1,722,648 research outputs found
How policy informs the evidence - 'evidence based' thinking can lead to debased policy making
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Adverse socioeconomic conditions in childhood and cause specific adult mortality: prospective observational study
Get PDF<b>Objective:</b> To investigate the association between social circumstances in childhood and mortality from various causes of death in adulthood.
Design: Prospective observational study.
Setting: 27 workplaces in the west of Scotland.
<b>Subjects:</b> 5645 men aged 35-64 years at the time of examination.
<b>Main outcome measures:</b> Death from various causes.
<b>Results:</b> Men whose fathers had manual occupations when they were children were more likely as adults to have manual jobs and be living in deprived areas. Gradients in mortality from coronary heart disease, stroke, lung cancer, stomach cancer, and respiratory disease were seen (all P<0.05), generally increasing from men whose fathers had professional and managerial occupations (social class I and II) to those whose fathers had semiskilled and unskilled manual occupations (social class IV and V). Relative rates of mortality adjusted for age for men with fathers in manual versus non-manual occupations were 1.52 (95% confidence interval 1.24 to 1.87) for coronary heart disease, 1.83 (1.13 to 2.94) for stroke, 1.65 (1.12 to 2.43) for lung cancer, 2.06 (0.93 to 4.57) for stomach cancer, and 2.01 (1.17 to 3.48) for respiratory disease. Mortality from other cancers and accidental and violent death showed no association with fathers' social class. Adjustment for adult socioeconomic circumstances and risk factors did not alter results for mortality from stroke and stomach cancer, attenuated the increased risk of coronary heart disease and respiratory disease, and essentially eliminated the association with lung cancer.
<b>Conclusions:</b> Adverse socioeconomic circumstances in childhood have a specific influence on mortality from stroke and stomach cancer in adulthood, which is not due to the continuity of social disadvantage throughout life. Deprivation in childhood influences risk of mortality from coronary heart disease and respiratory disease in adulthood, although an additive influence of adulthood circumstances is seen in these cases. Mortality from lung cancer, other cancer, and accidents and violence is predominantly influenced by risk factors that are related to social circumstances in adulthood
Height and risk of death among men and women: aetiological implications of associations with cardiorespiratory disease and cancer mortality
Get PDFOBJECTIVES: Height is inversely associated with cardiovascular disease mortality risk and has shown variable associations with cancer incidence and mortality. The interpretation of findings from previous studies has been constrained by data limitations. Associations between height and specific causes of death were investigated in a large general population cohort of men and women from the West of Scotland.
DESIGN: Prospective observational study.
SETTING: Renfrew and Paisley, in the West of Scotland.
SUBJECTS: 7052 men and 8354 women aged 45-64 were recruited into a study in Renfrew and Paisley, in the West of Scotland, between 1972 and 1976. Detailed assessments of cardiovascular disease risk factors, morbidity and socioeconomic circumstances were made at baseline.
MAIN OUTCOME MEASURES: Deaths during 20 years of follow up classified into specific causes.
RESULTS: Over the follow up period 3347 men and 2638 women died. Height is inversely associated with all cause, coronary heart disease, stroke, and respiratory disease mortality among men and women. Adjustment for socioeconomic position and cardiovascular risk factors had little influence on these associations. Height is strongly associated with forced expiratory volume in one second (FEV1) and adjustment for FEV1 considerably attenuated the association between height and cardiorespiratory mortality. Smoking related cancer mortality is not associated with height. The risk of deaths from cancer unrelated to smoking tended to increase with height, particularly for haematopoietic, colorectal and prostate cancers. Stomach cancer mortality was inversely associated with height. Adjustment for socioeconomic position had little influence on these associations.
CONCLUSION: Height serves partly as an indicator of socioeconomic circumstances and nutritional status in childhood and this may underlie the inverse associations between height and adulthood cardiorespiratory mortality. Much of the association between height and cardiorespiratory mortality was accounted for by lung function, which is also partly determined by exposures acting in childhood. The inverse association between height and stomach cancer mortality probably reflects Helicobacter pylori infection in childhood resulting inor being associated withshorter height. The positive associations between height and several cancers unrelated to smoking could reflect the influence of calorie intake during childhood on the risk of these cancers
Estimating the plausibility of a gene-environment interaction in cancer [Estimer la plausibilité d'une interaction gène-environnement dans le cancer]
No full textThis article proposes a method to estimate the plausibility of an interaction between an environmental risk factor for cancer and a genetic factor. It may be applied to other chronic diseases. Copyright © 2007 John Libbey Eurotext
Relation between number of siblings and adult mortality and stroke risk: 25 year follow up of men in the Collaborative study
Get PDF<b>Study objective</b>: To investigate the relation between number of siblings, mortality risk, and stroke risk.
<b>Design</b>: Prospective cohort study.
<b>Setting</b>: 27 workplaces in Scotland.
<b>Participants</b>: 5765 employed men aged 35–64 from a variety of different workplaces, screened between 1970 and 1973.
<b>Main results</b>: There were strong relationships between number of siblings and socioeconomic variables and also with adult behavioural measures. Men with greater numbers of siblings had an increased risk of dying of all causes, coronary heart disease, lung cancer, stomach cancer, and respiratory disease over a 25 year follow up period. Adjustment for risk factors could explain these associations, excepting stomach cancer mortality. With the definition of stroke as either a hospital admission for stroke or death from stroke, there was a strong relation between number of siblings and haemorrhagic stroke, but not ischaemic stroke.
<b>Conclusions</b>: Number of siblings is strongly related to mortality risk, but as it is also related to many risk factors, adjustment for these can generally explain the relation with mortality. The exceptions are stomach cancer mortality and haemorrhagic stroke, which are known to be related to deprivation in childhood, and, in the case of stomach cancer to childhood infection
Mortality in adults aged 26-54 years related to socioeconomic conditions in childhood and adulthood: post war birth cohort study
No full textObjective: To examine premature mortality in adults in relation to socioeconomic conditions in childhood and adulthood. Design: Nationally representative birth cohort study with prospective information on socioeconomic conditions. Setting: England, Scotland, and Wales. Study members: 2132 women and 2322 men born in March 1946 and followed until age 55 years. Main outcome measures: Deaths between 26 and 54 years of age notified by the NHS central register. Results: Study members whose father's occupation was manual at age 4, or who lived in the worst housing, or who received the poorest care in childhood had double the death rate during adulthood of those living in the best socioeconomic conditions. All indicators of socioeconomic disadvantage at age 26 years, particularly lack of home ownership, were associated with a higher death rate. Manual origins and poor care in childhood remained associated with mortality even after adjusting for social class in adulthood or home ownership. The hazard ratio was 2.6 (95% confidence interval 1.5 to 4.4) for those living in manual households as children and as adults compared with those living in non-manual households at both life stages. The hazard ratio for those from manual origins who did not own their own home at age 26 years was 4.9 (2.3 to 10.5) compared with those from non-manual origins who were home owners. Conclusions: Socioeconomic conditions in childhood as well as early adulthood have strongly influenced the survival of British people born in the immediate post war era
Maternal cotyledons at birth predict blood pressure in childhood
No full textINTRODUCTION: A small placental surface at birth has been shown to be associated with the development of hypertension in later life. In this study we extend this observation by looking at the relationship between the number of placental cotyledons and blood pressure in childhood. Because the number of cotyledons is correlated with the surface area, we hypothesized that fewer cotyledons would be associated with higher blood pressure.METHODS: The Alspac study is a longitudinal study of 13,971 children born in Bristol. Their placentas were stored in formalin. We photographed the placentas of a sample of the children and related the number of maternal cotyledons to their blood pressure levels at age 9 years.RESULTS: Contrary to our hypothesis, a greater number of maternal cotyledons was associated with higher blood pressure. Among boys, a greater number of cotyledons was associated with higher systolic and diastolic pressure but not with higher pulse pressure. Diastolic pressure rose by 2.2 mmHg (95% CI 0.6 to 3.7, p = 0.007) for every 10 additional cotyledons. Among girls, a greater number of cotyledons was associated with higher systolic pressure and pulse pressure but not with higher diastolic pressure. Pulse pressure rose by 2.7 mmHg (1.1-4.3, p < 0.001) for every 10 additional cotyledons. These associations were little changed by adjustment for placental surface area.CONCLUSION: Our study has shown that a large number of maternal cotyledons is associated with raised blood pressure in childhood. The associations differ in the two sexes
Alcohol consumption and use of acute and mental health hospital services in the West of Scotland Collaborative prospective cohort study
Get PDF<b>Background</b>: Overconsumption of alcohol affects health. Data from men from the West of Scotland Collaborative study were analysed to see how reported alcohol wasrelated to acute and mental health hospital admissions.
<b>Methods</b>: Men (N=5772) from a prospective cohort study located in 27 workplaces in West and Central Scotland were screened when aged 35-64 in 1970-3.The number of acute and mental health admissions and bed-days were calculated by alcohol category (none, 1-7,8-14, 15-21, 22-34 and 35 or more units per week) tothe end of 2005. Specific causes were coronary heartdisease (CHD), stroke, respiratory diseases and alcohol related.
<b>Results</b>: Men who consumed 22 or more units per week had a 20% higher rate of acute admissions than non drinkers.The number of bed-days were higher for men drinking eight or more units and increased with consumption, with the highest category having a 58% higher rate of bed-days than non-drinkers. Non-drinkers had the highest admissions for CHD. For stroke, drinkers of 15 or more units had higher admissions and higher number of bed-days and these increased with increasing consumption. Respiratory admissions were higher for drinkers of 22 or more units and bed-days were higher for drinkers of 15 or more units. Alcohol-related admissions and number of bed-days generally increased with consumption. Mental health admissions and number of bed-days were raised for drinkers of 22 or more units with a suggestion of a J-shaped relationship.
<b>Conclusion</b>: Alcohol consumption has a substantialeffect on acute and mental health admissions and bed-days
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