Looking for an explanation for the excessive male mortality in England and Wales since the end of the 19th century.

Several papers have primarily considered a female disadvantage in mortality as something to explain, considering a male disadvantage to be a "natural condition". Even if, due to biological reasons, shorter life expectancy among males has been demonstrated, other factors need to be involved to explain firstly the increasing, and then the decreasing, of the male relative disadvantage over the past century. The principal aim of this paper is to provide a clearer picture of the major age-class and cause-of-death contributions to male excess mortality in England and Wales from 1881 to 2011. Results indicate a clear shift in contributions to the male disadvantage from differences occurring during the first year of life to those occurring in ageing people, and from tuberculosis, respiratory diseases, external causes and perinatal and congenital conditions to neoplasms and circulatory diseases. In contrast, the narrowing of the gap since 1981 seems to be most closely related to the decrease in the male disadvantage in respiratory diseases and to the simultaneous increasing in the female disadvantage in old-age diseases. The most important novelty of this research relates to the method: instead of using ratios to investigate gender differences in health, we use decomposition methods.Economic and Social Research Council, Digitising Scotland project, ES/K00574X/

Cardio classics revisited: focus on the role of amlodipine

Amlodipine is a long-acting, dihydropyridine calcium antagonist now widely used for lowering of elevated blood pressure. In recent years it has been shown to be effective in reducing both blood pressure and risk of cardiovascular (CV) events when used in combination with other antihypertensive agents of different classes. Strong evidence of cardiovascular benefit has been attained for combination of amlodipine with diuretics or angiotensin converting enzyme (ACE) inhibitors in a number of high-risk CV groups, including those with established coronary artery disease, diabetes, and at risk of renal disease. Combination therapies of amlodipine with other agents eliciting renin-angiotensin-aldosterone system blockade (angiotensin II receptor blockers or renin inhibitors) have been shown to be effective blood pressure-lowering strategies, but await the results of ongoing trials for direct evidence of benefit for renal disease progression and CV morbidity and mortality

The structure of the accretion disk in NGC 4258 derived from observations of its water vapor masers

A wealth of new information about the structure of the maser disk in NGC 4258 has been obtained from a series of 18 VLBA observations spanning three years, as well as from 32 additional epochs of spectral monitoring data from 1994 to the present, acquired with the VLA, Effelsberg, and GBT. The warp of the disk has been defined precisely. The thickness of the maser disk has been measured to be 12 microarcseconds (FWHM), which is slightly smaller than previously quoted upper limits. Under the assumption that the masers trace the true vertical distribution of material in the disk, from the condition of hydrostatic equilibrium the sound speed is 1.5 km/s, corresponding to a thermal temperature of 600K. The accelerations of the high velocity maser components have been accurately measured for many features on both the blue and red side of the spectrum. The azimuthal offsets of these masers from the midline (the line through the disk in the plane of the sky) and derived projected offsets from the midline based on the warp model correspond well with the measured offsets. This result suggests that the masers are well described as discrete clumps of masing gas, which accurately trace the Keplerian motion of the disk. However, we have continued to search for evidence of apparent motions caused by ``phase effects.'' This work provides the foundation for refining the estimate of the distance to NGC 4258 through measurements of feature acceleration and proper motion. The refined estimate of this distance is expected to be announced in the near future.Comment: 8 pages, 5 figures, to appear in proceedings of IAU Symposium 242 "Astrophysical Masers and their Environments", held in Alice Springs, March 200

Women's Marriage Age Matters for Public Health: A Review of the Broader Health and Social Implications in South Asia.

In many traditional societies, women's age at marriage acts simultaneously as a gateway to new family roles and the likelihood of producing offspring. However, inadequate attention has previously been given to the broader health and social implications of variability in women's marriage age for public health. Biomedical scientists have primarily been concerned with whether the onset of reproduction occurs before the woman is adequately able to nurture her offspring and maintain her own health. Social scientists have argued that early marriage prevents women from attaining their rightful education, accessing employment and training opportunities, developing social relationships with peers, and participating in civic life. The aim of this review article is to provide comprehensive research evidence on why women's marriage age, independent of age at first childbirth, is a crucial issue for public health. It focuses on data from four South Asian countries, Bangladesh, India, Nepal, and Pakistan, in which marriage is near universal and where a large proportion of women still marry below the United Nations prescribed minimum marriage age of 18 years. Using an integrative perspective, we provide a comprehensive synthesis of the physiological, bio-demographic, and socio-environmental drivers of variable marriage age. We describe the adverse health consequences to mothers and to their offspring of an early age at marriage and of childbearing, which include malnutrition and high rates of morbidity and mortality. We also highlight the complex association of marriage age, educational attainment, and low societal status of women, all of which generate major public health impact. Studies consistently find a public health dividend of increased girls' education for maternal and child nutritional status and health outcomes. Paradoxically, recent relative increases in girls' educational attainment across South Asia have had limited success in delaying marriage age. This evidence suggests that in order for public health initiatives to maximize the health of women and their offspring, they must first address the factors that shape the age at which women marry

Associations of extracurricular physical activity patterns and body composition components in a multi-ethnic population of UK children (the Size and Lung Function in Children study): a multilevel modelling analysis.

BACKGROUND: Body Mass Index (BMI) is a common outcome when assessing associations between childhood overweight and obesity and physical activity patterns. However, the fat and fat-free components of BMI, measured by the Fat Mass Index (FMI) and Fat-Free Mass Index (FFMI), may show contrasting associations with physical activity, while ethnic groups may vary in both physical activity patterns and body composition. Body composition must therefore be evaluated when assessing the associations between childhood overweight and obesity and physical activity in multi-ethnic populations. METHODS: This cross-sectional study investigated associations of BMI, FMI and FFMI z-scores with extracurricular physical activity for 2171 London primary schoolchildren (aged 5-11 years) of black, South Asian and white/other ethnicity. Multilevel mixed-effects ordered logistic modelling was used, adjusting for age, sex and family and neighbourhood socioeconomic status as potential confounders. RESULTS: Controlling for ethnicity and individual, family and neighbourhood socioeconomic confounders, actively commuting children had significantly lower Odds Ratios for being in high BMI (Odds Ratio (OR) = 0.678; 95 % Confidence Interval (CI) = 0.531 - 0.865; p - value = 0.002) and FMI z-score groups (OR = 0.679; 95 % CI = 0.499 - 0.922; p = 0.013), but not FFMI z-score groups, than passive commuters. Children doing sports less than once a week had lower Odds Ratios for being in high BMI (OR = 0.435; 95 % CI = 0.236 - 0.802; p = 0.008) and FFMI (OR = 0.455; 95 % CI = 0.214 - 0.969; p = .041) z-score categories compared to daily active children. Differences in FMI between groups did not reach the significance threshold. A trend towards statistical significance was obtained whereby children's complete inactivity was associated with higher odds for being in higher BMI (OR = 2.222 : 95 % CI = 0.977 - 5.052; p = .057) and FMI z-score groups (OR = 2.485 : 95 % CI = 0.961 - 6.429; p = .060). FFMI z-scores did not show a similar trend with complete inactivity. CONCLUSIONS: Active commuting was objectively associated with lower adiposity, while more frequent extracurricular sports participation was correlated with greater fat-free mass accretion. These relationships were independent of ethnicity and individual, family or neighbourhood socioeconomic confounding factors.Wellcome Trust (WT094129MA) Gonville and Caius College, University of Cambridge (Gonville Scholarship

Associations of the objective built environment along the route to school with children's modes of commuting: A multilevel modelling analysis (the SLIC study).

As active commuting levels continue to decline among primary schoolchildren, evidence about which built environmental characteristics influence walking or cycling to school remains inconclusive and is strongly context-dependent. This study aimed to identify the objective built environmental drivers of, and barriers to, active commuting to school for a multi-ethnic sample of 1,889 healthy primary schoolchildren (aged 5-11) in London, UK. Using cross-sectional multilevel ordered logistic regression modelling, supported by the spatial exploration of built environmental characteristics through cartography, the objective built environment was shown to be strongly implicated in children's commuting behaviour. In line with earlier research, proximity to school emerged as the prime variable associated with the choice for active commuting. However, other elements of the urban form were also significantly associated with children's use of active or passive modes of transport. High levels of accidents, crime and air pollution along the route to school were independently correlated with a lower likelihood of children walking or cycling to school. Higher average and minimum walkability and higher average densities of convenience stores along the way were independently linked to higher odds of active commuting. The significance of the relations for crime, air pollution and walkability disappeared in the fully-adjusted model including all built environmental variables. In contrast, relationships with proximity, traffic danger and the food environment were maintained in this comprehensive model. Black children, pupils with obesity, younger participants and those from high socioeconomic families were less likely to actively commute to school. There is thus a particular need to ensure that roads with high volumes of actively commuting children are kept safe and clean, and children's exposure to unhealthy food options along the way is limited. Moreover, as short commuting distances are strongly correlated with walking or cycling, providing high-quality education near residential areas might incite active transport to school

The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model

Objective To model the long term effectiveness and cost effectiveness of daily dark chocolate consumption in a population with metabolic syndrome at high risk of cardiovascular disease

Toward a New Geometric Distance to the Active Galaxy NGC 4258. II. Centripetal Accelerations and Investigation of Spiral Structure

We report measurements of centripetal accelerations of maser spectral components of NGC 4258 for 51 epochs spanning 1994 to 2004. This is the second paper of a series, in which the goal is the determination of a new geometric maser distance to NGC 4258, accurate to possibly ~3%. We measure accelerations using a formal analysis method that involves simultaneous decomposition of maser spectra for all epochs into multiple, Gaussian components. Components are coupled between epochs by linear drifts (accelerations) from their centroid velocities at a reference epoch. For high-velocity emission, accelerations lie in the range $–0.7 to +0.7 km s^{−1} yr^{−1}$, indicating an origin within 13° of the disk midline (the perpendicular to the line of sight [LOS] to the black hole). Comparison of the projected positions of high-velocity emission in VLBI images with those derived from acceleration data provides evidence that masers trace real gas dynamics. High-velocity emission accelerations do not support a model of trailing shocks associated with spiral arms in the disk. However, we find strengthened evidence for spatial periodicity in high-velocity emission, of wavelength 0.75 mas. This supports suggestions of spiral structure due to density waves in the nuclear accretion disk of an active galaxy. Accelerations of low-velocity (systemic) emission lie in the range $7.7 to 8.9 km s^{−1} yr^{−1}$, consistent with emission originating from a concavity where the thin, warped disk is tangent to the LOS. A trend in accelerations of low-velocity emission, as a function of Doppler velocity, may be associated with disk geometry and orientation or with the presence of spiral structure.Astronom

Toward a New Geometric Distance To the Active Galaxy NGC 4258. III. Final Results and The Hubble Constant

We report a new geometric maser distance estimate to the active galaxy NGC 4258. The data for the new model are maser line-of-sight (LOS) velocities and sky positions from 18 epochs of very long baseline interferometry observations, and LOS accelerations measured from a 10 yr monitoring program of the 22 GHz maser emission of NGC 4258. The new model includes both disk warping and confocal elliptical maser orbits with differential precession. The distance to NGC 4258 is $7.60 \pm 0.17 \pm 0.15 Mpc$, a 3% uncertainty including formal fitting and systematic terms. The resulting Hubble constant, based on the use of the Cepheid variables in NGC 4258 to recalibrate the Cepheid distance scale, is $H_0 = 72.0 \pm 3.0 km s^{–1} Mpc^{–1}$.Astronom

A Class of Interstellar OH Masers Associated with Protostellar Outflows

Using the Very Large Array, we have detected weak OH maser emission near the Turner-Welch protostellar source in the W3 OH region. Unlike typical interstellar OH masers, which are associated with ultra-compact HII regions, our measured positions and proper motions (from Very Long Baseline Interferometry) indicate that these OH masers are associated with a bipolar outflow traced by strong H2O masers. These OH masers may be part of a class of interstellar OH masers that are associated with very young stars which have yet to, or may never, create ultra-compact HII regions. This class of OH masers appears to form near the edges of very dense material (within which H2O masers form), where total densities drop precipitously and interstellar UV radiation is sufficient to dissociate the H2O molecules. Observations of this class of OH masers may be an important way to probe the distribution of this important molecule in interstellar shocks at arcsecond resolution or better