Vitamin D and mortality: meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States

Objective: To investigate the association between serum 25-hydroxyvitamin D concentrations (25(OH)D) and mortality in a large consortium of cohort studies paying particular attention to potential age, sex, season, and country differences.

Design: Meta-analysis of individual participant data of eight prospective cohort studies from Europe and the US.

Setting: General population.

Participants: 26 018 men and women aged 50-79 years

Main outcome measures: All-cause, cardiovascular, and cancer mortality.

Results: 25(OH)D concentrations varied strongly by season (higher in summer), country (higher in US and northern Europe) and sex (higher in men), but no consistent trend with age was observed. During follow-up, 6695 study participants died, among whom 2624 died of cardiovascular diseases and 2227 died of cancer. For each cohort and analysis, 25(OH)D quintiles were defined with cohort and subgroup specific cut-off values. Comparing bottom versus top quintiles resulted in a pooled risk ratio of 1.57 (95% CI 1.36 to 1.81) for all-cause mortality. Risk ratios for cardiovascular mortality were similar in magnitude to that for all-cause mortality in subjects both with and without a history of cardiovascular disease at baseline. With respect to cancer mortality, an association was only observed among subjects with a history of cancer (risk ratio, 1.70 (1.00 to 2.88)). Analyses using all quintiles suggest curvilinear, inverse, dose-response curves for the aforementioned relationships. No strong age, sex, season, or country specific differences were detected. Heterogeneity was low in most meta-analyses.

Conclusions: Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.

Article 23: Equality between women and men

This analysis of Article 23 CFREU (Charter of Fundamental Rights for the European Union) argues that this provision can promote a more progressive understanding of gender equality then promoted by the European Court of Justice, in that it requires actual change in gender relations. It also finds shortcomings in that the EU conceptualises gender equality by relating women to men, thus falling short of providing a basis for women's rights.

It's a WRAP: Delivering Wellness for Women in the UK

Wellness Recovery Action Planning (WRAP) was first created by Mary Ellen Copeland in 1997 and reinforced the concept of people taking individual responsibility for their health status and wellbeing. To fuel personal responsibility for one's health status, Mary Ellen purported that it was necessary for the person to tap into their inner drive and resources with a view to owning their health. This concept has been widely accepted and disseminated within the field of mental health but has not yet been fully embraced by other professions, such as midwifery. In this piece, the authors highlight the recovery and wellness ethos inherent in the current zeitgeist of healthcare and discuss how WRAP could be utilised by midwives to facilitate the wellness of women during the antenatal period and beyond.

Midwifery Services in South Africa and the UK

This comparative study examines the UK and South Africa's maternity services. The study focuses on HIV in pregnancy, and attitudes to, and rates of, breastfeeding in the two countries. Similarities exist between the countries demographics, i.e. both have a diverse population. However, the study found that there is wide variation in both the attitudes to, and rates of, breastfeeding, and HIV in pregnancy between the countries. Yet despite being financially challenged, both countries offer support to HIV positive and breastfeeding women.

The Shakespearean Auteur and the Televisual Medium

In the wake offundamental shifts in television, programming and production have seen television creations which rival—even go beyond—standard cinema in scope, length and character development. This essay takes the distinctive approach of applying auteur theory to the small screen, exploring what understandings of the auteur might mean for a new era of television Shakespeare, and, as its case-study, considers the BBC’s Hollow Crown series. Characterized by a feature-film appearance, a multimillion pound budget, and an all-star cast, the series is exemplary of how television is now made; hence, the essay argues, the series needs to be investigated in relation to the most recent understandings of the medium. Central to this investigation is the way in which producer Sam Mendes’s vision imprintsitself upon each of the series’s four episodes, and the first part of the essay is accordingly concerned with his recognizable style and credentials as the series “showrunner.” However, Mendes’s is not the only auteurial stamp on the series, and the essay is equally concerned with how each of Mendes’s three co-directors places his or her auteurial signature on the Shakespearean source material in such a way as to lend each production a unique character. These individualized creative visions, the essay argues, unfold in concert with Mendes’s conceptualization of the series in its entirety. Ultimately, televisual auteurism is understood as a complex phenomenon that allows for more than one creative approach to be entertained.

‘“Indelible characters”:Tattoos, Power and the Late Nineteenth-Century Irish Convict Body

Since the late nineteenth-century works of criminologists Lombroso and Lacassagne, tattoos in Europe have been commonly associated with deviant bodies. Like many other studies of tattoos of non-indigenous origin, the locus of our research is the convict body. Given the corporeal emphasis of prison records, we argue that tattoos form a crucial part of the power dynamic. Tattoos in the carceral context embody an inherent paradox of their being a component in the reidentification of 'habitual criminals'. We argue that their presence can be regarded as an expression of convict agency: by the act of imprinting unique identifiers on their bodies, convicts boldly defied the official gaze, while equally their description in official records exacted power over the deviant body. Cursory findings show an alignment with other national studies; corporeal inscriptions in Ireland were more prevalent in men's prisons than women's and associated, however loosely, with certain occupations. For instance, maritime and military motifs find representation. Recidivists were more likely to have tattoos than first-time offenders; inscriptions were described as monotone, rudimentary in design and incorporated a limited range of impressions. Further to our argument that tattoos form an expression of convict defiance of prison authority, we have found an unusual idiosyncrasy in the convict record, that is, that the agency of photography, while undermined in general terms, was manipulated by prison officers.

The Victorian Press and the Fairy Tale (paperback)

Victorian writers often claimed that the press was killing the fairy tale. In fact, it ensured the genre's popularity, bringing literary tales and folklore to the first mass readerships. Exploring penny weeklies, adult and children's monthlies, little magazines and the labour press, this innovative study is the first to combine media and fairy tale history. Bringing reading communities back into focus, Sumpter explores ingenious political uses of the fairy tale: in debates over socialism, evolution and race, and in the context of women's rights, decadence and gay culture. The book offers new insights into the popularisation of folklore and comparative science, and also recovers neglected visual material. From the fantasies of Kingsley, MacDonald and J. H. Ewing to the writings of Keir Hardie, Laurence Housman and Yeats, Sumpter reveals that the fairy tale was intimately shaped by the press, and that both were at the heart of nineteenth-century culture.

The paperback edition includes a new Preface.

The Ulster Covenant and the Pulse of Protestant Ulster

The signing of the Ulster Covenant on 28 September 1912 by almost 450,000 men and women was a powerful act of defiance on the part of Unionists in the context of what they perceived as the threat to their way of life represented by the Liberal Government's policy of Irish Home Rule. This article attempts to look beyond the well-studied leadership figures of Carson and Craig in order to fashion insights into the way Ulster Protestant society was mobilised around the Covenant and opposition to Home Rule. It draws attention to hitherto over-shadowed personalities who can be said to have exerted crucial local influence. It also contends that although pan-Protestant denominational unity provided the basis for the success of the Covenant, the Presbyterian community was particularly cohesive and purposeful in the campaign. The article further argues that the risk-taking defiance that came more easily to the Presbyterians, on account of a troubled history, largely evaporated in the new political circumstances of Northern Ireland when it became a separate devolved political entity within the UK from 1921.

Is the multiracial congregation an answer to the problem of race? Comparative perspectives from South Africa and the USAF

This paper uses a comparative perspective to analyze how multiracial congregations may contribute to racial reconciliation in South Africa. Drawing on the large-scale study of multiracial congregations in the USA by Emerson et al., it examines how they help transform antagonistic identities and make religious contributions to wider reconciliation processes. It compares the American research to an ethnographic study of a congregation in Cape Town, identifying cross-national patterns and South African distinctives, such as discourses about restitution, AIDS, inequality and women. The extent that multiracial congregations can contribute to reconciliation in South Africa is linked to the content of their worship and discourses, but especially to their ability to dismantle racially aligned power structures. © Koninklijke Brill NV, 2008.

Finding Merit in Judicial Appointments: NIJAC and the Search for a New Judiciary in Northern Ireland

The post-Agreement constitutional architecture has produced a new legal space in Northern Ireland. While the court structure has largely endured in a recognisable format there are perhaps now new expectations of how it will function in the next stage of Northern Ireland’s transition from a society in conflict. These expectations come into focus around the nature and role of the judiciary that is to oversee this new legal space. At the same time there are other, wider forces pressing upon the judiciary across the United Kingdom and these are being acted out in the various appointment commissions and regimes that have been created to modernise the judiciary. This all contributes to establishing a dynamic context for considering whether and/or how the judiciary in Northern Ireland is changing, and the forces that may be conditioning any change. This chapter looks at some of the expectations that might arise for the judiciary. It focuses both on some ideas about what might be the role of a judge in a transitional context, and the debate about how judges generally should be appointed across the United Kingdom where the idea of “merit” emerges as governing concept. Next consideration is given to how this idea of merit plays out in the Northern Ireland context and, in particular, how it impacts on the appointment of women to senior judicial roles which has emerged as the central concern in the new dispensation. Here the chapter draws on two pieces of research: the first looking at the issues surrounding judicial appointments and attitudes towards seeking such posts in the Northern Ireland context, and a second project where the idea of “merit” as a governing factor in judicial appointment was further explored in focus groups and interviews. Finally the chapter looks ahead at the challenges around judicial appointment that remain and suggests that notion of ‘merit’ has not provided the robust foundation which its proponents imagined it would.

Gene expression and epigenetic discovery screen reveal methylation of SFRP2 in prostate cancer

Aberrant activation of Wnts is common in human cancers, including prostate. Hypermethylation associated transcriptional silencing of Wnt antagonist genes SFRPs (Secreted Frizzled-Related Proteins) is a frequent oncogenic event. The significance of this is not known in prostate cancer. The objectives of our study were to (i) profile Wnt signaling related gene expression and (ii) investigate methylation of Wnt antagonist genes in prostate cancer. Using TaqMan Low Density Arrays, we identified 15 Wnt signaling related genes with significantly altered expression in prostate cancer; the majority of which were upregulated in tumors. Notably, histologically benign tissue from men with prostate cancer appeared more similar to tumor (r = 0.76) than to benign prostatic hyperplasia (BPH; r = 0.57, p < 0.001). Overall, the expression profile was highly similar between tumors of high (≥ 7) and low (≤ 6) Gleason scores. Pharmacological demethylation of PC-3 cells with 5-Aza-CdR reactivated 39 genes (≥ 2-fold); 40% of which inhibit Wnt signaling. Methylation frequencies in prostate cancer were 10% (2/20) (SFRP1), 64.86% (48/74) (SFRP2), 0% (0/20) (SFRP4) and 60% (12/20) (SFRP5). SFRP2 methylation was detected at significantly lower frequencies in high-grade prostatic intraepithelial neoplasia (HGPIN; 30%, (6/20), p = 0.0096), tumor adjacent benign areas (8.82%, (7/69), p < 0.0001) and BPH (11.43% (4/35), p < 0.0001). The quantitative level of SFRP2 methylation (normalized index of methylation) was also significantly higher in tumors (116) than in the other samples (HGPIN = 7.45, HB = 0.47, and BPH = 0.12). We show that SFRP2 hypermethylation is a common event in prostate cancer. SFRP2 methylation in combination with other epigenetic markers may be a useful biomarker of prostate cancer.

Violence against women in the Irish War of Independence, 1919-1921

This chapter examines the nature and extent of violence experienced by women in Ireland during the Irish War of Independence (1919-1921) at the hands of both the Crown forces and the Irish Republican Army. It argues that targetted killings of women by either side was rare. The most common forms of such violence can be categorised as physical, gendered (cutting of hair) and psychological (intimidation and the killing of male relatives). It argues that there was a difference between gendered and sexual crime, the latter of which appears to have been very uncommon. A considerable part of the chapter uses theoretical literature on violence against women in conflict zones to explain why sexual violence was uncommon, arguing that neither side had much to gain from its employment, that the Crown forces were aware of the damage it could do to Britain's international reputation and that the terror tactics adopted by the Crown forces were sufficient to achieve their ends without resorting to rape. In regard to the IRA, the absence of any evidence of rape or sexual assault being perpetrated could be attributable to their Catholicism, reliance on support from the community, the efforts of the first Dáil to achieve foreign recognition of the Republic and the role of Cumann na mBan women in the guerrilla conflict. The historiography of women in the Irish revolution is also analysed.

Effect of major lifestyle risk factors, independent and jointly, on life expectancy with and without cardiovascular disease: results from the Consortium on Health and Ageing Network of Cohorts in Europe and the United States (CHANCES)

Seldom have studies taken account of changes in lifestyle habits in the elderly, or investigated their impact on disease-free life expectancy (LE) and LE with cardiovascular disease (CVD). Using data on subjects aged 50+ years from three European cohorts (RCPH, ESTHER and Tromsø), we used multi-state Markov models to calculate the independent and joint effects of smoking, physical activity, obesity and alcohol consumption on LE with and without CVD. Men and women aged 50 years who have a favourable lifestyle (overweight but not obese, light/moderate drinker, non-smoker and participates in vigorous physical activity) lived between 7.4 (in Tromsø men) and 15.7 (in ESTHER women) years longer than those with an unfavourable lifestyle (overweight but not obese, light/moderate drinker, smoker and does not participate in physical activity). The greater part of the extra life years was in terms of "disease-free" years, though a healthy lifestyle was also associated with extra years lived after a CVD event. There are sizeable benefits to LE without CVD and also for survival after CVD onset when people favour a lifestyle characterized by salutary behaviours. Remaining a non-smoker yielded the greatest extra years in overall LE, when compared to the effects of routinely taking physical activity, being overweight but not obese, and drinking in moderation. The majority of the overall LE benefit is in disease free years. Therefore, it is important for policy makers and the public to know that prevention through maintaining a favourable lifestyle is "never too late".

Novel functional interaction between the plasma membrane Ca2+ pump 4b and the proapoptotic tumor suppressor Ras-associated factor 1 (RASSF1)

Plasma membrane calmodulin-dependent calcium ATPases (PMCAs) are enzymatic systems implicated in the extrusion of calcium from the cell. We and others have previously identified molecular interactions between the cytoplasmic COOH-terminal end of PMCA and PDZ domain-containing proteins. These interactions suggested a new role for PMCA as a modulator of signal transduction pathways. The existence of other intracellular regions in the PMCA molecule prompted us to investigate the possible participation of other domains in interactions with different partner proteins. A two-hybrid screen of a human fetal heart cDNA library, using the region 652-840 of human PMCA4b (located in the catalytic, second intracellular loop) as bait, revealed a novel interaction between PMCA4b and the tumor suppressor RASSF1, a Ras effector protein involved in H-Ras-mediated apoptosis. Immunofluorescence co-localization, immunoprecipitation, and glutathione S-transferase pull-down experiments performed in mammalian cells provided further confirmation of the physical interaction between the two proteins. The interaction domain has been narrowed down to region 74-123 of RASSF1C (144-193 in RASSF1A) and 652-748 of human PMCA4b. The functionality of this interaction was demonstrated by the inhibition of the epidermal growth factor-dependent activation of the Erk pathway when PMCA4b and RASSF1 were co-expressed. This inhibition was abolished by blocking PMCA/RASSSF1 association with an excess of a green fluorescent protein fusion protein containing the region 50-123 of RASSF1C. This work describes a novel protein-protein interaction involving a domain of PMCA other than the COOH terminus. It suggests a function for PMCA4b as an organizer of macromolecular protein complexes, where PMCA4b could recruit diverse proteins through interaction with different domains. Furthermore, the functional association with RASSF1 indicates a role for PMCA4b in the modulation of Ras-mediated signaling.