Public Health

Violent video games tied to teen aggression

November 15, 2008 on 7:00 am | In Uncategorized | Comments Off NEW YORK (Reuters Health) - Adolescents who play violent video games may become increasingly aggressive over time, a new study of Japanese and U.S. teens suggests.

Researchers found that among three groups of 9- to 18-year-olds followed over several months, those who regularly played violent video games were more likely to get into more and more physical fights over time. The study is among the first to chart changes in gamers' aggressive behavior over time, lending weight to evidence that violent video games can encourage violence in some kids. And it's the first to show that the effects are seen across cultures, researchers report in the journal Pediatrics.

"Basically what we found was that in all three samples, a lot of violent video game play early in a school year leads to higher levels of aggression during the school year, as measured later in the school year -- even after you control for how aggressive the kids were at the beginning of the year," lead researcher Dr. Craig A. Anderson, of Iowa State University in Ames, explained.

An argument has been made that video games cannot be directly contributing to aggression because violence rates are low in Japan where video games are highly popular, Anderson said in a written statement.

"By gathering data from Japan," he said, "we can test that hypothesis directly and ask, 'Is it the case that Japanese kids are totally unaffected by playing violent video games?' And of course, they aren't. They're affected pretty much the same way American kids are.

The findings are based on two separate groups of teenagers from Japan -- 1,231 teens in all -- and 364 9- to 12-year-olds from the U.S. At the outset, participants estimated how often they played violent video games, then their own aggressive behavior was followed for up to six months afterward.

The Japanese teens reported on their own violent behavior using questionnaires, while teachers' and peers' reports were used to estimate the U.S. group's aggressive behavior.

In general, Anderson's team found that kids who habitually played violent video games were more likely than their peers to become increasingly involved in physical fights -- even when their behavior in the months leading up to the study was taken into account.

Of course, not all kids who play aggressive video games act them out in real life. Nor is media violence alone to blame for teenagers' aggression, the researchers point out.

But what these video games may do, the investigators say, is feed the idea that violence is a normal and acceptable way to react to everyday conflicts, like getting bumped in the school hallway. "It is important to realize that violent video games do not create schools shooters," Dr. Douglas A. Gentile, another researcher on the study, said in the statement.

"Violent games are certainly not the only thing that can increase children's aggression," he added, "but these studies show that they are one part of the puzzle in both America and Japan."

SOURCE: Pediatrics, November 2008.

Copyright © 2008 Reuters Limited.

Cigarette smoking may worsen premenstrual woes

November 15, 2008 on 7:00 am | In Uncategorized | Comments Off NEW YORK (Reuters Health) - Here's another reason not to smoke, if you're a woman: PMS.

Women 27 to 44 years old who smoke are twice as likely to develop premenstrual syndrome over the next two to four years, especially hormonally-related symptoms like backaches, bloating, breast tenderness, and acne, Dr. Elizabeth R. Bertone-Johnson of the University of Massachusetts in Amherst and her colleagues found.

"Our findings lend further support to the idea that smoking increases the risk of moderate to severe PMS, and provides another reason for women, especially adolescents and young women, not to smoke," Bertone-Johnson told Reuters Health via E-mail

Up to 20% of women have PMS severe enough to affect their relationships and interfere with their normal activities, Bertone-Johnson and her team note in the American Journal of Epidemiology. Smoking has been shown to affect levels of several different hormones, and the handful of studies looking into PMS and smoking have suggested that women with the syndrome are more likely to be smokers, the researchers add.

To investigate the relationship further, they analyzed data from the Nurses' Health Study II, which has been following 116,678 US registered nurses since 1989. The researchers looked at a subset of women who were PMS-free during the first two years of the study, comparing 1,057 who did go on to develop PMS to 1,968 who did not.

The women who were current smokers were 2.1 times as likely as non-smokers to report PMS within the next two to four years, the researchers found. The risk increased with the amount they smoked, and women who had picked up the habit in adolescence or young adulthood were at even greater risk; those who had begun smoking before their 15th birthday, for example, were 2.53 times as likely to develop PMS.

"Our findings do not suggest that this is entirely due to the fact that women who start smoking at younger ages smoke for more years than those starting when they are older. Additional research on the impact of smoking at different times in women's lives is needed," Bertone-Johnson said.

She continued: "Previous studies suggest that smoking may alter levels of estrogen, progesterone, testosterone, and other hormones, many of which may be involved in the development of PMS. Some studies have found that smokers have shorter and more irregular menstrual cycles than non-smokers. Smoking may also lower levels of vitamin D in the body, which also may increase a woman's risk of developing PMS."

A 2005 study found that 26% of female 12th-graders had smoked on at least one of the previous 30 days, Bertone-Johnson and her team note in their report. "Given the high prevalence of this behavior in young women," they say, "these findings may provide additional incentive for young women to avoid cigarette smoking."

SOURCE: American Journal of Epidemiology, October 15, 2008.

Copyright © 2008 Reuters Limited.

Tobacco smell won” trigger relapse in new quitter

November 15, 2008 on 7:00 am | In Uncategorized | Comments Off NEW YORK (Reuters Health) - Smokers who are trying to quit often find the scent of cigarette smoke pleasant, but new study findings suggest that it won't hinder their quit effort.

In a study of more than 1,100 smokers who had recently quit, researchers found that one quarter said that they found the scent of other people's cigarettes pleasant during their first week of abstinence.

This did not, however, seem to affect their odds of staying abstinent over the next several weeks, according to findings published in the journal Addiction.

"Recent quitters can be reassured that finding the smell of cigarette smoke pleasant is not likely to lead them back to smoking," lead researcher Dr. Hayden McRobbie, of the University of Auckland in New Zealand, told Reuters Health.

Still, that does not necessarily mean that newly abstinent smokers should make weekend plans with people who are still lighting up. Past studies have found that in the early stages of a quit attempt, a number of triggers may push some people toward relapse -- including watching other people smoke.

"People who are quitting should do evhaving a single puff," McRobbie advised. "If this means staying away from temptations, such as other people's cigarette smoke, then they should do this -- it will only be for the short-term."

For their study, McRobbie and his colleagues followed 1,110 men and women who had completed a smoking cessation program at the same London clinic.

After their quit date, participants filled out weekly questionnaires that asked them to rate the extent to which they found other people's cigarette smoke "pleasant" or "tempting." During their first week of abstinence, 23 percent said they found the smell of smoke to be pleasant, while 43 percent found it unpleasant and the remaining one- third had a neutral opinion.

The researchers found no clear differences among the three groups in the odds of remaining abstinent for the next three weeks.

On the other hand, just over half of the study group said that they found cigarette smoke tempting during their first quit week -- and this did seem to increase their risk of relapsing the following week. However, this effect was no longer seen once smokers got past their second week of abstinence.

SOURCE: Addiction, November 2008.

Copyright © 2008 Reuters Limited.

Aggressive bone care could prevent hip fractures

November 15, 2008 on 7:00 am | In Uncategorized | Comments Off NEW YORK (Reuters Health) - If the US health care system "started to take osteoporosis seriously," it could slash the number of Americans who suffer hip fractures by at least 25 percent, according to one of the authors of a new report on managing the brittle bone disease.

Dr. Richard Dell, an orthopedic surgeon with Kaiser Southern California, and his colleagues describe a program initiated by the 3.1 million-member HMO to identify patients at risk of fragility fractures and make sure they received treatment. The Healthy Bones Program, which was up and running in all of the health plan's 11 sites by 2002, saw reductions in hip fracture rates ranging from 23.1 percent to 60.7 percent.

Osteoporosis can have disabling and even deadly consequences, the researchers note; a quarter of the 325,000 patients who suffer a hip fracture every year will wind up in a nursing home, and a quarter will die within the year. Thirty percent of men die within the first year of a hip fracture, compared to 17 percent of women.

Orthopedic surgeons leading multidisciplinary teams identified 620,000 Kaiser Southern California members who were eligible to have their bone mineral density checked with a type of X-ray exam called dual X-ray absorptiometry, or DEXA. These included women over 65, men over 70, anyone on drugs that could worsen bone thinning, such as corticosteroids, and anyone over 50 who had previously had a fragility fracture, defined as a bone break that occurs after a fall from standing height or lower.

Patients whose DEXA scans revealed dangerously thin bones were offered an osteoporosis education program, and those who had suffered fragility fractures were enrolled in a treatment plan that included home health care and safety checks of the home.

Between 2002 and 2006, the researchers report, the number of health plan members getting DEXA scans more than doubled, while the rate for men increased six-fold. The number of patients on osteoporosis medications such as bisphosphonates rose by 35 percent. The average reduction in hip fractures seen across all of the HMO's medical centers was 37.2 percent.

While Kaiser has the great advantage of a comprehensive electronic medical record system that makes it possible to keep track of at-risk patients and monitor whether they are getting recommended DEXA scans and filling their prescriptions, Dell said in an interview, it should be possible even for private practitioners to reduce the risk of hip fractures in their patients by at least 25 percent.

"There remains a widely held misconception among many orthopedic surgeons that nothing can be done to prevent or treat osteoporosis," Dell and his team note in their report in the Journal of Bone & Joint Surgery. "The present study should help to dispel that misconception.

The researcher argues that orthopedic surgeons should take a leading role in treating patients who are at risk of fragility fractures, or who have already sustained them. "The problem with the current system is that we as orthopedic surgeons basically aren't the ones who typically initiate treatment," he said. "We defer that to other providers."

And often, Dell added, at-risk patients fall through the cracks due to continuity of care issues. "We should be identifying these people earlier, before they fracture," he said.

SOURCE: The Journal of Bone & Joint Surgery, online November 3, 2008.

Copyright © 2008 Reuters Limited.

Study IDs factors that help elderly thrive

November 15, 2008 on 7:00 am | In Uncategorized | Comments Off NEW YORK (Reuters Health) - Older adults who have never smoked, drink moderately and keep a positive outlook on life are more likely to stay healthy and happy for years, new research suggests.

In a study that followed more than 2,400 older adults for a decade, researchers found that 8 percent maintained "exceptional" health over time. These so-called "thrivers" had no significant disabilities and considered themselves happy and interested in life.

At least part of their secret, researchers found, seemed to be in lifestyle choices and other modifiable factors. Thrivers were more likely than their peers to have never smoked, to drink moderately -- up to one or two drinks a day -- and have relatively low stress levels and a bright outlook.

The study, published in the Journal of Gerontology: Medical Sciences, differs from past studies that have focused on risk factors for poor health in old age.

It came from the opposite approach -- asking what factors promote exceptional health -- and looked at multiple dimensions of health, including emotional well-being, explained lead researcher Dr. Mark Kaplan, of Portland State University in Oregon.

It suggests that decisions made early in life -- like refusing to smoke, dealing with stress and limiting alcohol to moderate levels -- can make an important difference not only in how long people live, but in the quality of their old age.

So it's "never too early" to start thinking about the long-range impact of lifestyle choices, Kaplan told Reuters Health.

But it's never too late, either, he added. Although never-smokers fared better in this study than former smokers did, for example, it's known that quitting reduces smokers' risk of lung cancer and heart disease.

The findings are based on 2,432 Canadian adults who were between the ages of 65 and 85 at the study's start. Each completed health surveys every two years over a decade. By the end of the study, 8 percent were considered thrivers, while 47 percent had at least a moderate disability, such as problems with their hearing, mobility or mental function.

The rest of the study group had either died or had entered a long-term care facility.

The researchers looked at a range of factors that could affect healthy aging. The ones that stood were never smoking, moderate drinking and low distress levels, as well as higher income.

"Many of these factors can be modified when you are young or middle- aged," co-researcher Dr. David Feeny, of the Kaiser Permanente Center for Health Research in Portland, said in a statement.

"While these findings may seem like common sense," he added, "now we have evidence about which factors contribute to exceptional health during retirement years."

SOURCE: Journal of Gerontology: Medical Sciences, October 2008.

Copyright © 2008 Reuters Limited.