Using brain scans, University of Arizona scientists found differences in how older rats “replayed” their actions in the brain during sleep.

They say this night-time process might help them remember better the next day.

Not all experts agree. A UK sleep expert said there could be other reasons why older people are less able to form memories while asleep.

This is the first study to suggest that an animal’s ability to perform a spatial memory task may be related to the brain’s ability to perform memory consolidation during sleep
Dr Carol Barnes
University of Arizona

The University of Arizona finding, reported in the Journal of Neuroscience, is the latest to investigate the role of an area of the brain called the hippocampus.

Studies suggest that it plays an important part in learning and memory, particularly in “episodic” memory - the ability to recall events, and the smell, sight and even tastes associated with them.

In the experiment, 22 rats - half young, and half old - were all given food rewards in return for successfully navigating mazes.

First, scientists measured activity within the hippocampus while they were in the maze, and then later, while the rats slept.

In the younger rats, the neural patterns closely matched those recorded during the maze activity itself, suggesting that they may have been “replaying” the action as part of the process of memory consolidation.

Maze success

However, in most of the older rats, the pattern produced did not match the original.

More evidence supporting the notion that these neural patterns might have a link to laying down memory came the following day, when the animals were put back in the same mazes.

Those whose neural patterns in sleep had been the best match performed better.

Dr Carol Barnes, who led the study, said: “This is the first study to suggest that an animal’s ability to perform a spatial memory task may be related to the brain’s ability to perform memory consolidation during sleep.”

Dr Michael Hasselmo, from Boston University, said that the study might “inspire” the development of new drugs to enhance this process during sleep.

But Dr John Groeger, from the Sleep Research Centre at the University of Surrey, said that the precise role of the hippocampus in the storing and recall of memory was yet to be proven.

He said: “It would be extremely difficult to test this theory in humans, because there are wide differences in the sleep patterns of older and younger people.

“On average, older people will not only sleep for between 1.5 and two hours less each night, but also have a completely different sleep architecture, in terms of the amount of each type of sleep they have.

“There could be other reasons for differences in the ability to consolidate memory.”

He added that it was quite logical that hippocampal activity in older people would be different, due to the natural shrinkage of the ageing human brain.

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Eight out of ten patients with advanced prostate cancer - which kills 10,000 men a year - may see their tumours shrink and be relieved of pain simply by taking a daily pill even if their disease has spread around the body, the study suggests.

Some men taking abiraterone have survived for more than twice as long as expected when all other treatments failed, suggesting that the most common cancer in men may in future become a manageable chronic disease.

Scientists are also starting trials of the drug for sufferers of breast cancer to see if it has similar benefits.
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Survival rates for common cancers such as breast and colon cancer have more than doubled in 60 years, and experts predict that, with this new drug, prostate cancer has the potential to join this list.

About 35,000 Britons have prostate cancer diagnosed each year. Many of the cancers do not spread and can be managed by surgery or monitoring.

Nearly all fatal cases are aggressive forms that are resistant to current treatments and are fuelled by testoster-one, the “male” sex hormone. After chemotherapy and radiotherapy have failed, the typical survival period is just one year or 18 months.

Johann de Bono, who led the study at the Institute of Cancer Research and the Royal Marsden Hospital, London, said that 250 men worldwide with advanced cases had so far taken the new drug - some for as long as 32 months, indicating that it could even tually boost survival by many years. The study, published today in the Journal of Clinical Oncology, found benefits for 21 patients with advanced prostate cancer. Trials are continuing.

Dr de Bono said he hoped that the new drug could be licensed and available for treatment of advanced disease within three years. He suggested that it could eventually make chemotherapy obsolete. “This is potentially a major step forward,” he said. “These men have very aggressive prostate cancer, which is exceptionally difficult to treat and almost always fatal. We hope that abiraterone will eventually offer them real hope of an effective way of managing their condition and prolonging their lives.”

Karol Sikora, a leading cancer specialist, described the study as a “significant piece of work”. He said: “We now can make people live with cancer. It’s not curable but we can keep people alive to the extent that they will die of something else. Most people affected by cancer are over 60, so if we can give them an extra 10 to 15 years that is as good as can be. We have to take into account the variability of some forms of hormone-driven cancer - this is not 100 per cent effective - but to be able to treat some of the worst cases, and grant them extra years of life, is a very positive thing.”

Advanced prostate cancer is typically treated with a form of chemical or surgical castration to block production of the male hormones. Abiraterone blocks the generation of these hormones in the testes and elsewhere in the body, including the generation of hormones in the cancer itself.

The pill decreased the size of tumours in 70 to 80 per cent of men with advanced prostate cancer, the researchers said. Patients also recorded large falls in prostate specific antigen levels in the blood - a key indicator of prostate cancer.

“Current treatments can be horrible, and carry side-effects such as loss of libido, but in some cases the cancer seems immune to therapy and carries on accelerating,” Dr de Bono said. “We believe that the cancer cells can make their own hormone ‘fuel’ to grow and survive. We believe we now have a drug that can block the ability of the cancer to make that fuel.”

An international study aims to recruit 1,200 men with advanced prostate cancer. The drug is also being used to treat breast cancer in women through a preliminary trial funded by Cancer Research UK.

Dr de Bono said: “It was able to help patients whose cancer had spread to the bones, liver, even lung. A number of patients were able to stop taking morphine for the relief of bone pain, and they got their quality of life back. In the wider context we eventually aim to make chemotherapy obsolete.”

Malcolm Mason, Cancer Research’s prostate cancer expert, said that the results were exciting but the studies were small and it was too early to say what role the drug might have in treating those with earlier stages of cancer.

The 52-year-old man’s tumours, which had spread to his lungs, disappeared after two months of treatment, scans indicated.

The astonishing outcome is the first solid evidence that the experimental T-cell treatment works.

American scientists pointed out that the breakthrough involved just one patient and said that further trials would be needed to prove that the results were not a fluke.

Advanced malignant melanoma, the most dangerous form of skin cancer, is notoriously difficult to treat once it starts to spread.

Cassian Yee, who led a team from the Fred Hutchinson Cancer Research Centre in Seattle, pioneered a new therapy based on infection-fighting “helper” CD4 T-cells from the patient’s own immune system.

Helper T-cells are specialised white blood cells that identify foreign invaders, or cancerous cells, and marshal other elements of the immune system against them.

The new technique, reported in The New England Journal of Medicine, involved extracting helper T-cells from the patient and cloning those specifically targeting melanoma. They were then stimulated to divide and multiply in the laboratory, boosting their number by up to 5,000 times.

An estimated 5 billion of the lab-grown cells were then infused back into the patient, unaccompanied by any additional therapies.

After two months the patient was found to be tumour-free, and there was still no sign of cancer when he was last checked two years later.

Before treatment, the man had stage 4 advanced melanoma which had spread to a groin lymph node and one of his lungs.

Dr Yee said that he was surprised by the effectiveness of the CD4 T-cells against the tumours.

He added: “For this patient we were successful, but we would need to confirm the effectiveness of therapy in a larger study.”

The patient had a specific type of immune system, and tumour cells producing a specific antigen. Dr Yee predicted that if the approach proved successful in other patients, it could be used for the 25 per cent of late-stage melanoma sufferers sharing the same profile as the trial patient.

Professor Peter Johnson, the chief clinician of the charity Cancer Research UK, said: “Although the technique is complex and difficult to use for all but a few patients, the principle that someone’s own immune cells can be expanded and made to work in this way is very encouraging.”

The Mediterranean diet is rich in fruit and vegetables

Adopting just a couple of elements of the Mediterranean diet could cut the risk of cancer by 12%, say scientists.

A study of 26,000 Greek people found just using more olive oil alone cut the risk by 9%.

The diet, reports the British Journal of Cancer, also includes higher amounts of fruits, vegetables, cereals, and less red meat.

A separate study found adding broccoli to meals might help men vulnerable to prostate cancer cut their risk.

It shows there are a number of things you can do, and there is no one ’superfood’ that can stop you developing the disease
Sara Hiom
Cancer Research UK

The Mediterranean diet came under scrutiny after researchers noticed lower rates of illnesses such as heart disease in countries such as Spain and Greece.

They noticed that people living there generally ate more vegetables and fish, less red meat, cooked in olive oil and drank moderate amounts of alcohol.

The latest study is one of the largest yet to look at the potential impact on cancer of the various parts of this diet.

‘No superfood’

Researchers from Harvard University persuaded thousands of Greek people of various ages to record their food intake over an eight-year-period.

Broccoli
Broccoli may help ward off prostate cancer

Their adherence to the Mediterranean diet was ranked using a scoring system, and the group with the worst score compared with those who followed a couple of aspects of the diet, and those who followed it the most closely.

The biggest effect they found - a 9% reduction in risk - was achieved simply by eating more “unsaturated” fats such as olive oil.

But just two changes - eating less red meat, and more peas, beans and lentils, cut the risk of cancer by 12%.

Dr Dimitrios Trichopoulos, who led the study, said: “Adjusting one’s overall dietary habits towards the traditional Mediterranean pattern had an important effect.”

Sara Hiom, from Cancer Research UK, said the research highlighted the importance of a healthy balanced diet.

“It shows there are a number of things you can do, and there is no one ’superfood’ that can stop you developing the disease.”

Broccoli benefit

The other study suggesting that food had the power to prevent cancer came from the Institute of Food Research in Norwich.

Scientists compared the effects of adding 400 grams of broccoli or peas a week to the diet of men at high risk of prostate cancer - and in the case of broccoli found differences in the activity of genes in the prostate which other studies have linked to cancer.

Their findings raised the possibility that broccoli, or other “cruciferous” vegetables, such as cauliflower and Brussels sprouts, could help prevent or slow down the disease, particularly if the man had a particular gene variant - GSTM1.

Professor Richard Mithen, who led the research, published in the Public Library of Science journal, said: “Eating two or three portions of cruciferous vegetables per week, and maybe a few more if you lack the GSTM1 gene - should be encouraged.”

Professor Karol Sikora, medical director of CancerPartnersUK, said the study was the first time in a properly controlled clinical trial that broccoli had been shown to change the expression of specific genes in the prostate gland.

“Although the observation period was too short and the numbers too small to show that the incidence of cancer actually fell, it is the first clear demonstration that broccoli and presumably other cruciferous vegetables may well reduce cancer risk.”

Many children are being admitted to hospital for emergency diabetes treatment. And many children are admitted to hospital with complications of diabetes, such as diabetic ketoacidosis (DKA).
What are the signs of diabetes?

Many people may not know the symptoms of diabetes. Would you know what to look for in your child?

The main symptoms of diabetes are:

* feeling very tired,
* feeling very thirsty most or all of the time, even though you’re drinking lots of water,
* going to the toilet a lot (passing large amounts of urine), and
* losing weight suddenly, or not growing normally.

When do symptoms affect children?

Diabetes is when there’s too much sugar (glucose) in your blood and your body can’t cope with.

Your body produces a hormone called insulin, which helps change sugar into energy. If your body doesn’t make enough insulin, or can’t use the insulin properly, too much sugar remains in your blood.

There are three types of diabetes:

* Type 1 diabetes - where your body produces no insulin at all. Symptoms usually develop before the age of 40. They often develop in teenagers. Out of all people with diabetes, only 5-15% have type 1.
* Type 2 diabetes - when your body produces too little insulin, or when your body doesn’t react properly to insulin. Symptoms can develop in children as young as seven, although they more commonly affect adults over 40. Type 2 is much more common - about 95% of people with diabetes have type 2.
* Diabetes insipidus is a rare condition where your body cannot retain enough water. It usually affects adults.

Most symptoms of type 1 and type 2 are the same, although they can develop in different ways. The symptoms of diabetes insipidus are similar.

See the ‘further information’ section to read more about these types of diabetes, including their symptoms and treatment.
What happens if diabetes symptoms aren’t treated?

It’s really important to recognise diabetes symptoms early

Symptoms of diabetes can be treated, to control how much sugar is in your blood. For example:

* Some people can control their condition by eating a healthy diet and taking regular exercise.
* Others need daily injections of insulin.

It’s really important to recognise diabetes symptoms early and seek advice about treatment. If the symptoms aren’t controlled, this can lead to:

* too little sugar in your blood - this can cause a ‘hypo’ (hypoglycaemia), and
* too much sugar in your blood (hyperglycaemia) - this can lead to diabetic ketoacidosis (DKA).

What are the signs of a hypo?

Signs of a hypo can include:

* feeling shaky and irritable,
* sweating,
* tingling lips,
* feeling weak,
* hunger, and
* feeling sick.

In a severe hypo, you can become drowsy and confused, and you may lose consciousness.
What are the signs of DKA?

Some complications need urgent medical treatment

Diabetic ketoacidosis (DKA) is a build-up of acids in your blood, caused by your body breaking down fats instead of sugar. It can develop in diabetic people if their symptoms are not controlled or treated.

Signs of DKA can include:

* loss of appetite,
* feeling or being sick,
* a high temperature,
* stomach pain, and
* a fruity smell on your breath, which may smell like pear drops or nail varnish.

DKA can eventually cause unconsciousness and even death.
Getting help

If your child has symptoms of DKA or a severe hypo, they need emergency medical treatment - dial 999 for an ambulance.

If you think your child has early symptoms of diabetes, speak with your GP. It’s important to start treatment as soon as possible.

Some pharmacies may offer free diabetes tests - you can ask at your local pharmacy for more information. Use the link below to find your nearest pharmacy, or you can call NHS Direct on 0845 4647.

Giving up smoking can be hard, but it’s well worth the effort. Ditching the cigarettes means you could live on average ten years longer. If you want to give up smoking, there is a lot of help available to support you and make the process more manageable.

Everyone knows that smoking causes heart disease and cancer, but because we don’t see what’s happening on our insides, it’s easy to avoid the issue. Giving up smoking, at any age, greatly improves your chances of avoiding smoking-related conditions and dying early.

Plus you’ll look and feel better in the long run. Quitting can put a stop to premature ageing, yellow teeth, bad breath, and smelling of stale tobacco. Being free of nicotine also makes you feel great emotionally and mentally, once the withdrawal symptoms have passed. It’s a misconception that smoking actually calms you down; in reality it’s your body craving a nicotine hit that makes you feel stressed.

Step two: eat well

In the busy world we live in, it’s easy to eat too much of the wrong foods because they are convenient and seemingly cheaper. A healthy balanced diet can be enjoyable, cheap and easy. You just have to try it, and you’ll see and feel the difference.

Eating too much saturated fat (fat from meat and dairy products, for example, butter and cheese), red meat, salt and sugar can lead to a long list of diseases and early death. Research shows, for example, that eating two portions of red or processed meat every day makes you a third more likely to develop bowel cancer. Coronary heart disease, strokes, cancer, and obesity are all less likely to affect you if you control your diet, which means keeping red meat, salt, sugar and saturated fat to a minimum, and eating more fruit and vegetables - at least five portions a day.

Eating healthily will also help you shift a few pounds if you’re overweight, and you’ll feel fantastic because your energy levels will soar. False highs from caffeine and sugar leave you feeling low afterwards. Following our top tips will help you feel great all day:

* Aim for five portions of fruit and vegetables a day (try a variety).
* Eat what you enjoy, but in moderation (you need a combination of carbohydrates, protein and fat).
* Eat regularly but control your portion size (don’t pile up your plate) and stop eating when you’re full.
* Swap white rice, pasta and bread for the wholegrain variety to increase your fibre intake and make you feel more full.
* Keep an eye on how much salt is in your food (an adult should have no more than 6g per day).
* Swap saturated fat for unsaturated fat (try olive oil instead of butter).
* Eat fish instead of red meat (keep red meat to once or twice a week if possible).

Step three: drink right

Drinking right means making sure you drink enough water, and keep tea, coffee and alcohol at healthy levels. Alcohol plays a part in 40,000 deaths a year, and is directly responsible for over 6,000 of these.

Conditions brought on by drinking too much include liver disease, cancer, strokes, heart problems, high blood pressure, fertility problems and erectile dysfunction.

It’s fine to have a drink now and then, but try to keep within your recommended limit to stay healthy. This means no more than 2-3 units of alcohol each day for women, and no more than 3-4 units a day for men. Remember that one unit is roughly the same as a small glass of wine, or half a pint of beer.

Alcohol also affects your physical appearance and mental health. Watching what you drink can prevent weight gain, bloodshot eyes and drinker’s nose, and help you avoid depression and anxiety.

Although your morning cuppa won’t do you any harm, drinking too much tea and coffee and not enough water can lead to dehydration. Dehydration affects your ability to concentrate and remember things, as well drying out your skin and making it look older than it is. Drinking enough water (6-8 glasses a day) helps your entire body function properly, so you will feel and look better.

Step four: exercise enough

As well as helping you lose weight and look great, exercise has loads of health benefits. Not getting enough exercise doubles your risk of getting coronary heart disease. Regular exercise about 30 minutes a day decreases your risk of stroke, diabetes, high blood pressure and obesity.

So make the effort to include exercise in your daily life. When you exercise, endorphins (a type of hormone) are released that make us feel fantastic, so exercise can be great for tackling depression. Try starting gradually, by having a game of football at the park or taking the stairs instead of the lift. Work up to 30 minutes a day of exercise that gets your heart rate up and makes you break a sweat. Don’t forget to drink more water to avoid dehydration.

The most common RSI conditions include:

* Bursitis - inflammation and swelling of the fluid-filled sac near a joint at the knee, elbow or shoulder.
* Carpal tunnel syndrome - pressure on the median nerve passing through the wrist.
* Dupuytren’s contracture - a thickening of deep tissue which passes from the palm of the hand into the fingers.
* Epicondylitis - inflammation of an area where bone and tendon join - for example, tennis elbow.
* Ganglion - a cyst in a tendon sheath, usually occurring on the wrist.
* Rotator cuff syndrome - inflammation of muscles and tendons in the shoulder.
* Tendinitis - inflammation of a tendon.
* Tenosynovitis - inflammation of the inner lining of the tendon sheath that houses the tendons that control the fingers and thumbs.
* Trigger finger - inflammation of the tendon sheaths of fingers or thumb accompanied by swelling of the tendon.
* Diffuse RSI - nerve damage.

RSI is often caused, or aggravated, by frequently repeated movements, such as a task or leisure activity - for example playing golf or tennis regularly. Symptoms usually persist over time if left untreated.

As the number of people using computers increases, the chances of developing RSI increases. The repetitive action of typing on a computer can cause painful symptoms in fingers and hands, such as a throbbing pain. RSI caused by typing on a computer is typically referred to as ‘writer’s cramp’.

RSI is also linked to many types of repetitive manual work, such as the use of vibrating equipment in factories.

If there are any symptoms, including painful, tingling or swollen hands, elbows, wrists or shoulders, it is important to get treatment quickly. The sooner treatment is started the better the chances of recovery.

Types of RSI

RSI can be categorised into two types, Type 1 RSI and Type 2 RSI:

* Type 1 RSI - this includes conditions that are due to repetitive tasks, but can also be common in people who do not carry out repetitive tasks. The main symptoms tend to be swelling and inflammation of muscles and tendons. Typical type 1 RSI conditions include carpal tunnel syndrome (pressure in the wrist), tendonitis (inflammation of a tendon), and tenosynovitis (inflammation of tendon sheath).
* Type 2 RSI - is when a person’s symptoms do not fit into one of the above listed conditions. This is usually because there is no obvious inflammation or swelling in the affected area, merely a feeling of pain. This type is often called ‘non-specific pain syndrome’.

The symptoms of repetitive strain injury (RSI) vary, but can include: * pains or tenderness in your muscles or joints,
* a throbbing sensation in the affected area,
* tingling (pins and needles) or numbness in your hand or arm, and
* loss of strength or sensation in your hand.

Initially these symptoms may only occur when you are carrying out the repetitive motion, for example during working hours. Towards the end of the day your symptoms may improve when you have finished work and are resting. This initial stage of symptoms may last for several weeks.

If left untreated, the symptoms are likely to persist, causing pain or aching much of the time. You may also have tender swelling in the affected area, which can last for several months.

Pain could also be experienced all the time, affecting your sleep. At this stage the condition may be irreversible. Therefore, recognising the early symptoms of RSI is important to ensure that any treatment is most effective.

The actual cause of repetitive strain injury (RSI) is unknown. In some cases, there is no swelling in your muscles or tendons, and yet pain can continue to cause you discomfort.

RSI is related to overuse of muscles in your hands, wrists, arms, shoulders, back, or neck. This overuse is usually a repeated action that is often carried out on a daily basis. For example, if you use a computer at work you may experience a typical RSI condition called ‘writers cramp’. The repetitive action of typing on the computer can cause painful symptoms in your hands, such as a throbbing pain.

Cold temperatures, vibrating equipment, or forceful movements are also thought to worsen the condition.

Other things that may bring on the symptoms of RSI include:

* awkward posture,
* poorly organised workstations,
* badly designed equipment, or
* lack of rest breaks.

Stress may also be a contributing factor in RSI. However, relaxation techniques may be able to help reduce stress (see treatment section).

There are no tests to confirm a diagnosis of repetitive strain injury (RSI). Pain felt in the affected area may be common, but can often be due to a variety of factors.

RSI is often diagnosed based on the fact that symptoms develop following a repetitive task, and tend to fade, or be partially relieved, once the task is stopped. For example, if you have recently done a lot of DIY around your house, once the task has been competed, the pain may disappear.

Your GP can diagnosis certain RSI conditions such as carpal tunnel syndrome (pressure in the wrist) by examining your affected arm or wrist. X-rays may be used, but this is rare.

Reporting early symptoms is essential to avoid repetitive strain injury (RSI) conditions becoming disabling - that is, reducing your mobility and independence. See you GP if you experience any aches or pain in a particular area over a prolonged period of time (if it continues for more than a couple of weeks).

It is likely that your GP will initially advise that, if possible, you stop doing the task or activity that appears to be causing your symptoms. In some cases, this might not be possible if it is an activity you carry out on a daily basis for work. In this case, you may need to tell your employee about your RSI so that improvements can be made to relieve your symptoms.

Treatment for RSI usually aims to help with your pain, and to enable your strength and mobility to return. Your GP may recommend that you take a course of anti-inflammatory painkillers, such as aspirin or ibuprofen, to help relieve any pain. Children under the age of 16 should not take aspirin. You may also need to use heat or cold packs, elastic supports, and firm splints. All of these are available over-the-counter (OTC) from your local pharmacy, but they only offer temporary pain relief.

Steroid injections are usually only considered if you have defined inflammation in an affected area. For example if you have pressure on the nerves of your wrist (carpel tunnel syndrome), or inflammation on your tendon sheath (tenosynovitis).

Your GP may also suggest you take a short course of sleeping tablets if your sleep is disturbed due to your RSI-related pain.

Complementary therapies

Because there is no cure for RSI, chronic sufferers may find complementary therapies also help to relieve symptoms. For example, if your symptoms are severe, your GP can refer you to a physiotherapist, who can help you with your posture and teach you how to strengthen the muscles that are causing you particular discomfort. Your physiotherapist may also decide to perform a therapy called electrotherapy, which uses small electrical impulses placed on particular points of your body to help reduce your pain.

Other complementary therapies that may prove helpful include:

* Messages - to help relax your upper body muscles and tissues.

* Osteopathy - a treatment that focuses on your skeleton and muscles.

* Chiropractic - a method using your body structure, particularly your spine, to ease symptoms.

* Kinesiology - oriental medicines are used to help restore your body’s energy flow and balance.

* Alexander technique - is a method that works to change your movement habits in your everyday activities, helping to make you aware of balance, posture and co-ordination.

* Feldenkrais method - is similar to the Alexander technique but focuses less on specific body positions.

* Pilates - is more strenuous than the Alexander technique and the Feldenkrais method, as it involves exercise to both strengthen and improve your flexibility.

* Acupuncture - is a traditional Chinese treatment method that is often used to relieve pain and restore balance to your life force.

* Shiatsu - is a traditional Japanese technique often described as ‘finger pressure’ therapy, which is a form of massage that applies pressure to energy lines using fingers, thumbs, and elbows.

* Reflexology - is a foot message of Chinese origin that has been said to improve blood circulation and help to relax you.

Fitness techniques

You may find that there are a number of fitness techniques you can include in your lifestyle to help ease your RSI pain. These include:

* walking,
* swimming,
* yoga - the practice of poses, stretches and flexibility,
* tai chi - a mind and body discipline of choreographed movements to restore your body’s harmony, and
* relaxation techniques, such as meditation.

Symptoms for repetitive strain injury (RSI) can ease over time. To prevent the development of RSI, or relieve your symptoms, you need to review particular aspects of your lifestyle. For example, if you take part in regular sporting activities remember to warm up before you start, and cool down afterwards.

Aspects of your working environment are likely to have the most impact on your RSI. For example:

* If you work at a computer all day, make sure your seat, keyboard, mouse, and screen are positioned so that they cause you the least amount of strain to your fingers, hands, wrists, neck and back.

* Sit at your desk with a good posture. Adjust your chair so that your forearms are horizontal with the desk, and that your eyes are the same height as the top of your computer screen.

* If you do a repetitive task at work try to take plenty of regular breaks. It is better to take more frequent smaller breaks than just one long break at lunch.

* Speak to your employer if there is anything relating to your working environment that you feel could be improved. It is in their interest to ensure they do everything possible to help prevent or ease your RSI. You may also find it beneficial to speak to your employer’s occupational health advisers for further assistance and advice.

1. Workstation Ergonomics

A well designed workstation is essential to maintaining good posture and reduce the risk of lower back pain and other computer related injuries.

2. Ergonomic Keyboards and Mice

There are quite a few ergonomically designed keyboards and mice available. The Microsoft Natural Keyboard is one example. This keyboard splits the keys into two panels - one for each hand, and angles each panel so that the hands sit naturally on the keyboard, rather than requiring them to be twisted into an unnatural position which is the case with normal keyboards. Many mice are now designed to fit neatly into either hand, and can often have a scrolling wheel, which can make scrolling through documents easier and less stressful than using scroll bars.

These ergonomic devices are generally more expensive than standard designs, but can be well worth the investment.

The computer mouse was originally designed to make using a computer easier - it is much easier to point at a picture and click than to learn a relatively complicated series of keystrokes. However, research has shown that using a mouse is a significant cause of repetitive strain injury. Especially if the mouse is located at the same level and to the side of the keyboard - it’s usual location. This requires extending your arm which introduces significant tensions and stresses in your arm, shoulder and neck.

The best position for your mouse is on a raised platform slightly above the numeric keypad on your computer. Also, if you reduce the speed of the mouse and the number of clicks you have to make you can greatly reduce the muscle tension in your arm and hand. Additionally, you can swap the primary and secondary mouse buttons (the left and right buttons), to change the mouse from being right handed to left handed. Using your left hand - or right hand if you are left handed - can take some getting used to, but can be very helpful if you are suffering from any aches and pains in one hand. Regularly alternating between left and right hands can also give your arms and hands a rest, thus minimizing the risk of developing any RSI condition. You can swap the mouse buttons using the Mouse applet in the Windows Control Panel - or directly from the Stress Buster context menu - with fewer mouse clicks and/or key strokes.

To reduce the mouse speed, open the Mouse applet in the Windows Control Panel, select the tab Pointer Options and move the pointer speed slider to the left to slow. Click OK.

To reduce the number of clicks you have to make, open the My Computer icon, then select Tools, Folder Options, and then under Click Items As Follows, choose Single-click to open an item.

If you can you should avoid using the mouse as much as possible. Most actions and commands can be carried out using keyboard shortcuts instead of the mouse. For example, to reduce the number of clicks you have to make with your mouse - as described above, you could use the following keyboard shortcuts:

1. Press the button on your keyboard to open the Windows Start Menu.

2. Use the arrow keys to select My Computer (or the alternative name you may have given to your computer), and then press Enter or Return. This will open an explorer window for your computer.

3. Hold down the Alt key and press “T” to open the Tools menu, then press “O” to open Folder Options.

4. In Folder Options, hold down the Alt key, and press “S”. This will select the option Single-click to open an item.

5. Press Enter or Return to close the Folder Options dialog.

Windows Help provides extensive help on using keyboard shortcuts with Windows. Individual applications such as Microsoft Office also have their own keyboard shortcuts - with the appropriate help. Learning keyboard shortcuts can take some time, but once learnt, using them tends to be faster than using the mouse, and avoids much of the discomfort associated with the mouse.

All ergonomic experts agree that taking frequent rest breaks is essential to avoid the risk of computer related injuries.

You should take frequent “eye breaks” - staring at a computer monitor for long periods causes you to blink less often - resulting in dryer eyes. Every 10 to 15 minutes you should look away from your monitor and blink your eyes rapidly for a few seconds. This will refresh the tear film and clear any dust from the surface of the eyes. Additionally you should focus on something at a distance - preferably 20 feet or more away - look out of the window if you can - this will relax the muscles inside the eye.

You should take frequent short pauses or “micro pauses” - for 10 seconds or so up to a minute - every 10 minutes or thereabouts. You should take regular short breaks - for 5 minutes or more - every hour or so - maybe go for a coffee or a short walk around the office, and you should take a long break every two or three hours - for at least 15 minutes, or preferably 30 minutes to an hour. Exactly how long and how frequent your breaks are depends on your own personal preferences and working environment.

5. Stretching Exercises

Regular stretching is an essential part of RSI prevention and recovery, remember that your body is not designed to be sat at a desk for 8 hours a day clicking a mouse. Respect your body and give it the movement and range of motion it normally expects.

6. Posture

Good posture is essential to avoid repetitive strain injury and other computer related injuries. Well designed workstation ergonomics can help in maintaining a good posture.

* Make sure that you can reach the keyboard with your wrists as flat as possible (not twisted up or down) and straight (not twisted left or right). An ergonomic keyboard can help to keep your wrists straight.

* Make sure that your elbow angle is 90 degrees or more to avoid nerve compression at the elbow.

* Make sure that your upper arm and elbow are as close to the body and as relaxed as possible for mouse use - avoid overreaching. Also make sure that your wrist is as straight as possible when the mouse is being used.

* Make sure that you sit back in the chair and that you have good back support - especially lumber support.

* Make sure that your feet are flat on the floor. Use a foot rest if necessary.

* Make sure that your head and neck are as straight as possible .

* Make sure that you are relaxed. Forcing yourself to sit up straight can sometimes introduce unhealthy tensions in the back muscles.

7. Alternative Input Devices

There are a number of alternative input devices you can use, instead of the mouse and keyboard, which you might find helpful. Examples are the trackball, a graphics table and pen, a touchpad, and even voice control.

RSI is a very serious health risk, especially with the young people who are coming to any industry sector that has continuous use of a PC. You need to take all the actions and preventions necessary to help minimize that risk.

Gerard Bulger is a part of the company http://www.threadbuilder.co.uk/ which creates Stress Buster the automated background program that monitors peoples computer usage and indicates when breaks should be taken to help alleviate RSI.

There was once a doctor who, when patients said they wished to lose weight, would say “read my book.” The book was nicely bound and, quite thick but, when opened all the pages were blank except for one upon which were written two words “Eat Less”.

There is a good deal of truth behind this simple statement for people put on weight when their food intake exceeds their energy output. Many patients have very little idea about their calorific input or output although this didn’t matter in the days when most people had a way of life which involved a significant amount of exercise.

Walking and cycling has now given way to the motorcar and public transport; manual work has been replaced by sedentary occupations; agricultural work – once the single most common manual occupation in the United Kingdom — has been largely replaced by technology; most food is processed to some extent before it meets the consumer whereas previously energy was spent by individuals in growing, harvesting, preparing, cooking and utilising foods in the kitchen. For example our parents can remember that oats were boiled for up to twelve hours before they were ready to become porridge. Quick porridge oats today take only minutes to prepare.

Central heating cuts down the amount of calories required to keep the body at an acceptable temperature and significant shivering, a potent means of using up calories, is now quite rare. Even the need to wear heavy warm clothing utilised energy but many people will live most of their lives in very lightweight clothing. Central heating and air conditioning is a reality for most.

Of course many patients deny overeating to which the doctor can say always that only plants can synthesize food out of air and water; human beings have to eat it. This brings us back to calories in and calories out. The calculation is simple. If the calories going out in exercise are more than the calories coming in as food the individual will loose weight.

If the calories coming in as food are greater than the calories going out as exercise then the individual will gradually put on weight no matter how small the difference.

If the individual indulges in very heavy exercise or manual labour then it is virtually impossible to eat too much. Labourers can have an intake of 4,000 to 5,000 calories a day and still lose weight. Computer operators, on the other hand, sitting virtually stationary throughout the working day can find 1,000 to 1,500 calories too much to allow them to keep a steady weight. Losing a lot of weight in a short time is rarely the way by which long term weight loss can be achieved. It does however, seem that a combination of a dietary restriction and exercise has a benefit greater than if only one of these procedures is carried out. This can be summed up into “one and one can make three.” Certainly dieting alone rarely seems to achieve the objective. A change in the way of life is what is required and a permanent balance achieved between food intake and exercise.