Population Projections and Demographic Knowledge in France and Great Britain in the Postwar Period

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111965/1/padr47.pd

Overdiagnosis in breast cancer screening: the importance of length of observation period and lead time

PMCID: PMC3706885This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Intra-generational social mobility and educational qualifications

AbstractThe relation between intra-generational social class mobility of parents and their children's subsequent educational qualifications, and the implications of this relation for educational stratification, is explored by fitting statistical models to data from two UK longitudinal datasets: one based on the UK Census (ONS LS) and the 1970 birth cohort study (BCS70). Children whose parents are upwardly mobile gain higher educational qualifications than their peers in their class of origin, but obtain lower qualifications than their peers in their class of destination. The reverse pattern is observed for the downwardly mobile. These results mirror those obtained for the relation between adult intra-generational social mobility and a number of widely used measures of health. The implications of the findings for different explanations of the social class gradient in educational attainment are examined. The findings provide greater support for theoretical explanations of educational inequalities that are based on differences in economic circumstances between social classes than they do for explanations based on social class variations in the levels of cultural capital and aspirations. This conclusion is strengthened by the fact that the overall pattern of results from these analyses is unchanged after statistically controlling for levels of parental education. The findings also have methodological implications for measuring the social class gradient in attainment and qualifications

Lung cancer risk in painters: a meta-analysis

We conducted a meta-analysis to quantitatively compare the association between occupation as a painter and the incidence or mortality from lung cancer. PubMed and the reference lists of pertinent publications were searched and reviewed. For the meta-analysis, we used data from 47 independent cohort, record linkage, and case-control studies (from a total of 74 reports), including > 11,000 incident cases or deaths from lung cancer among painters. Three authors independently abstracted data and assessed study quality. The summary relative risk (meta-RR, random effects) for lung cancer in paint-ers was 1.35 [95% confidence interval (CI), 1.29-1.41; 47 studies] and 1.35 (95% CI, 1.21-1.51; 27 studies) after controlling for smoking. The relative risk was higher in never-smokers (meta-RR = 2.00; 95% CI, 1.09-3.67; 3studies) and persisted when restricted to studies that adjusted for other occupational exposures (meta-RR = 1.57; 95% CI, 1.21-2.04; 5 studies). These results support the conclusion that occupational exposures in painters are causally associated with the risk of lung cancer

Prevalence and determinants of the use of self-tests by members of the public: a mixed methods study

Background Self-tests can be used by members of the public to diagnose conditions without involving a doctor, nurse or other health professional. As technologies to design and manufacture diagnostic tests have developed, a range of self-tests have become available to the public to buy over-the-counter and via the Internet. This study aims to describe how many people have used self-tests and identify factors associated with their use. Methods A postal questionnaire will elicit basic information, including sociodemographic characteristics, and whether the person has used or would use specified self-tests. Consent will be sought to recontact people who want to participate further in the study, and interviews and focus groups will be used to develop hypotheses about factors associated with self-test use. These hypotheses will be tested in a case-control study. An in-depth questionnaire will be developed incorporating the identified factors. This will be sent to: people who have used a self-test (cases); people who have not used a self-test but would use one in the future (controls); and people who have not used and would not use a self-test (controls). Logistic regression analysis will be used to establish which factors are associated with self-test use. Discussion Self-tests do have potential benefits, for example privacy and convenience, but also potential harms, for example delay seeking treatment after a true negative result when the symptoms are actually due to another condition. It is anticipated that the outcomes from this study will include recommendations about how to improve the appropriate use of self-tests and existing health services, as well as information to prepare health professionals for patients who have used self-tests

Influence of Poor Oral Health on Physical Frailty: A Population-Based Cohort Study of Older British Men.

OBJECTIVES: To investigate the associations between objective and subjective measures of oral health and incident physical frailty. DESIGN: Cross-sectional and longitudinal study with 3 years of follow-up using data from the British Regional Heart Study. SETTING: General practices in 24 British towns. PARTICIPANTS: Community-dwelling men aged 71 to 92 (N = 1,622). MEASUREMENTS: Objective assessments of oral health included tooth count and periodontal disease. Self-reported oral health measures included overall self-rated oral health; dry mouth symptoms; sensitivity to hot, cold, and sweet; and perceived difficulty eating. Frailty was defined using the Fried phenotype as having 3 or more of weight loss, grip strength, exhaustion, slow walking speed, and low physical activity. Incident frailty was assessed after 3 years of follow-up in 2014. RESULTS: Three hundred three (19%) men were frail at baseline (aged 71-92). Having fewer than 21 teeth, complete tooth loss, fair to poor self-rated oral health, difficulty eating, dry mouth, and more oral health problems were associated with greater likelihood of being frail. Of 1,284 men followed for 3 years, 107 (10%) became frail. The risk of incident frailty was higher in participants who were edentulous (odds ratio (OR) = 1.90, 95% confidence interval (CI) = 1.03-3.52); had 3 or more dry mouth symptoms (OR = 2.03, 95% CI = 1.18-3.48); and had 1 (OR = 2.34, 95% CI = 1.18-4.64), 2 (OR = 2.30, 95% CI = 1.09-4.84), or 3 or more (OR = 2.72, 95% CI = 1.11-6.64) oral health problems after adjustment for age, smoking, social class, history of cardiovascular disease or diabetes mellitus, and medications related to dry mouth. CONCLUSION: The presence of oral health problems was associated with greater risks of being frail and developing frailty in older age. The identification and management of poor oral health in older people could be important in preventing frailty

Alcohol consumption and lifetime change in cognitive ability:a gene × environment interaction study

Studies of the effect of alcohol consumption on cognitive ability are often confounded. One approach to avoid confounding is the Mendelian randomization design. Here, we used such a design to test the hypothesis that a genetic score for alcohol processing capacity moderates the association between alcohol consumption and lifetime change in cognitive ability. Members of the Lothian Birth Cohort 1936 completed the same test of intelligence at age 11 and 70 years. They were assessed for recent alcohol consumption in later life and genotyped for a set of four single-nucleotide polymorphisms in three alcohol dehydrogenase genes. These variants were unrelated to late-life cognition or to socioeconomic status. We found a significant gene × alcohol consumption interaction on lifetime cognitive change (p = 0.007). Individuals with higher genetic ability to process alcohol showed relative improvements in cognitive ability with more consumption, whereas those with low processing capacity showed a negative relationship between cognitive change and alcohol consumption with more consumption. The effect of alcohol consumption on cognitive change may thus depend on genetic differences in the ability to metabolize alcohol

What aspects of periods are most bothersome for women reporting heavy menstrual bleeding? Community survey and qualitative study

Background: Heavy menstrual bleeding is a common symptom amongst women of reproductive age, yet questions remain about why some women experience this as a problem while others do not. We investigated the concerns of women who reported heavy menstrual bleeding on questionnaire. Methods: A cross-sectional postal survey and qualitative interviews were carried out amongst a community-based sample of women in Lothian, Scotland. 906 women aged 25 to 44 reported heavy or very heavy periods in response to a postal survey of 2833 women registered with 19 general practices. Amongst those who had reported heavy menstrual bleeding, analysis was carried out of responses to the free text questionnaire item, "What bothers you most about your periods?" In addition, 32 of these women participated in qualitative interviews and their accounts were analysed to explore how menstrual symptoms and 'problems' with periods were experienced. Results: Even amongst this subgroup of women, selected on the basis of having reported their periods as heavy in the survey, pain was the aspect of their periods that 'most bothered' them, followed by heaviness, mood changes or tiredness, and irregularity or other issues of timing. Interviewees' accounts similarly suggested that a range of menstrual symptoms were problematic and some women did not disentangle which was worst. Judgements of periods as a problem were based on the impact of menstrual symptoms on daily life and this was contingent on social circumstances such as type of paid work and other responsibilities. Although women spoke readily of whether their periods were a problem, there was less clarity in accounts of whether or not menstrual loss was 'heavy'; women said they made judgements based on what was normal for them, degree of difficulty in containing blood loss and pattern of loss. Conclusion: Women with heavy periods are bothered by a range of menstrual symptoms and their impact on everyday life. Clinical emphasis should be on clarifying the presenting problem and providing help and advice for this, as well as on excluding serious disease. Sometimes simple approaches, such as help with analgesia, may be all that is required

Why do those out of work because of sickness or disability have a high mortality risk? Evidence from a Scottish cohort

<b>Background:</b> Existing evidence on the association between being out of work because of sickness or disability and high mortality risk suggests that most of the association cannot be explained by controlling for health, health behaviour or socio-economic position. However, studies are often based on administrative data that lack explanatory factors. Here, we investigate this high mortality risk using detailed information from a cohort study.<p></p> <b>Methods:</b> Data from the West of Scotland Twenty-07 prospective cohort study were used to follow those (average age 56 years) employed, unemployed and out of work in 1988 to death or end of follow-up in 2011. Using a parametric survival model, mean survival was calculated for each employment group after adjustment for health behaviours, health and socio-economic position.<p></p> <b>Results:</b> The difference in survival between those sick or disabled (30% survival at end of follow-up), and those unemployed (49%) or employed (61%) was mostly accounted for by adjusting for the higher levels of poor heath at baseline in the former group (49, 46 and 56%, respectively, after adjustment). After controlling for all variables, the difference between those sick or disabled (51%) and those employed (56%) was further attenuated slightly.<p></p> <b>Conclusion:</b> Our results suggest that the present health of those out of work and sick or disabled should be taken seriously, as their long-term survival prospects are considerably poorer than other employment groups.<p></p&gt