An analysis of the medical condition of 223 entrants to the nursing profession is attempted, with particular reference to 161 such nurses examined in accord with the recommendations of the King Edward's Hospital Fund for London (1943). This is followed by a short-term medical follow-up on these nurses by clinical examination, weight records, and ancillary tests. Of the total number of entrants eight (3·6 %) were rejected on medical grounds, and four (2·5 %) of the 161 were rejected on the findings of the initial examination.

An analysis of the sixty-five (29 %) nurses lost to the profession in their first year of service shows that 70 % had attempted an uncongenial vocation. It is suggested that vocation selection tests should be tried in attempting to lessen this costly drain of recruits. This figure of 29 % is no higher than the peacetime figure found by the Lancet Commission (Athlone Report, 1938).

An analysis of the illnesses of the nursing staff at Westminster Hospital during 3 years from 1 July 1943 to 30 June 1946 is presented, nearly 60 % of the illnesses being accounted for by respiratory tract infection and cutaneous sepsis. It has been shown that illness of more than 50 days in duration accounts for only 5 % of attacks of illness, but practically 30 % of the time lost through illness. It is suggested that such illness should be differentiated in analyses, from illnesses of shorter duration. A comparison of illnesses in staff nurses and student nurses follows; the figures suggest a lower morbidity rate in staff nurses, but the number of staff nurses is so small that the author cannot state that this has been demonstrated.

A comparison table between previous illness surveys and the present figures is presented which demonstrates a decreasing number of attacks of illness per nurse over the last 20 years in this country, probably due to better basic conditions of life.

A similar but international comparison applied to respiratory tract infection and cutaneous sepsis demonstrates that the former accounts for about 40 % of all the attacks of illness in this country and internationally. The previous figures for Great Britain, however, are exceptional in showing a much higher incidence of sepsis than elsewhere; this has not been substantiated by the present survey.

Figures for the amount of time lost per year through sepsis, tonsillitis and catarrhal disease are compared with those of Branson (1933) of 20 years ago, and perhaps illustrate the beneficial effect of surgery in cutaneous sepsis, and of sulphonamides in tonsillitis, as against the negligible therapeutic advances in catarrhal disease. The amount of tonsillitis sustained by nurses in the children's ward is shown as being out of proportion to the number of nurses employed.

Finally suggestions are made for promoting the health of nurses, which include: (i) the provision of a ‘welfare officer’ in the nurses' home; (ii) illness allowance proposals; (iii) remarks on the technique of ‘reporting sick’; (iv) staffing children's ward with senior nurses only.

(1) These experiments prove that the fumigator is safer to use than the dumping fixture, because high concentrations of the poison gas are avoided, so that dangerous pockets are not developed.

(2) The poison gas is more evenly distributed over the different parts of the section of the ship under treatment.

(3) High concentrations, however, can be developed^ at will in any part which requires special attention.

(4) The maximum concentrations of the poison gas were obtained in every part of the section in a shorter time, when the fumigator was used, than when the dumping fixture was employed.

(5) The artificial ventilation caused by the fan, which is capable of blowing into the section 500 to 1000 cubic feet of fresh air per minute, according to the speed of the motor, materially assists the rapid clearing of the poison gas from the ship, after it has accomplished its work. It is thus possible to complete the fumigation and ventilation of a ship in 3 hours using the cyanide fumigator, while more than 4 hours are required for the dumping fixture.

(6) Even more important is the fact that smaller quantities of cyanide can be used with greater efficiency in the fumigator, than larger quantities, with less efficiency in the dumping fixture.

(7) The general conclusion is arrived at, that, from the point of view of efficiency, safety and economy, the fumigator is superior to the dumping fixture. Creel has shown that, in respect to the time required for completing the fumigation, and in respect to the thoroughness of the process, both in killing rats and insects, the dumping fixture is superior to the Clayton gas machine. It follows, therefore, that the cyanide fumigator is very much superior in these respects to the Clayton gas machine.

Resistance of faecal Escherichia coli to ampicillin, tetracycline, sulphamethoxazole and gentamicin was studied in patients admitted to seven different departments in two hospitals. The resistance to ampicillin, tetracycline and sulphamethoxazole in the seven patient groups was 27–57%, 26–56% and 35–63%, respectively. Resistance to gentamicin was found in only one department. An E. coli flora predominantly resistant to ampicillin, tetracycline or sulphamethoxazole (> 50% of the E. coli strains in a faecal sample resistant) was found in 10–38%, 4–30% and 21–35% of the samples. A cross-sectional study focusing on the influence of the use of antimicrobial agents on the occurrence of resistant strains revealed a positive correlation between the annual turnover of broad-spectrum penicillins in various departments and the occurrence of predominantly ampicillin-resistant E. coli strains in these departments.

H. Smidt in a recent note on the reduction of methylene blue by means of milk confirmed the results of Schardinger that a mixture of formaldehyde and methylene blue is decolorised by the action of milk. This reaction depends on the presence of a ferment—a catalase—in the milk, and, as this ferment is readily destroyed by heat, serves as a very simple method of determining whether a given sample of milk is “raw” or not. By way of conclusion Smidt stated that he thought this test might be of still further utility in that it might be possible to estimate the degree of bacterial contamination of the milk by its means. If such a comparatively simple test could be employed, in an easy and effective fashion, it would be of immense service, as, owing to the rapidity with which it can be carried out, the milk could be examined before distribution.

The purpose of the study was to describe the results of follow up of human contacts of bovine tuberculosis. The bovine tuberculosis cases occurred on farms in North Staffordshire between 1993 and 1997. A total of 162 people were identified as having close contact with cattle diagnosed as having bovine tuberculosis, or who had drunk unpasteurized milk from a herd with bovine tuberculosis. A retrospective review of chest clinic notes was performed. One hundred and thirty-eight people attended for follow up, and Heaf test results, necessity for chest X-ray and further clinical follow-up are described. No case of human Mycobacterium bovis infection was identified. It is suggested that follow-up of human contacts is limited to those with close contact with herds who have bovine tuberculosis and cattle with visible pulmonary lesions or evidence of udder infection. Children on the farms with affected cattle should also be offered BCG in advance of the routine school's programme.

The following paper gives some results of a series of experiments on the bactericidal power of various sources of ultra-violet radiation. The “power” of the source was in each case measured by the quartz-cadmium photo-electric cell described by the authors (1925), and it is shown that very definite and practically useful correlations exist between the cell reading and this typical abiotic action.

The aim of this study was to determine the extent to which selective under-coverage of births to mothers more likely to be at risk of HIV-1 infection will result in a significant underestimation of the true neonatal seroprevalence. Census data, local birth statisties, maternity data and data from the prevalence monitoring programme were used to produce a model to predict the effects of under-coverage in the uptake of neonatal metabolic screening which has been observed in babies with a mother of ethnic group black African. The adjustment factor which allows for under-coverage is the relative inclusion ratio (RIR); the probability that samples from a group at different risk of HIV infection were included in the survey divided by the probability of inclusion for samples from all other babies. The RIR was found to be close to unity (0·97), indicating a minimal bias. Under usual conditions only if the relative inclusion ratio (RIR) declined to values of 0·87 or below would there be a substantial bias. Despite some selective under representation, the results obtained from the Unlinked Anonymous HIV Monitoring Programme Dried Blood Spot Survey would seem to identity levels of prevalence in the population of child-bearing women with a good degree of accuracy and remains a useful tool for resource allocation, planning of services, provision of care and counselling.

Although multiple cases of acute rheumatism have been observed to follow waves of streptococcal infection in institutions (see Green, p. 369) there is doubt as to whether acuter heumatism itself becomes epidemic under such circumstances or whether the element of infectivity lies in the preliminary throat infection as concluded by Sheldon (1931).

The present notes have been written in connection with official correspondence regarding the prophylactic inoculation against plague and the study of this and other health problems in India.

The practice of using preservatives in the process of making cider is very widely spread, and moreover is much encouraged by the makers of the preservatives.

A survey of both the prevailing and the desirable conditions for housing small laboratory animals, with particular reference to rats and mice, is described. The data surveyed are confined to laboratories in Great Britain and include requirements of space, heating, ventilation and building construction, with such accessories as cages, feeding devices and other equipment.

Antigenic substances have recently been extracted in soluble form from many bacteria, and the work of Boivin & Mesrobeanu (1934), Raistrick & Topley (1934) and Topley et al. (1937) has shown that polysaccharides in combination with other non-protein substances extracted from certain Gram-negative bacilli stimulate an effective immunity in mice and specific antibody formation in rabbits. The antigenicity of similar extracts of pneumococci has not been so readily demonstrated. Berkefeld filtrates of pneumococci lysed by bile or by alternate freezing and thawing were found to be non-antigenic in rabbits (Avery & Morgan, 1925; Avery & Neill, 1925), although it was possible to immunize mice effectively with bacteria-free solutions obtained from cultures of pneumococci (Perlzweig & Steffen, 1923; Perlzweig & Keefer, 1925; Meyer, 1927). The essential antigen for the production of immunity in mice has been shown to be the type-specific polysaccharide which is effective only in small doses, usually between 0.01 and 0.00001 mg. (Schiemann & Caspar, 1927; Schiemann, 1929; Enders, 1930; Wadsworth & Brown, 1931; Avery & Goebel, 1933). The type-specific polysaccharide has, however, been found to be without antigenic activity in rabbits (Avery & Goebel, 1933; Downie, 1937).

Circulating 25-hydroxy vitamin D (25(OH)D) is related to decreased rates of gastrointestinal and ear infections in school-age children. Vitamin D-binding protein (DBP) transports 25(OH)D and exerts immunological functions; however, it is unknown whether DBP is associated with infectious morbidity in children. We quantified plasma DBP concentrations in 540 school-age children at the time of recruitment into a cohort study in Bogotá, Colombia and obtained daily information on infectious morbidity symptoms and doctor visits during the school year. We compared the incidence rates of gastrointestinal and respiratory symptoms across quartiles of DBP concentration by estimating adjusted incidence rate ratios (IRRs) with 95% confidence interval (CI). We also estimated the per cent of the associations between DBP and morbidity that were mediated through 25(OH)D using a counterfactual frame. Mean ± s.d. DBP concentration was 2650 ± 1145 nmol/l. DBP was inversely associated with the rates of diarrhoea with vomiting (IRR for quartiles 2–4 vs. 1 = 0.48; 95% CI 0.25–0.92; P = 0.03) and earache/ear discharge with fever (IRR for quartiles 2–4 vs. 1 = 0.29; 95% CI 0.12–0.71; P = 0.006). The DBP–morbidity associations were not mediated through 25(OH)D. We conclude that plasma DBP predicts lower incidence of gastrointestinal and ear infections in school-age children independent of 25(OH)D.

There has been a lack of information on vaccine acceptance for Finnish adults. We conducted a secondary analysis of cross-sectional data collected through the Finnish Medicines Agency Medicine Barometer 2021 survey (response rate: 20.6%). We described and explained vaccine acceptance by investigating the associations between socio-demographic factors and statements using logistic regression and conducted a factor analysis. The majority of respondents (n = 2081) considered vaccines to be safe (93%), effective (97%), and important (95%). However, 20% and 14% felt they did not have enough information about vaccines and vaccine-preventable diseases (VPDs), respectively. Respondents aged 18–39 were 2.8 times more likely to disagree that they had enough information about VPDs compared to respondents aged 60–79 (p < 0.001), while respondents with poorer self-perceived health were 1.8 times more likely to declare not having enough information about vaccines (p < 0.001). We generated three-factor dimensions from the eight statements. They were related to ‘Confidence and attitudes towards vaccines’, ‘Access to information on vaccines and VPDs’, and ‘Debate on vaccine issues’, which may reflect the underlying thinking patterns. Access to and understanding of information about vaccines and VPDs need to be improved for Finnish adults to increase vaccine acceptance and uptake, thus preventing the spread of VPDs.

1. Nairobi township and other areas about the Mount Kenya endemic centre have frequently been penetrated by persons suffering from plague, but, at least during the last few years, plague has failed to become established in this way.

2. A survey of rats and fleas, conducted at Mombasa upon 66 truckloads of maize in transit, resulted in no rats being seen or captured, whilst only seven fleas (2 ♂ and 2 ♀ X. cheopis, 1 ♂ and 1 ♀ D. lypusus and 1 ♀ Ct. cabirus) were collected from clean white rats after they had been allowed to run about in the maize.

3. Although maize continues to be repeatedly unloaded and handled at Mombasa, this town has remained free from plague.

4. We have failed to obtain any evidence that the transport of maize from endemic centres by railway is a factor in the dissemination, of plague.

The outbreak of food infection which we are about to describe is of interest from more than one point of view. Not only was it possible to determine the organism which caused the outbreak and to trace its source to a paratyphoid carrier, but the bacteriological results yielded an important contribution to the difficult question of the differentiation of Bacillus paratyphosus B. and B. enteritidis, which for some years has been much discussed among bacteriologists.

In the first report (vol. vi. p. 450) we described several series of experiments which had as their object the determination of the relative importance of the Indian rat flea, Palex cheopis, and of actual close contact in the absence of fleas in the dissemination of plague from animal to animal. These observations were carried out in a series of small godowns or cabins, which were built especially for the purpose. The experiments which we have now to put on record are a continuation of those already published. They were carried out during the non-plague season of 1906 and the plague season of 1907.