The Relationship between Health Survey and Medical Chart Review Results in a Rural Population

The objective of this study was to understand the relationship between health survey and medical chart based information. The study population consisted of adult patients (17 years of age and older) attending the Bella Coola Medical Clinic who also completed a detailed Health and Quality of Life Survey. A total of 674 adults completed the Health and Quality of Life Survey. Demographically there was excellent agreement between self-report and clinic data for age, sex, height, weight and Aboriginal ancestry. For morbidity, there was excellent agreement between self-reported and clinically recorded diabetes. Good agreement was observed for diagnoses of cancer, heart problems, hypertension, arthritis and breathing problems. Poor agreement was observed for diagnoses of depression, back/neck problems, eye problems, walking problems, stroke, hearing problems and bone/joint problems. There was poor agreement between the number of self-reported and charted clinic visits. Excellent agreement was shown between self-reported height and weight and clinic height and weight. When BMI was calculated good agreement was achieved between self-report and chart data. It can be concluded that the relationship between chart review and self-report health information observed in this rural population is similar to findings from other populations. Researchers who use self-report data on co-morbidity and obesity measures should be aware of possible error in their estimates and how these errors could affect their findings.     

Juvenile Courts and Competency to Stand Trial

This article reviews the recent development of juvenile competency to stand trial (CST) policies across the United States in light of the inherent contradiction of this due process procedure in a separate juvenile court that is premised on the incompetence of youth. The article draws on existing CST legal doctrine and psycho‐legal research to demonstrate the need for sociolegal research to better understand who gains access to the CST process, CST decisions, and how CST may influence subsequent case processing decisions. Utilizing CST as an adopted formal policy from criminal court and an exploratory case study, I demonstrate the difficulties facing how court actors manage the role of youthfulness and culpability for CST decision‐making in contemporary juvenile courts. Overall, both quantitative and qualitative research is needed to examine whether court actors’ practice of CST serves to further deconstruct or reinforce the juvenile court’s rehabilitative ideal.     

Vitamin D and the postmenopausal population

Vitamin D, a hormone critical to the body's maintenance of serum calcium and phosphorus concentrations, is currently the subject of much scientific interest. Low levels of vitamin D have been observed in many populations and epidemiological studies have suggested a link between this biochemical state and a range of diseases, such as cancer, diabetes and multiple sclerosis. While the consequence of vitamin D deficiency is well documented for bone (rickets and osteomalacia), with mixed findings relating to falls and fractures, a causal link between vitamin D deficiency and these wider health outcomes has not been established. If these relationships were found to be causal, the morbidity and mortality resulting from low levels of vitamin D could be substantial; the current evidence base, however, most robustly supports the assessment of serum 25(OH)-vitamin D in the context of specific symptoms, low bone mineral density or biochemical abnormalities, rather than as an entity to treat in its own right or as the basis for a population-wide screening programme.     

Relation of transition probabilities in the Leslie model to those from experimental cumulative distributions

Summary We explore the relationship between transition probabilities in the Leslie model and those derived from experimental cumulative distributions. The nature of the two kinds of probabilities are discussed, and a formula derived for converting from one to the other. A numerical example is given to illustrate the differences.     

Measuring educational standards

Every summer, when English public examination results appear, there is a debate within the media about whether "educational standards" are changing. Harvey Goldstein argues that much of what passes for informed debate in the English media is both irrelevant and ill informed, and that there is no purely objective, statistical, means for measuring changes in "standards".