In a survey of attitudes towards remuneration for blood donation in Leeds, the following questions were completed by 489 adults (N), of whom 89 were regular donors, 105 were lapsed donors and 295 had never donated: 'If you needed blood, would you be content if the donor had been paid: yes/no'. 'If I were paid enough I would be less/equally/more likely to donate blood '. The majority (67.7%) of potential recipients would be content if the donor had been paid. The prospect of remuneration made 16.4% of respondents more likely and 14.5% less likely to donate. As the difference is less than 2% of N, offering remuneration may not lead to a significant increase in the number of donations. A statistical comparison (chi2 = 45, d.f. = 2, P << 0.001) showed associations between the responses 'more likely to donate if paid' and 'content to receive blood from a paid donor', and between the responses 'less likely to donate if paid' and 'not content to receive blood from a paid donor'. Age distributions are presented for the donor status categories and the responses to the main questions. Of 129 people who stated a minimum, nonzero payment that would persuade them to donate, 103 (80%) suggested pound sterling 10 or less.

Blood donors' motivations and reasons for lapsing and never donating were determined from a questionnaire completed by 489 adults (89 regular donors, 105 lapsed donors, 295 never donors) in Leeds, UK. The free text responses were classified according to themes that arose. Altruistic motivations including reciprocation and kinship towards family, friends, and unknowns were most numerous. Other motivations related to the NHS or National Blood Service, obligation, occupation, self-interest, convenience, peer-influence, health benefits, a rare blood group, donations being useful, a TV programme, or ethnicity. Reasons for non-donation were personal, medical, donation centre- or procedure-related, exclusions, and age-related. Suggestions are offered to increase the blood supply.

During an elective visit to Fiji we assessed the knowledge of diabetes possessed by patients who attended the hospital Diabetic Clinic in Lautoka. All the patients interviewed had type 2 diabetes and 15.4% were treated with insulin, 80.8% with oral therapy and 3.8% with diet alone. Blindness was the commonest complication known to patients but almost a quarter could not describe any diabetic complication. All patients had seen a hospital doctor regarding their diabetes; 17.9% also saw a private general practitioner, 80.8% had seen the diabetes nurse, 60.8% a dietician, and 57.7% a chiropodist. When asked about causative factors 12.8% thought diabetes was caused by overeating, 12.8% thought it was due to too much sugar in the diet, and the remaining 60.3% did not know.The methods by which the ever-increasing financial burden of diabetes in Fiji can be reduced are discussed. We feel that the prevention of diabetes and the early detection of complications would be the most cost-effective methods to improve overall diabetes care in Fiji. However, the whole diabetes care service in Fiji is constrained by the poor economic state of the country and the low profile of diabetes in the healthcare plans of the country. Copywright

Extremely preterm birth When planning preterm delivery before 26 weeks' gestation, it is important to consider the overall reproductive outcome for the mother. The choice of the most appropriate mode of delivery for extremely preterm infants is affected by the difficulty in carrying out a lower segment caesarean section at such early gestations and the potential for substantial fetal trauma. Classic (vertical incision) caesarean section presents major risks for the mother. After classic caesarean section, elective caesarean section for subsequent pregnancies is mandatory because there is an increased risk of uterine rupture and perinatal death. These issues are difficult for prospective parents and any discussion is limited by a lack of robust evidence to guide practice.