Is the onset of disabling chronic conditions in later childhood associated with exposure to social disadvantage in earlier childhood? A prospective cohort study using the ONS Longitudinal Study for England and Wales

Background: The aetiology of disabling chronic conditions in childhood in high income countries is not fully understood, particularly the association with socio-economic status (SES). Very few studies have used longitudinal datasets to examine whether exposure to social disadvantage in early childhood increases the risk of developing chronic conditions in later childhood. Here we examine this association, and its temporal ordering, with onset of all-cause disabling chronic later childhood in children reported as free from disability in early childhood. Methods: The study comprised a prospective cohort study, using data from the Office for National Statistics Longitudinal Study (ONSLS) for England and Wales. The study sample included 52,839 children with complete data born between 1981–1991 with no disabling chronic condition/s in 1991. Index cases were children with disability recorded in 2001. Comparison cases were children with no recorded disability in 1991. A socio-economic disadvantage index (SDI) was constructed from data on social class, housing tenure and car/van access. Associations were explored with logistic regression modelling controlling sequentially for potentially confounding factors; age, gender, ethnicity and lone parenthood. Results: By 2001, 2049 (4%) had at least one disability. Socio-economic disadvantage, age, gender and lone parenthood but not ethnicity were significantly associated with onset of disabling chronic conditions. The SDI showed a finely graded association with onset of disabling chronic conditions in the index group (most disadvantaged OR 2·11 [CI 1·76 to 2·53]; disadvantaged in two domains OR 1·45 [CI 1·20 to 1·75]; disadvantaged in one domain OR 1·14 [CI 0·93 to 1·39] that was unaffected by age, gender and ethnicity and slightly attenuated by lone parenthood. Conclusion: To our knowledge, this is the first study to identify socio-economic disadvantage in earlier childhood as a predisposing factor for onset of all-cause disabling chronic conditions in later childhood. Temporal ordering and gradation of the response indicate socio-economic disadvantage may play a causal role. This suggests that targeting preventative efforts to reduce socio-economic disadvantage in early childhood is likely to be an important public health strategy to decease health inequalities in later childhood and early adulthood

Reform and order on the Elizabethan stage: Sir Thomas More to Hamlet

Im Zuge des religious turn in Studien zur Frühen Neuzeit ist bisher die Bedeutung der Zensur für die Durchsetzung konfessioneller Konformität wenig berücksichtigt worden. Gleichzeitig haben Arbeiten zur Theaterzensur deren Bedeutung für die Gestaltung und Legitimation des in den Stücken verhandelten Konfessionalismus unterschätzt. In ihrem Aufsatz untersucht Janet Clare, wie mit dem Aufbrechen des Dualismus von geistiger und weltlicher Autorität die theologischen Konzepte von ‘Reform’ und ‘Ordnung’ als staatliche Werkzeuge zur Sicherung von Uniformität übernommen werden. Mit Bezug auf Sir Thomas More, dessen Manuskript zensiert wurde, das anonyme Stück The Troublesome Reign of King John sowie Shakespeares King John diskutiert Clare, wie im englischen Historiendrama über ‘Reform’ und ‘Ordnung’ Grundprinzipien der Rechtsprechung aufgerufen werden. Im Gegensatz dazu werden in den beiden ‘Wittenberg-Stücken’, Marlowes Dr Faustus und Shakespeares Hamlet, die vom protestantischen Reformstreben beeinflusst sind und nicht denselben ideologischen Zwängen unterliegen, die mit der Repräsentation englischer Geschichte einhergehen, ‘Reform’ und ‘Ordnung’ auf ihre theologischen Bedeutungen rückgeführt

Shakespeare’s hybrid style

Abstract – Starting from the critical commonplace that Shakespeare was not an original writer, this chapter provocatively discusses his working practice characteristic of the theatre industry of his time and aims at showing how his borrowing contributes to his distinctive hybrid style. Shakespeare’s technical virtuosity in mixing dramatic modes and emotional responses is discussed in relation to classical comedy (A Comedy of Errors), romantic comedy (Twelfth Night, The Merchant of Venice) and tragedy (Hamlet, King Lear) to show that it is in this unprecedented blending of generic qualities that his innovation and originality lie

Shakespeare and paradigms of early modern authorship

The essay examines current thinking on early modern authorship within the competitive economies of the theatre and publishing industries. In the wake of Foucault's seminal essay, 'What is an Author?', there has been much investigation of the status, the branding, the proprietary and moral rights of the author in the early modern period and claims made for the emergence and birth of the author. Janet Clare claims that while authors were increasingly alert to authorship being wrongly claimed, the late sixteenth to early seventeenth-century was a moment of transition and uncertainty. Unlike Ben Jonson not all authors vigorously identified with and laid claim to their work. The author's emergence was a slow and fluctuating process

The structure of the perennial growth of Disa uniflora Berg. (Orchidaceae)

The perennation of orchids is poorly understood, in particular that of the Orchidoidae. The understanding of perennation in the Orchidoidae is important because the root-stem tuberoid is used as the one character defining the Orchidoidae as a monophyletic group. The root-stem tuberoid has never been examined for variation before. This project focuses on perennial growth in the Diseae in order to study the structure and function of the root stem tuberoid in relation to other organs and to contribute to the understanding of Orchidoid phylogeny

"Matron Lit": a twenty first century voice?

In this thesis I argue that matron lit gives over-forties women a voice within contemporary popular fictional texts that they have previously been denied. This genre began to emerge around the turn of the twenty-first century as a sub-genre of chick lit and is now firmly entrenched in the mainstream of popular fiction. Contemporary popular fiction aimed at the baby-boom market has established its readership steadily. For the first time older female readers of popular fiction have heroines to whom they can relate. Matron lit discusses the gains and losses that are encountered by ageing women in Western society. Cultural attitudes about ageing and gender operate together to marginalise older women. Matron lit contributes to the debate around ageing and gender by reporting and exposing gendered and ageist discourses. In order to explore the impact of fictional narratives that represent the lives of older women, I draw on the work of Jacques Lacan, Michel Foucault and Judith Butler. These theorists provide a frame of reference that assist an understanding of the constructive discourse which promotes normative cultural concepts of ageing and gender. In reporting on gendered ageist discourses matron lit exposes the repetitive linguistic process that undermines mature, female identities. While matron lit sometimes simply recites ageist discourses, it occasionally challenges them directly and frequently subverts them through irony. The particular issues which I explore over five chapters are: The importance of body image and sexuality, in the lives of matron lit heroines. The effect of ageist attitudes on wellbeing. The significance of home for matron lit heroines. The relevance of relationships and friendships to mature women. The pursuit of ‘liminal’ space where post-reproductive women can re-evaluate their purpose

Disabling chronic conditions in childhood and socioeconomic disadvantage : a systematic review and meta-analyses of observational studies

Objective To determine the association of socioeconomic disadvantage with the prevalence of childhood disabling chronic conditions in high-income countries. Study design Systematic review and meta-analyses. Data sources 6 electronic databases, relevant websites, reference lists and experts in the field. Study selection 160 observational studies conducted in high-income countries with data on socioeconomic status and disabling chronic conditions in childhood, published between 1 January 1991 and 31 December 2013. Data extraction and synthesis Abstracts were reviewed, full papers obtained, and papers identified for inclusion by 2 independent reviewers. Inclusion decisions were checked by a third reviewer. Where reported, ORs were extracted for low versus high socioeconomic status. For studies reporting raw data but not ORs, ORs were calculated. Narrative analysis was undertaken for studies without data suitable for meta-analysis. Results 126 studies had data suitable for meta-analysis. ORs for risk estimates were: all-cause disabling chronic conditions 1.72 (95% CI 1.48 to 2.01); psychological disorders 1.88 (95% CI 1.68 to 2.10); intellectual disability 2.41 (95% CI 2.03 to 2.86); activity-limiting asthma 2.20 (95% CI 1.87 to 2.85); cerebral palsy 1.42 (95% CI 1.26 to 1.61); congenital abnormalities 1.41 (95% CI 1.24 to 1.61); epilepsy 1.38 (95% CI 1.20 to 1.59); sensory impairment 1.70 (95% CI 1.39 to 2.07). Heterogeneity was high across most estimates (I2>75%). Of the 34 studies without data suitable for meta-analysis, 26 reported results consistent with increased risk associated with low socioeconomic status. Conclusions The findings indicate that, in high-income countries, childhood disabling chronic conditions are associated with social disadvantage. Although evidence of an association is consistent across different countries, the review provides limited evidence to explain the association; future research, using longitudinal data, will be required to distinguish low socioeconomic status as the cause or consequence of childhood disabling chronic conditions and the aetiological pathways and mechanisms