Journal of another plague year

Recent years have seen a catalogue of plagues and sundry other contagions. Hard on the scaly heels of avian flu follows global warming, swine flu, obesity, and now the economic plague. This litany of woes has affect’d me deeply, as these few entries from my diary this past year shew. Rose early to enjoy reading the latest bill of mortality of estate agents in the Parish of St Giles, which show’d again a monthly increase. The Bankers, too, have this past year been struck low, and it transpires that their understanding of the term "Bank" has left much to be desired; they have been sinking our shillings in miscellaneous crackpot schemes in the Colonies that few understand, and fewer profit from: to wit, hedge funds, subprime mortgages, Ponzi schemes, plans to build golden stairways to the moon, and God knows how many other feeble minded schemes

Socio-economic inequalities in survival of patients with prostate cancer: role of age and Gleason grade at diagnosis

In the United Kingdom, survival of prostate cancer patients has improved since the 1990s. A deprivation gap in survival (better survival for the least deprived compared with the most deprived) has been reported but it is not known if differential distribution of earlier age or lower grade disease at diagnosis might explain such patterns. We therefore investigated the impact of age and Gleason grade at diagnosis on the deprivation gap in survival of prostate cancer patients over time. Incident cases of prostate cancer (ICD-10 C61) from the West of Scotland were extracted from the Scottish Cancer Registry from 1991 to 2007. Socio-economic circumstances were measured using the Scottish Index for Multiple Deprivation 2004 (SIMD). Age and deprivation specific mortality rates were obtained from the General Registrar Office for Scotland (GRO(S)). The survival gradient across the five deprivation categories was estimated with linear regression, weighted by the variance of the relative survival estimate. We examined the data for 15,292 adults diagnosed with prostate cancer between 1991 and 2007. Despite substantial improvements in survival of prostate cancer patients, a deprivation gap persists throughout the three periods of diagnoses. The deprivation gap in five year relative survival widened from −4.76 in 1991–1996 to −10.08 in 2003–2007. On age and grade-specific analyses, a significant deprivation gap in five year survival existed between all age groups except among patients' age ≥75 and both low and high grade disease. On multivariate analyses, deprivation was significantly associated with increased excess risk of death (RER 1.48, 95% CI 1.31–1.68, p-value<0.001) independent of age, Gleason grade and period of diagnosis. The deprivation gap in survival from prostate cancer cannot be wholly explained by socio-economic differentials in early detection of disease. Further research is needed to understand whether differences in comorbidities or treatment explain inequalities in prostate cancer outcomes

Better homes, better neighbourhoods

Abstract not availabl

Health effects of housing improvement: systematic review of intervention studies

OBJECTIVE: To review the evidence on the effects of interventions to improve housing on health. DESIGN: Systematic review of experimental and non-experimental housing intervention studies that measured quantitative health outcomes. DATA SOURCES: Studies dating from 1887, in any language or format, identified from clinical, social science, and grey literature databases, personal collections, expert consultation, and reference lists. MAIN OUTCOME MEASURES: Socioeconomic change and health, illness, and social measures. RESULTS: 18 completed primary intervention studies were identified. 11 studies were prospective, of which six had control groups. Three of the seven retrospective studies used a control group. The interventions included rehousing, refurbishment, and energy efficiency measures. Many studies showed health gains after the intervention, but the small study populations and lack of controlling for confounders limit the generalisability of these findings. CONCLUSIONS: The lack of evidence linking housing and health may be attributable to pragmatic difficulties with housing studies as well as the political climate in the United Kingdom. A holistic approach is needed that recognises the multifactorial and complex nature of poor housing and deprivation. Large scale studies that investigate the wider social context of housing interventions are required. [References: 42

What do we need for robust and quantitative health impact assessment?

Health impact assessment (HIA) aims to make the health consequences of decisions explicit. Decision-makers need to know that the conclusions of HIA are robust. Quantified estimates of potential health impacts may be more influential but there are a number of concerns. First, not everything that can be quantified is important. Second, not everything that is being quantified at present should be, if this cannot be done robustly. Finally, not everything that is important can be quantified; rigorous qualitative HIA will still be needed for a thorough assessment. This paper presents the first published attempt to provide practical guidance on what is required to perform robust, quantitative HIA. Initial steps include profiling the affected populations, obtaining evidence from for postulated impacts, and determining how differences in subgoups' exposures and suscepibilities affect impacts. Using epidemiological evidence for HIA is different from carrying out a new study. Key steps in quantifying impacts are mapping the causal pathway, selecting appropriate outcome measures and selecting or developing a statistical model. Evidence from different sources is needed. For many health impacts, evidence of an effect may be scarce and estimates of the size and nature of the relationship may be inadequate. Assumptions and uncertainties must therefore be explicit. Modelled data can sometimes be tested against empirical data but sensitivity analyses are crucial. When scientific problems occur, discontinuing the study is not an option, as HIA is usually intended to inform real decisions. Both qualitative and quantitative elements of HIA must be performed robustly to be of value

On the Theory of Superfluidity in Two Dimensions

The superfluid phase transition of the general vortex gas, in which the circulations may be any non-zero integer, is studied. When the net circulation of the system is not zero the absence of a superfluid phase is shown. When the net circulation of the vortices vanishes, the presence of off-diagonal long range order is demonstrated and the existence of an order parameter is proposed. The transition temperature for the general vortex gas is shown to be the Kosterlitz---Thouless temperature. An upper bound for the average vortex number density is established for the general vortex gas and an exact expression is derived for the Kosterlitz---Thouless ensemble.Comment: 22 pages, one figure, written in plain TeX, published in J. Phys. A24 (1991) 502

Energy requirement for the production of silicon solar arrays

Photovoltaics is subject of an extensive technology assessment in terms of its net energy potential as an alternate energy source. Reduction of quartzite pebbles, refinement, crystal growth, cell processing and panel building are evaluated for energy expenditure compared to direct, indirect, and overhead energies

Bringing remote sensing technology to the user community

The procedures and services available for educating and training potential users of remote sensing technology are discussed along with approaches for achieving an in-house capability for the analysis of remotely sensed data using numerical techniques based on pattern recognition principles. Cost estimates are provided where appropriate