1
872 Thrombosis Research Institute A multidisciplinary research institute for the prevention and treatment of thrombosis and thromboembolic diseases was opened in London on Oct 4. The unit, established by the trustees of the Thrombosis Research Trust with sponsorship from Kabi Pharmacia AB and Sandoz AG, is the first of its kind in Europe and is affiliated to the National Heart & Lung Institute and King’s College, London. Its first director, Prof V. V. Kakkar, said that the institute’s main research goals were to minimise thrombosis, to make it more easily identifiable and preventable, and to slow down the natural process of atherosclerosis. The institute is based in the Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK (tel: 071-3518300). Healthy cities During the past four years the World Health Organisation’s Healthy Cities Project has unquestionably become a major international success,l with 30 European cities now participating, and with networks of healthy cities projects in Canada, the United States, and Australia. A global extension of the project is being planned, and the concepts of health-promoting schools, hospitals, and companies are being developed. The theme of the fifth Healthy Cities symposium, held in Stockholm on Sept 23-26, was "supportive environments". Discussion covered a wide range of issues centred on the creation of healthy physical and social environments, the major themes being children and young people, and traffic in urban areas. An important theme of the project is collaboration between different sectors relevant to health, at both city and international level. In Sheffield a cascade approach is being used to train 250 politicians, professionals, and voluntary workers as "healthy city advocates" who will both spread the word about the healthy city concept in their particular "constituencies" and also join in a consultation process aimed at creating a participatory public-health strategy for the city. On a wider scale, groups of European cities are working together on the project’s Multi-City Action Plan to address common concerns in fields such as mental health, nutrition, housing, and health inequalities. During the symposium a set of healthy city indicators was agreed-not just the familiar old mortality and morbidity statistics but novel measures such as a "nuisance index" of noise, odour, and cleanliness; the proportion of green space within each city; the percentage of children with criminal records; the employment rate among disabled adults; and the prevalence of illiteracy, poverty, and poor housing. More notice is being taken of children’s views about their environment, and the Kids’ Place Survey first undertaken in Seattle has been replicated in several countries involved in the project. Major themes which children identify in their visions of a healthy city include cleanliness, freedom from unpleasant smells, beauty, quietness, and safety. Political commitment, leading to local action on these findings, is crucial and is increasingly being promoted through the involvement of large numbers of city politicians in the local projects and the annual symposia. Visits undertaken during the symposium were designed to reflect its major themes. Visitors to the suburb of Rinkeby were shown the city government’s attempts to cater for the needs of migrant workers. Members of the population speak no less than 100 languages between them, and children at the local primary school are taught in 47 of these. At the architect-designed community laundry, Turkish and other women, whose cultures normally keep them in their homes, are offered discussion groups and art exhibitions by local residents. Two minority statements from the symposium audience reflected concerns inadequately covered in the formal sessions. One reminded delegates of the enormous presence and spread of hatred in the world as a major force of destruction, suffering, and death. It suggested that health workers and health services in all countries have the responsibility to inform people about the health consequences of hate and to stimulate them to tolerance and reconciliation. Another related to the contrast between the official rhetoric of community participation and the extent to which this was lacking in the symposium itself, with many didactic presentations at a high level of abstraction and relatively few opportunities for discussion. WHO hopes to redress this position before next year’s conference in Barcelona, by which time it is also hoped that the project will have made major inroads into the newly liberated countries of eastern Europe. 1 Tsouros AD. World Health Organisation Healthy Cities Project. a project becomes a movement. Copenhagen WHO Regional Office for Europe, 1990 Chocolate liqueurs? What’s your favourite tipple: beer, gin-or chocolate? On July 1 Sweden lowered the blood alcohol limit for drivers to 20 mg!IOO ml. As a consequence, Swedish drivers with a sweet tooth may find themselves in trouble with the law. Hunnisett and colleagues2 found ethyl alcohol in the blood of 311 of 510 volunteers 1 h after ingestion of 5 g glucose. (Before testing, volunteers had fasted for 3 h and had taken no alcohol for 24 h.) The phenomenon-termed "auto- brewery syndrome"-probably depends on fermentation of glucose by gut flora. The maximum concentration of blood alcohol reported by Hunnisett et al was 7 mg/100 ml; however, they have previously recorded up to 19-7 mg/100 ml, which puts the Swedish limit well within the margins of testing error. If blood alcohol is positively related to the quantity of carbohydrate consumed, then cookie consumers and chocoholics should beware: digestive biscuits contain 66 g carbohydrate per 100 g, and plain chocolate 65 g 100 g,J 1 Havard J Sweden lowers blood alcohol limit for drivers. Br Med J 1990; 300: 1482. 2. Hunnisett A, Howard J, Davies S. Gut fermentation (or the ’auto-brewery’) syndrome: a new clinical trial with initial observations and discussion of clinical and biochemical implications. J Nutr Med 1990; 1: 33-38. 3 Paul AA, Southgate DAT. McCance and Widdowson’s the composition of foods 4th ed. London: HM Stationary Office, 1978 International Diary 1990 A symposium entitled Revolutions in Science is to take place in London on Wednesday, Oct 31: Secretary, Academic Unit, Wellcome Institute for the History of Medicine, 183 Euston Road, London NWl 2BN (071-3834252 ext 70). An annual symposium entitled The Right Job-Choosing It, Getting It will be held in London, UK, on Saturday, Nov 10: Dr Hilary Thomas, Meetings Secretary, Medical Women’s Federation London Association, 88 Ockendon Road, London N1 3NW (071-354 1354). 4th DPHM-INSERM conference on Drugs and Europe-Reality and Ambition will be held in Paris on Nov 26-29: Jeanne Renard, IPR International, 12 rue des Halles, 75001 Paris, France (1-42 33 75 51). A conference entitled Recent Developments in Child and Adolescent Psychiatry will take place in London on Dec 6-7: Mrs Lee Wildmg, Conference Office, Institute of Psychiatry, De Crespigny Park, London SE5 8AF (071-703 5411 ext 3170). An India-USA symposium and workshop on Endocrinology, Metabolism and Diabetes is to be held in New Delhi, on Dec 27-31: Prof N. Kochupillai, Organising Secretary, EMD-90, c/o Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India (661123 ext 237). 1991 1st international conference entitled Ultrasound in Obstetrics and Gynaecology will be held in London on Jan 7-10: Prof A. Kurjak, Opa bolnica "Dr J. Kajfes", Pavleka Miskine 64, 41001 Zagreb, Yugoslavia.

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872

Thrombosis Research Institute

A multidisciplinary research institute for the prevention andtreatment of thrombosis and thromboembolic diseases was openedin London on Oct 4. The unit, established by the trustees of theThrombosis Research Trust with sponsorship from KabiPharmacia AB and Sandoz AG, is the first of its kind in Europe andis affiliated to the National Heart & Lung Institute and King’sCollege, London. Its first director, Prof V. V. Kakkar, said that theinstitute’s main research goals were to minimise thrombosis, tomake it more easily identifiable and preventable, and to slow downthe natural process of atherosclerosis. The institute is based in theEmmanuel Kaye Building, Manresa Road, London SW3 6LR, UK(tel: 071-3518300).

Healthy cities

During the past four years the World Health Organisation’sHealthy Cities Project has unquestionably become a majorinternational success,l with 30 European cities now participating,and with networks of healthy cities projects in Canada, the UnitedStates, and Australia. A global extension of the project is beingplanned, and the concepts of health-promoting schools, hospitals,and companies are being developed. The theme of the fifth HealthyCities symposium, held in Stockholm on Sept 23-26, was"supportive environments". Discussion covered a wide range ofissues centred on the creation of healthy physical and social

environments, the major themes being children and young people,and traffic in urban areas.

An important theme of the project is collaboration betweendifferent sectors relevant to health, at both city and internationallevel. In Sheffield a cascade approach is being used to train 250politicians, professionals, and voluntary workers as "healthy cityadvocates" who will both spread the word about the healthy cityconcept in their particular "constituencies" and also join in aconsultation process aimed at creating a participatory public-healthstrategy for the city. On a wider scale, groups of European cities areworking together on the project’s Multi-City Action Plan to addresscommon concerns in fields such as mental health, nutrition,housing, and health inequalities.

During the symposium a set of healthy city indicators wasagreed-not just the familiar old mortality and morbidity statisticsbut novel measures such as a "nuisance index" of noise, odour, andcleanliness; the proportion of green space within each city; thepercentage of children with criminal records; the employment rateamong disabled adults; and the prevalence of illiteracy, poverty, andpoor housing. More notice is being taken of children’s views abouttheir environment, and the Kids’ Place Survey first undertaken inSeattle has been replicated in several countries involved in theproject. Major themes which children identify in their visions of ahealthy city include cleanliness, freedom from unpleasant smells,beauty, quietness, and safety. Political commitment, leading to localaction on these findings, is crucial and is increasingly beingpromoted through the involvement of large numbers of citypoliticians in the local projects and the annual symposia.

Visits undertaken during the symposium were designed to reflectits major themes. Visitors to the suburb of Rinkeby were shown thecity government’s attempts to cater for the needs of migrantworkers. Members of the population speak no less than 100

languages between them, and children at the local primary schoolare taught in 47 of these. At the architect-designed communitylaundry, Turkish and other women, whose cultures normally keepthem in their homes, are offered discussion groups and art

exhibitions by local residents.

Two minority statements from the symposium audiencereflected concerns inadequately covered in the formal sessions. Onereminded delegates of the enormous presence and spread of hatredin the world as a major force of destruction, suffering, and death. Itsuggested that health workers and health services in all countries

have the responsibility to inform people about the health

consequences of hate and to stimulate them to tolerance andreconciliation. Another related to the contrast between the officialrhetoric of community participation and the extent to which thiswas lacking in the symposium itself, with many didactic

presentations at a high level of abstraction and relatively fewopportunities for discussion. WHO hopes to redress this positionbefore next year’s conference in Barcelona, by which time it is alsohoped that the project will have made major inroads into the newlyliberated countries of eastern Europe.1 Tsouros AD. World Health Organisation Healthy Cities Project. a project becomes a

movement. Copenhagen WHO Regional Office for Europe, 1990

Chocolate liqueurs?What’s your favourite tipple: beer, gin-or chocolate? On July 1Sweden lowered the blood alcohol limit for drivers to 20 mg!IOOml. As a consequence, Swedish drivers with a sweet tooth may findthemselves in trouble with the law. Hunnisett and colleagues2 foundethyl alcohol in the blood of 311 of 510 volunteers 1 h after ingestionof 5 g glucose. (Before testing, volunteers had fasted for 3 h and hadtaken no alcohol for 24 h.) The phenomenon-termed "auto-brewery syndrome"-probably depends on fermentation of

glucose by gut flora. The maximum concentration of blood alcoholreported by Hunnisett et al was 7 mg/100 ml; however, they havepreviously recorded up to 19-7 mg/100 ml, which puts the Swedishlimit well within the margins of testing error. If blood alcohol ispositively related to the quantity of carbohydrate consumed, thencookie consumers and chocoholics should beware: digestive biscuitscontain 66 g carbohydrate per 100 g, and plain chocolate 65 g 100 g,J

1 Havard J Sweden lowers blood alcohol limit for drivers. Br Med J 1990; 300: 1482.2. Hunnisett A, Howard J, Davies S. Gut fermentation (or the ’auto-brewery’)

syndrome: a new clinical trial with initial observations and discussion of clinical andbiochemical implications. J Nutr Med 1990; 1: 33-38.

3 Paul AA, Southgate DAT. McCance and Widdowson’s the composition of foods 4thed. London: HM Stationary Office, 1978

International Diary1990

A symposium entitled Revolutions in Science is to take place in London onWednesday, Oct 31: Secretary, Academic Unit, Wellcome Institute for theHistory of Medicine, 183 Euston Road, London NWl 2BN (071-3834252ext 70).

An annual symposium entitled The Right Job-Choosing It, Getting Itwill be held in London, UK, on Saturday, Nov 10: Dr Hilary Thomas,Meetings Secretary, Medical Women’s Federation London Association, 88Ockendon Road, London N1 3NW (071-354 1354).

4th DPHM-INSERM conference on Drugs and Europe-Reality andAmbition will be held in Paris on Nov 26-29: Jeanne Renard, IPRInternational, 12 rue des Halles, 75001 Paris, France (1-42 33 75 51).

A conference entitled Recent Developments in Child and AdolescentPsychiatry will take place in London on Dec 6-7: Mrs Lee Wildmg,Conference Office, Institute of Psychiatry, De Crespigny Park, London SE58AF (071-703 5411 ext 3170).

An India-USA symposium and workshop on Endocrinology,Metabolism and Diabetes is to be held in New Delhi, on Dec 27-31: ProfN. Kochupillai, Organising Secretary, EMD-90, c/o Department of

Endocrinology, Metabolism and Diabetes, All India Institute of MedicalSciences, Ansari Nagar, New Delhi 110029, India (661123 ext 237).

1991

1st international conference entitled Ultrasound in Obstetrics and

Gynaecology will be held in London on Jan 7-10: Prof A. Kurjak, Opabolnica "Dr J. Kajfes", Pavleka Miskine 64, 41001 Zagreb, Yugoslavia.