Royal College of General Practitioners

About: Royal College of General Practitioners is a education organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Health care. The organization has 360 authors who have published 668 publications receiving 20881 citations.

Which terms should be used to describe autism? Perspectives from the UK autism community

Abstract: Recent public discussions suggest that there is much disagreement about the way autism is and should be described. This study sought to elicit the views and preferences of UK autism community membe...

Menarche, menopause, and breast cancer risk: Individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies

Abstract: BACKGROUND:Menarche and menopause mark the onset and cessation, respectively, of ovarian activity associated with reproduction, and affect breast cancer risk. Our aim was to assess the strengths of their effects and determine whether they depend on characteristics of the tumours or the affected women.METHODS:Individual data from 117 epidemiological studies, including 118 964 women with invasive breast cancer and 306 091 without the disease, none of whom had used menopausal hormone therapy, were included in the analyses. We calculated adjusted relative risks (RRs) associated with menarche and menopause for breast cancer overall, and by tumour histology and by oestrogen receptor expression.FINDINGS:Breast cancer risk increased by a factor of 1·050 (95% CI 1·044-1·057; p<0·0001) for every year younger at menarche, and independently by a smaller amount (1·029, 1·025-1·032; p<0·0001), for every year older at menopause. Premenopausal women had a greater risk of breast cancer than postmenopausal women of an identical age (RR at age 45-54 years 1·43, 1·33-1·52, p<0·001). All three of these associations were attenuated by increasing adiposity among postmenopausal women, but did not vary materially by women's year of birth, ethnic origin, childbearing history, smoking, alcohol consumption, or hormonal contraceptive use. All three associations were stronger for lobular than for ductal tumours (p<0·006 for each comparison). The effect of menopause in women of an identical age and trends by age at menopause were stronger for oestrogen receptor-positive disease than for oestrogen receptor-negative disease (p<0·01 for both comparisons).INTERPRETATION:The effects of menarche and menopause on breast cancer risk might not be acting merely by lengthening women's total number of reproductive years. Endogenous ovarian hormones are more relevant for oestrogen receptor-positive disease than for oestrogen receptor-negative disease and for lobular than for ductal tumours.

Joining together to combat poverty: Everybody welcome and needed

Abstract: The International Poverty and Health Network was created in December 1997 following a series of conferences organised by the World Health Organisation with the aim of integrating health into plans to eradicate poverty. Its formation was a response to the evidence of the persistent and growing burden of human suffering due to poverty. The more people who join the greater the likely impact of the network. Around 1.3 billion people live in absolute, grinding poverty on less than $1 per day.1 This is despite the overall growth of the world economy, which doubled in the 25 years before 1998 to $24 trillion. Of the 4.4 billion people in developing countries nearly three fifths lack access to sanitation, a third don't have clean water, about a fifth have no health care, and a fifth do not have enough dietary energy and protein. Economic disparities both within and between countries have grown, and in about 100 countries incomes are lower in real terms than they were a decade ago.2 By 1995 the richest fifth of the world's population had 82 times the income of the poorest fifth. The world's 225 richest people have combined wealth equivalent to the annual income of the poorest 2.5 billion (nearly half of the world's population).1 At the same time the world faces a growing scarcity of renewable resources from deforestation, soil erosion, water depletion, declining fish stocks, and lost biodiversity. The poor will be hit hardest by these problems. Despite overall dramatic increases in life …