Press releases Monday 14 December to Friday 18 December 2009
Please remember to credit the BMJas source when publicising an article and to tell your readers that they can
read its full text on the journal's website (http://www.bmj.com).
(1) Looking young for your age linked to longer life
(2) Listening to music during CPR training could improve technique
(3) Mathematics is good for your heart
(4) Darwin's ill health - finally some answers
(5) Santa should get off his sleigh and walk, says public health doctor
(6) Should flowers be banned in hospitals?
(7) More effort needed to crack down on "secret remedies"
(1) Looking young for your age linked to longer life
(Research: Perceived age as a clinically useful biomarker of ageing: cohort study)
http://www.bmj.com/cgi/doi/10.1136/bmj.b5262
People who look young for their age enjoy a longer life than those who look older than their years, finds a study in the Christmas issue published on bmj.com today.
Doctors often use perceived age as a general indication of a patient's health, but research on its validity has been sparse. So a team of researchers, led by Professor Kaare Christensen from the University of Southern Denmark, examined whether perceived age is linked with survival and important age related traits, such as physical and mental (cognitive) functioning and a molecular biomarker of ageing (leukocyte telomere length).
Telomere length indicates the ability of cells to replicate. Shorter length is associated with a host of diseases related to ageing, lifestyle factors and death.
In spring 2001, 1,826 Danish twins aged 70 years and over underwent physical and cognitive tests and had their faces photographed.
Three groups of assessors (20 female geriatric nurses aged 25-46, 10 male student teachers aged 22-37, and 11 older women aged 70-87) rated the perceived age of the twins from the facial photographs. The assessors did not know the age range of the twins, and each twin of a pair had their age assessed on different days.
Death records were then used to track the survival of the twins over a seven year period.
Perceived age was significantly associated with survival, even after adjusting for chronological age, sex, and the environment in which each pair of twins grew up. Perceived age, adjusted for chronological age and sex, also correlated with physical and cognitive functioning as well as leukocyte telomere length.
And the bigger the difference in perceived age within a twin pair, the more likely it was that the older looking twin died first.
The age, sex and professional background of the assessors made no difference to any of the results.
Perceived age based on facial photographs is a robust biomarker of ageing that predicts survival among people aged 70 years and over and correlates with important functional and molecular age related characteristics, conclude the authors.
They point to common genetic factors influencing both survival and perceived age to help explain these results.
Contact:
Professor Kaare Christensen, The Danish Twin Registry and The Danish Aging Research Centre, Institute of Public Health, University of Southern Denmark, Odense, Denmark
Email: kchristensen@health.sdu.dk
Listening to music during cardiopulmonary resuscitation (CPR) training may help people keep to the recommended compression rate, according to a study in the Christmas issue published on bmj.com today.
Cardiopulmonary resuscitation is an important lifesaving technique that can be effectively taught to most people. When initiated by a bystander one to two minutes before emergency services arrive it can double survival rates.
Mentally singing the nursery tune Nellie the Elephant is sometimes recommended during CPR training because of its appropriate rhythm and tempo to help individuals keep a rate of 100 compressions per minute, as recommended by UK Resuscitation Council guidelines.
So a team of researchers from the Universities of Birmingham, Coventry and Hertfordshire, and the West Midlands Ambulance Service NHS Trust, set out to test whether this really does help lay people to improve their CPR performance.
A total of 130 staff and students at Coventry University, untrained in CPR, were given a brief demonstration on a resuscitation manikin and had one minute to practise while listening to a metronome.
Participants were then asked to perform three sequences of one minute of continuous chest compressions accompanied by no music, repeated choruses of Nellie the Elephant by Little Bear, and That's the Way (I Like It) by KC and the Sunshine Band via headphones.
Both songs were chosen for their appropriate tempo - 105 beats per minute (bpm) for Nellie the Elephant and 109 bpm for That's the Way (I Like It).
Listening to Nellie the Elephant significantly increased the proportion of participants delivering compression rates at close to 100 per minute (32%) compared with 12% for no music and 9% for That's the Way (I Like It).
Unfortunately, it also increased the proportion of compressions delivered at an inadequate depth.
As current resuscitation guidelines give equal emphasis to correct compression rate and depth, listening to Nellie the Elephant as a learning aid during CPR training cannot be recommended, say the authors.
An earlier pilot study used the Bee Gees song Stayin' Alive. The BMJ authors suggest that further research is required to identify music that, when played during CPR training, improves chest compression performance. Potential tunes include Another One Bites the Dust by Queen, Quit Playing Games (With my Heart) by the Backstreet Boys, and Achy Breaky Heart by Billy Ray Cyrus.
Contact:
Malcolm Woollard, Professor in Pre-hospital and Emergency Care, Pre-hospital, Emergency and Cardiovascular Care Applied Research Group, Coventry University, UK
Email: malcolm.woollard@coventry.ac.uk
Researchers say that a healthy heart beat obeys the "divine proportion" rule - a mathematical ratio found in natural and man-made structures of great beauty.
Their findings are in the Christmas issue published on bmj.com today. Historically things that are beautiful often follow a mathematical formula known as the golden ratio. Examples of this inlcude the florets in a cauliflower head, the Parthenon in Athens, Notre Dame cathedral in Paris and George Clooney's face. A team led by Professor Hanno Ulmer from Innsbruck Medical University in Austria has now gone one step further and is claiming that "well individuals exhibit the harmonious golden ratio." Ulmer and his team evaluated blood pressure readings of over 160,000 people in western Austria who had taken part in a health promotion programme. The researchers found that individuals who had a ratio of 1.6180 between their systolic (maximum) and diastolic (minimum) blood pressure counts were less likely to have a fatal heart attack. This figure equates to the mathematical sequence phi (1.6180339887) or golden rule ratio, brought to the world's attention by the Italian mathematician Leonardo Pisano, also known as Fibonacci. Participants in the study who suffered fatal heart attacks had a higher ratio of 1.7459. The authors conclude that: "Although this finding is not likely to be of practical relevance for individual clinicians, at a population level this may be an important phenomenon and should be investigated in other cohorts." Contact:Cecily Kelleher, Public Health Physician, School of Public Health and Population Sciences, University College Dublin, Dublin, Ireland
Email: cecily.kelleher@ucd.ie
Charles Darwin probably suffered from cyclical vomiting syndrome (CVS), claims Professor John Hayman in the Christmas issue, published on bmj.com today.
In the bi-centenary of Darwin's birth, Professor Hayman, from the Anatomy and Developmental Biology Department at Monash University in Melbourne, argues that it is time to identify the illness that plagued Darwin "and to refute the many fanciful proffered diagnoses, both physical and psychological or psychoanalytical." Charles Darwin suffered from nausea, vomiting, headaches, stomach and skin problems for most of his adult life. For varying periods he was so disabled by his illness that he became a virtual recluse. Psychological diagnoses have included hypochondria, panic disorders, ‘repressed anger towards his father', nervousness about his relationship with his wife and guilt over conflict with his earlier religious belief. While physical diagnoses have included middle ear infection, arsenic poisoning and tropical parasitic disease. Hayman argues that the theories for Darwin's ill health "have all been disallowed for good reasons." The renowned scientist may have suffered from anxiety but this was probably because of his illness not the cause of it, says Professor Hayman. The author claims that Darwin's symptoms indicate that he suffered from cyclical vomiting syndrome. While this disease mainly affects children it can present for the first time in adulthood. The syndrome is related to migraine but is linked to genetic abnormalities. Classic symptoms of cyclical vomiting syndrome include severe sickness, headaches, anxiety and intense abdominal pain. Many patients also suffer from eczema and recurrent skin infections. Darwin's mother and members of her family suffered from many of these conditions. Hayman concludes: "Darwin was not aware of mitochondria or of genes and genetic mutations but he was very much aware of random variations within species ... His personal inherited genetic variation made him substantially ‘less fit' but his survival prospects were greatly increased by his driving intellect, loyal colleagues, a devoted wife, family and household servants and his personal wealth." Contact:John Hayman, Associate Professor, Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia
Email: hayman@johnhayman.net
Santa should share Rudolf's snack of carrots and celery sticks rather than brandy and mince pies and swap his reindeer for a bike or walk, says a public health expert in the Christmas issue published on bmj.com today.
Dr Nathan Grills, from Monash University in Australia, says the current image of Santa promotes obesity, drink-driving, speeding and a general unhealthy lifestyle. He argues that "Santa only needs to affect health by 0.1% to damage millions of lives" and that it would be better if his popularity was used to promote healthy living. Grills carried out a review of literature and web-based material to assess Santa's potential negative impact on public health - there were no peer reviewed publications on this issue. The investigation revealed very high Santa awareness amongst children. Indeed among American school kids Santa Claus was the only fictional character more highly recognised than Ronald McDonald, says the paper. Grills also found that "Santa sells, and sometimes he sells harmful products" and this happens on a global scale. "Like Coca-Cola, Santa has become a major export item to the developing world", says the author. While Santa is now banned from smoking, images of him enjoying a pipe or cigar can still be found on Christmas cards. Father Christmas also potentially promotes drink-driving, argues Grills, and refers to the tradition of leaving Santa Claus a brandy to wish him well on his travel, with a few billion houses to visit Santa would soon be over the limit, says the study. Also, Santa has real potential to spread infectious diseases, says the paper. If Santa sneezes or coughs around 10 times a day, all the children who sit on his lap may end up with swine flu as well as their Christmas present, argues Grills. While more research is needed before calling for authorities to regulate Santa's activities, Grills proposes a new image for Santa - a slimmed down version on a treadmill. Contact:Dr Nathan Grills, Public Health Fellow, Monash University, Department of Epidemiology and Preventative Medicine, Australia
Email: nathangrills@gmail.com
Does flower water harbour potentially deadly bacteria?
Do bedside blooms compete with patients for oxygen?
Do bouquets pose a health and safety risk around medical equipment?
These are some of the reasons given by many hospital wards in the UK to ban, or at least discourage, bedside bouquets. But is this anxiety justified, and what do patients feel about flower policies?
To find out more, Giskin Day and Naiome Carter of Imperial College London surveyed the literature and talked to patients and staff at the Royal Brompton Hospital and the Chelsea & Westminster Hospital about their attitudes towards flowers. Their findings are published on bmj.com today, as part of the Christmas issue.
A 1973 study found that flower water contained high counts of bacteria. However, subsequent research found no evidence that flower water has ever caused hospital acquired infection. Yet hospitals continue to prohibit flowers on the ward in the absence of any official ruling from the Department of Health.
Other negative effects have been ascribed to flowers. In the late 1900s it was common to remove flowers from bedsides at night as there was widespread belief that the blooms competed for patients' oxygen. But this was dismissed as a myth when studies showed that the impact of flowers on air composition in wards was negligible and did not justify the labour involved in moving flowers to and fro.
Southend University Hospital recently imposed a blanket ban on flowers on the grounds that they posed a health and safety risk around high tech medical equipment, but it could be argued that flower vases are no more risky than having crockery containing drinks or food around bedsides.
There is some evidence that most nurses are not in favour of flowers, partly because of the amount of work generated. Interviews with staff in this study also suggest that they are more concerned about the practical implications of managing flowers than risks of infection.
Other studies report that flowers have immediate and long term beneficial effects on emotional reactions, mood, social behaviours, and memory for men and women alike. One trial found that patients in hospital rooms with plants and flowers needed significantly fewer postoperative analgesics; had reduced systolic blood pressure and heart rate; lower ratings of pain, anxiety, and fatigue; and had more positive feelings than patients in the control group.
Given that flowers and herbs have been used as remedies in the earliest hospitals, and as a means of cheering up the hospital environment for at least 200 years, it seems remarkable that flowers still tend to be treated in an ad hoc fashion in hospitals, say the authors. Although flowers undoubtedly can be a time consuming nuisance, the giving and receiving of flowers is a culturally important transaction, they conclude.
In an accompanying editorial, Simon Cohn, a medical anthropologist at Cambridge University argues that flowers have fallen victim to new definitions of care. He suggests that the decision to ban flowers "seems to reflect a much broader shift towards a model of care that has little time or place for more messy and nebulous elements."
Christmas is a time for giving, so perhaps now is a good time to think about care not as an outcome that can be delivered but as a relationship that can be exchanged, he concludes.ded before calling for authorities to regulate Santa's activities, Grills proposes a new image for Santa - a slimmed down version on a treadmill.
Contact:Giskin Day, Course Director: Medical Humanities, Department of Humanities, Imperial College London, UK
Email: giskin.day@imperial.ac.uk
The medical establishment and politicians must do more to crack down on alternative medicine, argues a senior scientist on bmj.com today.
In 1909 the BMA, BMJ and politicians tried to end the marketing of secret remedies by uncovering the secret ingredients of popular products like Turlington's Balsam of Life, Mayr's wonderful stomach remedy, and Green Mountain magic pain remover. Yet, one hundred years on, the response of the medical establishment to the resurgence in magic medicine that started in the 1970s "looks to me like embarrassment," says Professor David Colquhoun from University College London in an editorial in this week's Christmas issue. Homeopaths regularly talk nonsense about quantum theory, and "nutritional therapists" claim to cure AIDS with vitamin pills, he writes. In 2007 American adults spent $12bn consulting practitioners of complementary and alternative medicine and $22bn buying their products. He claims the royal colleges "avoided the hard questions by setting up committees," while the Department of Health refers the hard questions to the Prince of Wales' Foundation for Integrated Health, which was asked to draft "national occupational standards" for make believe subjects like "naturopathy." Colquhoun cites two recent examples that illustrate the problems. First the Pittilo recommendations for statutory regulation of acupuncture and herbal and traditional Chinese medicine. Colquhoun argues that "you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense." He also claims the Royal College of Physicians still have "a blind spot about the evidence for acupuncture" in its submission to this report. The other example concerns the recent "evidence check: homeopathy" conducted by the House of Commons Science and Technology Select Committee, where the health minister Michael O'Brien was "eventually cajoled into admitting that there was no good evidence that homoeopathy worked but defended the idea that the taxpayer should pay for it anyway." Colquhoun points to the "evasive answers" given by the Department of Health's chief scientific advisor, David Harper, when questioned about the use of homoeopathy in terms of government policy on health. He also criticises the head of the Medicines and Healthcare products Regulatory Agency (MRHA) for suggesting that homoeopathy cannot be tested by proper randomised controlled trials. Finally, Colquhoun points to a recent article by the Sun's health journalist Jane Symons. "Imagine going to an NHS hospital for treatment and being sent away with nothing but a bottle of water and some vague promises," it said. "And no, it's not a fruitcake fantasy. This is homeopathy and the NHS currently spends around £10m on it." It isn't often that a Murdoch tabloid produces a better account of a medical problem than anything the Department of Health's chief scientific advisor can muster, he concludes. Contact:David Colquhoun, Research Professor, University College London, UK
Email: d.colquhoun@ucl.ac.uk
Also in this week's Christmas issue of the BMJ ...
Did gold play a part in the death of a 16th century French courtesan and favourite of Henri II?
www.bmj.com/video/fatalalchemy.dtl
Miracle beauty products may be a staple Christmas present today, but they're not a recent invention. Diane de Poitiers, a French noble woman and mistress of Henry II of France, tried to use gold to preserve her looks - in alchemical law, gold was immutable, and alchemists and apothecaries created various potions to pass this gift onto their customers. For Christmas, the BMJ has published a feature and made a video about a French research team's investigations of Diane's remains, and its discovery that the gold she used to preserve her youth was actually slowly poisoning her.
What killed sealers at the Swedish House during the winter of 1872-3?
www.bmj.com/video/swedishhouse.dtl
A research paper published in the Christmas issue reveals the fate of 17 sealers at the Swedish House at Kapp Thordsen, Spitsbergen during the winter of 1872-3. An accompanying video follows a group of Norwegian scientists and historians as they travel to the frozen tundra of Svalbard, an island in the Arctic Ocean. There they investigate the death of the seal hunters who were stranded on the island in 1872 - the official cause of death was scurvy, but Ulf Aasebø and his team reach a different conclusion.
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