bluuebunny/crossref_metadata_2025_split huggingface dataset:
OP18 Does Dementia Risk Begin in Early Life? Examining the Relationship Between Height and Dementia Mortality in an Individual Participant Meta-analysis of 181,800 People from Eighteen Prospective Cohort Studies
Authors: Russ T C , Kivimaki M , Stamatakis E , Starr J , Batty G D 
Published: September 2013

BackgroundRisk factors measured in middle age do not fully explain the occurrence of future dementia risk. This raises the possibility that pre-adult risk factors may be implicated in its aetiology. Height is a proxy for early life circumstances (early life illness, adversity, nutritional privation, or psychosocial stress). Lower physical stature is associated with elevated cardiovascular disease (CVD) rates. Since CVD and dementia have a shared aetiology, we examined the little-explored association between height and later-life dementia. This individual participant meta-analysis is the largest study to date to examine this relationship.MethodsWe pooled raw data from 18 country-wide, independent, prospective cohort studies comprising the Health Survey for England (N = 15) and the Scottish Health Survey (N = 3). Between 1994 and 2008, a total of 181,800 people aged 16 years or older participated in baseline surveys. Height was measured to the nearest millimetre with shoes removed with the study member stretching to their maximum height. Covariate data, including health behaviours, weight, self-reported general health, and socioeconomic status were quantified using standard protocols. Cause-specific mortality was ascertained through linkage to national mortality registersResultsA mean follow-up of 10 years gave rise to 426 dementia deaths in men and 667 in women. There was a dose-response association between shorter stature and risk of dementia death that was stronger for men (age- and sex-adjusted HR per standard deviation decrease in height 1.26 [95% CI 1.14, 1.40]) than women (1.10 [1.14, 1.19]). Incorporating measures of adulthood socioeconomic status, health, and health behaviours into the multivariable model had a negligible effect on the strength of these associationsConclusionEarly life circumstances, as indexed by adult height, may influence later dementia risk. These findings suggest that improved early life conditions may decrease dementia risk.
OP19 Increased Adherence to the Mediterranean Diet Protects Memory Decline over 20 years in a Longitudinal Study
Authors: Cadar D , Pikhart H , Mishra G , Nipp W , Stephen A , Richards M 
Published: September 2013

BackgroundCognitive decline is the first outward sign of dementia and represents a major public health effect. Evidence suggests that dietary patterns are associated with cardiovascular and cerebrovascular risk factors. A high quality diet such as Mediterranean diet might protect against Alzheimer’s disease, but its association with age-associated cognitive decline has been less explored.AimThe current analyses aim to examine the association between the adherence to a Mediterranean-style diet and 20 years of cognitive decline from age 43 years to 60–64 (>60) years in a prospective longitudinal population-based study.MethodsParticipants were 1018 study members from the MRC National Survey of Health and Development (the British 1946 birth cohort) regularly followed up since birth in 1946 across their entire life. Cognitive functioning was measured at age 43 years and older than 60 years by tests of verbal memory (maximum words recalled 45) and timed visual search (maximum letter searched 600). The adherence scale to the Mediterranean diet was constructed with information from a 5-day estimated diet diary at both 36 and 43 years, using the Trichopoulou model (2003). Participants were divided into 3 groups of adherence to the Mediterranean diet (low, middle, and high tertiles) and an average early-midlife score was calculated. The confounding variables were social class of origin, childhood cognition, education, adult social class depression and other lifestyle behaviours such as smoking and physical activity. The associations between the adherence to the Mediterranean diet and change in cognitive tests were tested via multiple linear regression.ResultsThere was a significant association between a higher level of adherence to the Mediterranean diet in early midlife and a slower verbal memory over 20 years period from 43 to 60+ in a fully adjusted model β = 1.03 (95% CI 0.24, 1.83) compared to the lower level of adherence. This association maintained its significance even after adjusting for the early-midlife level of smoking and physical activity. A higher adherence to the Mediterranean diet did not show a significant protection for the visual search decline over the same time period.ConclusionThe results from these analyses suggest that higher adherence to the Mediterranean diet in early midlife is protective of verbal memory decline from mid to later life independent of other lifestyle behaviours such as smoking or physical activity. Public health interventions based on healthy dietary styles (such as Mediterranean diet) should be considered as important measures of defence against cognitive decline and dementia in later life.
OP02 Women’s Views on Smoking Cessation Services and National Tobacco Control Measures
Authors: Barber J , Rumsby E , Parker S , Mohebati L , Venables S , Lawson K , Scanlon T , Memon A 
Published: September 2013

BackgroundA large proportion of public health resource is dedicated to smoking cessation services and national campaigns to control tobacco. Although it is well established that women start to smoke earlier, are more susceptible to smoking-related disease and find it harder to quit smoking than men, little research has been done to understand the perception of women regarding smoking cessation services and national tobacco control measures.MethodsEleven women who had used the NHS Stop Smoking Service in East Sussex were engaged in focus group discussions. Data were subjected to manual and NVIVO software-based thematic analysis.ResultsWomen felt that tailoring of services to their needs would improve cessation rates. They expect the smoking cessation counsellors to be non-judgmental and to offer a psychological insight into addiction, however they shared differing opinions on the need for counsellors to be female or ex-smokers. They praised the continuity of care, capacity for peer support, flexibility of time and location and free cessation aids offered. Conversely, they felt the service was poorly advertised, that access was not universally good and that women would be more likely to access and engage with services if female-only groups and drop-in clinics were available. Use of social networking and integration of services into schools were highlighted as ways to engage young women. Opinion varied on the effect that removing cigarettes from view, limiting availability and increasing price would have on initiation and cessation. Campaigns focusing on appearance and consequences of passive smoke inhalation in children were praised, whilst most shock tactics were felt to be ineffective, with a more positive message being favoured.DiscussionWomen value service flexibility in terms of group size, location and timing. Improved advertising, more universal access and more female-centred options such as female only groups may help to better meet women’s needs. Women’s suggestions of services, such as drop-in groups, which already exist is evidence that service promotion should be improved. Women are engaged by national campaigns focusing on appearance and effects of passive smoking on children; however more research is needed on whether positive messaging can have a greater impact on female cessation than shock tactics, and on how the effects of smoke on appearance can be made more relevant to younger women. More research is needed on the importance of counsellor characteristics, the effectiveness of group interventions, and whether social networking and support and accessing schools can alter smoking behaviour in younger women.
OP21 Modelled Health Impacts of the London Cycle Hire Scheme
Authors: Goodman A , Tainio M , Cheshire J , O’Brien O , Woodcock J 
Published: September 2013

BackgroundBicycle sharing systems are being implemented in many cities worldwide, but have received little robust evaluation. We modelled the impacts of the London cycle hire scheme (LCH) upon the health of its users.MethodsData sources included total-population operational registration and usage data for LCH (April 2011-March 2012); surveys of LCH users (2011); and London data on travel, physical activity, road traffic collisions and PM2.5 air pollution (collected 2005-2012). We quantified health impacts in terms of disability-adjusted life years (DALYs), using a stochastic macro-simulation model.ResultsOver the year examined, 578,607 users made 7.4 million LCH trips (estimated 71% by men). These would mostly otherwise have been walked (31%) or used public transport (47%). To date there have been no fatalities on hire bikes and a trend towards fewer injuries than expected for London cycling. Using these observed injury rates, LCH benefits substantially outweighed risks (gain currently estimated at 116 DALYs (95% CI 80, 172) among males; 28 (19, 64) among females). When we modelled injury rates as being equal to rates for all cycling in central London, however, these benefits reduced and became non-significant for women (97 DALYs (95% CI 60, 153) among males; 5 DALYs (-9, 40) among females). This sex difference reflected comparatively high road collision fatality rates for female cyclists in London.ConclusionLCH has positive health impacts overall, but these benefits are clearer for males than females. The benefits of bicycle sharing systems, and cycling more generally, do not necessarily apply to all groups in all settings.
OP26 Cardiovascular Disease Incidence and Dietary Fibre intake in the UK Women’s Cohort Study
Authors: Threapleton D E , Greenwood D C , Burley V J , Cade J E 
Published: September 2013

BackgroundCardiovascular disease (CVD) is a major cause of mortality and morbidity in developed countries. CVD risk can be modified via lifestyle habits and some prospective studies indicate greater fibre intake is associated with lower CVD risk. The aim of this work was to explore this association using data from the UK Women’s Cohort Study.Methods27,731 middle-aged women, with no prior history of CVD, were recruited in the mid 1990’s and followed for a median of 14.7 years. Habitual dietary intake was assessed with a food-frequency questionnaire at study baseline, along with other health and lifestyle information. Risk of incident coronary heart disease (CHD), stroke and CVD were assessed in relation to intakes of total dietary fibre, soluble fibre, insoluble fibre and fibre from key food sources. Cox proportional hazard regression was used to explore risk using both categorical (fifths of intake) and continuous exposure variables adjusting for age, body mass index, energy intake, ethanol, physical activity, smoking and socio-economic status.ResultsAfter 14.7 years, 513 CHD, 406 stroke and 902 CVD cases were observed. After adjustment, a number of inverse associations were observed with increasing intakes of dietary fibre, specifically for total fibre intake with stroke and CVD. Risk was reduced in each intake quintile which was compared to the lowest. CVD risk was also significantly reduced with greater insoluble fibre intake, in each intake quintile compared to lowest; HR 0.71 (95% CI 0.54, 0.95), p= 0.019 for highest vs. lowest consumers.Stroke risk was significantly reduced with greater cereal fibre intake in a continuous model, for each 3g/day increase; HR 0.93 (0.86, 1.00), p=0.048. Stroke and total CVD risk reduction were also associated with greater fibre from nuts/seeds in each intake category vs. lowest consumers and CHD risk was reduced in highest vs. lowest consumers of fibre from nuts/seeds; HR 0.71 (0.51, 1.00), p=0.048.ConclusionFibre intakes in the UK and many other countries fall below recommendations. Results indicate greater intakes, especially of cereal fibre, may be protective against risk of incident CVD. Although fibre intakes from different sources correlate, the contrasting observations for different exposures indicate associations are food-specific rather than simply result from residual confounding of lifestyle characteristics. However, associations may be explained by other non-fibre components within foods. Promoting intake of particularly beneficial food sources of fibre may prevent CVD development.
OP29 Examining Inequalities in the uptake of the School-Based HPV Vaccination Programme in England: A Retrospective Cohort Study
Authors: Fisher H , Audrey S , Mytton J , Hickman M , Trotter C 
Published: September 2013

BackgroundSince 2008, in the United Kingdom the HPV vaccine has been made routinely available to young women aged 12 to 13 years. A course of three doses of the vaccine offered protection against HPV 16 and 18, responsible for approximately 70% of cases of cervical cancer. Although uptake of the HPV vaccine is high, it is unknown whether the vaccine is being delivered equitably by ethnicity or deprivation. This study aimed to investigate factors associated with HPV vaccine initiation and completion within the routine HPV vaccination programme in the South West of England.MethodsYoung women eligible for routine HPV vaccination from 2008/09 to 2010/11 from three Primary Care Trusts/local authorities were included in this study. The following data were retrieved: (i) date of birth; (ii) postcode; (iii) ethnicity; (iv) dates of receipt of HPV and Measles, Mumps and Rubella (MMR) vaccinations, and; (v) name and code of school. Deprivation was assigned using the 2010 Index of Multiple Deprivation. Multivariable logistic regression models were developed to examine factors associated with uptake of HPV vaccination.ResultsOf 14,282 eligible young women, 12,658 (88.6%) initiated, of whom 11,725 (92.6%) completed the course. Initiation varied by programme year (86.5 to 89.6%) and Primary Care Trusts/local authorities (84.8 to 91.6%). There was no strong evidence for an overall association between deprivation quintile and initiation (p = 0.48) or completion (p = 0.10). In comparison to White British young women, young women classified as Asian or British Asian (AOR 0.50 [95% CI 0.44, 0.80]), Black or British Black (0.50 [0.32, 0.79]), and Chinese or other (0.48 [0.33, 0.71]), were less likely to initiate HPV vaccination. However, once initiated, were as likely to complete the course. Young women educated in non-mainstream educational settings were less likely to initiate (0.16 [0.11, 0.24]) and, if initiated, less likely to complete (0.27 [0.17, 0.44). Uptake of MMR vaccination was found to be patterned by ethnicity and deprivation (both <0.001). Young women who had received MMR vaccination were more likely to initiate HPV vaccination (OR 3.64 [3.27, 4.04]).ConclusionHPV vaccination uptake did not vary markedly by social deprivation. However, associations with ethnicity and substantially lower uptake in non-mainstream educational settings were observed. Research to identify reasons for low vaccine uptake in these population groups is required.
OP30 Exploring Reasons for Different Health Outcomes between Identically Deprived Post-Industrial UK Cities
Authors: Walsh D , McCartney G , McCullough S , Pol M van der , Buchanan D , Jones R 
Published: September 2013

BackgroundResearch has shown that Glasgow has an almost identical deprivation profile to Liverpool and Manchester. However, premature mortality is 30% higher, with mortality at all ages almost 15% higher. Many hypotheses have been proposed to explain this phenomenon: for many, however, no data have been available by which their plausibility could be properly assessed.MethodsA representative population survey of Glasgow, Liverpool and Manchester was undertaken. Data for various hypotheses were collected from 3,600 respondents (1,200 in each city): a 55% response rate was achieved. The hypotheses included: lower ‘sense of coherence’ (SoC) in Glasgow; lower social capital; the effects of historical government policy; different individual ‘values’ (e.g. psychological outlook (optimism, aspirations)), hedonism; lower social mobility. Wherever possible, previously validated questions and scales were used (e.g. Antonovski’s SoC Scale, Schwartz’s Human Values Scale, Life Orientation Test). Multivariate linear and logistic regression analyses were employed to assess whether any differences existed between the cities for these topics (after adjustment for age, gender, ethnicity, social class, area deprivation, education etc).ResultsAspects of social capital (trust & reciprocity, social participation) were significantly lower in Glasgow. For example: respondents in Liverpool and Manchester were more than twice as likely to have volunteered in the previous year compared to those in Glasgow (fully adjusted ORs Liverpool 2.6 [2.0, 3.4], p<0.0001; Manchester 2.5 [1.9, 3.3], p<0.0001); Liverpool and Manchester respondents were significantly more likely to report that ‘most people in their neighbourhood could be trusted’ (odds ratios: Liverpool 1.71 [1.4, 2.09], p<0.0001; Manchester 1.45 [1.18, 1.78], p<0.0001). However, SoC was shown to be significantly higher in Glasgow: Liverpool and Manchester respondents were associated, respectively, with fully adjusted mean SoC scores of -4.99 (-5.95, -4.03), p<0.0001 and -8.10 (-9.06, -7.14), p<0.0001 compared to those in Glasgow. The Glasgow sample was not associated with more negative individual values (e.g. lower optimism, hedonism), nor by motivations for social mobility. No clear ‘city’ differences emerged from the political effects questions.ConclusionThese new data suggest that some of the hypotheses proposed to explain higher mortality in Glasgow are plausible (social capital), and others less plausible (e.g. lower ‘sense of coherence’, different ‘values’). Others (e.g. political effects) remain less clear and require different methodological approaches. These analyses add focus to future research needs to help better understand reasons for excess levels of poor health seen in Glasgow compared to these two very similar post-industrial cities.
OP35 Sexual Risk Behaviour Among Young People in Rural Tanzania: Do those in Full-Time Education Practise Safer Sex?
Authors: Doyle A M , Changalucha J , Weiss H A , Watson-Jones D , Hayes R J , Zaba B , Ross D A 
Published: September 2013

BackgroundBeing in full-time education is associated with lower risk of HIV and other STIs. We describe sexual partnership histories reported by youth in rural Tanzania, and investigate the association between current attendance at post-primary education, and sexual behaviour and antibody responses to Herpes Simplex Virus Type 2 (HSV-2) infection.MethodsIn 2007/8, sexual partnership histories were collected through a face-to-face questionnaire and biological samples for STIs from 13,814 15–30 year olds in 20 rural communities, of Mwanza Region, Tanzania. We restricted this analysis to the 2683 females and 4402 males aged 15–24 years and not currently married. Partnership patterns of sexually-active participants were described based on reported dates of first and last intercourse with their last 3 partners in the past year. Point prevalence of concurrency was calculated at 6 months prior to the survey. Age-adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were estimated using conditional logistic regression. Sera were tested for antibodies to HSV-2 using KALON ELISA.ResultsThe mean age in the study was 21 years. The great majority of the 30% of females and 38% of males who reported being in full-time education were in secondary school with a few attending vocational or other training. Students were more likely to report being virgins than non-students (females: 32% vs.8%, AOR 3.8 [95% CI 3.0, 4.9]; males: 20% vs. 7%, AOR 2.5 [2.1, 3.1]). Among those who reported being sexually active in the previous year, students were less likely to report 2+ sexual partners in the previous year (females: 7% vs. 25%, AOR 0.16 [0.11, 0.24]; males: 39% vs. 62%, AOR 0.32 [0.27, 0.37]) and concurrent partners (females: 0.4% vs. 4.0%, AOR 0.08 [0.03, 0.27]; males: 3.2% vs. 8.2%, AOR 0.41 [0.3, 0.56]). Reported condom use at last sex was higher among students (females: 78% vs.28%, AOR 7.8 [5.9, 10.3]; males: 69% vs. 41%, AOR 3.2 [2.7, 3.9]). Students had lower levels of HSV2 infection than non-students (females: 15% vs. 39%, AOR 0.37 [0.29, 0.46]; males: 14% vs. 23%, AOR 0.60 [0.50, 0.72]).ConclusionUnmarried youth in full-time education reported lower risk behaviours compared to those not in education. Under-reporting of high risk sexual behaviours may have differed by current education status, but the much lower HSV-2 prevalence among students suggests real differences exist. Interventions to encourage youth to stay in education longer may reduce their sexual risk, but potential differences in other social determinants must also be considered, such as access to resources and parental support.
OP37 Declining Inequality in Obesity Among Urbanised Adult Mexican Women, but it is not Good News
Authors: Perez Ferrer C , McMunn A , Brunner E J 
Published: September 2013

BackgroundThe objective of this study was to assess the trend in socioeconomic inequalities in obesity from 1988-2012 for adult Mexican women. We hypothesised that education would be inversely associated with obesity in richer urban areas of Mexico but not in rural areas, and that the gradient in urban areas would become steeper as the nutrition transition progressed.MethodsData came from four nationally representative surveys carried out in 1988, 1999, 2006 and 2012. Response rate ranged from 80% to 97% and sample size of non-pregnant women age 20 to 49 from 10,318 to 14,531. Weight and height were measured by a nurse and education level (higher education, high school, secondary, primary or less) was self-reported. Analyses were adjusted for survey design. The relative index of inequality (RII) was computed and its trend from 1988-2012 tested.ResultsNationally, age-standardised obesity prevalence increased from 9.3% to 33.7% over the 25 year period. An inverse association between education and obesity was observed in urban areas. In rural areas, obesity prevalence increased markedly but there was no association with education level. Obesity increased 5.92 fold (95% CI 4.03, 8.70) among urban women with higher education in the period 1988-2012 compared to 3.23 fold (2.88, 3.63) for urban women with primary or no education. The RII in urban areas declined over the period from 2.87 (1.94, 4.25) in 1988 to 1.55 (1.33, 1.80) in 2012, trend p < 0.001.DiscussionAs expected, an inverse association between education and obesity was observed in urban areas of Mexico. However, the stepwise decline in obesity inequalities was because obesity prevalence increased faster among higher educated groups. These findings simulate trends observed in the USA and not in other middle income countries undergoing nutrition transition like Brazil and China. In rural areas there was no association between education level and obesity across the four surveys.