436

rather small sums in a pay round that has only a few weeksto run are the Review Body’s comments on the future. It picksup a hot chestnut that has been lying around ever since juniorhospital staff began to think in terms of a basic working weekplus overtime. The Review Body has always claimed that basicsalaries for these grades took partial account of the long hoursworked. It repeats this claim in its latest report, and Sir ErnestWoodroofe and his colleagues clearly have misgivings aboutrelating the earnings of professional men and women fixedlyto hours worked. The warning is quite clear: if higher rates forextra-duty payments are negotiated on top of a basic workingweek of forty hours then the salary scales for that basic weekare going to be lower.

NUTRITIONAL ANAEMIA

NUTRITIONAL anaemia is a worldwide health problem, es-

pecially in developing countries. The commonest cause is irondeficiency, but folate deficiency and, more rarely, vitamin Budeficiency or protein deficiency can also be causes; it occursmost frequently in pregnant women and young children.Although there have been advances in the investigation anddiagnosis of anaemia, a meeting in Geneva has found that thisknowledge is not being properly applied in public-health mea-sures.’ Two successful therapeutic supplementation trials onpregnant women were reported. In Israel,2 three groups ofwomen took daily doses of 100 mg iron, or 100 mg iron and300 µg folate, or 300 µg folate. 96% of the women receivingiron and folate showed a rise in haemoglobin, whereas only26% of those receiving iron or folate alone showed such a rise.A programme was implemented in which iron and folate weregiven to all pregnant women in a selected community, result-ing in a reduction in anaemia from over 50% to below 6%. Insimilar trials in India,3 haemoglobin concentration rose in allwomen given iron, but declined in those given no iron. Thosegiven folic acid and vitamin B12 in addition to iron showed aneven greater rise in mean haemoglobin concentration thanthose given the equivalent amount of iron only, indicating thateither folic acid or vitamin B12 was important in the patho-genesis of pregnancy anaemia. In populations where nutritionalansemia is prevalent strategy will vary, and plans of action willhave to be tailored to individual national requirements. Thismeans finding out what deficiencies are responsible for it, andplanning larger scale supplementation, as was done in Israel.Specific designs for such pilot and field trials have been workedout, with criteria for deciding between fortification of foodsand supplementation.

DEALING WITH DEATH

IN the West where death has become a topic not to be dis-cussed, perhaps not even to be considered, it is sometimes diffi-cult for people to obtain information on matters relating todying. For example, doctors whose patients approach them foradvice on donation of their organs or bodies after death maybe hard-pressed to recommend a suitable general text. The Artof Dying4 is a good source of such information. This bookcovers most aspects of death and even includes a chapter aboutthose who claim to have met death and survived, but it is atits best when describing current practice with regard to

burials, funerals, and the law. Ian Crichton has wisely optedfor a matter-of-fact style but avoids sounding unsympathetic.

1. Control of Nutritional Anæmia with Special Reference to Iron Deficiency:Report of an International Atomic Energy Agency/Agency for Interna-tional Development (U.S.A.)/W.H.O. Joint Meeting. Tech. Rep. Ser. WldHlth Org. 1975, no. 580.

2. Izak. G. and others, Scand. J. Hœmatol. 1973, 11, 236.3. Sood, S. K. and others, J. trop. Med. Hyg. 1974, 77, 177.4. The Art of Dying. By IAN CRICHTON. London: Peter Owen. 1976. Pp. 166.

£4.50.

University of Newcastle upon TyneDr H. N. A. Willcox has been appointed lecturer in ana-

tomy.

Influenza

THE Royal College of General Practitioners returns fromrepresentative practices have shown a sudden increase in ill-nesses diagnosed as epidemic influenza. During the week’beginning Jan. 28 the figure rose to 117.5 per 100 000 (provi-sional) compared with 42.1 per 100 000 (corrected) the pre-vious week.

Prof. Lynne Reid has been appointed to the S. Burt Wolbach chairof pathology at Harvard Medical School, and to the chairmanship ofthe department of pathology, Children’s Hospital Medical Center(Harvard Medical School, Boston).

The annual meeting of the British Nuclear Medicine Society is tobe held, with the Hospital Physicists’ Association, on Thursday andFriday, March 25 and 26, at the University of London Students’Union, Malet Street, WC1E 7HY. Details may be had from Dr D. N.Croft, Department of Nuclear Medicine, St. Thomas’s Hospital, Lon-don SE1 7EH.

Diary of the Week

FEB. 22 To 28

Monday,23rdCARDIOTHORACIC INSTITUTE, Brompton Hospital, Fulham Road, London SW3

6HP5.15 P.M. Dr J. Schneerson: Pulmonary Artery Pressures m Severe Skeletal

Deformity. Dr Ian Fawcett: Occupational Asthma due to EpoxyResins.

MANCHESTER MEDICAL SOCIETY8.30 P.M. (New Medical School.) General Practice. Prof. R, S. Illingworth-

Overtreatment.

Tuesday, 24thKING’S COLLEGE HOSPITAL MEDICAL SCHOOL, Denmark Hill, London SE5 8RX

4.30 p.m. Dr Francis Crick, F.R.S.: The Structure of Chromatin. (Wsltshirelecture.)

MANCHESTER MEDICAL SOCIETY5.30 P.M. (New Medical School.) Psychiatry. Prof. C. D. Marsden: The Pret-

lems of Side-effects of Neuroleptic Drugs.

Wednesday, 25thBRITISH POSTGRADUATE MEDICAL FEDERATION

1.15 P.M. (Channel 7, I.L.E.A. Closed Circuit Television System.) Prof. J. G,Humble: Bone-marrow Transplants-Present and Fututt

(Repeated on Wednesday at 6.30 P.M., Thursday at 12.15 P.M., andFriday at 1.15 P.M.)

ROYAL POSTGRADUATE MEDICAL SCHOOL, Hammersmith Hospital, Ducaae

Road, London W12 OHS2 P.M. Dr Merton Sandler: Monamine Metabolism in Man.

INSTITUTE OF NEUROLOGY, National Hospital, Queen Square, London WO’’3BG

6 P.M. Dr Jurgen Mertin: Immune Mechanisms in Multiple Sclerosis.7 P.M. Mr K. E. D. Shuttleworth: The Diagnosis and Management of tbe

Neuropathic Bladder Associated with Multiple Sclerosis. (SandocFoundation lectures.)

INSTITUTE OF PSYCHIATRY, de Crespigny Park, Denmark Hill, London SE55.30 P.M. Dr J. L. T. Birley: Depression and Unhappiness.

NORTHWICK PARK HOSPITAL, Watford Road, Harrow, Middlesex HA13CJ1 P.M. Dr E. B. Raftery: Digitalis and Anti-arrhythmic Drugs.

Thursday, 26thLONDON MEDICAL GROUP

6 P.M. (St. George’s Hospital, Blackshaw Road, Tooting, SW17.) Dr CMurray Parkes: Bereavement.

MANCHESTER MEDICAL SOCIETY5.30 P.M. (New Medical School.) Pcediatrics. Prof. J. S. Cameron: The Nept

rotic Child.

Friday, 27thINSTITUTE OF LARYNGOLOGY, 330/332 Gray’s Inn Road, London WC1X SEE

5.30 P.M. Dr G. A. S. Lloyd: Paranasal Sinuses.