Thunderstorm Related Asthma - the Epidemic of 24/25 June 1994

Background A large epidemic of asthma occurred following a thunderstorm in southern and central England on 24/25 June 1994. A collaborative study group was formed. Objectives To describe the epidemic and the meteorological, aerobiological and other environmental characteristics associated with it. Methods Collation of data from the Meteorological Office, the Pollen Research Unit, the Department of the Environment's Automatic Urban Network, from health surveillance by the Department of Health and the National Poisons Unit, from clinical experience in general practice and hospitals, and from an immunological study of some of the affected cases from north east London. Results The thunderstorm was a Mesoscale Convective System, an unusual and large form of storm with several centres and severe wind gusts. It occurred shortly after the peak grass pollen concentration in the London area. A sudden and extensive epidemic occurred within about an hour affecting possibly several thousand patients. Emergency services were stretched but the epidemic did not last long. Cases had high serum levels of IgE antibody to mixed grass pollen. Conclusion This study supports the view that patients with specific IgE to grass pollen are at risk of thunderstorm-related asthma. The details of the causal pathway from storm to asthma attack are not clear. Case-control and time series studies are being carried out.

Senior Managers’ Perspectives of Leading and Managing Effective, Sustainable and Successful Partnerships

Formal and informal partnerships have become key features of education policy and practice in many countries and managing such collaborative arrangements is an important dimension of the role(s) of leaders of educational organizations. Recent research has shown both the tensions and conflict that can develop in partnerships as well as the opportunities and benefits of partnership working for organizations and individuals. This article focuses on the characteristics of partnerships that contribute to their effectiveness, sustainability and success, filling a gap in the literature on educational partnerships. The research data emanate from a qualitative study of partnership working in England. The study used a grounded approach and inductively linked characteristics of partnerships found in the partnership literature with empirical data from a case study of a subregional partnership of education and training organizations. This combined evidence is used to conceptualize partnership as a continuum of weak to strong forms of partnership and to develop a table of characteristics which underpin such partnerships. The findings reveal the extent to which trust, networks, norms and values support effective, sustained and successful partnerships. These characteristics are differentiated and may fluctuate during the lifecourse of a partnership but remain fundamental features of partnership working and significantly contribute to the strength and effectiveness of partnerships.