- Email: [email protected]
Chief Scientist at Scottish health department
1327
patient’s interests to do so and if the patient cannot be judged capable of giving or withholding consent to disclosure. Advice on the
Urban
disclosure in connection with judicial proceedings has been expanded; in response to orders from a judge, presiding officer to
Childhood asthma should be added to the list of so-called "diseases of civilisation", according to the authors of a study in 2000 primary school children in Zimbabwe.! Keeley and colleagues found a 50-fold difference in prevalence of reversible airways obstruction (defined as peak expiratory flow below the 2-5th centile for height before exercise, a rise of more than 15 % after salbutamol inhalation, and a fall of 15% or more after exercise, with a subsequent rise after salbutamol) between children in a rural area (0-1%) and children in a rich urban area (5-8%). In children froma poor urban area the prevalence was 3-1%. In northern Harare, the only study area where there were white children, the prevalence was very similar between white (5-3%) and black children (5-9%). The authors attribute the differences to the far greater exposure of urban children to atmospheric pollution, such as car emissions, and to chemical additives in manufactured foods and drinks. All the studies were carried out in a 3-week period at the end of the rainy season, when the prevalence of asthma was relatively high. Indicators of nutritional status were not significantly different between black and white children in the rich urban area of northern Harare but were lower in the (black) children of urban southern Harare and lower still in rural Wedza. Urban living and higher material standards of living, say Keeley et al, appear to be associated with a higher prevalence of childhood asthma.
the court, coroner, Procurator Fiscal, or similar officer, doctors should first establish the precise extent of the information that needs to be disclosed and should not hesitate to make known his or her objections to the proposed disclosure, especially when the information required is of a confidential nature. Should information be needed in connection with the Council’s proposed performance review procedures the advice is that information may be disclosed at the direction of the chairman of a committee of the Council that is investigating a doctor’s fitness to practise if disclosure should be in the public interest and every reasonable effort has been made to obtain the patient’s consent. The paragraph on disclosure in the public interest remains restricted to the principle of disclosure, even though there had been debate on whether there should be specific mention of patients unfit to drive. The new guidance will appear in the next revision of Professional Conduct and Discipline: Fitness to Practise. Meanwhile, copies are available from the General Medical Council, 44 Hallam Street, London WIN 6AE.
DNA
living and asthma
fingerprints
A new computer technique virtually removes the element of doubt from DNA fingerprinting, the reliability of which was challenged in a recent report from the USA.1 The method currently used depends on visual comparison of the lengths of DNA sequences and is subject to observer error. The technique developed by Jeffreys et a1,2 based on the assay of sequence variation, rather than length differences, in minisatellite alleles, is objective and gives a far more detailed analysis of allelic variation. Farr and Goodfellow3 estimate that the new method of DNA typing will be several orders of magnitude more sensitive than the old. Jeffreys’ polymerase chain reaction (PCR) based approach, called minisatellite variant repeat (MRV) mapping, interprets variability within pairs of alleles as a simple ternary code, and the technique can be used on any minisatellite locus provided that variant repeats are not of abnormal length (which would throw the MVR ladders of the paired alleles out of register). Jeffreys et al have already identified a number of minisatellites that are suitable for MVR-PCR. The technique can be applied to mixed DNA samples-for example, from semen-bearing vaginal swabs in rape victims. It is particularly suitable for forensic work because it can be used on degraded DNA. Shapiro MM. Imprints on DNA fingerprints. Nature 1991; 353: 121-22. Jeffreys AJ, MacLeod A, Tamaki K, Neil DL, Monckton DG. Minisatellite repeat coding as a digital approach to DNA typing. Nature 1991; 354: 204-09. 3. Farr CJ, Goodfellow PN. New variations on the theme. Nature 1991; 354: 184.
1 2.
Register of radiation
research
To fulfil its responsibility to keep radiobiology under general review the Medical Research Council’s Committee on the Effects of Ionising Radiation (CEIR) has published a register of research on the biological effects of radiation being carried out in the UK. The register, which is to be published annually, will cover four main areas-molecular and cellular radiobiology, radioprotection, clinical applications, and epidemiology. The register is intended to include clear, concise accounts of all relevant research, but the first issue, compiled from invited contributions (from individuals and institutions) is inevitably incomplete, and the publisher would like to hear from investigators who wish to have their studies included in future editions or who wish to update their existing submissions. The Register of UK Research on the Biological Effects of Ionising Radiation will collect together abstracts (of not more than 250 words) on current research only and will not include studies that have already been completed and published. Abstract forms and copies of the register can be obtained from the CEIR Secretariat, MRC Radiobiology Unit, Chilton, Didcot OXll ORD, UK (telephone 0235 834393, fax 0235 834918).
1.
Keeley DJ, Neill P, Gallivan S. Companson of the prevalence of reversible airways obstruction in rural and urban Zimbabwean children. Thorax 1991; 46: 549-53.
Chief Scientist at Scottish health department
Bouchier, professor of medicine at the University of Edinburgh, will succeed Prof Roy Weir, who is retiring, as Chief Scientist in the Scottish Office Home and Health Department as from April 1, 1992. Prof Ian
In
England Now
Last month I was external examiner for a non-university licensing qualification. A psychiatric long case was included, and the registrar’s case sheet described the patient as "wearing old-fashioned clothes". Edwardian dress? Elizabethan? Woad? I tracked the patient down and found him wearing a tweed jacket with elbow patches, check shirt, club tie, and corduroy trousers. Exactly what colleagues describe as my country pursuits weekend wear. Old fashioned? I searched for the registrar partly for remonstrance and partly out of curiosity to see what he was wearing. He was not available, having gone off duty, presumably having clocked up his 72 hours-or perhaps psychiatrists have some dispensation that allows them to finish their working week on Tuesday afternoon because of their demanding patients. I cooled down by recalling that one should not be judgmental about people-or that is what psychiatrists tell us. *
*
*
My wife and I settled quickly into our Dublin hotel. I was there to give a paper at a conference; she to browse through the shops, galleries, and antique dealers’ stores. The meeting was short and we had booked for a few extra days. Dublin is one of my favourite cities, bringing back memories of my student days, when for a short time we left post-war austerity Britain to enjoy the luxuries of a fully stocked, charmingly populated, exuberant metropolis and to learn some midwifery besides. On our first evening, at dinner, being something of a man of the gave the waiter a sensible number of punts with instructions to look after our welfare during our stay. He was delighted and assured us that our comfort would be his main concern while we were there. The trouble was, we never saw him again. On inquiry, I found that he was a locum (as it were) and had been engaged for that evening only.
world, I
patient’s interests to do so and if the patient cannot be judged capable of giving or withholding consent to disclosure. Advice on the
Urban
disclosure in connection with judicial proceedings has been expanded; in response to orders from a judge, presiding officer to
Childhood asthma should be added to the list of so-called "diseases of civilisation", according to the authors of a study in 2000 primary school children in Zimbabwe.! Keeley and colleagues found a 50-fold difference in prevalence of reversible airways obstruction (defined as peak expiratory flow below the 2-5th centile for height before exercise, a rise of more than 15 % after salbutamol inhalation, and a fall of 15% or more after exercise, with a subsequent rise after salbutamol) between children in a rural area (0-1%) and children in a rich urban area (5-8%). In children froma poor urban area the prevalence was 3-1%. In northern Harare, the only study area where there were white children, the prevalence was very similar between white (5-3%) and black children (5-9%). The authors attribute the differences to the far greater exposure of urban children to atmospheric pollution, such as car emissions, and to chemical additives in manufactured foods and drinks. All the studies were carried out in a 3-week period at the end of the rainy season, when the prevalence of asthma was relatively high. Indicators of nutritional status were not significantly different between black and white children in the rich urban area of northern Harare but were lower in the (black) children of urban southern Harare and lower still in rural Wedza. Urban living and higher material standards of living, say Keeley et al, appear to be associated with a higher prevalence of childhood asthma.
the court, coroner, Procurator Fiscal, or similar officer, doctors should first establish the precise extent of the information that needs to be disclosed and should not hesitate to make known his or her objections to the proposed disclosure, especially when the information required is of a confidential nature. Should information be needed in connection with the Council’s proposed performance review procedures the advice is that information may be disclosed at the direction of the chairman of a committee of the Council that is investigating a doctor’s fitness to practise if disclosure should be in the public interest and every reasonable effort has been made to obtain the patient’s consent. The paragraph on disclosure in the public interest remains restricted to the principle of disclosure, even though there had been debate on whether there should be specific mention of patients unfit to drive. The new guidance will appear in the next revision of Professional Conduct and Discipline: Fitness to Practise. Meanwhile, copies are available from the General Medical Council, 44 Hallam Street, London WIN 6AE.
DNA
living and asthma
fingerprints
A new computer technique virtually removes the element of doubt from DNA fingerprinting, the reliability of which was challenged in a recent report from the USA.1 The method currently used depends on visual comparison of the lengths of DNA sequences and is subject to observer error. The technique developed by Jeffreys et a1,2 based on the assay of sequence variation, rather than length differences, in minisatellite alleles, is objective and gives a far more detailed analysis of allelic variation. Farr and Goodfellow3 estimate that the new method of DNA typing will be several orders of magnitude more sensitive than the old. Jeffreys’ polymerase chain reaction (PCR) based approach, called minisatellite variant repeat (MRV) mapping, interprets variability within pairs of alleles as a simple ternary code, and the technique can be used on any minisatellite locus provided that variant repeats are not of abnormal length (which would throw the MVR ladders of the paired alleles out of register). Jeffreys et al have already identified a number of minisatellites that are suitable for MVR-PCR. The technique can be applied to mixed DNA samples-for example, from semen-bearing vaginal swabs in rape victims. It is particularly suitable for forensic work because it can be used on degraded DNA. Shapiro MM. Imprints on DNA fingerprints. Nature 1991; 353: 121-22. Jeffreys AJ, MacLeod A, Tamaki K, Neil DL, Monckton DG. Minisatellite repeat coding as a digital approach to DNA typing. Nature 1991; 354: 204-09. 3. Farr CJ, Goodfellow PN. New variations on the theme. Nature 1991; 354: 184.
1 2.
Register of radiation
research
To fulfil its responsibility to keep radiobiology under general review the Medical Research Council’s Committee on the Effects of Ionising Radiation (CEIR) has published a register of research on the biological effects of radiation being carried out in the UK. The register, which is to be published annually, will cover four main areas-molecular and cellular radiobiology, radioprotection, clinical applications, and epidemiology. The register is intended to include clear, concise accounts of all relevant research, but the first issue, compiled from invited contributions (from individuals and institutions) is inevitably incomplete, and the publisher would like to hear from investigators who wish to have their studies included in future editions or who wish to update their existing submissions. The Register of UK Research on the Biological Effects of Ionising Radiation will collect together abstracts (of not more than 250 words) on current research only and will not include studies that have already been completed and published. Abstract forms and copies of the register can be obtained from the CEIR Secretariat, MRC Radiobiology Unit, Chilton, Didcot OXll ORD, UK (telephone 0235 834393, fax 0235 834918).
1.
Keeley DJ, Neill P, Gallivan S. Companson of the prevalence of reversible airways obstruction in rural and urban Zimbabwean children. Thorax 1991; 46: 549-53.
Chief Scientist at Scottish health department
Bouchier, professor of medicine at the University of Edinburgh, will succeed Prof Roy Weir, who is retiring, as Chief Scientist in the Scottish Office Home and Health Department as from April 1, 1992. Prof Ian
In
England Now
Last month I was external examiner for a non-university licensing qualification. A psychiatric long case was included, and the registrar’s case sheet described the patient as "wearing old-fashioned clothes". Edwardian dress? Elizabethan? Woad? I tracked the patient down and found him wearing a tweed jacket with elbow patches, check shirt, club tie, and corduroy trousers. Exactly what colleagues describe as my country pursuits weekend wear. Old fashioned? I searched for the registrar partly for remonstrance and partly out of curiosity to see what he was wearing. He was not available, having gone off duty, presumably having clocked up his 72 hours-or perhaps psychiatrists have some dispensation that allows them to finish their working week on Tuesday afternoon because of their demanding patients. I cooled down by recalling that one should not be judgmental about people-or that is what psychiatrists tell us. *
*
*
My wife and I settled quickly into our Dublin hotel. I was there to give a paper at a conference; she to browse through the shops, galleries, and antique dealers’ stores. The meeting was short and we had booked for a few extra days. Dublin is one of my favourite cities, bringing back memories of my student days, when for a short time we left post-war austerity Britain to enjoy the luxuries of a fully stocked, charmingly populated, exuberant metropolis and to learn some midwifery besides. On our first evening, at dinner, being something of a man of the gave the waiter a sensible number of punts with instructions to look after our welfare during our stay. He was delighted and assured us that our comfort would be his main concern while we were there. The trouble was, we never saw him again. On inquiry, I found that he was a locum (as it were) and had been engaged for that evening only.
world, I