What helped and hindered implementation of an intervention package to reduce smoking in pregnancy: process evaluation guided by normalization process theory.

Background: Smoking in pregnancy causes harm to mother and baby. Despite evidence from trials of what helps women quit, implementation in the real world has been hard to achieve. An evidence-based intervention, babyClear©, involving staff training, universal carbon monoxide monitoring, opt-out referral to smoking cessation services, enhanced follow-up protocols and a risk perception tool was introduced across North East England.

Does domiciliary welfare rights advice improve health-related quality of life in independent-living, socio-economically disadvantaged people aged ≥60 years? Randomised controlled trial, economic and process evaluations in the North East of England.

Background: There are major socio-economic gradients in health that could be influenced by increasing personal resources. Welfare rights advice can enhance resources but has not been rigorously evaluated for health-related impacts.

Methods: Randomised, wait-list controlled trial with individual allocation, stratified by general practice, of welfare rights advice and assistance with benefit entitlements, delivered in participants' homes by trained advisors.

Anticipated survival and health behaviours in older English adults: cross sectional and longitudinal analysis of the English Longitudinal Study of Ageing.

Background: Individuals may make a rational decision not to engage in healthy behaviours based on their assessment of the benefits of such behaviours to them, compared to other uncontrollable threats to their health. Anticipated survival is one marker of perceived uncontrollable threats to health. We hypothesised that greater anticipated survival: a) is cross-sectionally associated with healthier patterns of behaviours; b) increases the probability that behaviours will be healthier at follow up than at baseline; and c) decreases the probability that behaviours will be 'less healthy' at follow than at baseline.

Socioeconomic position and the association between anticipated and actual survival in older English adults.

Background: Socioeconomic disadvantage may cause individuals to have lower expectations of longevity and not engage in healthy behaviours because they judge the long-term health benefits of these to be minimal. We explored demographic, health behaviour, health and socioeconomic correlates of subjectively estimated lifespan ('anticipated survival'); the ability of anticipated survival to predict actual survival; and whether the predictive ability of anticipated survival differed by other variables, particularly socioeconomic position.

Methods: Data were from wave 1 of the English Longitudinal Study of Ageing.

Socioeconomic and behavioural risk factors for adverse winter health and social outcomes in economically developed countries: a systematic review of quantitative observational studies.

Background: Mortality and morbidity rates are often highest during the winter period, particularly in countries with milder climates. A growing body of research has identified potential socioeconomic, housing and behavioural mediators of cold weather-related adverse health and social outcomes, but an inclusive systematic review of this literature has yet to be performed.

Methods: A systematic review, with narrative synthesis, of observational research published in English between 2001 and 2011, which quantified associations between socioeconomic, housing or behavioural factors and cold weather-related adverse health or social outcomes.

Dynamics of human mortality.

Historical human mortality curves display five phases, differing in dimensions with population, time and circumstance. Existing explanatory models describe some but not all of these, and modelling of entire curves has hitherto necessitated an assumption of multiple distributions. A new distribution, shown previously to describe survival in experimental animals, postulates empirically that net mortality risk comprises two components described as 'redundancy decay' and 'interactive risk'.

The natural distribution of survival.

Great similarities in survival patterns permit the Gompertz and other established equations to describe parts of mortality curves in various species. These patterns appear non-random and invite inference of biological meaning, though no unifying explanation is agreed. Under the theory described here, linear decline of an initial quantity of species or strain-specific redundant reserve interacts with extrinsic hazards via a 'nested binomial' model, which is presented both in a simple, four parameter form, and a more complex form that incorporates inter-individual and inter-functional biological variation.

Postponement of postmenopausal mortality acceleration in low-mortality populations.

Mortality analyses commonly disregard postmenopausal acceleration. This study examined period log mortality in World Health Organization (WHO) data for 34 low-mortality countries in 2000, demonstrating significant gradient increases for women (33/34 countries) and men (22/34), from a later age than previously reported, dividing the postmenopausal period into phases. "Break points" were identified as intersects of lines of best fit to these and the same approach was used in analysis of Human Mortality Database data for 19 countries.

When does human ageing begin?

Through much of the 20th century, the low point of human mortality was seen at 12-13 years of age. Its stability and timing have been accorded significance in terms of evolution, maximal fitness and the onset of ageing. The nadir of mortality in developed nations now lies at 5-9 years, significantly predating fertility at a mean of 12-13.

Mortality spike at New Year but not Christmas in North East England.

Mortality in the USA has been shown to spike on Christmas and New Year's Day. No comparable analyses are available for European data despite recognised seasonal mortality variations. Deaths for 1986-2000 were analysed by date for Newcastle and North Tyneside (NNT) to examine the Christmas period and the weeks surrounding Easter.