{"title":"Smoking in pregnancy and low weight babies: a statistical consideration.","authors":"S J Senn","doi":"10.1136/jech.31.4.272","DOIUrl":"https://doi.org/10.1136/jech.31.4.272","url":null,"abstract":"A previously published article tries to account for the higher mortality of low birth weight babies born to mothers who do not smoke by a hypothesis concerning the mean birth weights below an arbitrary level based on the nature of the normal distribution. It claims that if the birth weights of babies born to mothers either smokers or nonsmokers are distributed as normal distributions of equal variance then under certain conditions one would expect on mathematical grounds that the average weight of low weight babies would be greater if their mothers smoked than if they did not despite the fact that overall the mean birth weight of babies born to mothers who do not smoke is highest. If low weight babies born to mothers who smoke are on average heavier than those born to mothers who do not smoke the mortality of such a group (other things being equal) would be lower. However this argument is not mathematically justified and is based on a false premise since if there are two normal distributions of equal variance but different means the average value of the variable in question in any given fixed range will always be greater in the distribution with the higher mean. Thus the published article is correct in stating that in practice the difference in mean birth weights of low weight babies is likely to be small but it is incorrect in proposing that a reversal of mean weights may in certain conditions occur if birth weights are distributed normally.","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"31 4","pages":"272-3"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.31.4.272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11800548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Geographical variation mortality from ischaemic heart disease in England and Wales.","authors":"R R West","doi":"10.1136/jech.31.4.245","DOIUrl":"https://doi.org/10.1136/jech.31.4.245","url":null,"abstract":"<p><p>Analysis ofthe proportional mortality attributed to ischaemic heart disease, adjusted for age, reminds us that many of the well known geographical, environmental, social, and economic variations within England and Wales are not disease specific.</p>","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"31 4","pages":"245-50"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.31.4.245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11800703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Developmental and behavioural functions in young children with elevated blood lead levels.","authors":"J M Ratcliffe","doi":"10.1136/jech.31.4.258","DOIUrl":"https://doi.org/10.1136/jech.31.4.258","url":null,"abstract":"<p><p>Blood lead levels in some pre-schoolchildren living near a lead works and particularly in some children with fathers employed at the lead works showed evidence of increased exposure. Forty-seven of them took part three years later in a follow-up study of their developmental and behavioural functions. The children were aged between 4 and 5 1/2 years and were closely matched for age, sex, social class, parental education, area, and length of residence. Only three children had moved house since their blood lead levels had been examined at two years of age; these levels ranged between 18 and 64 microgram/100 ml. None of the children had clinical symptoms of plumbism. No statistically significant (P less than or equal to 0.05) differences were found on developmental and behavioural scores when the children were divided into two groups of less than or equal to 35 microgram/100 ml (n = 23) and greater than 35 microgram/100 ml (n = 24). The differences in scores were of the same order as those between boys and girls, which were themselves generally not significant. Behaviour ratings did not differ. The variations in developmental skills were generally found to be more related to age and schooling; neither these factors nor the difference in sex was related to blood lead levels.</p>","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"31 4","pages":"258-64"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.31.4.258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11800705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cleft lip and palate in the Oxford area. An examination of the evidence for clustering in space and time.","authors":"A B Heath","doi":"10.1136/jech.31.4.269","DOIUrl":"https://doi.org/10.1136/jech.31.4.269","url":null,"abstract":"<p><p>Children with cleft lip and/or palate born during the period 1965-74 inclusive in the Oxford area were examined for evidence of any tendency for clustering. The methods suggested by Knox (1963), David and Barton (1966), and Smith and Pike (1974) were used. No clustering was evident in space or in time. There was some indication of clustering in space-time for isolated cleft palate during the period 1965-71, but this was not repeated during 1972-74.</p>","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"31 4","pages":"269-71"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.31.4.269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11800547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Why do women consult doctors? Social factors and the use of the general practitioner.","authors":"S A Beresford, J J Waller, M H Banks, C J Wale","doi":"10.1136/jech.31.4.220","DOIUrl":"https://doi.org/10.1136/jech.31.4.220","url":null,"abstract":"<p><p>This study was designed to investigate personal and social factors associated with demand for care by women aged between 20 and 44 years, a group unlikely to suffer from chronic illness. A random sample of women was drawn from the age-sex register of a south London group practice, and information was obtained concerning their daily symptom perception, anxiety level, social and health characteristics, and their consultations for one year. Social class, family involvement, number of children in household, satisfaction with the housing, and use of other health and social services were not associated with demand for general practitioner care. Absence of basic housing amenities, difficulties in running the household, brevity of stay in the house or neighbourhood, and lack of attachment of the neighbourhood were related to a high patient-initiated consultation rate. Some of the possible interpretations of these results are discussed together with their implications for social policy planning.</p>","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"31 4","pages":"220-6"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.31.4.220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11800699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A study of the organisation and functioning of the obstetric services in a health district.","authors":"D S Parken, P G Holt, D G Williams","doi":"10.1136/jech.31.4.227","DOIUrl":"https://doi.org/10.1136/jech.31.4.227","url":null,"abstract":"<p><p>A study was undertaken into the obstetric services of a health district to find out whether the new purpose-built obstetric accommodation was still needed and, if so, the best method for bringing it into use. If it was not required for its original purpose it was hoped that the study would reveal an alternative use. It was also hoped that the study would answer any further questions that might emerge from the investigation. The study showed that the purpose-built obstetric accommodation was not a present required. It was recommended that the 22 obstetric beds should be used for gynaecology and that the accommondation upgraded earlier for that purpose should form part of the geriatric provision.</p>","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"31 4","pages":"227-30"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.31.4.227","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11800700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perceived illness and its treatment. A naturalistic study in social medicine.","authors":"H Fabrega","doi":"10.1136/jech.31.4.213","DOIUrl":"https://doi.org/10.1136/jech.31.4.213","url":null,"abstract":"<p><p>This is the initial report of a longitudinal study conducted in a developing, culturally heterogeneous society. The study compares figures of frequency and length of perceived illness, subjective reports of biological and behavioural symptoms, and use of medical facilities in response to episodes of illness by female heads of households from two highly distinctive social-ethnic groups. Despite differences in socioeconomic status and cultural beliefs about disease and treatment, both groups showed roughly comparable rates of perceived illness, but certain differences were noted. The more prosperous Western group termed ladinos, showed they had had more illness which had also lasted longer, as well as higher levels of symptoms. The medical actions of the two groups in response to these episodes of illness differed. The significance of these results is discussed with respect to the multiplicity of factors which influence health status and judgements of perceived illness.</p>","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"31 4","pages":"213-9"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.31.4.213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11800698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidence of diabetes mellitus in Oslo, Norway 1956-65.","authors":"H J Ustvedt, E Olsen","doi":"10.1136/jech.31.4.251","DOIUrl":"https://doi.org/10.1136/jech.31.4.251","url":null,"abstract":"A study of the incidence of diabetes mellitus in Oslo for the period 1925-54 (Westlund, 1966), based on a comprehensive compilation of hospital documents, has been extended to 1956-65. The incidence rates for the two periods have been compared, by taking the year of diagnosis and age at diagnosis in each case. The incidence rates for 1925-54 were revised by adding cases for this period discovered during the 1956-65 study, and showed no major changes. In particular, few new cases were found that had been diagnosed during the second world war, so that the dramatic reduction in incidence shown in Westlund's paper is not affected. The trend is fairly constant, with two exceptions: there was an increase in incidence for boys and girls younger than 10 years and a decrease for women aged between 40 and 59 years. After considering the various sources of error in such a comparison it is concluded that since 1950 there may have been a real increase in rates of diabetes in children. The decrease in rates for middle-aged women is not supported by mortality data for which statistics are given for associated as well as for underlying causes. Mortality data are however difficult to interpret, and by relying on hospital documents and death certificates considerably higher incidence rates have been presented than would have been the case had the incidence estimations been based on death certificates alone. The incidence rates in 1956-64 for children tally fairly well with those reported for Great Britain and Ireland (Bloom et al., 1975) and for northern Norway (Bratlid, 1976).","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"31 4","pages":"251-7"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.31.4.251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11800704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Social group and mortality in Finland.","authors":"S. Näyhä","doi":"10.1136/jech.31.4.231","DOIUrl":"https://doi.org/10.1136/jech.31.4.231","url":null,"abstract":"Morality rates for various social groups within the population of Finland were compared, using 179 919 death certificates for the period 1969-72. Morality was generally lowest in the highest social groups and highest among unskilled workers. Male mortality from coronary heart disease was also high among lower salaried employees. In the less developed area of northern Finland, female mortality from coronary heart disease and vascular lesions of the central nervous system was highest among the agricultural population. Cancer of the breast, cancer of the intestine, and suicides among women were apparently concentrated in the higher classes. Life table analysis showed that the social group differences in life expectancy at birth could be as great as 7.2 years. It is considered indispensable for a national health policy to improve on the recording of occupational data and to give regularly the occupation of the deceased when publishing mortality rates.","PeriodicalId":75622,"journal":{"name":"British journal of preventive & social medicine","volume":"19 1","pages":"231 - 237"},"PeriodicalIF":0.0,"publicationDate":"1977-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87191240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}