138-566: The Caerphilly Heart Disease Study , also known as the Caerphilly Prospective Study (CaPS), is an epidemiological prospective cohort , set up in 1979 in a representative population sample drawn from Caerphilly , a typical small town in South Wales , UK. The initial aim was to examine relationships between a wide range of social, lifestyle, dietary and other factors with incident vascular disease . Opportunity
276-629: A county corporate . From the 13th to the 18th century, Bristol was among the top three English cities, after London, in tax receipts. A major port , Bristol was a starting place for early voyages of exploration to the New World. At the height of the Bristol slave trade , from 1700 to 1807, more than 2,000 slave ships carried an estimated 500,000 people from Africa to slavery in the Americas. The Port of Bristol has since moved from Bristol Harbour in
414-411: A statue of Colston was pulled down from its plinth by protestors and pushed into Bristol Harbour. The statue was recovered on 11 June and has become a museum exhibit. Bristol City council consists of 70 councillors representing 34 wards, with between one and three per ward serving four-year terms. As of May 2024, no party has an overall controlling majority, but Green Party are the largest group on
552-478: A 67% reduction in vascular disease, a 35% reduction in cancer (attributable to non-smoking alone) and a 64% reduction in cognitive impairment and dementia. Healthy behaviours are the responsibility of each individual, and <1% of the men in the Caerphilly Study followed all five, with only 5% following four consistently. Comparisons with data collected in the 2009 Welsh Health Survey indicate that while
690-781: A Director of Research in the French National Institute of Health and Medical Research in Lyon , and Professor Rod Flower FRS, then at the University of Bath . The work was done in a specially equipped mobile platelet laboratory, lent to the Caerphilly team by Serge Renaud, and towed by him from INSERM in Lyon, France, to the Miners' Hospital . Detailed work was also completed on thrombosis and haemostatic factors with
828-591: A car, van, motorbike or taxi, 2.2% commute by rail and 9.8% by bus, while 19.6% walk. The Runnymede Trust found in 2017 that Bristol "ranked 7th out of the 348 districts of England & Wales (1=worst) on the Index of Multiple Inequality." In terms of employment, the report found that "ethnic minorities are disadvantaged compared to white British people nationally, but this is to a greater extent in Bristol, particularly for black groups." Black people in Bristol experience
966-437: A causal association does not exist in general. Conversely, it can be (and is in some circumstances) taken by US courts, in an individual case, to justify an inference that a causal association does exist, based upon a balance of probability . The subdiscipline of forensic epidemiology is directed at the investigation of specific causation of disease or injury in individuals or groups of individuals in instances in which causation
1104-565: A commercial organisation, 'The Company Adventurers to the New Found Land', to assist their endeavours. However, they seem to have lost interest in North America after 1509, having incurred great expenses and made little profit. During the 16th century, Bristol merchants concentrated on developing trade with Spain and its American colonies. This included the smuggling of prohibited goods, such as food and guns, to Iberia during
1242-417: A compulsory load line on ships. By 1867, ships were getting larger and the meanders in the river Avon prevented boats over 300 ft (90 m) from reaching the harbour, resulting in falling trade. The port facilities were migrating downstream to Avonmouth and new industrial complexes were founded there. Some of the traditional industries including copper and brass manufacture went into decline, but
1380-687: A developed area between the Bristol city boundary and the M4, M5 and M32 motorways (now in South Gloucestershire) was so named as part of a 1987 plan prepared by the Northavon District Council of Avon county. The West of England Combined Authority was created on 9 February 2017. Covering Bristol and the rest of the old Avon county with the exception of North Somerset, the new combined authority has responsibility for regional planning, roads, and local transport, and to
1518-498: A health system responds to current population health issues but also how a health system can be managed to better respond to future potential population health issues. Examples of organizations that use population-based health management that leverage the work and results of epidemiological practice include Canadian Strategy for Cancer Control, Health Canada Tobacco Control Programs, Rick Hansen Foundation, Canadian Tobacco Control Research Initiative. Each of these organizations uses
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#17327931946411656-521: A lesser extent, basic research in the biological sciences. Major areas of epidemiological study include disease causation, transmission , outbreak investigation, disease surveillance , environmental epidemiology , forensic epidemiology , occupational epidemiology , screening , biomonitoring , and comparisons of treatment effects such as in clinical trials . Epidemiologists rely on other scientific disciplines like biology to better understand disease processes, statistics to make efficient use of
1794-509: A lesser extent, education and business investment. The authority is led by the Mayor of the West of England , Dan Norris . Bristol's boundaries can be defined in several ways, including those of the city itself, the developed area, or Greater Bristol . The city council boundary is the narrowest definition of the city itself. However, it unusually includes a large, roughly rectangular section of
1932-520: A much earlier cohort study in the US, had already shown that cholesterol is an important predictive factor for heart disease, and studies of US Veterans had shown that raised blood pressure is a major factor in stroke. The Caerphilly Study re-tested these predictors together with lipid fractions and high-density lipoproteins (total HDL , HDL2 and HDL3). More recently, arterial resistance and its contribution to blood pressure has also been studied within
2070-500: A number of questionnaires and biological tests were used in both the studies. This enabled a number of joint reports on vascular disease, and in particular on the relevance of blood lipids , to be based on the five thousand subjects within the two cohorts together. Initially, the study was funded by the Medical Research Council and led by Peter Elwood. Following Elwood's retirement in 1995 the study continued under
2208-787: A population (endemic). The term "epidemiology" appears to have first been used to describe the study of epidemics in 1802 by the Spanish physician Joaquín de Villalba [ es ] in Epidemiología Española . Epidemiologists also study the interaction of diseases in a population, a condition known as a syndemic . The term epidemiology is now widely applied to cover the description and causation of not only epidemic, infectious disease, but of disease in general, including related conditions. Some examples of topics examined through epidemiology include as high blood pressure, mental illness and obesity . Therefore, this epidemiology
2346-520: A population-based health management framework called Life at Risk that combines epidemiological quantitative analysis with demographics, health agency operational research and economics to perform: Applied epidemiology is the practice of using epidemiological methods to protect or improve the health of a population. Applied field epidemiology can include investigating communicable and non-communicable disease outbreaks, mortality and morbidity rates, and nutritional status, among other indicators of health, with
2484-561: A prominent role in funding Richard Strongbow de Clare and the Norman invasion of Ireland . The port developed in the 11th century around the confluence of the Rivers Frome and Avon , adjacent to Bristol Bridge just outside the town walls. By the 12th century, there was an important Jewish community in Bristol which survived through to the late 13th century when all Jews were expelled from England. The stone bridge built in 1247
2622-422: A prospective study, and confounders are more easily controlled for. However, they are more costly, and there is a greater chance of losing subjects to follow-up based on the long time period over which the cohort is followed. Cohort studies also are limited by the same equation for number of cases as for cohort studies, but, if the base incidence rate in the study population is very low, the number of cases required
2760-402: A random sample from the original population at risk. This has as a consequence that the control group can contain people with the disease under study when the disease has a high attack rate in a population. A major drawback for case control studies is that, in order to be considered to be statistically significant, the minimum number of cases required at the 95% confidence interval is related to
2898-497: A randomised trial. Milk consumption was found to be associated with a small reduction in the metabolic syndrome, and reductions in ischaemic heart disease, ischaemic stroke and diabetes, and these findings were confirmed in later overviews and meta-analyses. A reduction in blood pressure associated with milk consumption is well recognised, but new work in Caerphilly also identified a reduction in arterial stiffness associated with milk consumption. The consumption of fruit and vegetables
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#17327931946413036-445: A unique disease process different from any other individual ("the unique disease principle"), considering uniqueness of the exposome (a totality of endogenous and exogenous / environmental exposures) and its unique influence on molecular pathologic process in each individual. Studies to examine the relationship between an exposure and molecular pathologic signature of disease (particularly cancer ) became increasingly common throughout
3174-417: A vascular event. In addition to number and size of the platelets, three tests of platelet aggregation were performed, several being repeated after five years. A stressed template bleeding time test was also performed on each man. No prediction for heart disease was shown by any aspect of platelet morphology nor any platelet test, nor by the bleeding time test. An unexpected finding was that the men who had had
3312-475: Is 106 mi (171 km) west of London, 77 mi (124 km) south-southwest of Birmingham and 26 mi (42 km) east of the Welsh capital Cardiff . Areas adjoining the city fall within a loosely defined area known as Greater Bristol . Bath is located 11 mi (18 km) south east of the city centre, Weston-super-Mare is 18 mi (29 km) to the south west and the Welsh city of Newport
3450-503: Is 19 mi (31 km) to the north west. The climate is oceanic ( Köppen : Cfb) , milder than most places in England and United Kingdom. Located in southern England, Bristol is one of the warmest cities in the UK with a mean annual temperature of approximately 10.5 °C (50.9 °F). It is among the sunniest, with 1,541–1,885 hours of sunshine per year. Although the city
3588-399: Is a core component, that is unified with management science to provide efficient and effective health care and health guidance to a population. This task requires the forward-looking ability of modern risk management approaches that transform health risk factors, incidence, prevalence and mortality statistics (derived from epidemiological analysis) into management metrics that not only guide how
3726-428: Is based upon how the pattern of the disease causes change in the function of human beings. The Greek physician Hippocrates , taught by Democritus, was known as the father of medicine , sought a logic to sickness; he is the first person known to have examined the relationships between the occurrence of disease and environmental influences. Hippocrates believed sickness of the human body to be caused by an imbalance of
3864-479: Is beyond the domain of the science of epidemiology. Epidemiology has its limits at the point where an inference is made that the relationship between an agent and a disease is causal (general causation) and where the magnitude of excess risk attributed to the agent has been determined; that is, epidemiology addresses whether an agent can cause disease, not whether an agent did cause a specific plaintiff's disease. In United States law, epidemiology alone cannot prove that
4002-483: Is disputed or is unclear, for presentation in legal settings. Epidemiological practice and the results of epidemiological analysis make a significant contribution to emerging population-based health management frameworks. Population-based health management encompasses the ability to: Modern population-based health management is complex, requiring a multiple set of skills (medical, political, technological, mathematical, etc.) of which epidemiological practice and analysis
4140-537: Is famous for his investigations into the causes of the 19th-century cholera epidemics, and is also known as the father of (modern) Epidemiology. He began with noticing the significantly higher death rates in two areas supplied by Southwark Company. His identification of the Broad Street pump as the cause of the Soho epidemic is considered the classic example of epidemiology. Snow used chlorine in an attempt to clean
4278-499: Is in the term inference . Correlation, or at least association between two variables, is a necessary but not sufficient criterion for the inference that one variable causes the other. Epidemiologists use gathered data and a broad range of biomedical and psychosocial theories in an iterative way to generate or expand theory, to test hypotheses, and to make educated, informed assertions about which relationships are causal, and about exactly how they are causal. Epidemiologists emphasize that
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4416-418: Is increasing recognition that a wide range of modern data sources, many not originating from healthcare or epidemiology, can be used for epidemiological study. Such digital epidemiology can include data from internet searching, mobile phone records and retail sales of drugs. Epidemiologists employ a range of study designs from the observational to experimental and generally categorized as descriptive (involving
4554-692: Is partially sheltered by the Mendip Hills, it is exposed to the Severn Estuary and the Bristol Channel . Rain is fairly evenly distributed throughout the year, with autumn and winter the wetter seasons. The Atlantic Ocean influences Bristol's weather, keeping its average temperature above freezing throughout the year, but winter frosts are frequent and snow occasionally falls from early November to late April. Summers are warm and drier, with variable sunshine, rain and clouds, and spring weather
4692-404: Is reduced by 1 ⁄ 2 . Although epidemiology is sometimes viewed as a collection of statistical tools used to elucidate the associations of exposures to health outcomes, a deeper understanding of this science is that of discovering causal relationships. " Correlation does not imply causation " is a common theme for much of the epidemiological literature. For epidemiologists, the key
4830-405: Is represented by 5 constituencies, East , North East , North West , South , and Central . The city has a tradition of political activism. Edmund Burke , MP for the Bristol constituency for six years beginning in 1774, insisted that he was a Member of Parliament first and a representative of his constituents' interests second. Women's-rights advocate Emmeline Pethick-Lawrence (1867–1954)
4968-521: Is typically determined using DNA from peripheral blood leukocytes. Since the 2000s, genome-wide association studies (GWAS) have been commonly performed to identify genetic risk factors for many diseases and health conditions. While most molecular epidemiology studies are still using conventional disease diagnosis and classification systems, it is increasingly recognized that disease progression represents inherently heterogeneous processes differing from person to person. Conceptually, each individual has
5106-1035: Is unsettled. The weather stations nearest Bristol for which long-term climate data are available are Long Ashton (about 5 mi (8 km) south west of the city centre) and Bristol Weather Station, in the city centre. Data collection at these locations ended in 2002 and 2001, respectively, and following the closure of Filton Airfield, Almondsbury is the nearest weather station to the city. Temperatures at Long Ashton from 1959 to 2002 ranged from 33.5 °C (92.3 °F) in July 1976 to −14.4 °C (6.1 °F) in January 1982. Monthly high temperatures since 2002 at Filton exceeding those recorded at Long Ashton include 25.7 °C (78.3 °F) in April 2003, 34.5 °C (94.1 °F) in July 2006 and 26.8 °C (80.2 °F) in October 2011. The lowest recent temperature at Filton
5244-596: Is unusual among major British towns and cities in its larger black than Asian population. These statistics apply to the Bristol Unitary Authority area, excluding areas of the urban area (2006 estimated population 587,400) in South Gloucestershire, Bath and North East Somerset (BANES) and North Somerset—such as Kingswood, Mangotsfield, Filton and Warmley. 56.2% of the 209,995 Bristol residents who are employed commute to work using either
5382-439: Is used to describe the intersection of Host , Agent , and Environment in analyzing an outbreak. Case-series may refer to the qualitative study of the experience of a single patient, or small group of patients with a similar diagnosis, or to a statistical factor with the potential to produce illness with periods when they are unexposed. The former type of study is purely descriptive and cannot be used to make inferences about
5520-542: The Anglo-Spanish War (1585–1604) . Bristol's illicit trade grew enormously after 1558, becoming integral to its economy. The original Diocese of Bristol was founded in 1542, when the former Abbey of St. Augustine (founded by Robert Fitzharding four hundred years earlier) became Bristol Cathedral . Bristol also gained city status that year. In the 1640's, during the English Civil War ,
5658-921: The Ashton Court Estate , South Bristol crematorium and cemetery, High Ridge common and Whitchurch, with a further area around Frenchay Farm. The belt extends outside the city boundaries into surrounding counties and districts, for several miles in places, to afford a protection from urban sprawl to surrounding villages and towns. According to the 2011 census , 84% of the population was White (77.9% White British , 0.9% White Irish , 0.1% Gypsy or Irish Travellers and 5.1% Other White ); 3.6% mixed-race (1.7% white-and-black Caribbean, 0.4% white-and-black African, 0.8% white and Asian and 0.7% other mixed); 5.5% Asian (1.6% Pakistani , 1.5% Indian , 0.9% Chinese , 0.5% Bangladeshi , and 1% other Asian); 6% Black (2.8% African, 1.6% Caribbean , 1.6% Other Black ), 0.3% Arab and 0.6% with other heritage. Bristol
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5796-464: The Black Death of 1348–49, which checked population growth, and its population remained between 10,000 and 12,000 for most of the 15th and 16th centuries. During the 15th century, Bristol was the second most important port in the country, trading with Ireland, Iceland and Gascony . It was the starting point for many voyages, including Robert Sturmy 's (1457–58) unsuccessful attempt to break
5934-534: The IRA , in 1974 and again in 1978 . The 20th-century relocation of the docks to Avonmouth Docks and Royal Portbury Dock , 7 mi (11 km) downstream from the city centre, has allowed the redevelopment of the old dock area (the Floating Harbour). Although the docks' existence was once in jeopardy (since the area was seen as a derelict industrial site), the inaugural 1996 International Festival of
6072-453: The Kennet and Avon Canal , which had fully opened in 1810 as the main route for the transport of goods between Bristol and London. Competition from Liverpool (beginning around 1760), disruptions of maritime commerce due to war with France (1793) and the abolition of the slave trade (1807) contributed to Bristol's failure to keep pace with the newer manufacturing centres of Northern England and
6210-589: The Memorial Stadium . The city has two universities; the University of Bristol and the University of the West of England (UWE Bristol). It is connected to the world by Bristol Airport ; to the rest of the Great Britain via Bristol Temple Meads and Bristol Parkway mainline rail stations; by road by both the south-west to West Midlands M5 and the London to South Wales M4 (which connect to
6348-558: The West Midlands . The tidal Avon Gorge, which had secured the port during the Middle Ages, had become a liability. An 1804–09 plan to improve the city's port with a floating harbour designed by William Jessop was a costly error, requiring high harbour fees. During the 19th century, Samuel Plimsoll , known as "the sailor's friend", campaigned to make the seas safer; shocked by overloaded vessels, he successfully fought for
6486-456: The medical press . In 1948, an MRC epidemiological unit was set up in Cardiff , South Wales, under Professor Archie Cochrane . Peter Elwood joined Cochrane in 1963 and together they promoted long-term studies of representative population samples. They also conducted randomised controlled trials to test a variety of clinical hypotheses. Undoubtedly, the most important of their joint studies
6624-476: The " one cause – one effect " understanding is a simplistic mis-belief. Most outcomes, whether disease or death, are caused by a chain or web consisting of many component causes. Causes can be distinguished as necessary, sufficient or probabilistic conditions. If a necessary condition can be identified and controlled (e.g., antibodies to a disease agent, energy in an injury), the harmful outcome can be avoided (Robertson, 2015). One tool regularly used to conceptualize
6762-459: The "who, what, where and when of health-related state occurrence". However, analytical observations deal more with the 'how' of a health-related event. Experimental epidemiology contains three case types: randomized controlled trials (often used for a new medicine or drug testing), field trials (conducted on those at a high risk of contracting a disease), and community trials (research on social originating diseases). The term 'epidemiologic triad'
6900-600: The 12th century. An older form of the name survives as the surname Bristow , which is derived from the city. Archaeological finds, including flint tools believed to be between 300,000 and 126,000 years old made with the Levallois technique , indicate the presence of Neanderthals in the Shirehampton and St Annes areas of Bristol during the Middle Palaeolithic . Iron Age hill forts near
7038-515: The 2000s. However, the use of molecular pathology in epidemiology posed unique challenges, including lack of research guidelines and standardized statistical methodologies, and paucity of interdisciplinary experts and training programs. Furthermore, the concept of disease heterogeneity appears to conflict with the long-standing premise in epidemiology that individuals with the same disease name have similar etiologies and disease processes. To resolve these issues and advance population health science in
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#17327931946417176-504: The 2010s. By 2012, it was recognized that many pathogens' evolution is rapid enough to be highly relevant to epidemiology, and that therefore much could be gained from an interdisciplinary approach to infectious disease integrating epidemiology and molecular evolution to "inform control strategies, or even patient treatment." Modern epidemiological studies can use advanced statistics and machine learning to create predictive models as well as to define treatment effects. There
7314-491: The Caerphilly Heart Disease Study, with their primary focus on vascular disease, and the identification of predictors for platelet activity and thrombosis . Caerphilly was chosen for the work because the population was fairly stable, it had age and social class structures similar to that of the whole UK population, and there was a high incidence of ischaemic heart disease compared with the rest of
7452-637: The Future 's 2008 Sustainable Cities Index. Local initiatives include Sustrans (creators of the National Cycle Network , founded as Cyclebag in 1977) and Resourcesaver, a non-profit business established in 1988 by Avon Friends of the Earth. In 2014 The Sunday Times named it as the best city in Britain in which to live. The city received the 2015 European Green Capital Award , becoming
7590-492: The Italian monopoly of Eastern Mediterranean trade. New exploration voyages were launched by Venetian John Cabot , who in 1497 made landfall in North America. A 1499 voyage, led by merchant William Weston of Bristol, was the first expedition commanded by an Englishman to North America . During the first decade of the 16th century Bristol's merchants undertook a series of exploration voyages to North America and even founded
7728-560: The OR, a RR greater than 1 shows association, where the conclusion can be read "those with the exposure were more likely to develop the disease." Prospective studies have many benefits over case control studies. The RR is a more powerful effect measure than the OR, as the OR is just an estimation of the RR, since true incidence cannot be calculated in a case control study where subjects are selected based on disease status. Temporality can be established in
7866-628: The Sea held in and around the docks affirmed the area as a leisure asset of the city. From 2018, there were lively discussions about a new explicative plaque under a commemorative statue of one of the city's major benefactors in the 17th and 18th centuries. The plaque was meant to replace an original which made no reference to Edward Colston 's past with the Royal African Company and the Bristol Slave Trade . On 7 June 2020
8004-509: The UK. In 1979, all men aged between 45 and 59 years, who were on the electoral registers and/or general practice lists for Caerphilly and the adjoining villages of Abertridwr , Senghenydd , Trethomas , Bedwas and Machen were invited to co-operate in a long-term health study. 2,512 subjects (89% of the total eligible population) agreed to participate and were examined in Phase 1 (baseline) between July 1979 and September 1983. Since then,
8142-564: The active involvement of John O'Brien and in collaboration with Professor Gordon Lowe, in the Institute of Cardiovascular and Medical Sciences . At baseline, a 1:3 sample (668 men) completed a 7-day weighed dietary intake record. Data on the dietary intake of each subject in the cohort was collected during each phase of the study. Ten years into the study a detailed package of cognitive function tests were performed by each subject. These tests have been repeated several times and later enabled
8280-566: The arrest, trial and subsequent acquittal of a local slaver captain named Kimber. The city was associated with Victorian engineer Isambard Kingdom Brunel , who designed the Great Western Railway between Bristol and London Paddington , two pioneering Bristol-built oceangoing steamships ( SS Great Britain and SS Great Western ), and the Clifton Suspension Bridge . The new railway replaced
8418-407: The assessment of data covering time, place, and person), analytic (aiming to further examine known associations or hypothesized relationships), and experimental (a term often equated with clinical or community trials of treatments and other interventions). In observational studies, nature is allowed to "take its course", as epidemiologists observe from the sidelines. Conversely, in experimental studies,
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#17327931946418556-414: The case control study. However, the point estimate generated is the relative risk (RR), which is the probability of disease for a person in the exposed group, P e = A / ( A + B ) over the probability of disease for a person in the unexposed group, P u = C / ( C + D ), i.e. RR = P e / P u . As with
8694-560: The castle. A third bomb-damaged church nearby, St Nicholas was restored and after a period as a museum has now re-opened as a church. It houses a 1756 William Hogarth triptych painted for the high altar of St Mary Redcliffe . The church also has statues of King Edward I (moved from Arno's Court Triumphal Arch ) and King Edward III (taken from Lawfords' Gate in the city walls when they were demolished about 1760), and 13th-century statues of Robert, 1st Earl of Gloucester (builder of Bristol Castle ) and Geoffrey de Montbray (who built
8832-429: The causation of the disease. Case-control studies are usually faster and more cost-effective than cohort studies but are sensitive to bias (such as recall bias and selection bias ). The main challenge is to identify the appropriate control group; the distribution of exposure among the control group should be representative of the distribution in the population that gave rise to the cases. This can be achieved by drawing
8970-427: The cause-and-effect hypothesis and none can be required sine qua non ." Epidemiological studies can only go to prove that an agent could have caused, but not that it did cause, an effect in any particular case: Epidemiology is concerned with the incidence of disease in populations and does not address the question of the cause of an individual's disease. This question, sometimes referred to as specific causation,
9108-537: The city was occupied by Royalists , who built the Royal Fort House on the site of an earlier Parliamentarian stronghold. Fishermen from Bristol, who had fished the Grand Banks of Newfoundland since the 16th century, began settling Newfoundland permanently in larger numbers during the 17th century, establishing colonies at Bristol's Hope and Cuper's Cove . Growth of the city and trade came with
9246-484: The city are at Leigh Woods and Clifton Down , on the side of the Avon Gorge , and on Kings Weston Hill near Henbury . A Roman settlement, Abona, existed at what is now Sea Mills (connected to Bath by a Roman road ); another was at the present-day Inns Court . Isolated Roman villas and small forts and settlements were also scattered throughout the area. Bristol was founded by 1000; by about 1020, it
9384-684: The city centre by the Portway and M32 ). Bristol was named the best city in Britain in which to live in 2014 and 2017; it won the European Green Capital Award in 2015. The name derives from the Old English Brycgstow , meaning "assembly place by the bridge" or simply "site of the bridge", presumably in reference to a crossing over the Avon. The final l is an unetymological addition that first appears in
9522-588: The city centre to the Severn Estuary at Avonmouth and Royal Portbury Dock . The city's modern economy is built on the creative media, electronics and aerospace industries; the city-centre docks have been redeveloped as cultural and heritage centres. There are a variety of artistic and sporting organisations and venues including the Royal West of England Academy , the Arnolfini , Ashton Gate and
9660-551: The city's walls) from Bristol's Newgate . The rebuilding of Bristol city centre was characterised by 1960s and 1970s skyscrapers , mid-century modern architecture and road building . Beginning in the 1980s some main roads were closed , the Georgian-era Queen Square and Portland Square were restored, the Broadmead shopping area regenerated, and one of the city centre's tallest mid-century towers
9798-1111: The city, and its surrounding land has been protected from development as The Downs and Leigh Woods. The Avon estuary and the gorge form the county boundary with North Somerset , and the river flows into the Severn Estuary at Avonmouth . A smaller gorge, cut by the Hazel Brook which flows into the River Trym , crosses the Blaise Castle estate in northern Bristol. Bristol is sometimes described, by its inhabitants, as being built on seven hills, like Rome. From 18th-century guidebooks, these 7 hills were known as simply Bristol (the Old Town), Castle Hill, College Green, Kingsdown, St Michaels Hill, Brandon Hill and Redcliffe Hill. Other local hills include Red Lion Hill, Barton Hill , Lawrence Hill , Black Boy Hill, Constitution Hill, Staple Hill , Windmill Hill , Malborough Hill, Nine Tree Hill, Talbot, Brook Hill and Granby Hill. Bristol
9936-583: The city-council boundary, such as Kingswood , Mangotsfield , Stoke Gifford , Winterbourne , Almondsbury , Easton in Gordano , Whitchurch village, Filton , Patchway and Bradley Stoke , but excludes undeveloped areas within that boundary. Bristol lies within a limestone area running from the Mendip Hills in the south to the Cotswolds in the northeast. The rivers Avon and Frome cut through
10074-487: The cohort. The randomised controlled trial of aspirin had shown that blood platelets play a key role in vascular disease. The Caerphilly Study focused on this by developing a large data-bank of platelet testing during the early phases of the study. Platelet collection and analysis was undertaken in close collaboration with Dr John O'Brien, Consultant Haematologist in St Mary's Hospital, Portsmouth, Professor Serge Renaud,
10212-451: The components of metabolic syndrome , other than high blood pressure, were predictive of worse cognition. Hearing loss was also found to be predictive of later cognitive impairment and incident dementia. The main objective of the work on platelets was to identify an aspect of platelet morphology or activity with predictive power for incident vascular disease, which could be developed as a screening test to identify subjects at high risk of
10350-450: The council. Between 2012 and 2024, the council was led by a directly elected mayor, the Mayor of Bristol . The post was abolished following a 2022 referendum, in which voters chose to replace it with a council committee system. The lord mayor of Bristol is a figurehead elected each May by the city council. The lord mayor is Councillor Andrew Varney. In the House of Commons , Bristol
10488-604: The country with 237, as against London's 147. It was a major supplier of slaves to South Carolina before 1750. The 18th century saw an expansion of Bristol's population (45,000 in 1750) and its role in the Atlantic trade in Africans taken for slavery to the Americas. Bristol and later Liverpool became centres of the Triangular Trade . Manufactured goods were shipped to West Africa and exchanged for Africans;
10626-445: The data and draw appropriate conclusions, social sciences to better understand proximate and distal causes, and engineering for exposure assessment . Epidemiology , literally meaning "the study of what is upon the people", is derived from Greek epi 'upon, among' demos 'people, district' and logos 'study, word, discourse', suggesting that it applies only to human populations. However,
10764-497: The disease to the cases in the series. A prospective study would involve following the case series over time to evaluate the disease's natural history. The latter type, more formally described as self-controlled case-series studies, divide individual patient follow-up time into exposed and unexposed periods and use fixed-effects Poisson regression processes to compare the incidence rate of a given outcome between exposed and unexposed periods. This technique has been extensively used in
10902-599: The early 1900s by the Royal Edward Dock. Another new dock, the Royal Portbury Dock , opened across the river from Avonmouth during the 1970s. As air travel grew in the first half of the century, aircraft manufacturers built factories. The unsuccessful Bristol International Exhibition was held on Ashton Meadows in the Bower Ashton area in 1914. After the premature closure of the exhibition
11040-539: The enslaved captives were transported across the Atlantic to the Americas in the Middle Passage under brutal conditions. Plantation goods such as sugar, tobacco, rum, rice, cotton and a few slaves (sold to the aristocracy as house servants) returned across the Atlantic to England. Some household slaves were baptised in the hope this would lead them to be freed. The Somersett Case of 1772 clarified that slavery
11178-612: The epidemiologist is the one in control of all of the factors entering a certain case study. Epidemiological studies are aimed, where possible, at revealing unbiased relationships between exposures such as alcohol or smoking, biological agents , stress , or chemicals to mortality or morbidity . The identification of causal relationships between these exposures and outcomes is an important aspect of epidemiology. Modern epidemiologists use informatics and infodemiology as tools. Observational studies have two components, descriptive and analytical. Descriptive observations pertain to
11316-771: The era of molecular precision medicine , "molecular pathology" and "epidemiology" was integrated to create a new interdisciplinary field of " molecular pathological epidemiology " (MPE), defined as "epidemiology of molecular pathology and heterogeneity of disease". In MPE, investigators analyze the relationships between (A) environmental, dietary, lifestyle and genetic factors; (B) alterations in cellular or extracellular molecules; and (C) evolution and progression of disease. A better understanding of heterogeneity of disease pathogenesis will further contribute to elucidate etiologies of disease. The MPE approach can be applied to not only neoplastic diseases but also non-neoplastic diseases. The concept and paradigm of MPE have become widespread in
11454-400: The evaluation of factors with possible relevance to cognitive decline and dementia . The Caerphilly Study gave opportunity to study the relationship between lifestyle choices and health in a representative population sample drawn from a typical small town in the UK. The participants were asked detailed questions at baseline and at subsequent examinations about lifestyle behaviours, enabling
11592-571: The field and advanced methods to study cancer, a disease with patterns and mode of occurrences that could not be suitably studied with the methods developed for epidemics of infectious diseases. Geography pathology eventually combined with infectious disease epidemiology to make the field that is epidemiology today. Another breakthrough was the 1954 publication of the results of a British Doctors Study , led by Richard Doll and Austin Bradford Hill , which lent very strong statistical support to
11730-521: The first UK city to receive this award. In 2019 Bristol City Council voted in favour of banning all privately owned diesel cars from the city centre. Since then, the plans have been revised in favour of a clean air zone whereby older and more polluting vehicles will be charged to drive through the city centre. The Clean Air Zone came into effect in November 2022. The city has green belt mainly along its southern fringes, taking in small areas within
11868-409: The following 30 years 12% fewer would have developed diabetes; 6% fewer would have had a vascular disease event; 13% fewer would have developed dementia; and there would have been 5% fewer deaths. A video summarising this work is available on YouTube. Participants were asked to obtain from a close female relative the details of their own birth weight and how they had been fed as infants. Over half of
12006-405: The four humors (black bile, yellow bile, blood, and phlegm). The cure to the sickness was to remove or add the humor in question to balance the body. This belief led to the application of bloodletting and dieting in medicine. He coined the terms endemic (for diseases usually found in some places but not in others) and epidemic (for diseases that are seen at some times but not others). In
12144-458: The general population of patients with that disease. These types of studies, in which an astute clinician identifies an unusual feature of a disease or a patient's history, may lead to a formulation of a new hypothesis. Using the data from the series, analytic studies could be done to investigate possible causal factors. These can include case-control studies or prospective studies. A case-control study would involve matching comparable controls without
12282-461: The history of the Irish slave trade from Bristol, which he provocatively claimed continued into the reign of Henry VII . Hannah More , originally from Bristol, and a good friend of both Wilberforce and Clarkson, published "Slavery, A Poem" in 1788, just as Wilberforce began his parliamentary campaign. His major speech on 2 April 1792 likewise described the Bristol slave trade specifically, and led to
12420-539: The import and processing of tobacco flourished with the expansion of the W.D. & H.O. Wills business. Supported by new industry and growing commerce, Bristol's population (66,000 in 1801), quintupled during the 19th century, resulting in the creation of new suburbs such as Clifton and Cotham . These provide architectural examples from the Georgian to the Regency style, with many fine terraces and villas facing
12558-443: The initial aims of the study focused upon vascular disease, the wealth of data collected has enabled the testing of a large number of hypotheses relevant to other diseases too. From the start of the study, the term ' Collaborative ' was usually added to the title, paying tribute to the many physicians, laboratory technicians and other colleagues, expert in a wide range of clinical and metabolic disciplines, who were actively involved in
12696-704: The leadership of Dr John Gallacher ( Cardiff University ) and Professor Yoav Ben-Shlomo ( Bristol University ), together with Dr John Yarnell ( Queen's University ) and Professor Tony Bayer (Cardiff University). Financial support was obtained from the British Heart Foundation and the Alzheimer's Society . The Caerphilly Study's research strategy was to identify factors showing an association with vascular disease (and other diseases), and then to test these associations in randomised controlled trials and statistical analysis. The Framingham Heart Study ,
12834-490: The limestone to the underlying clay, creating Bristol's characteristically hilly landscape. The Avon flows from Bath in the east, through flood plains and areas which were marshes before the city's growth. To the west the Avon cuts through the limestone to form the Avon Gorge, formed largely by glacial meltwater after the last ice age . The gorge, which helped protect Bristol Harbour, has been quarried for stone to build
12972-575: The link between tobacco smoking and lung cancer . In the late 20th century, with the advancement of biomedical sciences, a number of molecular markers in blood, other biospecimens and environment were identified as predictors of development or risk of a certain disease. Epidemiology research to examine the relationship between these biomarkers analyzed at the molecular level and disease was broadly named " molecular epidemiology ". Specifically, " genetic epidemiology " has been used for epidemiology of germline genetic variation and disease. Genetic variation
13110-403: The main etiological work that brought forward the concept. His concepts were still being considered in analysing SARS outbreak by WHO in 2004 in the context of traditional Chinese medicine. Another pioneer, Thomas Sydenham (1624–1689), was the first to distinguish the fevers of Londoners in the later 1600s. His theories on cures of fevers met with much resistance from traditional physicians at
13248-498: The men have been re-examined seven times (at five-year intervals) with approximately 95% of the surviving men co-operating in each re-examination. Many questions and tests have been repeated, but the opportunity has also been taken to include new questionnaires and tests. In the early phases of the study, samples of fasting blood were collected for extensive testing and long-term storage, and on occasions urine and other biological samples were also taken, and aliquots stored. Thus, while
13386-511: The men obtained these details, and results showed that having been breast fed conferred some protection against the loss of cognitive function later in life, particularly in those whose birth weight had been low. Smoking, alcohol intake and leisure activities are lifestyle factors which were found to be predictive of cognitive function. Significant associations were also between cognitive function and blood rheology and negative associations with both haematocrit and plasma viscosity, but not with
13524-407: The men to be classified in terms of five healthy behaviours: These healthy behaviours displayed significant negative associations with cognitive impairment and dementia, with participant disease outcomes falling as the number of healthy behaviours followed increased. Men who followed four or five of the healthy behaviours during 30 years of follow-up experienced on average a 73% reduction in diabetes,
13662-484: The men. In addition to the association with cognitive function already mentioned, there was evidence of an increase in ischaemic stroke in men whose sleep is frequently disturbed, and an association between daytime sleepiness and a significant increase in ischaemic heart disease. Many analyses of foods and dietary factors were conducted, as well as an examination of Helicobacter pylori and other infections, and vascular disease risk. A reduction in vascular disease mortality
13800-448: The middle of the 16th century, a doctor from Verona named Girolamo Fracastoro was the first to propose a theory that the very small, unseeable, particles that cause disease were alive. They were considered to be able to spread by air, multiply by themselves and to be destroyable by fire. In this way he refuted Galen 's miasma theory (poison gas in sick people). In 1543 he wrote a book De contagione et contagiosis morbis , in which he
13938-403: The most active platelets in two tests, based on platelet rich plasma and whole blood, had the lowest subsequent risk of an incident ischaemic stroke. Detailed analyses of the dietary data identified a number of food items related to vascular disease risk. The consumption of fatty fish was associated with lower levels of blood lipids , and a reduction in vascular disease mortality was confirmed in
14076-506: The multicausality associated with disease is the causal pie model . In 1965, Austin Bradford Hill proposed a series of considerations to help assess evidence of causation, which have come to be commonly known as the " Bradford Hill criteria ". In contrast to the explicit intentions of their author, Hill's considerations are now sometimes taught as a checklist to be implemented for assessing causality. Hill himself said "None of my nine viewpoints can bring indisputable evidence for or against
14214-495: The neighbouring village of Kingswood , often in the open air. Wesley published a pamphlet on slavery, titled Thoughts Upon Slavery, in 1774 and the Society of Friends began lobbying against slavery in Bristol in 1783. The city's scions remained nonetheless strongly anti-abolitionist. Thomas Clarkson came to Bristol to study the slave trade and gained access to the Society of Merchant Venturers records. One of his contacts
14352-664: The north and Somerset to the south. The county is in the West of England combined authority area, which includes the Greater Bristol area ( eleventh most populous urban area in the United Kingdom) and nearby places such as Bath . Iron Age hillforts and Roman villas were built near the confluence of the rivers Frome and Avon. Bristol received a royal charter in 1155 and was historically divided between Gloucestershire and Somerset until 1373 when it became
14490-417: The odds of exposure in the cases (A/C) to the odds of exposure in the controls (B/D), i.e. OR = (AD/BC). If the OR is significantly greater than 1, then the conclusion is "those with the disease are more likely to have been exposed", whereas if it is close to 1 then the exposure and disease are not likely associated. If the OR is far less than one, then this suggests that the exposure is a protective factor in
14628-498: The odds ratio by the equation: where N is the ratio of cases to controls. As the odds ratio approaches 1, the number of cases required for statistical significance grows towards infinity; rendering case-control studies all but useless for low odds ratios. For instance, for an odds ratio of 1.5 and cases = controls, the table shown above would look like this: For an odds ratio of 1.1: Cohort studies select subjects based on their exposure status. The study subjects should be at risk of
14766-414: The outcome under investigation at the beginning of the cohort study; this usually means that they should be disease free when the cohort study starts. The cohort is followed through time to assess their later outcome status. An example of a cohort study would be the investigation of a cohort of smokers and non-smokers over time to estimate the incidence of lung cancer. The same 2×2 table is constructed as with
14904-459: The pattern of behaviours has changed, the proportions of subjects following four or five of the healthy behaviours has scarcely altered over the past 30 years. The Caerphilly Study estimated the likely effect of increased healthy living within the community by supposing that each man in the Caerphilly cohort had each been urged at the start of the study in 1979 to adopt just one additional healthy behaviour. If only half of them had complied, then over
15042-400: The prevailing Miasma Theory of the time, a model of disease in which poor air quality was blamed for illness. This was used to rationalize high rates of infection in impoverished areas instead of addressing the underlying issues of poor nutrition and sanitation, and was proven false by his work. Other pioneers include Danish physician Peter Anton Schleisner , who in 1849 related his work on
15180-640: The prevention of the epidemic of neonatal tetanus on the Vestmanna Islands in Iceland . Another important pioneer was Hungarian physician Ignaz Semmelweis , who in 1847 brought down infant mortality at a Vienna hospital by instituting a disinfection procedure. His findings were published in 1850, but his work was ill-received by his colleagues, who discontinued the procedure. Disinfection did not become widely practiced until British surgeon Joseph Lister 'discovered' antiseptics in 1865 in light of
15318-542: The purpose of communicating the results to those who can implement appropriate policies or disease control measures. Bristol Bristol ( / ˈ b r ɪ s t əl / ) is a city , unitary authority area and ceremonial county in South West England , the most populous city in the region. Built around the River Avon , it is bordered by the ceremonial counties of Gloucestershire to
15456-433: The rise of England's American colonies in the 17th century. Bristol's location on the west side of Great Britain gave its ships an advantage in sailing to and from the New World, and the city's merchants made the most of it, with the city becoming one of the two leading outports in all of England by the middle of the 18th century. Bristol was the slave capital of England: In 1755, it had the largest number of slave traders in
15594-492: The road, and at right angles to it. In the early 19th century, the romantic medieval gothic style appeared, partially as a reaction against the symmetry of Palladianism , and can be seen in buildings such as the Bristol City Museum and Art Gallery , the Royal West of England Academy , and The Victoria Rooms . Riots broke out in 1793 and 1831; the first over the renewal of tolls on Bristol Bridge, and
15732-402: The same population that gave rise to the cases. The case-control study looks back through time at potential exposures that both groups (cases and controls) may have encountered. A 2×2 table is constructed, displaying exposed cases (A), exposed controls (B), unexposed cases (C) and unexposed controls (D). The statistic generated to measure association is the odds ratio (OR), which is the ratio of
15870-462: The second against the rejection of the second Reform Bill by the House of Lords . The population by 1841 had reached 140,158. The Diocese of Bristol had undergone several boundary changes by 1897 when it was "reconstituted" into the configuration which has lasted into the 21st century. From a population of about 330,000 in 1901, Bristol grew steadily during the 20th century, peaking at 428,089 in 1971. Its Avonmouth docklands were enlarged during
16008-517: The site was used, until 1919, as barracks for the Gloucestershire Regiment during World War I . Bristol was heavily damaged by Luftwaffe raids during World War II ; about 1,300 people living or working in the city were killed and nearly 100,000 buildings were damaged, at least 3,000 beyond repair. The original central shopping area, near the bridge and castle, is now a park containing two bombed churches and fragments of
16146-403: The socioeconomic circumstances of the city's Afro-Caribbean residents. Local support of fair trade was recognised in 2005, when Bristol became a fairtrade zone . Bristol is both a city and a county, since King Edward III granted it a county charter in 1373. The county was expanded in 1835 to include suburbs such as Clifton , and it was named a county borough in 1889 when that designation
16284-456: The study of adverse reactions to vaccination and has been shown in some circumstances to provide statistical power comparable to that available in cohort studies. Case-control studies select subjects based on their disease status. It is a retrospective study. A group of individuals that are disease positive (the "case" group) is compared with a group of disease negative individuals (the "control" group). The control group should ideally come from
16422-439: The term is widely used in studies of zoological populations (veterinary epidemiology), although the term " epizoology " is available, and it has also been applied to studies of plant populations (botanical or plant disease epidemiology ). The distinction between "epidemic" and "endemic" was first drawn by Hippocrates , to distinguish between diseases that are "visited upon" a population (epidemic) from those that "reside within"
16560-420: The thrombotic potential of blood, as indicated by fibrinogen level. These relationships appear to be direct, and not through underlying long-term disease processes. Sleep pattern, and in particular severe daytime sleepiness, was also predictive of vascular dementia. In diabetic subjects, it was found that poor control of blood sugar was associated with a lower cognitive function, and diabetes per se, but none of
16698-716: The time. He was not able to find the initial cause of the smallpox fever he researched and treated. John Graunt , a haberdasher and amateur statistician, published Natural and Political Observations ... upon the Bills of Mortality in 1662. In it, he analysed the mortality rolls in London before the Great Plague , presented one of the first life tables , and reported time trends for many diseases, new and old. He provided statistical evidence for many theories on disease, and also refuted some widespread ideas on them. John Snow
16836-413: The water and removed the handle; this ended the outbreak. This has been perceived as a major event in the history of public health and regarded as the founding event of the science of epidemiology, having helped shape public health policies around the world. However, Snow's research and preventive measures to avoid further outbreaks were not fully accepted or put into practice until after his death due to
16974-486: The western Severn Estuary ending at (but not including) the islands of Flat Holm (in Cardiff , Wales) and Steep Holm . This "seaward extension" can be traced back to the original boundary of the County of Bristol laid out in the charter granted to the city by Edward III in 1373. The Office for National Statistics (ONS) has defined a Bristol Urban Area , which includes developed areas adjoining Bristol but outside
17112-637: The work of Louis Pasteur . In the early 20th century, mathematical methods were introduced into epidemiology by Ronald Ross , Janet Lane-Claypon , Anderson Gray McKendrick , and others. In a parallel development during the 1920s, German-Swiss pathologist Max Askanazy and others founded the International Society for Geographical Pathology to systematically investigate the geographical pathology of cancer and other non-infectious diseases across populations in different regions. After World War II, Richard Doll and other non-pathologists joined
17250-523: The work. Heart disease prevalence is far greater in men than women – therefore women were not included in the study. A far larger sample size would have been required if women had been the focus of the study, and unfortunately, the available resources were not sufficient for this. The work in Caerphilly was often linked with the Speedwell Study, a similar study operating in nearby Bristol , 60 km away. The survey techniques were similar and
17388-526: Was a randomised controlled trial of aspirin showing a reduction of vascular mortality. Reported in the British Medical Journal in 1974, this was the first study to demonstrate a protective role for aspirin in the reduction of death and reinfarction . The British Medical Journal recognised this article as one of the 50 most frequently cited papers published between 1945 and 1989. Following this trial, Elwood and his research team set up
17526-535: Was a trading centre with a mint producing silver pennies bearing its name. By 1067, Brycgstow was a well-fortified burh , and that year the townsmen beat back a raiding party from Ireland led by three of Harold Godwinson 's sons. Under Norman rule, the town had one of the strongest castles in southern England . Bristol was the place of exile for Diarmait Mac Murchada , the Irish king of Leinster , after being overthrown. The Bristol merchants subsequently played
17664-533: Was also taken, in collaboration with a range of clinical and laboratory colleagues, to collect data on a wide range of factors with possible relevance to diseases other than vascular, and at the same time to collect clinical information on incident disease events. The study was initiated by Professor Peter Elwood , Director of the Medical Research Council (MRC) Epidemiology Unit for South Wales. The work has so far led to over 400 publications in
17802-576: Was born in Bristol, and the left-winger Tony Benn served as MP for Bristol South East in 1950–1960 and again from 1963 to 1983. In 1963 the Bristol Bus Boycott , following the Bristol Omnibus Company 's refusal to hire black drivers and conductors, drove the passage of the UK's 1965 Race Relations Act . The 1980 St. Pauls riot protested against racism and police harassment and showed mounting dissatisfaction with
17940-523: Was demolished. Bristol's road infrastructure changed dramatically during the 1960s and 1970s with the development of the M4 and M5 motorways , which meet at the Almondsbury Interchange just north of the city and link Bristol with London (M4 eastbound), Swansea (M4 westbound across the Severn Estuary ), Exeter (M5 southbound) and Birmingham (M5 northbound). Bristol was bombed twice by
18078-861: Was found in those subjects most sexually active. Relationships between vascular disease and psychiatric symptoms, noise exposure, and hearing loss were also identified. Epidemiology Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population . It is a cornerstone of public health , and shapes policy decisions and evidence-based practice by identifying risk factors for disease and targets for preventive healthcare . Epidemiologists help with study design, collection, and statistical analysis of data, amend interpretation and dissemination of results (including peer review and occasional systematic review ). Epidemiology has helped develop methodology used in clinical research , public health studies, and, to
18216-472: Was illegal in England. At the height of the Bristol slave trade from 1700 to 1807, more than 2,000 slave ships carried a conservatively estimated 500,000 people from Africa to slavery in the Americas. In 1739, John Wesley founded the first Methodist chapel, the New Room , in Bristol. Wesley, along with his brother Charles Wesley and George Whitefield , preached to large congregations in Bristol and
18354-633: Was introduced. On 1 April 1974, Bristol became a local government district of the county of Avon . On 1 April 1996, Avon was abolished and Bristol became a unitary authority . The former Avon area, called Greater Bristol by the Government Office of the South West (now abolished) and others, refers to the city and the three neighbouring local authorities— Bath and North East Somerset , North Somerset and South Gloucestershire previously in Avon. The North Fringe of Bristol ,
18492-413: Was replaced by the current bridge during the 1760s. The town incorporated neighbouring suburbs and became a county in 1373, the first town in England to be given this status. During this period, Bristol became a shipbuilding and manufacturing centre. By the 14th century, Bristol, York and Norwich were England's largest medieval towns after London. One-third to one-half of the population died in
18630-401: Was shown to be positively associated with blood antioxidant levels. Detailed work with Serge Renaud on platelet activity showed a beneficial relationship between a low alcohol consumption and platelet aggregation, but an enhanced response to thrombin with binge drinking, confirming previous work in animals. A detailed questionnaire of sleep pattern was included in one of the re-examinations of
18768-668: Was the first to promote personal and environmental hygiene to prevent disease. The development of a sufficiently powerful microscope by Antonie van Leeuwenhoek in 1675 provided visual evidence of living particles consistent with a germ theory of disease . During the Ming dynasty , Wu Youke (1582–1652) developed the idea that some diseases were caused by transmissible agents, which he called Li Qi (戾气 or pestilential factors) when he observed various epidemics rage around him between 1641 and 1644. His book Wen Yi Lun (瘟疫论, Treatise on Pestilence/Treatise of Epidemic Diseases) can be regarded as
18906-460: Was the owner of the Seven Stars public house , who boarded sailors Clarkson sought to meet. Through these sailors he was able to observe how slaver captains and first mates "plied and stupefied seamen with drink" to sign them up. Other informants included ship surgeons and seamen seeking redress. When William Wilberforce began his parliamentary abolition campaign on 12 May 1788, he recalled
19044-519: Was −10.1 °C (13.8 °F) in December 2010. Although large cities in general experience an urban heat island effect, with warmer temperatures than their surrounding rural areas, this phenomenon is minimal in Bristol. Bristol was ranked as Britain's most sustainable city (based on its environmental performance, quality of life, future-proofing and approaches to climate change, recycling and biodiversity), topping environmental charity Forum for
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