Search tips
Search criteria 


Logo of jepicomhJournal of Epidemiology and Community HealthVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Epidemiol Community Health. 2007 June; 61(6): 560.
PMCID: PMC2465731


Female genital mutilation in Italy

Not only does female genital mutilation (FGM) persist in parts of the world where it has been traditionally practised but it has spread to developed countries through immigration. Between an estimated 100 and 140 million women and girls worldwide have been subjected to FGM. An additional two million girls will undergo some form of FGM every year, despite the practice being increasingly prohibited by law. FGM can have varying degrees of invasiveness, but all forms raise health related concerns that can be of considerable physical or psychological severity. Medical practice prohibits FGM as a violation of a person's fundamental rights to physical and mental integrity and to the health of women and girls. Last year Italy became the first European country to prohibit FGM, putting in place a set of measures to prevent and suppress the practice. The law provides for between 4 and 7 years' imprisonment for practising clitoridectomy, excisions, infibulations, and other mutilations in the absence of therapeutic requirements. Different interventions are considered, starting with information campaigns, training health workers, providing a toll‐free telephone helpline, and making the institution where the crime was committed responsible. Doctors have a role in this process. (Journal of Medical Ethics 2007;33:98–101)

Health status and health related quality of life

Baseline measurement of pre‐injury health states may be more appropriate than general population norms because the injured population may not be representative of the general population, a study from Australia has found. The study aimed to investigate the appropriateness of retrospective measurement of self‐reported baseline (pre‐injury) health status and health related quality of life (HRQL), in an injured population, in order to evaluate post‐injury losses. The main hypothesis was that if the retrospective measurement of baseline health is valid, pre‐injury values should approximate those measured at 12 months after injury in injured patients who report complete recovery. A cohort of 186 injured people admitted to hospital was followed up for 12 months. Their retrospectively measured pre‐injury health status and HRQL scores were compared with those at 12 months after injury for participants who reported complete recovery and those who did not; baseline scores for the whole cohort were also compared with the general population norms. For those who completely recovered no significant differences were observed between scores at baseline (measured retrospectively) and those 12 months after injury. Retrospectively measured pre‐injury scores were consistently higher than Australian norms. (Injury Prevention 2007;13:45–50)

Ulcerative colitis in Europe

Increased mortality was not found in patients with ulcerative colitis (UC) 10 years after disease onset, a Europe‐wide survey has found. The study was part of a follow‐up conducted by the European Collaborative Study Group of Inflammatory Bowel Disease (EC‐IBD) to compare the mortality in patients with UC with mortality in the background population, and to examine disease specific causes of death in various subgroups. The original study was carried out between October 1991 and September 1993 in 2201 patients with inflammatory bowel disease (IBD) from 20 treatment centres in 12 European countries. Of these 2201 patients, 1379 had UC, with the others being diagnosed with Crohn's disease or indeterminate colitis. After 10 years each of the 20 centres were invited to participate in the follow‐up; 13 centres agreed, with nine of these centres meeting the threshold limit of 60% response, giving a total of 775 patients taking part in the follow‐up. Expected mortality was calculated from the sex, age, and country specific mortality in the WHO mortality database for 1995‐8. A total of 661 of 775 patients were alive with a median follow‐up of 123 months (range 107‐144); that is, 73 deaths occurred compared with an expected 67. Observed mortality was almost identical to expected mortality at 1, 5, and 10 years of follow‐up. Standardised mortality ratios (SMRs) were higher for pulmonary disease and a trend towards an age related rise in SMR was observed. (Gut 2007;56:497–503)

Breast feeding and social mobility

Breast fed infants were more likely to show upward social mobility compared with infants who were bottle fed. In order to assess the association between breast feeding and social class mobility a historical cohort study with a 60 year follow‐up from childhood to adulthood was carried out in 16 urban and rural centres in England and Scotland. A total of 3182 original participants in the Boyd Orr Survey of Diet and Health in Pre‐War Britain (1937‐39) were sent follow‐up questionnaires between 1997 and 1998; analyses were based on 1414 responders. The prevalence of breast feeding varied by survey district but not by household income, expenditure on food, number of siblings, birth order, or social class in childhood. Participants who had been breast fed were 41% more likely to move up a social class in adulthood than bottle fed infants. A longer period of breast feeding was associated with greater odds of upward social mobility. Controlling for survey district, household income and food expenditure in childhood, childhood height, birth order or number of siblings did not attenuate these associations. Although in a cohort where there was little social patterning of breast feeding, breastfed infants were more likely to show upward mobility compared with those who were bottle fed, confounding by several measured childhood predictors of social class in adulthood did not explain this effect. The possibility of residual or unmeasured confounding cannot be excluded. The finding warrants further investigation before firm conclusions are drawn. (Arch Dis Child published online 14 February 2007; doi:10.1136/adc.2006.105494)

Glenys Hughes

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group