Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis

<p><b>Background:</b> Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.</p> <p><b>Methods and Findings:</b> Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.</p> <p><b>Conclusions:</b> Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.</p&gt

Seeking for solutions within a project setting

There has been increasing attention focused on the importance of ‘solution selling’ in the often very close relationships that characterize business-to-business marketing. While an extant predominantly product-centric view of solutions prevails in the literature, this has recently been juxtaposed with a more process-oriented view. We review such a process-oriented solution model briefly, and focus on the managerial challenge of how firms make this process-oriented approach work in practice. We argue that, in parallel to adopting a process-oriented approach, companies also have to focus their attention specifically on how to mobilize the different parties in order to amalgamate the perspectives and orientations between the interacting counterparts. We propose an interaction process model of how this ‘collective mind’ is achieved, using as an example a study of the United Kingdom’s Lean Aerospace Initiative (UK LAI), a large project with a specific solution in mind – improving the global competitiveness of the UK’s Aerospace industry. We use our model to show how the three main groups of actors (Government bodies, four Universities, and the aerospace companies themselves) interact in their pursuit of co-creating their collective solutions