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Women Leaders 2019
On 6th June 2019, over 150 senior women business leaders and entrepreneurs from the private, public, education and third sectors came together in London to celebrate women in leadership and to inspire more women leaders to get involved in the work of Local Enterprise Partnerships (LEPs) at board level.
In July 2018 the Government published Strengthened Local Enterprise Partnerships, setting out the role and responsibilities of Local Enterprise Partnerships in driving local growth and productivity. As part of that review, government said 1/3 of every LEP Board will be women by 2020, and 1/2 of every LEP Board by 2023. Many LEPs have already met or exceeded this, whilst others are working on action plans to improve gender diversity on their boards.
The LEP Network hosted the event to help LEPs achieve the LEP Review ambition of diversity by first bringing together a large group of women leaders - some of whom are successfully engaged in improving gender diversity within their organisations, and others who are leaders in their field and interested in working closer with LEPs as they shape their Local Industrial Strategy. This LEP Network event:
showcased existing women in leadership positions and the challenges and barriers they face;
inspired women leaders to get involved with LEPs;
promoted the impact that LEPs have had.
The event included a variety of dynamic speakers, panel discussions and Q&A sessions. Click here to download the full event programme.
Click here for more information. Click here to download the Building Small Business Britain report.
Speakers and panellists
We were delighted to have so many distinguished speakers and panellists from a wide range of organisations and sectors who shared their personal experiences and insights for inspiring more women into leadership roles. Click here to read their biographies.
Christine Gaskell CBE DL, Chair of Cheshire & Warrington LEP, explains why we need many more women in our boardrooms. On 25th September 2018 she brought together, for the first time, women LEP board members from around the country to meet with women business leaders and Government officials to find ways in which we can encourage more women to join LEP boards. And, of course, that is the purpose of our event on 6th June.
According to the World Economic Forum, during the last decade the proportion of women leaders increased by an average of a little more than 2% across the 12 industries it studied. "Along with my LEP Network colleagues, I passionately believe in equality and diversity of opportunity to develop skills and capabilities to create a pipeline of future leaders, regardless of gender. There is lots of evidence that points to a correlation between diversity and success. I am under no illusion that we can tip the scales overnight, but over time I'm confident we will achieve parity." Read more...
Why more women should consider applying for LEP board positions.
Sara Uzzell became a private sector board member for Dorset LEP in July 2016. She speaks about the benefits of non-executive positions and calls for more women to consider applying for LEP board positions. Read more...
Without greater female representation on boards, we are losing out.
Dr Philippa Roles is a non-executive director of Thames Valley Berkshire LEP and a Partner at Field Seymour Parkes LLP. Women leaders not only provide an important source of talent but also a critically different perspective. Read more...
What it's like to be a LEP Chair.
Dr Ann Limb CBE DL, outgoing Chair of South East Midlands LEP, talks about the opportunities and benefits of being a LEP Chair. Watch...
Ann also speaks out for strengthening women in leadership positions and on LEP boards in particular. Read more...
Julie Kapsalis, board member at Coast to Capital LEP, shares her insights on diversity and leadership and in particular what inspired her to become a LEP board member. "Our region is diverse – so I believe that Coast to Capital must reflect and celebrate this diversity – from the make-up of our Board and staff to our values and the way we engage with businesses and stakeholders. Diversity fosters growth and innovation and is integral to the delivery of our strategy." Read more...
Not enough women are putting themselves forward for non-executive positions
Anja Skvortsova is Associate Director of Audeliss and has over 13 years' international experience in executive talent acquisition. Anja describes the underlying reasons why not enough women are applying to be LEP board members and suggests some solutions. Read more...
Martino Burgess, Associate Director, Head of Corporate SME at Gregg Latchams and board member at West of England LEP, says: "One of the key things I get out of being on the LEP Board is a real insight into government policy nationally and how it fits into our region's economy. It's extremely important to have a mix of senior leadership experience and viewpoints on the LEP Board. We're a vast region with lots of different communities and it's good that all those communities are represented."
The Holy Grail of balanced boards
Linda Cheung, Enterprise M3 LEP board member and co-founder at Intrapreneur Nation, shares her thoughts on the challenges facing LEPs as they seek more balanced boards. Read more...
When was the last time you or your organisation took a chance on someone?
Simone Roche MBE, CEO & Founder of Northern Power Women explores why now is the time to take a chance on someone new and for your organisation to embrace mentoring, support and encouragement. Read more...
Amanda Lyne, board member at Liverpool City Region LEP explains how rewarding it is to get involved with your LEP at board level. You are part of a team that provides the strategic advice and guidance for economic development priorities for your area. You have a voice on local issues. It's enjoyable to be part of something bigger than your day-to-day responsibility where you make a real, valuable contribution to the economic success of your area. Read more...
News and opinions
The WBC was set up by now Prime Minister Theresa May in 2012, and produced its first report a year later structured around five key themes: (1) raising girls' aspirations to consider careers in STEM roles; (2) improving the talent pipeline from the classroom to the boardroom; (3) opening up opportunities for older working women; (4) increasing the number of female entrepreneurs; and (5) engaging more male business leaders. WBC has produced a number of reports since 2013 - the latest report was published in November 2018. It sets out the progress made over the past 5 years, in business and across society. Compared to 2013, there are now more women in employment; more women studying and entering typically higher paid STEM jobs; more women progressing to senior management positions, more women leading SMEs and more women in their 50s in work.
Landmark review sparks action to boost number of female entrepreneurs
Plans to increase the number of female entrepreneurs in Britain by 50% were set out on International Women's Day (Friday 8th March 2019), after research found women face too many barriers to setting up a business. The independent review – commissioned by the Treasury and headed up by Alison Rose, Deputy CEO of NatWest – identifies these barriers and makes recommendations on what can be done to overcome them. Read more…
Improving gender balance in FTSE leadership
The Hampton-Alexander Review is an independent review body which builds on the excellent work of the Davies Review to increase the number of women on FTSE 350 boards. We are committed to achieving the 33% target for women on boards and in leadership teams of FTSE 350 companies by 2020. The goal and inherent benefits for British business are within reach. However, success requires robust action from all stakeholders and every FTSE 350 company to play their part. Read more...
The 30% Club campaign was set up by Dame Helena Morrissey in 2010 with the aim of achieving a minimum of 30% female representation on FTSE 100 boards. The 30% Club believes that companies with a good balance of men and women in senior roles have better insights into their customers and market opportunities, make better decisions, and perform better financially. Read more...
International Women's Day, 8th March 2019
Right now is a great and important time in history to do everything possible to help forge a more gender-balanced world. Women have come a long way, yet there's still more to be achieved. Read more... And click here to see how we marked this special day.
Companies told women must make up third of senior directors by 2020
Dozens of firms have been told to put more women in their boardrooms. The Investment Association, a financial sector trade body, and the government-backed Hampton-Alexander review have written to 69 companies, calling on them to have 33% of their boards made up of women by 2020. They said it was "unacceptable" that one in five of the UK's biggest companies in the FTSE 350 index are falling short on gender diversity. Of the firms singled out, 66 have only one woman on their board, while three firms have an all-male board. Chris Cummings, Chief Executive of The Investment Association said "Companies must do more than take the tokenistic step of appointing just one woman to their board and consider that job done. Sir Philip Hampton, who chairs the review, said the fact that companies had failed to bring women into board rooms and into leadership positions "does not reflect the population of very talented women capable of making great contributions in boardrooms". Read more...
We were delighted to have Charlotte Keenan from the Goldman Sachs 10,000 Small Businesses programme as our opening keynote speaker and two alumni of the programme on our panels. For more information about the 10,000 Small Businesses programme click here or email.
If you think you have what it takes to lead and shape the economic growth ambitions of your local area, click here to find out more about current vacancies on LEP Boards.
Follow us on twitter and use the hashtag to join the conversation.
Cumbria LEP has just recruited three of the county's top women business leaders to help drive economic growth and productivity across Cumbria.
A big welcome to Lindsey Rix who has just been appointed Deputy Chair of the New Anglia LEP Board.
Greater Lincolnshire LEP boosted its board with four new recruits in January, two of them local women buisness leaders - Sarah Louise Fairburn and Nick Worboys.
Five new board members announced for the D2N2 Local Enterprise Partnership, significantly boosting its representation from the business community, three of whom are women business leaders. Read more...
Digital entrepreneur Zoe Easey has been co-opted onto the board of the Greater Lincolnshire LEP for a year to help steer the LEP's digital strategy. Read more...
Worcestershire LEP welcomes two new women business leaders to its board - Sue Jordan and Nicola Whiting. Read more...
LEP Chairs Christine Gaskell CBE DL and Dr Ann Limb CBE DL met with the Prime Minister at the PM Council of LEP Chairs in June 2018 and January 2019.
The Women of the Future Awards, founded by Pinky Lilani CBE DL in 2006, were conceived to provide a platform for the pipeline of female talent in the UK. Through the Women of the Future Programme we have built a remarkable, informal community of influential women determined not only to build fruitful professional and personal relationships with one another, but to be advocates for an exciting new generation of business talent. Nominations for 2019 will open in June. Click here for more information.
For every £1 of venture capital investment, less than 1p goes to all-women led teams, a new report finds. The research, commissioned by government, will inform ongoing work to tackle this issue and boost the economy. The UK VC & Female Founders report found that for every £1 of venture capital (VC) investment in the UK, all-women founder teams get less than 1p. By comparison, all-male founder teams get 89p and mixed-gender teams get the remaining 10p.
7th November 2019. The summit will bring together the innovators of today and tomorrow to explore the evolving values relevant to the next generation of leaders. We aim to inspire and energise the leaders of tomorrow and create a supportive global forum for them. Our mission is to discuss the key issues faced today and to consider how progress can be made. We will do this through the lens of a new generation of leaders, exploring how the shifts in culture and leadership style reflect global challenges in a different light, creating new ideas and opportunities. Read more...
Men as Change Agents
The Women's Business Council has highlighted that too often and for too long, gender equality has been the business of women. The Women's Business Council is committed to increasing the number of male leaders as change agents, by building and showcasing a critical mass of supportive male CEOs who can drive real change as trailblazer organisations improving outcomes for girls and women accessing, progressing and remaining in industry. Read more...
Are women sabotaging their own business by not dealing with their fear of public speaking? (Written by Aly Harrold for Elite Business magazine)
Women are increasingly stepping into the limelight – in the boardroom and in front of cameras. While many are finding their voices, sharing their opinions and shaping conversations about the world around us, some women find it hard to make themselves heard. At a time when the art of self-promotion is growing in importance and ways to broadcast our messages through social media stories are constantly evolving, more and more entrepreneurs are embracing these opportunities and benefiting from the results. But what do you do if the very thought of a live video or speaking in front of an audience is simply too terrifying? Read more…
@TheLEPNetwork
LEPs are already accelerating initiatives across sectors the Chancellor mentioned today incl. developing groundbreaking life sciences in Hertfordshire and getting over 50's back into the workforce through Skills Bootcamps. https://t.co/PvQ2Z3HA3H @Jeremy_Hunt @michaelgove
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The fifth Leicestershire Innovation Festival will take place in February – with organisers keen to place the spotlight on productivity and the role of...
The CBI will be delivering daily webinars to keep both members and the wider business community abreast of the latest updates and the impact of the vi...
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CBI Coronavirus Webinars
The CBI are holding daily updates on coronavirus, how it's impacting the business community, and what business is doing do mitigate the impact.
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I will prophesy that the signs of the coming of the Son of Man are already commenced. One pestilence will desolate after another. We shall soon have war and bloodshed. The moon will be turned into blood. I testify of these things, and that the coming of the Son of Man is nigh, even at your doors. If our souls and our bodies are not looking forth for the coming of the Son of Man; and after we are dead, if we are not looking forth, we shall be among those who are calling for the rocks to fall upon them.
Joseph Smith continued visiting myself and others up to a certain time, and then it stopped. The last time I saw him was in heaven. In the night vision I saw him at the door of the temple in heaven. He came and spoke to me. He said he could not stop to talk with me because he was in a hurry. The next man I met was Father Smith; he could not talk with me because he was in a hurry. I met half a dozen brethren who had held high positions on earth, and none of them could stop to talk with me because they were in a hurry. I was much astonished. By and by I saw the Prophet again, and I got the privilege to ask him a question. "Now," said I, "I want to know why you are in a hurry. I have been in a hurry all through my life; but I expected my hurry would be over when I got into the kingdom of heaven, if I ever did." Joseph said: "I will tell you, Brother Woodruff. Every dispensation that has had the Priesthood on the earth and has gone into the celestial kingdom, has had a certain amount of work to do to prepare to go to the earth with the Savior when He goes to reign on the earth. Each dispensation has had ample time to do this work. We have not. We are the last dispensation, and so much work has to be done, and we need to be in a hurry in order to accomplish it." Of course, that was satisfactory to me, but it was new doctrine to me.
And all they who suffer persecution for my name, and endure in faith, though they are called to lay down their lives for my sake yet shall they partake of all this glory.
Wherefore, fear not even unto death; for in this world your joy is not full, but in me your joy is full.
Living to participate in the glory of the second coming does not seem to be an issue for the righteous. As the scriptures just referred to point out, the righteous will be blessed with the wonders and blessings of the second coming whether in this world or the world to come.
We become aware of the excitement felt by those who are about to be resurrected from D&C 138.
All these had departed the mortal life, firm in the hope of a glorious resurrection, through the grace of God the Father and his Only Begotten Son, Jesus Christ.
I beheld that they were filled with joy and gladness, and were rejoicing together because the day of their deliverance was at hand.
They were assembled awaiting the advent of the Son of God into the spirit world, to declare their redemption from the bands of death.
Their sleeping dust was to be restored unto its perfect frame, bone to his bone, and the sinews and the flesh upon them, the spirit and the body to be united never again to be divided, that they might receive a fulness of joy.
And there he preached to them the everlasting gospel, the doctrine of the resurrection and the redemption of mankind from the fall, and from individual sins on conditions of repentance.
Notice that the term used here is the reverse of the term "abomination of desolation" used by Daniel in Daniel 9:27 and quoted by the Lord in Matthew 24:15; JS-M 1:32. In these verses the wicked (the abominable)destroy (make desolate) the temple and the city of Jerusalem. However, when the Lord comes he will make desolate (destroy) all that is wicked (abominable), thus the desolation of abomination of the wicked both in this world and in the world to come. It therefore appears that both the righteous and the wicked on both sides of the veil participate in some way in the second coming. Thus it becomes, as Malachi prophesied, ". . . the coming of the great and dreadful day of the Lord" (Malachi 4:5). It is great day for the righteous and dreadful day for the wicked on both sides of the veil.
When the Lord returns he will make some appearances to specific groups and then culminate his return by his appearance in great power, majesty, and glory, in such a manner that all the world will see him (see D&C 133:17-22 and 101:22-23). Four appearances of the Lord have had particular mention by the prophets: two of these appearances will be to the Saints; one appearance will be to the Jews; and the fourth will be his final coming to the world.
"Not many years hence there shall be another gathering of high priests and righteous souls in this same valley of Adam-ondi-Ahman. At this gathering Adam, the Ancient of Days, will again be present. At this time the vision which Daniel saw will be enacted. The Ancient of Days will sit. There will stand before him those who have held the keys of all dispensations, who shall render up their stewardship to the first patriarch of the race, who holds the keys of salvation. This shall be a day of judgment and preparation.
"Until this grand council is held, Satan shall hold rule in the nations of the earth; but at that time thrones are to be cast down and man's rule shall come to an end.. . Then shall he give the government to the saints of the Most High. . .
President Lorenzo Snow, speaking of those who will be living in Jackson County at that time, said: "If you will not have seen the Lord Jesus at that time you may expect Him very soon, to see him, to eat and drink with Him, to shake hands with Him and to invite him to your houses as He was invited when He was here before" (Deseret News, 15 June 1901, p. 1).
The appearance at the Mount of Olives.
The Savior's appearance to the Jews will occur when Jerusalem and its environs are besieged by many nations. At the close of a long and costly war, known as the battle of Armageddon, the Jews will flee for safety to the Mount of Olives. There the Savior will make his appearance. (See D&C 45:48-53; 77:15; 133:35; Revelation 11:1-13; Zechariah 14:1-9).
And it shall come to pass, that after they are laid before the bishop of my church, and after that he has received these testimonies concerning the consecration of the properties of my church, that they cannot be taken from the church, agreeable to my commandments, every man shall be made accountable unto me, a steward over his own property, or that which he has received by consecration, as much as is sufficient for himself and family.
And again, if there shall be properties in the hands of the church, or any individuals of it, more than is necessary for their support after this first consecration, which is a residue to be consecrated unto the bishop, it shall be kept to administer to those who have not, from time to time, that every man who has need may be amply supplied and receive according to his wants.
And righteousness will I send down out of heaven; and truth will I send forth out of the earth, to bear testimony of mine Only Begotten; his resurrection from the dead; yea, and also the resurrection of all men; and righteousness and truth will I cause to sweep the earth as with a flood, to gather out mine elect from the four quarters of the earth, unto a place which I shall prepare, an Holy City, that my people may gird up their loins, and be looking forth for the time of my coming; for there shall be my tabernacle, and it shall be called Zion, a New Jerusalem.
We have revelations that tell us that the gospel is to go to every nation, kindred, tongue, and people before the second coming of the Son of Man (Matt. 24:14; JS-M 1:31). And we have revelations that recite that when the Lord comes, he will find those who speak every tongue and are members of every nation and kindred, who will be kings and priests, who will live and reign on earth with him a thousand years (Rev. 5:9-10; 1 Ne. 14:12; D&C 90:11). That means, as you know, that people from all nations will have the blessings of the house of the Lord before the Second Coming.
Therefore, the Lord's judgments were considered righteous because all had been warned. However, before he appeared to them most of them had turned like a dog to his vomit and had become wicked again (3 Nephi 7:8).
For the day cometh that the Lord shall utter his voice out of heaven; the heavens shall shake and the earth shall tremble, and the trump of God shall sound both long and loud, and shall say to the sleeping nations: Ye saints arise and live; ye sinners stay and sleep until I shall call again.
Wherefore gird up your loins lest ye be found among the wicked.
For if I, who am a man, do lift up my voice and call upon you to repent, and ye hate me, what will ye say when the day cometh when the thunders shall utter their voices from the ends of the earth, speaking to the ears of all that live, saying–Repent, and prepare for the great day of the Lord?
Yea, and again, when the lightnings shall streak forth from the east unto the west, and shall utter forth their voices unto all that live, and make the ears of all tingle that hear, saying these words–Repent ye, for the great day of the Lord is come?
And again, the Lord shall utter his voice out of heaven, saying: Hearken, O ye nations of the earth, and hear the words of that God who made you.
It is true that the Lord has not yet spoken by the voice of thunders, calling upon the people from the ends of the earth, saying, "Repent and prepare for the great day of the Lord," but such an event will come; and when it does come it will not be a mere ordinary, common thunderstorm, such as we experience occasionally, extending only over a small extent of country, but the Lord will cause the thunders to utter their voices from the ends of the earth until they sound in the ears of all that live, and these thunders shall use the very words here predicted–"Repent O ye inhabitants of the earth, and prepare the way of the Lord, prepare yourselves for the great day of the Lord." These words will be distinctly heard by every soul that lives, whether in America, Asia, Africa, Europe, or upon the islands of the sea. And not only the thunders, but the lightings will utter forth their voices in the ears of all that live, saying, "Repent, for the great day of the Lord is come." Besides the voices of thunder and lightning, the Lord himself, before he comes in his glory, will speak by his own voice out of heaven in the ears of all that live, commanding them to repent and to prepare for his coming (emphasis added). I do not know how the Lord will send forth his voice so as to make all the people on the four quarters of the globe hear it, for the loudest sound that we can produce only extends over a small area, a few miles at most; but the Lord has power to make his voice heard by all that live on the four quarters of the earth, and when he fulfills this prediction, all that live will literally hear the words that are here named; and the wicked will perish out of the earth as they did in the days of Noah, and so far as they are concerned the earth will be made empty and desolate.
And there shall be men standing in that generation, that shall not pass until they shall see an overflowing scourge; for a desolating sickness shall cover the land.
 Brian H. Stuy, ed., Collected Discourses, 5 vols. [Burbank, Calif., and Woodland Hills, Ut.: B.H.S. Publishing, 1987-1992], 5: .
 Teachings of the Prophet Joseph Smith, selected and arranged by Joseph Fielding Smith [Salt Lake City: Deseret Book Co., 1976], 305.
 The Doctrine and Covenants Student Manual – Religion 324-325, (CES, The Church of Jesus Christ of Latter-day Saints, Salt Lake City, 1981), pp. 404-405.
 Neal A. Maxwell, Meek and Lowly [Salt Lake City: Deseret Book Co., 1987], 119.
 Joseph Smith, Teachings of the Prophet Joseph Smith, selected and arranged by Joseph Fielding Smith [Salt Lake City: Deseret Book Co., 1976], 286.
 Bruce R. McConkie, Sermons and Writings of Bruce R. McConkie [Salt Lake City: Bookcraft, 1998], 173.
 Journal of Discourses, 26 vols. [London: Latter-day Saints' Book Depot, 1854-1886], 15:332- 333.


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Anjal Jain
Science: "Rate of Vessel Density and Visual Field Loss using Optical Coherence Tomography Angiography and Humphrey Field Analyzer in Peripapillary Areas of Glaucomatous Eyes"
About Anjal
My name is Anjal Jain, and I am eighteen years old from Southern California. I am an aspiring Ophthalmologist, hoping to one day pioneer cutting-edge cures to untreatable visual impairments. This has been my dream for the past eleven years, and being a Davidson Fellow has placed me on the first step of this path. When I first started my research, it was a means to educate myself. Never did I imagine that my research had the potential to contribute to the active body of ophthalmologic research.
"The Davidson Fellows Scholarship has taught me that age does not define the bounds of curiosity and impact a person can make in the scientific field. Being a Davidson Fellow makes me feel empowered by my research and makes me inspired to continue my work towards finding a treatment for progressive vision loss."
Primary Open Angle Glaucoma is an irreversible and incurable visual impairment that gradually inflicts vision deterioration, leading to blindness over time. Currently, ophthalmologists use visual field tests from the Humphrey Field Analyzer machine to detect signs of glaucoma and monitor the degree of vision loss. A newer technology, the OCTA machine which captures vessel density, can also be used as an indicator of glaucoma-- smaller vessel densities implicating less ocular blood flow and hence deteriorating vision. My research compared visual field tests to OCTA images over the span of 12 - 16 months in non-glaucomatous and glaucomatous eyes. My findings revealed that the OCTA machine detected glaucoma at earlier stages before the traditional Humphrey Field Analyzer machine, meaning that the OCTA machine is capable of earlier glaucoma detection. This is vital for glaucoma patients: earlier glaucoma detection means treatment to slow vision loss can be administered earlier, and a greater magnitude of vision can be saved.
My passion for ophthalmology started when I was 7 years old-- one of my very close family members told me that he was diagnosed with Retinitis Pigmentosa, an irreversible and untreatable visual impairment. I was heartbroken that my role model could barely see my face and would soon be able to see nothing at all. As my family member's confidence was crumbling as fast as his condition was deteriorating, I was determined to learn more about his visual impairment and potential treatments for the future. During this process, I realized I was very passionate about ophthalmology, specifically its research, and was interested in pursuing it as a career.
So, in the summer of 2020, I reached out to Professor Grace Richter at USC's Keck School of Medicine, eager to get involved in her ophthalmologic research of visual impairments. Throughout the summer, I worked as part of Professor Richter's team, learning more about glaucomatous fundamentals and the Optical Coherence Tomography Angiography (OCTA) machine as a co-author on her research paper. Then a month later, my family member was diagnosed with glaucoma, a second irreversible visual impairment, and got visual field tests done by his ophthalmologist. Curious to understand more about his visual loss and how it was assessed in visual field tests, I independently researched the logistics behind visual tests taken by the Humphrey Field Analyzer. As I entered my junior year, I started taking the selective AP Research course at my high school. For my AP Research research paper, I decided to investigate a combination of my experiences at USC and my newly acquired knowledge of visual tests. I was interested in comparing two different means of glaucoma detection with each other, the OCTA machine and Humphrey Field Analyzer, to investigate the potential of early glaucoma detection, and hence earlier administrable treatment. As a high school researcher, I faced many challenges. Many regulations restricted my access to only deidentified patient data. For this reason, new data could not be morally and independently collected. So, I utilized databases instead. I only had 23 eyes in the non-glaucomatous group and 24 in the glaucomatous group. Having a larger number of patients would have been more ideal, as it would have increased the power of my t-test. This would have improved the accuracy of the averages and p-values presented in the results section, hence providing stronger evidence of whether a certain machine was statistically significant in terms of visual deterioration. In other words, it is possible that if I was able to increase my cohort size to 100 patients, the p-value could have changed. In the future, I hope to reach out to other universities and access their databases to add to my research dataset. Ultimately, however, the strict exclusion factors enacted allowed my research to be more representative of glaucomatous cases and hence produced more accurate p-values than the larger original dataset.
My findings have larger impacts and broader implications in the body of ophthalmologic knowledge: vessel density percent change can provide earlier signs of glaucoma than the conventional mean deviation difference in visual tests. This information is crucial in preserving patient eyesight. If glaucomatous visual deterioration is identified at an earlier stage, ophthalmologists would be able to administer treatment (ex: specialized eye drops or intraocular eye pressure surgeries) earlier. This would slow vision deterioration in glaucomatous patients, allowing them to cherish a greater portion of their eyesight. My research provides an additional means of earlier glaucoma detection, which in turn has the potential to administer earlier treatment and preserve a greater degree of vision. Glaucoma has impacted around 80 million people worldwide and is projected to impact 111 million by 2040. Research findings like mine in earlier glaucoma detection have the potential to slow visual deterioration and prevent irreversible blindness in millions. My research contributes to the future of bringing a vibrant world to the low-vision community.
Apart from being an Ophthalmologist, my dream job would be to pursue my artistic passions as a international singer who combines Hindustani and Western classical music and inspires young Indian children in the United States to stay connected with their culture.
If you could magically become fluent in any language, what would it be?
I would become fluent in Sanskrit, so that I could study the ancient literature of India and glean insights into the knowledge of some of the most brilliant minds in the world.
I have been singing ever since I was four years old and have found that it is a great means for me to destress and express my emotions. I attended the Orange County School of the Arts High School where I was able to pursue both my scientific and artistic passions as part of the classical voice conservatory.
Los Angeles – The Davidson Fellows Scholarship Program has announced the 2022 scholarship winners. Among the honorees are Vivien He, 18, of Rancho Palos Verdes, and Chunyi Zhou, 16, and Anjal Jain, 18, of Irvine. Only 21 students across the country are recognized as 2022 scholarship winners.

redpajama_set_name: RedPajamaCommonCrawl


On October 31, Law School students, faculty and visitors gathered for a lecture on the role of the International Court of Justice (ICJ), the principal judicial organ of the United Nations. This "broad brush of review" was delivered by one of the Court's fifteen judges, Hon. Bernardo Sepúlveda Amor.
Sepúlveda, who has sat on the ICJ since 2006, is a Professor of International Law at El Colegio de Mexico and an associate member of the Institut de Droit International. He was Mexico's Secretary of Foreign Relations from 1982 to 1988, served as its ambassador to Washington and to London, and was a member of the United Nations International Law Commission from 1997 to 2005.
Named in honor of Leo Berger J.D. '56 and his wife, Arvilla, the Berger International Legal Studies Program sponsors a varied and indispensable array of activities that provide Cornell Law students with legal training and skills of global relevance. The Berger Program has built links to law schools throughout Europe (for example, in France, Germany, Hungary, Italy, the Netherlands, Spain, and the U.K.) and in Australia. Other programs at the Law School have been active in Africa, East Asia and the Middle East. The Briggs Society of International Law, a student-run organization, was named in honor of one of Cornell's best-known public international law teachers and scholars. In cooperation with the Berger Program, the Briggs Society sponsors a number of field trips and events designed to bring J.D. and LL.M. students together throughout the year.


When working with other InterSystems products, a CSP (Web Server Page) file is a text file containing HTML, XML, or CSP markup commands. This file is stored on an InterSystems server machine and is compiled, by the CSP Engine, into an executable class that can process HTTP events sent from a browser.
You can use Studio to create and edit CSP files in the same way you would work with class definitions or routines. CSP files are displayed in the Studio syntax-coloring editor, allowing you to quickly spot errors in HTML as well as in any embedded server-side scripts.
Start Studio and create a new Project.
Select File > New > CSP File tab > Server Page to create a new CSP page.
Studio creates a new CSP Editor window containing a new CSP file named Untitled.csp.
Save the page with File > Save. The Save As dialog appears. Specify a directory location and project name, and select Save As.
Compile the page with Build > Compile .
View the resulting Web page from a browser with View > Web Page.
At this point, you should see a very simple Web page containing the words My Sample CSP Page in your browser.
Position the cursor in the CSP Editor window at the start of the blank line after My Sample CSP Page.
Select Insert > SQL Query.
Check Create HTML Table and select OK.
Save and recompile the page with Build > Compile.
View the resulting Web page from a browser with View > Web Page .
Now your CSP page displays a list of names and social security numbers in an HTML table.
To create a new CSP file, select File > New > CSP File tab > Server Page. This creates a new CSP file named Untitled.csp.
When you save this file for the first time, you are asked for a file name. If this file is part of a CSP application, create a folder with an application name, in which to put your new file.
The file name, which must have a .csp extension, is used for both saving a physical source file on the InterSystems server as well as in a URL requesting this page. The application name also determines the URL used to request the CSP page as well as other characteristics.
When you create a new CSP file in Studio, it opens a new CSP Editor window and copies into it the contents of a CSP template file. You can edit or replace this template file in order to customize how Studio creates new CSP files. This file is a text file called Default.csp and is located in the same directory as the Studio executable file.
You can edit a CSP file in the same way you would edit any other document in Studio.
Studio includes dialogs, a wizard, and templates to assist with editing CSP files. These dialogs are available under the Insert menu and are described in the table below.
Class Inserts a <csp:CLASS> tag at the current cursor location.
Loop Inserts a <csp:LOOP> tag at the current cursor location.
While Inserts a <csp:WHILE> tag at the current cursor location.
Object Inserts a <csp:OBJECT> tag at the current cursor location.
Query Inserts a <csp:QUERY> tag at the current cursor location.
SQL Query Inserts an SQL query (in a <SCRIPT> tag) at the current cursor location.
Save a CSP file using the File > Save. This sends the source of the CSP file back to the InterSystems server (which could be on a remote machine) and save it on the server's local file system in the appropriate directory (specified by the InterSystems server's CSP application settings). Studio automatically saves backup files for the five previous saves of a CSP file. For more information, see Save Automatically Backs Up Routines, Include Files.
Compile a CSP file using Build > Compile. Compiling a CSP File is a multi-step process: first the CSP file is fed through the CSP engine and converted into a class (derived from the %CSP.Page class). Then this generated class is compiled into one or more routines that contain executable code.
Sometimes it is easier to debug or understand a CSP file by looking at the code generated for it. You can use Studio to view the class generated for a CSP file, as well as the routines generated from this class, by opening them with File > Open or View > Other.
You can view the results of a CSP file in a browser by using View > Web Page. This launches your default browser with the URL for the current CSP page. You can also use this command when editing a %CSP.Page class.
You can modify the server address portion of the URL used to display a CSP page in a specific project. To do this, select Project > Settings and edit the value of the WEB Server field.
As an aid to debugging Web applications, Studio lets you request a web page from a URL and display its HTML source in a syntax coloring window. This can help you spot errors in web pages more easily than viewing the rendered HTML in a browser.


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text:
Cohort profile: the East London Health and Care Partnership Data Repository: using novel integrated data to support commissioning and research
Cohort profile
http://orcid.org/0000-0001-8369-9168Amy Ronaldson1,2,
Evangelos Chandakas3,
Qiongwen Kang3,
Katie Brennan3,
Aminat Akande3,
Irene Ebyarimpa3,
Eleanor Wyllie4,
George Howard4,
Richard Fradgley5,
Mark Freestone2,
http://orcid.org/0000-0002-9205-2144Kamaldeep Bhui2,6
1Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
2Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London, UK
3NHS Tower Hamlets Clinical Commissioning Group, London, London, UK
4Healthy London Partnership, London, UK
5East London NHS Foundation Trust, London, London, UK
6Department of Psychiatry, University of Oxford, Oxford, UK
Correspondence to Dr Amy Ronaldson; amy.ronaldson{at}kcl.ac.uk
Purpose The East London Health and Care Partnership (ELHCP) Data Repository was established to support commissioning decisions in London. This dataset comprises routine clinical data for the general practitioner (GP)-registered populations of two London boroughs, Tower Hamlets and City and Hackney, and provides a rich source of demographic, clinical and health service use data of relevance to clinicians, commissioners, researchers and policy makers. This paper describes the dataset in its current form, its representativeness and data completeness.
Participants There were 351 749 and 344 511 members of the GP-registered population in the two boroughs, respectively, for the financial year 2017/2018. Demographic information and prevalence data were available for 9 mental health and 15 physical health conditions. Prevalence rates from the cohort were compared with local and national data. In order to illustrate the health service use data available in the dataset, emergency department use across mental health conditions was described. Information about data completeness was provided.
Findings to date The ELHCP Data Repository provides a rich source of information about a relatively young, urban, ethnically diverse, population within areas of socioeconomic deprivation. Prevalence data were in line with local and national statistics with some exceptions. Physical health conditions were more common in those with mental health conditions, reflecting that comorbidities are the norm rather than the exception. This has implications for integrated care. Data completeness for risk factors (eg, blood pressure, cholesterol) was high in patients with long-term conditions.
Future plans The data are being further cleaned and evaluated using imputation, Bayesian and economic methods, principally focusing on specific cohorts, including type II diabetes, depression and personality disorder. Data continue to be collected for the foreseeable future to support commissioning decisions, which will also enable more long-term prospective analysis as data become available at the end of each financial year.
research cohort
This dataset will allow for the analysis of a relatively young, urban, ethnically diverse, considerably deprived population—groups that are hard to research with traditional survey methods.
The data are linked across care settings, allowing for the evaluation of integrated interventions.
Large amounts of data around health service utilisation and associated spend means this dataset can be used to support healthcare commissioning and health service delivery.
Reliance on primary care data for diagnostic information means that prevalence rates can be underestimated and certain information can be missed.
As is the case with all routine clinical data, the dataset requires extensive cleaning to remove errors.
The use of observational data is fundamental to healthcare service provision and health research, and increasingly large amounts of routinely collected clinical data are becoming available. The main advantage of these datasets is their comprehensive nature and large patient numbers.1 The development of these large routine datasets also allow for the application of big data analytic techniques within health research.2 These techniques can evaluate population characteristics, identify risk factors and allow for the development of predictive models relating to clinical outcomes.1 3 Moreover, these datasets identify areas of high health service utilisation and high-cost patients, which might support decision making around health service delivery for commissioners, policy makers and healthcare providers. To date, several large datasets comprising routine clinical data have been developed in the UK; these are being used to inform clinical practice and healthcare delivery.4–6
Recently, a large-scale routine clinical dataset has been developed in the Tower Hamlets borough of London, UK, comprising data from the general practitioner (GP)-registered populations of Tower Hamlets and its neighbouring borough, City and Hackney. The East London Health and Care Partnership (ELHCP) Data Repository was developed primarily to support commissioning decisions and health service delivery in East London and comprises rich information relevant to population health and clinical research. These areas of London are unique innercity areas with diverse populations and high levels of deprivation. Tower Hamlets is home to the largest Bangladeshi community in England.7 It also has the highest rate of poverty, child poverty and unemployment of any London borough.8 What might be of interest to researchers of severe mental illness (SMI) is that the borough of City and Hackney has the highest incidence of psychosis in England.9
The aim of this cohort profile is to introduce and describe the dataset in Tower Hamlets and City and Hackney, comparing population demographics, prevalence rates of mental and physical health conditions, health service utilisation and data completeness. We believe that this cohort profile might facilitate the development of other similar datasets. Moreover, these data will prove useful for clinicians, researchers, commissioners and policy makers, particularly those with an interest in understanding health in urban, diverse and deprived areas.
The development of the ELHCP Data Repository
The ELHCP Data Repository was developed by Tower Hamlets Clinical Commissioning Group (CCG) (https://www.towerhamletsccg.nhs.uk/) and North East London Commissioning Support Unit (NEL CSU) (http://www.nelcsu.nhs.uk/), with funding provided by Tower Hamlets CCG and Tower Hamlets Together (THT) Vanguard (https://www.towerhamletstogether.com/). Development of the dataset started in 2015 and efforts to expand the dataset (eg, to all areas in North East London) and improve data quality are ongoing.
The dataset comprises up-to-date patient-level data for GP-registered populations in the London boroughs of Tower Hamlets and City and Hackney and is updated every 3 months. All patient data are depersonalised and linked by replacing patient National Health Service (NHS) numbers with unique ID numbers. Data pertaining to geographic area (ie, Lower Super Output Area (LSOA)) and other population-level data are drawn from data aggregated by the Office of National Statistics. Presently, secure data streams are in place for: acute (inpatient, outpatient and emergency) services; community services; mental health services; substance misuse services and primary care services (eg, diagnostic information, prescribing). Efforts are underway to establish secure data streams for social care data, public health data (eg, sexual health) and urgent care data (eg, walk-in-centres). However, challenges surrounding linking social care data mean that sensitive information relating to housing and benefits will not be integrated into the dataset.
As illustrated in figure 1, data for acute, community and mental health services flow to the CCG via NHS digital, The Data Services for Commissioners Regional Office (DSCRO) and local CSUs. Pseudonymisation of the data is performed by the DSCRO hosted by the CSU. The data then flows to the local CSU, which formats and organises the data for use at the CCG. Primary care data flows to NEL CSU where a pseudonymisation process is carried out which mirrors that performed by the DSCRO. These data then flow to the local CSU alongside the acute, community and mental health data where they are added to the ELHCP Data Repository.
Diagram of data flows from healthcare providers to tower Hamlets and City Hackney CCGs. CCG, Clinical Commissioning Group; CDS, Commissioning Data Sets; CSU, Commissioning Support Unit; DCB, Data Coordination Board; DSCRO, Data Services for Commissioners Regional Office; NEL, North East London; NHS, National Health Service.
This cohort profile is a descriptive piece detailing the following:
Demographic information (eg, age, sex, ethnicity and deprivation).
Prevalence rates of mental and physical health conditions.
Data relating to health service utilisation in patients with mental health conditions
Information about data completeness.
All data presented in this profile were from financial year 2017/2018.
Population demographics
Demographic information for these populations included age, sex, ethnicity and deprivation index. There was also information relating to body mass index (BMI) and smoking status. Information about age, sex and ethnicity came from primary care records. Patients were classified into nine ethnic groups: white or not stated; Indian; Pakistani; Bangladeshi; other Asian; Black Caribbean; Black African; Chinese; other ethnic group. Deprivation was measured using the Index of Deprivation. This measure is provided for LSOAs—small areas that are focused on social homogeneity and a defined population size (1000–1500 residents).10 The ELHCP dataset allocates each LSOA in Tower Hamlets and City and Hackney to a decile of deprivation with '1' being the most deprived decile. Information relating to BMI and smoking status came from primary care records.
Mental and physical health conditions
Primary care data were used to identify and define 9 mental health conditions and 15 physical health conditions. These conditions are listed in box 1. Variables pertaining to each condition were formulated by NEL CSU using EMIS Read Codes (V.2 and V.3). Lists of the codes used to formulate each variable are available on request. All physical health variables were deemed long-term conditions, and therefore, a patient who had ever had a primary care diagnosis recorded was included in the physical health cohort. This was the same for SMI (ie, schizophrenia, psychosis, bipolar disorder), personality disorder, anorexia, bulimia, dementia and learning disabilities. As depression, low mood and anxiety can potentially be more episodic conditions, further work was done to determine the timelines that should be used to define these cohorts. Based on local clinical and academic advice and available evidence,11 we decided to create two patient cohorts for each conditions—patients who had ever received a diagnosis and patients who had a diagnosis recorded in the last 12 months.
Mental and physical health conditions recorded in primary care records
Depression; low mood*; anxiety; severe mental illness; personality disorder; anorexia; bulimia; dementia; learning disability.
Physical health conditions
Type 1 diabetes, type 2 diabetes, asthma, chronic obstructive pulmonary disorder, cancer (excluding basal cell carcinoma), stroke, coronary heart disease, heart failure, atrial fibrillation, hypertension, peripheral artery disease, chronic kidney disease, liver/pancreas complications (eg, hepatitis, liver disease, chronic pancreatitis), osteoporosis, epilepsy.
*Low mood is often recorded in primary care in place of depression and is therefore important to consider in any analyses relating to mental health.
Looking at the impact of the method of definition on activity in secondary care services indicated that the preferable way to define the depression, low mood and anxiety cohorts was to include those who had ever had a diagnosis recorded in primary care. This was partly because only looking at those who had received a diagnosis in the past 12 months meant that we omitted a considerable proportion of patients who likely had common mental health disorders (CMDs, ie, depression and/or anxiety) from our analyses. If required, it is possible to apply defined periods of time to conditions where full prolonged remission or cure is a possibility, for example, cancer.
Prevalence rates for each condition in both Tower Hamlets and City and Hackney were calculated from the data. We assessed population prevalence in the dataset and compared with both the local and the national population from other data sources. The prevalence rates of all 15 physical health conditions across 6 of the mental health conditions were also calculated in order to illustrate the bidirectional links between mental and physical health.
Health service utilisation
Health service utilisation data outlined in this profile covered use of emergency services for exemplary purposes. Data relating to specific mental health conditions were described. Health service utilisation data for elective and non-elective inpatient admissions, and outpatient appointments are also available in the ELHCP Data Repository. These data come from the Secondary Uses Service (SUS) dataset and provide number of attendances/admissions/appointments per patient per year. There is also data pertaining to associated spend (eg, spend per activity, spend per patient per year), which is currently being validated and is therefore not presented in this paper.
As the ELHCP Data Repository comprises routinely collected data from several different data flows, there is considerable variation in completeness across variables. Completeness of certain variables appears to be better in patients with diagnoses of mental/physical health conditions compared with those with no diagnoses. We used type 2 diabetes and chronic obstructive pulmonary disorder (COPD) as exemplar physical conditions, and depression and SMI as exemplar mental conditions to demonstrate how data quality differs across patient groups. We provided completeness counts on several demographic and clinical variables including age, sex, deprivation level, ethnicity, smoking status, alcohol use, BMI, weight (kg), systolic blood pressure, diastolic blood pressure and cholesterol. All variables were from primary care datasets. Alcohol use was measured using a composite variable of combined scores from the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-consumption (AUDIT-C) completed in primary care.
Cohort description and findings to date
The GP-registered populations for Tower Hamlets and City and Hackney in financial year 2017/2018 were 351 749 and 344 511, respectively. See table 1 for a summary of population demographics for both Tower Hamlets and City and Hackney. Data for age, sex and smoking status were recorded for the complete GP-registered populations in both East London boroughs. Deprivation index was recorded for most of the population (99.8% complete in both boroughs). Ethnicity data was recorded to a good level of completeness at 86.6% and 84.6% in Tower Hamlets and City and Hackney, respectively. BMI data was more problematic and was recorded in the primary care records for less than a quarter of GP-registered patients (Tower Hamlets: 23.4%, City and Hackney: 24.0%).
Population demographics for the GP-registered populations of Tower Hamlets and City and Hackney
Demographic data suggested that both Tower Hamlets and City and Hackney are 'young' boroughs relative to English national data12 (median age 39 years) with mean ages of 32 (median=31 years) and 34 years (median=33 years), respectively. In terms of ethnicity, the majority of the GP-registered population in Tower Hamlets (38.2%) and City and Hackney (46.8%) were of white (or not stated) ethnicity. A considerable proportion of the population of Tower Hamlets were of Bangladeshi ethnicity (27.4%) and a significant amount of the City and Hackney population belonged to 'other ethnic group' (16.8%). Most of the GP-registered population in both East London boroughs were living in areas of high deprivation: in Tower Hamlets and City and Hackney, 58.8% and 54.2% of the population, respectively, were in deciles 1 and 2, indicative of high deprivation. Approximately 20% of the population were recorded in primary care as being smokers. Although BMI is poorly recorded in primary care records, mean BMI scores indicated that the GP-registered population on average were overweight (Tower Hamlets: 26.3±8.1; City and Hackney: 27.1±8.6).
Prevalence rates of mental and physical health conditions
Prevalence rates for GP-coded diagnoses of mental health conditions in both Tower Hamlets and City and Hackney are provided in figure 2. Prevalence rates were similar across both boroughs for all conditions. Comparative local and national prevalence data for each condition is provided in table 2. We did not provide age-standardised and sex-standardised prevalence rates from the ELHCP Data Repository to allow direct comparison with unstandardised local prevalence data from Public Health England (PHE). The GP-coded prevalence of CMDs was 16.8% and 17.5% in Tower Hamlets and City and Hackney, respectively. In this case, CMD comprised diagnoses of depression, anxiety, as well as low mood. Low mood is often recorded both in place of and alongside depression in primary care and is therefore important to consider in a measure of CMD. For example, in Tower Hamlets of those with a diagnosis of depression, 33% also had a diagnosis of low mood. CMD prevalence was in line with data from the latest Adult Psychiatric Morbidity Survey (APMS), which reported that 17% of the English population have a CMD.13 However, the GP-coded prevalence of depression in Tower Hamlets (8.7%) and City and Hackney (11.4%) was higher than PHE prevalence data14 from the same areas from the same financial year (7.3%, 9.6%). This could be due to the GP-coded prevalence in this profile reflecting diagnoses of depression that were ever recorded, which likely led to somewhat inflated rates.
GP-coded prevalence rates of mental health conditions in Tower Hamlets and City and Hackney, financial year 2017/2018. *CMD incorporates depression, anxiety and low mood. CMD, common mental health disorder; GP, general practitioner.
GP-coded prevalence of mental health conditions in Tower Hamlets and City and Hackney compared with local and national prevalence data (sources: APMS 2014, PHE Public Health Profiles, PHE Psychosis Data Report 2016)
GP-coded prevalence of SMI (1.3%) from the ELHCP Data Repository was in line with data from the PHE Psychosis Data Report from 2016,9 which reported prevalence rates of SMI for both Tower Hamlets and City and Hackney at 1.32% and 1.36%, respectively. Prevalence rates for learning disability were also in line with local and national data provided by PHE.14 However, there were discrepancies between the GP-coded prevalence of personality disorder, eating disorders and dementia in the ELHCP Data Repository and local and national PHE14 and APMS13 data. What this suggests is that these conditions might be under-recorded in primary care in these boroughs.
Prevalence rates for GP-coded diagnoses of physical health conditions in the ELHCP Data Repository are provided in figure 3. Prevalence rates were similar across boroughs for most conditions. However, primary care records showed that levels of type 2 diabetes were higher in Tower Hamlets and levels of hypertension were higher in City and Hackney. Comparative local and national prevalence data for each condition is provided in table 3. Local and national prevalence data was sourced from PHE public health profiles.14 Overall, GP-coded prevalence of physical health conditions from the ELHCP Data Repository seems to be in line with PHE local data for the same areas. There is one notable discrepancy, however. Levels of asthma were much higher in the ELHCP Data Repository. This might be due to overdiagnosis of asthma in primary care, which has been reported in both adults15 and children.16 Moreover, PHE prevalence data is taken directly from Quality Outcomes Framework (QOF) registers. Prevalence data from QOF registers might differ from data from other sources due to coding or definitional issues, as well as population churn. Within the ELHCP Data Repository, 'liver disease' comprises many liver complications, for example, hepatitis, fatty liver disease, alcoholic liver disease. Therefore, it was not possible to directly compare prevalence data relating to liver disease with local and national statistics as PHE provide individual prevalence rates for each liver disease subtype.
General practitioner-coded prevalence rates of physical health conditions in Tower Hamlets and City and Hackney, financial year 2017/2018. COPD, chronic obstructive pulmonary disorder.
GP-coded prevalence of physical health conditions in Tower Hamlets and City and Hackney compared with local and national prevalence data (source: PHE Public Health Profiles)
Prevalence of physical health conditions among mental health conditions
Mental and physical health are inextricably linked.17 Having a mental health condition predisposes an individual to develop problems with their physical health. At the same time, living with a physical health condition can greatly impact mental health. Figure 4A,B illustrates the prevalence of physical health conditions among mental health conditions in the ELHCP Data Repository. Mental conditions included in this analysis were depression, low mood, anxiety, SMI and personality disorder.
(A) Prevalence of physical health conditions among mental health conditions in Tower Hamlets. (B) Prevalence of physical health conditions among mental health conditions in City and Hackney. CHD,coronary heart disease; CKD, chronic kidney disease; COPD,chronic obstructive pulmonary disorder.
Results indicate that levels of all 15 physical health conditions were increased in those with mental health conditions. The distribution of the prevalence of physical health conditions among mental health conditions was similar across boroughs. The most pronounced increases in physical health conditions were seen for those flagged by their GP as having depression, SMI and personality disorder. Some striking findings included the increase in levels of type 2 diabetes and hypertension among patients flagged by their GP as having SMI. Type 2 diabetes is known to be elevated in patients with SMI.18 19 This increase might be brought about through use of antipsychotic medications known to be both diabetogenic and linked with weight gain,20 as well as through social deprivation, poor nutrition, chronic stress and lifestyle changes.21 Associations between SMI and hypertension reported in the literature have been more mixed.21 Another striking finding that occurred in both boroughs was the high prevalence of asthma for people with a primary care diagnosis of personality disorder. This may be linked to smoking, which is known to be increased in patients with personality disorder.22 Personality disorder has been linked to hypochondriasis and perceived breathlessness,23 which might also be contributing factors to higher levels of asthma diagnosis in primary care for these patients.
Accident and emergency attendances across mental health conditions
We used accident and emergency (A&E) as an example of a health service utilisation outcome measure to illustrate some of the activity data available in the ELHCP Data Repository. Data relating to use of A&E across both boroughs are detailed in table 4. Based on crude attendance rates (per 1000 population), patients with mental health conditions attended A&E 54% and 76% more in Tower Hamlets and City and Hackney, respectively, compared with those without GP-recorded mental health conditions. Increased attendance rates were particularly pronounced in patients with dementia, personality disorder and SMI. Similar health service utilisation data exists relating to inpatient admissions and use of outpatient services.
The impact of mental health conditions on A&E attendances, financial year 2017/2018
The ELHCP Data Repository relies on data inputted by healthcare provider organisations (GP practices, clinical coders in acute care settings, etc). It is comprised of routinely collected data that can vary in completeness across variables. Examination of four example physical and mental health conditions illustrated how data completeness varies across patient groups. Table 5 details completeness on key demographic and clinical variables for patients with type 2 diabetes, COPD, depression and SMI in Tower Hamlets. These data were all recorded in primary care databases. Data pertaining to age, sex, deprivation level, ethnicity and smoking status were complete for all patients included in the analysis. Data relating to alcohol use and clinical factors differed between those with and without health conditions, in that the data was considerably more complete for patients registered as having a condition. This improvement in completeness is likely down to the implementation of financial incentive schemes introduced as part of the UK's QOF to improve clinical management of patients with chronic conditions.4 24 What this illustrates is that the ELHCP Data Repository is well-suited to perform research on individual physical and mental health conditions using primary care data, where data completeness is to a high standard.
ELHLP data completeness (%) across physical and mental health conditions in Tower Hamlets, financial year 2017/2018
The primary purpose of this project was for the health and care sector to use for system planning and effective commissioning, and therefore public stakeholders in this case comprised primary care managers, commissioners (GPs), public health experts and clinicians in primary and secondary care. A clinical expert group was convened consisting of 15 clinicians, commissioners and public health experts from primary care and secondary care (mental health) services. This group met on a quarterly basis during initial profiling of the cohort and provided feedback into the analysis and emerging clinical and demographic characteristics.
The dataset contains sensitive patient-level data; therefore, it was and remains important to ensure appropriate protections are in place. All data are deidentified, with no information such as name, home address or NHS number. Also, certain sensitive health data such as records relating to trauma and abuse, or specific sexual health data, are not visible.
To further preserve anonymity and to ensure proportionate and appropriate use of the data, access to records is limited to only being able to view aggregated records where there is a minimum of five individuals. Searches where there are fewer than five records are suppressed. Access to the complete deidentified records is further limited to specific individuals who are employed by, or under contract with, the health and care sector have knowledge of how to use the data effectively and have undergone appropriate training.
This dataset has been compiled for the health and care sector to use for system planning. Currently, plans are being made to deploy the data into an electronic platform for internal use: recognising the possible value this data holds for researchers, there may be scope to support analysis deemed to be in the public interest, with appropriate data protections in place. Currently, permissions must be sought on a case-by-case basis and approved by relevant IG governance groups.
Strengths and limitations
One of the main strengths of the dataset is that it provides the opportunity to analyse a relatively young, urban, ethnically diverse and considerably deprived population: groups that are hard to reach with traditional survey methods. Given patient records are linked across care settings, the data can be used to evaluate the impacts of integrated interventions. In this profile, we have illustrated that the ELHCP Data Repository is representative in terms of the prevalence of most mental and physical health conditions compared with other sources of local and national prevalence data supporting its suitability for real-world research and decision making. This dataset also allows for the analysis of comorbidities and multimorbidity. Moreover, there is a large amount of data available around health service utilisation and associated spend meaning that the dataset can be used to understand what drives use and spend and support healthcare commissioning and health service delivery.
The dataset is in regular use by commissioners to better understand the health and care needs of the population, highlight where there is scope for improved patient care and evaluate the impact of health and care interventions of patients and the system. This has provided commissioners, and others working on health and care system integration, with more sophisticated evidence and analysis to inform decisions about where to target improvement efforts to maximise benefit to both patients and the system. The findings presented in this cohort profile have highlighted where links between mental and physical health are most prevalent in the population and helped to shape commissioning priorities accordingly. For example, analysis highlighting mental and physical comorbidity supported conversations about expanding Improving Access to Psychological Therapies (IAPT) services within long-term condition pathways, noting that it may be particularly impactful for people with type 2 diabetes, respiratory conditions and cancer. Furthermore, over the next year, Tower Hamlets is investing in a new 24/7 core fidelity crisis service and the transformation of community mental health services to become embedded in primary care networks. These new models will support the assessment and treatment of patients at the right place at the right time. The ELHCP Data Repository described in this cohort profile will be an important tool in evaluating the impact these service changes have on patients and the healthcare system.
In terms of completeness, this paper highlighted that data were considerably more complete for patients with long-term mental or physical illness (ie, type 2 diabetes, COPD, depression, SMI) compared with patients without. This supports the suitability of the dataset for the analysis of patients with long-term conditions.
In terms of limitations associated with the dataset, in some cases prevalence data was not in line with local and national data, meaning that it is possible some conditions are under-recorded in primary care, that is, personality disorder, eating disorders and dementia. Also, as prevalence data relies on GP diagnoses, it is not possible to gauge disease duration in patients as the date in which a diagnosis is first recorded might not be the date the patient received the diagnosis. For example, the diagnosis might have been recorded on the day the patient registered with their GP, reflecting that date rather than the date of diagnosis. In terms of data completeness, although this is good for patients with long-term conditions, there is considerable missingness among 'healthy' patients in the dataset. This has also been reported in a study of a large primary care databases in the UK, which partially attributed the discrepancy in missing data to GP incentive schemes.25 It is possible to resolve this with imputation to some degree. As is the case with all routine clinical data, the dataset requires extensive cleaning to remove duplicate entries and spurious values out of clinical range (eg, BMI, blood pressure) prior to analysis. Another limitation involves the amount of data available. Currently, there are two financial years of data that are at an acceptable standard for research and/or decision support. New data continues to be collected and flow into this data set, so the time series available will increase over time. A further limitation surrounds the ability to measure population mobility in a dataset of this kind. One way is to look at the length of GP registration as a proxy for this, but this is problematic as it is not possible to determine whether the mobility is within the borough or whether patients have come from outside.
Conclusions and future collaborations
This cohort profile describes a unique patient-linked dataset in East London, which can be used to facilitate the development of similar datasets in other parts of the UK. Moreover, this dataset provides a unique opportunity to analyse a relatively young, urban, diverse and deprived population in East London. The dataset is growing year on year and data quality should improve over time, making this an invaluable resource for researchers, clinicians, commissioners and policy makers. The data are being further cleaned and evaluated using imputation, Bayesian and economic methods, including engagement with machine learning work funded by the Alan Turing Institute to improve and automate the analysis of large-scale electronic medical records (KNIFE project). Queries regarding data access should be directed to Katie Brennan (katie.brennan1@nhs.net) or Nathan Cheetham (nathan.cheetham1@nhs.net) at the NHS Tower Hamlets CCG.
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. Ethnicity facts and figures: age groups. HM government services, 2018. Available: https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity/demographics/age-groups/latest#download-the-data [Accessed 6 Jun 2019].
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. The epidemiology of diabetes in psychotic disorders. Lancet Psychiatry 2015;2:431–51.doi:10.1016/S2215-0366(15)00007-3pmid:http://www.ncbi.nlm.nih.gov/pubmed/26360287
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. Differential effects of risperidone, olanzapine, clozapine, and conventional antipsychotics on type 2 diabetes: findings from a large health plan database. J Clin Psychiatry 2002;63:920–30.doi:10.4088/jcp.v63n1010pmid:http://www.ncbi.nlm.nih.gov/pubmed/12416602
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. Personality disorders and cigarette smoking among adults in the United States. J Psychiatr Res 2011;45:835–41.doi:10.1016/j.jpsychires.2010.11.009pmid:http://www.ncbi.nlm.nih.gov/pubmed/21168156
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. Personality profiles and breathlessness perception in outpatients with different gradings of asthma. Am J Respir Crit Care Med 1998;157:116–22.doi:10.1164/ajrccm.157.1.9702093pmid:http://www.ncbi.nlm.nih.gov/pubmed/9445288
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. Health indicator recording in UK primary care electronic health records: key implications for handling missing data. Clin Epidemiol 2019;11:157–67.doi:10.2147/CLEP.S191437pmid:http://www.ncbi.nlm.nih.gov/pubmed/30809103
Twitter @DrRonaldson, @QiongwenKang, @ksbhui
Correction notice The title of the paper has been corrected.
Contributors AR drafted the manuscript with input and critical revisions from all authors. QK, KBrennan, EW, GH, RF, MF and KBhui provided supervision throughout. KBhui is the principal investigator and grant holder. Analysis of the data was performed by AA, EC and IE. All authors reviewed the paper before submission.
Funding Funding for this project was granted by East London NHS Foundation Trust (ELFT) (184091163), the Tower Hamlets Together Board, the Health London Partnership Mental Health Transformation Board, and the City and Hackney Transformation Board. This report is independent research supported by the National Institute for Health Research ARC North Thames.
Competing interests MF received research grants from East London NHS Foundation Trust and The Alan Turing Institute during the conduct of this study.
Data availability statement Data may be obtained from a third party and are not publicly available. The data is housed at the NHS Tower Hamlets Clinical Commissioning Group. Permission to access the data will need to be requested from Katie Brennan (katie.brennan1@nhs.net) or Nathan Cheetham (nathan.cheetham1@nhs.net) at the NHS Tower Hamlets Clinical Commissioning Group.


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text:
Q: Tapestry Extensions (TapX) DateField cannot parse valid DateFormat I'm experiencing an issue with using tapx-datefield, more accurately, improved DateField component.
My TML:
<t:form>
    <t:label for="dateAndTime"/>
    <tx:DateField t:id="dateAndTime" t:format="prop:dateTimeFormat"/>

    <input type="submit" value="Submit"/>
    <t:errors/>
</t:form>

<t:if t:test="dateAndTime">

Date and Time: ${dateAndTime}

        Nothing :(

</t:if>

My POJO class:
public class TestDateTimePage {

    @Property
    @Persist(PersistenceConstants.FLASH)
    private Date dateAndTime;

    public DateFormat getDateTimeFormat() {
        return new SimpleDateFormat("EEE, dd MMM yyyy HH:mm:ss z");
    }
}

When I pick the date from the calendar, the "ss z" part of the format is ignored:

And I know for a fact that that format is just fine:
DateFormat df = new SimpleDateFormat("EEE, dd MMM yyyy HH:mm:ss z");
System.out.println(df.format(new Date()));

Tue, 25 Mar 2014 12:38:19 GMT

Is this intended behaviour (ignoring seconds, timezone and such) or a bug?
If so, is there a known workaround?

A: So, I've been doing some inspecting of tapx source on GitHub and from what I've seen, it does not have inherent support of parsing seconds:
from tapx-datefield Date#parseDate function:
...
return new Date(y, m, d, hr, min, 0);

while the Date object has the following ctor:
var d = new Date(year, month, day, hours, minutes, seconds, milliseconds);

redpajama_set_name: RedPajamaStackExchange


text:
Q: I cant make Linq compare geodistances? Im getting the error:
'new GeoCoordinate(MyEntity.Lat, MyEntity.Lon).GetDistanceTo(14.4416616666667, 5.71794583333333)' is not supported in a 'Where' Mobile Services query expression.

From the following query:
GeoCoordinate mypos = new GeoCoordinate(MainPage.myEntity.Lat, MainPage.myEntity.Lon);

var items = await App.MobileService
                        .GetTable<MyEntity>()
                        .Where(MyEntity => MyEntity.Id != MainPage.myEntity.Id && MyEntity.IsSelected == MainPage.myEntity.IsSelected
                            && (MyEntity.Lat != 0 && MyEntity.Lon != 0)
                            && new GeoCoordinate(MyEntity.Lat, MyEntity.Lon).GetDistanceTo(mypos) <= 5000)
                        .Take(20)
                        .ToListAsync();

I'm trying to get 20 entities from a table that is not me and within 5 km of my position.

A: One thing you need to be aware is that the line expression is not executed locally. It's instead translated into a query string which is sent to the server - otherwise you'd be downloading a lot more data than you need (which you still can do, by the way). Given that, there's no way to translate the method GeoCoordinate.GetDistanceTo into something which can be sent over the wire.
There are some operations which are supported in the server, such as arithmetic (+, -, *, /), and you could potentially implement something similar to what you need. Something like the code below should work (haven't tried it yet). Notice that you'll need to do the conversion between distance in coordinates (lat / lon) and whatever unit is returned by the GetDistanceTo method.
GeoCoordinate mypos = new GeoCoordinate(MainPage.myEntity.Lat, MainPage.myEntity.Lon);
double maxDistance = 1;
var items = await App.MobileService
    .GetTable<MyEntity>()
    .Where(e => e.Id != MainPage.myEntity.Id &&
                e.IsSelected == MainPage.myEntity.IsSelected &&
                (e.Lat != 0 && e.Lon != 0) &&
                ( ((e.Lat - mypos.Lat) * (e.Lat - mypos.Lat) +
                   (e.Lon - mypos.Lon) * (e.Lon - mypos.Lon)) < maxDistance )
    .Take(20)
    .ToListAsync();

Or, another alternative as I mentioned before would be to simply not to filter by the distance on that call, and filter it afterwards. Something like the code below:
GeoCoordinate mypos = new GeoCoordinate(MainPage.myEntity.Lat, MainPage.myEntity.Lon);
List<MyEntity> items = new List<MyEntity>();
int skip = 0;
while (items.Count < 20) {
    var temp = await App.MobileService
        .GetTable<MyEntity>()
        .Where(e => e.Id != MainPage.myEntity.Id &&
                    e.IsSelected == MainPage.myEntity.IsSelected &&
                    (e.Lat != 0 && e.Lon != 0)
        .Skip(skip)
        .Take(20)
        .ToListAsync();
    if (temp.Count == 0) break;
    foreach (var item in temp)
    {
        if (new GeoCoordinate(item.Lat, item.Lon).GetDistanceTo(mypos) <= 5000)
        {
            items.Add(item);
        }
    }
}


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