Releases Saturday 22 December 2001
No 7327 Volume 323

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(1) HEART DEATHS INCREASE ON "UNLUCKY" DAYS

(2) RECITING AVE MARIA LINKED TO A HEALTHY HEART

(3) OSCAR WINNING SCREENWRITERS HAVE SHORTER LIVES THAN NOMINEES

(4) NATIONAL LOTTERY COULD TEACH US HOW INCOME IMPROVES HEALTH

(1) HEART DEATHS INCREASE ON "UNLUCKY" DAYS

(The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death)
http://bmj.com/cgi/content/full/323/7327/1443

Chinese and Japanese people are more likely to die from heart disease on
the fourth day of the month because the number 4 evokes superstitious
stress among this group, finds a study in this week's Christmas issue of
the BMJ.

David Phillips and colleagues found evidence that Chinese and Japanese
Americans associate the number 4 with death. They then compared death
certificates for Chinese and Japanese Americans with white Americans from
1973 to 1998.

On the fourth of each month, cardiac deaths were significantly more
frequent than on any other day of the month, and were 7% higher than the
average for the rest of the week. This effect was not evident in white
Americans, nor was it evident in Chinese and Japanese Americans who die
from causes other than chronic heart disease, say the authors.

The authors call this peak "the Baskerville effect" because in The Hound of
the Baskervilles, by writer and doctor, Sir Arthur Conan Doyle, Charles
Baskerville dies of a heart attack induced by extreme psychological stress.

The fourth day peak does not seem to occur because of changes in the
patient's diet, alcohol intake, exercise, or drug treatment, say the
authors. At present, the only explanation is that psychological stress
linked to the number 4 elicits additional deaths among Chinese and Japanese
patients, they say.

"Our findings are consistent with the scientific literature and with a
famous, non-scientific story," say the authors. "The Baskerville effect
exists both in fact and in fiction and suggests that Conan Doyle was not
only a great writer but a remarkably intuitive physician as well," they
conclude.

Contact:

Professor David Phillips, Sociology Department, University of California at
San Diego, La Jolla, CA, USA
Email: dphillip{at}weber.ucsd.edu
 

(2) RECITING AVE MARIA LINKED TO A HEALTHY HEART

(Effect of rosary prayer and yoga mantras on autonomic cardiovascular rhythms: comparative study)
http://bmj.com/cgi/content/full/323/7327/1446

Reciting the rosary prayer or yoga mantras enhance some aspect of heart and
lung function and might be viewed as a health practice as well as a
religious practice, finds a study in this week's Christmas issue of the
BMJ.

Luciano Bernardi and colleagues recorded breathing rates in 23 healthy
adults during normal talking, during recitation of the Ave Maria and yoga
mantras, and during six minutes of controlled breathing.

Normal talking reduced the breathing rate more irregularly. Breathing was
markedly more regular during controlled breathing, the Ave Maria, and the
mantra. Both the Ave Maria and the mantra slowed breathing to around six
breaths per minute, inducing a favourable effect on the heart's rhythm.

The benefits of breathing exercises in the practice of yoga have long been
reported, and mantras may have evolved as a simple device to slow
respiration, improve concentration, and induce calm. Similarly, the rosary
may have partly evolved because it synchronised with the body's natural
heart rhythms, and thus gave a feeling of wellbeing, and perhaps an
increased responsiveness to the religious message, suggest the authors.

As such, the rosary might be viewed as a health practice as well as a
religious practice, they conclude.

Contacts:

Luciano Bernardi, Associate Professor of Internal Medicine, University of
Pavia, Pavia, Italy
Email: lbern1ps{at}unipv.it
 

(3) OSCAR WINNING SCREENWRITERS HAVE SHORTER LIVES THAN NOMINEES
(Longevity of screenwriters who win an academy
award: longitudinal study )
http://bmj.com/cgi/content/full/323/7327/1491

(Death in Hollywood )
http://bmj.com/cgi/content/full/323/7327/1441

Oscar winning screenwriters have shorter lives than losing nominees, even
though greater success is usually linked to better health, finds a study in
this week's Christmas issue of the BMJ.

Researchers in Canada identified all 850 screenwriters ever nominated for
an academy award. On average, winners were more successful than nominees,
as indicated by a 14% longer career, 34% more films, and 58% more four star
films.

Life expectancy was 3.6 years shorter for winners than for nominees,
equivalent to a 37% relative increase in death rates. Additional awards
were associated with a 22% relative increase in death rates, whereas a
career with many nominations but no awards caused no significant increase
in death rates.

These results are not easily explained by talent, prestige, financial
earnings, material conditions, or simple demographics, say the authors.
They suggest that screenwriters are more apt to have unhealthy lifestyles
(eg, more smoking, less exercise, frequent late nights with no sleep),
unlike actors whose lives are under steady scrutiny. This may explain why
Oscar winning actors and actresses live longer than nominees, and
underscores the importance of behaviour as a factor that can modulate and
even reverse the link between status and survival, they conclude.

Screenwriters are, notoriously, a heavily exploited branch of the movie
industry and for a screenwriter an Oscar may give a considerable immediate
psychological boost but will not guarantee future success or employment,
suggests Professor George Davey Smith in an accompanying editorial.

Contact:

Donald Redelmeier, Clinician Scientist, Sunnybrook and Women's Hospital,
Toronto, Canada
Email:dar{at}ices.on.ca
 

(4) NATIONAL LOTTERY COULD TEACH US HOW INCOME IMPROVES HEALTH
(Income, health, and the National Lottery )
http://bmj.com/cgi/content/full/323/7327/1438

Most people in the United Kingdom have taken part in a world-leading,
multi-billion pound trial of a major health determinant. Unfortunately,
most are unaware the trial exists and no-one knows the results.

The National Lottery is a ready-made trial of increased income, suggests
Anthony Rodgers in this week's Christmas issue of the BMJ. It provides a
unique opportunity to understand how income improves health, especially
among families living in poverty, he argues.

Evidence suggests that modest increases in income, if sustained, could lead
to important health benefits. Therefore, some winners could receive
regular, income-like payments (such as £40, £80, or £160 a month for a
decade). Winners would then be compared to a random selection of
non-winners to assess the long term effects on outcomes such as diet and
smoking, and broader indicators like employment, education and even
entrepreneurship.

Most people buy lottery tickets and winning is purely chance, so the study
would be, in effect, a trial of income supplementation in a group drawn at
random from the majority of the UK population, says the author.

If just 5% of one year's worth of prize money was redistributed in this
way, more than 15,000 people could be winners for a decade. The project
would be entirely self-funding. Long-term prizes are well accepted
overseas, but the novelty here could revitalise sales, especially if there
was a higher chance of winning and people could use non-winning normal
tickets to enter. It would also fit with the government's aim to direct
lottery funds more actively to health, education, and the environment, and
with the move towards evidence based social policy, adds the author.

If successful, the project could be adopted elsewhere: most countries have
lotteries and well over US$100bn is spent on lottery sales world wide each
year, says the author. However, because it is so large and well organised
the National Lottery provides the best opportunity to see how much and how
quickly increased income improves health and wellbeing. It could provide
uniquely valuable evidence for social policies, particularly those aiming
to lift people out of poverty, he concludes.

Contact:

Anthony Rodgers, Clinical Trials Research Unit, Department of Medicine,
University of
Auckland, Auckland, New Zealand (in UK until 29 Dec)
Email: a.rodgers{at}auckland.ac.nz

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