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The mortality rate due to intrapartum asphyxia is generally considered a good guide to the quality of perinatal care. Using a routine system of surveillance, we identified a six‐fold difference in mortality rate due to intrapartum asphyxia depending on the hospital of birth, with the lowest rate (95 per cent confidence intervals) of 0.25 (0.10, 0.64)/1,000 births and the highest rate of 1.59 (0.77, 3.27)/1,000 births. A framework of internal and external reviews of the clinical services was developed, that is able to tackle such clinical governance issues in a robust but sensitive manner. The outcome included specific improvements in service provision. The model is generally applicable and is thus suitable for use wherever such clinical governance issues are identified.

Aims to establish a mechanism to determine prospectively the health status at two years of babies who weighed less than 1.5kg at birth, born and receiving neonatal intensive care in North Wales. Maternal and neonatal data on all babies discharged from each of the three units in North Wales meeting this criteria were collated by the study co‐ordinator. A mechanism for review of the health status at two years, corrected for gestational age, was established using the data set recommended by a working group convened by the National Perinatal Epidemiology Unit and Oxford Regional Health Authority. The procedures developed and the outcome data, for a two year cohort of babies born in 1995 and 1996, are reported. Concludes that prevalence of severe disability was similar to that found in other studies, with a considerable number exhibiting impaired growth and delay in speech development.

Domestic refrigerators could be considered as one of the major potential sources of food-borne diseases, in addition limited data are available regarding the level of contamination of domestic refrigerators in Iran. The purpose of this paper is to detect some of bacterial contamination in domestic refrigerators.

In total, 104 households were randomly selected from ten health centers in five areas of Tehran, Iran. Visual inspection and temperature evaluation of the households’ refrigerators were done. In addition, the refrigerators were swabbed and analyzed for contaminants using polymerase chain reaction (PCR) method. DNA was isolated and purified by the proposed standard protocol.

Screening of the domestic refrigerators by PCR method showed that 51.7 percent of the samples were positive for pathogens as follows: L. monocytogenes 41.6 percent, S. aureus 5.5 percent, Salmonella spp 4.6 percent, and E. coli O157:H7 0 percent; consequently, none of mentioned pathogens were detected in 48.3 percent of the refrigerators. Results of the visual inspection indicated that 57 percent of the refrigerators were on desirable, 36.5 percent were acceptable, and 7 percent were weak conditions. Most of the refrigerators about 44 percent had desirable temperatures. There were no significant correlations between the visual inspection scores, temperature and frequency of isolation of specific pathogens in the domestic refrigerators. A significant correlation was observed between contamination and education of parents (p < 0.05).

Determination of the bacterial contamination and evaluating the temperature of domestic refrigerators in Iran can be considered as a novel approach of current study. These findings could be employed in designing and implementing appropriate educational interventions to promote food safety and diminish the risk of food-borne illnesses. Also, obtained results might be applied as introduction for further investigations.