Does the 5-second rule really work?

March 24, 2017 in Everyday Medicine, In the News, The Science Behind...

I’m sure you’re familiar with and maybe even ‘daring’ enough to use the 5-second rule, but a news article this week has brought this question to my attention as Professor Anthony Hilton has decreed that it’s indeed true, to a degree. For those of you who actually don’t know what it is, the 5-second rule suggests that if food is dropped on the floor, it can still be eaten if it is picked up within a window of 5 seconds.

 

Notably since 2003, scientists have been making attempts to prove or disprove this theory with Jillian Clarke starting the proceedings by proving that foods will be contaminated- even with brief exposure- to a floor inoculated with E.coli. She did, however, also find that there was little evidence that public floors are in fact contaminated. In 2006, another study found that bacteria could thrive under dry conditions for over a month and that contamination does increase as the food is left on the floor for longer.

Researchers at Rutgers University tested extensively using different surfaces and foods with a total of 2,560 measurements to find that wet foods pick up more contaminants than dry, and that carpet is surprisingly a better surface than steel or tile when it comes to transference of bacteria. Lead researcher Professor Schaffner states, “Bacteria can contaminate instantaneously” and the evidence agrees, but does that answer the question?

As previously mentioned, Anthony Hilton at Aston University led a study in 2014 which found much the same as Schaffner’s yet suggests such results support the 5-second claim. Whilst he accepts that bacteria is inevitably picked up and that eating food from the floor is never “entirely risk-free”, he also points out that the research shows food is unlikely to pick up harmful bacteria from the few seconds spent on the floor. Furthermore, he has said there should be little concern about food that has touched the floor for such a short time. I think that this conclusion rings true with more of the general public than the latter, with 79% of 2000 people admitting to eating food that had fallen on the floor.

 

My view is that most people do not truly believe zero bacteria is picked up in those precious 5 seconds, but assume that the amount is negligible and neither numerous nor dangerous enough to cause any harm. The science does show that the longer food is on the floor, the more bacteria is picked up and in those first 5 seconds any harm from said bacteria is unlikely. Therefore, I would argue that the 5-second rule does work, but really it is up to personal preference and circumstance. But if you’ve dropped a slice of watermelon (made up of 97% water) on a visibly dirty tile, I’d say give it a miss- it’s just common sense…

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A Look Back at Anaesthesia

March 18, 2017 in History

An anaesthetic is a substance that induces insensitivity to pain with anaesthesia literally meaning ‘without sensation’. Anaesthesia is used in modern times on a day to day basis, during tests and surgical operations in order to numb areas of the body or induce sleep. The types which you are probably most aware of, local and general, are the two most common but there are other types such as regional anaesthetics and sedatives.

Anaesthetics may not be perfect, with c.10 deaths for every million anaesthetics given in the UK, however developments over the years has made the use of anaesthesia to be considered very safe with serious problems being rare. I’m taking a look back in time to see how anaesthesia- more specifically general- has changed over the last 2 centuries.

 

 

Starting in the 1820s, Henry Hickman explored the use of carbon dioxide as an anaesthetic to perform painless surgery on animals. Carbon dioxide could be used to effectively suffocate the animals out of consciousness for a long enough time to perform the surgery. This is considered to have been a major breakthrough in surgery and anaesthesia, however carbon dioxide wasn’t used widespread due to the risks associated with partial asphyxiation and Hickman’s work was heavily criticised at the time. In more recent times, carbon dioxide was said to be used for medicine in the USA during the 1950s and is currently used before slaughter in numerous slaughterhouses.

 

Ether had a reputation as a recreational drug during the 1800s but in 1842 it was used for the first time as an anaesthetic by American physician William Clarke in a tooth extraction. That same year, Crawford Long used it to remove a tumour from a man’s neck although he did not publish an account of until several years later, in which he described that the patient felt nothing throughout the procedure.

Morton gave the use of ether popularity when in 1846 he removed a tumour from a man’s jaw. News of the operation travelled round the world quickly and ether became a widely adopted method with Morton often being credited as the pioneer of general anaesthesia. Ether did have it’s drawbacks though, causing coughing in patients and being highly flammable meaning research in anaesthesia continued to develop.

 

Humphrey Davy discovered that nitrous oxide could dull pain in 1799, however the use of nitrous oxide as an anaesthetic wasn’t fully realised until 1844. Horace Wells attended a public demonstration of nitrous oxide by Gardner Colton and the very next day Wells himself underwent the first ever reported painless tooth extraction while Colton administered nitrous oxide. Nitrous oxide is still used today, you may know it better as ‘laughing gas’, in dentistry and childbirth and even recreationally as the 4th most used drug in the UK (according the Global Drug Survey 2015). Of course, nitrous oxide only dulls pain so could not and cannot be used in major surgery unless used in conjunction with other anaesthetics.

 

You may have heard that Queen Victoria used chloroform during the birth of her 8th child in 1853, but it had actually been around 6 years beforehand and was met with a lot of opposition preceding said event. Scottish obstetrician James Simpson was the first to use chloroform to relieve the pain of childbirth in 1847, and it widely replaced the use of ether as it was quicker acting, didn’t smell as pungent and had fewer side effects. Nevertheless, it was met with opposition mainly due to deaths and religion.

Some religious people believed it was God’s intention for women to feel pain during childbirth so such pain should be endured, not relieved. At the time religion held a lot of power so this scared many God-fearing people away from chloroform. Meanwhile administration required great skill, as surgeons had to be experienced enough to give the right dose. As such the first reported death from chloroform overdose was in 1848. Chloroform fatalities were widely publicised but were mainly caused from poor administration, which was overcome when John Snow invented the chloroform inhaler which controlled the dosage to make the anaesthetic safer and more effective. When Snow used the inhaler to anaesthetise Queen Victoria, the positive publicity left little opposition remaining. The use of chloroform has since been discontinued as it was realised that chloroform could cause liver and heart damage.

 

Skipping forward to 1934, when sodium thiopental was made as the first intravenous aesthetic (injected into bloodstream). It was founded by Ernest Volwiler and Donalee Tabern, both working for Abbott Laboratories and a clinical trial of thiopental at the Mayo Clinic was conducted 3 months later. It rapidly entered common practice as it was short and fast acting (4-7 minutes and 30 seconds respectively), and the fact that it was intravenous allowed for more precise dosage. Volwiler and Tabern were inducted into the National Inventors Hall of Fame in 1986, and thiopental is still used in conjunction/before other anaesthetics although not alone because its effects do not last long enough to be of practical value. Since the 1980s thiopental has been slowly replaced by propofol as it too is short and fast acting but also has antiemetic properties (prevents nausea and vomiting).

 

Halogenated inhaled agents are routinely used today and it could be argued that their emergence transformed anaesthesia as much as chloroform did over 100 years prior. Halothane was first synthesised by C. Suckling in 1951 and first used clinically by Dr Johnstone in Manchester 5 years later and is still widely used in developing countries and veterinary surgery because it is low cost. Following halothane came enflurane(1966), isoflurane(1979), sevoflurane(1990) and finally desflurane(1990s). These halogenated inhaled agents have the beneficial properties of low solubility (meaning they take rapid effect), minimal cardiorespiratory depression and non-flammability. Despite these characteristics, halogenated agents only cause lack of consciousness and do not relieve pain so are used in conjunction with other anaesthetics.

 

Curare was traditionally used on poison darts and arrows by aboriginal people and became the first non-depolarising muscle relaxant (blocks the agonist from binding to receptors) in 1942. Neuromuscular blocking drugs like curare can be used to produce paralysis, allowing intubation of the trachea and to optimise the surgical field. Endotracheal intubation is important as it is used to administer gases like the halogenated inhaled agents, and to aid ventilation of the lungs. The fact that muscle relaxants basically paralyse the muscle means that muscles cannot contract, enabling surgery to be performed as best and safely as possible. Patients can still feel pain at full intensity with the use of muscle relaxants but cannot move, so analgesics (pain relieving drugs) are often also given to prevent anaesthesia awareness.

 

As you can see, anaesthetics has changed a lot in the last 200 years and anaesthesia is now an entire section of medicine in its own right. Nowadays, general anaesthetic cannot be given to a patient without a trained anaesthetist, dosage is carefully controlled and a combination of anaesthetics can be used to achieve the ideal effect.

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The Science Behind Clinodactyly

March 10, 2017 in The Science Behind...

The word ‘clinodactyly’ stems from the Ancient Greek meaning “to bend” and “digit”, and that is basically what this genetic abnormality is. I first became interested in this when I noticed my younger sister’s little finger was bent inwards, although until now I’d always assumed that it was nothing…

 

Clinodactyly is the medical term used to describe when a finger or toe is curved or bent at an angle, usually with an incline between 15° and 30°. The condition affects about 10% of the population and is passed on through inheritance. It may present either as an isolated anomaly or as part of an associated syndrome, for example a significant percentage of individuals with Down syndrome also have clinodactyly. The condition occurs more in boys than girls and is visible as soon as the child is born.

In most cases, clinodactyly is caused by the growth plate in the hand (or foot) being an abnormal shape or having an abnormal orientation, so the bones do not grow at 90° to the finger axis. Treatment is only necessary if the digit is bent enough to cause disability or emotional distress, in most cases a person with Clinodactyly can use their hands or feet normally. If surgery is required due to inference with function, the procedure involves making a small incision on the affected finger or toe and cutting the bone to correct the deformity. The finger is then stabilised until the bone and soft tissue has healed. Most of the time, surgery is successful however there is a risk that the digit reverts resulting in the need for future surgery.

 

So that’s just a short and simple post about a minor abnormality that you’re likely to see everywhere, now that you know about what you’re looking for.

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Technology & Medicine

February 24, 2017 in In the News

Technology has integrated itself every aspect of life and medicine is no exception. From 3D printing of organs to genetic engineering of embryos, advances in technology directly link to advances in medicine and here’s just a couple examples of present and future applications of it…

 

Walking around a city centre, you probably don’t notice the AED machines that you may pass in train stations, shopping centres and leisure centres but from now on I implore you to take a notice, as you could save a life. Yes, you! The great thing about the automated external defibrillator is that it’s designed for non-medical people (laypersons) with simple audio and visual commands to guide the user through the appropriate steps to be taken- although it would ideally be used by someone who has received AED training.

It is used in cases of cardiac arrhythmia  (irregular heartbeat) leading to cardiac arrest. However, AEDs aren’t designed to shock asystolic patients (flatline) so it is very important that CPR is carried out before the AED is used, and during if you are instructed. An AED is ‘automated’ because of the unit’s ability to automatically diagnose the heart rhythm and determine if a shock is needed. Following a shock, most devices will analyse the patient and either instruct the user to give CPR or administer another shock. An AED is likely to have an ‘event memory’ also, which stores the ECG of the patient along with details of the number, strength and time of any shocks delivered. So keep a look out for any AED machines in public settings and should you ever be in a position where have to use one, be grateful that in that admittedly pressured environment the automated external defibrillator will do most of the legwork for you.

 

Virtual reality is an immersive simulation of a 3D environment, created by technology and experienced by movement of the body. It has been used in gaming for some time now, but has been branching out into many more sectors including usage in museums, education and military training as the technology for VR has advanced. And now, a team of Cardiff University psychologists are working to develop virtual reality environments to help with the diagnosis and rehabilitation of patients suffering from visual vertigo.

Symptoms of visual vertigo include dizziness and nausea, these can be sparked by various environments depending on the sufferer and can be so debilitating that in some cases a patient cannot even leave their house. It is very difficult to rehabilitate patients as it cannot be fixed quickly and patients have to be seen multiple times. By using VR, the team in Cardiff have flexibility over the different environments they can show to patients- this will allow them to find out a patient’s individual trigger and subsequently tailor specific rehabilitation therapies.

Immersive VR therapy could also be used to rehabilitate stroke and brain injury victims to help them regain motor and cognitive function faster. What’s more, the exercises could be made to feel like games to motivate patients to practice everyday. Whilst little in the way of virtual reality in medicine has been implemented yet, it does look very promising and I am keen to see further research into it…

 

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Euthanasia- Should it be legalised in the UK?

February 18, 2017 in Difficult Debates

Untitled

There is no doubt that euthanasia is a difficult debate, with passionate views  both for and against it. Assisted suicide has been legal in Oregon since 1997, and assisted suicide and euthanasia have been legal in the Netherlands since 2002- so why, in 2017, is no form of assisted suicide or euthanasia legal in the UK?

 

First, what is euthanasia? Euthanasia is the act of deliberately ending a person’s life to relieve suffering. Meanwhile, assisted suicide is the act of deliberately assisting or encouraging another person to kill themselves.

Euthanasia can be defined as active or passive and voluntary, non-voluntary or involuntary. Active euthanasia is when a person directly ends someone’s life, for example giving a person a lethal injection. Passive euthanasia is when a person causes death by withholding or withdrawing treatment which is necessary to maintain life, for example taking a person off a life-support machine.

Voluntary euthanasia is when a person wants to die and involuntary euthanasia is when a person is killed against their express wishes. Non-voluntary euthanasia is when a person is unable to give consent so another person makes the decision on their behalf, for example if a person is in a coma.

 

Under English law, euthanasia is regarded as either manslaughter or murder and is punishable with a maximum penalty of life imprisonment. Assisted suicide is also illegal and punishable with up to 14 years imprisonment.

Active euthanasia is legal in Belgium, the Netherlands, Luxembourg and Colombia. Assisted suicide is legal in the Netherlands, Oregon, Washington, Vermont, Montana and Switzerland.

One of the few doctors in Britain charged with attempted murder was Dr Nigel Cox in 1992. He injected his patient of 13 years, Lillian Boyes (70 years old) who had rheumatoid arthritis, with potassium chloride in order to stop her heart. She was said to have pleaded with him to end her life and during the court case, Ms Boyes’ family never wavered in their support of the doctor’s actions. Dr Cox was charged with attempted murder because it couldn’t be proved that the injection itself killed her and he was given a 12-month suspended sentence.

 

The principle of autonomy can be used to argue for the legalisation of euthanasia. In medicine, autonomy is the right of competent adults to make informed decisions about their own medical care. This means that patients have the right to refuse medical treatments and to decide what happens to their body after they die (for example, donating organs). It could then be argued that patients should also have the right to die, and that making euthanasia illegal does not allow for complete patient autonomy.

This must be weighed against beneficence. Doctors are meant to ‘do no harm’ and do what’s in the best interest of the patient. Therefore, it is questionable whether or not ending a patient’s life is breaking a doctor’s code of conduct. However, one could argue that as long as the patient understands every facet of the decision at hand and would still like to end their life, then it is a doctor’s duty to help them do so. As well as beneficence, there is fear that the legalisation of euthanasia could damage the doctor-patient relationship. Patients could begin to lose trust in their doctors, and believe that the doctor does not have the patient’s best interest at heart but instead just want to ‘get rid of them’.

 

The law against euthanasia can be unfair, as it does not allow those wanting to end their lives to do so in a safe and peaceful manner. Without an assisted dying or euthanasia law people try to commit suicide in private, ending their lives at home and alone as they cannot talk to their family or doctor about the decision. People should not be forced into such circumstances, and should be able to say a proper goodbye and be with loved ones if they still make the decision to die.

Also, people may instead decide to travel abroad to die (e.g: Dignitas in Switzerland) because they cannot die how they want to in the UK. A trip like this can cost up to £10, 000 and people are often in pain, so travelling may put them in distress. Furthermore, a person wanting to die may journey abroad sooner than is necessary as they fear that if they stay in the UK, they will miss their chance to leave by becoming too ill to travel.

 

Many people believe that the government should not be able to intervene in personal matters like death. In the past and even currently, should the government introduce a policy for vaccination it is met with a flood of opposition and yet the government can make assisted dying illegal? It is a fair argument to say that the state should not create laws that prevent people from being able to choose when or how they die, as that is not the purpose of the government.

Despite that, the government do have a duty to protect those who are vulnerable such as the ill, elderly and disabled from feeling pressured into ending their lives and being exploited. In 2015, MPs rejected the legalisation of assisted dying in England and Wales with 330 votes against and 118 in favour- this shows that clearly the government is nowhere near legalising assisted suicide or euthanasia with such an overwhelming majority voting against it.

 

A sizeable proportion of those opposing euthanasia argue on religious grounds; human life is sacred and only God has the right to take life away. Some go as far as to say that the pain terminally ill people may experience in death is just another test set by God, similar to some of the reasoning behind refusal of chloroform use during childbirth when it was first discovered in Victorian times.

However, not all religious people do oppose euthanasia. In the above mentioned rejected bill a Rabbi said, “We are saddened that it failed to progress, as it dashes the hopes of those who wish to avoid ending their days in pain or incapacity”. Like with many other things in religion, opinions of euthanasia is dependent on personal understanding and observance of religious teachings thus can vary from person to person.

 

Religious and atheist people alike argue that euthanasia devalues life in society’s eyes, making it easier to end lives and accepting that some lives are worth less than others. This is one of the more potent arguments against euthanasia, as it links to the ever prevalent ‘slippery slope’ issue. The concern that legalising voluntary euthanasia might lead to allowing non-voluntary and involuntary euthanasia is at the forefront of most people’s mind when discussing euthanasia, and with good reason.

Nevertheless, the very fact that people are so apprehensive of the ‘slippery slope’ means that if euthanasia or assisted suicide was legalised, people would be vigilant and safeguarding would be put into effect to ensure no one was pressured into ending their lives and that any euthanasia carried out was definitely voluntary. What’s more, Oregon is a working model and proof that the slippery slope is not inevitable. Assisted suicide for the terminally ill has been legal for almost 20 years in Oregon and there have been absolutely no cases of abuse reported. The UK would not be the first to legalise euthanasia and we could use the methods in places like Oregon and the Netherlands as a template for our own laws.

Likewise, another case made against euthanasia is that it could lead to a lack of compassion in doctors as they become used to ending lives although I think this is unlikely as such fears are voiced about abortion yet it has not happened in the 50 years that abortion has been legalised.

 

The final and perhaps simplest argument against legalising euthanasia: with modern medical care and pain relief, there is no reason that in the right environment a person can’t have a dignified and painless death. So is legalisation of euthanasia or assisted suicide really necessary?

Sadly, not all people would agree. Quality of life is very subjective and impossible to truly measure, so we cannot decide for other people whether they’re life is worth living or not. Despite the alternatives to ending one’s life, such as palliative care, if a person believes their pain is too great for them to  bear then no matter how great the alternatives are, euthanasia should be available to them should they request it as it is almost cruel to force people to live and adds to their pain.

 

In conclusion, euthanasia is possibly one of the toughest and most serious medical ethics debate but it is important to think and form opinions about it. The 2015 vote was the first ever serious attempt to change Britain’s assisted suicide laws in the House of Commons in at least 20 years, but that was only the beginning. Currently, a man with Motor Neuron Disease (Noel Conway) is seeking a judicial review of the Suicide Act of 1961 and other countries have increasingly been changing their laws to support assisted suicide and even euthanasia in the last 10 years.

I think, on balance, that I would support a change to the law regarding assisted suicide and euthanasia. Whether or not I agree with euthanasia is besides the point because for me, I see this as a choice issue and I believe people should be given that choice as it is not fair that the law forces the opinions of those opposed to euthanasia on those in need. That said, if it ever is legalised in the UK, the law must support and protect both those who wish to end their lives and those who do not to ensure that there is no abuse at the same time as providing mercy to those who ask.

 

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The Science Behind Popcorn

February 4, 2017 in The Science Behind...

London Empire

Ever wondered why popcorn pops? Or how a little kernel of corn becomes a tasty snack with just a little bit of heat? Well, whether you have or not I am about to explain the science behind popcorn!

 

First, how does the kernel become popcorn? The kernel is made up of three parts; the pericarp, germ and endosperm. The pericarp is the outer shell surrounding the kernel which is the key to making it pop, and the endosperm contains some trapped water-as well as starch granules which serve as food  for the germ when it sprouts.

Anatomy of a kernel

When heated to above 180°C this trapped water expands into steam, building up pressure inside the pericarp. This steam transforms the soft starch grains in the endosperm into gelatinous material, making it softer and more pliable. When the pressure builds up to above 930 kPa, the pericarp ruptures thus releasing the steam and gelatinous starch (basically turning the kernel inside-out) that solidifies when cooled.

 

So that’s what’s happening in the microwave, but when does the familiar popping sound occur? A study carried out by two French physicists shows the sound is caused by the release of the water vapour. The sudden change in pressure when the steam escapes causes the cavities in the kernel to vibrate and produce that ‘pop’ sound. The researchers also found out why popcorn flies about whilst being cooked, and it’s not actually due to the pop sound. From the ruptured pericarp, a ‘leg’ shaped structure made of starch forms which is compressed under the heat, and then propelled into the air by the ‘leg’ as it expands. The shape of this jump actually mirrors the movement of a gymnast doing a somersault!

 

Popcorn is the only grain in the corn family that pops when heated in this way, but we all know that not every kernel does pop. At the bottom of every bag of popcorn, there’s a handful or less (if you’re lucky) of unpopped popcorn kernels, but why? To start, the optimum percentage of water in kernels for best popping is 14%. Any lower, and the kernels are smaller and fewer will pop. Most popcorn is harvested in the autumn with a moisture level of 16-20% but are then dried out by forced air to reach that optimum level.

Another thing to think about is the structure of the pericarp. In a study comparing 14 different genetic varieties of popcorn they found that best popping kernels had a stronger, more ordered crystalline structure of cellulose (which is what the pericarp is mostly made up of). This is because during heating, the pericarp acts as a pressure cooker that locks the steam inside the kernel until enough pressure builds up for the kernel to rupture and pop. The researchers showed that the stronger crystalline structure tended to maximise moisture retention, leading to a more complete rupture and fewer unpopped kernels. How this information can be used to ensure that we find fewer kernels at the bottom of the bag isn’t clear, but possible techniques include selective breeding of the best kernel varieties or genetic engineering of the corn plant.

 

Regardless of those few disappointing kernels, popcorn is one of the world’s favourite snacks with some nutritionists calling it a perfect snack food because it is whole grain, a source of fibre and low in fat. It also has more protein that crisps gram for gram and is a great way to stave off hunger cravings as it’s mostly air. So treat yourself with this fabulous snack and listen out for that snap, crackle and most importantly: pop!

 

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The Immeasurable Weight of Music

January 27, 2017 in Everyday Medicine

Piano

I feel confident in saying that music is part of everyone’s lives and for many it plays a big part. Playing, producing and writing music brings enjoyment to those who do it and to those who listen and there are so many different types that you are sure to love at least one. I’m sure everyone has heard the theory ‘Mozart makes you smarter’ but there are actually a multitude of proven effects that music has on your brain and body, and I’d like to fill you in on them…

 

Medically, music can be used as it’s own form of treatment as it can reduce pain, blood pressure and boost immunity. Listening to music has been known to reduce pain from a range of conditions including arthritis. Part of this could be thanks to the endorphin release caused by music which counteracts the pain, but another fact is that music distracts and relaxes patients thus making the pain less predominant in the patient’s mind. This tends to work best if the patient listens to their own preferred music, whatever that may be, meanwhile playing relaxing or classical music is necessary to reduce blood pressure as well as slow breathing and heart rate.

Research shows that listening to music with a repeated 10-second rhythm results in a lower blood pressure. Examples of such music include Beethoven’s symphony no. 9 adagio from the 3rd movement or Schubert’s Ave Maria in Latin (translations change the pace and rhythm). Other research shows that by playing such music for 30 minutes everyday, people with high blood pressure can ‘train themselves’ to have a lower blood pressure. In this case, using rock, pop or faster classical music has no effect on blood pressure, and could even cause an increase. Whilst you may be unexcited at the prospect of having to listen to classical music, this would make further introduction of music therapy in medicine very simple as it wouldn’t need to be tailored to each patient.

Studies also show that listening to music can boost your immune system. Scientists found that after listening to 50 minutes of happy dance music, the levels of antibodies in the 300 test subjects had increased and cortisol levels (which can weaken the immune system) had decreased. However, the researchers didn’t test the affect of different music genres on immunity, so listening to your favourite music (if it’s not dance) could boost immunity just as much as dance music might.

 

Now here’s a fun tip which might’ve been handy to my mum 16 years ago, as it could’ve saved her quite a few sleepless nights. Playing music to your babies before and after childbirth could make them fall asleep in those testing first weeks. In 2001 the University of Leicester’s Music Research Group followed a group of mothers who played the same piece of music to their babies during the last trimester, and found that the babies could recognise that same music up to 12 months after being born. As a result when mothers played the music, the babies would fall asleep faster and sleep longer than babies who didn’t hear music.

As for intelligence, scientists aren’t 100% sure that ‘Mozart makes babies smarter’ but music does have the power to enhance reading and literacy skills, mathematical abilities, emotional intelligence, creativity and memory. Music with a 60bpm beat pattern, such as Mozart and Baroque music, activates both sides of the brain. This maximises learning and your ability to absorb information. Plus, listening to the same music that you learnt/revised with (or ‘playing’ the songs in your head) helps you to recall information- although this only works if the music doesn’t have words.

Learning to play music can be even more beneficial, as there is evidence that musicians develop a better memory than non-musicians and when playing music both sides of your brain is engaged, making the brain more capable of processing information. One study showed that children that had been learning to play an instrument for three or more years performed better in fine motor skills and nonverbal reasoning. What’s more, a recent study at the University of Montreal has revealed that musicians have faster reaction times, performing on average 30% better than non-musicians. This leads us to believe that people that have played an instrument for a long enough time may be safer drivers due to these faster reactions. That said, another study has been done to show that when people listen to their choice of music as opposed to silence, drivers make more mistakes and drive more aggressively so perhaps music lovers don’t have the upper hand on the road.

Now, back to the listening of music. Anyone with writer’s block might want to try listening to music at a moderate noise level to improve creativity. The volume is important because the ambient noise increases processing difficulty, which stimulates our brains to think more abstract and creatively.  However in high noise levels, creative thinking is impaired and we struggle to process information.

Alternatively, you can crank up both the volume and tempo when trying to get a good workout. Music improves athletic performance by combatting fatigue, and improving motor coordination. In the same way that music can distract you from chronic pain, it also helps reduce the feeling of fatigue so that you can push through the pain and exercise longer and harder.

And after an optimal workout, you can use music to beat insomnia with Bach. Many people suffering from insomnia find that Bach music helps them, and research shows that just 45 minutes of relaxing music before bed can make for a restful night. Why? Relaxing music reduces sympathetic nervous system activity, decreases anxiety, blood pressure, heart and respiratory rate and promotes relaxation of tense muscles.

 

I’m sure that everyone knows of Albert Einstein to some degree, but a perhaps less well known fact is that music was the key that helped Einstein unlock that potential. Having done poorly at school and being advised to take a manual labour job, Einstein’s parents bought him a violin and Einstein himself claimed that the reason he was so smart was because he played the violin. He loved the music of Mozart and Bach the most, and a friend of his said that the way Einstein figured out his problems and equations was by improvising on the violin. I think that puts the power of music into some perspective, and is pretty inspiring.

To finish, whilst most studies look at the benefits of listening to classical music in particular, I would say that every music genre can be valued for it’s positive effects on listeners, even if it’s effects are as seemingly simple as making someone happy.

 

In addition to this week’s blog, I’ve also put together a table of supposed traits linked to different music genre fans. I’m curious to see if this information is any good, so why not compare yourself to your ‘assigned’ traits and comment to let me know if it’s accurate or not?

 

Self-esteem

Creative

Outgoing

Gentle

At ease

Hard-working

Pop

⬆︎

⬇︎

⬆︎

⬆︎

⬇︎

⬆︎

Rock

⬇︎

⬆︎

⬇︎

⬆︎

⬆︎

⬇︎

Soul

⬆︎

⬆︎

⬆︎

⬆︎

⬆︎

-

Indie

⬇︎

⬆︎

-

⬇︎

-

⬇︎

Classical

⬆︎

⬆︎

⬇︎

-

⬆︎

-

Jazz/Blues

⬆︎

⬆︎

⬆︎

⬆︎

⬆︎

-

Dance

-

⬆︎

⬆︎

⬇︎

-

-

Opera

⬆︎

⬆︎

-

⬆︎

-

-

Country

-

-

⬆︎

-

-

⬆︎

Rap

⬆︎

-

⬆︎

-

-

-

 

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A Broken Heart- Can you die from one?

January 21, 2017 in In the News

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It’s a romantic sentiment,  the idea that the death of a loved one or even a break up can ‘break’ your heart, but is it a real thing and could you actually die from one? Something I’d not considered until a news article a little while ago sparked my interest and got me researching, and here’s what I’ve found…

 

Broken heart syndrome, or in medical terms Takotsubo cardiomyopathy, is a type of non-ischemic cardiomyopathy (not caused by coronary artery disease) in which  the heart muscles are temporarily weakened as a result of emotional stress or physical stress, although in some cases even happier events trigger it such as winning a lot of money. Some drugs can also cause broken heart syndrome for example the epinephrine used to treat asthma attacks and allergic reactions.

The cause of broken heart syndrome is not exactly known, but it is thought to be linked to a surge in stress hormones like adrenaline which might temporarily damage the heart. How the hormones damage the heart is even less clear, the main idea being due to a temporary constriction of coronary arteries and another theory being that the hormones cause part of the heart to stop beating and another section of the heart to beat too fast or too hard.

 

So where does the name Takotsubo come from? Well, it comes from the Japanese word for an octopus trap because in Takotsubo cardiomyopathy, the left ventricle changes shape to develop a narrow neck and round bottom, thus resembling the fishing pot.

Other symptoms of Broken Heart Syndrome include chest pain, shortness of breath and ECG changes mimicking a heart attack. In some cases, people may also suffer collapsing, nausea and vomiting.

The symptoms might mimic a heart attack, but Takotsubo cardiomyopathy is clinically different in that the patients are at low risk of heart disease, are generally healthy prior to the triggering event and recovery rates are faster than with a normal heart attack. It can occur at any age, but in general affects post-menopausal women and those with past or present neurological or psychiatric disorders are at higher risk also.

So now we know that the ‘broken heart’ is a real thing…sort of… we can answer the real question; can you die from one? Most who experience Broken Heart Syndrome recover within two months, but in rare cases it can be fatal. There is a very low rate of complications like pulmonary edema (fluid in the lungs), hypotension (low blood pressure) or heart failure and unless there is an underlying heart problem, long term treatment or medication isn’t necessary.

As for dying from Takotsubo cardiomyopathy, there’s a  number of cases of elderly couples dying within weeks, days or even hours of each other and similar cases between mothers who lose children. However, given that only around 2% of ‘heart attacks’ are actually Takotsubo cardiomyopathy, the chances of then dying from it as opposed to the normal fast recovery is not exactly high. Of course it generally occurs in healthy patients, so there aren’t any preventative measures that can be taken except supporting grieving, anxious and stressed loved ones through tough (and sometimes successful) times.

The only thing left to say is that I think there’s something quite poetic about broken heart syndrome, a rather beautiful Shakespearian tragedy with a modern medical twist.

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Making the Burr Hole

January 13, 2017 in History

Trepanned Skull

‘Making a Burr Hole’ is just another way of saying trepanning. What is trepanning? Basically, it’s drilling a hole in the skull and is one of the oldest surgical procedures which has archaeological evidence.

I have recently been to London, and during my trip spent an afternoon in the Science Museum, which I would recommend to any science lover, prospective medic, history buff and it’s great for kids. During my visit, I visited the ‘Journeys Through Medicine’ exhibition which was super interesting, and sparked my interest in a lot of areas to do with medicine and the history of it all. It’s amazing to see how ideas and practices have changed over time, and this is just one such area that I’d like to talk about.

 

So, back to trepanning. It dates all the way back to prehistory, with evidence to say it was being used as far back as 6,500 BC. And the motivation? Medicine! Surely you’d assume that such a method at a time before even writing had been invented would never actually help and I’m sure it didn’t, yet people back then clearly believed it did because trepanning was used right up until Renaissance time.

During Prehistory, it may have been used to remove evil spirits which were believed to be causing pain, for example headaches or cranial injuries. However, given the lack of hard evidence about the purpose, much of it is up to speculation and some historians have found evidence to suggest that trepanning was used as part of a ritual, so perhaps not related to medicine.

What is really interesting is that with many of the trepanned skulls found in archaeological digs, the bone showed signs of healing which proves the ‘patient’ survived the procedure which says something about the prehistoric people, right?

 

Trepanning continued through the Ancient period with evidence of the scrapings of the skull being used to make potions in Ancient Egypt, and mentions of trepanning from Hippocrates (Greek) during which time the instrument used was similar to the modern trephine. Trepanning is also seen during Ancient Roman times with Galen specifying the risks associated with trepanning,

“If pressed too heavily on the brain, the effect is to render the person senseless as well as incapable of all voluntary motion”.

Over time we see the method become slightly more refined. For example during the Ancient Roman period, due to the frequency of war as Romans conquered more lands, army doctors gained lots of practice on wounded soldiers in basic first aid and surgery, leading to improvement in technique. What’s more, during the Ancient era the focus of trepanning began to shift towards dealing with trauma as opposed to superstitious beliefs.

However during the Medieval period, there were few developments and even some regression so typically a medieval surgeon would carry out trephining on an epileptic patient for similar reasons as they did during Prehistoric times.

Finally, details of ‘old-school’ trepanning appear during the Renaissance as Paré’s notes describe trepanning as the most commonly used procedure to treat skull fractures. He even provided an image of what trepanning tools of the Renaissance looked like!

 

Now, I know I said a long time ago but in fact trepanning is still used in the modern day. For example, trepanation is used in some modern eye surgeries like in a corneal transplant. It is also used in intercranial pressure monitoring and in surgery to treat subdural and epidural haematomas (blood clot) in which a craniotomy or burr hole is made to remove the blood. See the connection?

 

Thousands of years, and trepanning is still around in one form or another. That’s a lot of history, huh?

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The Key to Success

January 6, 2017 in Everyday Medicine

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So I have been pretty successful in my GCSEs, and since then people like to ask me what I did and what they can do to get the grades they need. And to be honest, I tend to start with the fact that there is no secret. Everyone learns and thinks in different ways so there isn’t a ‘right’ way to revise really.

 

Nevertheless, I am going to share with you my key to success or, should I say, keys…

Firstly, outlook is important. The tips mentioned later work best only if this fundamental concept is grasped. Anyone revising, or just generally studying, should not be doing the work for the sake of it or because their teacher has set it. You need to try to understand the reason that you do every piece of work, be it to increase knowledge, consolidate understanding, practice exam technique or develop analytical thinking. If you can see the reason behind everything and stop thinking of homework or revision as a ‘chore’ then your work will reflect that, and be of a better quality because you want it to be!

Of course, the fact that you’re reading this probably means that I’m preaching to the converted but here’s something that might not be so obvious- you need to want to work hard. How? Find something that motivates you, set yourself both long and short term goals to keep you focussed and on the ball. For example, my short term goal involved my GCSE grades and my long term goal is to become a doctor, a really fantastic one at that! If you don’t have something to motivate you then it is all too easy to procrastinate or burn out.

 

Speaking of burning out, endless revision will not help. You need to be smart about how you revise, make sure that it actually benefits you in some way and if it doesn’t, then change tactics! Remember: it’s quality not quantity. Take a bit of time working out what form of revision works for you best, be it visual, kinetic or auditory learning. I find that it was a mixture for me, but by the time I started the exam season I knew the exact revision regime that would produce my best results.

Another thing is to make sure that you’re body is ready to learn. Don’t revise until the wee hours, make sure you get some sleep! We are recommended to have 8 hours of good sleep and if we don’t get it, our ability to concentrate and perform tasks requiring complex thinking is hindered. Not to mention, excessive sleepiness impairs memory so if you’re trying to remember facts for a test, better get some rest! Furthermore, eating well is also important as studies show an association between having a healthy breakfast and educational performance.

 

So, don’t overdo it. But don’t become idle either. The single most important thing when it comes to success is not natural ability (at least, not in my opinion), it’s about working hard. What’s special about that? Everyone around will no doubt be working hard during exam season but I’m not talking about working a week before a test, a month or two months before a test. You should be working as soon as you’re taught the material right up to the exam. Not loads! Bear in mind what I’ve said in the previous paragraph. It may be confusing but let me put it this way: think of it as a long term investment. If you put a little bit of work in regularly over a long period of time, the return will be better than if you cram last minute. My GCSEs were in June 2016, but I began my revision in September 2015. I only did, say, half an hour everyday but that built up so that when it came to the exam period I didn’t need to cram. Another analogy would be running. I completed my GCSEs marathon-style going slow but steady and spreading the work out thinly across 9-10 months as opposed to sprinting in the last month. It meant I could remain stress-free in May whilst everyone panicked around me, and in the end my work paid off because the marathon way really does work better.

 

So those are my three master keys to the chest of gold that is success. My final offer to you, or reward for making it this far into the blog(!) is a bit of revision material. For my GCSEs I had a very clear method of revision:

  1. Write flashcards for my subjects
  2. Revise flashcards
  3. Complete past papers

The making of the flashcards is what I was doing in September right up to June, whilst the last two steps were introduced around Easter time. Since then, some specifications have changed but despite that, these flashcards would still be a useful revision resource for GCSE and preparation for the BMAT so that’s exactly what I’m giving you!

 

Here are links to find and use all the flashcards that I myself have made on the app or website Brainscape, free and to A* standard. Granted, there are a few typos in there are given the changes to the spec for GCSEs taken in 2017 I wouldn’t use them as a sole revision resource but they are good to jog your memory and a perfect stepping stone to get you revising.

 

Good luck, and I hope this has been useful!

P.S: Please rate every post you read so I know who’s reading and what you guys are more interested in, thanks!

 

Biology- https://www.brainscape.com/packs/6435118/invitation?referrer=1665765

 

Chemistry- https://www.brainscape.com/packs/6349164/invitation?referrer=1665765

 

Physics- https://www.brainscape.com/packs/6245361/invitation?referrer=1665765

 

Geography- https://www.brainscape.com/packs/6283631/invitation?referrer=1665765

 

History- https://www.brainscape.com/packs/6700501/invitation?referrer=1665765

 

(and just in case..)

 

Music- https://www.brainscape.com/packs/6740060/invitation?referrer=1665765

 

RS- https://www.brainscape.com/packs/6718999/invitation?referrer=1665765

 

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