Four out of five DS children now survive at least 10 years. Adequate educational and health service provision needs to be made for them, especially those with congenital heart defects. The need for studies which compare survival and quality of life in DS children with CAVD who undergo cardiac surgery versus those who do not, taking account of various selection factors, is identified.

Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.

An outbreak of cryptosporidiosis occurred in the Isle of Thanet during December 1990 and January 1991. A total of 47 cases ranging in age from 2 months to 85 years were identified in residents from the Margate, Broadstairs and Ramsgate areas, with dates of onset of illness from 3 December to 14 January. A case-control study demonstrated a strong statistical association between illness and the consumption of unboiled tap water from a particular source, with evidence of a dose-response relationship. Although no cryptosporidial oocysts were identified in samples of untreated or treated water taken during the investigation, the results were consistent with the view that the source of infection was treated river water which was used to supplement borehole water.

Most of the evidence for the effectiveness of workplace health promotion has been reported in the U.S. ] Such interventions may also be cost-effective, 2 though not necessarily in all countries, because of variations in the mode of health care delivery and cultural differences in the determinants of health behaviors. Few programs have focused on the needs of women, especially those in blue-collar occupations. Yet there is indisputable evidence that lifestyle patterns vary according to socioeconomic position and that patterns of health inequality exist for most major diseases among workers) The explanations for this are complex and may relate to educational level or social conditions. 4 We wished to assess whether a health promotion program based on the findings of a focused needs and therefore primarily client-led assessment, would have an impact on lifestyle and health, particularly in the case of blue-collar or manual occupation women. The program focused on lifestyle factors related to cancer risk, and the 10-point European Code Against Cancer formed an integral part of the study design. 5 METHODS Design The study was conducted in three stages: baseline assessment, 1-year intervention program, and follow-up sur

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