Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men

Both subjective and objective measures of lower social position have been shown to be associated with poorer health. A psychosocial, as opposed to material, aetiology of health inequalities predicts that subjective social status should be a stronger determinant of health than objective social position. In a workplace based prospective study of 5232 Scottish men recruited in the early 1970s and followed up for 25 years we examined the association between objective and subjective indices of social position, perceived psychological stress, cardiovascular disease risk factors and subsequent health. Lower social position, whether indexed by more objective or more subjective measures, was consistently associated with an adverse profile of established disease risk factors. Perceived stress showed the opposite association. The main subjective social position measure used was based on individual perceptions of workplace status (as well as their actual occupation, men were asked whether they saw themselves as “employees”, “foremen”, or “managers”). Compared to foremen, employees had a small and imprecisely estimated increased risk of all cause mortality, whereas managers had a more marked decreased risk. The strongest predictors of increased mortality were father's manual as opposed to non-manual occupation; lack of car access and shorter stature, (an indicator of material deprivation in childhood). In the fully adjusted analyses, perceived work-place status was only weakly associated with mortality. In this population it appears that objective material circumstances, particularly in early life, are a more important determinant of health than perceptions of relative status. Conversely, higher perceived stress was not associated with poorer health, presumably because, in this population, higher stress was not associated with material disadvantage. Together these findings suggest that, rather than targeting perceptions of disadvantage and associated negative emotions, interventions to reduce health inequalities should aim to reduce objective material disadvantage, particularly that experienced in early life

Limitations of adjustment for reporting tendency in observational studies of stress and self reported coronary heart disease

Recently, observational evidence has been suggested to show a causal association between various "psychosocial" exposures, including psychological stress, and heart disease. Much of this evidence derives from studies in which a self reported psychosocial exposure is related to an outcome dependent on the subjective experience of coronary heart disease (CHD) symptoms. Such outcomes may be measured using standard symptom questionnaires (like the Rose angina schedule). Alternatively they may use diagnoses of disease from medical records, which depend on an individual perceiving symptoms and reporting them to a health worker. In these situations, reporting bias may generate spurious exposure-outcome associations. For example if people who perceive and report their life as most stressful also over-report symptoms of cardiovascular disease then an artefactual association between stress and heart disease will result

Individual employment histories and subsequent cause specific hospital admissions and mortality: a prospective study of a cohort of male and female workers with 21 years follow up

It is a widely held view that the labour market is demanding increased levels of flexibility, and that this is causing greater psychosocial stress among employees.1 Such stress may affect health, either through neuroendocrine pathways, or through increases in behaviours linked with poor health.2 Previously we presented evidence linking an unstable employment history, as measured by a greater number of job changes and shorter duration of current job, with a greater prevalence of smoking and greater alcohol consumption, in male and female workers.3 4 Despite this, we did not observe clear detrimental effects of such instability on health related physiological measures (body mass index, diastolic blood pressure, cholesterol, and lung function), nor on current cardiovascular health (electrocardiogram determined ischaemia and reported symptoms of angina). Finding work is easier for healthy persons, and those persons who need to find work repeatedly will be particularly likely to drop out of the workforce if their health deteriorates. Consequently, an occupational cohort, upon which our previous work was based, is least likely to include people of poor health with an unstable work history. If such people are underrepresented, attempts to determine the association between health and individual work histories will mislead. This study links the same cohort to information on the hospitalisations and deaths experienced over a 21 year follow up period. While those people whose health deteriorated before the enrolment of this cohort must remain poorly represented, these prospective data permit unbiased observation of those cases who experienced ill health subsequently, whether or not this resulted in an exit from the workforce. We hypothesise that an employment history characterised by frequent job changes, whatever the motivation for those changes, will require the person to be more focused on work, and less focused on maintaining personal health, with consequent poorer health for such people

Cause-specific hospital admission and mortality among working men: association with socioeconomic circumstances in childhood and adult life, and the mediating role of daily stress

BACKGROUND: The aim of this study was to investigate the association of childhood and adulthood social class with the occurrence of specific diseases, including those not associated with a high mortality rate, and to investigate daily stress as the mechanism for that part of any association which cannot be accounted for by established risk factors. METHODS: This was a prospective cohort study with 25 years of follow-up for cause-specific morbidity and mortality. A total of 5577 Scottish men were recruited from 27 workplaces in the West of Scotland. Childhood social class was determined from the occupation held by the individual's father, and adulthood social class from the individual's occupation at enrolment. Daily stress was measured at enrolment using the Reeder Stress Inventory. RESULTS: Health differentials were found for cardiovascular diseases, lung cancer, peptic ulcer, asthma, accidents and violence, alcohol-related diseases, and perhaps psychiatric illness. Adulthood circumstances were associated with the incidence of most diseases in adulthood, the exception being stroke, which was strongly associated with less privileged circumstances in childhood. Both childhood and adulthood circumstances contributed to the incidence of coronary heart disease. Daily stress did not underlie any of these associations once the influence of established risk factors had been taken into account. CONCLUSIONS: Socioeconomic circumstances in childhood and adulthood both contribute to health differentials in adulthood, the relative contributions depending upon the particular disease. Where known risk factors explained only part of the excess of a disease among individuals raised or living in less-privileged circumstances, there was no evidence to suggest that daily stress was the reason for the unexplained excess

Upconversion of a relativistic Coulomb field terahertz pulse to the near infrared

We demonstrate the spectral upconversion of a unipolar subpicosecond terahertz (THz) pulse, where the THz pulse is the Coulomb field of a single relativistic electron bunch. The upconversion to the optical allows remotely located detection of long wavelength and nonpropagating components of the THz spectrum, as required for ultrafast electron bunch diagnostics. The upconversion of quasimonochromatic THz radiation has also been demonstrated, allowing the observation of distinct sum- and difference-frequency mixing components in the spectrum. Polarization dependence of first and second order sidebands at ωopt±ωTHz, and ωopt±2ωTHz, respectively, confirms the χ(2) frequency mixing mechanism

Two \u3ci\u3eEntomophthora\u3c/i\u3e Species Associated with Disease Epizootics of the Alfalfa Weevil, \u3ci\u3eHypera Postica\u3c/i\u3e (Coleoptera: Curculionidae), in Ontario

Recent studies have shown that disease epizootics in Ontario populations of the alfalfa weevil, Hypera postica (Gyllenhal), are caused by a complex of two fungi

The best practice for preparation of samples from FTA®cards for diagnosis of blood borne infections using African trypanosomes as a model system

Background: Diagnosis of blood borne infectious diseases relies primarily on the detection of the causative agent in the blood sample. Molecular techniques offer sensitive and specific tools for this although considerable difficulties exist when using these approaches in the field environment. In large scale epidemiological studies, FTA®cards are becoming increasingly popular for the rapid collection and archiving of a large number of samples. However, there are some difficulties in the downstream processing of these cards which is essential for the accurate diagnosis of infection. Here we describe recommendations for the best practice approach for sample processing from FTA®cards for the molecular diagnosis of trypanosomiasis using PCR. Results: A comparison of five techniques was made. Detection from directly applied whole blood was less sensitive (35.6%) than whole blood which was subsequently eluted from the cards using Chelex®100 (56.4%). Better apparent sensitivity was achieved when blood was lysed prior to application on the FTA cards (73.3%) although this was not significant. This did not improve with subsequent elution using Chelex®100 (73.3%) and was not significantly different from direct DNA extraction from blood in the field (68.3%). Conclusions: Based on these results, the degree of effort required for each of these techniques and the difficulty of DNA extraction under field conditions, we recommend that blood is transferred onto FTA cards whole followed by elution in Chelex®100 as the best approach

Novel African trypanocidal agents: membrane rigidifying peptides

The bloodstream developmental forms of pathogenic African trypanosomes are uniquely susceptible to killing by small hydrophobic peptides. Trypanocidal activity is conferred by peptide hydrophobicity and charge distribution and results from increased rigidity of the plasma membrane. Structural analysis of lipid-associated peptide suggests a mechanism of phospholipid clamping in which an internal hydrophobic bulge anchors the peptide in the membrane and positively charged moieties at the termini coordinate phosphates of the polar lipid headgroups. This mechanism reveals a necessary phenotype in bloodstream form African trypanosomes, high membrane fluidity, and we suggest that targeting the plasma membrane lipid bilayer as a whole may be a novel strategy for the development of new pharmaceutical agents. Additionally, the peptides we have described may be valuable tools for probing the biosynthetic machinery responsible for the unique composition and characteristics of African trypanosome plasma membranes