15 research outputs found

    Inequalities in colorectal cancer screening participation in the first round of the national screening programme in England

    Get PDF
    BACKGROUND: Introduction of organised, population-based, colorectal cancer screening in the United Kingdom using the faecal occult blood test (FOBT) has the potential to reduce overall colorectal cancer mortality. However, socio-economic variation in screening participation could exacerbate existing inequalities in mortality.METHODS: This study examined FOBT uptake rates in London, England in relation to area-level socio-economic deprivation over the first 30 months of the programme during which 401 197 individuals were sent an FOBT kit. Uptake was defined as return of a completed test kit within 3 months. Area-level deprivation in each postcode sector was indexed with the Townsend Material Deprivation Index. Analyses controlled for area-level household mobility, ethnic diversity and poor health, each of which was associated with lower return rates.RESULTS: The results showed a strong socio-economic gradient in FOBT uptake, which declined from 49% in the least deprived quintile of postcodes to 38% in the middle quintile and 32% in the most deprived quintile. Variation in socio-economic deprivation between sectors accounted for 62% of the variance in return rates, with little attenuation as a result of controlling for ethnic diversity, household mobility or health status.CONCLUSION: These results highlight the need to understand the causes of socio-economic gradients in screening participation and address barriers that could otherwise increase disparities in colorectal cancer survival

    Cancer and heart attack survivors’ expectations of employment status: results from the English Longitudinal Study of Ageing

    Get PDF
    Background: Sociodemographic, health- and work-related factors have been found to influence return to work in cancer survivors. It is feasible though that behavioural factors, such as expectation of being at work, could also affect work-related outcomes. Therefore, the effect of earlier identified factors and expectation of being at work on future employment status in cancer survivors was explored. To assess the degree to which these factors specifically concern cancer survivors, a comparison with heart attack survivors was made. Methods: Data from the English Longitudinal Study of Ageing were used. Cancer and heart attack survivors of working age in the UK were included and followed up for 2 years. Baseline characteristics of both cancer and heart attack survivors were compared regarding employment status. Univariate and multivariate regression analyses were performed in survivors at work, and the interaction between independent variables and diagnose group was assessed. Results: In cancer survivors at work (N = 159), alcohol consumption, participating in moderate or vigorous sport activities, general health and participation were univariate associated with employment status at two-year followup. Only fair general health (compared to very good general health) remained statistically significant in the multivariate model (OR 0.31; 95% CI 0.13–0.76; p = 0.010). In heart attack survivors at work (N = 78), gender, general health and expectation of being at work were univariate associated with employment status at follow-up. Female gender (OR 0.03; 95% CI 0.00–0.57; p = 0.018) and high expectation of being at work (OR 10.68; 95% CI 1.23–93.92; p = 0.033) remained significant in the multivariate model. The influence of gender (p = 0.066) and general health (p = 0.020) regarding employment status was found to differ significantly between cancer and heart attack survivors. Conclusions: When predicting future employment status in cancer survivors in the UK, general health is the most relevant factor to consider. While expectation of being at work did not show any significant influence in cancer survivors, in heart attack survivors, it should not be disregarded though, when developing interventions to affect their employment status. Future research should focus on more specific measures for expectation, and additional behavioural factors, such as self-efficacy, and their effect on employment status

    Baryons in the relativistic jets of the stellar-mass black-hole candidate 4U 1630-47

    Get PDF
    Accreting black holes are known to power relativistic jets, both in stellar-mass binary systems and at the centres of galaxies. The power carried away by the jets, and, hence, the feedback they provide to their surroundings, depends strongly on their composition. Jets containing a baryonic component should carry significantly more energy than electron–positron jets. Energetic considerations1, 2 and circular-polarization measurements3 have provided conflicting circumstantial evidence for the presence or absence of baryons in jets, and the only system in which they have been unequivocally detected is the peculiar X-ray binary SS 433 (refs 4, 5). Here we report the detection of Doppler-shifted X-ray emission lines from a more typical black-hole candidate X-ray binary, 4U 1630-47, coincident with the reappearance of radio emission from the jets of the source. We argue that these lines arise from baryonic matter in a jet travelling at approximately two-thirds the speed of light, thereby establishing the presence of baryons in the jet. Such baryonic jets are more likely to be powered by the accretion disk6 than by the spin of the black hole7, and if the baryons can be accelerated to relativistic speeds, the jets should be strong sources of γ-rays and neutrino emission

    Reviewing the use of resilience concepts in forest sciences

    Get PDF
    Purpose of the review Resilience is a key concept to deal with an uncertain future in forestry. In recent years, it has received increasing attention from both research and practice. However, a common understanding of what resilience means in a forestry context, and how to operationalise it is lacking. Here, we conducted a systematic review of the recent forest science literature on resilience in the forestry context, synthesising how resilience is defined and assessed. Recent findings Based on a detailed review of 255 studies, we analysed how the concepts of engineering resilience, ecological resilience, and social-ecological resilience are used in forest sciences. A clear majority of the studies applied the concept of engineering resilience, quantifying resilience as the recovery time after a disturbance. The two most used indicators for engineering resilience were basal area increment and vegetation cover, whereas ecological resilience studies frequently focus on vegetation cover and tree density. In contrast, important social-ecological resilience indicators used in the literature are socio-economic diversity and stock of natural resources. In the context of global change, we expected an increase in studies adopting the more holistic social-ecological resilience concept, but this was not the observed trend. Summary Our analysis points to the nestedness of these three resilience concepts, suggesting that they are complementary rather than contradictory. It also means that the variety of resilience approaches does not need to be an obstacle for operationalisation of the concept. We provide guidance for choosing the most suitable resilience concept and indicators based on the management, disturbance and application context

    Identifying change over time in small area socio-economic deprivation

    No full text
    The measurement of area level deprivation is the subject of a wide and ongoing debate regarding the appropriateness of the geographical scale of analysis, the input indicator variables and the method used to combine them into a single figure index. Whilst differences exist, there are strong correlations between schemes. Many policy-related and academic studies use deprivation scores calculated cross-sectionally to identify areas in need of regeneration and to explain variations in health outcomes. It would be useful then to identify whether small areas have changed their level of deprivation over time and thereby be able to: monitor the effect of industry closure; assess the impact of area-based planning initiatives; or determine whether a change in the level of deprivation leads to a change in health. However, the changing relationship with an outcome cannot be judged if the ‘before’ and ‘after’ situations are based on deprivation measures which use different, often time-point specific variables, methods and geographies. Here, for the whole of the UK, inputs to the Townsend index obtained from the 1991 and 2001 Censuses have been harmonised in terms of variable detail and with the 1991 data converted to the 2001 Census ward geography. Deprivation has been calculated so that the 1991 scores are directly comparable with those for 2001. Change over time can be then identified. Measured in this way, deprivation is generally shown to have eased due to downward trends in levels of lack of access to a car, non-home ownership, household overcrowding but most particularly, to reductions in levels of unemployment. Despite these trends, not all locations became less deprived with gradients of deprivation largely persisting within the UK’s constituent countries and in different area types. For England, Wales and Scotland, the calculation of Townsend scores can readily be backdated to incorporate data from the 1971 and 1981 Censuses to create a 1971–2001 set of comparable deprivation scores. The approach can also be applied to the Carstairs index. Due to differences in data availability prior to 1991, incorporating small areas in Northern Ireland would be challenging

    Effects of different fire intensities on chemical and biological soil components and related feedbacks on a Mediterranean shrub (Phillyrea angustifolia L.)

    No full text
    In July 2000, six plots of Mediterranean maquis in the Castel Volturno Nature Reserve were burnt at two intensity levels to examine the effects of fire intensities on chemical and biological soil components and their relationships with ecophysiological processes of Phillyrea angustifolia L. Net photosynthesis and stomatal conductance, as well as P availability, were higher in burnt plots than in control plots, even 2 years after fire; the TM density of total soil microfungi was significantly lower in the first 8 months after fire, while xerotolerant and heat-stimulated soil microfungi were still higher 2 years after fire. Significant correlations between photosynthesis and stomatal conductance in resprouts and mycorrhizal status, as well as changes in the soil fungal components of the communities, suggest that both soil and mycorrhizal fungi play a role in immobilizing and translocating nutrients temporarily released in the below-ground system by fire. Nutrient balance interacts with physiological processes, and a feedback mechanism is well represented by stomatal conductance, which allows both the influx of water and mineral nutrients from the soil; moreover, the post-fire increase in photosynthetic activity promotes vigorous resprouting and may lead to increased availability of carbohydrates for soil biota and, consequently, to enhanced vegetation resilience
    corecore