Examining the pathways linking lower socioeconomic status and advanced melanoma

BACKGROUND. Low socioeconomic status (SES) is associated with more advanced melanoma at diagnosis and decreased survival. Exploring the pathways linking lower SES and thicker melanoma will help guide public and professional strategies to reduce deaths. METHODS. The authors surveyed 566 newly diagnosed patients at Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System, and University of Michigan. SES was assessed by education level (high school/general education degree or less [HS], associate/technical school degree, or ≥college graduate). All data was obtained by self‐report among patients within three months of their diagnosis. RESULTS. HS‐educated individuals were significantly more likely than college graduates to believe that melanoma was not very serious (odds ratio [OR], 2.90; 95% confidence interval [CI], 1.79‐4.71) and were less likely to know the asymmetry, borders (irregular), color (variegated), and diameter (>6 mm) (ABCD) melanoma rule or the difference between melanoma and ordinary skin growths (OR, 0.34 [95% CI, 0.23‐0.52] and 0.26 [95% CI, 0.16‐0.41] respectively). Physicians were less likely to have ever told HS‐educated versus college‐educated individuals they were at risk for skin cancer (OR, 0.46; 95% CI, 0.31‐0.71) or instructed them on how to examine their skin for signs of melanoma (OR, 0.40; 95% CI, 0.25‐0.63). HS‐educated individuals were less likely to have received a physician skin examination within the year before diagnosis (OR, 0.54; 95% CI, 0.37‐0.80). CONCLUSIONS. Decreased melanoma risk perception and knowledge among low‐SES individuals and decreased physician communication regarding skin examinations of these individuals may be key components of the consistently observed socioeconomic gradient in mortality. The current findings suggest the need to raise melanoma awareness among lower‐SES patients and to increase physician awareness of socioeconomic disparities in clinical communication and care. Cancer 2012. © 2011 American Cancer Society. The authors examined several potential pathways that may play a role in the previously described socioeconomic disparity in melanoma stage at diagnosis and survival. Less educated melanoma patients have little awareness of the risks of melanoma and less basic knowledge about melanoma detection, and they receive less physician communication about melanoma risk factors and screening and fewer physician skin examinations than more educated patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92359/1/26706_ftp.pd

Early-life and adult socioeconomic status and inflammatory risk markers in adulthood

Background: Associations between childhood and adult socioeconomic status (SES) and adult levels of inflammatory markers (C-reactive protein [CRP], fibrinogen, white blood cell count [WBC], and von Willebrand factor [vWF]) were examined in the Atherosclerosis Risk in Communities (ARIC) Study cohort. Methods: A total of 12,681 white and African-American participants provided information on SES (via education and social class) and place of residence in childhood and adulthood. Residences were linked to census data for neighborhood SES information. Multiple imputation was used to impute missing data. Hierarchical and linear regression were used to estimate the effects of SES and possible mediation by adult cardiovascular disease (CVD) risk factors. Findings: Low childhood social class and education were associated with elevated levels of CRP, fibrinogen, WBC, and vWF (increments of 17%, 2%, 4% and 3% for lowest versus highest education in childhood, respectively) among whites. Findings were less consistent among African-Americans. Adult SES was more strongly associated with inflammation than childhood SES. Individual-level SES measures were more consistently associated with inflammation than neighborhood-level measures. Fibrinogen and WBC showed the most consistent associations with SES; the largest changes in inflammation by SES were observed for CRP. Covariate adjustment strongly attenuated these associations. Mediation of the SES-inflammation associations by BMI, smoking and HDL cholesterol (HDL-C) are suggested by these data. Conclusion: Low individual- and neighborhood-level SES in childhood and adulthood are associated with modest increments in adult inflammatory burden. These associations may operate through the influence of low SES on traditional CVD risk factors, especially BMI, smoking and HDL-C.http://deepblue.lib.umich.edu/bitstream/2027.42/57775/1/Early life and adult Socioeconomic Status and Inflammatory risk Markers in Adulthood .pd

Cumulative life course and adult socioeconomic status and markers of inflammation in adulthood

OBJECTIVE: To examine the association between cumulative life course and adult socioeconomic status (SES) and adult levels of inflammatory risk markers (fibrinogen, white blood cell count (WBC), C-reactive protein (CRP), von Willebrand factor (vWF) and an overall inflammatory score). DESIGN: Retrospective cohort study. SETTING: 12,681 white and African-American participants in the Atherosclerosis Risk in Communities (ARIC) study and two ancillary studies. METHODS: Participants provided information on SES and place of residence in childhood and young (30-40 years) and mature (45+) adulthood. Residences were linked to census data for neighbourhood SES information. Multiple imputation (MI) was used for missing data. Linear regression and adjusted geometric means were used to estimate the effects of SES on inflammatory risk marker levels. RESULTS: Graded, statistically significant associations were observed between greater cumulative life-course exposure to low education and social class and elevated levels of fibrinogen and WBC among white participants. Stronger graded, statistically significant associations were observed between low adult education, social class and neighbourhood SES and elevated inflammatory levels. Associations were weaker and less consistent in African-Americans. Covariate adjustment attenuated results but many associations remained strong. CONCLUSIONS: Our results suggest that cumulative exposure to adverse SES conditions across the life course and low adult SES are associated with an elevated systemic inflammatory burden in adulthood. Chronic systemic inflammation may be one pathway linking low life-course SES and elevated cardiovascular disease risk.http://deepblue.lib.umich.edu/bitstream/2027.42/60947/1/Cumulative life course and adult socioeconomic status and markers if inflammation in adulthood.pd

Historical measures of social context in life course studies: Retrospective linkage of addresses to decennial censuses

Background There is evidence of a contribution of early life socioeconomic exposures to the risk of chronic diseases in adulthood. However, extant studies investigating the impact of the neighborhood social environment on health tend to characterize only the current social environment. This in part may be due to complexities involved in obtaining and geocoding historical addresses. The Life Course Socioeconomic Status, Social Context, and Cardiovascular Disease Study collected information on childhood (1930–1950) and early adulthood (1960–1980) place of residence from 12,681 black and white middle-aged and older men and women from four U.S. communities to link participants with census-based socioeconomic indicators over the life course. Results Most (99%) participants were linked to 1930–50 county level socioeconomic census data (the smallest level of aggregation universally available during this time period) corresponding to childhood place of residence. Linkage did not vary by race, gender, birth cohort, or level of educational attainment. A commercial geocoding vendor processed participants' self-reported street addresses for ages 30, 40, and 50. For 1970 and 1980 censuses, spatial coordinates were overlaid onto shape files containing census tract boundaries; for 1960 no shape files existed and comparability files were used. Several methods were tested for accuracy and to increase linkage. Successful linkage to historical census tracts varied by census (66% for 1960, 76% for 1970, 85% for 1980). This compares to linkage rates of 94% for current addresses provided by participants over the course of the ARIC examinations. Conclusion There are complexities and limitations in characterizing the past social context. However, our results suggest that it is feasible to characterize the earlier social environment with known levels of measurement error and that such an approach should be considered in future studies.http://deepblue.lib.umich.edu/bitstream/2027.42/57747/1/Historical measures of social context in life course studies Retrospective linkage of addresses to decimal censuses.pd

Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review

BACKGROUND: A relatively consistent body of research supports an inverse graded relationship between socioeconomic status (SES) and cardiovascular disease (CVD). More recently, researchers have proposed various life course SES hypotheses, which posit that the combination, accumulation, and/or interactions of different environments and experiences throughout life can affect adult risk of CVD. Different life course designs have been utilized to examine the impact of SES throughout the life course. This systematic review describes the four most common life course hypotheses, categorizes the studies that have examined the associations between life course SES and CVD according to their life course design, discusses the strengths and weaknesses of the different designs, and summarizes the studies' findings. METHODS: This research reviewed 49 observational studies in the biomedical literature that included socioeconomic measures at a time other than adulthood as independent variables, and assessed subclinical CHD, incident CVD morbidity and/or mortality, and/or the prevalence of traditional CVD risk factors as their outcomes. Studies were categorized into four groups based upon life course design and analytic approach. The study authors' conclusions and statistical tests were considered in summarizing study results. RESULTS: Study results suggest that low SES throughout the life course modestly impacts CVD risk factors and CVD risk. Specifically, studies reviewed provided moderate support for the role of low early-life SES and elevated levels of CVD risk factors and CVD morbidity and mortality, little support for a unique influence of social mobility on CVD, and consistent support for the detrimental impact of the accumulation of negative SES experiences/conditions across the life course on CVD risk. CONCLUSIONS: While the basic life course SES study designs have various methodologic and conceptual limitations, they provide an important approach from which to examine the influence of social factors on CVD development. Some limitations may be addressed through the analysis of study cohorts followed from childhood, the evaluation of CVD risk factors in early and middle adulthood, and the use of multiple SES measures and multiple life course analysis approaches in each life course study

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Surfing of bacterial droplets: Bacillus subtilis sliding revisited

Hennes et al. (1) report on the collective slipping ofBacillus subtilis colonies across the agar surface, termed?colony surfing.? We read this article with great interest.However, we understand that specific points require amore detailed discussion. We would like to highlightcomplementary biological observations on this area previouslypublished by us and others but omitted byHennes et al. (1) with the aim of bringing about a commonterminology that facilitates understanding betweenthe biophysics and the microbiology communities. Bacterial movement on surfaces can be powered byvarious active appendages, such as flagella, pili, orinteraction of cytoskeletal and focal membrane complexes,but can also be driven by passive factors (2?4).Hennes et al. (1) report that B. subtilis droplets surf downagar surfaces independently of the presence of flagella,by recruiting water from the environment to these movingcolonies, lowering surface tension, and enhancingsubstrate wettability. Importantly, this process is demonstratedto be dependent on surfactin production.Fil: Kovács, Ákos T.. Technical University of Denmark; DinamarcaFil: Grau, Roberto Ricardo. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Microbiología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pollitt, Eric J. G.. University of Sheffield; Reino Unid