The objectives of this study were to identify the prevalence of psychosocial need, and the contributory factors to need, among cancer patients, using a descriptive cross-sectional questionnaire survey of adult cancer patients. The participants were 1,000 patients from four hospitals in the north west of England with the following characteristics: tumour type (breast, colorectal, lymphoma, lung), being 1 month from a 'critical moment' in the cancer journey (i.e. (i) diagnosis, (ii) end of first treatment, (iii) recurrence, (iv) move from active treatment to palliative care), and aged over 18 years. The main outcome measure was a psychosocial needs inventory comprising seven needs categories (48 need items). A sample of 402 was achieved (40% response rate). Psychosocial needs relating to the need categories 'health professionals', 'information' and 'support networks' are commonly expressed and strongly felt by cancer patients. Needs relating to 'identity', 'emotional and spiritual' issues and 'practical' issues are less commonly expressed but are also strongly felt. Particular needs are related to tumour type, illness 'critical moment', age, gender, health status, socioeconomic and other social factors. This information should increase awareness among cancer care professionals about a range of psychosocial needs and may help them target particular patient groups for particular support interventions.

Family and kinship factors are important as motivations for moving and as major considerations promoting or deferring migration. This is most obviously the case for family events that involve the establishment of new households or the dissolution of old ones, through cohabitation, marriage, separation and divorce. The overall importance of such events can be gauged from life-history data where the timing of residential moves and family events are both recorded. One such data set, from the Social Change and Economic Life Initiative, is used in this paper. The results confirm that there is indeed a relationship between these family events and migration, although there is a surprising number of separations, in particular, which do not seem to have involved residential moves. It may be noted that migration does not necessarily coincide exactly with marriage or divorce, and moves related to these events may sometimes occur a year or two before or after. This is to be expected because residential moves associated with household formation or dissolution may occur well before the family event is made official through marriage or divorce.

Rates of alcohol-related mortality in England and Wales increased significantly for people between the early 1990s and early 21st century, and were substantially greater for those in more disadvantaged socio-economic classes. There is also evidence that these socio-economic differences were greater at younger ages, especially for men at ages 25-49.

Objectives-To seek objective evidence for geographical clustering of places of residence of patients with motor neuron disease (MND). Methods-A complete residential history from birth to onset of disease was obtained from a cohort of 130 patients with MND from Lancashire and south Cumbria presenting to the Department of Neurology in Preston between 1 January 1989 and 31 December 1993. These data were compared with population based reference data from the 1991 UK Census. Results-Some areal units showed a greater, others a lesser, number of MND patient residences than expected. The results suggest that the background population incidence of MND is relatively low and that the overall incidence figures previously quoted have been skewed upwards by areas in which the incidence of MND is relatively increased. These findings were further tested by Poisson modelling. The Poisson model provided a poor fit for the data at postcode district and sector levels confirming that patients with MND were significantly more likely to have lived in some areas than others after allowing for variation in population of the diVerent areal units and for variation in duration of residence. Conclusions-These findings reinforce the results of previous work, much of which has been qualitative rather than quantitative. The results presented here suggest a low background incidence of MND in the context of generally quoted overall incidence figures. This low background incidence is, however, skewed upwards by some areal units with a relatively high incidence, thus achieving overall incidence rates comparable with generally quoted figures. We conclude that there is prima facie evidence of spatial patterns in the distribution of places of residence of patients with MND. Further examination of occupational and environmental factors in the lives of the patients with MND is required to obtain a better understanding of the importance of these findings. (J Neurol Neurosurg Psychiatry 1998;65:842-847)

In this paper the extent to which migration of the elderly is linked to changing family living situations is explored. The work described is part of a larger project concerned with the relationship between migration, kinship, and household change. Discussions of the living arrangements of older people have often referred to moves made to join adult children or other relatives. In this paper we use the Household Sample of Anonymised Records to investigate moves of this type. The Sample of Anonymised Records allows the identification of individuals who have joined already existing households within the previous year. We make use of information on people over 65 years in Great Britain who have changed address in the previous year but are now part of a household some of whose members have not moved. This paper is confined to the limited range of information available from the 1991 census but it does allow us to estimate the number of older people making moves of this type, and to identify their age, sex, and marital status, and their relationship to the household they have joined. It is also possible to say something about the households which these people are joining, in terms of tenure and house type, and to describe the distribution of distances moved. Although the data do not allow direct inferences about whether these moves are related to the needs of the old people for care, the census question on limiting long-term illness provides data relevant to this issue.