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Using Multivariate Statistics

admission. This proportion could already be greater in some parts of the country and may increase if referrals of cases of self-poisoning increase faster than the facilities for their assessment and management. The provision of social work and psychiatric expertise in casualty departments may be one means of preventing unnecessary medical admissions without risk to the patients. Dr Blake's and Dr Bramble's figures do not demonstrate, however, that any advantage would attach to medical teams taking over assessment from psychiatrists except that, by implication, assessments would be completed sooner by staff working on the ward full time. What the figures actually suggest is that if assessment of overdoses were left to house doctors there would be an increase in admissions to psychiatric units (by 19°U), outpatients (by 5O°'), and referrals to social services (by 140o). So for house doctors to assess overdoses would provide no economy for the psychiatric or social services. The study does not tell us what the consequences would have been for the six patients who the psychiatrists would have admitted but to whom the house doctors would have offered outpatient appointments. E J SALTER

Vitamin D deficiency.

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Part I: AN INTRODUCTION TO INQUIRY. 1. Human Inquiry and Science. 2. Paradigms, Theory, and Research. 3. The Ethics and Politics of Social Research. Part II: THE STRUCTURING OF INQUIRY: QUANTITATIVE AND QUALITATIVE. 4. Research Design. 5. Conceptualization, Operationalization, and Measurement. 6. Indexes, Scales, and Typologies. 7. The Logic of Sampling. Part III: MODES OF OBSERVATION: QUANTITATIVE AND QUALITATIVE. 8. Experiments. 9. Survey Research. 10. Qualitative Field Research. 11. Unobtrusive Research. 12. Evaluation Research. Part IV: ANALYSIS OF DATA:QUANTITATIVE AND QUALITATIVE . 13. Qualitative Data Analysis. 14. Quantitative Data Analysis. 15. Reading and Writing Social Research. Appendix A. Using the Library. Appendix B. Random Numbers. Appendix C. Distribution of Chi Square. Appendix D. Normal Curve Areas. Appendix E. Estimated Sampling Error.

社会研究方法基础 = The Basics of Social Research

List of Figures List of Tables Foreword Introduction Robin P. Fawcett, M.A.K. Halliday, Sydney M. Lamb and Adam Makkai 1 Language as Code and Language as Behaviour: A Systemic-Functional Interpretation of the Nature and Ontogenesis of Dialogue M.A.K. Halliday 2 Metaphors of Information John Regan 3 How Universal is a Localist Hypothesis? A Linguistic Contribution to the Study of 'Semantic Styles' of Language Yoshihiko Ikegami 4 Some Speculations on Language Contact in a Wider Setting Jeffrey Ellis 5 Ways of Saying: Ways of Meaning Ruqaiya Hasan Index

Language as social semiotic

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3.3-O1Socio-economic determinants of breastfeeding uptake and duration intention among women with and without migration background. Results from the BaBi birth cohort study in Bielefeld, Germany

Explanation model for the relationship between migration and health

This chapter presents some selected major health concerns in Africa with a focus on their sociological dimensions. The chapter proceeds with the explanation of the social correlates of malaria. Critical issues include the influence of poor environmental conditions, poverty, misconceptions about malaria, and limited access to preventive and treatment measures. The chapter discusses sociocultural factors in the spread of HIV/AIDS as it is noted that they play a dominant role in the prevalence of HIV/AIDS in Africa. Some of the factors discussed include gender, polygyny, early marriage and non-consensus union, traditional beliefs and healing practices, stigma, and harmful cultural practices (e.g., widowhood rites, scarification, and female genital cutting). The state of maternal and child health is examined, stressing that Africa still bears the brunt of the problem because of poor structural indicators. The presentation of a community approach to health care for developing societies is to invoke more discussion about community engagement that can alleviate the burden of disease, especially in Africa. This chapter has links (through cross-referencing) to concepts and theoretical stances discussed in previous chapters, thereby creating a reflective interpretation of conceptual issues in line with some practical realities.

A Sociological Study of Health Problems in Africa

On 23 June 2016, the citizens of the United Kingdom (UK) voted in favour of the so-called ‘‘Brexit’’ when they were asked in a referendum if they wanted their country to remain in or leave the European Union (EU). Since the vote, the political debate has been tense, showcasing the opposition of two irreconcilable views of the British society and of the role of the UK in Europe. In the Remain camp, it is believed that the common market and free movement of persons will contribute to greater social progress and economic opportunities. The Leavers, or Brexiteers, expect that a more independent nation in control of its borders and migration influx will be stronger and more likely to thrive economically. In reality things are still uncertain, and the conditions of the ‘‘exit’’ are yet to be negotiated. This transition period has seen so far an increase in hate crimes and other aggressive behaviours toward those with a migration background, or thought to have a migration background such as ethnic minorities (NPCC 2016), encouraged by the discourse of anti-immigration, anti-multiculturalism which fuelled the referendum outcome in the first place (Hobolt 2016). In the meantime, anxiety has reached new heights among migrants from the EU and beyond who reside in the UK and now fear to see their prospects darkened, jobs threatened, and rights dented. The trigger of Article 50 marking the beginning of a 2-year exit negotiations process in March 2017, and the 8 June 2017 general elections which saw the victory (albeit not as large as expected) of the Conservative Party, have allowed even further the hard stance on Brexit to prevail. Driven by the good intention of making the most out of the inevitability of Brexit, some prominent figures of the UK public health community are arguing that now is the time to start working in favour of a ‘‘soft’’ Brexit rather than oppose the Brexit as a block. They hope that a soft Brexit would at least soften the blow for UK citizens’ health (Horton 2017). Their plea for a constructive approach is motivated by mounting concerns about the fact that European health workers may desert or be forced to desert the National Health Service (NHS), that access to healthcare for British people residing in other European countries may become more challenging, and that EU funding for UKbased public health research may vanish. Unlike the partisans of the pragmatic solution, we believe that there is still an urgent need to clearly position oneself against the underlying arguments of Brexit. Indeed, even its softest version will have far-reaching consequences for bystanders such as refugees and immigrants, and even for non-British EU citizens in the UK. It is this aspect that we are missing in the discussions about the soft Brexit. By focusing principally on the interests of the British people, a soft Brexit will equally contribute to building an othering, ‘‘us versus them’’ narrative that is divisive, contradicting the principles of global health and likely to compromise even further the health of less protected groups such as refugees and immigrants. Our argument is based on the following possible public health outcomes. First, second-class resident status, or absence of legal status, force people out of preventative and curative care systems, jeopardizing their health and potentially ending up costing more to the health systems than it should have due to emergency procedures. Second, ‘‘othering’’ runs the risk of increasing mental illness among & Oliver Razum oliver.razum@uni-bielefeld.de

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Brexit: the country goes, but UK public health principles remain

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Oliver Razum

Papers

3.3-O1Socio-economic determinants of breastfeeding uptake and duration intention among women with and without migration background. Results from the BaBi birth cohort study in Bielefeld, Germany

Explanation model for the relationship between migration and health

A Sociological Study of Health Problems in Africa

Brexit: the country goes, but UK public health principles remain

How can Schools of Public Health Actively Promote Peace