Evaluation of attempted prevention of unexpected infant death in very high-risk infants by planned health care

Three hundred and ninety-six babies born in Sheffield between 1982 and 1990 identified as being at "very high risk" of unexpected infant death by means of a scoring system, received an intensive programme of health care including a case discussion between a paediatrician, the GP and the health visitor held in the family doctor's surgery, weekly visits from the health visitor and informal hospital admission. Significantly fewer sudden unexpected infant deaths occurred in this group than were expected by logistic regression anlysis or occurred in the best available control group with comparable scores ( p = 0.024). Problems in evaluation include identification of an adequate control population, ethical difficulties in introducing a controlled study when the programme is already perceived as effective, and the calculation of "expected death rates". The results of this study indicate that very energetic programmes of intervention may prevent some deaths in vulnerable infants.     

The descriptive epidemiology of pharyngeal cancer in Scotland

There have been recent reports of substantial increases occurring in the incidence of and/or mortality from tongue and mouth cancers in several countries. In this paper using data from Scotland (1960–89) we report on time trends in pharyngeal cancer. Similar increases in rates are evident for cancers of the oropharynx and hypopharynx while there has been little change in the occurrence of nasopharyngeal cancer (which has distinct aetiological factors). It therefore seems that reported changes in the incidence of and mortality from oral cancer may be real, and in Scotland, this is most probably due to changes in alcohol consumption.Corresponding author.     

Daily mortality and environment in English conurbations. Air pollution, low temperature, and influenza in Greater London.

With the decline in concentrations of suspended particulate pollution in Greater London the association seen in the 1950s and early 1960s between daily mortality and air pollution in the conurbation is no longer apparent. Associations between unusually cold weather and short-term increases in mortality have been noted; there appears to be a tendency for influenza epidemics to follow cold spells.