miltiadis, Tuzcu, Emin Murat, Uchendu, Uche S, Ukwaja, Kingsley N, Uzun, Selen B, van de Vijver, Steven, Van Dingenen, Rita, van Gool, Coen H, van Os, Jim, Varakin, Yuri Y, Vasankari, Tommi J, Vasconcelos, Ana Maria N, Vavilala, Monica S, Veerman, Lennert J, Velasquez-Melendez, Gustavo, Venketasubramanian, N, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wagner, Gregory R, Waller, Stephen G, Wallin, Mitchell T, Wan, Xia, Wang, Haidong, Wang, JianLi, Wang, Linhong, Wang, Wenzhi, Wang, Yanping, Warouw, Tati S, Watts, Charlotte H, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Wessells, K Ryan, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Williams, Hywel C, Williams, Thomas N, Woldeyohannes, Solomon M, Wolfe, Charles D A, Wong, John Q, Woolf, Anthony D, Wright, Jonathan L, Wurtz, Brittany, Xu, Gelin, Yan, Lijing L, Yang, Gonghuan, Yano, Yuichiro, Ye, Pengpeng, Yenesew, Muluken, Yentür, Gökalp K, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Younoussi, Zourkaleini, Yu, Chuanhua, Zaki, Maysaa E, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zhu, Shankuan, Zou, Xiaonong, Zunt, Joseph R, Lopez, Alan D, Vos, Theo, and Murray, Christopher J

Published
2015
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28. Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Newton, John N, Briggs, Adam D M, Murray, Christopher J L, Dicker, Daniel, Foreman, Kyle J, Wang, Haidong, Naghavi, Mohsen, Forouzanfar, Mohammad H, Ohno, Summer Lockett, Barber, Ryan M, Vos, Theo, Stanaway, Jeffrey D, Schmidt, Jürgen C, Hughes, Andrew J, Fay, Derek F J, Ecob, Russell, Gresser, Charis, McKee, Martin, Rutter, Harry, Abubakar, Ibrahim, Ali, Raghib, Anderson, H Ross, Banerjee, Amitava, Bennett, Derrick A, Bernabé, Eduardo, Bhui, Kamaldeep S, Biryukov, Stanley M, Bourne, Rupert R, Brayne, Carol E G, Bruce, Nigel G, Brugha, Traolach S, Burch, Michael, Capewell, Simon, Casey, Daniel, Chowdhury, Rajiv, Coates, Matthew M, Cooper, Cyrus, Critchley, Julia A, Dargan, Paul I, Dherani, Mukesh K, Elliott, Paul, Ezzati, Majid, Fenton, Kevin A, Fraser, Maya S, Fürst, Thomas, Greaves, Felix, Green, Mark A, Gunnell, David J, Hannigan, Bernadette M, Hay, Roderick J, Hay, Simon I, Hemingway, Harry, Larson, Heidi J, Looker, Katharine J, Lunevicius, Raimundas, Lyons, Ronan A, Marcenes, Wagner, Mason-Jones, Amanda J, Matthews, Fiona E, Moller, Henrik, Murdoch, Michele E, Newton, Charles R, Pearce, Neil, Piel, Frédéric B, Pope, Daniel, Rahimi, Kazem, Rodriguez, Alina, Scarborough, Peter, Schumacher, Austin E, Shiue, Ivy, Smeeth, Liam, Tedstone, Alison, Valabhji, Jonathan, Williams, Hywel C, Wolfe, Charles D A, Woolf, Anthony D, and Davis, Adrian C J

Published
2015
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31. An investigation of geographic blood pressure variations among men and women in Britain

Author

Bruce, Nigel Graeme

Subjects
616.1
Abstract

The age at which blood pressure (BP) variations between different communities emerge has important implications for aetiological research and for the primary prevention of hypertension. An opportunity to investigate this question in Britain arose with the finding of marked differences in mean BP of men aged 40-59 living in the 24 towns included in the British Regional Heart Study (BRHS). The Nine Towns Study (NTS) was set up to investigate whether these geographic variations in BP also existed for women, whether they were already present in young adults, and to begin exploring the reasons for the differences. A total of 2610 men and women aged 25-29, 40-44, and 55-59 form nine of the BRHS towns were examined, the towns having been chosen to cover the full range of mean BPs identified in the BRHS. A Dinamap 1846 automated recorder was used to minimise observer variation in BP measurement. Differences in age-adjusted mean town BPs at 40-59 years were 9.0 mmHg systolic in men (ANOVA; p=0.05) and 8.6 mmHg systolic in women (NS), and 5.0 mmHg diastolic (p<0.001) in men and 4.5 mmHg diastolic in women (p<0.01). The magnitude of the differences at 25-29 years were similar, and furthermore it was found that towns with higher mean BP in middle age tended to have higher mean BP in the young adults (correlations between town mean BPs at 25-29 and at 40-59 were, for systolic: r=0.74 for men and 0.65 for women; diastolic: r=0.76 for men and 0.78 for women). Associations between mean town BP in the NTS and in the BRHS at ages 40-59 were apparent for systolic (men r=0.66 p<0.05, women r=0.55), but not for diastolic. The associations between town BPs and the town mortality rates for cardiovascular disease were much stronger, with correlations of 0.81 (p<0.01) for systolic in men, and r=0.74 (p<0.05) for systolic in women. There was no evidence that the slopes of BP rise with age differed between the towns, either when the BP values for each subject were regressed linearly on age, or when differences in rates of hypotensive medication with age were taken into account. It is concluded that the geographic BP differences seen in late middle-age are already established by age 25-29. The Dinamap was compared with a Hawksley Random Zero sphygmomanometer in three separate validation studies covering the period of the main survey, and showed acceptable repeatability. Medication effects were allowed for by adjusting the town medians assuming that treated subjects had pre-treatment BP levels that were higher than the median for their age/sex group. A study of general practice BP readings for responders and non-responders suggested that the response rate, which varied between towns and age/sex groups, would not have introduced important bias. Overall observer effects were small, but there was evidence that the difference between observers varied between towns. Room and outdoor temperature and outdoor humidity were not important factors in explaining the pattern of town BP results. The most important validation of the findings came from the associations between mean town BPs and cardiovascular mortality. This study has shown that geographic blood pressure variations in Britain are already established in men and women aged 25-29 years. These results are consistent with the findings of studies which compare populations in different countries, urban/rural comparisons, and studies of different racial groups. Preliminary work on the causes of the geographic blood pressure differences is presented, and this suggests that BMI, the Na/K ratio and alcohol consumption are the most important factors for systolic differences in men, and BMI and Na/K for systolic differences in women. However, these factors explained very little of the geographic differences in diastolic blood pressure. The results of this study indicate the potential value of research into the determinants of differing population blood pressure levels in children and adolescents, and suggest that action on obesity, the Na/K ratio and alcohol consumption would be a valuable part of a public health strategy aimed at the primary prevention of raised blood pressure.

Published
1991

32. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Wang, Haidong, Liddell, Chelsea A, Coates, Matthew M, Mooney, Meghan D, Levitz, Carly E, Schumacher, Austin E, Apfel, Henry, Iannarone, Marissa, Phillips, Bryan, Lofgren, Katherine T, Sandar, Logan, Dorrington, Rob E, Rakovac, Ivo, Jacobs, Troy A, Liang, Xiaofeng, Zhou, Maigeng, Zhu, Jun, Yang, Gonghuan, Wang, Yanping, Liu, Shiwei, Li, Yichong, Ozgoren, Ayse Abbasoglu, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Alemu, Zewdie Aderaw, Allen, Peter J, AlMazroa, Mohammad AbdulAziz, Alvarez, Elena, Amankwaa, Adansi A, Amare, Azmeraw T, Ammar, Walid, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Asad, Majed Masoud, Assadi, Reza, Banerjee, Amitava, Basu, Sanjay, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Bhutta, Zulfiqar, Blore, Jed D, Basara, Berrak Bora, Boufous, Soufiane, Breitborde, Nicholas, Bruce, Nigel G, Bui, Linh Ngoc, Carapetis, Jonathan R, Cárdenas, Rosario, Carpenter, David O, Caso, Valeria, Castro, Ruben Estanislao, Catalá-Lopéz, Ferrán, Cavlin, Alanur, Che, Xuan, Chiang, Peggy Pei-Chia, Chowdhury, Rajiv, Christophi, Costas A, Chuang, Ting-Wu, Cirillo, Massimo, da Costa Leite, Iuri, Courville, Karen J, Dandona, Lalit, Dandona, Rakhi, Davis, Adrian, Dayama, Anand, Deribe, Kebede, Dharmaratne, Samath D, Dherani, Mukesh K, Dilmen, Uğur, Ding, Eric L, Edmond, Karen M, Ermakov, Sergei Petrovich, Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fijabi, Daniel Obadare, Foigt, Nataliya, Forouzanfar, Mohammad H, Garcia, Ana C, Geleijnse, Johanna M, Gessner, Bradford D, Goginashvili, Ketevan, Gona, Philimon, Goto, Atsushi, Gouda, Hebe N, Green, Mark A, Greenwell, Karen Fern, Gugnani, Harish Chander, Gupta, Rahul, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Harb, Hilda L, Hay, Simon, Hedayati, Mohammad T, Hosgood, H Dean, Hoy, Damian G, Idrisov, Bulat T, Islami, Farhad, Ismayilova, Samaya, Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B, Juel, Knud, Kabagambe, Edmond Kato, Kazi, Dhruv S, Kengne, Andre Pascal, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khang, Young-Ho, Kim, Daniel, Kinfu, Yohannes, Kinge, Jonas M, Kokubo, Yoshihiro, Kosen, Soewarta, Defo, Barthelemy Kuate, Kumar, G Anil, Kumar, Kaushalendra, Kumar, Ravi B, Lai, Taavi, Lan, Qing, Larsson, Anders, Lee, Jong-Tae, Leinsalu, Mall, Lim, Stephen S, Lipshultz, Steven E, Logroscino, Giancarlo, Lotufo, Paulo A, Lunevicius, Raimundas, Lyons, Ronan Anthony, Ma, Stefan, Mahdi, Abbas Ali, Marzan, Melvin Barrientos, Mashal, Mohammad Taufiq, Mazorodze, Tasara T, McGrath, John J, Memish, Ziad A, Mendoza, Walter, Mensah, George A, Meretoja, Atte, Miller, Ted R, Mills, Edward J, Mohammad, Karzan Abdulmuhsin, Mokdad, Ali H, Monasta, Lorenzo, Montico, Marcella, Moore, Ami R, Moschandreas, Joanna, Msemburi, William T, Mueller, Ulrich O, Muszynska, Magdalena M, Naghavi, Mohsen, Naidoo, Kovin S, Narayan, KM Venkat, Nejjari, Chakib, Ng, Marie, de Dieu Ngirabega, Jean, Nieuwenhuijsen, Mark J, Nyakarahuka, Luke, Ohkubo, Takayoshi, Omer, Saad B, Caicedo, Angel J Paternina, Wyk, Victoria Pillay-van, Pope, Dan, Pourmalek, Farshad, Prabhakaran, Dorairaj, Rahman, Sajjad UR, Rana, Saleem M, Reilly, Robert Quentin, Rojas-Rueda, David, Ronfani, Luca, Rushton, Lesley, Saeedi, Mohammad Yahya, Salomon, Joshua A, Sampson, Uchechukwu, Santos, Itamar S, Sawhney, Monika, Schmidt, Jürgen C, Shakh-Nazarova, Marina, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Singh, Jasvinder A, Skirbekk, Vegard, Sliwa, Karen, Soshnikov, Sergey S, Sposato, Luciano A, Stathopoulou, Vasiliki Kalliopi, Stroumpoulis, Konstantinos, Tabb, Karen M, Talongwa, Roberto Tchio, Teixeira, Carolina Maria, Terkawi, Abdullah Sulieman, Thomson, Alan J, Thorne-Lyman, Andrew L, Toyoshima, Hideaki, Dimbuene, Zacharie Tsala, Uwaliraye, Parfait, Uzun, Selen Begüm, Vasankari, Tommi J, Vasconcelos, Ana Maria Nogales, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Waller, Stephen, Wan, Xia, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Westerman, Ronny, Wilkinson, James D, Williams, Hywel C, Yang, Yang C, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Younis, Mustafa, Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhu, Shankuan, Vos, Theo, Lopez, Alan D, and Murray, Christopher J L

Published
2014
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35. Dovetailing Language and Content: Teaching Balanced Argument in Legal Problem Answer Writing.

Author

Bruce, Nigel

Abstract

Describes an approach to teaching first-year law students in an English for academic purposes course on how to write the academic genre of the legal problem answer. Offers students rhetorical tools to translate legal reasoning moves into effective written response to legal problems. The dovetailing of language and content involved considerable research into the law of tort and the legal reasoning moves required to analyze the legal problem question genre. (Author/VWL)

Published
2002

36. Providing Electronic Writing Resources for Academic Purposes: Issues of Control and Flexibility.

Author

Bruce, Nigel

Abstract

Reviews "Academic Writing: An Interactive Language Based CD-ROM for Teaching Academic Writing Skills to University Students." Suggests language teachers in the tertiary sector are required to accommodate the specific disciplinary needs of their students, and that it is rare for most commercial textbooks to find their way into an English for academic purposes or English for special purposes classroom. (Author/VWL)

Published
2001

38. Don't Forget the Teachers! Evaluating the Impact of IT Integration into a University Curriculum.

Author

Bruce, Nigel and Desloge, Pat

Abstract

Reports findings from two surveys into the experiences and attitudes of teachers in a university English teaching unit to the prospect of a curriculum increasingly mediated through information technology. Responses bear witness to problems teachers experienced attempting to computerize their pedagogical practices and show how issues of technology, workload, and support can contribute to anxiety and resistance in the workplace. (Author/VWL)

Published
1999

42. Communicative Dynamism in Expository Academic English: Some Strategies in Teaching the Pragmatics of Writing.

Author

Bruce, Nigel J.

Abstract

There are qualities or organizational principles in discourse that determine its information structure and contribute to its communicative dynamism. A "wave" model of discourse analysis shows graphically how each successive item of new information in a text provides a platform for the next new item, or "wave," of information. The model is based on the following concepts: (1) new information tends to come near the end of information units, and assumed or understood information at the beginning; (2) information tends to be ordered from left to right in the information unit according to its degree of informativity; (3) in descriptive scientific texts, there is a tendency for the structural/concrete to precede the functional/abstract; and (4) the degree of informativity of a clause or sentence can determine its position in the left-right hierarchy of a sentence or thematic unit. Using the model, the student can ask questions to test the purpose and appropriateness of an utterance by matching what the utterance seems to be answering against what it should answer in light of contextual and rhetorical expectation. The model is illustrated using a paragraph classifying three muscle types in the body. A brief bibliography is included. (MSE)

Published
1988

43. The Roles of Metadiscourse, Speech Acts & the Language of Abstraction in a Top-Down Approach to Teaching English for Academic Purposes (or: 'Never Mind What He's Saying, What's He Doing?').

Author

Bruce, Nigel J.

Abstract

Instruction in English for academic purposes can be enhanced by an approach using metadiscourse, or an awareness of the operations of discourse. Student competence in this area would improve the ability to appreciate the strategies of academic writers, describe the arguments of others, and write academic essays, particularly introductions. In teaching academic reading and writing, it is vital to emphasize the value of paraphrasing. This requires articulation at a level of abstraction most second-language students have little experience with. One method, the study cycle approach, takes students through a communication cycle in stages similar to those used in other subject areas, including: access to information presented in academic English; analysis of the underlying conceptual content and rhetorical design; synthesis and organization of the resulting information; and articulation in English of a range of academic response types (summary, interpretation, argument, etc.). Materials using this approach should be designed: (1) using a matrix of concepts underlying the principal text used; (2) emphasizing organization of information; and (3) focusing on the transitions across levels of abstraction and the importance of advanced vocabulary training. A brief bibliography, list of metadiscourse vocabulary, and additional teacher material are appended. (MSE)

Published
1989

44. The Revision Process in Academic Writing: From Pen & Paper to Word Processor.

Author

Chadwick, Stephen and Bruce, Nigel

Abstract

A study at Hong Kong University explored the use of the word processor as a writing tool in enhancing a process approach to writing instruction and the effect it has on writing performance, student attitudes to writing and revising, and the process by which students revise their scripts. A comparative analysis was done on a control group of 13 first-year industrial and mechanical engineering students and on an experimental group comprised of 12 first-year students from the civil and electrical engineering departments. On entry to the report writing course both groups were found to be comparable in terms of writing skills. Both groups also had the same instructor. The control group was taught in a conventional setting, doing all their work by hand, whereas sessions for the experimental group were timetabled in a computer laboratory and writing was done on word processors. Findings suggest that writing on the computer did produce immediate and direct effects on writing quality. Findings revealed no significant differences in opinions about pre-writing, writing, or revision strategies. Students in the experimental group, however, were more positive about the improvement and effectiveness of their writing. The experimental group revealed greater improvement in the revision process at the macrostructural level, particularly in the categories of substitution, addition, and permutation. Data suggest that use of the computer is a vast improvement in the process-oriented approach to writing. (Three appendixes of data and 26 references are attached.) (KEH)

Published
1989

45. Hongkong Papers in Linguistics and Language Teaching, 12.

Author

Hong Kong Univ. Language Centre., Bruce, Nigel J., and Crewe, William J.

Abstract

Papers on linguistics and language teaching in this volume are the following: "The Revision Process in Academic Writing: From Pen and Paper to Word Processor" (Stephen Chadwick, Nigel Bruce); "Sentence Sequence and Coherence: In Search of Readers' Problems in Academic Discourse" (Desmond Allison); "Plural Marking in Hong Kong English" (Carol Budge); "A Reading Experiment with L2 Readers of English in Hong Kong--Effects of Rhetorical Structure of Expository Texts on Reading Comprehension" (Rebecca W. K. Foo); "Quis Custodiet...? Errors in Guides to English Usage for Hong Kong Students" (Mark Newbrook); and "Review of 'Code-Mixing and Code Choice: A Hong Kong Case Study' by John Gibbons" (Mark Newbrook). Editorial policy, a style sheet, notes on contributors, and an index to papers in volumes 1-11 are also included. (MSE)

Published
1989

49. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis

Author

Nair, Harish, Nokes, D James, Gessner, Bradford D, Dherani, Mukesh, Madhi, Shabir A, Singleton, Rosalyn J, O'Brien, Katherine L, Roca, Anna, Wright, Peter F, Bruce, Nigel, Chandran, Aruna, Theodoratou, Evropi, Sutanto, Agustinus, Sedyaningsih, Endang R, Ngama, Mwanajuma, Munywoki, Patrick K, Kartasasmita, Cissy, Simões, Eric AF, Rudan, Igor, Weber, Martin W, and Campbell, Harry

Published
2010
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