Order of birth and the strongly associated variable maternal age have often been investigated as possible determinants of a variety of congenital abnormalities. The work of Penrose (1934) and Malzberg (1950) on mongolism, and that of Still (1927) and McKeown, MacMahon, and Record (1951) on congenital pyloric stenosis has pointed to some of the difficulties. Birth order has also frequently been examined in studies of intelligence, juvenile delinquency, psychosis, and epilepsy, and after allowance has been made for the pitfalls in such investigations a general impression remains of a handicapping of the first-born. In psychiatric work, the emphasis shifts somewhat from the order of birth to the position in the family. This has long been looked upon as one of the influences moulding character. The schools of Freud and Adler in particular have always laid stress on this factor, and the tacit assumption has been made that it is also of aetiological importance in the production of mental and nervous disorder. If this is so, the decrease in mean family size from Victorian times to the present (from 5-71 to 2 19, vide Report of the Royal Commission on Population, 1949) may be important. Despite a wealth of anecdotal material there is a surprising paucity of recorded factual evidence. The present investigation attempts to answer the question whether the incidence of neurosis is related to maternal age and order of birth. The incidence of neurotic illness in only children, and in youngest, intermediate, and eldest children in families with more than one child, is also examined, as is the association with father's age, age differences between parents, and loss of one or both parents. Parts of this field have been surveyed in the last thirty years, particularly by Holmes (1921), Jones (1933), Thurstone and Jenkins (1931), Hsiao (1931), and Miller (1944), but much new material has been published since these reports were compiled.
{"title":"Incidence of neurosis related to maternal age and birth order.","authors":"A NORTON","doi":"10.1136/jech.6.4.253","DOIUrl":"https://doi.org/10.1136/jech.6.4.253","url":null,"abstract":"Order of birth and the strongly associated variable maternal age have often been investigated as possible determinants of a variety of congenital abnormalities. The work of Penrose (1934) and Malzberg (1950) on mongolism, and that of Still (1927) and McKeown, MacMahon, and Record (1951) on congenital pyloric stenosis has pointed to some of the difficulties. Birth order has also frequently been examined in studies of intelligence, juvenile delinquency, psychosis, and epilepsy, and after allowance has been made for the pitfalls in such investigations a general impression remains of a handicapping of the first-born. In psychiatric work, the emphasis shifts somewhat from the order of birth to the position in the family. This has long been looked upon as one of the influences moulding character. The schools of Freud and Adler in particular have always laid stress on this factor, and the tacit assumption has been made that it is also of aetiological importance in the production of mental and nervous disorder. If this is so, the decrease in mean family size from Victorian times to the present (from 5-71 to 2 19, vide Report of the Royal Commission on Population, 1949) may be important. Despite a wealth of anecdotal material there is a surprising paucity of recorded factual evidence. The present investigation attempts to answer the question whether the incidence of neurosis is related to maternal age and order of birth. The incidence of neurotic illness in only children, and in youngest, intermediate, and eldest children in families with more than one child, is also examined, as is the association with father's age, age differences between parents, and loss of one or both parents. Parts of this field have been surveyed in the last thirty years, particularly by Holmes (1921), Jones (1933), Thurstone and Jenkins (1931), Hsiao (1931), and Miller (1944), but much new material has been published since these reports were compiled.","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 4","pages":"253-8"},"PeriodicalIF":0.0,"publicationDate":"1952-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.4.253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22589778","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 note on the sex ratio in anencephalus.","authors":"B MACMAHON, T MCKEOWN","doi":"10.1136/jech.6.4.265","DOIUrl":"https://doi.org/10.1136/jech.6.4.265","url":null,"abstract":"","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 4","pages":"265-6"},"PeriodicalIF":0.0,"publicationDate":"1952-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.4.265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22589780","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}
Between 1939 and 1946, over 7 million men were examined by the medical boards of the Ministry of Labour and National Service out of a possible population of about 10 million. The object of the examination was to separate the fit from the unfit for military service. The records give information about both these classes, and provide a mass of data?which could hardly have been collected by normal methods of research?about the relationship between certain body measurements, occupation, age, place of birth, and medical grade. These records have been made available to us, and are being used to estimate the distribution of stature, weight, and chest circumference in the population, and to define such variations in these measurements as can be related to age, domicile, and occupation. Knowledge about the way stature and weight vary in the population is useful in dealing with a number of practical problems, such as the assessment of nutritional status, and the standardiza tion of the dimensions of equipment and clothing. A preliminary study has been made of the data for Scotland, and the findings for stature are reported here.
{"title":"Stature of Scotsmen aged 18 to 40 years in 1941.","authors":"E M B CLEMENTS, K G PICKETT","doi":"10.1136/jech.6.4.245","DOIUrl":"https://doi.org/10.1136/jech.6.4.245","url":null,"abstract":"Between 1939 and 1946, over 7 million men were examined by the medical boards of the Ministry of Labour and National Service out of a possible population of about 10 million. The object of the examination was to separate the fit from the unfit for military service. The records give information about both these classes, and provide a mass of data?which could hardly have been collected by normal methods of research?about the relationship between certain body measurements, occupation, age, place of birth, and medical grade. These records have been made available to us, and are being used to estimate the distribution of stature, weight, and chest circumference in the population, and to define such variations in these measurements as can be related to age, domicile, and occupation. Knowledge about the way stature and weight vary in the population is useful in dealing with a number of practical problems, such as the assessment of nutritional status, and the standardiza tion of the dimensions of equipment and clothing. A preliminary study has been made of the data for Scotland, and the findings for stature are reported here.","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 4","pages":"245-52"},"PeriodicalIF":0.0,"publicationDate":"1952-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.4.245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22589777","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}
Statistical procedures may subserve either of two ends. In the conduct of government, commerce, and manufacture it may be legitimate to invoke them with no aim other than to prescribe a course of action which limits certain assignable risks. We speak appropriately of any such prescription as conditional. In biological research our primary concern is to establish propositions worthy to take their place in the corpus of scientific knowledge accepted as a basis for subsequent action unrestricted by immediate administrative preoccupations. We speak of any such assertion as unconditional. Much needless confusion concerning the credentials of statistical techniques arises through failure to recognize how far each is meaningful in one or other domain. Since our concern in this context is with the validification of results obtained in the conduct of scientific research, unconditional statisti cal inference alone is relevant to the end in view.
{"title":"Statistical theory of prophylactic and therapeutic trials. II. Methods of operational advantage.","authors":"L HOGBEN, R WRIGHTON","doi":"10.1136/jech.6.4.205","DOIUrl":"https://doi.org/10.1136/jech.6.4.205","url":null,"abstract":"Statistical procedures may subserve either of two ends. In the conduct of government, commerce, and manufacture it may be legitimate to invoke them with no aim other than to prescribe a course of action which limits certain assignable risks. We speak appropriately of any such prescription as conditional. In biological research our primary concern is to establish propositions worthy to take their place in the corpus of scientific knowledge accepted as a basis for subsequent action unrestricted by immediate administrative preoccupations. We speak of any such assertion as unconditional. Much needless confusion concerning the credentials of statistical techniques arises through failure to recognize how far each is meaningful in one or other domain. Since our concern in this context is with the validification of results obtained in the conduct of scientific research, unconditional statisti cal inference alone is relevant to the end in view.","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 4","pages":"205-25"},"PeriodicalIF":0.0,"publicationDate":"1952-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.4.205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22589775","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}
In Great Britain, men and women die from respiratory tuberculosis at very different rates. After due allowance is made for variations in age structure, the death rate for men is much higher than for women. Even more striking is the difference between the curves exhibiting age-specific death rates in the two sexes. The male curve is now characterized by a slow rise from early adult life to a peak at about 60 years and then a decline to old age. The female curve, in contrast, rises steeply to a high peak between 20 and 30 years and then falls away almost as rapidly. The aim of this paper is to examine some of the many factors which may be responsible for these different mortality patterns. Investigation has been confined to the examination of existing records, all of which have been taken from various volumes of the Registrar-General's Statistical Review of England and Wales, and from his Decennial Supplement for 1931. From these tables, numbers of deaths from respiratory tuberculosis by age, sex, social class, and occupation have been extracted for different years. The populations of each group were obtained from the same source. Age-specific death rates were calculated from these figures in various population groups. In a few instances the calculation had already been made by the Registrar-General. The usefulness of this method of study is limited by the fact that mortality records are the only indices of respiratory tuberculosis used. Death is the terminal event in a disease which may have been going on for many years. A description of the circumstances which are associated at death may bear little or no relation to those which set the morbid process in motion. This is particularly true of circumstances leading to the primary infection with the tubercle bacillus. Tuberculin testing surveys have shown that no significant difference exists between the percentage of male and female reactors (McDougall, 1949a). This fact suggests that mortality differences may be attributed either to some inherent difference between the sexes, to unequal chances of reinfection, or to other environmental inequalities. HISTORICAL TRENDS.-Tuberculosis mortality has been falling for at least a century, and consideration of Fig. 1 gives evidence of the very considerable improvement which has taken place during the past 50 years. The standardized mortality per million for the years 1851-60 was 2,694 for men and 2,854 for women. By 1939 these rates had dropped to 556 and 404 (Registrar General, 1947), a reduction to one-fifth of the male rate and to one-seventh of the female rate.
{"title":"Factors influencing sex differences in mortality from respiratory tuberculosis in England and Wales.","authors":"J C MCDONALD","doi":"10.1136/jech.6.4.259","DOIUrl":"https://doi.org/10.1136/jech.6.4.259","url":null,"abstract":"In Great Britain, men and women die from respiratory tuberculosis at very different rates. After due allowance is made for variations in age structure, the death rate for men is much higher than for women. Even more striking is the difference between the curves exhibiting age-specific death rates in the two sexes. The male curve is now characterized by a slow rise from early adult life to a peak at about 60 years and then a decline to old age. The female curve, in contrast, rises steeply to a high peak between 20 and 30 years and then falls away almost as rapidly. The aim of this paper is to examine some of the many factors which may be responsible for these different mortality patterns. Investigation has been confined to the examination of existing records, all of which have been taken from various volumes of the Registrar-General's Statistical Review of England and Wales, and from his Decennial Supplement for 1931. From these tables, numbers of deaths from respiratory tuberculosis by age, sex, social class, and occupation have been extracted for different years. The populations of each group were obtained from the same source. Age-specific death rates were calculated from these figures in various population groups. In a few instances the calculation had already been made by the Registrar-General. The usefulness of this method of study is limited by the fact that mortality records are the only indices of respiratory tuberculosis used. Death is the terminal event in a disease which may have been going on for many years. A description of the circumstances which are associated at death may bear little or no relation to those which set the morbid process in motion. This is particularly true of circumstances leading to the primary infection with the tubercle bacillus. Tuberculin testing surveys have shown that no significant difference exists between the percentage of male and female reactors (McDougall, 1949a). This fact suggests that mortality differences may be attributed either to some inherent difference between the sexes, to unequal chances of reinfection, or to other environmental inequalities. HISTORICAL TRENDS.-Tuberculosis mortality has been falling for at least a century, and consideration of Fig. 1 gives evidence of the very considerable improvement which has taken place during the past 50 years. The standardized mortality per million for the years 1851-60 was 2,694 for men and 2,854 for women. By 1939 these rates had dropped to 556 and 404 (Registrar General, 1947), a reduction to one-fifth of the male rate and to one-seventh of the female rate.","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 4","pages":"259-64"},"PeriodicalIF":0.0,"publicationDate":"1952-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.4.259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22589779","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}
The relevance to social medicine of changes in the age-structure of a community needs little amplifica tion. A previous communication (Taylor, 1951) demonstrated the importance of adequate provision for a community in which survival to a level pre viously entitled "old age" would be commonplace. Since mortality is so low in the middle age ranges, this communication focuses on the other end of life and seeks to interpret the recent rapid changes in the birth rate with a view to appropriate provision of hospital and ancillary services, the need for which depends on the current number of maternities. Though the issue is of importance in other spheres, e.g. in the demand for educational services, it has special relevance to the National Health Service, if we reflect upon the cost of maternity and child welfare services before, during, and after birth.
{"title":"Cohort analysis of fertility in England and Wales, 1939-50.","authors":"W TAYLOR","doi":"10.1136/jech.6.4.226","DOIUrl":"https://doi.org/10.1136/jech.6.4.226","url":null,"abstract":"The relevance to social medicine of changes in the age-structure of a community needs little amplifica tion. A previous communication (Taylor, 1951) demonstrated the importance of adequate provision for a community in which survival to a level pre viously entitled \"old age\" would be commonplace. Since mortality is so low in the middle age ranges, this communication focuses on the other end of life and seeks to interpret the recent rapid changes in the birth rate with a view to appropriate provision of hospital and ancillary services, the need for which depends on the current number of maternities. Though the issue is of importance in other spheres, e.g. in the demand for educational services, it has special relevance to the National Health Service, if we reflect upon the cost of maternity and child welfare services before, during, and after birth.","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 4","pages":"226-44"},"PeriodicalIF":0.0,"publicationDate":"1952-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.4.226","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22589776","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":"Association of congenital malformation of the heart with birth rank and maternal age.","authors":"B MacMAHON","doi":"10.1136/jech.6.3.178","DOIUrl":"https://doi.org/10.1136/jech.6.3.178","url":null,"abstract":"","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 3","pages":"178-82"},"PeriodicalIF":0.0,"publicationDate":"1952-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.3.178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24383169","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}
The belief that a morbid condition is attributable to their genes may lead parents to limit the size of the sibship in two ways. If the belief precedes the birth of an affected individual (A), the parents may decline to take the risk of producing another. We may then say that the criterion of termination is A = 1. If they have no such preconception, the birth of a second affected sib may lead them to the same conclusion with the same result. We may then say that the criterion of termination is A = 2. Such contingencies raise the question: does the decision to terminate the sibship affect the expected proportion of affected individuals in an otherwise random selection of fraternities? The issue so stated arises frequently in familial studies; and the answer is not so simple as it might appear to be. To clarify it, we shall initially postulate a fixed target value of s, the size the sibship would attain in the absence of any indication relevant to the criterion of termination. This assumption implies the existence of some fraternities which consist of s members, none of them affected. If p = (1q) be the probability that an individual of given parentage will be affected, the probability of this occurrence is qS; and p is also the expected proportion of affected sibs in a complete pool of s-fold fraternities chosen randomwise. We may hope to obtain a complete pool in this sense, if the criterion of ascertainment is the phenotype of one or both parents, as when the relevant morbid condition is hereditary in the sense formerly current in medical literature. The problem is then on all fours with the issue: what would happen if all parents terminated the sibship on the arrival of a boy ? When our concern is with so-called familial conditions, the method of ascertainment excludes fraternities containing no affected members. The expected proportion of affected sibs in a pool of a-fold fraternities, otherwise chosen at random, will then be greater than p, being in fact
{"title":"Selective limitation of sibship size.","authors":"L HOGBEN","doi":"10.1136/jech.6.3.188","DOIUrl":"https://doi.org/10.1136/jech.6.3.188","url":null,"abstract":"The belief that a morbid condition is attributable to their genes may lead parents to limit the size of the sibship in two ways. If the belief precedes the birth of an affected individual (A), the parents may decline to take the risk of producing another. We may then say that the criterion of termination is A = 1. If they have no such preconception, the birth of a second affected sib may lead them to the same conclusion with the same result. We may then say that the criterion of termination is A = 2. Such contingencies raise the question: does the decision to terminate the sibship affect the expected proportion of affected individuals in an otherwise random selection of fraternities? The issue so stated arises frequently in familial studies; and the answer is not so simple as it might appear to be. To clarify it, we shall initially postulate a fixed target value of s, the size the sibship would attain in the absence of any indication relevant to the criterion of termination. This assumption implies the existence of some fraternities which consist of s members, none of them affected. If p = (1q) be the probability that an individual of given parentage will be affected, the probability of this occurrence is qS; and p is also the expected proportion of affected sibs in a complete pool of s-fold fraternities chosen randomwise. We may hope to obtain a complete pool in this sense, if the criterion of ascertainment is the phenotype of one or both parents, as when the relevant morbid condition is hereditary in the sense formerly current in medical literature. The problem is then on all fours with the issue: what would happen if all parents terminated the sibship on the arrival of a boy ? When our concern is with so-called familial conditions, the method of ascertainment excludes fraternities containing no affected members. The expected proportion of affected sibs in a pool of a-fold fraternities, otherwise chosen at random, will then be greater than p, being in fact","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 3","pages":"188-9"},"PeriodicalIF":0.0,"publicationDate":"1952-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.3.188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24384932","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}
All three sources are limited, the first as to scope of diseases, the second as to time, and the third as to age coverage and degree of completeness in reporting (especially during the war years, 1939-45, which have been ignored). Mortality is referred to where the figures are of interest. The diseases studied are dealt with in the following order: chicken-pox, diphtheria, german measles (rubella), measles, mumps, whooping cough, scarlet fever. Chicken-Pox.?A sample of hospital admissions in 1938 gave the figures in Table I for patients admitted with diseases other than chicken-pox. Table I incidence of chicken-pox in hospital admissions, BY SEX, 1938.
{"title":"Incidence of common infections of childhood.","authors":"B BENJAMIN, A T GORE","doi":"10.1136/jech.6.3.197","DOIUrl":"https://doi.org/10.1136/jech.6.3.197","url":null,"abstract":"All three sources are limited, the first as to scope of diseases, the second as to time, and the third as to age coverage and degree of completeness in reporting (especially during the war years, 1939-45, which have been ignored). Mortality is referred to where the figures are of interest. The diseases studied are dealt with in the following order: chicken-pox, diphtheria, german measles (rubella), measles, mumps, whooping cough, scarlet fever. Chicken-Pox.?A sample of hospital admissions in 1938 gave the figures in Table I for patients admitted with diseases other than chicken-pox. Table I incidence of chicken-pox in hospital admissions, BY SEX, 1938.","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 3","pages":"197-204"},"PeriodicalIF":0.0,"publicationDate":"1952-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.3.197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24384935","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}
In the autumn of 1947, the notification of acute rheumatism became compulsory in the County Boroughs of Sheffield, Bristol, Grimsby, and Lincoln, and the Administrative County of Lincolnshire (Parts of Lindsey), thus providing opportunity for a fresh attack on some neglected problems of the disease. The Rheumatic Fever Committee of the Royal College of Physicians decided to exploit this opportunity by setting on foot a special study of the notified cases. The study dealt with the social background of the disease in general and was closely modelled on the Medical Research Council investigation of 1927. The present paper is an abridged version of a report prepared for the Rheumatic Fever Committee of the Royal College of Physicians, but the responsibility for the form of analysis and for the conclusions drawn rests entirely with the authors. In the regulation introducing notification (S.R. and O., No. 1828) acute rheumatism was defined as the following conditions occurring separately or together in a person under the age of 16 years:
{"title":"Some epidemiological aspects of acute rheumatism.","authors":"D HEWITT, A STEWART","doi":"10.1136/jech.6.3.161","DOIUrl":"https://doi.org/10.1136/jech.6.3.161","url":null,"abstract":"In the autumn of 1947, the notification of acute rheumatism became compulsory in the County Boroughs of Sheffield, Bristol, Grimsby, and Lincoln, and the Administrative County of Lincolnshire (Parts of Lindsey), thus providing opportunity for a fresh attack on some neglected problems of the disease. The Rheumatic Fever Committee of the Royal College of Physicians decided to exploit this opportunity by setting on foot a special study of the notified cases. The study dealt with the social background of the disease in general and was closely modelled on the Medical Research Council investigation of 1927. The present paper is an abridged version of a report prepared for the Rheumatic Fever Committee of the Royal College of Physicians, but the responsibility for the form of analysis and for the conclusions drawn rests entirely with the authors. In the regulation introducing notification (S.R. and O., No. 1828) acute rheumatism was defined as the following conditions occurring separately or together in a person under the age of 16 years:","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"6 3","pages":"161-8"},"PeriodicalIF":0.0,"publicationDate":"1952-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.6.3.161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24383167","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}
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