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The article presents a comparison of interview and postal methods of social surveys in field of HIV/AIDS. Interview based surveys about HIV infection usually use quota sampling techniques, while probability samples are drawn for postal surveys. Response rates depends on the perceived relevance of a postal questionnaire and respondents' interest in its subject matter. It is observed that response rates in general are usually high in interviewer surveys. One of the drawbacks of interview surveys are that these surveys suffer from interviewer bias. Face-to-face interviews are more expensive than postal surveys. The circumstances of each study determine the choice of method used. Over the time market research methods have become increasingly popular as a method of study.

Objective: To describe the incidence and prevalence of primary biliary cirrhosis in an urban population between 1987 and 1994, using stringent inclusion criteria and a well-defined study area and population.Design: Descriptive study based on a case register compiled by a retrospective and prospective case-finding exercise and examination of case notes.Setting: The city of Newcastle upon Tyne. MAIN INCLUSION CRITERIA: (1) Definite cases: fulfilling all three of the following diagnostic criteria: positive antimitochondrial antibody (AMA) > or = 1:40; cholestatic liver function tests (LFT); diagnostic or compatible liver histology. (2) Probable cases: fulfilling two of these criteria.Subjects: All cases of primary biliary cirrhosis identified by multiple case-finding methods, alive from 1 January 1987 to 31 December 1994, in the defined area.Main Outcome Measurements: Incidence and point prevalence rates by age and sex.Results: In all, 202 potential cases were identified, of whom 160 met at least two inclusion criteria. In definite cases annual incidence varied from 14 to 32 (mean 22) per million whole population (with no clear trend) and point prevalence rose from 180 per million in 1987 to 240 in 1994. Mean age at diagnosis in cases incident during the study period was 63.2 years (S.D. 11.1 years, range 39.8-85.7 years).Conclusions: Primary biliary cirrhosis is much more common in Newcastle than has previously been reported anywhere in the world, and prevalence appears to be rising. [ABSTRACT FROM AUTHOR]

This review considers the value of the observation that Legionnaires' disease varies geographically. Estimates of disease incidence, derived from case registers and from studies measuring the proportion of cases of pneumonia which are Legionnaires' disease, and of the prevalence of the population with antibody, show that there is geographical variation in disease frequency. Much, but not all, of this variation is artefact due to differences in definitions, diagnostic methods, surveillance systems and data presentation. Some of the variation is attributed to publication bias, e.g. in 10 small studies (< 100 patients) 13.2% of pneumonia patients had Legionnaires' disease but in five large studies (> or = 500 patients) the figure was 3.6%. Research to explain variations has been neglected but a few studies have provided important insights into disease transmission. Future studies should: be based on agreed disease definitions and data collection and analysis methods; analyse subgroups separately; and collect data to develop explanations for geographical variation. [ABSTRACT FROM AUTHOR]

A response from the author of the article "A systematic review on the social context of smokeless tobacco use in the South Asian population: implications for public health," in the 2012;126 issue is presented.

The article offers information on the XIXth International Epidemiology Association (IEA) World Congress of Epidemiology to be held in Edinburgh, Scotland on August 7-11, 2011.

A response by authors including David Walsh, Neil Bendel, and Richard Jones to a letter to the editor about their article "What We Want to Know Is ... Is It True or False," is presented.

A letter to the editor is presented in response to the article "What We Want to Know Is ... Is It True or False."

A response by David Gordon to a letter to the editor about the article "What We Want to Know Is ... Is It True or False," is presented.

Background: Recruitment of ethnic minority groups into trials is important. This was studied from the recruiters' perspective in the Prevention of Diabetes and Obesity in South Asians (PODOSA) trial. Methods: Semi-quantitative questionnaire survey of all 22 health professionals and 27 community workers involved in Edinburgh and Glasgow. Numbers and proportions were tabulated, while free-text responses were grouped into themes. Results: The response rate was 40/49 (82%). In the closed questions, family responsibilities, prior general practitioner screening and low interest were the main factors reported by recruiters as hindering referrals (each 28%), followed by fear of needle pricks and finding out their diabetes status (each 23%). The importance of the prevention of diabetes (60%), explaining the trial in a South Asian language (46%), verbal dialogue (43%) and the recruiter's personal relationship with the recruitee (40%) favoured referrals. Health professionals' perceived strength was their knowledge of diabetes (66%), and community workers' strength was explaining the trial in South Asian languages (65%). Strategies to improve recruitment included stronger partnership between researchers and community organizations. The open-ended response identified seven main themes: (1) shortage of recruiters' and recruitees' time; (2) poor understanding of the trial by recruitees; (3) lack of knowledge about the disease among recruitees; (4) lack of motivation and interest among recruitees; (5) delay in receiving appointments from the PODOSA team; (6) mistrust of research; and (7) narrow entry criteria. Conclusion: These insights into recruiters' perspectives should help trialists improve participation by ethnic minority populations. [ABSTRACT FROM AUTHOR]

Little research has been conducted on health in Chinese communities in the UK and there are few representative data on smoking, alcohol consumption or other aspects of lifestyle. We undertook a cross sectional population-based study of 380 Chinese and 625 European men and women aged 25 to 64 y, using self-completion and interview questionnaires in Newcastle upon Tyne, UK between 1991 and 1995. We measured self-reported prevalence of cigarette smoking, number of cigarettes smoked per week and age at starting smoking; self-reported prevalence of alcohol consumption and units of alcohol consumed per week. In age-adjusted comparisons smoking was less common in Chinese (24%) than European men (35%) (P=0.00002) and among Chinese (1%) compared with European women (33%) (P<0.00001). Number of cigarettes smoked was similar among Chinese and European male smokers. Median age at starting smoking was higher among Chinese (18.5 y) compared with European men (15 y) (P=0.00001). Smoking was commonest in older Chinese and in younger Europeans.The prevalence of alcohol consumption was lower among Chinese (63%) than European men (93%) (P<0.00001) and among Chinese (29%) compared to European women (89%) (P<0.00001). Median alcohol consumption was significantly lower among Chinese (2 units/week) than European men (16 units/week) (P<0.00001), and among Chinese (1 unit/week) compared to European women (6 units/week) (P<0.00001). Among those who drank alcohol, Chinese men were less likely to drink above recommended limits than European men (1% vs 39%; P<0.00001). Chinese men and women currently have relatively favourable patterns of smoking compared to European adults in Newcastle. Average alcohol consumption among Chinese who drink is lower than among Europeans, and a substantial proportion of the Chinese population in Newcastle drink no alcohol. Patterns of health related behaviour should be tracked over time in ethnic minority populations to identify changes that pose risk to... [ABSTRACT FROM AUTHOR]

Objectives Immigration into Europe has raised contrasting concerns about increased pressure on health services and equitable provision of health care to immigrants or ethnic minorities. Our objective was to find out if there were important differences in hospital use between the main ethnic groups in Scotland. Study design A census-based data linkage cohort study. Methods We anonymously linked Scotland's Census 2001 records for 4.62 million people, including their ethnic group, to National Health Service general hospitalisation records for 2001-2013. We used Poisson regression to calculate hospitalisation rate ratios (RRs) in 14 ethnic groups, presented as percentages of the White Scottish reference group (RR = 100), for males and females separately. We adjusted for age and socio-economic status and compared those born in the United Kingdom or the Republic of Ireland (UK/RoI) with elsewhere. We calculated mean lengths of hospital stay. Results 9.79 million hospital admissions were analysed. Compared with the White Scottish, unadjusted RRs for both males and females in most groups were about 50-90, e.g. Chinese males 49 (95% confidence interval [CI] = 45-53) and Indian females 76 (95% CI 71-81). The exceptions were White Irish, males 120 (95% CI 117-124) and females 115 (95% CI 112-119) and Caribbean females, 103 (95% CI 85-126). Adjusting for age increased the RRs for most groups towards or above the reference. Socio-economic status had little effect. In many groups, those born outside the UK/RoI had lower admission rates. Unadjusted mean lengths of stay were substantially lower in most ethnic minorities. conclusions Use of hospital beds in Scotland by most ethnic minorities was lower than by the White Scottish majority, largely explained by their younger average age. Other countries should use similar methods to assess their own experience. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and distribution of, and trends in, physical inactivity and diabetes in adult West African populations. Design: Systematic review and meta-analysis. Methods: Literature searches were conducted using four electronic databases. Journal hand searches and examination of citations of relevant articles were also undertaken. To be included, studies had to be population based, use clearly defined criteria for measuring diabetes and physical inactivity, present data that allowed calculation of the prevalence of diabetes or physical inactivity, and sample adult participants. Studies retrieved were appraised critically. Meta-analysis was performed using the DerSimonian- Laird random effect model. Results: Twenty-one reports were retrieved for diabetes and 15 reports were retrieved for physical in/ activity. Most studies (10 for diabetes and six for physical activity) were conducted solely among urban populations. The prevalence of diabetes in West Africa was approximately 4.0% [95% confidence interval (Cl) 2.0-9.0] in urban adults and 2.6% (95%CI 1.5-4.4) in rural adults, and was similar in men and women [prevalence ratio (PR) 1.36, 95%CI 0.96-1.92]. Cumulative time trend analyses suggested an increase in the prevalence of diabetes among adults in urban West Africa, from approximately 3.0% (95%CI 1.0-7.0) to 4.0% (95%CI 2.0-9.0) in the past 10 years. The prevalence of inactivity in West Africa was 13% (95%CI 9.0-18.0). An association was found between physical inactivity and being older (≥50 years) (PR 1.82, 95%CI 1.36-2.44), female gender (PR 1.62, 95%C1 1.41-1.87) and urban residence (PR 2.04, 95%CI 1.58-2.63). Conclusions: Diabetes and physical inactivity are important public health issues in urban West Africa, with similar prevalences to wealthy industrialized countries. There is an urgent need for policy makers, politicians and health promotion experts to put measures in place to encourage active lifestyles and control diabetes in urban West Africa. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the distribution of and trends in obesity in adult West African populations. Between February and March 2007, a comprehensive literature search was conducted using four electronic databases. Journal hand searches, citations and bibliographic snowballing of relevant articles were also undertaken. To be included, studies had to be population-based, use well-defined criteria for measuring obesity, present data that allowed calculation of the prevalence of obesity and sample adult participants. Studies retrieved were critically appraised. Meta-analysis was performed using the DerSimonian-Laird random effect model. Twenty-eight studies were included. Thirteen studies were conducted in urban settings, 13 in mixed urban/rural and one in rural setting. Mean body mass index ranged from 20.1 to 27.0 kg2. Prevalence of obesity in West Africa was estimated at 10.0% (95% CI, 6.0–15.0). Women were more likely to be obese than men, odds ratios 3.16 (95% CI, 2.51–3.98) and 4.79 (95% CI, 3.30–6.95) in urban and rural areas respectively. Urban residents were more likely to be obese than rural residents, odds ratio 2.70 (95% CI, 1.76–4.15). Time trend analyses indicated that prevalence of obesity in urban West Africa more than doubled (114%) over 15 years, accounted for almost entirely in women. Urban residents and women have particularly high risk of overweight/obesity and obesity is rising fast in women. Policymakers, politicians and health promotion experts must urgently help communities control the spread of obesity in West Africa. [ABSTRACT FROM AUTHOR]

Background: Ethnicity can influence susceptibility to infection, as COVID-19 has shown. Few countries have systematically investigated ethnic variations in infection., Methods: We linked the Scotland 2001 Census, including ethnic group, to national databases of hospitalizations/deaths and serological diagnoses of bloodborne viruses for 2001-2013. We calculated age-adjusted rate ratios (RRs) in 12 ethnic groups for all infections combined, 15 infection categories, and human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses., Results: We analysed over 1.65 million infection-related hospitalisations/deaths. Compared with White Scottish, RRs for all infections combined were 0.8 or lower for Other White British, Other White and Chinese males and females, and 1.2-1.4 for Pakistani and African males and females. Adjustment for socioeconomic status or birthplace had little effect. RRs for specific infection categories followed similar patterns with striking exceptions. For HIV, RRs were 136 in African females and 14 in males; for HBV, 125 in Chinese females and 59 in males, 55 in African females and 24 in males; and for HCV, 2.3-3.1 in Pakistanis and Africans., Conclusions: Ethnic differences were found in overall rates and many infection categories, suggesting multiple causative pathways. We recommend census linkage as a powerful method for studying the disproportionate impact of COVID-19., (© The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health.)

Background: Recording patients' ethnic group supports efforts to achieve equity in health care provision. Before the Equality Act (2010), recording ethnic group at hospital admission was poor in Scotland but has improved subsequently. We describe the first analysis of the utility of such data nationally for monitoring ethnic variation., Methods: We analysed all in-patient or day case hospital admissions in 2013. We imputed missing data using the most recent ethnic group recorded for a patient from 2009 to 2015. For episodes lacking an ethnic code, we attributed known ethnic codes proportionately. Using the 2011 Census population, we calculated rates and rate ratios for all-cause admissions and ischaemic heart diseases (IHDs) directly standardized for age., Results: Imputation reduced missing ethnic group codes from 24 to 15% and proportionate redistribution to zero. While some rates for both all-cause and IHD admissions appeared plausible, unexpectedly low or high rates were observed for several ethnic groups particularly amongst White groups and newly coded groups., Conclusions: Completeness of ethnicity recoding on hospital admission records has improved markedly since 2010. However the validity of admission rates based on these data is variable across ethnic groups and further improvements are required to support monitoring of inequality., (© The Author(s) 2019. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Type 2 diabetes is extremely common in South Asians, e.g. in men from Pakistani and Indian populations it is about three times as likely as in the general population in England, despite similarities in body mass index. Lifestyle interventions reduce the incidence of diabetes. Trials in Europe and North America have not, however, reported on the impact on South Asian populations separately or provided the details of their cross-cultural adaptation processes. Prevention of diabetes and obesity in South Asians (PODOSA) is a randomized, controlled trial in Scotland of an adapted, lifestyle intervention aimed at reducing weight and increasing physical activity to reduce type 2 diabetes in Indians and Pakistanis. The trial was adapted from the Finnish Diabetes Prevention Study. We describe, reflect on and discuss the following key issues: The core adaptations to the trial design, particularly the delivery of the intervention in homes by dietitians rather than in clinics. The use of both a multilingual panel and professional translators to help translate and/or develop materials. The processes and challenges of phonetic translation. How intervention resources were adapted, modified, newly developed and translated into Urdu and Gurmukhi (written Punjabi). The insights gained in PODOSA (including time pressures on investigators, imperfections in the adaptation process, the power of verbal rather than written information, the utilization of English and the mother-tongue languages simultaneously by participants and the costs) might help the research community, given the challenge of health promotion in multi-ethnic, urban societies., (© The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

This study investigated the relationships between Legionnaires' disease (LD) incidence and weather in Glasgow, UK, by using advanced statistical methods. Using daily meteorological data and 78 LD cases with known exact date of onset, we fitted a series of Poisson log-linear regression models with explanatory variables for air temperature, relative humidity, wind speed and year, and sine-cosine terms for within-year seasonal variation. Our initial model showed an association between LD incidence and 2-day lagged humidity (positive, P = 0·0236) and wind speed (negative, P = 0·033). However, after adjusting for year-by-year and seasonal variation in cases there were no significant associations with weather. We also used normal linear models to assess the importance of short-term, unseasonable weather values. The most significant association was between LD incidence and air temperature residual lagged by 1 day prior to onset (P = 0·0014). The contextual role of unseasonably high air temperatures is worthy of further investigation. Our methods and results have further advanced understanding of the role which weather plays in risk of LD infection.

With approximately 1.5 billion people at risk, the staggeringly high risk of Type 2 diabetes in South Asians comprises a global problem. The causes of this high risk are complex, with 23 major risk factors identified in a Lancet seminar. This paper proposes a four-stage explanatory model: (1) the birth of a small, adipose, lowlean mass South Asian baby--the phenotype tracking through life; (2) in childhood and early adulthood, the deposition of any excess energy intake preferentially in upper body and ectopic fat stores rather than in the lower body or superficial subcutaneous fat stores; (3) as a consequence of points 1 and 2, and exacerbated by an environment of low physical activity and excess calories, the accelerated appearance of high levels of plasma insulin, triglycerides and glucose, and the fatty-liver vicious cycle; (4) β-cell failure as a result of fewer β-cells at birth, exposure to apoptotic triggers such as fat in the pancreas, and high demand from insulin resistance, which causes diabetes. Other risk factors--especially energy-dense hyperglycaemic diet and low physical activity--play into this pathway. The recommended behavioural changes fit with this model, which brings clarity to guide future research, policy, practice and health promotion., (© 2012 The Author. Diabetic Medicine © 2012 Diabetes UK.)

Background: Ethnic variations in stroke require more European studies, especially as differences are reportedly large., Methods: We created a retrospective cohort study of 4.65 million people in Scotland linking ethnicity from the census and stroke incidence and mortality from NHS databases. Rate ratios using direct age standardization and risk ratios were calculated, the latter to model the influence of educational qualification in a Poisson regression model., Results: Age-adjusted rate ratios varied little, compared to the White Scottish group (reference value 100) and the 95% CIs usually included 100, e.g. higher in Pakistani men (120.5, 95% CI 95.2-145.8) and in African men (137.9, 95% CI 91.5-184.4) but not in Pakistani or African women. Stroke rates were low in the Other White British (78.3, 95% CI 75.4-81.2 in men and 84.9, 95% CI 82.0-87.8 in women), Other White (89.8, 95% CI 81.5-98.1 in men and 88.8, 95% CI 80.9-96.7 in women) and Chinese men (70.3, 95% CI 45.7-94.8). Adjusting for highest educational qualification attenuated some and augmented other risk ratios, e.g. in Other White British men, the risk ratio changed from 71.4 to 80.2 (95% CI 74.2-86.6) and in African men from 124.2 to 138.8 (95% CI 107.7-178.8)., Conclusions: Ethnic variations deserve further study, including in White European origin subgroups and the Chinese. Extremely high rates in South Asian and African origin were not corroborated in Scotland. Linkage methods are practical in Europe.

Objectives: Smokeless tobacco (SLT) is an addiction resulting in serious health problems including cancers. The social context around SLT use among South Asians was reviewed to help inform interventions for its prevention and cessation., Study Design: Systematic review., Methods: Electronic databases were searched to identify studies examining the social context of SLT use. As heterogeneous qualitative, quantitative and mixed method studies were included, meta-analysis was not appropriate., Results: Of 428 studies identified, 17 were reviewed. These studies were conducted in India, Nepal, Pakistan and the UK between 1994 and 2009. SLT use among South Asians was culturally widely acceptable due to its association with socializing, sharing and family tradition (100% in Anwar et al.'s study). Other reasons for use were addiction, easy accessibility, low cost and lack of prohibitive legislation. SLT users had limited awareness of its association with oral cancer (29.3% in Ahmed et al.'s study); however, there was a distinct lack of knowledge regarding other health effects, such as cardiovascular disease (0.85%). Users attempted to quit (32.7% in Prabhu et al.'s study) but success was low (8.2%)., Conclusions: Cessation programmes for South Asians should address cultural acceptance, limited knowledge of health effects, inadequate legislation and controls, scarce social support and insufficient SLT cessation services., (Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Objective: Ethnic variations in heart failure are, apparently, large (eg, up to threefold in South Asians compared with White populations in Leicestershire, UK) but data are limited and conflicting. The incidence of first occurrence of heart failure hospitalisation or death by ethnic group in Scotland was studied. DESIGN, SETTING, POPULATIONS AND OUTCOMES: A retrospective cohort study was developed of 4.65 million people using non-disclosive, computerised methods linking the Scottish 2001 census (providing ethnic group) to community death and hospital discharge/deaths data (SMR01). Annual, directly age standardised incidence rates per 100,000, incidence rate ratios (RRs) and risk ratios using Poisson regression were calculated. Ratios were multiplied by 100. Risk ratios were adjusted for age and highest education qualification. Statements of difference imply the 95% CI excludes 100 (reference), otherwise the CI is given., Results: In men, other White British (RR=86.4) and Chinese (RR=54.2) had less heart failure than White Scottish (100) populations while Pakistani men had more (RR=134.9). In women, the pattern was similar to men. Adjustment for highest educational qualification attenuated differences in risk ratios in other White British men (risk ratio=75.8 to 85.4) and women (66.2 to 74.6), made little difference to Pakistani men (146.9 to 142.1) and women (177.4 to 158.1), and augmented them in Indian men (115.4 (95% CI 93.1 to 143.0) to 131.7 (107.4 to 161.5))., Conclusions: Ethnic variations in heart failure were important in this population setting and not abolished by adjusting for highest education, one important indicator of socioeconomic differences. The ethnic variations were substantial but did not support other studies showing 3-20-fold differences between ethnic groups.

Background: Accurate waist and hip measurement are increasingly central to the goal of weight control and the battle against diabetes and cardiovascular disease. Protocols and methods vary widely, with little guidance on clothing. This pilot study investigated the effect of light clothing on measurement., Aims: To determine whether light clothing and underwear make a potentially clinically significant difference of 0.5 cm to the measurement of waist and hip circumference in a group of volunteer subjects., Methods: We measured waist circumference over light clothing and then over bare skin. We measured hip circumference over light clothing and then over underwear and with a small sub-group, on bare skin., Results: 50 volunteers were measured. Potentially clinically significant differences were found in the mean values as followed (mean; 95% CI): light clothing compared to bare skin at the waist (0.50 cm; -1.54 to 2.55 cm); light clothing compared to underwear at the hip (2.58 cm; -0.75 to 5.91 cm)., Conclusion: This study demonstrates that the effect of clothing on waist and hip measurements is not always trivial, and deserves a larger study. Waist circumference measurements should be made on bare skin whenever possible and hip circumference measurements over underwear., (© 2010 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.)

Objective: To review the prevalence of diabetes, obesity and physical inactivity among Ghanaians and Nigerians in Africa, Europe and North America., Methods: This systematic literature review used MEDLINE 1966--2005, EMBASE 1980--2005 and cited references to identify relevant studies on Ghanaians and Nigerians., Results: No studies on Ghanaians or Nigerians in Europe or North America have been reported. Sixteen studies in Africa were included; 13 on Nigerians and three on Ghanaians. The data were limited, poorly reported and not easily comparable. Pooled analysis was not possible. Precise time trend analysis was not possible, but diabetes seemed rare at 0.2% in urban Ghana in 1963 and 1.65% in urban Nigeria in 1985. The prevalence of diabetes in Nigerian adults (age > or = 40 years) in 2000 was 6.8% [confidence intervals (CI) 4.6-9.0]. In Ghana, the prevalence of diabetes in adults (age > or = 25 years) was 6.3% (CI 5.6-7.0) in 1998. Obesity (body mass index > or = 30) among Nigerian adults was 8.8% (CI 7.0-10.6) in 2000, and obesity in Ghanaian adults (> or = 25 years) was 14.1% (CI 13.1-15.1%) in 1998. Various studies reported that 25-57% of Nigerians were physically inactive., Conclusion: Although weak, the evidence base points to a rise in diabetes prevalence in Ghana and Nigeria, with major urban-rural differences. There is an urgent need for accurate and comparable surveys on diabetes and its risk factors among Nigerians and Ghanaians. Effective public health policies are vital to control the diabetes epidemic.

The objective of the study was to review published evidence on whether blood pressure levels and the prevalence of hypertension are higher or lower in South Asian adults living in the UK as compared to white populations. A systematic literature review was carried out using MEDLINE 1966-2001, EMBASE 1980-2001, and citations from references. A total of 12 studies were identified. The data showed important differences between studies in terms of age and sex of samples, definition of South Asians (Indian, Pakistani and Bangladeshi) and methods of evaluating blood pressure. Seven studies reported lower mean systolic blood pressures, while seven studies showed higher diastolic pressures in South Asian men compared to white men. In women, six of nine studies showed lower systolic blood pressures, while five reported higher diastolic pressures. For prevalence of hypertension, five of 10 studies reported higher rates in South Asian men than in white men. Two of six studies showed higher prevalence rates in South Asian women. Overall, the most representative sample and up-to-date data came from the Health Survey of England 1999. Both blood pressure and the prevalence data show important differences between South Asian subgroups, yet most studies combined them. The data also showed a geographical variation between London (comparatively high blood pressure in South Asians) and the rest of the UK (comparatively low or similar blood pressure). Bangladeshis had low blood pressure and body mass index (BMI). In other South Asian subgroups, low blood pressure and the low BMI did not always coincide. To conclude, the common perception that blood pressure in South Asians is comparatively high is unreliable-the picture is complex. Overall, blood pressures are similar but there is stark heterogeneity in the South Asian groups, with slightly higher blood pressure in Indians, slightly lower blood pressure in Pakistanis, and much lower blood pressure in Bangladeshis. Variations in study methods, body shape, size and fat, and in the mix of South Asian groups probably explain much of the inconsistency in the results.

Background: Parental supervision is an important factor related to childhood injuries. However, little research has been done on; what outdoor activities children believe they are allowed or their parents allow them to do; parents' ideas about the age children can do activities, and the age they would allow their children to do them. This study described children's independent outdoor activities after-school, comparing age groups (school year 5 and 3), boys with girls, and the less socio-economically well off with the better off., Methods: A cross-sectional study using questionnaires completed by 476 children aged seven and nine years and 471 parents in nine primary schools in Newcastle-upon-Tyne, England., Results: Children reported they were permitted many outdoor activities such as cycling (78.8%), playing (78.6%) and roller skating in the street (62.7%). Parents of older children, boys, and more socio-economically deprived children were more likely than their comparison groups to allow children to do outdoor activities independently e.g. 34% of 9-year-olds were allowed to cross a road without an adult compared with 8% of 7-year-olds. Mostly, parents of boys and socio-economically deprived children, perceived children can do outdoor activities slightly younger than parents of girls and the socio-economically better off., Conclusion: Children and parents value and support children's independent outdoor activity. Differences in children's and parents' understanding of what activities are permissible and in their judgements about the appropriate age for children's independent activities, may partly underline variations by sex, age and socio-economic status in injury patterns.

Primary biliary cirrhosis (PBC) is a disease of unknown etiology, with unexplained geographical variation. Various exposures have been suggested as triggers for disease development-possibly in susceptible individuals, but the evidence was not always well founded. We therefore conducted a population-based case-control study in Northeast England to investigate these and other exposures. All cases incident during 1993 to 1995 in a defined area of Northeast England were identified, and age- and sex-matched population controls were identified from primary care population registers. Cases and controls were sent postal self-completion questionnaires covering medical history and lifestyle. Information was received from 100 cases and 223 controls. The familial tendency of PBC was found to be less marked than has been claimed: Only weak associations were found with other autoimmune diseases. Among factors considered previously, no significant associations were found with surgical procedures, events in pregnancy, past infections, vaccinations, and medications. No significant associations were found for previously unconsidered lifestyle factors (drinking alcohol, previous pets, or stressful events), but there was an unexpected association with past smoking (ever smoked: 76% in cases vs. 57% in controls, odds ratio 2.4; smoked for 20 years or more: 64% vs. 35%, odds ratio 3.5). There were also unexpected significant associations with psoriasis (13% in cases vs. 3% in controls, odds ratio 4.6) and eczema (3% in cases vs. 11% in controls, odds ratio 0. 13). These findings merit further investigation.