Segmenting excessive alcohol consumers : implications for social marketing

While extant studies have mainly investigated differences between drinkers and non-drinkers, the literature on segmenting heavy drinkers and profiling them is surprisingly scarce. This study makes a significant contribution to the social marketing literature by illustrating a novel way of targeting heavy drinkers by utilizing their health management styles and provides useful insights into understanding how segmentation could be a valuable tool for developing effective social marketing programmes that are aimed at reducing excessive alcohol consumption. Analysis of data collected through the HINTS study reveals a two-cluster segmentation model. The two segments of heavy drinkers distinctly differ in terms of the extent of reliance and trust they place on health service professionals. Hence, the segmentation analysis provides interesting and novel insights into the level of dependence of heavy drinkers on the health care system and their health management styles. The study provides an actionable perspective for future research, public policy and social marketing

Understanding historical coastal spit evolution : a case study from Spurn, East Yorkshire, UK

Globally sandy coastlines are threatened by erosion driven by climatic changes and increased storminess. Understanding how they have responded to past storms is key to help manage future coastal changes. Coastal spits around the world are particularly dynamic and therefore potentially vulnerable coastal features. Therefore, how they have evolved over the last few centuries is of great importance. To illustrate this, this study focuses on the historical evolution of a spit at Spurn on the east coast of the UK, which currently provides critical protection to settlements within the Humber estuary. Through the combination of digitized historical mapping and luminescence dating, this study shows that Spurn has been a consistent coastal feature over at least the past 440 years. No significant westward migration was observed for the last 200 years. Results show a long‐term extension of the spit and a decrease in its overall area, particularly in the last 50 years. Breaches of the neck cause temporary sediment pathway changes enabling westward extension of the head. Use of digitized historical maps in GIS combined with OSL dating has allowed a more complete understanding of long‐term spit evolution and sediment transport modes at Spurn. In doing so it helps inform future possible changes linked to pressures, such as increases in storm events and sea‐level rise

Reconstruction of Lamb weather type series back to the eighteenth century

The Lamb weather type series is a subjective catalogue of daily atmospheric patterns and flow directions over the British Isles, covering the period 1861–1996. Based on synoptic maps, meteorologists have empirically classified surface pressure patterns over this area, which is a key area for the progression of Atlantic storm tracks towards Europe. We apply this classification to a set of daily pressure series from a few stations from western Europe, in order to reconstruct and to extend this daily weather type series back to 1781. We describe a statistical framework which provides, for each day, the weather types consistent enough with the observed pressure pattern, and their respective probability. Overall, this technique can correctly reconstruct almost 75% of the Lamb daily types, when simplified to the seven main weather types. The weather type series are described and compared to the original series for the winter season only. Since the low frequency variability of synoptic conditions is directly related to the North Atlantic Oscillation (NAO), we derive from the weather type series an NAO index for winter. An interesting feature is a larger multidecadal variability during the nineteenth century than during the twentieth century

Isothermal and Cyclic Aging of 310S Austenitic Stainless Steel

Unusual damage and high creep strain rates have been observed on components made of 310S stainless steel subjected to thermal cycles between room temperature and 1143 K (870 °C). Microstructural characterization of such components after service evidenced high contents in sigma phase which formed first from δ-ferrite and then from γ-austenite. To get some insight into this microstructural evolution, isothermal and cyclic aging of 310S stainless steel has been studied experimentally and discussed on the basis of numerical simulations. The higher contents of sigma phase observed after cyclic agings than after isothermal treatments are clearly associated with nucleation triggered by thermal cycling

Diversification of U.S. medical schools via affirmative action implementation

BACKGROUND: The diversification of medical school student and faculty bodies via race-conscious affirmative action policy is a societal and legal option for the U.S. Supreme Court has recently ruled its use constitutional. This paper investigates the implications of affirmative action, particularly race-conscious compared to race-blind admissions policy; explains how alternative programs are generally impractical; and provides a brief review of the history and legality of affirmative action in the United States. DISCUSSION: Selection based solely on academic qualifications such as GPA and MCAT scores does not achieve racial and ethnic diversity in medical school, nor does it adequately predict success as practicing physicians. However, race-conscious preference yields greater practice in underserved and often minority populations, furthers our biomedical research progression, augments health care for minority patients, and fosters an exceptional medical school environment where students are better able to serve an increasingly multicultural society. SUMMARY: The implementation of race-conscious affirmative action results in diversity in medicine. Such diversity has shown increased medical practice in underserved areas, thereby providing better health care for the American people

Upstream Solutions: Does the Supplemental Security Income Program Reduce Disability in the Elderly?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72843/1/j.1468-0009.2007.00512.x.pd

Early Markers of Glycaemic Control in Children with Type 1 Diabetes Mellitus

Background: Type 1 diabetes mellitus (T1DM) may lead to severe long-term health consequences. In a longitudinal study, we aimed to identify factors present at diagnosis and 6 months later that were associated with glycosylated haemoglobin (HbA 1c) levels at 24 months after T1DM diagnosis, so that diabetic children at risk of poor glycaemic control may be identified. Methods: 229 children,15 years of age diagnosed with T1DM in the Auckland region were studied. Data collected at diagnosis were: age, sex, weight, height, ethnicity, family living arrangement, socio-economic status (SES), T1DM antibody titre, venous pH and bicarbonate. At 6 and 24 months after diagnosis we collected data on weight, height, HbA 1c level, and insulin dose. Results: Factors at diagnosis that were associated with higher HbA1c levels at 6 months: female sex (p,0.05), lower SES (p,0.01), non-European ethnicity (p,0.01) and younger age (p,0.05). At 24 months, higher HbA1c was associated with lower SES (p,0.001), Pacific Island ethnicity (p,0.001), not living with both biological parents (p,0.05), and greater BMI SDS (p,0.05). A regression equation to predict HbA1c at 24 months was consequently developed. Conclusions: Deterioration in glycaemic control shortly after diagnosis in diabetic children is particularly marked in Pacific Island children and in those not living with both biological parents. Clinicians need to be aware of factors associated wit

Inequalities in health: a comparative study between ethnic Norwegians and Pakistanis in Oslo, Norway

BACKGROUND: The objective of the study was to observe the inequality in health from the perspective of socio-economic factors in relation to ethnic Pakistanis and ethnic Norwegians in Oslo, Norway. METHOD: Data was collected by using an open and structured questionnaire, as a part of the Oslo Health Study 2000–2001. Accordingly 13581 ethnic Norwegians (45% of the eligible) participated as against 339 ethnic Pakistanis (38% of the eligible). RESULTS: The ethnic Pakistanis reported a higher prevalence of poor self-rated health 54.7% as opposed to 22.1% (p < 0.001) in ethnic Norwegians, 14% vs. 2.6% (p < 0.001) in diabetes, and 22.0% vs. 9.9% (p < 0.001) in psychological distress. The socio-economic conditions were inversely related to self- rated health, diabetes and distress for the ethnic Norwegians. However, this was surprisingly not the case for the ethnic Pakistanis. Odd ratios did not interfere with the occurrence of diabetes, even after adjusting all the markers of socio-economic status in the multivariate model, while self-reported health and distress showed moderate reduction in the risk estimation. CONCLUSION: There is a large diversity of self-rated health, prevalence of diabetes and distress among the ethnic Pakistanis and Norwegians. Socio-economic status may partly explain the observed inequalities in health. Uncontrolled variables like genetics, lifestyle factors and psychosocial factors related to migration such as social support, community participation, discrimination, and integration may have contributed to the observed phenomenon. This may underline the importance of a multidisciplinary approach in future studies