BMJ : British medical journal
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Multicenter Study
Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study.
To evaluate the association between a simple lifestyle index based on the recommendations for five lifestyle factors and the incidence of colorectal cancer, and to estimate the proportion of colorectal cancer cases attributable to lack of adherence to the recommendations. ⋯ Adherence to the recommendations for physical activity, waist circumference, smoking, alcohol intake, and diet may reduce colorectal cancer risk considerably, and in this population 23% of the cases might be attributable to lack of adherence to the five lifestyle recommendations. The simple structure of the lifestyle index facilitates its use in public health practice.
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Multicenter Study
Patients' experience and satisfaction in primary care: secondary analysis using multilevel modelling.
To explore whether responses to questions in surveys of patients that purport to assess the performance of general practices or doctors reflect differences between practices, doctors, or the patients themselves. ⋯ Analyses of surveys of patients should take account of the hierarchical nature of the data by using multilevel models. Measures related to patients' experience discriminate more effectively between practices than do measures of general satisfaction. Surveys of patients' satisfaction fail to distinguish effectively between individual doctors because most of the variation in doctors' reported performance is due to differences between patients and random error rather than differences between doctors. Although patients' reports of satisfaction and experience are systematically related to patients' characteristics such as age and sex, the effect of adjusting practices' scores for the characteristics of their patients is small.
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Multicenter Study
Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study.
To assess the association of Apgar score 5 minutes after birth with cerebral palsy in both normal weight and low birthweight children, and also the association with the cerebral palsy subdiagnoses of quadriplegia, diplegia, and hemiplegia. ⋯ Low Apgar score was strongly associated with cerebral palsy. This association was high in children with normal birth weight and modest in children with low birth weight. The strength of the association differed between subgroups of spastic cerebral palsy. Given that Apgar score is a measure of vitality shortly after birth, our findings suggest that the causes of cerebral palsy are closely linked to factors that reduce infant vitality.