Relationship between socioeconomic deprivation or urban/rural residence and visual acuity before cataract surgery in Northern Scotland

Purpose: To evaluate the influence of socioeconomic factors on visual acuity before cataract surgery. ?Methods: The medical case notes of 240 consecutive patients listed for cataract surgery from January 1, 2010, at Grampian University Hospital, Aberdeen, were reviewed retrospectively. Patients with ocular comorbidity were excluded. Demographics, postal codes, and visual acuity were recorded. Scottish Index of Multiple Deprivation was used to determine the deprivation rank. Home location was classified as urban or rural. The effect of these parameters on preoperative visual acuity was investigated using chi-square tests or Fisher exact test as appropriate. ?Results: A total of 184 patients (mean 75 years) were included. A total of 127 (69%) patients had visual acuity of 6/12 or better. An association was found between affluence and preoperative visual acuity of 6/12 or better (?2trend = 4.97, p = 0.03), with a significant rising trend across quintile of deprivation. There was no evidence to suggest association between geographical region and preoperative visual acuity (p = 0.63). ?Conclusion: Affluence was associated with good visual acuity (6/12 or better) before cataract surgery. There was no difference in preoperative visual acuity between rural and urban populations.

The effect of socioeconomic deprivation on corneal graft survival in the United Kingdom

Objective: To investigate the effect of socioeconomic deprivation on cornea graft survival in the United Kingdom.

Design: Retrospective cohort study.

Participants: All the recipients (n = 13?644) undergoing their first penetrating keratoplasty (PK) registered on the United Kingdom Transplant Registry between April 1999 and March 2011 were included.

Methods: Data of patients' demographic details, indications, graft size, corneal vascularization, surgical complication, rejection episodes, and postoperative medication were collected at the time of surgery and 1, 2, and 5 years postoperatively. Patients with endophthalmitis were excluded from the study. Patients' home postcodes were used to determine the socioeconomic status using a well-validated deprivation index in the United Kingdom: A Classification of Residential Neighborhoods (ACORN). Kaplan–Meier survival and Cox proportional hazards regression were used to evaluate the influence of ACORN categories on 5-year graft survival, and the Bonferroni method was used to adjust for multiple comparisons.

Main Outcome Measures: Patients' socioeconomic deprivation status and corneal graft failure.

Results: A total of 13?644 patients received their first PK during the study periods. A total of 1685 patients (13.36%) were lost to follow-up, leaving 11?821 patients (86.64%) for analysis. A total of 138 of the 11?821 patients (1.17%) developed endophthalmitis. The risk of graft failure within 5 years for the patients classified as hard-pressed was 1.3 times that of the least deprived (hazard ratio, 1.3; 95% confidence interval, 1.1–1.5; P = 0.003) after adjusting for confounding factors and indications. There were no statistically significant differences between the causes of graft failure and the level of deprivation (P = 0.14).

Conclusions: Patients classified as hard-pressed had an increased risk of graft failure within 5 years compared with the least deprived patients.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article

Food web indicators under the Marine Strategy Framework Directive: From complexity to simplicity?

The Marine Strategy Framework Directive (MSFD) requires that European Union Member States achieve "Good Environmental Status" (GES) in respect of 11 Descriptors of the marine environment by 2020. Of those, Descriptor 4, which focuses on marine food webs, is perhaps the most challenging to implement since the identification of simple indicators able to assess the health of highly dynamic and complex interactions is difficult. Here, we present the proposed food web criteria/indicators and analyse their theoretical background and applicability in order to highlight both the current knowledge gaps and the difficulties associated with the assessment of GES. We conclude that the existing suite of indicators gives variable focus to the three important food web properties: structure, functioning and dynamics, and more emphasis should be given to the latter two and the general principles that relate these three properties. The development of food web indicators should be directed towards more integrative and process-based indicators with an emphasis on their responsiveness to multiple anthropogenic pressures. (C) 2013 Elsevier Ltd. All rights reserved.

Rigorous Specification and Low-Latency Implementation of Technical Market Indicators

Technical market indicators are tools used by technical an- alysts to understand trends in trading markets. Technical (market) indicators are often calculated in real-time, as trading progresses. This paper presents a mathematically- founded framework for calculating technical indicators. Our framework consists of a domain specific language for the un- ambiguous specification of technical indicators, and a run- time system based on Click, for computing the indicators. We argue that our solution enhances the ease of program- ming due to aligning our domain-specific language to the mathematical description of technical indicators, and that it enables executing programs in kernel space for decreased latency, without exposing the system to users’ programming errors.

Risk of Several Cancers is Higher in Urban Areas after Adjusting for Socioeconomic Status. Results from a Two-Country Population-Based Study of 18 Common Cancers

Some studies suggest that there are urban-rural variations in cancer incidence but whether these simply reflect urban-rural socioeconomic variation is unclear. We investigated whether there were urban-rural variations in the incidence of 18 cancers, after adjusting for socioeconomic status. Cancers diagnosed between 1995 and 2007 were extracted from the population-based National Cancer Registry Ireland and Northern Ireland Cancer Registry and categorised by urban-rural status, based on population density of area of residence at diagnosis (rural 15 people per hectare). Relative risks (RR) were calculated by negative binomial regression, adjusting for age, country and three area-based markers of socioeconomic status. Risks were significantly higher in both sexes in urban than rural residents with head and neck (males RR urban vs. rural = 1.53, 95 % CI 1.42-1.64; females RR = 1.29, 95 % CI 1.15-1.45), esophageal (males 1.21, 1.11-1.31; females 1.21, 1.08-1.35), stomach (males 1.36, 1.27-1.46; females 1.19, 1.08-1.30), colorectal (males 1.14, 1.09-1.18; females 1.04, 1.00-1.09), lung (males 1.54, 1.47-1.61; females 1.74, 1.65-1.84), non-melanoma skin (males 1.13, 1.10-1.17; females 1.23, 1.19-1.27) and bladder (males 1.30, 1.21-1.39; females 1.31, 1.17-1.46) cancers. Risks of breast, cervical, kidney and brain cancer were significantly higher in females in urban areas. Prostate cancer risk was higher in rural areas (0.94, 0.90-0.97). Other cancers showed no significant urban-rural differences. After adjusting for socioeconomic variation, urban-rural differences were evident for 12 of 18 cancers. Variations in healthcare utilization and known risk factors likely explain some of the observed associations. Explanations for others are unclear and, in the interests of equity, warrant further investigation. © 2014 The New York Academy of Medicine.

Arcellacea (Testate Amoebae) as Bio-indicators of Road Salt Contamination in Lakes

Winter deicing operations occur extensively in mid- to high-latitude metropolitan regions around the world and result in a significant reduction in road accidents. Deicing salts can, however, pose a major threat to water quality and aquatic organisms. In this paper we examine the utility of Arcellacea (testate amoebae) for monitoring lakes that have become contaminated by winter deicing salts, particularly sodium chloride. We analysed 50 sediment samples and salt-related water-property variables (chloride concentrations; conductivity) from 15 lakes in the Greater Toronto Area and adjacent areas of southern Ontario, Canada. The sampled lakes included lakes in proximity to major highways and suburban roads, and control lakes in forested settings away from road influences. Samples from the most contaminated lakes, with chloride concentrations in excess of 400 mg/l and conductivities of >800 μS/cm, were dominated by species typically found in brackish and/or inhospitable lake environments and by lower faunal diversities (lowest Shannon Diversity Index values) than samples with lower readings. Q-R-mode cluster analysis and Detrended Correspondence Analysis (DCA) resulted in the recognition of four assemblage groupings. These reflect varying levels of salt contamination in the study lakes, along with other local influences, including nutrient loading. The response to nutrients can, however, be isolated if the planktic eutrophic indicator species Cucurbitella tricuspis is removed from the counts. The findings show that the group have considerable potential for biomonitoring in salt-contaminated lakes, and through application to lake sediment cores, may provide significant insights into long-term benthic community health, which is integral for remedial efforts.

Women (Re)Negotiating Care across Family Generations: Intersections of Gender and Socioeconomic Status

Changing Generations, a study of intergenerational relations in Ireland undertaken between 2011 and 2013 by the Social Policy and Ageing Research Centre (SPARC), Trinity College, Dublin, and the Irish Centre for Social Gerontology (ICSG), NUI Galway, used the Constructivist Grounded Theory method to interrogate support and care provision between generations. This article draws on interviews with 52 women ages 18 to 102, allowing for simultaneous analysis of older and younger women’s perspectives. The intersectionality of gender and class emerged as central to the analysis. Socioeconomic positions shape contrasting forms of interdependency among family generations, ranging from “enmeshed” lives among lower socioeconomic groups to “freed” lives among higher socioeconomic groups. Women are initiating changes in how care and support flow across generations. Older women in higher socioeconomic groups are attuned to how emotional capital women expend across family generations can constrain (young) women’s lives. In an expression of solidarity, older women are renegotiating the place of care labor in their own lives and in the lives of younger women. A new reciprocity emerges that amounts to women “undoing gender.” This process is, however, deeply classed as it is women in higher socioeconomic groups whose resources best place them to renegotiate care.

War, food rationing, and socioeconomic inequality in Germany during the First World War

Germany experienced a devastating period during the First World War due to severely restricted import possibilities and a general shortage of foodstuffs. This study uses the heights of some 4,000 individuals who served during the Second World War to quantify biological living standards from the 1900s to the 1920s, and focuses primarily on socioeconomic inequality during this period. The results suggest that generally the upper social strata, measured by fathers' occupation, exhibited the tallest average height, followed by the middle and lower classes. These socioeconomic differences became more pronounced during the First World War when the rationing system provided a limited food supply. Wealthier individuals were able to purchase additional foodstuffs on black markets. Therefore, children from upper-class families experienced only a small decline in average height compared to their counterparts from the middle and lower social strata.

Anthropometric within-country Inequality and the Estimation of Skill Premia with Anthropometric Indicators

Recently, a method to measure inequality has been proposed that is based on an- thropometric indicators. Baten (1999, 2000) argued that the coefficient of variation of human stature (henceforth ‘CV’) is correlated with overall inequality in a society, and that it can be used as indicator, especially where income inequality measures are lack- ing. This correlation has been confirmed in further analyses, for example by Pradhan et al. (2003), Moradi and Baten (2005), Sunder (2003), Guntupalli and Baten (2006), Blum (2010a), van Zanden et al. (2010), see also Figure 1 and Table 1. The idea is that average height reflects nutritional conditions during early childhood and youth. Since wealthier people have better access to food, shelter and medical resources, they tend to be taller than the poorer part of the population. Hence, the variation of height of a cer- tain cohort may be indicative of income distribution during the decade of their birth. The aim of this study is firstly to provide an overview of different forms of within- country height inequality. Previous studies on the aspects of height inequality are re- viewed. Inequalities between ethnic groups, gender, inhabitants of different regions and income groups are discussed. In the two final sections, we compare height CVs of anthropological inequality with another indicator of inequality, namely skill premia. We also present estimates of skill premia for a set of countries and decades for which “height CVs”, as they will be called in the following, are available.

A Randomized Controlled Trial Evaluation of an After-School Pro-Social Behavior Program in an Area of Socioeconomic Disadvantage

A randomized controlled trial was used to evaluate the effects of a pro-social behavior after-school program called Mate-Tricks for nine and ten year old children and their parents living in an area of significant socioeconomic disadvantage. The children were randomly assigned to an intervention (n=220) or a control group (n=198). Children were compared on measures of pro-social behavior, anti-social behavior and related outcome measures. The trial found adverse effects on four outcomes among the intervention group compared to the control group: anti-social behavior increased on two different measures (d=+0.20) and (d=+0.18); child reported liberal parenting increased (d=+0.16); and child reported authoritarian parenting also increased (d=+0.20). In addition, parental participation was significantly associated with several program outcomes. It was concluded, that group based after-school behavior programs may have the potential to cause iatrogenic effects and must be designed, piloted, evaluated and implemented with a high degree of care.