This week in the BMJ
Volume 330, Number 7500, Issue of 14 May 2005Antioxidant supplementation doesn't prevent kwashiorkor in children
Antioxidant supplementation doesn't prevent kwashiorkor in children
Giving children supplementary antioxidants does not prevent the onset of kwashiorkor. Ciliberto and colleagues (p 1109) randomised 2372 Malawi children to a daily dietary supplement of antioxidant powder or placebo for 20 weeks. They found that children who received the supplement—containing riboflavin, vitamin E, selenium, and N-acetylcysteine at a dose that provided three times the recommended dietary allowance for each nutrient—were as likely as the controls to develop kwashiorkor, and they did not experience less fever, cough, or diarrhoea, or gain more weight or height.
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Overcoming lack of control over life may avoid self harm
Alcohol dependence, depression, and adolescent distress are common factors triggering self harm. Interviewing 20 people who had a history of deliberate self harm but no longer harmed themselves, Sinclair and Green (p 1112) found that most talked about their experience in terms of lack of control over their lives, through alcohol dependence, untreated depression, or, in adolescents, uncertainty within their family relationships. Hospital management of deliberate self harm can help in overcoming depression and alcohol misuse and thus reduce the risk of self harm, but it may be less appropriate in adolescents, who may be traumatised by admission to hospital.
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Weight gain is more dangerous for women who were born light
Weight gain increases cardiovascular disease risk among all women, but especially among those who were lighter at birth. Following up 66 111 US women included in the nurses' health study, Rich-Edwards and colleagues (p 1115) found that those with lower birth weights were at higher risk of cardiovascular disease—coronary artery disease and stroke. Those with low birth weight who grew to be heavy adults were at particularly high risk of coronary heart disease.
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People with mental illness prefer to be treated by their GP
People with serious mental illness prefer to consult their own general practitioner rather than be referred to a specialist in mental health. Lester and colleagues (p 1122) interviewed 45 patients with a serious mental illness, 39 general practitioners, and eight practice nurses, and found that most patients viewed primary care as the cornerstone of their care, whereas general practitioners felt that their lack of specialist knowledge limited their useful involvement in care. The patients valued continuity of care, listening skills, willingness to learn, and optimism in treatment more than specific knowledge about mental health.
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Scientists bypass journal subscriptions
Sharing scientific reprints through non-journal websites effectively creates a degree of open access, says Wren (p 1128). He searched the internet for articles that were published in 13 selected subscription journals and four open access journals between 1994 and 2004 and indexed in Medline. Articles published in higher impact journals and more recent articles were more likely to be shared at non-journal websites. Online availability was similar for open access journals and subscription journals with a mid-range impact factor. This indicates that the probability that a journal article is shared on a non-journal website depends less on copyright or ownership and more on impact factor or readership levels, says the author.
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