Does exposure to violent scenes create violent teens?

Over the recent decades, film technology has increased significantly that we are able to recreate more exciting and fast-paced action scenes using better special effects. One only needs to look back to the 1970s to see the difference. Take for example, the film Battlestar Galactica. Spaceships were warring it out amongst themselves, but you could tell the laser beams of enemy ships and the good guys were merely light being reflected onto strings of model ships. Nowadays we have stunt doubles and pyrotechnics, and the improvements in CGI have meant that it is possible to create a scene without it actually having physically taken place.

Action movies and action scenes draw crowds and revenue. After all, we go to to the movies for some form of escapism – we wouldn’t if the film showed something we were already experincing in real life. In the last few decades, action movies have risen in number. They have always faced criticism about the level of violence inherent, and are often blamed for inciting anti-social behaviour, but is this accusation valid?

In the book Everybody Lies, Seth Stephens-Davidowitz, a data scientist and writer, makes the point that during the run of a violent movie at local theatres, especially on opening night, crime actually goes down. The evidence is that young men, who have a propensity for violence, are actually at the movies. And late night movies actually see a proportionate decrease in violence and crime. Why is this so? The book again suggests that movies are an outlet, a form of distraction, and the fact that a lot of crime is alcohol-fuelled – and cinemas and theatres don’t serve alcohol – means that there is a form of aggression release that substitutes for crime.

But one should not get too eager about showing all the KilL Bill movies at the local cinema. There are many examples of life imitating art, with men hypnotised with what they had just seen on screen. A showing of the gang movie Colours was followed by violent shooting. The movie New Jack City incited riots. And four days after the film The Money Train was shown, men used lighter fluid to ignite a subway toll booth, as if to see if it would really work. In the movie, the operator escaped. The real life operator burned to death.

There is evidence from experiements that subjects exposed to a violent film show more anger and hostility, even if they do not imitate what they have seen.

We could say the same of alcohol. Alcohol may be a substitute for an anti-social evening. That is to say that men and women who might otherwise go out for a night of crime may be prevented so by staying in on a night of catching up over a glass of wine. But the same could be used to say that alcohol instead fuels crime outside of the immediate time frame.

Another useful area to examine is in the effect of music in the film. Does watching a film with “violent” music influence how we act in the aftermath? We know about the effects of music in a film, but it would be useful to see how music – especially since it is such a fabric of society – influences individuals.

One drink a day shortens your life

Ah, alcohol.

Some people don’t touch it for religious reasons.

Some people drink in moderation.

Some to excess.

Alcoholic drinks are classified by how many units of alcohol they contain. A recent study suggested that drinkers who consumed over 12.5 units (100g) of alcohol were more likely to die sooner than those who did not breach this amount.

If we follow current UK guidelines, this means that we should not drink more than 6 pints of average strength beer at 4%, or these might have serious repercussions for our health.

6 pints! Some people exceed that in a single day or two!

The limits established by the UK seem lower compared to those in the other countries, but nevertheless, each country sets its own guidelines based on lifestyle and economic factors.

The crux of this research was that adults over the age of 40 would lose between one or two years of their life is they exceeded the UK guidelines.

The somewhat irony of this research was that drinking alcohol was linked with higher incidences of cardiovascular symptoms, except for heart attacks, where it was lower.

How can these be so? How can drinking lead you to develop health problems, yet not cause you heart attacks?

This is where the “blind spot” of the research falls. It may not just be the drinking that is difficult to measure empirically.

You may argue that is not so much the level of alcohol that is the problem, but the lifestyle factors associated with the level of alcohol.

For example, those who exceed the UK threshold for alcohol consumption regularly may have lifestyle concerns or health worries that cause stress on the heart. Think of someone who is depressed and drowning himelf in sorrows. It is not necessarily the alcohol that he keeps swigging down, but more the stress that the depression is taking on him.

You may also argue that those who don’t exceed this limit have less stressful lifestyles. Or perhaps they have other outlets for stress, such as sport and exercise, and hence do not feel the need to drink as much.

It is like analysing football fans. You might find that the ardent supporters are more likely to have suffered the stresses, the highs and lows of their football team. They are also likelier to be older fans. Those who have not followed football teams as passionately or for as long are likely to be younger individuals. But you cannot say the number of football games watched cuts your life expectancy.

Why do drinking limits differ from place to place? I mentioned earlier that in some countries, this is due to economic interference. But how is this so? Imagine a country like, say, Spain, which produces various kinds of wines. As a higher percentage of the country’s economy depends on sales of alcohol, it is likely that Spain will have higher recommended guidelines. And Spain does. While UK men are told not to drink above 14 units of alcohol, this limit is 35 units in Spain. A staggering 2.5 times higher than in Britain!

The UK limit is also lower than Ireland (21.2). What does Ireland export? Guinness. It has been calculated that every day 10 million glasses of Guinness are sold all across the world and 1.8 billion points of Guinness are sold.

It is difficult to measure the health effect beyond the recommended threshold because it would be unethical to make someoe drink above that limit for a long time. But the results of the study suggest that consumption for many people is best reduced and monitored.

 

Broccoli is good for your heart

“Research has shown eating broccoli, cauliflower, cabbage and brussels sprouts to be particularly beneficial for the hearts of elderly women,” The Guardian reports.

Researchers investigating the benefit of a vegetable diet in Australia found that women who consumed the highest number of vegetables displayed less thickening of the walls of a vessel that supplies blood to the brain. The blood vessel is known as the common carotid artery and it has been linked to incidences of stroke, as a blockage in the artery prevents blood getting to the brain.

 

Might it have been a case of merely the consumption of vegetables? After all, we know that vegetables are good for you. Did the consumption of broccoli specifically have health benefits?

When looking at specific types of vegetables, researchers in Australia found that cruciferous vegetables seemed to provide the most benefits. These are a range of vegetables that belong to the same cabbage “family” (Brassicaceae) and include broccoli, brussels sprouts, cabbage, cauliflower and kale.

While previous research has linked a healthy diet with plenty of fruit and vegetables to lower risk of heart attacks and stroke, this study looks at the potential effect of specific types of vegetables.

The study could not merely narrow down the benefits solely to the consumption of vegetables, particularly broccoli But after variances in other factors was taken care of, the results held true after taking account of other factors such as women’s lifestyle, medical history and other components of their diet.

Cruciferous vegetables are good for you and the evidence suggests that older women in particular should make an effort to include them in their diet.

The researchers who carried out the study came from Edith Cowan University, the University of Western Australia, Children’s Hospital at Westmead, Flinders University and Sir Charles Gairdner Hospital, all in Australia. The study was funded by Healthway Western Australian Health Promotion Foundation and the National Health and Medical Research Council of Australia. It was published in the peer-reviewed Journal of the American Heart Association, and is available to read free online.

Surprisingly enough, the Mail Online reported the study results accurately. Nevertheless, as is often the case, did not make it clear that this type of study cannot prove that one factor (cruciferous vegetables) is a direct cause of another (carotid artery wall thickness).

The Guardian headline and introduction said the study showed vegetables provided “heart benefits”, although thickening of the carotid artery is more closely linked to risk of stroke.

Why health articles in newspapers should be retired

What is it that people look forward to? Most want time to pursue their interests and doing things they love. Some people have managed to combine all this by the traditional interest-led approach, doing things they love, starting up a blog, gaining readership, and then selling advertising space on their blog, or affiliate marketing and other things associated with making money from a website. For others, this lure for things they like is compromised by the need of having to make a living, and hence this is shelved while having to earn a living and put off until retirement.

For most people, retirement would be when they would be able to have the time and money to indulge in things they put off earlier. Some people have combined the starting of a blog and retirement, and made a living by blogging (and gaining a readership) about how they have or intend to retire early.

Retirement. Out of the rat race. All the time in the world. For most people, retirement is the time to look forward to.

A recent study however suggests that retirement is not all that wonderful. Despite it being seen as the time of the life where financial freedom has been achieved and time is flexible, it has been suggested that the onset of mental decline starts with retirement.

The Daily Telegraph reported that retirement caused brain function to rapidly decline, and this information had been provided by scientists. It further cautions that those workers who anticipate leisurely post-work years may need to consider their options again because of this decline. Would you choose to stop work, if this meant your mental faculties would suffer and you would have all the free time in the world but not the mental acuity?

Retired civil servants were found to have a decline in their verbal memory function, the ability to recall spoken information such as words and names. It was found that verbal memory function deteriorated 38% faster after an individual had retired than before. Nevertheless, other areas of cognitive function such as the ability to think and formulate patterns were unaffected.

Even though the decline of verbal memory function had some meaningful relevance, it must be made clear that the study does not suggest anything about dementia or the likelihood of that happening. There were no links drawn with dementia. Just because someone retires does not mean they are more likely to develop dementia.

The study involved over 3000 adults, and they were asked to recall from a list of twenty words after two minutes, and the percentages were drawn from there. The small sample size, not of the adults, but of the word list, meant the percentage decline of post-retirement adults may have been exaggerated.

Look at this mathematically. From a list of twenty words, a non-retiree may recall ten. A retiree may recall six. That difference of four words is a percentage decline of 40%.

Ask yourself – if you were given a list of twenty words, how many would you remember?

It is not unsurprising if retirees exhibit lower abilities at verbal memory recall because the need for these is not really exercised post-retirement. What you don’t use, you lose. We should not be worried about the decline, because it is not a permanent mental state, but it is reversible; in any case the figure is bloated by the nature of the test. If a non-retiree remembers ten words, and a retiree makes one-mistake and remembers it, that would be promoted as a 10% reduction in mental ability already.

Furthermore, decline is not necessarily due to the lack of work. There are many contributing factors as well, such as diet, alcohol and lifestyle. Retirement is not necessarily the impetus behind mental decline. Other factors may confound the analyses.

The research did not involve people who had retired early. For example, hedge fund managers might have retired in their forties. But you would struggle to think that someone in their forties would lose 38% of verbal memory recall.

Would a loss of 38% of verbal memory have an impact on quality of life? It is hard to tell if there is the evidence to support this. But the results point to a simple fact. If you want to get better at verbal memory, then practice your verbal memory skills. If you want to get better at anything, then practice doing it.

Was this piece of news yet another attempt by mainstream media to clog paper space with information – arguably useless? You decide.

A short history of non-medical prescribing

It had long been recognised that nurses spent a significant amount of time visiting general practitioner (GP) surgeries and/ or waiting to see the doctor in order to get a prescription for their patients. Although this practice produced the desired result of a prescription being written, it was not an efficient use of either the nurses’or the GPs’time. Furthermore, it was an equally inefficient use of their skills, exacerbated by the fact that the nurse had usually themselves assessed and diagnosed the patient and decided on an appropriate treatment plan.

The situation was formally acknowledged in the Cumberlege Report (Department of Health and Social Security 1986), which initiated the call for nurse prescribing and recommended that community nurses should be able to prescribe from a limited list, or formulary. Progress was somewhat measured, but The Crown Report of 1989 (Department of Health (DH) 1989) considered the implications of nurse prescribing and recommended suitably qualified registered nurses (district nurses (DN) or health visitors (HV)) should be authorised to prescribe from a limited list, namely, the nurse prescribers’formulary (NPF). Although a case for nurse prescribing had been established, progress relied on legislative changes to permit nurses to prescribe.

Progress continued to be cautious with the decision made to pilot nurse prescribing in eight demonstration sites in eight NHS regions. In 1999, The Crown Report II (DH 1999) reviewed more widely the prescribing, supply and administration of medicines and, in recognition of the success of the nurse prescribing pilots, recommended that prescribing rights be extended to include other groups of nurses and health professionals. By 2001, DNs and HVs had completed education programmes through which they gained V100 prescribing status, enabling them to prescribe from the NPF. The progress being made in prescribing reflected the reforms highlighted in The NHS Plan (DH 2000), which called for changes in the delivery of healthcare throughout the NHS, with nurses, pharmacists and allied health professionals being among those professionals vital to its success.

The publication of Investment and Reform for NHS Staff –Taking Forward the NHS Plan (DH 2001) stated clearly that working in new ways was essential to the successful delivery of the changes. One of these new ways of working was to give specified health professionals the authority to prescribe, building on the original proposals of The Crown Report (DH 1999). Indeed, The NHS Plan (DH 2000) endorsed this recommendation and envisaged that, by 2004, most nurses should be able to prescribe medicines (either independently or supplementary) or supply medicines under patient group directions (PGDs) (DH 2004). After consultation in 2000, on the potential to extend nurse prescribing, changes were made to the Health and Social Care Act 2001.

The then Health Minister, Lord Philip Hunt, provided detail when he announced that nurse prescribing was to include further groups of nurses. He also detailed that the NPF was to be extended to enable independent nurse prescribers to prescribe all general sales list and pharmacy medicines prescribable by doctors under the NHS. This was together with a list of prescription-only medicines (POMs) for specified medical conditions within the areas of minor illness, minor injury, health promotion and palliative care. In November 2002, proposals were announced by Lord Hunt, concerning ‘supplementary’prescribing (DH 2002).

The proposals were to enable nurses and pharmacists to prescribe for chronic illness management using clinical management plans. The success of these developments prompted further regulation changes, enabling specified allied health professionals to train and qualify as supplementary prescribers (DH 2005). From May 2006, the nurse prescribers’extended formulary was discontinued, and qualified nurse independent prescribers (formerly known as extended formulary nurse prescribers) were able to prescribe any licensed medicine for any medical condition within their competence, including some controlled drugs.

Further legislative changes allowed pharmacists to train as independent prescribers (DH 2006) with optometrists gaining independent prescribing rights in 2007. The momentum of non-medical prescribing continued, with 2009 seeing a scoping project of allied health professional prescribing, recommending the extension of prescribing to other professional groups within the allied health professions and the introduction of independent prescribing for existing allied health professional supplementary prescribing groups, particularly physiotherapists and podiatrists (DH 2009).

In 2013, legislative changes enabled independent prescribing for physiotherapists and podiatrists. As the benefits of non-medical prescribing are demonstrated in the everyday practice of different professional groups, the potential to expand this continues, with consultation currently under way to consider the potential for enabling other disciplines to prescribe.

Migraines could be a headache of the past

Is there hope for the many millions of migraine sufferers in the United Kingdom and around the world? Researchers at King’s College Hospital certainly believe that this is the case. While they are cautious about the findings of their latest research, the results certainly are one that point towards optimism for migraine sufferers.

It is estimated that the number of migraine attacks everyday in the UK number over 190,000. This figure was estimated by the Migraine Trust, and it was probably obtained by taking a sample size of the population, taking into account the number of migraine attacks experienced within that group and then multiplying it by the general population in the United Kingdom. This of course means two things: firstly, the figure was proposed by a group that has an interest in promoting awareness about migraines and is hence slightly biased, probably over-estimated. Secondly, bearing in mind that the UK population is over 66 million, and it is unlikely that the Trust surveyed 1 million people – or even anywhere near that – any differences could have been amplified by over 66 times.

What is the difference between a migraine and a normal headache? A migraine is a headache which happens frequently. Migraines themselves are classed as two types. Headaches which happen more than 15 days a month are known as chronic migraine, while episodic migraine is a term used to describe headaches which happen less than fifteen times a month.

The research uncovered that a chemical in the brain was involved both in the feeling of pain and sensitivity to sound and light. This chemical is known as calcitonin gene-related peptide, or CGRP. If CGRP is neutralised, or if part of a brain cell which it interacts with is blocked, then pain receptors are dulled and migraines are reduced.

There are currently four drug companies in the race to develop a CGRP neutraliser.

Race is an accurate term, for the company that develops and trials the drug successfully may win the patent for developing and marketing the drug over twenty years. Drug companies or pharmaceuticals are normally granted that period to reward them for the time and cost invested into research.

One such company, Novartis, trialled an antibody, erenumab on episodic migraine sufferers. Those who took part in the trial suffered migraines on an average of eight days a month.

955 patients took part in the trial and half of those who received injections of erenumab successfully halved their number of migraine days per month. 27% of patients also reduced their number of migraine days without treatment. The results suggest that the drug was successful, particularly as it worked for over 450 people, and that if it were used for those with chronic migraine it might be equally successful. Even if the same percentage were maintained (50% vs 27%), the number of working days saved by migraine prevention could have significant savings for the economy.
Another pharmaceuticals company, Teva, produced another antibody, fremanezumab, and trialed it on 1130 patients. Unlike Novartis’s trials, the participants in Teva’s were those with chronic migraine, with over 15 or more attacks each month. In the Teva trial, 41% of patients reportedly halved the number of days that they suffered migraine attacks. 18% reported the same effect, so the confidence interval in the trial is pretty high and suggests a high degree of positive use.

The study is very important and useful because of the understanding it offers in treating migraine, and the medical products can reduce the frequency and severity of headaches. It makes for fewer days lost to the disease and more positive, functioning people.

Besides CGRP antibodies, there are other current treatments for migraine such as epilepsy and heart disease pills. Even botox is sometimes used. However, all three come with side-effects and are not necessarily the best for everyone.

The hope is that CGRP antibodies, which are traditionally more expensive to manufacture, will in the long term be available at a more affordable cost, and would benefit those who currently get no benefit from existing therapies.

If the estimation that one in seven people live with regular migraine is accurate, migraine reduction could have significant life-improvement effects for humans. Chronic migraine is in the top seven disabling conditions and improvements in understanding it and how to manage it would not only improve the quality of life for those who suffer with it, but also in reducing the number of work days lost for the economy. But the benefits do not just remain with migraine sufferers. Having to live with chronic disabling conditions often leads to other symptoms such as depression. Who knows? Perhaps CGRP antibodies may even negate the effect of depression, resulting in a secondary effect. It may be possible that those who suffer from migraine alongside depression may even not require treatment for the latter if the CGRP antibodies prove to be effective.
Can you imagine a world without anti-depressants? At the moment millions live on some pain-relief medication of some sort. It would be great if they could be phased out. Although it might not be so great for the economy!

Should we be excited about the results? Well, yes. The combined large sample size of both studies, of over 2000 migraine sufferers showed that there was some weight behind the study compared to if – for example – it had been done only on one hundred participants. Secondly, while the research was undertaken by pharmaceutical companies, the outcome was actionable, meaning that it produced a result that was useful, rather than one that merely formed the prelude to a more extensive study. In previous posts I demonstrated how some – such as the coffee umbrella review – did not produce any significantly useful outcome. But we know from this particular research that it may work to neutralise either CGRP, or lessen its interaction with the particular brain cells in order to lower the effect of migraine.

Did the media have a field day with this? Unsurprisingly, no. You see, good research does not lend itself to sensationalist headlines.

Is there any truth about the benefits of Classical music?

Is there any truth to the commonly accepted notion that listening to classical music improves mental capacity? Somehow it has been accepted in modern society that classical musicians have larger frontal cortices, better mental reasoning powers and perhaps intelligence quotients. Over the last two decades or so this idea has fuelled a rise in the number of pregnant mothers listening to classical music – whether or not they like it – and parents enrolling their children into music classes. The music of Mozart, in particular, has enjoyed a resurgence as its classical form is deemed to be more logical and organised, compared to music of other periods, assisting in triggering patterns of organisation in the brain amongst its listeners.

How did this idea about Classical music come about? In the 1990s scientists conducted a series of experiments where one group of students were played one of Mozart’s piano sonatas before a spatial reasoning test, while another group sat in silence. The group that was played the music beforehand performed better on that task than the control group. The effect on the control group was temporary and only lasted fifteen minutes, meaning that after the fifteen minute mark the disparities between the results were minimal and statistically the same. The results of the group found also that while music primed the individual particularly for mathematical tasks, after an hour of listening to Classical music, the effect on the brain was lost.

That piece of research was pounced on by the media and other individuals and seemingly perpetuated to promote the listening of Classical music. One governor of the state of Georgia even decreed that newborn babies be given a copy of a CD of Mozart’s works upon leaving the hospital. The Mozart Effect, to give it its common name, was written about in newspapers and magazines, and this began the spur of Mozart-related sales of music as well as the trend of mothers playing such music to their children in and out of the womb.

The most important question we need to ask is whether there is any truth in such research, and whether it can be corroborated.

We know that some forms of music has a soothing, calming effect on individuals. Playing the music to the students may have calmed that so they were not nervous, allowing them to perform better on the task. However, relaxation need not take them the form of Classical music. Any activity that promotes calm before a task – reading a light magazine, playing computer games, talking with a friend – can also hence be said to have the same effect as the classical music that was played.

What if the students in the group had read a joke book or comic beforehand, been less worried about the test and scored better? It might have prompted a deluge of articles claiming “Reading Archie (or The Beano – insert your own title here) improves your IQ”.

Or if the students had been offered a protein drink beforehand, it would not be inconceivable that someone would latch to that piece of research and declare that “Protein Drinks not just good for your body, but for your brain too”.

Mozart’s music has been said to embody the elements of classical music as we know it. Organised formal structures, chords and harmonies through related keys, use of contrasting tunes, contrasts in volume all feature in his music. But the music of other composers have such features too. Imagine if the composer Josef Haydn had been the lucky beneficiary of the experiment and his music had been played instead. The sales of his music catalogue would have hit the roof!

Subsequent scientists all found that listening to music of any form caused improvements, and the genre of music – whether rock or Classical – was irrelevant. But studies today still quote Mozart.

Is it ethical that the media promotes unsubstantiated research by reporting without closer scrutiny? As we have seen in previous blogs posts, the media reports on things without necessarily scrutinising the evidence, and entrusts so-called experts to corroborate the evidence, while it fills column inches and air time with modal auxiliary verbs? Huh? In simple terms, it means that if there is a sniff of a link between A and B, the media reports that “A could cause B”. Never mind whether it does or not, there is always the disclaimer of the word “could”.

In this instance, students performed better on a spatial reasoning task after listening to Mozart; hence the headline “Mozart could improve mental powers”. Diluted over several recounts, you could get “According to XXX newspaper, Mozart improves brain power” before arriving at “Mozart improves brain power”. Unfortunately, this is when the headline is then pounced on by anyone who would stand to profit from espousing this theme.

Who would profit from this? The Classical music world – performers, writers, musicians – can use this “research” to entice people into taking up lessons and buying CDs and magazines. If you read any music teacher’s website you may find them espousing the benefits of learning music; it is rare if you find one that advises it is a lot of effort.

The media will profit from such “research” because it means there is an untapped well of news to report and bleed dry in the quest for filling column inches and air time. News exclusives will be brought out, and so-called experts will also profit for appearing on the news and programmes, either monetarily or in the form of public exposure.

One must question the ethics of incorrect reporting. Unfortunately unsubstantiated research leads to more diluted misreporting, which can then form the basis of new research – research that uses these claims as the groundwork for investigation.

It is scary to think that all the medical research that has been done into effect of music and health could be biased because of the so-called effect of classical music. Could musical activities such as learning the piano help reduce Parkinson’s disease? Could listening to the music of Beethoven reduce the incidence of higher cases of Alzheimer’s disease? Could it all be wrong – have we all been sent down the wrong tunnel by an avalance of hype reporting?

It may be fair to say the human impulse is to buy first and consider later, because we are prone to regret. If we have missed an opportunity to improve the lives and abilities of our children, then we will be kicking ourselves silly forever with guilt.

So if you are still not convinced either way about whether classical music – either in the listening or the practice – really does have any effect, you could at least mitigate your guilt by exposing your child to piano music, for example that has predictable patterns in the left hand. Sometimes, listening to structurally-organised music such as from the Baroque may be useful, but it is also good to listen to Romantic music because the greater range of expression arguably develops a child that has more emotionally subtlety and intelligence.

You may find that ultimately, any truth in the research about Classical music and its mental benefits is not due to the blind passive listening, sitting there while the music goes on around your children. It is in the child’s inner drive to mentally organise the sounds that are heard, the trying and attempts to organise background sounds that really triggers the mental activity in the brain. It is more the practised ability in the inner mind to organise musical sounds that causes better performance in related mental tasks.