Notes and News

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1198 Notes and News PROFESSIONS FOR WORLD DISARMAMENT AND DEVELOPMENT THE third conference of Professions for World Disarmament and Development was held in London at the Royal Society of Medicine on Nov 9. PWDD now has sixteen national affiliates-and more are expected. In Britain the Medical Association for Prevention of War* and the Medical Campaign Against Nuclear Weaponst have been among its supporters from the start. Bishop Trevor Huddleston chaired the morning session, at which Mary Midgley, former senior lecturer in philosophy in the University ofNewcastle-upon-Tyne, discussed the responsibility of the professions. She believed that the professions had accepted a situation in which they saw themselves as responsible for a strictly limited area of knowledge and skill. This attitude had deterred many from becoming involved in wider global issues, such as the prevention of wars and famines. Yet our greater scientists and thinkers had not limited themselves to narrow issues: take for example, the work of Darwin, Thomas Huxley, Waddington, and Margaret Mead. In today’s interdependent world the narrow view of professional responsibility was no longer tenable. Professionals were both experts and human beings-interested in social service and human survival. Moreover, those with influence had a duty to use it, and power conveyed responsibility. PWDD could help those colleagues who felt guilty if they stepped outside the narrow academic and professional confines when it pointed out that the old definitions of "professional" were arbitrary and had become irrelevant. Frank Barnaby, nuclear physicist and visiting professor at Delft University, reviewed the world’s vast effort and expenditure on military research and development and on weaponry. He pointed to developments in research for nuclear weapons, such as an effective anti-submarine warfare system, which might make a first strike plausible and bring nearer the threat of nuclear war. At the same time, developments in conventional weapons systems increased their accuracy and lethality and shifted command, control, and communications towards automatic response. This trend in conventional weapons research afforded opportunity to move from nuclear confrontation to non-nuclear defence. Professionals should be aware of the increasing threat to human survival posed by nuclear weapons, they should communicate their fears to the public, and they should press for security through non-aggressive non-nuclear defence. Richard Sandbrook, a chartered accountant and secretary of Earth Resources Research Ltd, put the case for professional responsibility for sustainable development. Whatever was done in the name of development had to be environmentally, culturally, and technically sound, economically beneficial, and morally fair. Development was sounder when it proceeded from below (people) upwards rather than from above (government) downwards. The professional needed to study the situation at first hand and not in the splendid isolation of a desk in Whitehall. * 16b Pnnce Arthur Road, London NW3 6AY (tel: 01-435 1872). t7 Temson Road, Cambridge CB1 2DG (tel: 0223 313828). FOOD AND HEALTH THE British Government is reluctant to spell out too plainly to the public the real meaning of eating healthily. For, if there were a popular switch to foods of vegetable origin, high in fibre and low in saturated fat, salt, and sugar, retailers would stop buying highly refined and processed fatty foods from the food manufacturers, who would have to stop buying the subsidised butter produced in surplus by farmers trying to maximise their returns under the EEC’s Common Agricultural Policy. Farmers might suffer some loss of revenue from such a switch in demand, but the health of the nation 1. See Lancet 1985, ii 410 (now world leader in deaths from coronary heart disease) would show an improvement. Publication of Eating for a Healthy Hearl,! which endeavoured to translate the technical language of the COMA report into dietary guidelines for the layman, and which has been criticised by the health lobby (see for example, Michael O’Donnell in the British Medical_7ournal, Oct 26, p 1211) for failing to achieve this simple aim, was actually delayed by the Department of Health and Social Security in deference to the Ministry of Agriculture, Food, and Fisheries. So, the consumer is dependent on sources other than the Government for information about healthy eating. One such source in recent months has been television, which has broadcast many forceful programmes on health, such as Plague of Hearts, repeated recently on BBC2. Dr M. O’Donnell next concentrated on the role of food in health and in life in general (Michael O’Donnell Investigates... Food), in an important contribution to the BBC food and health campaign. While a BBC campaign might seem to be a powerful way of reaching a wide audience, such programmes tend to be watched by consumers who are already informed and motivated. A pair of excellent books have been produced in connection with the campaign. One (The Taste of Health) is for the Kitchen. The other, by Colin Tudge (The Food Connection 2) is technical but offers a thorough summary of knowledge about the importance of diet. FOOD SAFETY DESPITE growing consumer concern about the potential hazards of food additives the final paragraph of a report3 from the Food Safety Research Consultative Committee proposes that this area of research be cut back to release more money for "use in areas of higher priority". The reason given for this recommendation is the lack of significant evidence of danger associated with the presence of additives and contaminants in the UK food supply. The real reason could of course be that, of the 11 members of the committee, 4 (including the chairman) represent industrial interests: Cadbury Schweppes plc, Unilever Research plc, Beecham Group plc, and Whitbread and Co plc. It is odd to find such a recommendation tucked away at the end of the report-odd because the emphasis of the report is on underlining the committee’s regret at a planned decrease in the proportion of the Ministry of Agriculture, Fisheries, and Food funds for food research allocated to safety research. CENTRES APPROVED BY VOLUNTARY LICENSING AUTHORITY ON IN-VITRO FERTILISATION THE voluntary licensing authority for human in-vitro fertilisation and embryology, set up earlier this year by the Medical Research Council and the Royal College of Obstetricians and Gynaecologists, has so far approved 11 centres carrying out work on in-vitro fertilisation (5 centres providing a clinical service only, 4 providing a clinical service and undertaking some research on human pre- embryos, and 2 concerned solely with research on human pre- embryos). The authority reports that all the research projects approved have been relevant to clinical problems, such as diagnosis and treatment of infertility or genetic disorders, and none of the pre- embryos have been used beyond 9 days of development. Research has centred on cryopreservation of pre-embryos, identification of the optimum growth media for pre-embryos, identification, by non- destructive means, of normal stages of growth of pre-embryos, and the study of chromsome abnormalities. The authority intends to publish an annual report giving details of centres approved and indicating those not approved and those which have not made an application to the authority. Each centre submitting an application will be visited by the authority before approval is given. 2. The Food Connection. By Colin Tudge London: BBC Publications, 1985 Pp 151 £4.25 3. Food Safety Research Consultative Committee Report to the Priorities Board Available (£3.50 including postage) from the Publications Unit, MAFF. Lion House, Willowburn Trading Estate, Alnwick, Northumberland NE66 2PF

Transcript of Notes and News

1198

Notes and News

PROFESSIONS FOR WORLD DISARMAMENT AND

DEVELOPMENTTHE third conference of Professions for World Disarmament and

Development was held in London at the Royal Society of Medicineon Nov 9. PWDD now has sixteen national affiliates-and more areexpected. In Britain the Medical Association for Prevention ofWar* and the Medical Campaign Against Nuclear Weaponst havebeen among its supporters from the start.

Bishop Trevor Huddleston chaired the morning session, at whichMary Midgley, former senior lecturer in philosophy in the

University ofNewcastle-upon-Tyne, discussed the responsibility ofthe professions. She believed that the professions had accepted asituation in which they saw themselves as responsible for a strictlylimited area of knowledge and skill. This attitude had deterred manyfrom becoming involved in wider global issues, such as the

prevention of wars and famines. Yet our greater scientists andthinkers had not limited themselves to narrow issues: take for

example, the work of Darwin, Thomas Huxley, Waddington, andMargaret Mead. In today’s interdependent world the narrow viewof professional responsibility was no longer tenable. Professionalswere both experts and human beings-interested in social serviceand human survival. Moreover, those with influence had a duty touse it, and power conveyed responsibility. PWDD could help thosecolleagues who felt guilty if they stepped outside the narrowacademic and professional confines when it pointed out that the olddefinitions of "professional" were arbitrary and had becomeirrelevant.

Frank Barnaby, nuclear physicist and visiting professor at DelftUniversity, reviewed the world’s vast effort and expenditure onmilitary research and development and on weaponry. He pointed todevelopments in research for nuclear weapons, such as an effectiveanti-submarine warfare system, which might make a first strikeplausible and bring nearer the threat of nuclear war. At the sametime, developments in conventional weapons systems increasedtheir accuracy and lethality and shifted command, control, andcommunications towards automatic response. This trend inconventional weapons research afforded opportunity to move fromnuclear confrontation to non-nuclear defence. Professionals shouldbe aware of the increasing threat to human survival posed by nuclearweapons, they should communicate their fears to the public, andthey should press for security through non-aggressive non-nucleardefence.Richard Sandbrook, a chartered accountant and secretary of Earth

Resources Research Ltd, put the case for professional responsibilityfor sustainable development. Whatever was done in the name ofdevelopment had to be environmentally, culturally, and technicallysound, economically beneficial, and morally fair. Development wassounder when it proceeded from below (people) upwards ratherthan from above (government) downwards. The professionalneeded to study the situation at first hand and not in the splendidisolation of a desk in Whitehall.* 16b Pnnce Arthur Road, London NW3 6AY (tel: 01-435 1872).t7 Temson Road, Cambridge CB1 2DG (tel: 0223 313828).

FOOD AND HEALTH

THE British Government is reluctant to spell out too plainly to thepublic the real meaning of eating healthily. For, if there were apopular switch to foods of vegetable origin, high in fibre and low insaturated fat, salt, and sugar, retailers would stop buying highlyrefined and processed fatty foods from the food manufacturers, whowould have to stop buying the subsidised butter produced in surplusby farmers trying to maximise their returns under the EEC’sCommon Agricultural Policy. Farmers might suffer some loss ofrevenue from such a switch in demand, but the health of the nation

1. See Lancet 1985, ii 410

(now world leader in deaths from coronary heart disease) wouldshow an improvement. Publication of Eating for a Healthy Hearl,!which endeavoured to translate the technical language of theCOMA report into dietary guidelines for the layman, and which hasbeen criticised by the health lobby (see for example, MichaelO’Donnell in the British Medical_7ournal, Oct 26, p 1211) for failingto achieve this simple aim, was actually delayed by the Departmentof Health and Social Security in deference to the Ministry ofAgriculture, Food, and Fisheries. So, the consumer is dependent onsources other than the Government for information about healthyeating.One such source in recent months has been television, which has

broadcast many forceful programmes on health, such as Plague ofHearts, repeated recently on BBC2. Dr M. O’Donnell next

concentrated on the role of food in health and in life in general(Michael O’Donnell Investigates... Food), in an importantcontribution to the BBC food and health campaign. While a BBCcampaign might seem to be a powerful way of reaching a wideaudience, such programmes tend to be watched by consumers whoare already informed and motivated. A pair of excellent books havebeen produced in connection with the campaign. One (The Taste ofHealth) is for the Kitchen. The other, by Colin Tudge (The FoodConnection 2) is technical but offers a thorough summary of

knowledge about the importance of diet.

FOOD SAFETY

DESPITE growing consumer concern about the potential hazardsof food additives the final paragraph of a report3 from the FoodSafety Research Consultative Committee proposes that this area ofresearch be cut back to release more money for "use in areas of

higher priority". The reason given for this recommendation is thelack of significant evidence of danger associated with the presence ofadditives and contaminants in the UK food supply. The real reasoncould of course be that, of the 11 members of the committee, 4(including the chairman) represent industrial interests: CadburySchweppes plc, Unilever Research plc, Beecham Group plc, andWhitbread and Co plc. It is odd to find such a recommendationtucked away at the end of the report-odd because the emphasis ofthe report is on underlining the committee’s regret at a planneddecrease in the proportion of the Ministry of Agriculture, Fisheries,and Food funds for food research allocated to safety research.

CENTRES APPROVED BY VOLUNTARY LICENSINGAUTHORITY ON IN-VITRO FERTILISATION

THE voluntary licensing authority for human in-vitro fertilisationand embryology, set up earlier this year by the Medical ResearchCouncil and the Royal College of Obstetricians and Gynaecologists,has so far approved 11 centres carrying out work on in-vitrofertilisation (5 centres providing a clinical service only, 4 providinga clinical service and undertaking some research on human pre-embryos, and 2 concerned solely with research on human pre-embryos). The authority reports that all the research projectsapproved have been relevant to clinical problems, such as diagnosisand treatment of infertility or genetic disorders, and none of the pre-embryos have been used beyond 9 days of development. Researchhas centred on cryopreservation of pre-embryos, identification ofthe optimum growth media for pre-embryos, identification, by non-destructive means, of normal stages of growth of pre-embryos, andthe study of chromsome abnormalities. The authority intends topublish an annual report giving details of centres approved andindicating those not approved and those which have not made anapplication to the authority. Each centre submitting an applicationwill be visited by the authority before approval is given.

2. The Food Connection. By Colin Tudge London: BBC Publications, 1985 Pp 151£4.25

3. Food Safety Research Consultative Committee Report to the Priorities BoardAvailable (£3.50 including postage) from the Publications Unit, MAFF. LionHouse, Willowburn Trading Estate, Alnwick, Northumberland NE66 2PF

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QUALITY IN GENERAL PRACTICE

THE Royal College of General Practitioners continues its

campaign for the improvement of quality in general practice. A newpolicy statement’ is a sequel to a 1983 document on qualityinitiatives2and to a discussion paper3 published earlier this year.The underlying belief is that good general practitioners are still thebest way of providing primary health care. The College thereforerepeats its call for improvements in the quality of GPs and greaterconsistency in delivery of services.Quality assessment is seen as crucial to future developments.

Standards must be set and performances reviewed. GPs have beenshowing increased interest in the assessment of quality and in theneed for good practice data. One of the controversial issues has beenhow to extend quality assessment to all GPs on a voluntary basis.Many doctors are seeking practical help and advice on this matter.Much of this information should now be available through facultiesof the College, regional postgraduate organisations, and otherbodies.Practice management and teamwork are vital to quality

improvement. Since the practice team is the essential operationalunit the promotion and maintenance of health care must be a sharedresponsibility. Of prime concern is the overall success of the

practice team, not simply the performance of individuals.

Nevertheless, a balance must be struck between individualism andteamwork. GPs must learn to operate like business managers,delegating responsibility and decision making and creating policies,and cooperating with non-medical practice managers.Improvements in practice management inevitably require increaseduse of computers and better record-keeping. In the past, systemisedoperational data on the work of individual general practitionershave been notably deficient.The new College document also emphasises accountability,

incentives, and investment. The way NHS GPs are remunerated isseen to be out of step with patient care. "There is no obvious linkbetween remuneration and performance." In fact doctors who dointroduce innovations and extend their range of services can be

substantially out of pocket.Perhaps the most important point is the quality of professional

development of GPs. The call is for higher standards duringvocational training, with stricter and more objective assessments ofperformance. Appropriate standards should be reached on

completion of training. There should be opportunities for highertraining, and continuing educational activities should be

encouraged. Quality assessment should be part and parcel ofeveryday practice. Accreditation should be given on the completionof higher training. Finally, doctors should avail themselves ofresearch opportunities, thereby widening knowledge and

experience. Implementation of such a strategy rests solely on thecooperation of GPs: it is up to them to change attitudes and habits.The ultimate aim is that every GP should be able to describe his orher present work and to state categorically what services the practiceprovides for patients.

OCCUPATIONAL EXPOSURE TO LEAD

FROM Jan 1, 1986, British employers will be required to suspendfrom work any employee with a repeat blood-lead concentration of70 pg/dl or more. This is one of the main changes (the previous limitbeing 80 g/dl) in the Health and Safety Commission’s revision ofthe approved code of practice made under the Control of Lead atWork Regulations 1980. The code makes recommendations foremployer and employee, and the revisions are directed largely at theresponsibilities of employers: air sampling results which show highlead-m-air levels are to be given to employees quickly; propercontrols are to be applied when incidents give rise to increasedexposure to lead; employers are to specify the type of respiratory

1 Quality in general practice Policy statement 2. November, 1985. Obtainable fromRoyal College of General Practitioners. 14 Princes Gate, London SW7 1PU.

2 J R Coll Gen Practnrs 1983, 33: 523-24.3 Towards quality in general practice A consultation document from the RCGP council

See. Lancet 1985; i 1520.4 Health and Safety Commission Control of lead at work, approved code of practice

revised June, 1985 London; HM Stationery Office, 1985 Pp 29, price £3 90.

protection to be worn if exposure cannot be controlled by othermeans. The standards for lead in air have not changed since the 1980code (0-15 mg/m3 for lead in air and 0-10 mg/m3 for tetraethyl lead,8 h time-weighted averages). Air monitoring for each workplaceshould be carried out every 2 months, or less if the leadconcentration is known to be low or if degree of exposure does notvary. Medical assessments, including medical and occupationalhistories, clinical assessment, and measurement of blood lead andhaemoglobin should be done periodically, with blood-lead measure-ments every 3 months, or more or less frequently at the discretion ofthe employment medical adviser. Persons exposed to the more toxictetraethyl lead should be reviewed more frequently. The code doesnot have the force of law, but failure to comply with the provisionsof such a code may be used in criminal proceedings.

DRUNKEN DRIVING

AN occasional paper from the Institute of Alcohol Studies

suggests that one of the main reasons for the high level of drinkingand driving in the UK is a realistic appraisal by drivers of the lowrisk of being caught. In contrast to other countries, Britain has,according to the author, Dr James Dunbar, become complacentabout adopting strong measures to deter drunken driving. In

Finland, for example, road blocks were introduced to catch everydriver passing along a particular stretch of road. 1 - 5% of driverswere found, on average, to be over the legal alcohol limit, this smallproportion then being cited by the UK Government as a reason fornot introducing random testing. Nevertheless, although only 1 - 5%were over the legal limit, five years of random testing in Finlandproduced a sharp fall to 0 - 5%. A similar reduction was obtained bythe introduction of random testing in Australia. Random testing isclearly a strong deterrent. Dr Dunbar, director of the Tayside SafeDriving Project since 1980, also suggests that potentialGovernmental action against drunken driving could be enhanced bythe activities of pressure groups, such as an American organisation,Mothers Against Drunk Drivers, which patrols the streets at

night, contacts the police by CB radio when a drunken driver isobserved, follows until the driver is arrested, and then monitors theensuing legal action to ensure strong penalties. A similar group hasrecently been established in the UK: Campaign Against DrunkDrivers, Graham Buxton, Little Camberton, North Pershore,Worcestershire WR10 3HR (0386 74426).

PRISON SANITATION

PRISON sanitation facilities in Britain are so inadequate that morethan half the prison population have to use chamber pots at nightand queue to slop out at unlocking time. A survey done on the nightof Aug 30 last year, when the total inmate population was near42 000, showed that more than a quarter were locked in their owncells with a chamber pot and more than a third had to use a pot in the

presence of their cell mates. Efforts to improve sanitation

arrangements include the building of new prisons and extensions,the modification of existing cells, and the installation of electronicor computer-controlled unlocking systems. In his report2 for 1984,the Chief Inspector of Prisons expresses his department’s doubtsabout the reliability of the unlocking systems and their reservationsabout the installation of water closets within cells because of the

persistence of smells despite mechanical ventilation. The "one-in-three" modification-whereby the middle of every block of threecells is converted into two lavatories for the two outer cells, some ofwhich become designated for two instead of one inmate-is beingplanned for a dozen prisons over the next 15 years, but it costs about6000 per cell unit (ie, cell with adjoining toilet). The inspectorate’sview is that the best option in higher security establishments wouldbe a sanitary annexe for cells or dormitories, and in lower securityplaces it would be best to grant inmates ready access to communallavatories at all times.

1 A Quiet Massacre: A Review of Drinking and Driving in the United Kingdom. ByJames Dunbar. Available (£3.75) from the Institute of Alcohol Studies, AllianceHouse, 12 Caxton Street, London SW1H 0QS.

2. Home Office. Report of Her Majesty’s Chief Inspector of Prisons 1984. London: HMStationery Office 1985. Pp 25 £3.30

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Reports of Torture in Zimbabwe

Amnesty International has announced this month that reports oftorture of suspected opponents of the Zimbabwe Government haveincreased sharply since the general elections in July. The reports oftorture, which includes beatings, electric shock, and bags full ofwater tied over prisoners’ heads until they lose consciousness, havebeen supported by a wide number of sources, particularly inBulawayo, where there is strong support for Joshua Nkomo’s party,The Zimbabwe African People’s Union.

Rape and Sexual Assault

One of a number of recommendations arising from a study of theexperiences of rape victims (carried out by the Medical Women’sFederation Birmingham Working Party, chaired by Prof RuthBowden) is the recruitment of more women police surgeons so thatalleged victims of rape and sexual assault may be examined bywomen doctors, should they so wish.

Rubella in PregnancyWhen the National Rubella Council was formed in 1983, Sense,

one of the organisations making up the Council, commissioned areview of the data available from 1941 onwards on the associationbetween rubella and pregnancy and congenital malformation. Thereview, of some 1800 publications, is now ready, and nearly half ofit is a summary of existing information on rubella immunisation.Updates are planned.

Medical Research Council

Prof D. T. Baird, professor of obstetrics and gynaecology at theUniversity of Edinburgh, has been awarded an MRC clinicalresearch professorship to be held at Edinburgh. Professor Baird will

1. Sidle N. Rubella in Pregnancy. A Review of Rubella as an Infection in Pregnancy, itsConsequences and Prevention. Available (£5 plus 50p postage) from Sense, TheNational Deaf-Blind and Rubella Association, 311 Gray’s Inn Road, London WC18PT. 1985. Pp 108.

be known as MRC clinical research professor of reproductiveendocrinology.Dr Stephen Lock, Editor of the British Medicallourna4 will give the 1985

Rock Carling memorial lecture at the Royal College of Physicians of London,on Friday, Dec 6, at 5.30 pm. Dr Lock will speak on A DfficultBalance-Editorial Peer Reviewjn Medicine: The Secretary, NuffieldProvinical Hospitals Trust, 3 Prince Albert Road, London NWI 7SP (01-4856632).

Dr G. W. G. Bird has been appointed president of the British BloodTransfusion Society in succession to Professor F. Stratton, who has held theoffice since the Society’s inauguration.

A one-day conference on Aspects of Modern Neonatal Care will be heldat the Institute of Obstetrics and Gynaecology, London, on Friday, Nov 29:Symposium Secretary, Institute of Obstetrics and Gynaecology, QueenCharlotte’s Maternity Hospital, Goldhawk Road, London W6 (01-741 8351extension 15).

"

An ASME one-day conference on Qualitative Research Methods inMedical Education-How to Do It will be held at the Royal College ofGeneral Practitioners, London, on Wednesday, Dec 4: Maureen Gyle,Association for the Study of Medical Education, 2 Roseangle, Dundee DD]4LR (0382 26801).

A one-day symposium on Alcohol and Health will be held at King’sCollege of Medicine and Dentistry, London, on Wednesday, Dec 11: MedicalCouncil on Alcoholism, 1 St Andrew’s Place, Regent’s Park, London NW14LB (01-487 4445).

A meeting of the Birmingham Medical Institute on Illustrating Medicineand Surgery will take place at the Institute on Thursday, Dec 12: The

Secretary, BMI, 36 Harborne Road, Edgbaston, Birmingham B15 3AF(021-454 5007).

The Society for Drug Research will hold a symposium on Senile Dementiaof the Alzheimer Type at the School of Pharmacy, London WC1, onThursday, Dec 12: SDR Secretariat, c/o Institute of Biology, 20 QueensberryPlace, London SW7 2DZ (01-581 8333).

Diary of the Week

Nov 24 To 30

Monday, 25thINSTITUTE OF DERMATOLOGY, 5 Lisle Street, London WC2H 7BJ4.45 pm Prof N. Wnght- Regulation of Epidermal Cell Growth.

INSTITUTE OF LARYNGOLOGY AND OTOLOGY, Royal National Throat, Nose &Ear Hospital, 330/332 Gray’s Inn Road, London WC1X 8EE

5.30 pm Mr J. W P. Hazell: Tinnitus.ST GEORGE’S HOSPITAL MEDICAL SCHOOL, 3rd Floor, Lanesborough Wing,

Cranmer Terrace, London SW17 ORE12.30 pm Dr Thomas F. Halpm(Massachusetts): Intra-eptthelial Neoplasia of the Cervix.

KING’S COLLEGE SCHOOL OF MEDICINE AND DENTISTRY, Medical SchoolLecture Theatre, Denmark Hill, London SE5

4.30 pm Sir James Black, FRS: The Significance of Hormone Receptor Classificationas Exemplified by a-andrenoceptors.

UNIVERSITY COLLEGE LONDON AND MIDDLESEX HOSPITAL MEDICAL

SCHOOL, Christopher Ingold Laboratories, Gordon Street, London WC 15.30 pm Dr M. G. Marmot: Epidemiology and the Art of the Soluble.MANCHESTER MEDICAL SOCIETY, John Rylands University Library, Oxford

Road, Manchester M13 9PP8 15 pm Prof Norman: Applying Pharmacokmetics to Anaesthesia.8.30 pm Dr C. M. Harris: An Information Service for General Practitioners.

Tuesday, 26thLONDON MEDICAL GROUP

5.45 pm (King’s College Hospital, Denmark Hill, London SE5) Symposium-Self-inflicted Injuries in a Free Society?

ROYAL STATISTICAL SOCIETY, Manson Theatre, London School of Hygiene andTropical Medicine, Keppel Street, London WC1E 7HT

5 pm Dr P. K. Andersen (Copenhagen): Modelling Nephropathy and Mortality inDiabetics.

ICRF CANCER EPIDEMIOLOGY AND CLINICAL TRIALS UNIT, Ida GreenSeminar Room, Observer’s House, Green College, Oxford

5 pm Peter Anderson: Is There a Safe Level of Alcohol Consumption ?MANCHESTER MEDICAL SOCIETY5.30 pm ProfT. Silverstone: Mama-the Pharmacological Approach.

BIRMINGHAM MEDICAL INSTITUTE, 36 Harborn Road, Edgbaston, BirminghamB153AF

12.30 pm Mr B. Speculand: So Your Face Doesn’t Fit

NINEWELLS HOSPITAL AND MEDICAL SCHOOL, Dundee DDI 9SY1 pm Dr D. Taylor: Obstetric Antecedents of Neurodevelopmental Disability.

Wednesday, 27thINSTITUTE OF NEUROLOGY, National Hospital, Queen Square, London

WC1N 3BG6 pm ProfH. F. Bradford: Monitoring Amino Acid Neurotransmitter Release in Normal

and Epileptic Animals..

7 pm Dr R. C Roberts: Monitoring Seizures in Man.WELLCOME INSTITUTE FOR THE HISTORY OF MEDICINE, 183 Euston Road,

London NW1 2BP5.30 pm Dr Gweneth Whitteridge: The Re-foundation of St Bartholomew’s

Hospital by Henry VIII in 1547.ROYAL FREE HOSPITAL, Pond Street, London NW3 2QG

5 pm Prof Ian Cameron: Chronic Hypoxaemia-An Alternative Approach to

Treatment.CHACE POSTGRADUATE MEDICAL CENTRE, Chase Farm Hospital, The

Ridgeway, Enfield, Middlesex1 pm Mr P. M. S. O’Brien: The Management of Pregnant Diabetics.

Thursday, 28thROYAL COLLEGE OF SURGEONS OF ENGLAND

3.15 pm (Middlesex Hospital, Mortimer Street, London WI) Mr J. A. P. Marston’ TheGut and its Blood Supply (John Kinmonth lecture).

5 pm Mr H. H. G. Eastcott: Milestone and Frontiers in Vascular Surgery(CecilJoll prizelecture).

LONDON MEDICAL GROUP5.45 pm (London Hospital, Whitechapel, London El) Illustrated symposium-The

Psychopathology of the Football Hooligan.MANCHESTER MEDICAL SOCIETY

5.30 pm Prof W. W. Holland: Aspects of the Evaluation of Health Care.

Friday, 29thCARDIOTHORACIC INSTITUTE, Fulham Road, London SW3 6HP8 am Prof Nick Saunders (Newcastle): Sleep Apnoea Syndromes.

INSTITUTE OF DERMATOLOGY4.45 pm Dr R. Dawber’ Genetically-determined Disorders of the Hair.

Saturday, 30thNUFFIELD ORTHOPAEDIC CENTRE, Headmgton, Oxford8 30 am Prof J Grimley Evans: Significance of Non Surgical Factors in Surgical

Results9.30 am Dr V. Wilkinson. Response of Children and Their Families to Physical

Disability.