DEVELOPING THEORIES AND METHODS FOR PRACTICE

In this issue we carry a number of convergent papers on Theory and Methods that will contribute to the debate about “fit for purpose” academic support for practice. From the United States, Dr Roux provides a comprehensive glossary of terms for the increasingly important multilevel analysis, while Wardle and colleagues explore the use of a home affluence scale as an alternative means of assessing socioeconomic status in adolescence.

See pages 588, 595

From Manchester come two complementary papers that propose the use of impact numbers in health policy decisions and in measuring the effects of interventions on population health, and McCarthy and his London group contribute to the developing literature of health impact assessment, environmental change, and development.

See pages 600, 606, 611

In our Research section, Ross River Virus transmission and climate variability get a rare outing—we could do with more environmental health in this journal. A fascinating report on the changing sex ratio in Iran between 1976 and 2000 raises more questions than it answers, and from Sweden, there is support for the idea that early unemployment can contribute to adult health problems.

See pages 617, 622, 624

From Israel, Biderman reports on a set of common risk factors that increase the risk of falls and depression in the elderly, and Smits in the Netherlands demonstrates a higher risk of stroke in areas of below average socioeconomic status.

See pages 631, 637

In a stronger set of papers on Public Health Policy and Practice than usual, a British group offer an approach to performance managing public health governance, while Virtanen and colleagues from Finland throw light on the impact of perceived security in employment, as compared with contractual security, on health status. The outbreak of unexplained illness among heroin users in parts of Europe during the year 2000 finds a footnote from Dublin in a case-control study that spotlights the risk of injecting into muscle. From America comes support for feminist concerns about interference in normal childbirth to suit the routines of hospital life, and from Britain comes a substantial offering on “Transitions to informal care during the 1990s”—with a rapidly aging population we can expect research in support of practice to be a major growth area in relation to informal and lay care.

See pages 563, 569, 575, 577, 579

Our Gallery this month, coming from the Andes, reminds us of the continuing consequences to traditional health care systems from the over enthusiastic export of Western practices in the past. Miranda informs us that we are still undoing the damage and redefining the role of traditional birth attendants. Over zealous technical interference is of course a problem in the West and North too, see above.

See page 562

Finally, Speaker's Corner reminds us of the complex nuances of power, politics, and social class at a time when some believe that the post-second world war expansion of opportunity is coming to a halt with the nouveau middle class pulling the ladder up behind it.

See page 562