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Press releases Saturday 24 December 2005

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No evidence that hangover cures work

Soaps paint far too rosy a picture of coma

Money won±t buy you happiness

Short glasses more likely to lead to over-indulgence

Didgeridoo playing improves your sleep

Rearchers investigate the case of the disappearing teaspoons

Harry Potter protects children from injury

(1) No evidence that hangover cures work
(Interventions for preventing or treating alcohol hangover: systematic review of randomised controlled trials)
http://bmj.com/cgi/content/full/331/7531/1515

No compelling evidence exists to suggest that any complementary or conventional intervention is effective for treating or preventing alcohol hangover, say researchers in this week±s BMJ.

In Britain, alcohol hangovers account for about ±2bn in lost wages each year, mostly due to sickness absence, and a plethora of ±hangover cures± is on offer.

The team searched medical databases and the internet, and contacted experts and manufacturers for randomised controlled trials of any medical intervention for preventing or treating alcohol hangover.

They found eight trials testing eight different agents: propranolol (beta-blocking drug), tropisetron (drug for nausea and vertigo), tolfenamic acid (painkiller), fructose or glucose, and the dietary supplements borage, artichoke, prickly pear, and a yeast based preparation.

Most trials reported no beneficial effects, although encouraging findings existed for borage, a yeast based preparation, and tolfenamic acid.

±We are confident that our search strategy located all published trials on the subject,± say the authors. ±Our findings show no compelling evidence to suggest that any complementary or conventional intervention is effective for treating or preventing the alcohol hangover.±

The most effective way to avoid the symptoms of alcohol induced hangover is thus to practise abstinence or moderation, they conclude.

Contact:
Max Pittler, Research Fellow, Complementary Medicine, Penninsula Medical School, Universities of Exeter and Plymouth, Exeter, UK Email: m.h.pittler@ex.ac.uk


(2) Soaps paint far too rosy a picture of coma
(Epidemiology and prognosis of coma in daytime television dramas)
http://bmj.com/cgi/content/full/331/7531/1537

American soap operas paint an improbably rosy picture of coma patients± survival and recovery, says a study in this week±s BMJ, with potentially important consequences for viewers.

Tracking storylines containing coma patients over 10 years, researchers found that soap opera patients were far more likely to survive a coma than in real life. And they were also much more likely to emerge unscathed.

Only 8% of soapland patients died during coma for instance, compared with 50% upwards in real life. And all those who did survive recovered fully from their comas, while realistically just one in ten would regain their previous health - usually after months of intense rehabilitation, say the authors.

Such unrealistic outcomes have implications for viewers± expectations when dealing with family members or partners in comas, or if recovering from comas themselves. Television storylines have substantial influence on viewers, say the authors. American soaps reach 40 million viewers in the US alone and are broadcast in 90 countries worldwide - a huge audience for convincing health messages.

Although families of coma patients are not often faced with decisions over life-sustaining treatment, when needed such decisions are difficult and shrouded in uncertainty, say the authors. It may not be helpful to have unrealistic expectations of a patient±s survival - leading to disagreements between doctors and families which often end up in the courts.

While soap storylines are not written to reflect real life, say the authors, the media in general should balance stories of improbable survival and recovery with compelling and compassionate stories of characters who die with comfort and dignity.

Contact:
David Casarett, Assistant Professor, Center for Health Equity Research and Promotion, Philadelphia, USA Email: casarett@mail.med.upenn.edu


(3) Money won±t buy you happiness
(Happiness: Get happy ± it±s good for you)
http://bmj.com/cgi/content/full/331/7531/1489

Money is not the key to happiness, argues an editorial in this week±s BMJ - but family networks and having a full life outside work may do the trick.

±Individuals usually get richer during their lifetimes ± but not happier± says the author.

Research from Mexico, Ghana, Sweden, USA and the UK shows that despite vastly different levels of wealth, citizens of these countries report similar levels of satisfaction. And most advanced nations have seen almost no change to individuals± happiness levels over the last 50 years, despite a huge hike in income.

This may be because people don±t experience wealth without comparing it to others, says the author: ±As we realise one set of aspirations, it seems we immediately trade up to a more expensive set, to which we transfer our hopes for happiness.±

Happiness also affects health, as demonstrated in the former Soviet Union where people are ±among the unhappiest in the world± and their life expectancy is dropping.

However, one can improve one±s chance of happiness by being married, says the author. Married people live on average three years longer and have better health and wellbeing than the unmarried. Well developed family, social and community networks ± ±social capital± ± also have a positive effect.

Work is key to individual satisfaction, adds the author. Scant control over workload or decision-making correlates with lower happiness levels. And ±make sure you±re not working so hard that you±ve no time left for personal relationships and leisure±, says the author.

The happiness of its citizens should be the business of government, with ministers as answerable on happiness levels as they are on a nation's gross domestic product (GDP), he concludes.

Contact:
Dr Tony Delamothe, Deputy Editor, British Medical Journal, London, UK Email: tdelamothe@bmj.com0044016


(4) Short glasses more likely to lead to over-indulgence
(Shape of glass and amount of alcohol poured: comparative study of effect of practice and concentration)
http://bmj.com/cgi/content/full/331/7531/1512

People pour 20-30% more alcohol into short, wide glasses than into tall, narrow ones of the same volume, but they wrongly believe that tall glasses hold more, finds a study in this week±s BMJ.

Even professional bartenders pour more into short, wide ±tumblers± than into ±highball± glasses, suggesting that experience of pouring alcohol has little effect.

The study involved 198 college students and 86 bartenders from a large city in the United States.

After several practice pours, half the students were given tall, slender 355 ml glasses and half were given short, wide 355 ml glasses. They were then asked to pour a standard ±shot± of alcohol (1.5 ounces, 44.3 ml) for four mixed drinks (vodka tonic, rum and Coke, whiskey on the rocks, and gin and tonic).

Each bartender was also asked to pour the same four drinks, either with no instructions or after being told to take their time.

Both students and bartenders poured more into short, wide glasses than into tall, slender glasses. Among students, practice reduced the tendency to overpour into tall glasses, but not into short, wide glasses. Most students also believed that the tall glasses held more.

Despite an average of six years of experience, bartenders poured 20.5% more into short, wide glasses than tall, slender ones. Paying careful attention reduced but did not eliminate the effect.

These findings suggest that alcohol consumption studies should include questions about the shape of the glass, say the authors.

To avoid overpouring, they suggest using tall, narrow glasses or ones on which the alcohol level is marked. And to realise that when alcoholic drinks are served in a short, wide glass, two drinks are actually equal to two and a half.

Contact:
Brian Wansink, Cornell University, Ithaca, NY, USA Email: wansink@cornell.edu


BMJ Online first
(5) Didgeridoo playing improves your sleep
(Didgeridoo playing as alternative for obstructive sleep apnoea syndrome: randomised controlled trial)
http://bmj.bmjjournals.com/cgi/reprint/bmj.38705.470590.55

Regular didgeridoo playing reduces snoring and daytime sleepiness, finds a study published online by the BMJ today.

Snoring and obstructive sleep apnoea syndrome are common sleep disorders caused by the collapse of the upper airways. Continuous positive airway pressure therapy is effective, but is not suitable for many patients.

Reports of didgeridoo players experiencing reduced daytime sleepiness and snoring after practising, led experts in Switzerland to test the theory that training of the upper airways by didgeridoo playing can improve these disorders.

They identified 25 patients with moderate obstructive sleep apnoea syndrome and who complained about snoring. Patients were randomly allocated to an intervention group (didgeridoo lessons and daily practice at home for four months) or a control group (remained on a waiting list for lessons).

Compared with the control group, daytime sleepiness and apnoea scores improved significantly in the didgeridoo group. Partners of patients in the didgeridoo group also reported much less sleep disturbance.

Although overall quality of sleep did not differ significantly between groups, a combined analysis of sleep related measures showed a moderate to large effect of didgeridoo playing.

The authors conclude that regular training of the upper airways by didgeridoo playing reduces daytime sleepiness and snoring in people with moderate obstructive sleep apnoea syndrome and also improves the sleep quality of partners.

±Larger trials are needed to confirm our preliminary findings, but our results may give hope to the many people with moderate obstructive sleep apnoea syndrome and snoring, as well as to their partners,± they say.

Contact:
Otto Braendli, Specialist in Respiratory and Sleep Medicine, Zuercher Hoehenklinik Wald, Faltigberg-Wald, Switzerland Tel: +41 55 256 61 11 Email: otto.braendli@zhw.ch

(6) Researchers investigate the case of the disappearing teaspoons
(The case of the disappearing teaspoons: longitudinal cohort study of the displacement of teaspoons in an Australian research institute)
http://bmj.com/cgi/content/full/331/7531/1498

±Where have all the bloody teaspoons gone?± is an age old question in the workplace. In this week±s BMJ, researchers at the Burnet Institute in Australia attempt to measure the phenomenon of teaspoon loss and its effect on office life.

They purchased and discreetly numbered 70 stainless steel teaspoons (54 of standard quality and 16 of higher quality). The teaspoons were placed in tearooms around the institute and were counted weekly over five months.

After five months, staff were told about the research project and asked to complete a brief anonymous questionnaire about their attitudes towards and knowledge of teaspoons and teaspoon theft.

During the study, 56 (80%) of the 70 teaspoons disappeared. The half life of the teaspoons was 81 days (that is, half had disappeared permanently after that time). The half life of teaspoons in communal tearooms (42 days) was significantly shorter than those in rooms linked to particular research groups (77 days).

The rate of loss was not influenced by the teaspoons± value and the overall incidence of teaspoon loss was 360.62 per 100 teaspoon years. At this rate, an estimated 250 teaspoons would need to be purchased annually to maintain a workable population of 70 teaspoons, say the authors.

The questionnaire showed that most employees (73%) were dissatisfied with teaspoon coverage in the institute, suggesting that teaspoons are an essential part of office life. The rapid rate of teaspoon loss shows that their availability (and therefore office life) is under constant assault.

One possible explanation for the phenomenon is resistentialism (the theory that inanimate objects have a natural aversion to humans), they write. This is demonstrated by the fact that people have little or no control over teaspoon migration.

Given the widely applicable nature of these results, they suggest that the development of effective control measures against the loss of teaspoons should be a research priority.

Contact:
Campbell Aitken, Senior Research Officer, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia Email: aitken@burnet.edu.au

(7) Harry Potter protects children from injury
(Harry Potter casts a spell on accident prone children)
http://bmj.com/cgi/content/full/331/7531/1505

Harry Potter books seem to protect children from traumatic injuries, according to a study in this week±s BMJ.

Injuries caused by ±craze± activities such as inline skating and microscooters have previously been reported. One modern craze is the Harry Potter series of books and films. Given the lack of horizontal velocity, height, wheels, or sharp edges associated with this particular craze, researchers at the John Radcliffe Hospital, Oxford investigated the impact of these books on children±s traumatic injuries during the peak of their use.

They reviewed all children aged 7-15 who attended their emergency department with musculoskeletal injuries over the summer weekends of 2003-5.

The launch dates of the two most recent Harry Potter books (The Order of the Phoenix and The Half-Blood Prince) were Saturday 21 June 2003 and Saturday 16 July 2005. They compared the numbers of admissions for these weekends (intervention weekends) with those for summer weekends in previous years (control weekends).

The average attendance rate during the control weekends was 67, while for the two intervention weekends, the attendance rates were 36 and 37. At no other point during the three year surveillance period was attendance that low. MetOffice data obtained for each of the weekends suggested no confounding effect of weather conditions.

±We observed a significant fall in the numbers of attendees to the emergency department on the weekends that the two most recent Harry Potter books were released,± say the authors.

Both these weekends were in mid-summer with good weather, suggesting that there is a place for a committee of safety conscious, talented writers who could produce high quality books for the purpose of injury prevention.

Potential problems with this project would include an unpredictable increase in childhood obesity, rickets, and loss of cardiovascular fitness, they conclude.

Contact:
Stephen Gwilym, Specialist Registrar, Department of Orthopaedic Trauma Surgery, John Radcliffe Hospital, Oxford, UK Email: s_gwilym@yahoo.com

Also in this week's BMJ ...

Doctors, detectives, and common sense
(A detective story by Alexander McCall Smith BMJ Volume 331, pp 1495-7)

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