Lion's mane jellyfish (Cyanea capillata) envenoming presenting as suspected decompression sickness.

Lion's mane jellyfish stings are usually characterised by local inflammation, especially weals. Systemic symptoms are not widely described although there is a well known fictional description of a fatal reaction to envenoming. We describe five divers presenting with suspected decompression sickness, where the probable diagnosis was jellyfish envenoming.

Can child-focused sanitation and nutrition programming improve health practices and outcomes? Evidence from a randomised controlled trial in Kitui County, Kenya.

Introduction: In Kenya's Kitui County, 46% of children under 5 years are stunted. Sanitation and nutrition programmes have sought to reduce child undernutrition, though they are typically implemented separately. We evaluate the effectiveness of an integrated sanitation and nutrition (SanNut) intervention in improving caregiver sanitation and nutrition knowledge and behaviours.

The psychological impact of accidents on recreational divers: a prospective study.

Objective: The present study aimed to examine the medium and long term psychological impact of diving accidents on the victims (n=52), compared with the impact on two control groups: the victim's diving "buddy" (n=40) who simply witnessed the accident, and a second control from the same boat who did not dive with the victim (n=38).

Methods: This was a prospective cohort study of the impact of an accident on the victims who attended the Hyperbaric Unit, in comparison with the two control groups. Pre-accident psychological morbidity was assessed using the General Health Questionnaire.

Targeting appropriate interventions to minimize deterioration of drinking-water quality in developing countries.

In developing countries, it has been observed that drinking-water frequently becomes recontaminated following its collection and during storage in the home. This paper proposes a semi-quantified 'disease risk index' (DRI) designed to identify communities or households that are 'most at risk' from consuming recontaminated drinking-water. A brief review of appropriate physical and educational intervention measures is presented, and their effective use is discussed.

Decompression illness presenting as breast pain.

We present two cases of decompression illness in women in whom the initial symptom causing distress after completion of the dives was breast pain. Both women were also subsequently found to have a patent foramen ovale. We postulate that breast pain may be an unusual under-recognized manifestation of decompression illness.