"Traffic-related pollution," especially diesel combustion produced,
may be shown to increase testosterone. It is my hypothesis that increased
maternal testosterone increases preeclampsia
(http://anthropogeny.com/Incresing%20Testosterone%20and%20Preeclampsia.htm
).
I suggest the findings of Pereira, et al., may be explained by
increased maternal testosterone.
"Traffic-related pollution," especially diesel combustion produced,
may be shown to increase testosterone. It is my hypothesis that increased
maternal testosterone increases preeclampsia
(http://anthropogeny.com/Incresing%20Testosterone%20and%20Preeclampsia.htm
).
I suggest the findings of Pereira, et al., may be explained by
increased maternal testosterone.
We all know eating together as a family can boost conversation,
foster closeness and encourage healthy ways with food. However, a 2011
survey of 1354 people for the insurance firm Cornish Mutual found 48% of
British households do not share a meal every day. [1]
This study shows that by having a family dinner together it can
increase children's daily fruit and vegetable intake to reach the 5 A Day
target. It rei...
We all know eating together as a family can boost conversation,
foster closeness and encourage healthy ways with food. However, a 2011
survey of 1354 people for the insurance firm Cornish Mutual found 48% of
British households do not share a meal every day. [1]
This study shows that by having a family dinner together it can
increase children's daily fruit and vegetable intake to reach the 5 A Day
target. It reinforces the view that children learn more from what adults
do than what they say, therefore it is the parental role modelling that
helps shape their future habits.
The strengths of this study are its large sample size (2383 children)
and reliable methods of assessing dietary intake through a validated food
intake tool. However, there are limitations which have not been noted by
the researchers.
This is a single sample of London schoolchildren taking part in
trials assessing school gardening and diet. We do not know whether the
children who were taking part in this trial may have particular
characteristics that make them different from, for example, children
selected from a completely random primary school sample. Also, the
children in this London area may not be representative of the entire UK
population in terms of culture and ethnicity, which may be related to
family eating patterns.
While home environment and parental food attitudes are likely to
influence the child's food intake, there may be other factors such as
children's preference, social factors or peer pressure. One or a
combination of these factors could directly influence the child's food
intake.
In the United States, the month of October is the national "Eat
Better, Eat Together Month". [2] A tool kit has been developed to promote
family meal time. [3]
If your family isn't already making dining together a priority, now
is the perfect time to start!
REFERENCES
1. Deborah Clark Associates. Press release: Half of UK families are
not eating together. 24 February 2011. http://www.dca-pr.co.uk/Latest-
News/Cornish-Mutual/Half-of-UK-families-are-not-eating-together-123.aspx
We welcome the glossary of theories presented last month by Smith
& Katikireddi (2012) and applaud the intention to introduce wider
thinking from the political sciences on these subjects to health
researchers. Drawing on our practical experiences in the fields of
healthcare management and health services research, we would like to
identify three related areas which may also be useful for the public
health audience....
We welcome the glossary of theories presented last month by Smith
& Katikireddi (2012) and applaud the intention to introduce wider
thinking from the political sciences on these subjects to health
researchers. Drawing on our practical experiences in the fields of
healthcare management and health services research, we would like to
identify three related areas which may also be useful for the public
health audience. We suggest this commentary solely to help the glossary to
be more widely used and increase its impact.
Firstly, although several useful definitions of policymaking are
described, we feel that 'policy' tends to be interpreted too broadly by
public health practitioners, and narrowing down the definition of policy
in relation to the concepts of 'management' and 'governance' might be
useful. Management' refers to the organisation and leadership of practice,
and is primarily concerned with execution and implementation(Mitchell
& Shortell, 2000)). 'Governance' in non-profit contexts most
frequently refers to the funding and oversight roles of government
agencies (Provan & Kenis, 2008). We believe that understanding the
differences between policy, management and governance are essential for
public health researchers to explore how public health, and indeed health
services and public policy more generally operate and can be influenced.
As it stands, the glossary predominantly focuses on policy, rather than
management and governance. However, the theories of policymaking should
not be blindly transferred to the fields of management and governance as
these are often concerned with policy implementation, rather than
policymaking.
Secondly, the glossary notes the existence of knowledge brokerage and
policy entrepreneurship, which are part of a wider debate about how policy
is made, and the role of evidence in policy making. The degree to which
research evidence can, should and actually is used in policy making has
been an area of extensive debate, and it is worth highlighting a number of
seminal sources dealing with these issues. Nutley, Walter and Davies
describe the importance of evidence use by policy makers (Nutley et al.,
2007). Much of the work in this area is informed by the work of Carol
Weiss (1979) with her helpful categorisation of the meanings of research
utilisation into seven categories: as' knowledge-driven', 'problem
solving', 'interactive' 'enlightenment', 'political',' tactical'
'instrumental', and 'research as an intellectual enterprise'(Weiss, 1979).
More recently, Lomas and colleagues have contributed the 'linkage and
exchange' model, focusing on relationships between researchers and
policymakers, now acknowledged to be a fundamental part of knowledge
translation (Lomas & Brown, 2009). Ray Pawson and colleagues have
worked extensively on bringing realist interpretations to the use of
evidence in policy (Greenhalgh et al., 2004; Pawson, 2006). More recently,
a more critical stance about the definitions and uses of evidence has
been taken by Marston and watts (Marston & Watts, 2003)) with the
impact of evidence-use on population outcomes also in doubt (Macintyre,
2003).
Thirdly and finally, we note that the impetus for producing the
glossary was an observation that "public health's efforts to influence
policy often appear to be uninformed by the empirically-based theories
about policymaking developed within social and political sciences". We
welcome the focus on empirically-led theory, but questions remain about
the extent to which the models and rhetoric around policymaking are indeed
data-, as opposed to theory-driven. While it is true that many models of
policy making exist, we believe that it is not clear whether models are
employed analytically to understand empirical datasets, or tested across
different scenarios. This would be a useful exercise for all researchers
interested in evidence-based policy.
Reference List
Greenhalgh, T., Robert, T., MAcfarlane, F., Bate, P., &
Kyriakidou, O. (2004). Diffusion of Innovations in Service Organizations:
Systematic Review and Recommendations. The Milbank Quarterly, 82.
Lomas, J. & Brown, A. D. M. A. (2009). Research and advice
giving: A functional view of evidence-informed policy advice in a Canadian
ministry of health. [References]. Milbank Quarterly., 87, 903-926.
Macintyre, S. (2003). Evidence based policy making. BMJ, 326, 5-6.
Marston, G. & Watts, R. (2003). Tampering with the evidence: A
critical appraisal of evidence-based policy-making. The Drawing Board: An
Australian Review of Public Affairs, 3, 143-163.
Mitchell, S. & Shortell, S. (2000). The Governance and Management
of Effective Community Health Partnerships: A typology for Research,
Policy and Practice. The Milbank Quarterly, 78, 241-289.
Nutley, S., Walter, I., & Davies, H. T. O. (2007). Using
Evidence: How Research Can Inform Public Services. The Policy Press.
Pawson, R. (2006). Evidence-based Policy.
Provan, K. G. & Kenis, P. (2008). Modes of Network Governance:
Structure, Management, and Effectiveness. Journal of Public Administration
Research and Theory, 18, 229-252.
Weiss, C. H. (1979). The Many Meanings of Research Utilization.
Public Administration Review, 39, 426-431.
We all know eating together as a family can boost conversation, foster closeness and encourage healthy ways with food. However, a 2011 survey of 1354 people for the insurance firm Cornish Mutual found 48% of British households do not share a meal every day. [1]
This study shows that by having a family dinner together it can increase children's daily fruit and vegetable intake to reach the 5 A Day target. It reinforces the view that children learn more from what adults do than what they say, therefore it is the parental role modelling that helps shape their future habits.
The strengths of this study are its large sample size (2383 children) and reliable methods of assessing dietary intake through a validated food intake tool. However, there are limitations which have not been noted by the researchers.
This is a single sample of London schoolchildren taking part in trials assessing school gardening and diet. We do not know whether the children who were taking part in this trial may have particular characteristics that make them different from, for example, children selected from a completely ra...
We all know eating together as a family can boost conversation, foster closeness and encourage healthy ways with food. However, a 2011 survey of 1354 people for the insurance firm Cornish Mutual found 48% of British households do not share a meal every day. [1]
This study shows that by having a family dinner together it can increase children's daily fruit and vegetable intake to reach the 5 A Day target. It reinforces the view that children learn more from what adults do than what they say, therefore it is the parental role modelling that helps shape their future habits.
The strengths of this study are its large sample size (2383 children) and reliable methods of assessing dietary intake through a validated food intake tool. However, there are limitations which have not been noted by the researchers.
This is a single sample of London schoolchildren taking part in trials assessing school gardening and diet. We do not know whether the children who were taking part in this trial may have particular characteristics that make them different from, for example, children selected from a completely random primary school sample. Also, the children in this London area may not be representative of the entire UK population in terms of culture and ethnicity, which may be related to family eating patterns.
While home environment and parental food attitudes are likely to influence the child's food intake, there may be other factors such as children's preference, social factors or peer pressure. One or a combination of these factors could directly influence the child's food intake.
In the United States, the month of October is the national "Eat Better, Eat Together Month". [2] A tool kit has been developed to promote family meal time. [3]
If your family isn't already making dining together a priority, now is the perfect time to start!
REFERENCES
1. Deborah Clark Associates. Press release: Half of UK families are not eating together. 24 February 2011.
In their recent paper, Smith and Katikireddi (2012) provide a useful
outline of theories for understanding policymaking. The article is aimed
at public health practitioners and researchers who are seeking to shape
policy. It rightly encourages them to draw on relevant theory to more
productively guide their interactions with, and potential influence on,
relevant policy. This is a timely and welcome...
In their recent paper, Smith and Katikireddi (2012) provide a useful
outline of theories for understanding policymaking. The article is aimed
at public health practitioners and researchers who are seeking to shape
policy. It rightly encourages them to draw on relevant theory to more
productively guide their interactions with, and potential influence on,
relevant policy. This is a timely and welcome message. However, authors
have failed to include an important shift in political science and policy
studies that is highly relevant to the process of shaping public health
policy.
Approaches to thinking about policy come from three epistemological
frameworks (Shaw 2010). Firstly, a rationalist framework that conceives of
policymaking in terms of clear 'stages' that actors simply feed evidence
into. Secondly a political rationalist framework that recognises the way
that ideas, values, interests and actors interact in a more complex, non-
linear way to shape policy. Thirdly a policy-as-discourse framework that
recognises that language and social interaction shape policy. Authors
focus briefly on the first, largely on the second and not at all on the
third. Whilst this perhaps reflects the dominance of rationalist thinking
about policy, by not acknowledging policy-as-discourse authors fail to
provide the glossary that they claim to provide.
A policy-as-discourse approach has relevance for those seeking to
shape health policy because, amongst other things, it acknowledges that
social problems are identified and addressed through the activities of
different interest groups (clinicians, managers, patients and so on). By
drawing attention to the language and arguments used by groups, such an
approach encourages public health practitioners and researchers to
consider how policy problems are framed, by who and why. It also
encourages them to consider their own language and how they might
productively use it to challenge public health policies and open up
possibilities for social change.
We encourage those interested in shaping policy to consider, not only
the theories outlined by Smith and Katikireddi, but also policy-as-
discourse. Such theory reflects a wider 'linguistic and argumentative
turn' in the social and political sciences (Fischer and Forester 1996),
which has been very influential in some areas of social policy, but has
yet to filter through into health policy. Doing so will not only provide
additional insight into what are often complex areas of policy (e.g.
health inequalities), but also ensure a more comprehensive theoretical
landscape from which public health practitioners and researchers can
select appropriately.
References
Fisher F and Forester J (1996) The Argumentative Turn in Policy
Analysis and Planning. Durham/London, Duke University Press.
Shaw SE (2010) Reaching the parts that other theories and methods
can't reach: How and why a policy-as-discourse approach can inform health-
related policy. Health 14(2) 196-212
Smith KE and Katikireddi SV (2012) A glossary of theories for
understanding policymaking. JECH Online First doi:10.1136/jech-2012-
200990.
It is with great interest we read "Frequent shopping by men and women increases survival in the older Taiwanese population" by Chang et al.1 The authors have found that highly frequent shopping compared to never or rarely is likely to predict survival as it captures several dimensions of personal well-being, health and security as well as contributing to the community's cohesiveness and economy. The significance has remained after...
It is with great interest we read "Frequent shopping by men and women increases survival in the older Taiwanese population" by Chang et al.1 The authors have found that highly frequent shopping compared to never or rarely is likely to predict survival as it captures several dimensions of personal well-being, health and security as well as contributing to the community's cohesiveness and economy. The significance has remained after adjustment for a number of covariates, including common and classical risk factors such as smoking, alcohol, and physical inactivity, in the regression models. However, the most important mortality predictor particularly in the adulthood, hypertension, was not taken into account.2
More than that, recent research have discovered that higher blood pressure in early adulthood was associated with elevated risk of all-cause mortality and other chronic diseases.3 In this context, therefore, without considering hypertension symptoms in the pathway between shopping behaviour and risk of death could seriously bias the effect that was observed since without having hypertension shall exhibit stronger protective effect on survival. In spite of this, the prevalence of hypertension is predicted to increase more among women than men.4 In the current study, women actually did less shopping than men. These together are likely to imply a correlation between hypertension and shopping behaviour on risk of death. Furthermore, as shopping is related to money status, individual income would be a potential buffer because people with more money and/or higher socioeconomic status are more capable of doing shopping. I wonder this should be also considered before drawing the conclusion and bringing the public health message to the general public.
References
1. Chang YH, Chen RCY, Wahlqvist ML, Lee MS. Frequent shopping by men and women increases survival in the older Taiwanese population. J Epidemiol Community Health. 2012;66:e20.
2. Chiang CE, Wang TD, Li YH, Lin TH, Chien KL, Yeh HI, Shyu KG, Tsai WC, Chao TH, Hwang JJ, Chiang FT, Chen JH; Hypertension Committee of the Taiwan Society of Cardiology. 2010 Guidelines of the Taiwan Society of Cardiology for the management of hypertension. J Formos Med Assoc. 2010109:740-773.
3. Gray L, Lee IM, Sesso HD, Batty GD. Blood pressure in early adulthood, hypertension in middle-age, and future cardiovascular disease mortality: HAHS (Harvard Alumni Health Study). J Am Coll Cardiol. 2011;58:2396-2403.
4. Pimenta E. Hypertension in women. Hypertens Res. 2012;35:148-152.
The aim of the authors was to assess the validity and agreement of
self-reported prevalent cases of stroke and AMI in the Spanish cohort of
the European Prospective Investigation into Cancer and Nutrition (EPIC).
They calculated sensitivity, specificity, positive predictive values and ?
statistics. The sensitivity of self-reported prevalent cases of stroke was
81.3% and that for AMI was 97.7%. The positive predictive value...
The aim of the authors was to assess the validity and agreement of
self-reported prevalent cases of stroke and AMI in the Spanish cohort of
the European Prospective Investigation into Cancer and Nutrition (EPIC).
They calculated sensitivity, specificity, positive predictive values and ?
statistics. The sensitivity of self-reported prevalent cases of stroke was
81.3% and that for AMI was 97.7%. The positive predictive value was 22.2%
and 60.7% for stroke and AMI, respectively. The agreement between self-
report questionnaire results and medical records was substantial (?=0.75)
for AMI but not for stroke (?=0.35).1
To scientifically assess the accuracy (validity) of a test, there are 7
estimations named Sensitivity, Specificity, Positive Predictive Value
(PPV), Negative Predictive Value (NPV), Likelihood ratio positive, LR+
(true positive/false positive), Likelihood ratio negative, LR- (false
negative/true negative) and finally Odds ratio, OR (true results /false
results).2 Considering limitations of the first 4 estimations, preferably
the last 3 estimations are being reported. However, due to the different
range of these estimations [(LR+ from 1 to infinity; the higher, the
better) (LR- from 0 to 1; the closer to the zero, the better) and OR
greater than 50 indicates a valid test), usually two different tests are
being evaluated compared to a gold standard. 2
Regarding agreement, to compute kappa value, just concordant cells are
being considered, whereas discordant cells should also be taking into
account in order to reach a correct estimation of agreement (Weighted
kappa).2-4
It is crucial to know that there is no value of kappa that can be regarded
universally as indication good agreement. Statistics cannot provide a
simple substitute for clinical judgment. Two important weaknesses of k
value to assess agreement of a qualitative variable are as follow: It
depends upon the prevalence in each category and also depends upon the
number of categories. So it is obvious that the less our categories, the
higher will be our kappa value which can easily lead to
misinterpretation.2-4
S.Sabour, MD, PhD
References:
1- Mach?n M, Arriola L, Larra?aga N, Amiano P, Moreno-Iribas C, Agudo A,
Ardanaz E, Barricarte A, Buckland G, Chirlaque MD, Gavrila D, Huerta JM,
Mart?nez C, Molina E, Navarro C, Quiros JR, Rodr?guez L, Sanchez MJ,
Gonz?lez CA, Dorronsoro M. Validity of self-reported prevalent cases of
stroke and acute myocardial infarction in the Spanish cohort of the EPIC
study. J Epidemiol Community Health. 2012 May 10
2- Epidemiology, biostatistics and preventive medicine, Jeckel, 1st
edition, 2008
3- Modern Epidemiology, K. Rothman, 3 rd edition, 2010
4- Clinical Epidemiology, D.E Grobbee, 1st edition, 2010
I was interested to read your letter/article in the Journal of
Epidemiology and Community Health, and your conclusion that there were
significant reductions in IMR. You wondered whether this might have been
due to interventions such as Sure Start and the Health in Pregnancy grant.
I would be surprised if the latter played any significant part, as it came
far too late in pregnancy to do anything significant and, anecdotally...
I was interested to read your letter/article in the Journal of
Epidemiology and Community Health, and your conclusion that there were
significant reductions in IMR. You wondered whether this might have been
due to interventions such as Sure Start and the Health in Pregnancy grant.
I would be surprised if the latter played any significant part, as it came
far too late in pregnancy to do anything significant and, anecdotally at
least, was often spent on items that would not contribute to health
outcomes. As a midwife and health visitor, it seemed the most ill-thought-
out piece of spending the government put in place, spending that could so
easily have been better used earlier in pregnancy, if directed more
specifically - maybe to provide maternal folic acid and Vitamin D freely
to all pregnant women.
If we are seeing an improvement in inequalities in IMR, I would
submit that higher breastfeeding initiation and continuation rates, and
the investment that the government of the time put into supporting
breastfeeding (largely withdrawn now), could well be a significant
contributing factor. Recent DH data comparing admissions and breastfeeding
rates show a significant reduction in admissions of infants to hospital
for conditions such as chest infections, bronchiolitis and gastroenteritis
in areas where breastfeeding rates are high, even where deprivation levels
are also high. Modelling by Bartick and Reinhold (2010) in the US showed
that, if 90% women followed the recommendations to breastfeeding
exclusively for 6 months, over 900 excess infant deaths would be prevented
each year, as well as $13 billion annually. I believe that similar
modelling is being undertaken in the UK, and I would imagine it might well
show similar results, even if on a smaller scale.
Conflict of Interest:
I am Infant Feeding Coordinator for a London borough, tasked with leading the borough to UNICEF Baby Friendly accreditation, to ensure that all mothers, however they choose to feed their babies, receive the information and support they need to do that appropriately and successfully.
Numerous studies conducted have found evidence for a positive
relation between green space in peoples environment and self reported
indicators of morbidity and mortality (Lee and Maheswaran, 2011). The
authors in this study have found mortality from all causes to be higher in
greener cities. Attempts have been made to adjust for factors which may
act as confounders, however other community level factors have not been
tak...
Numerous studies conducted have found evidence for a positive
relation between green space in peoples environment and self reported
indicators of morbidity and mortality (Lee and Maheswaran, 2011). The
authors in this study have found mortality from all causes to be higher in
greener cities. Attempts have been made to adjust for factors which may
act as confounders, however other community level factors have not been
taken into account which influence mortality levels like health care
access and crime rates in the cities. Part of the relation found in the
study between green space and all causes mortality may be explained by
indirect selection. Indirect selection takes place when people with
certain characteristics related to well being (such as income) tend to
live in a greener environment. Migration flows are related to
sociodemographic characteristics such as age, income and education (Maas
et al, 2009). Possible migration of the elderly post retirement to greener
areas may most likely skew all cause mortality levels and which needs
investigation. Moreover, no association was found between greenness and
mortality from diseases of lung cancer, heart disease, diabetes and motor
vehicle fatalities when analyzed individually. Analysis of the mortality
data based on the city of residence may prove more helpful in
understanding the association between greenness and health, given that
many diseases develop temporally and exposure could have occurred in the
past.
Also, the authors have used the proportion of households without an
automobile as a measure of automobile dependency for urban form and
function. The number of household members and the number of cars per
household have been ignored and which influence the measure of automobile
dependency differently.
References
1. Lee ACK and Maheswaran. The healthcare benefits of urban green spaces:
a review of the evidence. J Public Health (2011) 33 (2); 212-222
2. Maas J, Verheij RA, Spreeuwenberg P, Groenewegen PP. Physical activity
as a possible mechanism behind the relationship between green space and
health: a multilevel analysis. BMC Public Health. 2008 Jun 10;8:206.
Sir,
I read with interest the article by Yu-Hung Chang et al.(1) Authors have articulated some limitations in their paper.
However, the findings are derived from purpose of the Elderly Nutrition and Health Survey in Taiwan (1999-2000), done to assess the diet, nutrition and health of persons aged 65 and above in Taiwan. One of the common and often forgotten limitation of such surveys is Survivor Bias.(2) People who go to shoppin...
Sir,
I read with interest the article by Yu-Hung Chang et al.(1) Authors have articulated some limitations in their paper.
However, the findings are derived from purpose of the Elderly Nutrition and Health Survey in Taiwan (1999-2000), done to assess the diet, nutrition and health of persons aged 65 and above in Taiwan. One of the common and often forgotten limitation of such surveys is Survivor Bias.(2) People who go to shopping might be those who are healthy and survived minor illness. Hence, Survival is a determinant of whether people remain active and whether they can go to shopping. Also, people who are debilitated, disabled and who have severe illness might not be able to go to shopping at all. It will be interesting to know whether authors have considered this limitation and if yes, why have they not chosen to discuss regarding this in their paper.
References:-
1. Chang Y-H, Chen RC-Y, Wahlqvist ML, et al. J Epidemiol Community Health (2011). doi:10.1136/jech.2010.12669
2. Giridhara R Babu.Do you see an elephant or just its trunk? The need of learning Modern Epidemiologic Methods: An introduction. The Internet Journal of Epidemiology. 2011 Volume 10 Number 1 (Under Print)
"Traffic-related pollution," especially diesel combustion produced, may be shown to increase testosterone. It is my hypothesis that increased maternal testosterone increases preeclampsia (http://anthropogeny.com/Incresing%20Testosterone%20and%20Preeclampsia.htm ).
I suggest the findings of Pereira, et al., may be explained by increased maternal testosterone.
Conflict of Interest:
...We all know eating together as a family can boost conversation, foster closeness and encourage healthy ways with food. However, a 2011 survey of 1354 people for the insurance firm Cornish Mutual found 48% of British households do not share a meal every day. [1]
This study shows that by having a family dinner together it can increase children's daily fruit and vegetable intake to reach the 5 A Day target. It rei...
We welcome the glossary of theories presented last month by Smith & Katikireddi (2012) and applaud the intention to introduce wider thinking from the political sciences on these subjects to health researchers. Drawing on our practical experiences in the fields of healthcare management and health services research, we would like to identify three related areas which may also be useful for the public health audience....
We all know eating together as a family can boost conversation, foster closeness and encourage healthy ways with food. However, a 2011 survey of 1354 people for the insurance firm Cornish Mutual found 48% of British households do not share a meal every day. [1]
This study shows that by having a family dinner together it can increase children's daily fruit and vegetable intake to reach the 5 A Day target. It reinforces the view that children learn more from what adults do than what they say, therefore it is the parental role modelling that helps shape their future habits.
The strengths of this study are its large sample size (2383 children) and reliable methods of assessing dietary intake through a validated food intake tool. However, there are limitations which have not been noted by the researchers.
This is a single sample of London schoolchildren taking part in trials assessing school gardening and diet. We do not know whether the children who were taking part in this trial may have particular characteristics that make them different from, for example, children selected from a completely ra...
Show MoreDear Editor
In their recent paper, Smith and Katikireddi (2012) provide a useful outline of theories for understanding policymaking. The article is aimed at public health practitioners and researchers who are seeking to shape policy. It rightly encourages them to draw on relevant theory to more productively guide their interactions with, and potential influence on, relevant policy. This is a timely and welcome...
The aim of the authors was to assess the validity and agreement of self-reported prevalent cases of stroke and AMI in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). They calculated sensitivity, specificity, positive predictive values and ? statistics. The sensitivity of self-reported prevalent cases of stroke was 81.3% and that for AMI was 97.7%. The positive predictive value...
I was interested to read your letter/article in the Journal of Epidemiology and Community Health, and your conclusion that there were significant reductions in IMR. You wondered whether this might have been due to interventions such as Sure Start and the Health in Pregnancy grant. I would be surprised if the latter played any significant part, as it came far too late in pregnancy to do anything significant and, anecdotally...
Numerous studies conducted have found evidence for a positive relation between green space in peoples environment and self reported indicators of morbidity and mortality (Lee and Maheswaran, 2011). The authors in this study have found mortality from all causes to be higher in greener cities. Attempts have been made to adjust for factors which may act as confounders, however other community level factors have not been tak...
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