787

Substandard care-the term that replaces "avoidable factors"used in previous reports for England and Wales-was the factorassociated with most of the deaths. The report points out that amajor contribution to such care was the level of seniority andexperience of those looking after the patient; "too little, too late" wasa recurring theme in many of the deaths.Among the many recommendations that the report makes are the

setting up within every health region of an expert team (consisting ofobstetricians, physicians, anaesthetists, and midwives) to advise onor accept for care any woman with severe pre-eclampsia oreclampsia; that any woman admitted with recurrent or moderatelysevere vaginal bleeding be seen as soon as possible by the mostsenior obstetrician in the duty team; that all available methods beused to establish the diagnosis of thromboembolism, radioactiveisotopes for this purpose not being contraindicated in the latter halfof pregnancy; and that an anaesthetist be involved early in themanagement of severe pre-eclampsia, even if preoperative deliveryis not planned, to assist with analgesia, sedation, antihypertensivetherapy, and monitoring.

1. Department of Health, Welsh Office, Scottish Home and Health Department,Department of Health and Social Services, Northern Ireland. Report onConfidential Enquiries into Maternal Deaths m the United Kingdom 1985-87.London. HM Stationery Office. 1991. Pp 164. £9.85. ISBN 0-113253336.

Milk, butter, and heart disease

The curious affair of the lilac-covered progress report VII fromthe MRC Epidemiology Unit (Cardiff) Caerphilly and SpeedwellStudies (March 9, p 607) reached some sort of conclusion on March21 when a Medical Research Council panel of referees concludedthat the results "provide no basis for altering public healthrecommendations about diet". The panel (Prof D. J. P. Barker, ProfN. Day, Prof G. Rose, and Dr R. Whitehead) states of the findingsof less heart disease in men who drank more milk and used butterrather than polyunsaturated margarine that "a statistical associationof this kind does not necessarily mean that observed differences indiet cause differences in heart disease". "This is a single study", thepanel adds, "which is briefly reported... and a full evaluation willonly be available on completion." The report is 138 pages long."The interim data must be set against the considerable body ofevidence supporting the role of dietary fat in heart disease. Morework is needed to understand the reasons for the results obtained

»

Gloomy prospect for UK medical research

"A plan for contraction" is how Dr Dai Rees, secretary of theMedical Research Council, described the council’s corporate planfor the next four years,l published this week. Despite a modest risein grants-in-aid between 1991-92 CC200 4 million) and 1994-95(209 million), the MRC is proposing to reduce the number ofannual research awards by 30% from the 1989-90 level andallocated funds also by 30%. Commitment to the council’s existingunits (excluding the National Institute for Medical Research, theCentre for Clinical Research, and the Laboratory of MolecularBiology) is expected to fall by 15% by the end of the planningperiod. Many research workers will be wondering who is to be nextfor the axe."The MRC cannot be at the forefront of every field", says the

plan, "but must maintain diversity in its areas of research" in orderto adapt to changing needs and opportunities. New MRC initiativeswill concentrate on human genetics, neuroscience, nutrition, theenvironment, diabetes, and imaging.Dr Rees said "we have judged it still feasible-just-to continue

to aim to cover all important health issues". But further reduction inresources, he warned, "will force us to abandon these aims and seekto define a more modest role". The prospects for government-funded medical research in the UK have never looked bleaker.

1. Corporate plan 1991. Medical Research Council, 20 Park Crescent, LondonW1N 4AL.

Psoriasis Association award

The Psoriasis Association is offering a Josie Bradbury award tosupport travel outside the United Kingdom by suitable applicantsinterested in the study of any aspect of psoriasis and its treatment.The total sum available in any one year will not exceed ;[800.Application forms, which should be returned by June 1, 1991, canbe obtained from The Secretary, Josie Bradbury Travel Award,Psoriasis Association, 7 Milton Street, Northampton NN2 7JG.

Calling Dr Davies

Recently, an American television journalist was beaten up byunidentified people in Iasi, Romania. The journalist, called Davies,responded not by anger and revenge but by donating$200 toestablish a prize to be offered to a Romanian medical student whodemonstrates an interest and ability in clinical research. The prizewill be offered through the Society of Physicians and Naturalists ofIasi (secretary, Dr Traian Mihaescu, 16 Independentei Blvd, POBox 25, Iasi 6600, Romania). Anyone called Davies who welcomesthe idea behind this response to violence is invited to contribute.

International Diary

10th joint meeting of British Endocrine Societies is to take place inSussex on April 15-18: Janet Crompton, Administrative Officer, Society forEndocrinology, 23 Richmond Hill, Bristol BS8 1EN, UK (0272 734662).

International conference on Melanoma will take place in Brighton onMay 8-11: Dr J. E. White, Wykeham House, 88 The Hundred, Romsey S058BX, UK (0794 512350).

National conference on Alcohol and Health is to be held in Edinburgh onWednesday, May 22: Hamish Macandrew, Training Executive, Universityof Edinburgh Technologies, FREEPOST, 16 Buccleuch Place, EdinburghEH8 OLL, UK (031-650 3476).

2nd national conference on Immunisation will take place in Canberra,Australia, on May 27-29: Immunisation Secretariat, PO Box 746,Turramurra, NSW 2074, Australia (02-449 1525).

A course entitled Magnetic Resonance Imaging and Spectroscopywill be held in Trondheim on May 27-31: Mona Kirkeby Eidem, MRCenter, N 7034 Trondheim, Norway (47 7 99 7700).

A conference on Developmental and Genetic Disorders of theCentral Nervous System is to be held in British Columbia, Canada, onJuly 7-10: Carol Blagowidow, Project Coordinator, Professional ServicesDepartment, March of Dimes, Birth Defects Foundation, National Office,1275 Mamaroneck Avenue, White Plains, New York 10605, USA (914-4287100).

A meeting of the International Association of Cancer Registries willtake place in Quito on October 7-9: National Tumor Registry, Shyris 3307 yTomas de Berlanga, PO Box 4965 CCI, Solca, Quito, Ecuador (442-122).

European workshop on Progress in Magnetic Resonance Imaging isto take place in Cologne, Germany, on Oct 24-25: European MagneticResonance Forum, PO Box 161, CH 1807 Blonay, Switzerland (41219433834).

A symposium on Perinatal Bereavement will take place in London onTuesday, Oct 29: Symposium Secretariat, Royal Postgraduate MedicalSchool, Institute of Obstetrics and Gynaecology, Queen Charlotte’s andChelsea Hospital, Goldhawk Road, London W6 OXG, UK (081-740 3904).

6th world conference on Lung Cancer will be held in Melbourne on Nov10-14: MCS Convention Services, PO Box 335, Heidelberg 3084, Victoria,Australia (03-499 6722).

1st Dead Sea conference entitled The Interaction Between Westernand Eastern Medicines will take place at the Dead Sea, Israel, on Nov 4-8:The Secretariat, PO Box 50006, Tel Aviv 61500, Israel (03-654571).

An international symposium on Cervical Cancer is to be held in SaintLucia on Nov 26-30: Dr Jean Paul Tyst, Ministry of Health, Chaussee Road,Castries, Saint Lucia, West Indies (80945 32668).