Contribution of modifiable risk factors to social inequalities in type 2 diabetes: prospective Whitehall II cohort study.

OBJECTIVE: To assess the contribution of modifiable risk factors to social inequalities in the incidence of type 2 diabetes when these factors are measured at study baseline or repeatedly over follow-up and when long term exposure is accounted for. DESIGN: Prospective cohort study with risk factors (health behaviours (smoking, alcohol consumption, diet, and physical activity), body mass index, and biological risk markers (systolic blood pressure, triglycerides and high density lipoprotein cholesterol)) measured four times and diabetes status assessed seven times between 1991-93 and 2007-09. SETTING: Civil service departments in London (Whitehall II study). PARTICIPANTS: 7237 adults without diabetes (mean age 49.4 years; 2196 women). MAIN OUTCOME MEASURES: Incidence of type 2 diabetes and contribution of risk factors to its association with socioeconomic status. RESULTS: Over a mean follow-up of 14.2 years, 818 incident cases of diabetes were identified. Participants in the lowest occupational category had a 1.86-fold (hazard ratio 1.86, 95% confidence interval 1.48 to 2.32) greater risk of developing diabetes relative to those in the highest occupational category. Health behaviours and body mass index explained 33% (-1% to 78%) of this socioeconomic differential when risk factors were assessed at study baseline (attenuation of hazard ratio from 1.86 to 1.51), 36% (22% to 66%) when they were assessed repeatedly over the follow-up (attenuated hazard ratio 1.48), and 45% (28% to 75%) when long term exposure over the follow-up was accounted for (attenuated hazard ratio 1.41). With additional adjustment for biological risk markers, a total of 53% (29% to 88%) of the socioeconomic differential was explained (attenuated hazard ratio 1.35, 1.05 to 1.72). CONCLUSIONS: Modifiable risk factors such as health behaviours and obesity, when measured repeatedly over time, explain almost half of the social inequalities in incidence of type 2 diabetes. This is more than was seen in previous studies based on single measurement of risk factors.

RATHMANN, Michael (ed. ). Studien zur antiken Geschichtsschreibung. Bonn : Habelt GMBH, 2009

No menos útil que la escritura de la historia para conocer lo que sucedió realmente es analizar las maneras de escribir esa misma historia para saber qué motivaciones, intenciones, fi lias o fobias latieron bajo la prosa de un historiador, un arte del que ya la misma antigüedad nos brindó excelentes ejercicios, por citar dos ejemplos ilustres, como la Maledicencia de Heródoto, de Plutarco, o el Cómo se debe escribir la historia, de Luciano de Samosata. A esa labor tan interesante se dedicó, en diciembre de 2006, un coloquio en el Institut für Geschichtswissenschaft, Abteilung Alte Geschichte de la Rheinische Friedrich- Wilhelms-Universität de Bonn y con el no menos importante motivo de festejar el octogésimo aniversario de una celebridad de la historia antigua como la del profesor Gerhard Wirth.

Le pilote du Danube / Jules Verne ; illustrations par George Roux...

Collection : Les voyages extraordinaires

Un billet de loterie, le numéro 9672 ; Suivi de Frritt-Flacc / par Jules Verne ; dessins par George Roux

Collection : Bibliothèque d'éducation et de récréation

Le village aérien / par Jules Verne... ; dessins par George Roux...

Collection : Les voyages extraordinaires

Oeuvres de George Sand. 10

Collection : Bibliothèque choisie