Cervical cancer screening in Middle Eastern and Asian migrants to Australia: A record linkage study

Background. Australia's organized cervical screening program recommends two-yearly screening for women aged 18–69 years and reminder letters are sent at 27 months. Cervical screening registers hold comprehensive information on screening, but not country of birth. A linkage study was performed in order to assess cervical screening behavior in migrants. Methods. To assess screening participation, we linked year 2000 records for 12,541 Middle Eastern/Asian-born women 20–54 years of age, and an age and area matched random sample of 12,143 Australian-born women in the New South Wales (NSW) Midwives Data Collection (MDC), which records country of birth, to screening register records. Screening behavior after 2000 was assessed in women without a recorded prior cervical abnormality. Results. The odds ratios for being screened at least once within a 3 year period, with reference to Australian-born women and adjusted for age, parity, socioeconomic status and smoking, were 0.88 (95% CI: 0.81–0.97) and 0.74 (95% CI: 0.70–0.79) in women born in the Middle East and Asia, respectively. Screening increased with increasing socioeconomic status (SES), absence of smoking and greater parity in Australian-born women but little, if at all, in migrant women. In a sensitivity analysis in which hospital admitted patients were the source of population samples, some patterns were sufficiently different to suggest that selection for illness can affect the strength and direction of associations in linked data. Conclusion. Migrant women from Asian and Middle-eastern countries are less likely than Australian-born women to participate in cervical screening at the recommended interval. Their likelihood of screening is also less related to socioeconomic status, smoking and parity than that in Australian-born women.     

Size‐dependent costs of migration: Migrant bird species are subordinate to residents,but only at small body sizes

Migrant species are commonly thought to be poor competitors in aggressive interactions with resident species. However, no studies have tested whether this relationship is widespread. Here, we compare the behavioural dominance of closely related species of migratory and nonmigratory birds, testing whether migrants are consistently subordinate to resident species in aggressive contests. We compiled published behavioural dominance data involving migrant and resident congeners, gathering additional data on the body mass and migratory distance of each species. Focal species included a diverse array of birds (28 taxonomic families, 12 orders) from around the world. We found that migrant species are usually subordinate to resident species, but that this relationship disappears at larger body sizes. For smaller birds (<500 g), resident species were behaviourally dominant in 83%–88% of comparisons; for larger birds (>500 g), resident species were dominant in only 25%–30% of comparisons. The relative difference in body mass best predicted dominance relationships among species, with larger species dominant in 80%–84% of comparisons. When migrant and resident masses were equal, however, resident species were still more likely to be dominant in smaller birds, suggesting that other factors may also contribute to the subordinate status of migrants. Overall, our results suggest that in smaller species, the evolution of migration is associated with lighter weights and other traits that compromise the competitive abilities of migrants relative to residents. In contrast, larger species appear able to evolve migration without compromising their size or competitive abilities in aggressive contests, suggesting size‐dependent constraints on the evolution of migration.     

Dietary behaviors as associated factors for overweight and obesity in a sample of adolescents from Aquitaine, France

This study aimed to identify dietary behaviors that might be considered as associated factors for overweight or obesity among French adolescents. Forty-nine of the 536 middle and high schools in Aquitaine (southwest of France) were invited to take part in the study. For each school, participating adolescents were selected using stratification by grade. A self-report questionnaire, including information about sex, age, dietary behaviors, physical and sedentary activities, and parental socioeconomic status (SES), was filled in by adolescents during class. Overweight and obesity were defined according to the age- and sex-specific body mass index cutoff points of the International Obesity Task Force. Multivariate analysis (logistic regression) was used to identify independent dietary factors associated with overweight including obesity and obesity alone (adjustment on sex, age, parental SES, and weight status and adolescents' sedentary activity). In addition to parental SES and weight status and adolescents' sedentary activity, some dietary behaviors are also independently and significantly associated with a higher prevalence of overweight including obesity: absence (OR 1.43, 0.91–2.23) or rare (OR 1.57, 1.23–2.01) breakfast intake (p?<?0.01) and absence (OR 5.03, 3.19–7.92) or rare (OR 1.90, 1.46–2.47) light afternoon meal intake (p?<?0.001). All variables were also significantly and independently associated with obesity alone. This study shows that socioeconomic factors and individual behaviors are associated with overweight or obesity. These results confirm the importance to carry out multifaceted educational actions among adolescents, by promoting physical activity and healthy food choices in order to prevent overweight and promote healthy lifestyle behaviors.     

Maximal aerobic capacity across age in healthy Hispanic and Caucasian women.

We tested the hypothesis that the age-related decline in maximal aerobic capacity, as measured by maximal oxygen uptake (VO(2 max)), is greater in Hispanic than in Caucasian women. We studied 146 healthy sedentary women aged 20-75 yr: 53 Hispanic (primarily of Mexican descent) and 93 Caucasian (non-Hispanic white). The groups did not differ in mean age, body mass, percent body fat, estimated physical activity-related energy expenditure, or education-based socioeconomic status (SES). During maximal exercise, respiratory exchange ratio, rating of perceived exertion, and percent predicted maximal heart rate were similar across age and ethnicity, suggesting equivalent maximum voluntary efforts in all subjects. VO(2 max) (ml x kg(-1) x min(-1)) was inversely related to age (P < 0.01) in Caucasian (r =-0.68) and Hispanic (r = -0.61) women. The absolute rate of decline in VO(2 max) with age was the same in the two groups (-0.31 ml x kg(-1) x min(-1) x yr(-1)). The relative rate of decline (% from age 25 yr) also was similar in the Caucasian (-9.0%) and Hispanic (-9.2%) women. When subjects of all ages were pooled, mean levels of VO(2 max) were similar in the two groups (approximately 28 ml x kg(-1) x min(-1)). These results, the first to our knowledge in Hispanics, indicate that mean levels of VO(2 max), as well as the rate of decline in VO(2 max) with age, are similar in healthy sedentary Hispanic and Caucasian women of similar SES. Thus it does not appear that Hispanic ethnicity per se modulates maximal aerobic capacity in this population.     

Socio-economic Predictors of Life Style. A pilot study

In epidemiological studies there exists the evidence of relationship between socio-economic status (SES) and health. The suspicious cause of these differences is life-style. The aim of the presented study was to identify the relationship between SES, demographic characteristics and the life-style in an industrial region. A structured questionnaire was distributed to a random sample of some 3,000 aged 25-70 and collected by postal delivery. The SES and demographic factors being analysed were sex, age, education, marital status and economic situation of the family in the relationship with a wide range of information on life style. The data was analysed using the chi-square test and logistic regression. The total number of analysed questionnaires was 634. The lowest response-rate was in the group with the basic education. Significant differences were found by sex in education (less women with university degree) and household income (more women in the lowest income category, men in the highest one). A detail analysis of the aggregated variables (adjusted for all SES variables) found: passivity and contentment were in adverse correlation with the level of education and economic situation; psychical well-being was correlated with family status and economic situation, risk behaviour was correlated with all SES factors except sex and education. Among the analysed factors economical situation of respondents, family and education were the most significant determinants of the differences in life-style.     

Socio-demographic patterning of physical activity across migrant groups in India: results from the Indian Migration Study

Objective

To investigate the relationship between rural to urban migration and physical activity (PA) in India.

Methods

6,447 (42% women) participants comprising 2077 rural, 2,094 migrants and 2,276 urban were recruited. Total activity (MET hr/day), activity intensity (min/day), PA Level (PAL) television viewing and sleeping (min/day) were estimated and associations with migrant status examined, adjusting for the sib-pair design, age, site, occupation, education, and socio-economic position (SEP).

Results

Total activity was highest in rural men whereas migrant and urban men had broadly similar activity levels (p<0.001). Women showed similar patterns, but slightly lower levels of total activity. Sedentary behaviour and television viewing were lower in rural residents and similar in migrant and urban groups. Sleep duration was highest in the rural group and lowest in urban non-migrants. Migrant men had considerably lower odds of being in the highest quartile of total activity than rural men, a finding that persisted after adjustment for age, SEP and education (OR 0.53, 95% CI 0.37, 0.74). For women, odds ratios attenuated and associations were removed after adjusting for age, SEP and education.

Conclusion

Our findings suggest that migrants have already acquired PA levels that closely resemble long-term urban residents. Effective public health interventions to increase PA are needed.     

Microfilament regulatory protein MENA increases activity of RhoA and promotes metastasis of hepatocellular carcinoma

Mammalian enabled (MENA), usually known as a direct regulator of microfilament polymerization and bundling, promotes metastasis in various cancers. Here we focus on the role of MENA in hepatocellular carcinoma (HCC) metastasis and the relevant mechanism from the view of RhoA activity regulation. By HCC tissue microarray analysis, we found that MENA expression was positively associated with satellite lesions (P<0.01) and vascular invasion (P<0.01). Cases with membrane reinforcement of MENA staining in HCC tissues had significantly higher rates of early recurrence in the intermediate MENA expression group. Knockdown of MENA significantly suppressed HCC cell migration and invasion in vitro, as well as their intrahepatic and distant metastasis in vivo. Knockdown of MENA also decreased filopodia and stress fibers in SMMC-7721 cells. Furthermore, a decrease of RhoA activity was detected by a pull-down assay in SMMC-7721-shMENA cells. The ROCK inhibitor, Y-27632, suppressed migration of both MENA knockdown SMMC-7721 cells and control cells, but diminished their difference. Thus, our findings suggest that MENA promotes HCC cell motility by activating RhoA.     

Psychological Distress during Pregnancy in a Multi-Ethnic Community: Findings from the Born in Bradford Cohort Study

Purpose

Antenatal anxiety and depression are predictive of future mental distress, which has negative effects on children. Ethnic minority women are more likely to have a lower socio-economic status (SES) but it is unclear whether SES is an independent risk factor for mental health in pregnancy. We described the association between maternal mental distress and socio-demographic factors in a multi-ethnic cohort located in an economically deprived city in the UK.

Methods

We defined eight distinct ethno-language groups (total N = 8,454) and classified a threshold of distress as the 75th centile of within-group GHQ-28 scores, which we used as the outcome for univariate and multivariate logistic regression for each ethnic group and for the sample overall.

Results

Financial concerns were strongly and independently associated with worse mental health for six out of the eight ethnic groups, and for the cohort overall. In some groups, factors such as working status, education and family structure were associated with worse mental health, but for others these factors were of little importance.

Conclusions

The diversity between and within ethnic groups in this sample underlines the need to take into consideration individual social, migration and economic circumstances and their potential effect on mental health in ethnically diverse areas.     

Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9

Background

Parental obesity is a predominant risk factor for childhood obesity. Family factors including socio-economic status (SES) play a role in determining parent weight. It is essential to unpick how shared family factors impact on child weight. This study aims to investigate the association between measured parent weight status, familial socio-economic factors and the risk of childhood obesity at age 9.

Methodology/Principal Findings

Cross sectional analysis of the first wave (2008) of the Growing Up in Ireland (GUI) study. GUI is a nationally representative study of 9-year-old children (N = 8,568). Schools were selected from the national total (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Children and their parents had height and weight measurements taken using standard methods. Data were reweighted to account for the sampling design. Childhood overweight and obesity prevalence were calculated using International Obesity Taskforce definitions. Multinomial logistic regression examined the association between parent weight status, indicators of SES and child weight. Overall, 25% of children were either overweight (19.3%) or obese (6.6%). Parental obesity was a significant predictor of child obesity. Of children with normal weight parents, 14.4% were overweight or obese whereas 46.2% of children with obese parents were overweight or obese. Maternal education and household class were more consistently associated with a child being in a higher body mass index category than household income. Adjusted regression indicated that female gender, one parent family type, lower maternal education, lower household class and a heavier parent weight status significantly increased the odds of childhood obesity.

Conclusions/Significance

Parental weight appears to be the most influential factor driving the childhood obesity epidemic in Ireland and is an independent predictor of child obesity across SES groups. Due to the high prevalence of obesity in parents and children, population based interventions are required.     

The impact of health insurance affiliation and socioeconomic status on cervical cancer survival in Bucaramanga,Colombia

Cervical cancer is still an important cause of death in countries like Colombia. We aimed to determine whether socioeconomic status of residential address (SES) and type of health insurance affiliation (HIA) might be associated with cervical cancer survival among women in Bucaramanga, Colombia. All patients residing in the Bucaramanga Metropolitan Area diagnosed with invasive cervical cancer (ICD-0–3 codes C53.X) between 2008 and 2016 (n = 725) were identified through the population-based cancer registry, with 700 women having follow-up data for >5 years (date of study closure: Dec 31, 2021), yielding an overall 5-year survival estimate (95 % CI) of 56.4 % (52.7 – 60.0 %). KM estimates of 5-year overall survival were obtained to assess differences in cervical cancer survival by SES and HIA. Multivariable Cox-proportional hazards modeling was also conducted, including interaction effects between SES and HIA. Five-year overall survival was lower when comparing low vs. high SES (41.9 % vs 57.9 %, p < 0.0001) and subsidized vs. contributive HIA (45.1 % vs 63.0 %, p < 0.0001). Multivariable Cox modeling showed increased hazard ratios (HR) of death for low vs. high SES (HR = 1.78; 95 % CI = 1.18–2.70) and subsidized vs. contributive HIA (HR = 1.44; 95 % CI = 1.13–1.83). The greatest disparity in HR was among women of low SES affiliated to subsidized HIA (vs. contributive HIA and high SES) (HR=2.53; 95 % CI = 1.62–3.97). Despite Colombia’s universal healthcare system, important disparities in cervical cancer survival by health insurance affiliation and socioeconomic status remain.     

Socioeconomic determinants of age at first marriage in Bangladesh

Using data from the 1976 Bangladesh Fertility Survey, multiple classification analysis was used to evaluate the effect of socioeconomic factors on age at 1st marriage. The independent variables considered were education, childhood and current residence, religion, work status before marriage, and husband's childhood residence, education, and occupation. Analysis was carried out for the total sample as well as for 3 birth cohorts of approximately equal size: 1) those born before 1940, 2) those born between 1940-50, and 3) those born after 1950. Of all the included variables, women's education has the strongest influence on the variation of age at 1st marriage. For all ever-married women, the mean age at marriage for women with primary education is 13.4 years, 0.9 years higher than for women with no education (12.5 years), and 1.2 years lower than for women with a high school education or beyond (14.6 years). Difference in means for cohorts indicate a gradually increasing influence of education on people's decision in marriage. Husband's education does not appear to be as important. Childhood residence has, directly and indirectly, a strong influence in marriage age. Among other factors, women's premarital work participation, as well as region and husband's occupation, are important. Since women's education, childhood residence, and work participation are the strongest socioeconomic variables affecting marriage age, the modernizing influences of education, urbanization, and female work participation should have an effect on the marriage pattern; this effect is consistent with that observed in other societies.     

Parental education and living environmental influence on physical development, nutritional habits as well as level of physical activity in Polish children and adolescents

The aim of this work was to evaluate the physical development and nutritional status, the nutrition habits as well as level of physical activity of boys and girls in relation to the socio-economic status of their families. The study was conducted on a group of 529 boys and 535 girls aged 7-16 years from Swietokrzyskie Province in Poland. Boys and girls from high SES families had the greatest body height, BMI, upper arm muscle area, as well as upper arm fat tissue area, while the lowest values of these features occurred among those studied coming from families of a low SES. The higher the family SES, the higher habitual frequency of consuming vegetables and fruit as well as fish. The diet of children coming from higher SES families was also linked with a higher total protein content as well as animal protein, all analysed minerals and some vitamins, but there were no significant differences of energetic value in daily food rations as well as fat content. The longer time spent on some sedentary activities was connected with a higher family SES. The girls coming from a high status families also declared a higher level of physical activity, whereas such relationship was not observed among boys. A more rational set of nutritional habits observed among children from a higher SES families can be the basic reason for their higher advancement in development. A shorter time devoted to sedentary activities is assumed to be the main cause of a smaller relative body mass and less obesity among girls and boys from low SES families.     

In urban South Africa, 16 year old adolescents experience greater health equality than children

Despite the strongly established link between socio-economic status (SES) and health across most stages of the life-course, the evidence for a socio-economic gradient in adolescent health outcomes is less consistent. This paper examines associations between household, school, and neighbourhood SES measures with body composition outcomes in 16 year old South African Black urban adolescents from the 1990 born Birth to Twenty (Bt20) cohort. Multivariable regression analyses were applied to data from a sub-sample of the Bt20 cohort (n = 346, 53% male) with measures taken at birth and 16 years of age to establish socio-economic, biological, and demographic predictors of fat mass, lean mass, and body mass index (BMI). Results were compared with earlier published evidence of health inequality at ages 9–10 years in Bt20. Consistent predictors of higher fat mass and BMI in fully adjusted models were being female, born post term, having a mother with post secondary school education, and having an obese mother. Most measures of SES were only weakly associated with body composition, with an inconsistent direction of association. This is in contrast to earlier findings with Bt20 9–10 year olds where SES inequalities in body composition were observed. Findings suggest targeting obesity interventions at females in households where a mother has a high BMI.     

Prevalence, causes and socio-economic determinants of vision loss in Cape Town, South Africa

Purpose

To estimate the prevalence and causes of blindness and visual impairment in Cape Town, South Africa and to explore socio-economic and demographic predictors of vision loss in this setting.

Methods

A cross sectional population-based survey was conducted in Cape Town. Eighty-two clusters were selected using probability proportionate to size sampling. Within each cluster 35 or 40 people aged 50 years and above were selected using compact segment sampling. Visual acuity of participants was assessed and eyes with a visual acuity less than 6/18 were examined by an ophthalmologist to determine the cause of vision loss. Demographic data (age, gender and education) were collected and a socio-economic status (SES) index was created using principal components analysis.

Results

Out of 3100 eligible people, 2750 (89%) were examined. The sample prevalence of bilateral blindness (presenting visual acuity <3/60) was 1.4% (95% CI 0.9–1.8). Posterior segment diseases accounted for 65% of blindness and cataract was responsible for 27%. The prevalence of vision loss was highest among people over 80 years (odds ratio (OR) 6.9 95% CI 4.6–10.6), those in the poorest SES group (OR 3.9 95% CI 2.2–6.7) and people with no formal education (OR 5.4 95% CI 1.7–16.6). Cataract surgical coverage was 68% in the poorest SES tertile (68%) compared to 93% in the medium and 100% in the highest tertile.

Conclusions

The prevalence of blindness among people ≥50 years in Cape Town was lower than expected and the contribution of posterior segment diseases higher than previously reported in South Africa and Sub Saharan Africa. There were clear socio-economic disparities in prevalence of vision loss and cataract surgical coverage in this setting which need to be addressed in blindness prevention programs.     

Obesity among male adolescent migrants in Vienna, Austria

Childhood overweight and obesity--especially among migrant children--are health problems in several European countries. The prevalence rates of overweight and obesity among 936 migrant boys of low socio-economic status from Turkey and former Yugoslavia were compared with those of Austrian boys in Vienna. In the longitudinal study, children were measured at the ages of 6, 10 and 15 years. Weight status was estimated by means of the body mass index and percentile curves were used for weight status classification. The prevalence of overweight and obesity was high among migrant boys as well as Austrian boys at all age groups. Ten-year-old boys from Yugoslavia exhibited the highest percentage of overweight (nearly 38%). The lowest percentage of overweight was among 6-year-old Austrian boys (17.2%). Being overweight or obese at the age of 6 years increased the risk of being overweight at 10 and 15 years significantly (p<0.001). This was true of all groups independent of migrant status. The impact of migrant status on weight status at the ages of 10 and 15 was not significant. Therefore, although migrant boys from former Yugoslavia exhibited the highest rates of overweight and obesity, migrant status is not associated significantly with an increased prevalence of obesity in this sample characterized by a generally low socio-economic status. Prevention should start as early as possible for all children, since overweight tends to persist from childhood into adolescence independent of migrant status.     

Genetic and environmental effects on growth of children from a subsistence agricultural community in southern Mexico

Sibling correlations for size attained in height, weight, sitting height, estimated leg length, the triceps skinfold, arm circumference, and estimated midarm muscle circumference were compared in 6- through 13-year-old schoolchildren grouped by household socioeconomic status. The children were residents of a Zapotec-speaking, subsistence agricultural community in the Valley of Oaxaca in southern Mexico. Sibling pairs were classified as being from high and low socioeconomic status (SES) households, and sibling correlations were computed within each SES group controlling for environmental effects derived from a factor analysis of information on household demography and land and livestock holdings. Like-sex siblings from lower SES households have significantly different correlations in four instances. Correlations are higher for leg length in lower SES brothers and higher for sitting height and weight in lower SES sisters, while the correlation for sitting height is higher in upper SES brothers. The sibling correlation results are not entirely consistent with observations on growth status by SES, particularly if the power and similarity of a common environment is the only cause of higher sibling correlations. Reduced body size under poorer socioeconomic and presumably nutritional circumstances is apparent, but it is not possible in this analysis to distinguish whether genotypic (developmental) plasticity or genetic adaptation, or both, are involved.     

Age- and Sex-Specific Relationships between Household Income,Education, and Diabetes Mellitus in Korean Adults: The Korea National Health and Nutrition Examination Survey, 2008-2010

Background

To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults.

Methods

Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels.

Results

The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected.

Conclusions

We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.     

Social and biological determinants of age at first marriage in Taiwan, 1970

This study examines the social and biological determinants of age at first marriage in 2 townships in Northern Taiwan, one very rural and traditional and the other urban and modernized. Using a sample of 5707 once-married women, a path analysis examined age at first marriage as a function of age, educational status, urban origin, premarital labor force participation, and age at menarche. Age at menarche, with a positive effect on the dependent variable, was the most important direct cause of age at first marriage. This biological factor is interrelated with socioeconomic influences as predictors of age at marriage. Older cohorts of women tended to marry about 2 years earlier than did the women below 30. Urban women had a mean age at first marriage 1.76 year later than did rural women. Age at marriage steadily increases as education increases; a 4 year age differntial exists between those who have no formal education and those who have at least 12 years of education. Also, women who worked before marriage married later than those who had never worked. This study reemphasizes that in Taiwan, as elsewhere, there is a complex interplay of socioeconomic and biological factors embedded within a cultural context that influences age at first marriage for females.     

Ethnic,racial and socioeconomic disparities in breast cancer survival in two Brazilian capitals between 1996 and 2012

ObjectiveTo study the impact of socio-economic status and ethno-racial strata on excess mortality hazard and net survival of women with breast cancer in two Brazilian state capitals.MethodWe conducted a survival analysis with individual data from population-based cancer registries including women with breast cancer diagnosed between 1996 and 2012 in Aracaju and Curitiba. The main outcomes were the excess mortality hazard (EMH) and net survival. The associations of age, year of diagnosis, disease stage, race/skin colour and socioeconomic status (SES) with the excess mortality hazard and net survival were analysed using multi-level spline regression models, modelled as cubic splines with knots at 1 and 5 years of follow-up.ResultsA total of 2045 women in Aracaju and 7872 in Curitiba were included in the analyses. The EMH was higher for women with lower SES and for black and brown women in both municipalities. The greatest difference in excess mortality was seen between the most deprived women and the most affluent women in Curitiba, hazard ratio (HR) 1.93 (95%CI 1.63–2.28). For race/skin colour, the greatest ratio was found in Curitiba (HR 1.35, 95%CI 1.09–1.66) for black women compared with white women. The most important socio-economic difference in net survival was seen in Aracaju. Age-standardised net survival at five years was 55.7% for the most deprived women and 67.2% for the most affluent. Net survival at eight years was 48.3% and 61.0%, respectively. Net survival in Curitiba was higher than in Aracaju in all SES groups.”ConclusionOur findings suggest the presence of contrasting breast cancer survival expectancy in Aracaju and Curitiba, highlighting regional inequalities in access to health care. Lower survival among brown and black women, and those in lower SES groups indicates that early detection, early diagnosis and timely access to treatment must be prioritized to reduce inequalities in outcome among Brazilian women.     

Are changes in body dimensions of adult females from Italy (Sardinia and Latium) related to secular trend?

This paper presents secular changes in height, weight, sitting height, relative sitting height, BMI and estimated lower limb length in two samples of Italian adult females from Sardinia (Cagliari) and Latium (Rieti). The samples consist of 579 healthy women from the province of Cagliari and 138 from the town of Rieti, aged 20.0-39.9 years, measured in the period 2003-2006. The women were divided into four 5-year age groups. The anthropometric variables were considered according to different socioeconomic status (SES) in the Cagliari sample, while the Rieti sample was considered as a whole, as the SES was homogeneous. ANOVA results suggest that the secular trend was very slow or had come to a halt in the Rieti sample but continues in the Cagliari sample, as shown by the statistically significant differences for estimated lower limb length (p≤0.02), and relative sitting height (p≤0.05). However, these differences disappear after ANCOVA with sibship size and socioeconomic status controlled for, suggesting that they depend mainly on the composition of the Cagliari sample in terms of SES. Therefore, it can be hypothesised that the secular trend might be very slow or has stopped in the Cagliari subsamples homogeneous for SES.