After 50 years and 200 papers, what can the Midspan cohort studies tell us about our mortality?

Objective: To distil the main findings from published papers on mortality in three cohorts involving over 27,000 adults, recruited in Scotland between 1965 and 1976 and followed up ever since. Method: We read and summarized 48 peer-reviewed papers about all-cause and cause-specific mortality in these cohorts, published between 1978 and 2013. Results: Mortality rates were substantially higher among cigarette smokers in all social classes and both genders. Exposure to second-hand smoke was also damaging. Exposure to higher levels of black smoke pollution was associated with higher mortality. After smoking, diminished lung function was the risk factor most strongly related to higher mortality, even among never-smokers. On average, female mortality rates were much lower than male but the same risk factors were predictors of mortality. Mortality rates were highest among men whose paternal, own first and most recent jobs were manual. Specific causes of death were associated with different life stages. Upward and downward social mobility conferred intermediate mortality rates. Low childhood cognitive ability was strongly associated with low social class in adulthood and higher mortality before age 65 years. There was no evidence that daily stress contributed to higher mortality among people in lower social positions. Men in manual occupations with fathers in manual occupations, who smoked and drank >14 units of alcohol a week had cardiovascular disease mortality rates 4.5 times higher than non-manual men with non-manual fathers, who neither smoked nor drank >14 units. Men who were obese and drank >14 units of alcohol per day had a mortality rate due to liver disease 19 times that of normal or underweight non-drinkers. Among women who never smoked, mortality rates were highest in severely obese women in the lowest occupational classes. Conclusion: These studies highlight the cumulative effect of adverse exposures throughout life, the complex interplay between social circumstances, culture and individual capabilities, and the damaging effects of smoking, air pollution, alcohol and obesity

Effect of tobacco smoking on survival of men and women by social position: a 28 year cohort study

<b>Objective:</b> To assess the impact of tobacco smoking on the survival of men and women in different social positions. <b>Design:</b> A cohort observational study. <b>Setting:</b> Renfrew and Paisley, two towns in west central Scotland. <b>Participants:</b> 8353 women and 7049 men aged 45-64 years recruited in 1972-6 (almost 80% of the population in this age group). The cohort was divided into 24 groups by sex (male, female), smoking status (current, former, or never smokers), and social class (classes I + II, III non-manual, III manual, and IV + V) or deprivation category of place of residence. <b>Main outcome measure:</b> Relative mortality (adjusted for age and other risk factors) in the different groups; Kaplan-Meier survival curves and survival rates at 28 years. <b>Results:</b> Of those with complete data, 4387/7988 women and 4891/6967 men died over the 28 years. Compared with women in social classes I + II who had never smoked (the group with lowest mortality), the adjusted relative mortality of smoking groups ranged from 1.7 (95% confidence interval 1.3 to 2.3) to 4.2 (3.3 to 5.5). Former smokers’ mortalities were closer to those of never smokers than those of smokers. By social class (highest first), age adjusted survival rates after 28 years were 65%, 57%, 53%, and 56% for female never smokers; 41%, 42%, 33%, and 35% for female current smokers; 53%, 47%, 38%, and 36% for male never smokers; and 24%, 24%, 19%, and 18% for male current smokers. Analysis by deprivation category gave similar results. <b>Conclusions:</b> Among both women and men, never smokers had much better survival rates than smokers in all social positions. Smoking itself was a greater source of health inequality than social position and nullified women’s survival advantage over men. This suggests the scope for reducing health inequalities related to social position in this and similar populations is limited unless many smokers in lower social positions stop smoking

A Tale of Two Cities. A comparative study of ISIS in Ramadi and Fallujah

Postponed access: the file will be accessible after 2019-06-01ISIS attacked Ramadi and Fallujah in the early days of January 2014, and while Fallujah fell at once with no visible resistance, it took protracted fighting and a three-day surge by ISIS before Ramadi fell on May 17 the same year. Through the application of social movement theory to the cases, I argue that it is possible to provide an understanding of the processes that led up to the two different outcomes, by looking at the Sunni Protest movement in Anbar throughout 2013. I argue that to understand the rise of ISIS, it is important to look beyond the group itself. It is necessary to include environmental dynamics, intramovement relations and the influence of outside actors in the analysis. This study finds that internal competition of frames caused Ramadi and Fallujah to develop differently. Fallujah was more receptive to extremist frames, while moderate frames resonated best in Ramadi. State repression and violence confirmed the dominant and extreme frames in Fallujah perfectly. The repression also affected Ramadi negatively, but not as much as in Fallujah. The radical flank effect increased the difference by affecting how the government handled the movement in general and how the government handled the cities specifically. As the Iraqi security forces pulled away from the cities after clashing with protesters in late December, the local councils inserted themselves as the governing bodies of Ramadi and Fallujah. Because Ramadi had remained relatively moderate, it was not in its interest to cooperate with ISIS, thus siding with the Iraqi security forces in fighting the extremists. Fallujah, on the other hand, which had been increasingly radicalised throughout the year, had no problem cooperating with ISIS. Fallujah let ISIS into the city, and that is why ISIS was able to enter unopposed in January 2014.Masteroppgave i demokratibyggingSAMPOL65

Multiscale computational homogenization: review and proposal of a new enhanced-first-order method

This is a copy of the author 's final draft version of an article published in the Archives of computational methods in engineering. The final publication is available at Springer via http://dx.doi.org/10.1007/s11831-016-9205-0The continuous increase of computational capacity has encouraged the extensive use of multiscale techniques to simulate the material behaviour on several fields of knowledge. In solid mechanics, the multiscale approaches which consider the macro-scale deformation gradient to obtain the homogenized material behaviour from the micro-scale are called first-order computational homogenization. Following this idea, the second-order FE2 methods incorporate high-order gradients to improve the simulation accuracy. However, to capture the full advantages of these high-order framework the classical boundary value problem (BVP) at the macro-scale must be upgraded to high-order level, which complicates their numerical solution. With the purpose of obtaining the best of both methods i.e. first-order and second-order, in this work an enhanced-first-order computational homogenization is presented. The proposed approach preserves a classical BVP at the macro-scale level but taking into account the high-order gradient of the macro-scale in the micro-scale solution. The developed numerical examples show how the proposed method obtains the expected stress distribution at the micro-scale for states of structural bending loads. Nevertheless, the macro-scale results achieved are the same than the ones obtained with a first-order framework because both approaches share the same macro-scale BVP.Peer ReviewedPostprint (author's final draft

The diagnosis, treatment and prevention of CAPD peritonitis

Introduced in 1976, continuous ambulatory peritoneal dialysis (CAPD) is an effective and increasingly popular form of long-term dialysis. Infective peritonitis is its main drawback. This can be caused by a wide variety of micro-organisms, but usually by bacteria from the skin or gut. The commonest and most troublesome causative organism is the coagulase-negative staphylococcus. Although improvements in methods of diagnosis, treatment and prevention were made during the first five years of its use, CAPD continued to be plagued by peritonitis in most centres.This study was carried out between 1982 and 1984 in the Queen Elizabeth Hospital, Birmingham. A CAPD service began there in 1981 and peritonitis quickly became the main threat to its success. It was soon evident that the methods then in use for the microbiological diagnosis of CAPD peritonitis were inadequate. A simple method of culture was developed which greatly increased the chances of a positive microbiological diagnosis. This method became the cornerstone of a more effective and economical laboratory service to the CAPD progranme.The antibiotic sensitivities of organisms causing CAPD peritonitis were studied with the aim of establishing a more effective initial treatment policy. Vancomycin was found to be the most consistently active of the antibiotics tested against Gram positive isolates in general and the coagulase-negative staphylococcus in particular. Aminoglycosides were the most consistently active against Gram negative isolates. A trial of intra-peritoneal vancomycin and tobramycin showed that this combination was much more effective in the initial treatment of CAPD peritonitis than cefuroxime, previously the antibiotic of first choice. However, potentially ototoxic levels of tobramycin were encountered.With the aim of making initial treatment both simpler and safer, a modified protocol involving once-daily intra-peritoneal vancomycin and gentamicin was developed. One hundred episodes of CAPD peritonitis were treated, of which 88 were cured without recourse to other antibiotics. This study showed for the first time that most episodes of CAPD peritonitis could be safely treated at home using intra-peritoneal antibiotics self-administered oncedaily. The problem of aminoglycoside toxicity was not solved, however.Many episodes of CAPD peritonitis follow contamination of the administration set with organisms on the patient's hands. Contamination usually occurs during the dialysate exchange procedure. We studied how effectively bacteria were removed from the patients' hands by washing with povidone iodine detergent or 70% ethyl alcohol. Surprisingly, povidone iodine was often found to be counter-productive. Ethyl alcohol was much more effective and convenient.Despite improvements in the diagnosis and treatment of CAPD peritonitis, its incidence at the Queen Elizabeth Hospital has recently increased. This may in part be due to a steady decline in the amount of time staff can devote to training and supervising individual patients: staffing of the programme has failed to keep pace with the rapid rise in patient numbers. The thesis ends with a review of a variety of recently developed techniques and strategies which aim to prevent CAPD peritonitis

Yes, School Librarians Teach Reading: Reading Skill Reinforcement and the School Librarian

The article discusses that school librarians are the literacy leaders in their buildings. It mentions that reinforcing reading skills taught in the classroom and motivating students to practice reading are an integral part of a school librarian\u27s job; and also mentions that reading aloud to students from chapter books helps develop their imagination

Comparison of drug use and psychiatric morbidity between prostitute and non-prostitute female drug users in Glasgow, Scotland

Aims: To compare psychiatric morbidity between 176 female drug users with lifetime involvement in prostitution (prostitutes) and 89 female drug users with no involvement (non-prostitutes) in Glasgow, Scotland. Method: The Revised Clinical Interview Schedule (CIS-R) measured current neurotic symptoms. Results: Prostitutes were more likely to report adult physical (OR 1.8) or sexual abuse (OR 2.4), to have attempted suicide (OR 1.7) and to meet criteria for current depressive ideas (OR 1.8) than non-prostitutes. Seventy-two percent of prostitutes and sixty-seven percent of non-prostitutes met criteria for a level of current neurotic symptoms likely to need treatment (CIS-R ≥18). Being in foster care (OR 8.9), being prescribed medication for emotional problems in the last 30 days (OR 7.7), adult sexual abuse (OR 4.5), poly drug use in the last 30 days (OR 3.6) and adult physical abuse (OR 2.6) were significantly associated with a CIS-R score of ≥18 for prostitutes using multiple logistic regression. Conclusions: Higher rates of adulthood abuse among prostitutes may explain the greater proportion of prostitutes than non-prostitutes meeting criteria for current depressive ideas and lifetime suicide attempts

Cause specific mortality, social position, and obesity among women who had never smoked: 28 year cohort study

Objective To investigate the relations between causes of death, social position, and obesity in women who had never smoked