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Several epidemiological studies have demonstrated at the individual level an elevated risk of cardiovascular death for women who have been using oral contraceptives. Nevertheless, there has been no detectable increase in the number of cardiovascular deaths during the last fifteen years in countries where the use of oral contraceptives has become widespread. In this paper, we have tried to analyse this apparent contradiction and to discuss the causal nature of the relationship linking oral-contraceptives and cardiovascular death. For this purpose, we present a bibliographical summary of the relevant studies as well as an analysis of the trend in cardiovascular deaths among women in France from 1968 to 1975.

In Britain, we are in the process of closing the majority of the old psychiatric hospitals. In 1954, there were 148,000 psychiatric beds, and in 1990 about 50,000 still remained. At Friern Hospital, in North London, a research team has studied 1,000 long-term in-patients who have been discharged from hospital. This paper sets out the results for the first 350 of these patients, discharged from Friern and Claybury hospitals between 1985 and 1990, comparing before and after discharge. In the first year after discharge 16% were readmitted to hospital. We used the following scales to measure the function of these patients: Present State Examination, Social Behaviour Schedule, Physical Health Index, Social Network Scale, Patient Attitude Questionnaire. One year after discharged, the majority of these measures showed no change. However, significant changes (p < 0.01) were noted for: the attitude of patients (who preferred their new way of life in the community), the costs of care (which were initially reduced by 5% for patients discharged from hospital), and for the improved quality of accommodation (which allowed more choice for patients). These first results suggest that care in the community is no worse, in many respects is better, and is no more expensive than hospital care.