Releases Saturday 1 March 2003
No 7387 Volume 326

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(1) VITAMIN D CAN PREVENT FRACTURES IN
OLDER PEOPLE

(2) FATHER'S GENES MAY PLAY A ROLE IN
TIMING OF BIRTH

(3) MOBILE PHONES COULD BE ALLOWED IN
SOME PARTS OF HOSPITALS

(4) MEDIA MAY FACILITATE SUICIDAL ACTS



(1) VITAMIN D CAN PREVENT FRACTURES IN
OLDER PEOPLE

(Effect of four monthly oral vitamin D3 (cholecalciferol)
supplementation on fractures and mortality in men and
women living in the community: randomised double blind
controlled trial)
http://bmj.com/cgi/content/full/326/7387/469

Vitamin D supplements reduce fractures in men and
women aged over 65 living in the general community,
finds a study in this week's BMJ.

Researchers identified 2,686 people (2,037 men and
649 women) aged 65-85 years living in the community.
They sent one capsule containing 100,000 IU vitamin D3
(cholecalciferol) or matching placebo by post every four
months for five years (15 doses in total). They asked
participants to take the capsule immediately and
complete and return a checklist of events (fracture or
major illness).

Participants in the vitamin D treatment group had a 22%
lower rate for first fracture at any site and a 33% lower
rate for a fracture occurring in common osteoporotic
sites (hip, wrist or forearm, or vertebrae).

Many interventions effective in high risk groups are not
feasible in the general population owing to poor
compliance or side effects or are not cost effective, say
the authors. In contrast, the cost of four monthly vitamin
D capsules is less than £1 annually, they conclude.

Contact:

Kay Tee Khaw, Professor of Clinical Gerontology,
Clinical Gerontology Unit, University of Cambridge
School of Clinical Medicine, Addenbrooke's Hospital,
Cambridge, UK
Email: kk101@medschl.cam.ac.uk

(2) FATHER'S GENES MAY PLAY A ROLE IN
TIMING OF BIRTH

(Risk of recurrence of prolonged pregnancy)
http://bmj.com/cgi/content/full/326/7387/476

A father's genes may play a role in the timing of birth and
in the risk of repeating a prolonged pregnancy, suggest
researchers in this week's BMJ.

Prolonged pregnancy - a pregnancy with a gestational
length of 294 days or more - occurs in about 5% of all
births. It is associated with a higher incidence of
complications in the mother and child, but little is known
about it causes.

The team identified all women with a prolonged
pregnancy in the first delivery and in a subsequent
delivery during 1980-94, and a sample of women with
two or more pregnancies recorded in the period
1980-92 (only the first two deliveries were used for
analysis).

The post-term group included all women who had a
singleton live infant born post-term (42 weeks or more)
and a subsequent live infant. The term group included all
women who had a singleton live infant born at term
(37-41 weeks) and a subsequent live infant. This gave
21,746 sibling pairs in the post-term group and 7,009
sibling pairs in the term group.

The risk of recurrence of post-term delivery was 19.9%.
It increased with increasing gestational age to
approximately 30% for a gestational age of 44 weeks. In
the term group, 7.7% were post-term in the subsequent
birth.

However, the risk of recurrence of post-term delivery
was reduced to 15.4% when the first and second child
had different fathers. Length of pregnancy differed by
more than one week in women who had changed
partners, compared with those who had not.

We believe that this is a new observation, say the
authors. It suggests that the timing of birth may, in part,
be determined by paternal genes, they conclude.

Contact:

Annette Wind Olesen, Research Fellow, Danish
Epidemiology Science Centre, University of Aarhus,
Denmark
Email: awo@soci.au.dk

(3) MOBILE PHONES COULD BE ALLOWED IN
SOME PARTS OF HOSPITALS

(Editorial: Mobile phones in hospitals)
http://bmj.com/cgi/content/full/326/7387/460

The use of mobile phones in hospitals is not as hazardous
as believed and they could be allowed in selected areas,
say doctors at the John Radcliffe Hospital in this week's
BMJ.

Anecdotal reports exist of interference with medical
electrical equipment, but the evidence for serious harm is
flimsy. A study by the UK Medical Devices Agency
found some interference from monitors and pacemakers.
However, the effects are temporary and very localised
and do not seem to justify the outright ban on mobile
phones and hostility towards users, say the authors.
Furthermore, the provision of phones for patients and
relatives on wards is often inadequate and goes only
some way towards addressing the needs of patients, they
add.

It is time we took a more sensible and considered
approach to the use of mobile phones in hospitals, say
the authors. It seems sensible to restrict their use in
clinical areas and on wards, but they should be allowed
in all non-clinical areas (such as corridors, offices,
entrance halls, and cafeterias) and outpatient waiting
areas.

The Chelsea and Westminster Hospital in London
already has such an enlightened approach to mobile
phone use and relatives say that they find being able to
use their mobile phones in selected areas invaluable.

"We hope that hospital managers and clinical directors
will consider the points raised here and adopt a more
sensible and flexible policy towards mobile phones. A
practical balance can be achieved, and it is hoped that
this would remove the aggressive overreaction of some
staff and members of the public to their use in hospitals,"
they conclude.

Contact:

Saul Myerson, Clinical Lecturer Department of
Cardiology, John Radcliffe Hospital, Oxford, UK
Email: saul.myerson@cardiov.ox.ac.uk

(4) MEDIA MAY FACILITATE SUICIDAL ACTS

(Letters: Media influence on suicide)
http://bmj.com/cgi/content/full/326/7387/498

The media should be more aware of their potential
influence on suicide, according to several letters in this
week's BMJ.

Two letters examine the effect of the death from cervical
cancer of a television character (Alma in Coronation
Street) on the NHS cervical screening programme.

Researchers in Manchester found that 14,000 additional
cervical smear tests were performed as a result of the
storyline (a 21% increase on the previous year) and led
to a huge strain on local laboratories. Another team,
based in London, found that the same story triggered up
to 300 additional weekly enquiries to CancerBACUP's
helpline (the United Kingdom's leading cancer
information charity).

They suggest that television programme makers should
realise the power of such stories, while those responsible
for promoting health need to engage public programme
makers in a full ethical debate.

A third letter reveals the alarming escalation of charcoal
burning suicide in Hong Kong after an incident in 1998
was widely reported in the media. In 2001 it replaced
hanging as the second commonest method of suicide,
accounting for 25% of all deaths from suicide.

As a result, concerns have been raised about the
potentially contagious impact of media reporting.
However news editors have expressed reservations and
remain unconvinced about guidelines on suicide
reporting.

Contacts:

Andy Howe, Specialist Registrar in Public Health,
Greater Manchester Strategic Health Authority,
Manchester, UK
Email: andyhowe@clara.co.uk

Daisy O'Clee, Press Officer, CancerBACUP, London,
UK
Email: doclee@cancerbacup.org

Kathy Chan, Adjunct Associate Professor, Chinese
University of Hong Kong, China
Email: chanpm@ha.org.hk


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