Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study

Objective. To examine the association between pre-diagnostic circulating vitamin D concentration, dietary intake of vitamin D and calcium, and the risk of colorectal cancer in European populations. Design Nested case-control study. Setting. The study was conducted within the EPIC study, a cohort of more than 520 000 participants from 10 western European countries. Participants: 1248 cases of incident colorectal cancer, which developed after enrolment into the cohort, were matched to 1248 controls. Main outcome measures. Circulating vitamin D concentration (25-hydroxy-vitamin-D, 25-(OH)D) was measured by enzyme immunoassay. Dietary and lifestyle data were obtained from questionnaires. Incidence rate ratios and 95% confidence intervals for the risk of colorectal cancer by 25-(OH)D concentration and levels of dietary calcium and vitamin D intake were estimated from multivariate conditional logistic regression models, with adjustment for potential dietary and other confounders. Results. 25-(OH)D concentration showed a strong inverse linear dose-response association with risk of colorectal cancer (P for trend <0.001). Compared with a pre-defined mid-level concentration of 25-(OH)D (50.0-75.0 nmol/l), lower levels were associated with higher colorectal cancer risk (<25.0 nmol/l: incidence rate ratio 1.32 (95% confidence interval 0.87 to 2.01); 25.0-49.9 nmol/l: 1.28 (1.05 to 1.56), and higher concentrations associated with lower risk (75.0-99.9 nmol/l: 0.88 (0.68 to 1.13); ≥100.0 nmol/l: 0.77 (0.56 to 1.06)). In analyses by quintile of 25-(OH)D concentration, patients in the highest quintile had a 40% lower risk of colorectal cancer than did those in the lowest quintile (P<0.001). Subgroup analyses showed a strong association for colon but not rectal cancer (P for heterogeneity=0.048). Greater dietary intake of calcium was associated with a lower colorectal cancer risk. Dietary vitamin D was not associated with disease risk. Findings did not vary by sex and were not altered by corrections for season or month of blood donation. Conclusions The results of this large observational study indicate a strong inverse association between levels of pre-diagnostic 25-(OH)D concentration and risk of colorectal cancer in western European populations. Further randomised trials are needed to assess whether increases in circulating 25-(OH)D concentration can effectively decrease the risk of colorectal cancer.

Determinants of non- response to a second assessment of lifestyle factors and body weight in the EPIC-PANACEA study.

BACKGROUND This paper discusses whether baseline demographic, socio-economic, health variables, length of follow-up and method of contacting the participants predict non-response to the invitation for a second assessment of lifestyle factors and body weight in the European multi-center EPIC-PANACEA study. METHODS Over 500.000 participants from several centers in ten European countries recruited between 1992 and 2000 were contacted 2-11 years later to update data on lifestyle and body weight. Length of follow-up as well as the method of approaching differed between the collaborating study centers. Non-responders were compared with responders using multivariate logistic regression analyses. RESULTS Overall response for the second assessment was high (81.6%). Compared to postal surveys, centers where the participants completed the questionnaire by phone attained a higher response. Response was also high in centers with a short follow-up period. Non-response was higher in participants who were male (odds ratio 1.09 (confidence interval 1.07; 1.11), aged under 40 years (1.96 (1.90; 2.02), living alone (1.40 (1.37; 1.43), less educated (1.35 (1.12; 1.19), of poorer health (1.33 (1.27; 1.39), reporting an unhealthy lifestyle and who had either a low (<18.5 kg/m2, 1.16 (1.09; 1.23)) or a high BMI (>25, 1.08 (1.06; 1.10); especially ≥30 kg/m2, 1.26 (1.23; 1.29)). CONCLUSIONS Cohort studies may enhance cohort maintenance by paying particular attention to the subgroups that are most unlikely to respond and by an active recruitment strategy using telephone interviews.

Social inequalities and mortality in Europe-results from a large multi-national cohort

BACKGROUND Socio-economic inequalities in mortality are observed at the country level in both North America and Europe. The purpose of this work is to investigate the contribution of specific risk factors to social inequalities in cause-specific mortality using a large multi-country cohort of Europeans. METHODS A total of 3,456,689 person/years follow-up of the European Prospective Investigation into Cancer and Nutrition (EPIC) was analysed. Educational level of subjects coming from 9 European countries was recorded as proxy for socio-economic status (SES). Cox proportional hazard model's with a step-wise inclusion of explanatory variables were used to explore the association between SES and mortality; a Relative Index of Inequality (RII) was calculated as measure of relative inequality. RESULTS Total mortality among men with the highest education level is reduced by 43% compared to men with the lowest (HR 0.57, 95% C.I. 0.52-0.61); among women by 29% (HR 0.71, 95% C.I. 0.64-0.78). The risk reduction was attenuated by 7% in men and 3% in women by the introduction of smoking and to a lesser extent (2% in men and 3% in women) by introducing body mass index and additional explanatory variables (alcohol consumption, leisure physical activity, fruit and vegetable intake) (3% in men and 5% in women). Social inequalities were highly statistically significant for all causes of death examined in men. In women, social inequalities were less strong, but statistically significant for all causes of death except for cancer-related mortality and injuries. DISCUSSION In this European study, substantial social inequalities in mortality among European men and women which cannot be fully explained away by accounting for known common risk factors for chronic diseases are reported.

Macronutrient composition of the diet and prospective weight change in participants of the EPIC-PANACEA study.

BACKGROUND The effect of the macronutrient composition of the usual diet on long term weight maintenance remains controversial. METHODS 373,803 subjects aged 25-70 years were recruited in 10 European countries (1992-2000) in the PANACEA project of the EPIC cohort. Diet was assessed at baseline using country-specific validated questionnaires and weight and height were measured at baseline and self-reported at follow-up in most centers. The association between weight change after 5 years of follow-up and the iso-energetic replacement of 5% of energy from one macronutrient by 5% of energy from another macronutrient was assessed using multivariate linear mixed-models. The risk of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to initial Body Mass Index. RESULTS A higher proportion of energy from fat at the expense of carbohydrates was not significantly associated with weight change after 5 years. However, a higher proportion of energy from protein at the expense of fat was positively associated with weight gain. A higher proportion of energy from protein at the expense of carbohydrates was also positively associated with weight gain, especially when carbohydrates were rich in fibre. The association between percentage of energy from protein and weight change was slightly stronger in overweight participants, former smokers, participants ≥60 years old, participants underreporting their energy intake and participants with a prudent dietary pattern. Compared to diets with no more than 14% of energy from protein, diets with more than 22% of energy from protein were associated with a 23-24% higher risk of becoming overweight or obese in normal weight and overweight subjects at baseline. CONCLUSION Our results show that participants consuming an amount of protein above the protein intake recommended by the American Diabetes Association may experience a higher risk of becoming overweight or obese during adult life.

What social security: Beveridgean or Bismarckian?

Why are Bismarckian social security systems associated with largerpublic pension expenditures, a smaller fraction of private pension andlower income in-equality than Beveridgean systems? These facts arepuzzling for political economy theories of social security whichpredict that Beveridgean systems, involving intra-generationalredistribution, should enjoy larger support among low-income people andthus be larger. This paper explains these features in a bidimensionalpolitical economy model. In an economy with three income groups,low-income support a large, redistributive system; middle-income favoran earning-related system, while high-income oppose any public system,since they have access to a superior saving technology, a privatesystem. We show that, if income inequality is large, the voting majorityof high-income and low-income supports a (small) Beveridgean system,and a large private pillar arises; the opposite occurs with lowinequality. Additionally, when the capital market provides higherreturns, a Beveridgean system is more likely to emerge.

D'une assise locale à un réseau régional : élites et institutions dans la région de Lanaudière (1825-1865)

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Análisis del arrendamiento como alternativa en la política de vivienda de interés social en Colombia. Lecciones y reflexiones aprendidas a partir de la experiencia de Sudáfrica

Los esfuerzos de la presente investigación se concentran en el cumplimiento del objetivo principal, el cual consiste en analizar el arrendamiento como un programa que puede ser incorporado en la política de vivienda en Colombia, para dar respuesta de forma transitoria y/o temporal de alojamiento a los hogares con ingresos iguales o inferiores a dos salarios mínimos, ya que actualmente la política sectorial no incorpora esta forma tenencia de la vivienda para ofertar soluciones habitacionales. El arrendamiento tiene rasgos interesantes e importantes de destacar, tales como que él mismo constituye una forma de tenencia de vivienda eminentemente urbana. Además, es un mercado al que acuden todos los estratos socioeconómicos, por lo cual no es un mercado segregado. Igualmente, al relacionar ésta tenencia con el territorio y por ende con la economía espacial, se puede decir que no existe segregación socio-espacial muy pronunciada frente a la distribución urbana de la tenencia de la vivienda en arrendamiento. En este sentido, la tenencia de la vivienda en forma de arrendamiento se presenta en todo el territorio urbano de Cali, Medellín y Bogotá.

Aportes de la inversión social publico - privada a la sostenibilidad de estrategias de superación de pobreza extrema sopó cundinamarca (2009 - 2012)

El presente Estudio de Caso tiene como objetivo describir la estrategia de superación de la pobreza extrema en el municipio de Sopó Cundinamarca y la importancia de los aportes de la inversión social público -privada para sostenibilidad de éstas.

El honor como expresión de la conciencia colectiva en la sociedad del Virreinato de la Nueva Granada, 1760 - 1810

Este documento ofrece un análisis sociológico del papel que cumplía el honor como valor en la sociedad neogranadina a finales de la Colonia a partir de algunos conceptos clave que ofrecen autores clásicos de la disciplina. El honor se puede enmarcar dentro de lo que algunos autores han denominado solidaridades sociales o conciencia colectiva. Es decir, dentro del conjunto de creencias y valores compartidos por los integrantes de una misma sociedad. Dado que para la época estudiada la herencia española en torno al honor ya había logrado un alto nivel de arraigo, es posible pensar que el interés por proteger el honor hacía parte del sentimiento común en la sociedad neogranadina. Y es que el hecho de que la noción de honor estuviese anclada en los valores religiosos, que tanto la Iglesia como la Corona promovieron, condujo a que el fundamento del honor tuviese un carácter moral, logrando así una alta difusión dentro del territorio americano. La idea del honor determinaba, en buena medida, los parámetros del orden social deseado.

The emergence of integrated private reporting

Purpose: Private social and environmental reporting (SER) has grown considerably in recent years, consistent with a rise in institutional investor engagement and dialogue with investee companies. We interpret the emergence of integrated private reporting through the lens of institutional logics. We frame the emergence of integrated private reporting as a merging of two hitherto separate and possibly rival institutional logics. Methodology/Approach: We interviewed 19 companies listed on the FTSE100 and 20 UK institutional investors. The interviews were semi-structured and analysed in an interpretive fashion. Findings and Implications: We provide evidence to suggest that private SER is beginning to merge with private financial reporting and that, as a result integrated private reporting is emerging. This trend is mirroring the international trend in public reporting toward an integrated approach. Specifically, we find that specialist social responsible investment managers are starting to attend private financial reporting meetings whilst mainstream fund managers are starting to attend private meetings on environmental, social and governance (ESG) issues. Further, senior company directors are becoming increasingly conversant with ESG issues. We interpret our findings as two possible scenarios: (i) there is a genuine hybridisation occurring in UK institutional investment such that integrated private reporting is emerging, or; (ii) the financial logic is absorbing and effectively neutralising the responsible investment logic. Originality: This is the first research investigating the evolution of private integrated reporting.

Health care rights and NHS rationing: turning theory into practice

How should we understand the nature of patients’ right in public health care systems? Are health care rights different to rights under a private contract for car insurance? This article distinguishes between public and private rights and the relevance of community interests and notions of social solidarity. It discusses the distinction between political and civil rights, and social and economic rights and the inherently political and redistributive nature of the latter. Nevertheless, social and economic rights certainly give rise to “rights” enforceable by the courts. In the UK (as in many other jurisdictions), the courts have favoured a “procedural” approach to the question, in which the courts closely scrutinise decisions and demand high standards of rationality from decision-makers. However, although this is the general rule, the article also discusses a number of exceptional cases where “substantive” remedies are available which guarantee patients access to the care they need.

Formation of social capital in Eastern Europe : explaining the gap vis-à-vis developed countries

Recent Eurobarometer survey data are used to document and explain the leveI of social capital in thirteen new members and fifteen current members of the European Union. Social capital in Eastern Europe - measured by participation in clubs and organization, intensity of networks or altruistic behavior - lags behind that in developed countries. The differences in individual-leveI determinants cannot fully account for the gap at the aggregate leveI. Once we also include aggregate measures of economic development and quality of institutions, the gap disappears. This implies that the EU enlargement will contribute to a convergence in social capital, assuming that it contributes to the economic and institutional development of Eastern European countries. A necessary condition is that both, formal and informal institutions and their interaction should be regarded in this process.

Responsabilidade social e investimento social privado na empresa GTECH Brasil: estudo de caso

Esta dissertação traça uma trajetória, evitando, no entanto, uma linha evolucionista, dos termos e conceitos que foram usados no decorrer da história para identificar as intervenções das empresas em ações sociais, desde as atuações assistencialistas até a atuação direta em projetos, com criação de institutos e fundações ligados às empresas, compartilhando não só investimentos financeiros, mas conhecimento, tecnologia e mão de obra especializada. Mas, como veremos, só isso não é suficiente para que uma empresa seja caracterizada como socialmente responsável. Como parâmetro, será trabalhada a diferenciação entre responsabilidade social empresarial (RSE) e investimento social privado (ISP), usando as definições e modelos do Instituto Ethos de Responsabilidade Social e do Grupo de Institutos e Fundações e Empresas (GIFE), respectivamente. Como estudo de caso, será apresentada a GTECH Brasil, empresa multinacional do ramo de loterias online, que, para realizar ações sociais, criou o Instituto Gtech de Cidadania e Cultura (IGCC), em 2000. A empresa, fazendo uso da verba disponível de incentivo à cultura, com a Lei Rouanet, realizou um projeto corporativo de arte-educação, chamado Projeto Asa, que tinha por foco trabalhar com jovens de sete a 17 anos, englobando arte e tecnologia. Por acreditar no poder transformador da arte, o projeto foi se atualizando e passou a desenvolver o conceito de arte-cidadania. O Asa funcionou até 2009, durando mais do que a própria empresa, que, em 2006, encerrou as atividades no Brasil. Nesse período, atendeu a mais de 3.500 crianças e jovens. Por meio de documentos, manuais, relatórios e diversas entrevistas, o presente trabalho delineou as atividades sociais da GTECH, analisando se a empresa deveria se enquadrar como RSE ou ISP e também demonstrando alguns dos impactos gerados pelas ações realizadas tanto nos funcionários da empresa, quanto na equipe do projeto e, principalmente, nos jovens que participaram das atividades.

A avaliação do impacto social de projetos em parceria com o Estado: um novo olhar sobre o “accountability” do financiamento de projetos sociais

O relatório de prestação de contas do recurso investido em projetos oriundos de parcerias entre o Estado e as organizações da sociedade civil não pode ser a única forma de avaliação da aplicação de recursos públicos. O presente trabalho analisa a necessidade de ampliar a ótica atual do accountability praticado pelo poder público, com o objetivo de incluir a avaliação do impacto social na análise dos recursos investidos em projetos de parcerias sociais público-privadas. A análise do impacto social provoca alterações substanciais no planejamento de políticas públicas abarcadas pelos projetos implementados. O diagnóstico da eficiência e a eficácia dos recursos investidos em parcerias sociais público-privadas é concretizado com a avaliação do impacto social do projeto.

Gestão Social em Empreendimentos Econômicos Solidários: uma abordagem no Oeste Potiguar

The central research question was to search for data to ratify the theory and discourse of the so-called practitioners of economic solidarity, by defending the substantive rationality should guide the principles of economic solidary, designing the space economy incidental and not the primacy of relations in determining social as well, reflecting the predominance of dimensions of social management in administrative practices of ESS's. For both analyzed the theoretical dimensions of social management - sociopolitical, economic, organizational and environmental - manifested in organizational practices supportive of economic organization Potiguar West. For the success of the research realized the triangulation involving a combination of quantitative and qualitative methodological approaches. At first the research will use a quantitative approach, from the cluster analysis, to verify the behavior of the sample chosen for this study. In the second stage of the qualitative study was carried out focus group technique (FLICK, 2002) for further analysis of the dimensions of social management on organizational practices supportive of economic organization, related to the principles of Solidary Economy, established in a quantitative approach. In quantitative analysis, the socio-political dimension, it was clear that the more equity instruments of internal and external, from the purposeful living in public spaces, the best monetary results. Another point worth stressing concerns the economic dimension, with the practice reciprocity prevailing in market. Thus, the qualitative approach was possible to understand the processes of exchange of product or service. Rural enterprises surveyed in the allocation of the agro-ecological products have the following scale of priority, sequentially: self-consumption (domestic), market and exchange. The research leads to the fact that training and practices that enhance the socio-political dimension (knowledge, empowerment, sense of belonging) become the guiding principle for the strengthening of the social management in the context of other dimensions, leading to gains sociopolitical, economic, organizational and environmental. Despite the weaknesses found in the organizational dimension and environment, both in a quantitative as in qualitative, we determined that the practices of ESS's Potiguar West incorporate predominantly elements of social management and economic solidarity, with a preponderance of substantive rationality in the primacy of the instrumental. Finally, research has brought information that the participants of the ESS's do not give the money economy primacy in determining social relations, which in turn leads to the confirmation that, in practice the solidarity economy, prevailing the dominance of substantive rationality, as a guide for organizational practices