In 4 hospitals, we demonstrated frequent dispersal of fluorescent tracer and fluoroquinolone-resistant gram-negative bacilli from sink drains to sink bowls and to surfaces outside the bowl. Fluorescent tracer dispersal correlated inversely with the depth of the sink bowl. Modifications in sink design could substantially reduce the risk for pathogen dissemination.

In hospital sinks, a novel plastic drain cover was effective in preventing dispersal of gram-negative bacilli and fluorescent gel associated with splattering of flowing water. Our findings suggest that the sink drain covers could provide a simple means to reduce dissemination of pathogens from contaminated sinks.

Forty-four schizophrenic patients were followed up for five years after their first admission to hospital for a first episode of illness. Thirteen (30%) of 43 patients had not relapsed; 28 of the 30 patients who did relapse did so within the first 42 months. The relapses occurred despite antipsychotic drug therapy. Also, 24% of patients had at least one course of ECT. Only 19% of the patients at five years were in open employment; unemployment was strongly associated with relapse. Eighteen per cent had neither relapses nor schizophrenic symptoms at follow-up. Poor outcome at five years was associated with greater psychological distress among relatives at first admission. At five years 43% of relatives continued to show case level psychological stress.

This is the initial report of a prospective study by computerised tomography brain scan of first episode schizophrenia. Twenty-seven patients who met Research Diagnostic Criteria for schizophrenia were compared with volunteer controls on ventricular: brain ratio, sulcal: brain volume ratio, and the widths of third ventricle and Sylvian and interhemispheric fissures. The results provide evidence that sulcal enlargement, but not ventricular abnormalities, may be detected at first admission for schizophrenic illness, and are discussed in relation to findings from other studies.

Of 49 schizophrenic patients followed up 12 months after their first admission to hospital, only about 45% had experienced no relapse and had no schizophrenic symptoms; a poorer outcome was more often found in Feighner positive than Feighner negative schizophrenic patients. The patients' overall level of unemployment had more than doubled to 51%. In patients whose acute episodes responded to treatment, pimozide taken once weekly as maintenance therapy was as effective as intramuscular flupenthixol decanoate, but tardive dyskinesia appeared in two patients receiving weekly pimozide; the repeat psychometric assessment at 12 months found modest improvements, i.e. no evidence of intellectual decline, in Matrices, Block Design, and Digit Copying tests. Forty per cent of relatives still showed significant psychological distress, which correlated with patients' schizophrenic symptoms, and the relatives' social functioning remained poorer than that of a normal community sample.

An assessment of 31 main care-giving relatives living with schizophrenics was carried out using the General Health Questionnaire and the Social Adjustment Scale by Self Report. More than 75% of relatives had a high probability of themselves being a psychiatric case. Relatives also showed social role dysfunction and impairment especially marked in social and leisure activities. Relatives' distress was related to the level of symptoms in patients, as assessed by the Present State Examination.