Stig Wall

Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).

A series of metalinguistic tasks, including segmentation and synthesis of words, were given to 143 children in kindergarten. The children were followed up in school where reading and writing achievement was assessed with several tests and ratings. A causal model was postulated concering the relationships between general abilities, metalinguistic competence, and reading and spelling skills. The quantitative implications of the model were worked out by path analysis, which revealed an orderly and interpretable picture. The most invariant and important determinant of basic reading and spelling skills was the analysis of simple words. Failure and success in school could be predicted with high accuracy on the basis of preschool data. Over 70% of the children were classified correctly in the extreme quartiles as to their future school achievement. The methodological advantage of applying path analysis instead of conventional multiple regression analysis on the present problem was discussed.

BACKGROUND AND OBJECTIVE: In Sweden, mortality from cardiovascular diseases (CVD) increased steadily during the 20th century and in the mid-1980s it was highest in the county of Västerbotten. Therefore, a community intervention programme was launched - the Västerbotten Intervention Programme (VIP) - with the aim of reducing morbidity and mortality from CVD and diabetes. DESIGN: The VIP was first developed in the small municipality of Norsjö in 1985. Subsequently, it was successively implemented across the county and is now integrated into ordinary primary care routines. A population-based strategy directed towards the public is combined with a strategy to reach all middle-aged persons individually at ages 40, 50 and 60 years, by inviting them to participate in systematic risk factor screening and individual counselling about healthy lifestyle habits. Blood samples for research purposes are stored at the Umeå University Medical Biobank. RESULTS: Overall, 113,203 health examinations have been conducted in the VIP and 6,500-7,000 examinations take place each year. Almost 27,000 subjects have participated twice. Participation rates have ranged between 48 and 67%. A dropout rate analysis in 1998 indicated only a small social selection bias. Cross-sectional, nested case-control studies and prospective studies have been based on the VIP data. Linkages between the VIP and local, regional and national databases provide opportunities for interdisciplinary research, as well as national and international collaborations on a wide range of disease outcomes. A large number of publications are based on data that are collected in the VIP, many of which also use results from analysed stored blood samples. More than 20 PhD theses have been based primarily on the VIP data. CONCLUSIONS: The concept of the VIP, established as a collaboration between politicians and health care providers on the one hand and primary care, functioning as the operating machinery, and the public on the other, forms the basis for effective implementation and endurance over time. After more than 20 years of the VIP, there is a large comprehensive population-based database, a stable organisation to conduct health surveys and collect data, and a solid structure to enable widespread multidisciplinary and scientific collaborations.