We know that Christmas is now as far away as it gets, but the BMJ is looking ahead anyway. Any material that you would like us to consider for the Christmas issue of the BMJ should ideally be submitted by the beginning of September 2005. Electronic submission is essential—and straightforward—and you can find out how to do it by going to bmj.com and clicking on “Submit a manuscript” under “Services.”

Hospital managers responsible for balancing the books would have been interested in the ESCAPE trial, which showed that a chest pain observation unit is more effective than routine care and is cost effective in Britain's NHS. Further analysis now shows that these results are likely to be generalisable to most settings, but for hospitals that currently admit less than 35% of patients, such units will not reduce costs. The authors have helpfully produced a nomogram to predict whether a chest pain observation unit will be cost effective in specific hospitals

The world's first automobile fatality apparently took place in the Irish Midlands in 1869. Mary Ward fell from a steam carriage, which had been designed and built by her cousin, and she died after being crushed by its heavy iron wheels. She had enjoyed a multitude of achievements before her unfortunate …