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(1) Scientists discover recipe for life: eating the 'Polymeal' cuts heart disease by 76%

(2) Democracy is good for your health

(3) Magnetic bracelets reduce the pain of osteoarthritis

(4) The human eye cannot spot the offside rule

(5) Thanks for the memories: cinematic portrayal of amnesia is profoundly misleading

(6) Data protection rules may risk patient safety on wards

(1) Scientists discover recipe for life: eating the 'Polymeal' cuts heart disease by 76%
http://bmj.com/cgi/content/full/329/7480/1447

(The Polymeal: a more natural, safer and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%)

Scientists in this week's Christmas issue of the BMJ have discovered the 'Polymeal', a set of ingredients which cuts the risk of heart (cardiovascular) disease by 76% and significantly increases life expectancy.

Results of dining on the Polymeal were most dramatic for men, who were projected to live on average 6.6 years longer in total than those not eating the meal. Men will also live for nine years longer without succumbing to heart disease, and those that do will suffer it for less years of their lives.

Women eating the Polymeal will also live significantly longer, nearly five years more than women not eating the meal. They will also put off the onset of heart disease for eight years longer.

The Polymeal includes wine, fish, dark chocolate, fruits and vegetables, almonds and garlic, eaten on a daily basis (but four times a week for fish). Scientists reviewed the medical literature on how much each ingredient cuts heart disease, blood pressure or cholesterol levels by varying amounts, (150ml wine daily for instance reduces heart disease by 32%) and worked out the combined effect of the ingredients. They then calculated the potential effect across an ongoing study of American adults.

The findings follow research last year (2003) into a 'Polypill', a combination of drugs taken in one dose which was designed to reduce heart disease by more than 80%. The authors of the Polymeal study were searching for a non-pharmaceutical alternative.

In Western society we are all at risk from the causes of cardiovascular disease, say the authors, and the diseases that accompany it. Following the Polymeal promises to be an effective, non-pharmacological, safe and tasty means to increasing life expectancy and reducing heart disease across the population, they conclude.

Contacts:
Oscar Franco, Scientific Researcher, Dept of Public Health, Erasmus Medical Centre, University Medical Centre Rotterdam, Netherlands Email: o.francoduran{at}erasmusmc.nl
Or
via press office contact: Fred Balvert Email: f.balvert@erasmusmc.nl

(2) Democracy is good for your health
http://bmj.com/cgi/content/full/329/7480/1421

(Effect of democracy on health: ecological study)

Freedom has become the political buzzword of the 21st century. Now that the surviving Afganis and Iraqis are enjoying the benefits of Western freedoms, what will this mean for their health?

A study in this week's Christmas issue of the BMJ finds that people living in democracies enjoy better health than those who must endure repressive regimes.

Using published freedom ratings, researchers explored the effect of democracy on life expectancy and mother and infant deaths in 170 countries, representing 98% of the world's population.

Overall, 45% of the countries were free, 32% partially free, and 24% not free. The highest levels of health were found in free countries, followed by the partially free countries, and the worst levels of health were in countries that were not free.

These results did not change after a country's wealth, level of inequity, and the size of its public sector were taken into account.

The underlying mechanisms for this association are still unknown, but the authors suggest that democracies allow for more space for social networks and pressure groups, opportunities for empowerment, better access to information, and better recognition by government of people's needs.

If this relation is confirmed, the extent of freedom of a country could provide a new approach to decreasing national mortality, they say.

Increasing democratisation may be a way to counteract the deleterious effect on health of the unequal distribution of economic resources on a global scale.

Contact:
Professor Carlos Alvarez-Dardet, Observatory of Public Policies and Health, Departamento de Salud Publica, Universidad de Alicante, Spain Email: carlos.alvarez{at}ua.es

(3) Magnetic bracelets reduce the pain of osteoarthritis
http://bmj.com/cgi/content/full/329/7480/1450

(Randomised controlled trial of magnetic bracelets for relieving pain in lower limb osteoarthritis)

Magnetic bracelets reduce pain in osteoarthritis of the hip and knee, finds a study in this week's Christmas issue of the BMJ.

Osteoarthritis affects around 760,000 people in the United Kingdom, producing over 3 million general practice consultations in 2000. Manufacturers of magnetic bracelets claim that they can reduce pain and worldwide sales were estimated at £2.6bn ($5bn) in 1999. But evidence about their effectiveness is contradictory.

Researchers from the Peninsula Medical School recruited 194 patients aged 45-80 years with osteoarthritis of the hip or knee from five rural general practices in Devon. Patients wore either a standard strength magnetic bracelet, a weak magnetic bracelet, or a non-magnetic (dummy) bracelet for 12 weeks. Changes in pain were recorded using a recognised pain scoring scale.

They found a significant reduction in pain scores between the standard and dummy magnet groups. The results for the weak magnet group were similar to those of the dummy magnets, and this suggests that the magnetic strength of the bracelet is important.

The authors emphasise that the benefits are in addition to existing treatments, which should not be suddenly stopped without discussion with their doctor. Also they note that high strength magnets (170mTesla or more) seem to be needed.

Although factors such as use of painkillers and patients' beliefs about the type of bracelet they were testing did not affect the results, the authors cannot be certain whether their findings are due to a specific effect of magnets or a placebo effect. But, whatever the mechanism, the benefit from magnetic bracelets seems clinically useful.

The (one-off) cost of bracelets (around £30-£50 or $58-$96), also compares well with that of painkillers, such as paracetamol and anti-inflammatory drugs, and larger investigations should now test the safety of magnets relative to the well-known risks of these drugs, they add.

Further work is also needed to replicate these findings and determine whether the effect extends beyond 12 weeks, they conclude.

Contact:
Hannah Skeggs, Communications Department, Peninsula Medical School, Plymouth, UK Email: hannah.skeggs{at}pms.ac.uk

(4) The human eye cannot spot the offside rule
http://bmj.com/cgi/content/full/329/7480/1470

(Can the human eye detect an offside position during a football match?)

The human eye is unable to detect an offside position during a football match, claims a doctor from Spain in this week's Christmas issue of the BMJ. This may explain why so many offside decisions are controversial.

Dr Francisco Belda Maruenda analysed the physiology of the human eye to clarify if it is able to process all the visual information needed to apply the rule.

To apply the offside rule correctly, the referee must be able to keep at least five moving objects in his visual field at the same time (two players of the attacking team, the last two players of the defending team, and the ball).

This is beyond the capacity of the human eye, especially as these five objects can be anywhere within the defenders' half of the pitch, an area of at least 3200m2, says the author. This may explain at least some of the instances when television replays of a game clearly show that the offside rule was not properly implemented.

The relative position of four players and the ball cannot be assessed simultaneously by a referee, and unavoidable errors will be made in the attempt. The use of modern technology during games, such as freeze frame television and frame by frame analysis is advisable to limit these errors, he concludes.

Contact:
Francisco Belda Maruenda, Specialist in Family Medicine (general practice), Centro de Salud de Alquerias, Murcia, Spain Email: fbeldam{at}meditex.es

(5) Thanks for the memories: cinematic portrayal of amnesia is profoundly misleading
http://bmj.com/cgi/content/full/329/7480/1480

(Memories aren't made of this: amnesia at the movies)

The way the movies represent amnesia is profoundly misleading, and gives the general public a false view of what to expect if they are diagnosed with the condition, says a paper in this week's BMJ.

Analyzing a host of movies from the silent era up to the present day, the paper traces a number of regular misconceptions about the condition.

Most amnesics in films are able to function as if on a 'clean slate', suffering few problems with everyday tasks, while managing to hold down new jobs and function socially. In reality amnesic patients experience significant difficulties in taking in new information, making many everyday tasks extremely difficult.

Movies often portray amnesics as undergoing complete personality changes, with a "startling number of originally 'bad' characters becoming 'good' after the onset of amnesia." In reality however personality and identity are often unaffected.

One of the most "neurologically bizarre features" of amnesia in films is the myth of a second serious head injury reversing the effects of a previous blow, says the paper's author Dr Sallie Baxendale. Movies also promote the idea that hypnosis or contact with a familiar object are ways out of the condition, but this is rarely the case.

Conversely, one of the more accurate portrayals of amnesia in films was the animated character Dory in last year's Finding Nemo (2003) says Dr Baxendale. The character finds it difficult to retain new information, remember names or know where she is going or why. The film also shows the frustration of those around her, and although she is a comic character, it reflects her vulnerability when she finds herself alone, lost and profoundly confused.

The widespread influence of cinema in shaping public perceptions must not be underestimated by the medical profession, says Dr Baxendale. Doctors should be aware of the myths about amnesia promoted in the movies when talking to patients and their relatives, she concludes.

Contact:
Dr Sallie Baxendale, Clinical Neuropsychologist, National Society for Epilepsy, Chalfont St Peter Email: sallieb{at}ion.ucl.ac.uk

(6) Data protection rules may risk patient safety on wards
http://bmj.com/cgi/content/full/329/7480/1491

(Data protection gone too far: questionnaire survey of patients' and visitors' views about having their names displayed in hospital)

Removing patient name boards from hospital wards because they do not comply with the Data Protection Act 1998 may risk the safe delivery of care to patients, argue researchers in this week's Christmas issue of the BMJ.

Patients in wards used to be identifiable from name boards at the nursing station and by name cards above their beds. Since their removal, patients have been misplaced as no one was aware that they were still in hospital.

Believing this to be an unacceptable and dangerous practice, a team of doctors in Wales did a survey to find out how patients and visitors felt about having patients' names displayed on the wards.

The survey included 243 patients and 215 visitors from orthopaedic and surgical wards. Overall, 233 (96%) patients were in favour of having their names written on name boards, and 194 (90%) of the visitors did not think this infringed upon patients' privacy.

When asked about name cards, 236 (97%) patients and 201 (93%) visitors were in favour of names being displayed. Only 16 (3%) were opposed to having name boards placed in the open

Most patients and visitors do not object to having their names displayed either on cards above their beds or on name boards in front of the nurses' station, say the authors. Name boards and name cards should be clearly displayed to ensure the safe delivery of care to patients, they conclude.

Contact:
Ravindra Gudena, Senior House Officer, Trauma Orthopaedics, Birmingham, UK Email: gudenar{at}msn.com

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