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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

There is an unresolved debate about the potential effects of financial speculation on food prices and price volatility. Germany's largest financial institution and leading global investment bank recently decided to continue investing in agricultural commodities, stating that there is little empirical evidence to support the notion that the growth of agricultural-based financial products has caused price increases or volatility. The statement is supported by a recently published literature review, which concludes that financial speculation does not have an adverse effect on the functioning of the agricultural commodities market. As public health professionals concerned with global food insecurity, we have appraised the methodological quality of the review using a validated and reliable appraisal tool. The appraisal revealed major shortcomings in the methodological quality of the review. These were particularly related to intransparencies in the search strategy and in the selection/presentation of studies and findings; the neglect of the possibility of publication bias; a lack of objective or rigorous criteria for assessing the scientific quality of included studies and for the formulation of conclusions. Based on the results of our appraisal, we conclude that it is not justified to reject the hypothesis that financial speculation might have adverse effects on food prices/price volatility. We hope to initiate reflections about scientific standards beyond the boundaries of disciplines and call for high quality, rigorous systematic reviews on the effects of financial speculation on food prices or price volatility.

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Relationship between financial speculation and food prices or price volatility: applying the principles of evidence-based medicine to current debates in Germany.

Measurement of maternal health.

Why it is important to consider contextual factors in public health.

Die international publizierte Literatur zeigt fur Migrantinnen in verschiedenen europaischen Landern widerspruchliche Resultate bei den geburtshilflichen Ergebnisdaten im Vergleich zur jeweiligen Mehrheitsbevolkerung. Fur Deutschland lagen bis vor kurzem keine validen Daten aus groseren Studien zum Zusammenhang „Migration-Akkulturation-perinatales Outcome“ vor, da im Rahmen der ansonsten vorbildlichen perinatalen Qualitatssicherung in Deutschland keine genauen Angaben z. B. zum Herkunftsland der Mutter oder anderen migrationsrelevanten soziodemografischen Parametern erfasst werden. Im Rahmen der hier vorgestellten Berliner Perinatalstudie wurden solche Daten erstmals fur eine grosere Zahl von Frauen (n = 7100, davon 57,9 % mit Migrationshintergrund) aus dieser Zielgruppe prospektiv erhoben. Es werden wesentliche Ergebnisse der o. g. Studie zum Rauchverhalten in der Schwangerschaft, zur Nutzung von Schwangerenvorsorgemasnahmen, zur Haufigkeit von Sectioentbindungen und zu weiteren geburtshilflichen Ergebnisparametern sowie Daten zur Stillhaufigkeit und zur Nutzung von Verhutungsmitteln post partum prasentiert und diskutiert.

Oliver Razum

Papers

Relationship between financial speculation and food prices or price volatility: applying the principles of evidence-based medicine to current debates in Germany.

Measurement of maternal health.

Why it is important to consider contextual factors in public health.

Perinataldaten besser als gedacht! Zum Einfluss von Migration und Akkulturation auf die Gesundheit schwangerer Frauen und ihrer Neugeborenen

The impact of psychosocial factors on breastfeeding duration in the BaBi-Study. Analysis of a birth cohort study in Germany.