Effects of childhood socioeconomic position on subjective health and health behaviours in adulthood: how much is mediated by adult socioeconomic position?

<p>Abstract</p> <p>Background</p> <p>Adult socioeconomic position (SEP) is one of the most frequently hypothesised indirect pathways between childhood SEP and adult health. However, few studies that explore the indirect associations between childhood SEP and adult health systematically investigate the mediating role of multiple individual measures of adult SEP for different health outcomes. We examine the potential mediating role of individual measures of adult SEP in the associations of childhood SEP with self-rated health, self-reported mental health, current smoking status and binge drinking in adulthood.</p> <p>Methods</p> <p>Data came from 10,010 adults aged 25-64 years at Wave 3 of the Survey of Family, Income and Employment in New Zealand. The associations between childhood SEP (assessed using retrospective information on parental occupation) and self-rated health, self-reported psychological distress, current smoking status and binge drinking were determined using logistic regression. Models were adjusted individually for the mediating effects of education, household income, labour market activity and area deprivation.</p> <p>Results</p> <p>Respondents from a lower childhood SEP had a greater odds of being a current smoker (OR 1.70 95% CI 1.42-2.03), reporting poorer health (OR 1.82 95% CI 1.39-2.38) or higher psychological distress (OR 1.60 95% CI 1.20-2.14) compared to those from a higher childhood SEP. Two-thirds to three quarters of the association of childhood SEP with current smoking (78%), and psychological distress (66%) and over half the association with poor self-rated health (55%) was explained by educational attainment. Other adult socioeconomic measures had much smaller mediating effects.</p> <p>Conclusions</p> <p>This study suggests that the association between childhood SEP and self-rated health, psychological distress and current smoking in adulthood is largely explained through an indirect socioeconomic pathway involving education. However, household income, area deprivation and labour market activity are still likely to be important as they are intermediaries in turn, in the socioeconomic pathway between education and health.</p

Selection for specialist training: what can we learn from other countries?

The chaos surrounding the UK's centralised application service led to the system being abandoned. Tony Jefferis examines how similar systems work elsewher

Construction techniques for bored piling in sand using polymer fluids

This paper is concerned with the use of polymer fluids for the construction of bored piles in silty fine sand, a situation which has been found to significantly increase the risk of ‘soft toes' and concrete contamination due to the settling of the suspended soil particles in the fluid. To illustrate how these problems can be avoided by adopting a simple fluid-testing regime and improved construction practice, this paper presents a case history of polymer use at a site in Glasgow where the ground conditions consist of silty fine sand. Fluid testing showed that the used polymer fluid was heavily laden with soil particles and that cleaning using chemical additives alone was not sufficient to reduce the amount of suspended solids to an acceptable level. The pile bores were therefore left open overnight to allow the particles to settle out of suspension, the effect of which was confirmed by further fluid testing. The settled solids were removed with a base cleaning bucket. Structural integrity tests conducted on over 50 working piles constructed using this method showed no sign of defects. High-strain dynamic loading tests on two completed piles also confirmed their performance despite the extended pile bore open period. </jats:p

Properties and applications of polymer support fluids in geotechnical engineering

Synthetic polymer fluids have been used as an alternative to conventional bentonite slurries for the excavation of foundation elements over the last two decades. Thus far their use has excited polarised views in the industry – some construction professionals avoid using them after hearing ‘horror stories’ about past failures whereas others believe that they are the future of support fluids because of the many benefits that they can offer. This situation has been found to be mainly due to a lack of understanding of what polymers really are and their properties. To address this issue, the various polymer products currently available in the market have been categorised based on their intended functions, and the fundamental properties of some of them have been characterised. The research showed that significant difference exists between polymers even of the same chemical family. Based on a series of rheological experiments, it was found that the properties of polymer fluids are highly dependent on the governing shear rate, time, and a range of site dependent factors. The research also showed that the current procedure for the interpretation of viscosity data is incorrect. After an analysis of the properties of currently available polymers, the latter part of the thesis describes a field trial carried out at a site in Stratford, East London. The aims of the trial were twofold: to compare the performance between piles constructed using bentonite and polymer fluids, and to assess the effect of extended pile bore open time for pile bores supported by polymers. From the results, it was found that the polymer piles showed much stiffer load–settlement response than the bentonite pile, and that a pile bore open time of up to 26 h had no adverse effect on the pile performance. The load test results have been carefully back-analysed using a range of methods. It was found that, compared to their bentonite counterparts, polymer fluids can improve the interface shearing resistance with Thanet Sand and the shear modulus of the Lambeth clay.This thesis is not currently available via ORA

Handover practice amongst core surgical trainees at the Oxford School of Surgery

Purpose: To date there are no United Kingdom (UK) studies specifically evaluating handovers amongst core surgical trainees (CSTs). The Oxford School of Surgery examined regional handover practice, aiming to assess and improve trainee perception of handover, its quality, and ultimately patient care. Methods: Based on two guidance documents (&apos;Safe handover, safe patients&apos; by the British Medical Association and &apos;Safe Surgical Practice&apos; by the Royal College of Surgeons&apos;), a 5-point Likert style questionnaire was designed, exploring handover practice, educational value, and satisfaction. This was given to 50 CSTs in 2010. Results: There were responses from 40 CSTs (80.0 %). The most striking findings revolved around perceived educational value, formal training, and auditing practice with regards to handover, which were all remarkably lower than expected. CST handover was thus targeted in the Department of Plastic Surgery at the University Hospital, with the suggestion and implementation of targeted changes to improve practice. Conclusion: In the EWTD era with many missed educational opportunities, daily handover represents an underused educational tool for CSTs, especially in light of competency-based and time-limited training. We recommend modifications based on our results and the literature and hope schools of surgery follow suit nationally by assessing and addressing handover practice

State of the Art Lecture on Environmental Geotechnics. Protecting the environment from contamination with barrier systems: advances and challenges

The state-of-the-art for barriers systems control of pollution migration and hydraulic structures including liner systems for landfills, mine waste, and dams/lagoons are discussed along with some comments on current significant environmental issues. Recent research on geomembranes, geosynthetic clay liners, and composite liners and the practical implications are discussed. The need to design taking account of the interactions between the liner system components is highlighted. Regional differences relating to environmental geotechnics of municipal solid waste and mining waste and the implications of differences in regulations and climate are discussed. Vertical barrier systems may be regarded as mature technologies and research funding is much more limited. A bibliography of key papers on cut-off walls has been compiled. It is recognized that major changes to cement-bentonite formulations will be necessitated by the drive to reduce carbon footprints together with the dwindling availability of pulverised fuel ash and blastfurnace slag. The implications for environmental geotechnics associated with recycled materials, waste minimization, and some overarching issues are discussed. The paper finishes with some thoughts about the future of environmental geotechnics and some concluding comments