Analysis of trends in premature mortality by Labour voting in the 1997 general election

Mortality relates to voting patterns within areas: mortality is higher the greater the proportion of the electorate who vote Labour or abstain and the converse is the case with regard to the percentage of the electorate who vote Conservative. This reflects the socioeconomic characteristics of individuals who vote for these parties, with Labour being identified with the working class and the Conservatives with the middle class. In the 1997 election, Labour was returned to office after 18 years in opposition. The government has released targets for reducing health inequalities and made it clear that such a reduction is a principal policy aim. These targets may be difficult to meet for two reasons. Firstly, factors influencing inequalities in adult health act from an early age onwards and may not respond rapidly to social change3; secondly, there has as yet been no reduction in social inequality (as indexed by income inequality) under the Labour government.4 Here we use premature mortality as an indicator of which population groups have fared best under the present government

Inequalities in premature mortality in Britain: observational study from 1921 to 2007

Objective To report on the extent of inequality in premature mortality as measured between geographical areas in Britain. Design Observational study of routinely collected mortality data and public records. Population subdivided by age, sex, and geographical area (parliamentary constituencies from 1991 to 2007, pre-1974 local authorities over a longer time span). Setting Great Britain. Participants Entire population aged under 75 from 1990 to 2007, and entire population aged under 65 in the periods 1921-39, 1950-3, 1959-63, 1969-73, and 1981-2007. Main outcome measure Relative index of inequality (RII) and ratios of inequality in age-sex standardised mortality ratios under ages 75 and 65. The relative index of inequality is the relative rate of mortality for the hypothetically worst-off compared with the hypothetically best-off person in the population, assuming a linear association between socioeconomic position and risk of mortality. The ratio of inequality is the ratio of the standardised mortality ratio of the most deprived 10% to the least deprived 10%. Results When measured by the relative index of inequality, geographical inequalities in age-sex standardised rates of mortality below age 75 have increased every two years from 1990-1 to 2006-7 without exception. Over this period the relative index of inequality increased from 1.61 (95% confidence interval 1.52 to 1.69) in 1990-1 to 2.14 (2.02 to 2.27) in 2006-7. Simple ratios indicated a brief period around 2001 when a small reduction in inequality was recorded, but this was quickly reversed and inequalities up to the age of 75 have now reached the highest levels reported since at least 1990. Similarly, inequalities in mortality ratios under the age of 65 improved slightly in the early years of this century but the latest figures surpass the most extreme previously reported. Comparison of crudely age-sex standardised rates for those below age 65 from historical records showed that geographical inequalities in mortality are higher in the most recent decade than in any similar time period for which records are available since at least 1921. Conclusions Inequalities in premature mortality between areas of Britain continued to rise steadily during the first decade of the 21st century. The last time in the long economic record that inequalities were almost as high was in the lead up to the economic crash of 1929 and the economic depression of the 1930s. The economic crash of 2008 might precede even greater inequalities in mortality between areas in Britain

Contextual effect on mortality of neighbourhood level education explained by earlier life deprivation

Various aspects of socioeconomic conditions in the neighbourhood have in recent years been found to have an influence on morbidity and mortality even after individual characteristics are taken into account.1 Increasing evidence suggests that to measure fully the impact social conditions may have on mortality risk, the whole life course must be taken into account as mortality risk increases cumulatively over the life course.2 Few studies have combined ecological and life course factors to see if contextual effects may be explained by social conditions earlier in life at the individual level.3,4 Most studies of neighbourhood effects have had a cross sectional design or with short follow up. Effects seen could be a consequence of the fact that people in these areas may have different earlier life experiences that have not been fully taken into account. In this study we examine whether the contextual effect of educational level aggregated to the neighbourhood on mortality risk could be explained by earlier life deprivation

Optimization of plasmon–plasmon coupling in photorefractive layered media

In this paper we study grating-induced plasmon–plasmon coupling in photorefractive layered media using a weakcoupling approximation. The method used is applicable to general layered structures that support both plasmonic and optical modes, such as photorefractive liquid crystal cells. The approximate equations are accurate when compared to S matrix approaches and capture the plasmon propagation at the surface of the device along with the optical modes guided by the layered geometry underneath. Analysis of the resulting model provides insight into the effect of the control parameters in this device and the means to optimize the diffraction efficiency. For example, by considering the case in which the plasmon is spectrally separated from the guided modes it is possible to determine the optimum gold thickness and grating strength required to obtain the strongest possible diffraction

Fabrication of a single mode laser by UV-writing in neodymium doped silica-on-silicon

We describe the fabrication of a waveguide laser by UV-writing in neodymium doped silica-on-silicon. The substrate is fabricated by Flame Hydrolysis Deposition and solution doping techniques. Lasing at 1048-1056nm was observed with a slope efficiency of 33% and threshold of 4mW for the transition. Lasing was also observed at 1356nm

Lead, zinc and copper mineralisation in basal Carboniferous sediments at Westwater, south Scotland

A zioneo f lead, zinc and copperm ineralisatioins developedo ver a minimum I of 4 km of strikeo f basal Carboniferoucse mentstoneg roup sedimentsa nd immediatelyu nderlyingB irrenswarkL avas atwestwater,n ear Laqholm in south Scotland. Grades so far obtained from sparse rock exposures and from shallow boreholes a fissure sulphides are usuallyO .l-O.j%o f combinedm etals over 1-2 m of thickness,bu t vein of higher grade and a relativelyt hick zone of disseminated were also located. Galena, sphalerite,c halcopyritea ndbaryte occur mainly in thin dolomitev eins but disseminationosf galenaa re also presenti n sandstoneu nits. The mineralisatioins of low temperaturet ype I was emplaceda long northeasterlyt rendingn ormal faultsa nd cross faults regardeda s late Carboniferouisn age. and Mineralisatiohna s been controlledb y faulting,r egionalf aciesv aziation and local lithologicalv ariationa s well as by stratigraphipco sition. These controlsa re applicablei n furthere xplorationo f Lower Carboniferourso cks in both south and central Scotland. The heavy mineral fraction of stream sediment is the optimums amplingt ype in reconnaissanceex plorationo f areas of calcareous . rocks such as the Lower Carboniferouso f south Scotlanda nd basal till sampling is the most effectivem ethod of follow-upe xplorationi n those areas where glaciald epositsa re widespreada nd often thick

Parental height in relation to offspring coronary heart disease: examining transgenerational influences on health using the west of Scotland Midspan Family Study

<b>Background </b>Adult height is known to be inversely related to coronary heart disease (CHD) risk. We sought to investigate transgenerational influence of parental height on offspring’s CHD risk. <p></p> <b>Methods </b>Parents took part in a cardiorespiratory disease survey in two Scottish towns during the 1970s, in which their physical stature was measured. In 1996, their offspring were invited to participate in a similar survey, which included an electrocardiogram recording and risk factor assessment.<p></p> <b>Results </b>A total of 2306 natural offspring aged 30–59 years from 1456 couples were subsequently flagged for notification of mortality and followed for CHD-related hospitalizations. Taller paternal and/or maternal height was associated with socio-economic advantage, heavier birthweight and increased high-density lipoprotein cholesterol in offspring. Increased height in fathers, but more strongly in mothers (risk ratio for 1 SD change in maternal height = 0.85; 95% confidence interval: 0.76 to 0.95), was associated with a lower risk of offspring CHD, adjusting for age, sex, other parental height and CHD risk factors. <p></p> <b>Conclusion </b>There is evidence of an association between taller parental, particularly maternal, height and lower offspring CHD risk. This may reflect an influence of early maternal growth on the intrauterine environment provided for her offspring

Suppression of monocyte and neutrophil function by recombinant IL-2

Little IS known about the influence of IL-2 on phagocytes. We now describe the effects of human recombinant IL-2 on human neutrophil and monocyte functions related to mobility, phagocytosis, glucose uptake, respiration and degranulation. Neutrophil adherence and hexose monophosphate shunt activities were both suppressed after incubation with IL-2. IL-2 had no effect on neutrophil migration, phagocytosis, deoxyglucose uptake or degranulation, ionocytes demonstrated a greater sensitivity to IL-2 with suppression of monocyte adherence, random and stimulated migration, glucose uptake and hexose monophosphate shunt activity, even after addition of phorbol myristate acetate. Monocyte phagocytosis and degranulation were not affected. All of the effects observed were dose-dependent within a biologically active range for IL-2. These studies suggest that IL-2 may have an important down-regulatory role across a broad range of monocyte functions including movement, deoxyglucose uptake and respiration. However, its role in regulation of neutrophil function is limited to adherence and respiration. IL-2 may be a more versatile cytokine than has previously been appreciated

Are we teaching our students what they need to know about ageing? Results from the National Survey of Undergraduate Teaching in Ageing and Geriatric Medicine

Introduction - Learning about ageing and the appropriate management of older patients is important for all doctors. This survey set out to evaluate what medical undergraduates in the UK are taught about ageing and geriatric medicine and how this teaching is delivered. Methods – An electronic questionnaire was developed and sent to the 28/31 UK medical schools which agreed to participate. Results – Full responses were received from 17 schools. 8/21 learning objectives were recorded as taught, and none were examined, across every school surveyed. Elder abuse and terminology and classification of health were taught in only 8/17 and 2/17 schools respectively. Pressure ulcers were taught about in 14/17 schools but taught formally in only 7 of these and examined in only 9. With regard to bio- and socio- gerontology, only 9/17 schools reported teaching in social ageing, 7/17 in cellular ageing and 9/17 in the physiology of ageing. Discussion – Even allowing for the suboptimal response rate, this study presents significant cause for concern with UK undergraduate education related to ageing. The failure to teach comprehensively on elder abuse and pressure sores, in particular, may be significantly to the detriment of older patients

Cholesterol and coronary heart disease: screening and treatment

Coronary heart disease (CHD) is a major cause of morbidity and mortality in the United Kingdom, accounting for just under one quarter of all deaths in 1995: 27% among men and 21% among women.1 Although many CHD deaths occur among elderly people, CHD accounts for 31% of male and 13% of female deaths within the 45–64 age group