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Objective: To estimate the number of strokes in Leicestershire and investigate possible differences between South Asian and white patients.Design: Prospective incidence sample survey.Setting: Leicestershire.Participants: Acute stroke cases occurring in registered populations of 12 'high Asian' and 11 'low Asian' general practices.Results: The age-specific incidence rates of stroke in Leicestershire were similar to those of the Oxford Community Stroke Project. South Asian patients were less likely to be living alone at home before their stroke and they tended to be younger than whites. However, only 12% of South Asian patients with a stroke were not admitted to hospital within 7 days of their stroke compared to 23% of white patients (chi2 = 3.24, d.f. = 1, P = 0.07). Only 21% of South Asian patients died within 28 days of their stroke compared to 33% of white patients (age-adjusted odds ratio = 0.37; 95% CI: 0.14-0.97).Conclusions: Overlapping case-finding was crucial to finding all 'possible' strokes and this required close collaborative working between general practices, community health services, hospitals and the health authority. Relatively fewer South Asian patients were managed in the community in the first 7 days. Interestingly, South Asian patients were less likely than white patients to die within 28 days. This is an area worthy of further research. [ABSTRACT FROM AUTHOR]

Childhood diabetes diagnosed before the age of 24 months presents specific management problems. We report here on the establishment (using the British Diabetic Association [BDA] Children's Register) and mortality of a cohort of children with diabetes diagnosed before age 24 months. Children registered during the period 1972–1981 were traced by contacting consultants or by using the National Health Service Central Registers (NHSCR) of the Office of Popula tion Censuses and Surveys (OPCS). Standardized mortality ratios (SMR) were estimated using person-years of follow-up for each child and age-specific death rates for the England and Wales population for the years 1972–1989. Of 339 children notified during 1972–1981, 231 were traced through consultants and 99 of the remaining 108 through the NHSCR. Twenty were found to be ineligible. The cohort available for mortality analysis comprised 310 (97%) of 319 eligible children. Their age at the time the cohort was established was 8–18 years, and their duration of diabetes 8–17 years. The male:female ratio is 1.4:1. Of 310 children studied, seven have already died: SMR 5.4(95% Cl: 2.5–11.5). We have established a large, unique cohort of children with diabetes diagnosed before age 24 months and still living in the UK and Ireland. The natural history including mortality and occurrence of complications will be analysed prospec tively in this cohort and compared to other cohorts of similar disease duration, but later age at onset. [ABSTRACT FROM PUBLISHER]

Jooste P L (Research Institute for Nutritional Diseases and Centre for Epidemiological Research in Southern Africa, South African Medical Research Council, PO Box 70, Tygerberg 7505, South Africa) Yach D, Steenkamp H J, Botha J L and Rossouw J E. Drop-out and newcomer bias in a community cardiovascular follow-up study. 1990; : 284–289. Bias resulting from a loss of baseline subjects at follow-up (drop-out), and newcomer bias resulting from subjects entering the study at the follow-up stage, were investigated in a three-community coronary risk factor follow-up study. The study consisted of a cross-sectional baseline study on 7188 participants aged 15 to 64 years, a four-year intervention period and a follow-up cross-sectional study in the same communities on 6283 participants aged 19 to 68 years. The overall non-response rate of 45% in men and 42% in women varied from 30 to 79% in the various age and sex groups, with the biggest drop-out rate occurring in the youngest age group of 15 to 24 years. At baseline drop-outs were more likely to have lower educational qualifications than those who participated in both the baseline and follow-up studies (stayers) and included significantly more smokers than non-smokers. Coronary risk factors of newcomers were not different from that of the stayers at follow-up except for slightly, but not significantly, higher smoking rates in newcomers. These findings suggest that drop-out and newcomer bias need to be assessed and its effect studied before final evaluation of data in community follow-up studies. [ABSTRACT FROM PUBLISHER]

Asian immigrants to the United Kingdom and elsewhere are at greater risk of mortality and morbidity from coronary heart disease (CHD) than UK whites. This predisposition has yet to be explained. More than 63000 Asian people, a high proportion of whom are under 40, live in Leicester. Projections of the local Asian and non-Asian populations indicate that numbers of Asian people in higher-risk age groups will more than double between 1988 and 2008. In the absence of effective intervention, numbers of CHD deaths among Asian people, and the prevalence of other manifestations of CHD in this group, will rise by an equivalent amount. This predicted shift in the ethnic distribution of CHD has important implications for the planning of acute services in Leicester. Our predictions also demonstrate both a valuable opportunity and a pressing need for local research into the aetiology of CHD among Asian people, upon which preventative strategies may be based. [ABSTRACT FROM PUBLISHER]

Women returning for assessment of abnormal breast screens completed user satisfaction questionnaires: 103 at the clinic(100 per cent response) and 79 (87 per cent) of 91 without malignancies a week later. Women were satisfied with invitations' timing and with the information in one of three letter versions tested. A small group (11 per cent) had not discussed their invitations with anybody and also declined to do so with the Breast Care Sister. Twenty-nine per cent of women had towait longer than 15 minutes (longer than expected for nine of them). Most women (69 per cent) described the staff as the best aspect of their visit, 55 per cent found nothing unpleasant and 96 per cent said they would attend again. Others mentioned waiting, the dressing gowns and the mammography as unpleasant. The audit allowed the service to be improved and provided invaluable feedback to staff working in a stressful environment. Similar audits will be repeated when screening otherLeicestershire areas. [ABSTRACT FROM PUBLISHER]