no / All universities have the capacity to embrace, embed or ignore sustainable development. Looking across the sector and reflecting on the past seven years and my own institutional experiences, the key finding is that change for campus and curriculum-based sustainability is clearly possible but unpredictable. For many years my own institution (University of Bradford) struggled to make progress in a number of key aspects of `campus greening¿ including recycling, green build, energy management, green travel, fair trade etc. It employed its first environmental manager as recently as 2003. Up until 2007, education for sustainable development (ESD) was largely found in one small academic department. Now, as this paper describes, it is a central feature of the learning and teaching strategy for the university and an overall institutional objective.

Yes / The central aim of the paper is to examine the nature and function of higher education in Africa, and to explore the potential for partnerships between institutions in the Global North and South to assist in meeting the current capacity challenge. The paper starts with a critical exploration of the contemporary shifts taking place in higher education around the world and how this is transforming academic and professional identities. Following this is an analysis of the rationales that drive the process of ¿internationalisation¿ of higher education. We argue that internationalisation and globalisation present both a challenge and an opportunity for the rapidly expanding systems of higher education in Africa. We then go on to consider how international partnerships might support the development of Higher Education institutions in Africa and we present a critical analysis of the pitfalls and potentials of such collaborations. We also reflect on a long-term collaborative relationship between the Universities of Bradford (UK) and Mzumbe (Tanzania). From this we take the view that robust and strategic long-term partnerships can avoid neo-colonial relationships and offer potential for both partners, but this requires institutional commitment at all levels. This literature review serves as a foundational study, which will feed into further papers reflecting on the evolution and practice of the partnerships in place between JEFCAS (University of Bradford) and HE institutions in Africa.

no / City Park opened in early 2012 and despite some on-going criticism, during the summer the site drew thousands of people to the heart of Bradford and was the scene of much relaxed and good natured conviviality amongst socially diverse groups. As a new and unique public space in Bradford and a focal point for the city, a number of staff from the Centre for Applied Social Research believed researching City Park to be a fruitful endeavour to help promote a dialogue with the public and other sectors about living together in Bradford.

yes / The car is a symbolic presence at the heart of the everyday experience of multi-ethnic coexistence. Exploring the potential significance of car ownership among members of the Pakistani/Muslim population in Bradford has an inherent interest and virtue, but more acutely, it can shed light on social relations where class, gender, religion and ethnicity intersect. The ‘young Asian/White/Muslim/Black male driver’ has acquired a certain meaning and reputation which has largely negative associations across Britain. However, once stereotypes such as the ones at play in the diary entry above are unpicked and engaged with, meaning becomes more nuanced and complicated, but no less vital. Indeed, the research upon which this paper is based suggests that car culture offers insights: first, into how some aspects of broader ‘British Muslim’ identity are framed; and second, that often negative, exoticized and racialized aspects of identity can be detuned and thus made less potent markers of racialized thinking.

Since the publication 20 years ago of reports, which identified parallel living between diverse communities in northern towns, including Bradford, there has been increasing concern about how difference can be accommodated alongside commitment to a collaborative, national enterprise. I examine this conundrum, with the assistance of a cohort of 18 people whose families hail from India and Pakistan, from the perspective of the Council of Europe’s recognition of the duty of the immigrant to integrate. I do this by considering how a sense of ethnic social group identity may constrain meaningful engagement in wider society. Framing this sense of ethnic social group identity is distance of the heart, the term coined by one of the cohort to explain ongoing emotional ties to homeland, long after migration, which have the potential to distract from total commitment to society here. My primary question was: what factors, inherent in ethnic social group identity, and elaborated by the term distance of the heart, may have shaped the experience of integration of Asian communities in Bradford? My secondary research questions explore how sense of belonging and home, parallel living, religion, heritage language usage, cultural endogamy, and caste and clan allegiances may impact integration. Utilising a critical realist approach I identify factors, or mechanisms, underpinning ethnic social group identity, which help to sustain minority exclusivity and result in a sense of living on the edge. However, my findings challenge assumptions about the dangers of parallel living by suggesting these can be trumped by agential choice. I found that while cohort members have a strong sense of ethnic identity, and commitment to minority community, they also engage with people from other communities and describe a British identity, which encompasses their ethnic identity. This demands a more nuanced response to parallel living, which treats it as a characteristic of, rather than a barrier to, cohesion.

Within the United Kingdom, a developing role for primary care services in cancer and palliative care has resulted in an increase in palliative home care teams. The provision of professional care in the home setting seeks to provide necessary services and enhanced choice for patients whose preference is to die at home. A mismatch between patient preference for home death and the actual number of people who died at home was identified within Bradford, the locality of this study. In response to this mismatch, and reflecting the policy environment of wishing to enhance community service provision, the four Primary Care Trusts (PCTs) in the city sought to offer support to patients who wished to remain in their own homes through the final stages of a terminal illness. To offer this support they set up a dedicated hospice at home team. This would provide services and support for patients in achieving a dignified, symptom free and peaceful death, allowing families to maximise time spent together. The aim of the study was to evaluate the Bradford hospice at home service from the perspective of carers, nurses and General Practitioners. Postal questionnaires were sent to carers (n = 289), district nurses (n = 508) and GP's (n = 444) using Bradford's hospice at home service. Resulting quantitative data was analysed using the Statical Package for Social Sciences (SPSS) and qualitative data was analysed using grounded theory techniques. The data from carers, district nurses and GPs provide general support for the Bradford hospice at home service. Carers valued highly the opportunity to 'fulfil a promise' to the individual who wished to be cared for at home. District nurses and GPs cited the positive impact of access to specialist expertise. This was a 'reassuring presence' for primary healthcare teams and offered 'relief of carer anxiety' by providing prompt, accessible and sensitive care. Carers and health professionals welcomed the increased possibility of patients being cared for at home. The study identified the need to focus on improving skill levels of staff and on ensuring continuity of care.

More than 1 billion people live in societies where consanguineous marriages are common. When children are born to consanguineous unions, there is an increased probability of the expression of single-gene disorders with a recessive mode of inheritance. There are presumptive social benefits of consanguineous marriages reported in the literature. METHODS: The UK's Born in Bradford birth cohort study recruited 12 453 women at 26-28 weeks' gestation between 2007 and 2010. In all, 11 396 completed a questionnaire, including questions about their relationship to their baby's father. We compared Pakistani and Other ethnic groups in consanguineous relationships and Pakistani, Other and White British groups not in consanguineous relationships, calculating percentages and age-adjusted prevalence ratios (95% confidence intervals). RESULTS: In the Pakistani group, 59.3% of women (n = 3038) were blood relatives of their baby's father. Consanguinity was uncommon in the Other ethnic group (7.3%, n = 127) and rare (n = 5) in the White British group. Compared with non-consanguineous counterparts, mothers in consanguineous relationships were socially and economically disadvantaged (e.g. never employed, less likely to have higher education). The Pakistani consanguineous group's social, economic and health lifestyle circumstances were equivalent to, in some cases better than, women in non-consanguineous relationships (e.g. up-to-date in paying bills, or in disagreeing that they wished for more warmth in their marital relationship). The consanguineous relationship group had less separation/divorce. Rates of cigarette smoking during pregnancy were lower in mothers in consanguineous relationships. CONCLUSION: Debate about consanguinity should balance the potential protective effect of consanguineous relationships with established genetic risk of congenital anomaly in children.

Congenital anomalies are a leading cause of infant death and disability and their incidence varies between ethnic groups in the UK. Rates of infant death are highest in children of Pakistani origin, and congenital anomalies are the most common cause of death in children younger than 12 in this ethnic group. We investigated the incidence of congenital anomalies in a large multiethnic birth cohort to identify the causes of the excess of congenital anomalies in this community. Methods: We obtained questionnaire data from the mothers of children with one or more anomalies from the Born in Bradford study, a prospective birth cohort study of 13 776 babies and their families in which recruitment was undertaken between 2007 and 2011. Details of anomalies were prospectively reported to the study and we cross checked these details against medical records. We linked data for anomalies to maternal questionnaire and clinical data gathered as part of the Born in Bradford study. We calculated univariate and multivariate risk ratios (RRs) with 95% CIs for various maternal risk factors. Findings: Of 11 396 babies for whom questionnaire data were available, 386 (3%) had a congenital anomaly. Rates for congenital anomaly were 305·74 per 10 000 livebirths, compared with a national rate of 165·90 per 10 000. The risk was greater for mothers of Pakistani origin than for those of white British origin (univariate RR 1·96, 95% CI 1·56–2·46). Overall, 2013 (18%) babies were the offspring of first-cousin unions. These babies were mainly of Pakistani origin—1922 (37%) of 5127 babies of Pakistani origin had parents in first-cousin unions. Consanguinity was associated with a doubling of risk for congenital anomaly (multivariate RR 2·19, 95% CI 1·67–2·85); we noted no association with increasing deprivation. 31% of all anomalies in children of Pakistani origin could be attributed to consanguinity. We noted a similar increase in risk for mothers of white British origin older than 34 years (multivariate RR 1·83, 95% CI 1·14–3·00). Maternal education to degree level was protective (0·53, 95% CI 0·38–0·75), irrespective of ethnic origin. Interpretation: Consanguinity is a major risk factor for congenital anomaly. The risk remains even after adjustment for deprivation, and accounts for almost a third of anomalies in babies of Pakistani origin. High levels of educational attainment are associated with reduced risk in all ethnic groups. Our findings will be valuable in health promotion and public health, and to those commissioning antenatal, paediatric, and clinical genetic services. Sensitive advice about the risks should be provided to communities at increased risk, and to couples in consanguineous unions, to assist in reproductive decision making. Funding: National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care programme.

No / The present study aimed to explore previously unreported ethnic differences in infant feeding practices during the introduction of solid foods, accounting for maternal and birth factors, and to determine whether these feeding patterns are associated with BMI at 3 years of age. An observational study using Poisson regression was carried out to investigate the relationship between ethnicity and infant feeding practices and linear regression was used to investigate the relationship between feeding practices and BMI at 3 years of age in a subsample of 1327 infants in Bradford. It was found that compared with White British mothers, mothers of Other ethnicities were less likely to replace breast milk with formula milk before introducing solid foods (adjusted relative risk (RR) – Pakistani: 0·76 (95 % CI 0·64, 0·91), Other South Asian: 0·58 (95 % CI 0·39, 0·86), and Other ethnicities: 0·50 (95 % CI 0·34, 0·73)). Pakistani and Other South Asian mothers were less likely to introduce solid foods early ( < 17 weeks) (adjusted RR – Pakistani: 0·92 (95 % CI 0·87, 0·96) and Other South Asian: 0·87 (95 % CI 0·81, 0·93)). Other South Asian mothers and mothers of Other ethnicities were more likely to continue breast-feeding after introducing solid foods (adjusted RR – 1·72 (95 % CI 1·29, 2·29) and 2·12 (95 % CI 1·60, 2·81), respectively). Pakistani and Other South Asian infants were more likely to be fed sweetened foods (adjusted RR – 1·18 (95 % CI 1·13, 1·23) and 1·19 (95 % CI 1·10, 1·28), respectively) and Pakistani infants were more likely to consume sweetened drinks (adjusted RR 1·72 (95 % CI 1·15, 2·57)). No association between infant feeding practices and BMI at 3 years was observed. Although ethnic differences in infant feeding practices were found, there was no association with BMI at 3 years of age. Interventions targeting infant feeding practices need to consider ethnicity to identify which populations are failing to follow recommendations.

Yes / Objectives Preterm birth (PTB) and small for gestational age (SGA) are major causes of perinatal mortality and morbidity. Previous studies indicated a range of risk factors associated with these poor outcomes, including maternal psychosocial and economic wellbeing. This paper will explore a range of psycho-social and economic factors in an ethnically diverse population. Methods The UK’s Born in Bradford cohort study recruited pregnant women attending a routine antenatal appointment at 26–28 weeks’ gestation at the Bradford Royal Infirmary (2007–2010). This analysis includes 9680 women with singleton live births who completed the baseline questionnaire. Data regarding maternal socio-demographic and mental health were recorded. Outcome data were collected prospectively, and analysed using multivariate regression models. The primary outcomes measured were: PTB (<37 weeks’ gestation) and SGA (<10th customised centile). Results After adjustment for socio-demographic and medical factors, financial strain was associated with a 45 % increase in PTB (OR 1.45: 95 % CI 1.06–1.98). Contrary to expectation, maternal distress in Pakistani women was negatively associated with SGA (OR 0.65: CI 0.48–0.88). Obesity in White British women was protective for PTB (OR 0.67: CI 0.45–0.98). Previously recognized risk factors, such as smoking in pregnancy and hypertension, were confirmed. Conclusions This study confirms known risk factors for PTB and SGA, along with a new variable of interest, financial strain. It also reveals a difference in the risk factors between ethnicities. In order to develop appropriate targeted preventative strategies to improve perinatal outcome in disadvantaged groups, a greater understanding of ethno-specific risk factors is required