Scientific analysis of Tweets quantifies Pokémon Go! dangers

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Reports of Pokémon Go! being hazardous for those who don’t pay attention have a definite “duh” factor.

But despite that, some people continue to put their lives and the lives of others in danger at times while playing the mobile virtual reality game. As the old saying goes, “It’s all fun and games until someone gets killed.”

A fascinating report breaking in JAMA Internal Medicine this morning reveals that 18 percent of people tweeting about Pokémon Go! from July 10 to 20 indicated they were playing and driving. Another 11 percent said they were playing the game while riding in a car with someone else behind the wheel (but barking out rapid-fire orders to the driver) and 4 percent indicated they encountered risk of injury simply by playing the game while walking.

Read more: Where to hunt for Pokémon in the Quad-Cities

The public health experts analyzed a random sample of 4,000 Tweets out of a whopping 345,433 Tweets about Pokémon Go! during the 10-day period. That number only includes Pokémon Go! Tweets including “Pokémon” and “driving,” “drives,” “drive” or “car.”

Further analyses categorized phrases such as “omg I’m catching a Pokémon and driving,” “just made sis drive me around to find Pokémon” and “almost got hit by a car playing Pokémon Go!”

“Our findings can help develop strategies for game developers, legislators, and the public to limit the potential dangers of Pokémon Go! and other augmented reality games,” the researchers reported. “For instance, passengers using mobile devices are typically not considered a driving risk, but given its augmented reality feature, gaming passengers may implore drivers to take risks to aid their play.”

Read more: Pokémon Go! maps of the Quad-Cities

Scientists recommend game restrictions

The authors recommend:

Changing the game’s software to restrict play at any driving speed. Currently, the game stops working at speeds over 10 mph.

Disabling the game near roadways in parking lots to protect pedestrians.

The authors admit the game theoretically has a health benefit by getting a younger generation made less active by technology to move again. But they say those benefits are negated by the hazards of the game.

Read more: Where to find rare Pokémon in the Quad-Cities

“Motor vehicle crashes are the leading cause of death among 16- to 24-year-olds, whom the game targets,” they reported. “Moreover, according to the American Automobile Association, 59 percent of all crashes among young drivers involve distractions within six seconds of the accident.”

I wrote a few stories about Pokémon Go! for MapQuest that have been among my best performing MapQuest stories (and I’ve sprinkled them throughout this piece). I have friends who enjoy playing the game safely with their children.

However, none of us can deny the distractions. I have a terrible tendency to want to Facebook while driving. I know it’s dangerous and I try to stop myself.

And as someone who didn’t have a car for two years, I also know all too well about walking and Smart phoning, and have suffered a ton of bumps, bruises and scrapes to prove it.

Be careful out there, and “catch ‘em all!”

Read more: Top 5 Pokémon gyms in the Quad-Cities

Grandma’s fan may be doing her more harm than good

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I remember going to visit my grandma (my mom’s mom) on Sundays. We went every Sunday, like clockwork, to watch “Wonderful World of Disney” and “The Muppet Show.”

Sometimes in the summer, it was insanely hot in grandma’s house. She only had a fan in the window – no air conditioning. My mother would beg her to come stay at our house, but she would refuse.

On top of all of this, grandma only had one lung. Still, she wouldn’t budge, and it always worried my mother deeply during heat waves.

A research letter published today in JAMA shows that electric fan use by elderly people during extreme heat could in fact be harmful. While I personally find it outrageous that every elderly person in America is not furnished with air-conditioning no matter where they are, I realize that some just don’t like it, or they believe they cannot afford the electric bill.  I’m sure many can’t, sadly, but many communities do have air conditioning assistance programs for the elderly, both through the power company to pay the bill, as well as local charities that will provide refurbished air conditioners to elderly people who cannot afford to buy one.

The study admittedly was tiny – three men and six women, average age of 68.

There’s a reason why the sample was small. Wearing  only shorts (men) or shorts and a sports bra (women), the volunteers sat in a 108-degree chamber. After 30 minutes of humidity at 30 percent, the humidity went up 2 percent every five minutes until it reached 70 percent. Such conditions are not uncommon in summers in the Midwestern and Southern states, or even in the Northeast. The study was conducted by University of Texas Southwestern Medical Center, Dallas.

Conventional wisdom in the medical community has been to discourage fan use at temperatures above 95 degrees, “due to theoretical risks of accelerated heat gain and dehydration,” the authors wrote. “However, empirical data to support or refute their use during heat wave conditions are sparse.”

Researchers observed the participants on randomly assigned days with and without a 16-inch fan located about three feet from them. They could not drink any fluids during the experiment. Their heart rates, core temperatures and sweat loss were monitored.

Surprisingly, when the fan was in use, core temperature and heart rate spiked. “Although differences were small, their cumulative effect may become clinically important with fan use during more prolonged heat exposure,” the researchers concluded. “Fan use elevates sweat loss in young adults. This was not observed in elderly adults, suggesting that age-related impairments in sweating capacity possibly limit the effectiveness of electric fans. Overall, this preliminary study indicates that electric fans may be detrimental for attenuating cardiovascular and thermal strain of elderly adults during heat waves.”

Grandma lived down the hill from us, in a housing project known back then as the Arsenal Courts. Originally, the projects were built to house soldiers working at the nearby Rock Island Arsenal during World War II. They were not equipped with even window units.

It was a very dangerous place back then, quite frankly, but grandma was very poor. My grandpa, Grant, died in a car accident when my mom was only 16. Grandma then spent many years in a tuberculosis sanitarium. She never really developed workplace skills as a farm wife, and when her husband died, she became sick with tuberculosis.

As if TB wasn’t bad enough, she also had several bouts of cancer. Grandma suffered many years, but was a devout Christian woman and always maintained a smile. She lived to be 81, my longest living relative next to my dad’s sister, who is 83. My dad came in third (God bless him!) at 77.

At any rate, if you know of an elderly person who just refuses to come out of the heat when it’s uncomfortable even for young people, you might want to share this study with them and see what you can do to help them get an air conditioner, if they will agree to one. A fan just isn’t enough, and is in fact harmful during heat waves, or so at least it appears in this very small (albeit interesting to me) study.

Study: Depressed people with HIV at greater risk for heart attack

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We’ve known for quite some time that for a person living with HIV but treating it with modern antiretroviral therapy, a heart attack is a much greater threat than an opportunistic infection.

And now we know that when you put depression into the mix, the heart attack risk is even greater.

While the findings aren’t surprising because they mirror a link between depression and heart attack risk in the general population, the paper published online this morning in JAMA Cardiology is cause for concern. That’s because people with HIV already are at far greater risk of having a heart attack than the general population, due in part to the heightened state of inflammation HIV causes in the body.

“Our findings raise the possibility that, similar to the general population, major depressive disorder may be independently associated with incident atherosclerotic cardiovascular disease in the HIV-infected population,” the authors wrote. “Considering the dearth of research in this area, future epidemiologic and mechanistic studies that include women and non-VA populations with HIV are needed.”

Researchers from Tennessee’s Vanderbilt University followed more than 26,000 HIV-infected veterans without cardiovascular disease at baseline (1998-2003) participating in the U.S. Department of Veterans Affairs Veterans Aging Cohort Study from April 1, 2003 to Dec. 31, 2009. At baseline, 19 percent of them suffered from major depressive disorder as classified by the International Classification of Diseases codes.

“We report novel evidence that HIV-infected adults with major depressive disorder have a 30 percent increased risk for acute myocardial infarction (a heart attack) than HIV-infected adults without major depressive disorder after adjustment for many potential confounders,” the authors wrote.

Depression a problem among people with HIV

The findings are troubling because not only is heart disease far more prevalent among people with HIV than in the general population (one study showed that the risk is increased by 50 percent), so is depression.

Read more: My report for HIV Equal on a “PrEP Against Heart Disease” being studied now among people with HIV

Two years ago, I wrote a story for Healthline News headlined, “People with HIV Suffer from Depression Caused by Pain, Shame, Substance Abuse.” You can read the story by clicking here. I don’t think I ever have received more email from readers than I did for that story, mostly thanking me for bring me the issue to light. People with HIV run twice the risk of depression than the general population, studies show.

Many people with HIV simply are getting older, and older Americans are at greater risk for depression even without a chronic illness. Older people are at greater risk for heart attack, too.

The mean age among people with HIV with major depressive disorder in the Vanderbilt study was 48. The mean age among those without depression was 47.

“It is possible that the presence of major depressive disorder further exacerbates the persistent inflammatory and coagulatory activation already present in HIV, resulting in higher cardiovascular disease event rates,” the authors wrote. “Potential behavioral mechanisms underlying the major depressive disorder incident CVD association are poor health behaviors (eg. smoking and sedentary lifestyle and treatment non-adherence).”

Studies have shown that people who are depressed are less adherent to their HIV medication.

It all adds up to a deadly mix for people with HIV who aren’t taking care of themselves. The authors hope their study stimulates new research for depression treatments among people with HIV.

Read more: My Healthline News report on why people with HIV must stop smoking

Yes, pharma reps likely do have a say in which medications you take

MedsYou probably have seen them in your doctor’s office: Those really nice looking young people in a coat and tie, or a pretty pantsuit, carrying a spiffy briefcase and a bag filled with medicine samples.

They’re pharmaceutical reps. And a new study shows they probably wield just as much influence as the cynical among us always thought they did.

Published today in BMJ, researchers from Yale and the Center for Medicare Services have shown an association between payments to physicians for speaking and consulting fees, food and drink and other perks and written prescriptions for those companies’ drugs – at least when it comes to non-insulin diabetes meds and oral anticoagulants, both common among our booming elderly population.

The study was massive. Researchers examined 46 million Medicare Part D prescriptions written by more than 600,000 physicians to more than 10 million patients. They looked at more than 300 hospital referral regions.

“One additional payment in a region (median value $13) was associated with approximately 80 additional days filled of the marketed drug in the region,” the study concluded. “Payments to specialists and payments for speaking and consulting fees were associated with larger regional changes in prescribing than payments for non-specialists or payments for food and beverages or education.”

We all know what prescription drugs cost. That’s some serious bang for the buck.

Docs got $169 million for these two classes of drugs alone

Just how much money are we talking in terms of the dollars doled out to docs?

Nearly a million payments were given to the physicians in the 300-plus regions in 2013 and 2014. Just for the anti-coagulants, which are used to treat atrial fibrillation (A-fib) and other cardiovascular disorders, payments totaled more than $61 million. For the non-insulin diabetes drugs, approximately 1.8 million payments totaling more than $108 million were showered upon the docs.

Read more: My interview with actor Howie Mandel about his A-fib

How this study, the first of its kind, finally became possible is noteworthy as well. In a word: Obamacare.

“The Open Payments program, enacted as part of the Affordable Care Act, mandated manufacturers of pharmaceuticals and medical devices to report payments to physicians and teaching hospitals to the Centers for Medicare & Medicaid Services (CMS). The resulting data include direct and indirect payments as well as payments in kind, such as the value of food and gifts, and details the manufacturers products associated with the payment.”

Previous studies have shown that doctors do not believe they are influenced by the payments.

Do you think your doctor is prescribing the best drug for you? Or is he or she possibly prescribing a more expensive drug that isn’t necessary, or even a drug that might not be as effective as something else? These are concerns I heard for more than two years as a reporter for Healthline News from patients with all sorts of medical conditions. I hope to someday write a long-form look at such practices as it pertains to HIV medications.

Read more: My infographic report on the cost of HIV medications around the world

Authors admit study has limitations

The study does have limitations, the authors admit.

“Our findings do not necessarily suggest that payments by pharmaceutical manufacturers are harmful for patient care,” they wrote. “Patients may benefit from physicians being made aware of newly approved, effective treatments that may have fewer adverse effects, reduce the need for monitoring tests, or improve adherence. However, our findings support long voiced concerns about the potential influence of even small payments to physicians by pharmaceutical companies, such as for food and beverages.

“This influence on prescribing can potentially negatively affect patients through inappropriate prescribing, or more likely prescribing of more expensive, branded drugs when cheaper, generic alternatives exist. By one estimate, the geographic variance in high cost or low cost drug prescribing cost Medicare $4.5 billion in 2008.”

I always have said I really have no idea whether Obamacare is a good or a bad thing, because I’ve written about it so much I could see it either way. But I will say this: This sort of transparency is good for America any way it comes in our current climate of rampant political and corporate corruption.

“Our study has important limitations,” the authors go on to note. “Firstly, as the study was cross-sectional, we cannot prove the causality that marketing causes prescribing; it is possible that pharmaceutical companies market in regions where prescribing is already higher. Secondly, our results likely underestimate the association between payments by the manufacturers of pharmaceuticals and physician prescribing since we only had data on prescriptions filled, not prescribed, and our analyses were focused solely on Medicare Part D enrollees, who received approximately 25 percent of all the prescriptions written in the United States.”

The researchers report; you decide.

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Read more: My report on how insurers use higher drug costs to discourage sick patients from enrolling