Infant feeding practices: 1984-85 versus 1977-78.

In 1979 and 1980 the Canadian Paediatric Society''s Nutrition Committee published guidelines for professionals counselling mothers of infants on feeding practices. The practices in 1984-85 of mothers in Toronto were determined for comparison with the practices identified in a similar study conducted in Toronto and Montreal in 1977-78 to ascertain if practices had changed in favour of the recommendations. Between July 1984 and February 1985, 404 metropolitan Toronto mothers of infants were interviewed. Compared with the 1977-78 group of mothers, more of the 1984-85 mothers had chosen to breast-feed and fewer had stopped breast-feeding in the first month. As well, fewer of the 1984-85 infants had been fed unmodified cow''s milk in the first 6 months of life and introduced to solid foods before 4 months of age. We conclude that major changes in infant feeding practices had occurred since 1977-78 and that the 1984-85 practices corresponded closely to the infant feeding guidelines.     

The UK cardiac surgical register, 1977-82.

Data for 1977-82 obtained from the Cardiac Surgical Register, established by the Society of Thoracic and Cardiovascular Surgeons of Great Britain and Northern Ireland in 1977, were analysed for trends in incidence and mortality of cardiac surgery and regional workload in the United Kingdom. Operative mortality for most types of cardiac operation showed a general decline. The numbers of operations performed for valvular and congenital heart disease had remained unchanged, but a striking increase had occurred in the number of coronary bypass graft operations: 2297 in 1977 to 6008 in 1982. The figure for 1982, representing an annual rate of 107 operations per million population, was still well below that for other countries such as Australia (410 per million in 1982) and the United States (750 per million in 1981). A wide variation was seen in the regional provision of cardiac surgical services within the United Kingdom. This was particularly appreciable for coronary bypass graft surgery, in which there was a 10-fold difference in numbers of operations performed between the various regions. The UK Cardiac Surgical Register provides an important source of information on trends within the specialty that could well be followed by other surgical specialties.     

Malaria in Britain: 1977-86

The incidence of malaria in Britain as reported to the Malaria Reference Laboratory during the past decade has increased by 51%, from 1529 to 2309 cases, and infection with Plasmodium falciparum has increased from one fifth to one third of all cases. The case fatality rate for P falciparum infections declined from 2·7% to 0·5%. Of the 67 persons who died, 54 were of British origin, nine of Asian descent, and four African. Sixteen had taken chemoprophylaxis; of these, nine had taken pyrimethamine alone.The pattern of infection shows that resident ethnic minority groups, temporary residents from west Africa, and tourists who visit Kenya are particularly at high risk. The calculated attack rates suggest that men, children, and young adults are at greater risk of malaria than women and older people. Rates are highest in immigrants who have settled in Britain who visit relatives: 316 and 331 per 100 000 for Africa and Asia respectively, 120 and 39 in tourists to those same regions, and 228 and 38 in business travellers to those regions.