Are there socioeconomic gradients in stage and grade of breast cancer at diagnosis? Cross sectional analysis of UK cancer registry data

Socioeconomic gradients in uptake of breast cancer screening in the United Kingdom should, intuitively, lead to socioeconomic gradients in disease progression at diagnosis. However, studies have found little evidence of such an effect. Although this could be interpreted as evidence that socioeconomic gradients in uptake of screening do not have clinically important consequences, all of the published studies have used data from before (pre-1988) or during the early stages (1988-95) of implementation of the national breast cancer screening programme. We investigated the relation between socioeconomic position and progression of breast cancer at diagnosis by using recent data from the Northern and Yorkshire Cancer Registry and Information Service (NYCRIS), which is estimated to achieve around 93% ascertainment

Changing Adolescents\u27 Food-Related Behavior Via Nutrition Education

A nutrition education behavior change strategy for secondary health classes was developed, implemented, and evaluated with 159 adolescents in 6 schools. The experimental design was pretest/posttest, treatment/control group with two treatment groups--one receiving only the behavior change strategy (BC) and one receiving the strategy plus a traditional knowledge-oriented component (BC+). Fundamental concepts of the behavior change strategy included personalization, goal setting, self-management, self-implementation, structured feedback, and structured self-evaluation. Based on a personal nutrient analysis, each adolescent in a treatment group selected improvement of one nutrient as a goal. Effectiveness of the strategy was tested by changes made in nutrient intake related to goal set. Pre- /post-assessments included three-day food records and written questionnaires of food practices and nutrition attitudes and knowledge. A rating instrument was administered to adolescents in treatment groups to assess their perceptions of activities facilitating change. Setting a goal for specific nutrient improvement had the strongest effect on change. No difference between treatment groups was found. Adolescents who set a goal related to calcium, vitamin A, and vitamin C increased intake and those with a sodium-related goal decreased sodium. No positive changes in nutrient intake occurred for the control group. Gender was related to positive change for calcium, vitamin A, folacin, and vitamin C, with males making significant improvements. Nutrition attitudes and knowledge generally were not related to change. Food practice scores, as assessed by the written questionnaire, increased for the BC+ group only. Knowledge scores increased in both treatment groups but not in the control group. No differences in attitudes were seen, either within or among groups. Activities perceived as most helpful in facilitating change included keeping food records, assessing personal nutrient intake, implementing a plan for nutrient improvement, and participating in follow-up classes

Characterisation of UK diets according to degree of food processing and associations with socio-demographics and obesity: cross-sectional analysis of UK National Diet and Nutrition Survey (2008-12).

BACKGROUND: Food processing alters food from its natural state for safety, convenience, taste or palatability. Previous research suggests that industrially processed foods, and diets high in these products, tend to be less healthful. However, most previous work is based on household, rather than individual-level, data. Little has been reported on the relationship between processed food consumption and markers of health; or on socio-demographic correlates of processed food consumption. Our objective was to describe: the nutritional content of foods classified according to degree of processing; the nutritional content of diets with different relative intakes of processed foods; the socio-demographic characteristics of individuals with different relative intakes of processed foods; and the association between intake of processed foods and body weight. METHODS: Secondary analysis of data from the UK National Diet and Nutrition Survey (2008-12), a large national cross-sectional study of diet. Dietary information was collected using four-day, unweighed, food-diaries. Foods were classified as: unprocessed or minimally processed (MPF; foods with no processing or mostly physical processes applied to single whole foods), processed ingredients (PI; extracted and purified components of single whole foods), or ultra-processed food products (UPF; products produced from industrial combining of MPF and PI). RESULTS: Two thousand one hundred seventy four adults were included. MPF and diets high in these foods, had the most healthful nutritional profile. UPF did not necessarily have the least healthful nutritional profile, but diets high in these foods did. Women, and older adults consumed more energy from MPF, and less from UPF. Those living in lower occupation social class households consumed less energy from MPF, but no more from UPF. Only higher intake of PI was consistently, inversely, associated with body weight. CONCLUSIONS: This is the first study to explore correlates of processed food consumption, using individual-level data from a large, national sample. Although higher intakes of MPF and lower intakes of UPF were associated with the most healthful dietary profiles, only intake of PI was consistently associated with body weight. Consumption of UPF varied by age and gender, but, unexpectedly, not by occupational social class. Longitudinal work is required to confirm relationships with health markers.This work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The funders played no role in the design, conduct or interpretation of this research, or the decision to publish.This is the final version of the article. It was first available from BioMed Central via http://dx.doi.org/10.1186/s12966-015-0317-

Prevalence and socio-demographic correlates of time spent cooking by adults in the 2005 UK Time Use Survey. Cross-sectional analysis.

This study aimed to document the prevalence and socio-demographic correlates of time spent cooking by adults in the 2005 UK Time-Use Survey. Respondents reported their main activities, in 10 minute slots, throughout one 24 hour period. Activities were coded into 30 pre-defined codes, including 'cooking, washing up'. Four measures of time spent cooking were calculated: any time spent cooking, 30 continuous minutes spent cooking, total time spent cooking, and longest continuous time spent cooking. Socio-demographic correlates were: age, employment, social class, education, and number of adults and children in the household. Analyses were stratified by gender. Data from 4214 participants were included. 85% of women and 60% of men spent any time cooking; 60% of women and 33% of men spent 30 continuous minutes cooking. Amongst women, older age, not being in employment, lower social class, greater education, and living with other adults or children were positively associated with time cooking. Few differences in time spent cooking were seen in men. Socio-economic differences in time spent cooking may have been overstated as a determinant of socio-economic differences in diet, overweight and obesity. Gender was a stronger determinant of time spent cooking than other socio-demographic variables.This work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration (MR/K023187/1), is gratefully acknowledged.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.appet.2015.05.02

An acceptability predictor for websites.

User acceptance is a high priority for website design and implementation. Two significant, but largely separate, approaches to acceptability are: First, the Web Accessibility Initiative (WAI) has explored the measurement of technical features of a website to gauge its accessibility. Second, human judgments about acceptability are obtained from intended users or experts. The present work explores the important question of how best to combine these two methods. Experiment One required new users to explore automatic website evaluation systems. They found two of four systems difficult or impossible to use and system outputs difficult to understand. Experiment Two combines formal properties and user judgments, using an automatic system to predict user judgments from formal website properties. A simple system was able to predict user judgments within 91% accuracy. Clearly, user judgments about websites can be predicted reliably, a result of value to designers

Different scientific approaches are needed to generate stronger evidence for population health improvement.

In a Perspective, Martin White and Jean Adams discuss challenges in the evaluation of interventions intended to benefit population health.MW and JA lead research in the Centre for Diet and Activity Research, a UK Clinical Research Collaboration Public Health Research Centre of Excellence, which receives funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, NIHR and the Wellcome Trust. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

School system merger: A study of power and redistribution of resources

The purpose of this study was to examine the merger of the school systems of the City of South Norfolk and Norfolk County in the State of Virginia. The merger of these two geographical entitites was consummated on January 1, 1963. Norfolk County was formed in 1636 by the Virginia General Assembly. The cities of Norfolk, Portsmouth, and South Norfolk were carved from this county. A series of annexations by these cities between 1940 and 1960 cost Norfolk County thirty-three square miles of territory, 110,000 residents, and {dollar}1,881,000 in revenue.;In order to protect its viability, Norfolk County voted to merge with the small City of South Norfolk. The City of Chesapeake was formed. Since schools were a major issue during the pre-merger campaign, this study examined the merger of the two school systems with primary emphasis on the control of power and the distribution of resources for facilities in the newly formed city.;The research data included primary and secondary sources in the areas of documents, newspapers, oral history, quantitative records, historical texts, and relics. A number of major figures in the school system of that period were available for personal interviews.;The hypothesis that resources for facilities were distributed equitably to the former South Norfolk and Norfolk County areas was accepted. Equitable did not mean equal since South Norfolk schools were in much greater physical need at the time of the 1963 merger. Therefore, the new Chesapeake School Board provided a larger share of the 1963 bond revenues and other fiscal resources to the former South Norfolk schools.;The hypothesis that the power in the newly merged Chesapeake School System was unevenly controlled by former Norfolk County leaders and residents was accepted. While it is fair to conclude from a review of School Board minutes, newspapers, periodicals, and interviews that former Norfolk County leaders and residents controlled decisionmaking through the Chesapeake School Board and major central office leadership roles, there was no indication that this power was used unjustly. Research into sources of the period and extensive interviews indicated that the leaders genuinely wanted the best for the new school system.;The issues of power and distribution of resources examined in this dissertation must be considered in any merger of school systems. Research into other school system mergers would advance this study

Barriers in Educating Homeless Children and Youth

Across America, homeless students face a myriad of barriers that impede education and school access and success of homeless children. The purpose of this study was to determine the barriers to enrollment and school success for homeless students. The ultimate goal was to provide information to parents, teachers, administrators, and school districts that could serve as a vital resource tool in educating homeless students while removing barriers. The participants consisted of 215 certified teachers, school administrators, and homeless liaisons in 23 school districts representing the populations that provide afterschool instruction to homeless students. The study was conducted in the spring of 2003 using a survey that consisted of demographic information, and questions were asked concerning the educational barriers to enrollment for homeless students and barriers to school success faced by homeless students. Results of the data analysis revealed that 36.3% of respondents were at and over 41 years of age. A very large percentage were female (81.9%). Respondents were experienced educators for the most part, with 31.2% having over 25 years of teaching/administrative experience. Also, 43 % had worked in the after-school program for homeless students less than 4 years. The data indicated that a majority of the respondents\u27 highest educational level obtained was a bachelor\u27s or master\u27s degree. The findings of the study revealed that lack of transportation, lack of school records, and state guardianship/residency requirements were moderate barriers to school enrollment. Results also revealed that lack of parental involvement, frequent absenteeism, and frequent mobility were perceived as major barriers to school success

Natural Supergravity inflation

We identify a new mechanism in supergravity theories which leads to successful inflation without any need for fine tuning. The simplest model yields a spectrum of density fluctuations tilted away from scale-invariance and negligible gravitational waves. We demonstrate that this is consistent with the observed large-scale structure for a cold dark matter dominated, critical density universe. The model can be tested through measurements of microwave background anisotropy on small angular scales.Comment: 14 pages (revtex) including 3 figures (epsf); Minor changes to Introduction and discussion and modified Figure 1; to appear in Phys. Lett. B; Postscript also available from ftp://ftp.physics.ox.ac.uk/pub/local/users/sarkar/SugraInfl.ps.g

Informing the development of services supporting self-care for long term mental health conditions: A mixed method study of community based mental health initiatives in England

Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings