Social deprivation and exposure to health promotion. A study of the distribution of health promotion resources to schools in England

This article has been made available through the Brunel Open Access Publishing Fund and is available from the specified link - Copyright @ 2010 Chivu and ReidpathBACKGROUND: Area deprivation is a known determinant of health. It is also known that area deprivation is associated with lower impact health promotion. It is less well known, however, whether deprived areas are less responsive to health promotion, or whether they are less exposed. Using data from a national, school-based campaign to promote vaccination against the human papilloma virus (HPV), the relationship between area deprivation and exposure was examined. METHODS: Taking advantage of a health promotion campaign to provide information to schools about HPV vaccination, a cross sectional study was conducted to examine the relationship between area level, social deprivation, and take-up of (i.e., exposure to) available health promotion material. The sample was 4,750 schools across England, including government maintained and independent schools. The relationship between area deprivation and exposure was examined using bi- and multivariate logistic regression. RESULTS: It was found that schools in the least deprived quintile had 1.32 times the odds of requesting health promotion materials than schools in the most deprived areas (p = .01). This effect was independent of the school size, the type of school, and the geographic region. Conclusion The relationship between area deprivation and the impact of health promotion may be due, at least in part, to differential levels of exposure. The study was limited in scope, pointing to the need for more research, but also points to potentially important policy implications

The association of smoking and socioeconomic status on cutaneous melanoma: a population‐based, data‐linkage, case–control study

BACKGROUND: Previous studies have identified an inverse association between melanoma and smoking; however, data from population-based studies are scarce. OBJECTIVES: To determine the association between smoking and socioeconomic (SES) on the risk of development of melanoma. Furthermore, we sought to determine the implications of smoking and SES on survival. METHODS: We conducted a population-based case-control study. Cases were identified from the Welsh Cancer Intelligence and Surveillance Unit (WCISU) during 2000-2015 and controls from the general population. Smoking and SES were obtained from data linkage with other national databases. The association of smoking status and SES on the incidence of melanoma were assessed using binary logistic regression. Multivariate survival analysis was performed on a melanoma cohort using a Cox proportional hazard model using survival as the outcome. RESULTS: During 2000-2015, 9636 patients developed melanoma. Smoking data were obtained for 7124 (73·9%) of these patients. There were 26 408 controls identified from the general population. Smoking was inversely associated with melanoma incidence [odds ratio (OR) 0·70, 95% confidence interval (CI) 0·65-0·76]. Smoking was associated with an increased overall mortality [hazard ratio (HR) 1·30, 95% CI 1·09-1·55], but not associated with melanoma-specific mortality. Patients with higher SES had an increased association with melanoma incidence (OR 1·58, 95% CI 1·44-1·73). Higher SES was associated with an increased chance of both overall (HR 0·67, 95% CI 0·56-0·81) and disease-specific survival (HR 0·69, 95% CI 0·53-0·90). CONCLUSIONS: Our study has demonstrated that smoking appeared to be associated with reduced incidence of melanoma. Although smoking increases overall mortality, no association was observed with melanoma-specific mortality. Further work is required to determine if there is a biological mechanism underlying this relationship or an alternative explanation, such as survival bias. What's already known about this topic? Previous studies have been contradictory with both negative and positive associations between smoking and the incidence of melanoma reported. Previous studies have either been limited by publication bias because of selective reporting or underpowered. What does this study add? Our large study identified an inverse association between smoking status and melanoma incidence. Although smoking status was negatively associated with overall disease survival, no significant association was noted in melanoma-specific survival. Socioeconomic status remains closely associated with melanoma. Although higher socioeconomic populations are more likely to develop the disease, patients with lower socioeconomic status continue to have a worse prognosis

Supersymmetric mass spectra and the seesaw type-I scale

We calculate supersymmetric mass spectra with cMSSM boundary conditions and a type-I seesaw mechanism added to explain current neutrino data. Using published, estimated errors on SUSY mass observables for a combined LHC+ILC analysis, we perform a theoretical $\chi^2$ analysis to identify parameter regions where pure cMSSM and cMSSM plus seesaw type-I might be distinguishable with LHC+ILC data. The most important observables are determined to be the (left) smuon and selectron masses and the splitting between them, respectively. Splitting in the (left) smuon and selectrons is tiny in most of cMSSM parameter space, but can be quite sizeable for large values of the seesaw scale, $m_{SS}$. Thus, for very roughly $m_{SS} \ge 10^{14}$ GeV hints for type-I seesaw might appear in SUSY mass measurements. Since our numerical results depend sensitively on forecasted error bars, we discuss in some detail the accuracies, which need to be achieved, before a realistic analysis searching for signs of type-I seesaw in SUSY spectra can be carried out.Comment: 17 pages, 7 figure

Wilson Lines and a Canonical Basis of SU(4) Heterotic Standard Models

The spontaneous breaking of SU(4) heterotic standard models by Z_3 x Z_3 Wilson lines to the MSSM with three right-handed neutrino supermultiplets and gauge group SU(3)_C x SU(2)_L x U(1) x U(1) is explored. The two-dimensional subspace of the Spin(10) Lie algebra that commutes with su(3)_C + su(2)_L is analyzed. It is shown that there is a unique basis for which the initial soft supersymmetry breaking parameters are uncorrelated and for which the U(1) x U(1) field strengths have no kinetic mixing at any scale. If the Wilson lines "turn on" at different scales, there is an intermediate regime with either a left-right or a Pati-Salam type model. We compute their spectra directly from string theory, and adjust the associated mass parameter so that all gauge parameters exactly unify. A detailed analysis of the running gauge couplings and soft gaugino masses is presented.Comment: 59 pages, 9 figure

Geographical epidemiology of health and overall deprivation in England, its changes and persistence from 2004 to 2015: a longitudinal spatial population study

Background - Socioeconomic deprivation is a key determinant for health. In England, the Index of Multiple Deprivation (IMD) is a widely used composite measure of deprivation. However, little is known about its spatial clustering or persistence across time. Methods - Data for overall IMD and its health domain were analysed for 2004–2015 at a low geographical area (average of 1500 people). Levels and temporal changes were spatially visualised for the whole of England and its 10 administrative regions. Spatial clustering was quantified using Moran’s I, correlations over time were quantified using Pearson’s r. Results - Between 2004 and 2015 we observed a strong persistence for both overall (r=0.94) and health-related deprivation (r=0.92). At the regional level, small changes were observed over time, but with areas slowly regressing towards the mean. However, for the North East, North West and Yorkshire, where health-related deprivation was the highest, the decreasing trend in health-related deprivation reversed and we noticed increases in 2015. Results did not support our hypothesis of increasing spatial clustering over time. However, marked regional variability was observed in both aggregate deprivation outcomes. The lowest autocorrelation was seen in the North East and changed very little over time, while the South East had the highest autocorrelation at all time points. Conclusions - Overall and health-related deprivation patterns persisted in England, with large and unchanging health inequalities between the North and the South. The spatial aspect of deprivation can inform the targeting of health and social care interventions, particularly in areas with high levels of deprivation clustering

The effect of modifiable risk factors on geographic mortality differentials: a modelling study

Background Australian mortality rates are higher in regional and remote areas than in major cities. The degree to which this is driven by variation in modifiable risk factors is unknown. Methods We applied a risk prediction equation incorporating smoking, cholesterol and blood pressure to a national, population based survey to project all-causes mortality risk by geographic region. We then modelled life expectancies at different levels of mortality risk by geographic region using a risk percentiles model. Finally we set high values of each risk factor to a target level and modelled the subsequent shift in the population to lower levels of mortality risk and longer life expectancy. Results Survival is poorer in both Inner Regional and Outer Regional/Remote areas compared to Major Cities for men and women at both high and low levels of predicted mortality risk. For men smoking, high cholesterol and high systolic blood pressure were each associated with the mortality difference between Major Cities and Outer Regional/Remote areas--accounting for 21.4%, 20.3% and 7.7% of the difference respectively. For women smoking and high cholesterol accounted for 29.4% and 24.0% of the difference respectively but high blood pressure did not contribute to the observed mortality differences. The three risk factors taken together accounted for 45.4% (men) and 35.6% (women) of the mortality difference. The contribution of risk factors to the corresponding differences for inner regional areas was smaller, with only high cholesterol and smoking contributing to the difference in men-- accounting for 8.8% and 6.3% respectively-- and only smoking contributing to the difference in women--accounting for 12.3%. Conclusions These results suggest that health intervention programs aimed at smoking, blood pressure and total cholesterol could have a substantial impact on mortality inequities for Outer Regional/Remote areas. Background: Australian mortality rates are higher in regional and remote areas than in major cities. The degree to which this is driven by variation in modifiable risk factors is unknown. Methods. We applied a risk prediction equation incorporating smoking, cholesterol and blood pressure to a national, population based survey to project all-causes mortality risk by geographic region. We then modelled life expectancies at different levels of mortality risk by geographic region using a risk percentiles model. Finally we set high values of each risk factor to a target level and modelled the subsequent shift in the population to lower levels of mortality risk and longer life expectancy. Results: Survival is poorer in both Inner Regional and Outer Regional/Remote areas compared to Major Cities for men and women at both high and low levels of predicted mortality risk. For men smoking, high cholesterol and high systolic blood pressure were each associated with the mortality difference between Major Cities and Outer Regional/Remote areas - accounting for 21.4%, 20.3% and 7.7% of the difference respectively. For women smoking and high cholesterol accounted for 29.4% and 24.0% of the difference respectively but high blood pressure did not contribute to the observed mortality differences. The three risk factors taken together accounted for 45.4% (men) and 35.6% (women) of the mortality difference. The contribution of risk factors to the corresponding differences for inner regional areas was smaller, with only high cholesterol and smoking contributing to the difference in men - accounting for 8.8% and 6.3% respectively - and only smoking contributing to the difference in women - accounting for 12.3%. Conclusions: These results suggest that health intervention programs aimed at smoking, blood pressure and total cholesterol could have a substantial impact on mortality inequities for Outer Regional/Remote areas

Sneutrino dark matter in low-scale seesaw scenarios

We consider supersymmetric models in which sneutrinos are viable dark matter candidates. These are either simple extensions of the Minimal Supersymmetric Standard Model with additional singlet superfields, such as the inverse or linear seesaw, or a model with an additional U(1) group. All of these models can accomodate the observed small neutrino masses and large mixings. We investigate the properties of sneutrinos as dark matter candidates in these scenarios. We check for phenomenological bounds, such as correct relic abundance, consistency with direct detection cross section limits and laboratory constraints, among others lepton flavour violating (LFV) charged lepton decays. While inverse and linear seesaw lead to different results for LFV, both models have very similar dark matter phenomenology, consistent with all experimental bounds. The extended gauge model shows some additional and peculiar features due to the presence of an extra gauge boson Z' and an additional light Higgs. Specifically, we point out that for sneutrino LSPs there is a strong constraint on the mass of the Z' due to the experimental bounds on the direct detection scattering cross section

Hefty MSSM-like light Higgs in extended gauge models

It is well known that in the MSSM the lightest neutral Higgs h^0 must be, at the tree level, lighter than the Z boson and that the loop corrections shift this stringent upper bound up to about 130 GeV. Extending the MSSM gauge group in a suitable way, the new Higgs sector dynamics can push the tree-level mass of h^0 well above the tree-level MSSM limit if it couples to the new gauge sector. This effect is further pronounced at the loop level and h^0 masses in the 140 GeV ballpark can be reached easily. We exemplify this for a sample setting with a low-scale U(1)_R x U(1)_B-L gauge symmetry in which neutrino masses can be implemented via the inverse seesaw mechanism.Comment: 14 pages, 3 figures; references added, typos corrected; published versio

Coherent elastic neutrino-nucleus scattering: Terrestrial and astrophysical applications

Coherent elastic neutrino-nucleus scattering (CE$\nu$NS) is a process in which neutrinos scatter on a nucleus which acts as a single particle. Though the total cross section is large by neutrino standards, CE$\nu$NS has long proven difficult to detect, since the deposited energy into the nucleus is $\sim$ keV. In 2017, the COHERENT collaboration announced the detection of CE$\nu$NS using a stopped-pion source with CsI detectors, followed up the detection of CE$\nu$NS using an Ar target. The detection of CE$\nu$NS has spawned a flurry of activities in high-energy physics, inspiring new constraints on beyond the Standard Model (BSM) physics, and new experimental methods. The CE$\nu$NS process has important implications for not only high-energy physics, but also astrophysics, nuclear physics, and beyond. This whitepaper discusses the scientific importance of CE$\nu$NS, highlighting how present experiments such as COHERENT are informing theory, and also how future experiments will provide a wealth of information across the aforementioned fields of physics