Video Game Overuse May Be an Addiction

Millions of U.S. children and adults obsessed with video games may suffer from a real addiction, according to a proposal up for debate by top U.S. doctors.

Delegates attending the American Medical Association conference in Chicago, which starts Saturday, will discuss the proposed addition of video game addiction to a list of "formal disorders," where it would join other problem behaviors such as pathological gambling.

Dr. Martin Wasserman, executive director of MedChi, the Maryland State Medical Society, helped spearhead the new proposal, which has resulted in a 10-page report submitted to the AMA by the group's Council on Science and Public Health.

"The concern came up because one of our psychiatrists here in Maryland was seeing older people who were losing their social contacts," specifically because of their overuse of video games, Wasserman said. "It was ruining their family life. So, it was not unlike gambling addictions or alcohol, where it was having a profound impact on the lives of individuals."

According to the AMA report, one soon-to-be-released British study polled 7,000 "gamers" and found that 12 percent of them met World Health Organization criteria for addictive behaviors.

Statistics released in 2005 by the Entertainment Software Association (ESA), an industry group, estimated that 70 percent to 90 percent of American children play video games. The typical gamer is a 30-year-old male who spends about seven or eight hours a week gaming.

The ESA survey also found that video game overuse was most prevalent among the approximately 9 percent of video game users who play against others online in Internet-based "massive multiplayer online role playing games."

The new AMA report defines "heavy game use" as two or more hours a day, but Wasserman, a pediatrician, said addictions are best defined by their impact on an individual's life and psyche.

"Basically, you're using a disproportionate amount of time on the video game, and it's what you are thinking about even when you're not on the video game," he said. "And even though it's having negative consequences for you in school or your family situation, or it's taking a disproportionate amount of your money, you still continue to do it. You spend less time with your friends or in other social things."

One theory why certain individuals spend so much time on online games is that they prefer the experience to real-world interaction. According to the report's authors, the "current theory is that these individuals achieve more control of their social relationships and more success in social relationships in the virtual reality realm than in real relationships."

But that sense of control may come at a price, Wasserman said, especially for children and adults obsessed with games loaded with violent imagery.

"The violent aspects of this, in particular, have got to be a threat to the normal growth and development that we'd like to see in young people," he said. "People have observed more aggressive behaviors [linked to gaming], and if you do subjective testing, there are studies which have shown aggressive behaviors in young people and less supportive behaviors."

Wasserman wonders, as well, about the sedentary aspects of hours of video game use. "I can't tell you if this is associated with our current epidemic of child obesity," he said, "but too much time in front of a video tube -- and much of that time spent watching violent interactions -- can't be good for our kids."

That's a sentiment shared by a majority of the American public, according to a survey of more than 1,000 parents of children aged 2 to 17 that was released Tuesday by the nonprofit Kaiser Family Foundation. According to the Associated Press, two-thirds of parents responding to the survey said they were "very concerned" about the amount of sex and violence their children are exposed to in various media.

But the AMA report remains merely a starting point for discussion among doctors gathering in Chicago. It is far from certain that the physicians' group will, in fact, move to label excessive gaming an addiction.

The report's authors are urging that the AMA pressure the American Psychiatric Association (APA) to include "Internet/video game addiction" in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, the standard diagnostic text used by psychiatrists worldwide.

But Dr. James Scully, medical director at the APA, said any decision on the matter is a long way off.

Right now, "we don't agree or disagree" with the idea, he said. "As a diagnostic issue, it is going to be several years before we make a determination of that. It's clearly something that we want to consider."

In the meantime, he said, it's up to parents to limit their child's exposure to video games, especially the more violent ones. Both the AMA and the APA support current recommendations from the American Academy of Pediatrics that limit children's exposure to all "screen time" -- TV, computers and video games -- to a total of two hours a day.

Wasserman believes this simple rule can minimize media's potentially harmful effects. Media, in itself, isn't always bad, he said, but "everything needs to be done in moderation."

"That's what we taught our kids -- if they didn't do it in moderation in our home, we moderated it for them," he said. "It didn't hurt them."
Source :http://www.forbes.com

Patient's death jeopardizes hospital

When Edith Isabel Rodriguez showed up in the emergency room of an inner-city hospital complaining of severe stomach pain, the staff was already familiar with her.

It was at least her third visit to Los Angeles County's public Martin Luther King Jr.-Harbor Hospital in as many days. "You have already been seen, and there is nothing we can do," a nurse told her.

Minutes later, the 43-year-old mother of three collapsed on the floor screaming in pain and began vomiting blood. Employees ignored her, and she was soon dead.

Now state and federal regulators are threatening to close the hospital or pull its funding unless it can be improved, and Rodriguez has become a symbol of everything wrong with the facility derisively known as "Killer King."

After she collapsed, surveillance cameras show that Rodriguez was left for dead on the floor.

Nurses walked past her. A janitor cleaned up around her. No one did anything until police were called to cart her away. They didn't get far before she went into cardiac arrest and died.

"This needs to stop," state Health Services Director Sandra Shewry said Thursday as the agency moved to revoke the hospital's license. "We're doing this in response to the egregious incidents that have come to light in the last six weeks."

The hospital, formerly known as Martin Luther King Jr.-Drew Medical Center, was built after the 1965 Watts riot to bring health care to poor, minority communities in south Los Angeles.

But it had been plagued by patient deaths blamed on sloppy nursing care, among other things. The county attempted over the last few years to correct the problems with a multimillion dollar rescue effort, disciplining workers, reorganizing management, closing the trauma unit and reducing the number of beds from 200 to 48.

After Rodriguez's death, federal reports showed those efforts were failing and patients were in "immediate jeopardy." Of the 60 cases reviewed between February and June, more than a quarter received substandard care, according to the U.S. Centers for Medicare and Medicaid Services.

In February, a brain tumor patient languished in the emergency room for four days before his family drove him to another hospital for emergency surgery. A pregnant woman who complained of bleeding was given a pregnancy test and left, only to return three days later and have a miscarriage after waiting more than four hours to see a doctor.

The findings have sent county officials scrambling to improve care before a federal inspection due by Aug. 15 that could determine whether the hospital keeps its federal funding. The county might close the facility without that money.

The hospital, meanwhile, could contest the state allegations in a hearing before a Department of Health Services administrative law judge.

"I'm losing hope," Zev Yaroslavsky, member of the county Board of Supervisors that oversees King-Harbor, told hospital managers earlier this week. "We need to be prepared for the worst-case scenario."

On Friday, the county's Department of Health Services released a contingency plan to deal with closing hospital departments and relocating patients if they must. The plan, which also lays out how the hospital could eventually be reopened if a private partner is found, will be presented to the Board of Supervisors on Tuesday, said Bruce Chernof, director of the department.

Even though hospitals nationwide struggle with too many patients and not enough staff, the scope and severity of King-Harbor's problems are rare.

"Most hospitals in America have long waits, they have crowded ERs," said Dr. Bruce Siegel, former chief of New York City's public hospitals and a George Washington University professor. "But they don't let people die in the waiting room after they call 911. This is a whole new level here."

Rodriguez, who struggled with drug addiction over the years, had visited King-Harbor several times for stomach pain in the days before she died. Each time, she was sent home, in some cases with pain medication, after doctors said she suffered from gallstones.

"They discharged me, but I don't feel good. I feel sick," she told her sister, Marcela Sanchez.

At the urging of her sister, Rodriguez returned to the hospital.

Early on May 9, she was wheeled into the ER by county police officers.

"Thanks a lot, officers, she's a regular here," a nurse said. "She has already been seen and was discharged."

After the nurse again refused to help, Rodriguez slid off her wheelchair and onto her knees in a fetal position, screaming in pain, according to a federal report based in part on surveillance videotape.

Over the next half hour, hospital staff walked past her. Soon, her boyfriend, Jose Prado, who had left for about an hour, returned to the hospital.

"When I came back, I found her lying on the floor with blood coming out of her mouth," Prado said. "She said, 'Honey, help me! Nobody will help me here!'"

He pleaded with medical staff and then a county police sergeant to intervene, but no one did.

"I told him she had blood in her mouth," Prado says he told the sergeant. "But he told me, 'Don't worry, she just has chocolate in her mouth."

Then he called 911.

"My wife is dying and the nurses don't want to help her out," he said in Spanish through an interpreter

"What's wrong with her?" a dispatcher asked.

"She's vomiting blood," Prado said.

When the dispatcher refused assistance, he hung up and frantically ran back to Rodriguez.

"I just hugged her. I didn't know what else to do. I couldn't think of anything else," he said.

Eventually, officers arrested her on a parole violation.

Police wheeled her out of the ER, then returned minutes later after Rodriguez's heart had stopped. Autopsy results revealed she died of a perforated bowel that probably developed in the previous 24 hours, a condition that is often treatable if caught early enough.

"They took her outside to die like an animal," Prado said.

After her death, a triage nurse was put on leave, resigned and was reported to the state Nursing Board for investigation. Six others — a nurse, two nursing assistants, and three hospital finance workers — were disciplined. Sheriff's detectives, meanwhile, have opened a homicide investigation.

Rodriguez's family said little will ease their grief. They plan to sue and are seeking copies of the video surveillance tapes, which are being held as part of a criminal investigation.

"They took my sister," Sanchez said. "It wasn't time for her to go."
Source :http://www.chron.com

U.S. posts hospital death rates for heart ailments

The U.S. government posted mortality data on Thursday for the nation's thousands of hospitals for heart attacks and heart failure, in an effort to shed light on which hospitals provide the best care.

Health care in the United States is notorious for its lack of transparency -- for both the price of goods and services, as well as the quality of care provided by doctors and hospitals.

The new mortality data updates a year-old project by the U.S. Department of Health and Human Services, contrasting prices and experience at the nation's 4,500 acute-care hospitals. The government's Web site compares 31 elective hospital procedures such as heart valve operations, gallbladder removal and hernia operations.

"We don't yet have the Formula One version. We have the go cart version," Secretary Mike Leavitt said during a briefing on the government's efforts to make hospitals -- which get a large portion of their revenue from government health programs -- more accountable.

The new measures track 30-day mortality following a heart attack and heart failure and make risk adjustments for a patient's health, age and other factors.

Hospitals are rated in-line with the national average, above average, or below average for the two heart conditions. Just seven hospitals were rated worse-than-average for death rates following a heart attack, while 17 were rated better-than- average.

In heart failure, 38 hospitals scored a top rating, while 35 scored a worse-than-average for that measure.

The small numbers reflect a conservative approach taken by the consortium, which developed the measures, and included researchers from Harvard and Yale Universities.

During the 1980s, the government tried releasing hospital quality data, but the industry revolted and they were eventually scrapped.
Source :http://www.reuters.com

FDA Issues Dietary Supplement Rules

The U.S. Food and Drug Administration announced Friday that manufacturers of vitamins, herbal pills and other dietary supplements would have to test the ingredients of all their products for safety and purity.

The new standards follow concerns that existing regulations are too weak in that they allow supplements on the market that were contaminated or whose ingredients didn't match claims made on the label.

But while the rules may strengthen enforcement in these areas, some experts say that the real question is the effectiveness of these products.

"This final rule establishes industrywide standards," said Robert Brackett, director of the center for food safety and applied nutrition at the FDA, in a press conference this morning. "Consumers should have increased confidence that the dietary products that they purchase are safe."

Published in an 800-plus page report, the regulations set so-called good manufacturing processes for the 29,000 dietary supplement products currently on the market -- including vitamins, minerals, botanicals, sports nutrition supplements, weight management products and specialty supplements.

The supplement makers will have to test the ingredients of all their products for purity, and accurately report ingredients on their labels.

Before his, supplements fell under the same regulatory guidelines used for food. But according to the FDA, regulating supplements in this way missed some critical problems.

"[The final rule] tries to be more specific about regulating the processes used to make diet supplements, which are quite different from the way you process food," said Vasilios Frankos, division director of the office of dietary supplements at the FDA.

The requirements also apply to imported supplements manufactured outside the U.S. Enforcement of the new guidelines begins Aug. 24.

"The aim is to prevent the wrong ingredients getting into supplements," said Frankos. The regulations also try to prevent contamination of supplements as well as the accidental inclusion of pesticides, glass or heavy metals like lead.

Fable-Free Labels

"These new regulations will at least take the quality issue off the table," says Dr. Brent Bauer, director of the complementary and integrative medicine program at the Mayo Clinic. "If a patient wants to try ginseng, they can be assured that when they purchase a ginseng brand that claims to have 5 percent ginsenosides, they will know that is what they are getting."
Source :http://www.abcnews.go.com

The Brains of the Family?

Given the choice, 9-year-old Carlyle Quinn would spend all day with his microscope, while younger brother Max would opt for the electric guitar.

There's no telling how these brothers living in Brooklyn, N.Y., will grow up. But according to groundbreaking new research, it is very likely Carlyle will have the highest IQ.

The study, published in the current issue of the journal Science, involved more than 240,000 Norwegian men who took intelligence tests when they entered the military. In most families, the scores of the firstborn were three points higher than the second child, and four points higher than a third.

It's not a huge difference, but it might be enough to divide an A student from a B student.

"It is a breakthrough study that is very difficult to dispute methodologically," Frank Sulloway, a University of California psychologist who wrote an accompanying editorial to the study, told ABC News correspondent Bill Weir.

Lead study author Petter Kristensen, an epidemiologist at the University of Oslo, doesn't think the results apply only to Norwegians, but he added that it would be interesting to examine if family patterns are different in some way in Norway.

As for the reasons behind the apparent intelligence gap, Kristensen and other researchers insist it is not due to nature but nurture, with the firstborn enjoying the fruits of undivided attention early in life.

Intelligence Through Teaching

Experts believe that when older children tutor their siblings, it may help their brains grow.

Add to this the fact that in many families, if the eldest is organized and studious, the younger finds more creative ways to get attention.

Sulloway said such differences are not necessarily bad; in fact, such an arrangement might allow younger children to shine in different ways.

"Younger siblings may have three points of something else that doesn't show up on an IQ test," he said.

Exceptions to the Rule

Examine certain sets of famous siblings, and a tantalizing dynamic emerges that seems to support these findings. Studious Prince William and his playful brother Harry, for example. Or Bill and Roger Clinton.
Source :http://www.abcnews.go.com

Health insurers to halt ad effort

Government officials said seven of the country's largest insurers will cease marketing some plans to seniors amid allegations of misleading and aggressive sales practices.

The companies agreeing to the suspension include Humana, WellCare Health Plans and UnitedHealth. Under the voluntary agreement, the companies will not promote their so-called private-fee-for-service plans until Medicare officials certify the companies use accurate and understandable marketing communication.

Medicare is the government-run health benefit that covers 43 million seniors. Roughly 20 percent of those seniors receive their benefits through privately run Medicare Advantage plans.

Last month, state insurance officials told lawmakers they have received hundreds of complaints from seniors who thought they were signing up for the traditional government program, only to learn they had been enrolled in a for-profit corporate plan.

In other cases, agents misled seniors into leaving the government program for a privately run Medicare Advantage plan.

While nearly all the major health insurers offer the plans, nearly half of all patients enrolled are in Humana plans, Medicare officials said.

The plans are popular among seniors -- over 1 million are enrolled -- because of the benefits, which often include dental and vision care. However, they often carry unexpected costs and limited access to physicians.
Source :http://www.suntimes.com

Race May Color Heart Doctors' Choices

When you roll into the ER with crushing chest pain, does your skin color determine the care you get?

A new study in this week's Journal of the American Medical Association suggests it very well might, though experts continue to be at odds over the impact of race in heart disease treatment.

Lead study author Dr. Ioana Popescu and colleagues at the University of Iowa Medical School reported on a five-year study of what happened to more than 1 million elderly black and white Medicare patients after they had heart attacks.

What Popescu found was that that black patients were less likely to receive invasive, aggressive treatments following a heart attack -- procedures like bypass surgery or receiving an artery-opening stent.

Though the study did not examine certain other factors that could influence death rates -- such as obesity and smoking -- Popescu cited consistently higher death rates for black patients between one month and one year after their episode.

The importance of the findings was echoed by other cardiologists and heart surgeons not affiliated with the study.

Dr. Carl Pepine, chief of cardiology at the University of Florida, noted, "These are very important findings that emphasize that we have much important work remaining in the battle against heart disease that is not linked simply to insurance status."

Fewer Aggressive Treatments

When dealing with a patient who has suffered heart problems, doctors have an array of options, some more aggressive than others.

A stent is a sort of scaffolding that props a clogged artery open. In a bypass surgery, a nonessential vein (like one from the leg) is cut out and used to reroute blood away from the blocked artery that caused the heart attack.

Both can be done on an emergency basis, or can be scheduled if an artery is dangerously close to closing off.

Heart patients who do not receive these treatments instead take medications, such as beta-blockers and aspirin, to prevent another heart attack.
Source :http://abcnews.go.com

Children with autism get day in court

The parents of 12-year-old Michelle Cedillo asked a federal court Monday to find that their child's autism was caused by common childhood vaccines, a precedent-setting case that could pave the way for thousands of autistic children to receive compensation from a government fund set up to help people injured by the shots.

Wearing noise-canceling headphones, Michelle, of Yuma, Ariz., was brought into the courtroom in a wheelchair at the start of the proceedings before the U.S. Court of Federal Claims. She stayed only a short time.

Her parents, Theresa and Michael Cedillo, allege a preservative called thimerosal that had been used in vaccines weakened their daughter's immune system and prevented her body from clearing the measles virus after she was immunized for the disease at age 15 months.

Today, Michelle suffers from a litany of health problems, including severe autism, inflammatory bowel disease, glaucoma and epilepsy.

"We hope to find out what happened and hopefully get the help she needs," said Theresa Cedillo, who takes care of her daughter full time at home.

Special Master George Hastings Jr. thanked the family for allowing theirs to be the first of nine test cases that will help guide the resolution of some of the nearly 5,000 similar claims lodged with the government.

"Clearly the story of Michelle's life is a tragic one," Hastings said in pledging to listen carefully to the evidence presented during the three-week hearing.

The burden of proof is easier than in a traditional court. Plaintiffs only have to prove that a link between autism and the shots is more likely than not, based on a preponderance of evidence.

Large scientific studies have found no association between autism and vaccines containing thimerosal.

But many parents say their children's symptoms did not show up until after their children received the vaccines, required by many states for admission to school.

"These are families who followed the rules. These are families who brought children in for vaccines. These are families who immunized their children," said the Cedillos' attorney, Thomas Powers.

Powers said that the science regarding a possible vaccine-autism link is in dispute.

Government attorney Vincent Matanoski dismissed much of what the plaintiffs are expected to present as conjecture or speculation.

"You'll find their hypotheses untested or, when tested, have been found false," Matanoski said.

Since 1999, more than 4,800 families have filed claims with the government alleging their children developed autism as a result of routine vaccinations. Most contend that a preservative called thimerosal is to blame for the impaired social interaction typical of the disorder.

The court is being asked to decide whether there is a link between autism and childhood vaccines. If it finds one exists, the families could be eligible for compensation under the Vaccine Injury Compensation Fund, a program established by Congress to ensure an adequate supply of vaccines by safeguarding manufacturers from lawsuits. Under the program, people injured by vaccines receive compensation through a special trust fund.

Autism is characterized by impaired social interaction. Those affected often have trouble communicating, and they exhibit unusual or severely limited activities and interests. Classic symptoms of mercury poisoning include anxiety, fatigue and abnormal irritation, as well as cognitive and motor dysfunction.

Monday's case addresses the theory that the cause of autism is the measles, mumps and rubella vaccine in combination with other vaccines containing thimerosal. The preservative, about 50 percent mercury by weight, is no longer found in routine childhood vaccines but is used in some flu shots.

In July 1999, the U.S. government asked vaccine manufacturers to eliminate or reduce, as expeditiously as possible, the mercury content of their vaccines to avoid any possibility of infants who receive vaccines being exposed to more mercury than is recommended by federal guidelines.
Source :http://www.chron.com

FDA Steps Up Oversight of Body Parts Companies

U.S. health officials said Tuesday that they're stepping up inspections of companies that use cadavers to harvest body parts for tissue transplants.

The increased vigilance comes after scandal shook the transplant industry last year when it was discovered that funeral homes were harvesting body parts and selling them without consent, including body parts from Alistair Cooke, the 90-year-old former host of PBS' Masterpiece Theater.

f not screened properly, transplanted tissues can cause serious infections, including HIV, hepatitis -- even death. Harvested tissues are used in some 1 million medical procedures in the United States each year, many of them for knee and back surgeries. Up to 100 recipients may receive tissue from a single donor, the FDA said.

In response to the scandal, the U.S. Food and Drug Administration formed the Human Tissue Task Force, which issued its first report Tuesday.

"Today's report finds no significant industry-wide problem in the recovery of human tissues," Dr. Celia Witten, director of FDA's Office of Cellular, Tissue and Gene Therapies, said during an afternoon teleconference. "This provides our belief that the risk of disease transmission is very low for patients who receive these products."

Still, the task force is calling for still more inspections. "There is reason to be ever vigilant because the tissue industry is growing," Witten said.

There are more than 2,000 cell and tissue establishments registered with FDA, the agency said.

Originally, the task force recommended targeted inspections -- or a "blitz" -- of U.S. companies that recover human tissues, including tendons, ligaments, bone and other musculoskeletal tissues, said David Elder, director of the FDA's Office of Enforcement, Office of Regulatory Affairs.

To date the FDA has inspected 153 major human tissue recovery firms and plans on inspecting an additional 300 companies, Elder said. "What our investigators found was encouraging for tissue safety," he said during the teleconference. "Although we identified some deviations from regulations, we generally saw no unsafe or deceptive practices that could put tissue recipients at risk for disease."

The biggest company involved in illegally harvesting body parts was Biomedical Tissue Services of New Jersey. The company faces trial, along with a former New York state funeral home director, on charges they stole bodies and dissected them unlawfully, the Associated Press reported.

In addition, seven funeral home directors have already pleaded guilty and tens of thousands of body parts removed by the company have been recalled. About 10,000 people are believed to have received tissues from the company, according to the AP.

The FDA task force is also recommending:

* Increased education and outreach. The FDA should sponsor a workshop on tissue processing and microbiology for industry, surgeons and academics, to develop and share best practices for reducing the risk of disease transmission.
* Research regulations and guidance. In September 2006, the FDA issued a "guidance document" that emphasized responsibilities for ensuring tissue safety between establishments and their contractors. The FDA will issue guidance on "current good tissue practices" to encourage tissue manufacturers to seek the best methods to further reduce the risk of infection transmission.

The FDA's Center for Biologics Evaluation and Research has strengthened its collaboration with the U.S. Centers for Disease Control and Prevention, to oversee tissue-safety surveillance and adverse reaction investigations, according to the report.
Source :http://www.forbes.com