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Violent video games trigger aggressive thinking and behaviour in children

 

MD-FM Thursday March 27, 2014 

 

 

SARAH:

MD-FM, the latest medical news from around the world… Here’s Peter Goodwin.

SEGMENT 1: PSYCHIATRY: Violent video games lead to aggressive thinking in children

 

PETER:

Hello and, to begin with, children who play a lot of violent video games apparently start to think more aggressively. That’s the finding of a study, published in JAMA Pediatrics, that showed violent computer games can also change how kids interact socially and how they interpret the world. Sarah Maxwell is here with the details…

 

SARAH:

A three-year study looking at about 3000 children found violent video games were associated with long-term aggressive thinking, which in turn led to aggressive behaviours. Senior study author Craig Anderson:

 

ANDERSON:

This is really the first study to really pin down this idea that almost all of the violent video games’ effects on aggressive behaviour was operating through this increase in aggressive thinking. These are primarily linear effects, it’s not like a threshold kind of model, where so many hours leads to lots of problems and if you’re under that there’s no problem. Essentially, when you play a lot of violent video games, it changes the way you see the world, you start thinking of the world in a more aggressive fashion.

 

SARAH:

Dr. Craig Anderson, from Iowa State University. His team measured three variables representing aggressive thinking. The findings were the same regardless of: gender, age or how aggressive the children were to begin with:

 

ANDERSON:

The general public has been misled frequently into thinking that only a few people are affected –you know: only boys are affected, or that only highly aggressive individuals or that only young children are affected by violent games, but a vast majority of the research community knows that these effects do tend to generalize, even if the effect is relatively small. The fact that almost the entire population is exposed means that this is an important phenomenon, it’s really a public health issue.

 

SARAH:

Craig Anderson, from Iowa.

 

 

SEGMENT 2: Radiofrequency ablation safe and effective in patients with low-grade dysplasia and Barrett’s syndrome 

 

PETER:

In patients with Barrett Esophagus who had low-grade dysplasia radiofrequency ablation (RFA), given earlier than it’s currently performed, reduced the risk of progression and was safe and effective…

 

SARAH:

Yes, RFA is often used to remove presumed early cancerous cells in patients with high-grade dysplasia. This randomised study, reported in JAMA, looked at patients with low-grade dysplasia. It showed that compared to endoscopic surveillance, ablation at an earlier stage was associated with a 25 per cent reduced absolute risk of progression to high-grade dysplasia. And the risk of progression to cancer was also reduced by 7.4 per cent.

 

PETER:

So Sarah, does this mean all patients with low-grade dysplasia should have ablation then?

 

SARAH:

Well, no. And deciding which patients should is still difficult in practice. First of all, low-grade dysplasia is very often over-diagnosed; and lead author, Jacques Bergman, recommends that it needs biopsy confirmation by an expert:

 

BERGMAN:

Sometimes there are inflammatory changes that may mimic dysplasia and, especially if the pathologist does not see a lot of dysplastic cases, then he has difficulty making the distinction between inflammatory changes and dysplastic changes. So a majority of patients that are said to have low grade will not have low grade if an expert pathologist reviews the biopsy.

 

SARAH:

That was Jacques Bergman, from the University of Amsterdam. Another key point is that not all patients with low-grade dysplasia progress to cancer! In this study, 28 per cent of those with a strongly confirmed diagnosis actually regressed naturally, without intervention:

 

BERGMAN:

At this point we’re working on studies to make the selection even better and it’s likely that factors in that selection process will be the length of the Barrett’s, the number of times that the diagnosis of low grade dysplasia has been confirmed but also the extent of low grade dysplasia within the Barrett segment –is it a single biopsy or do all biopsies show low grade dysplasia?

 

SARAH:

Professor Jacques Bergman, from The Netherlands.

 

SEGMENT 3: Aromatase inhibitor cut breast cancer incidence by half in high-risk postmenopausal women

 

PETER:

In a study of cancer prevention, postmenopausal women at high-risk of breast cancer, who took anastrozole for five years, were half as likely to develop the disease, according to findings from a randomised placebo controlled study, published in The Lancet. Because this aromatase inhibitor has fewer side effects than tamoxifen and raloxifene –already being recommended for prevention –it could be even more appropriate. But an editorial comment points out that no reduction in breast cancer mortality or overall mortality has yet been reported, so any side effects at all need to be appraised.

 

SEGMENT 4: Stool DNA testing detects more colon cancers than faecal immunochemical testing among average-risk patients

 

PETER:

For patients at average-risk of colorectal cancer, a stool DNA test detected significantly more cancers than the conventional faecal immunochemical test (FIT).

 

SARAH:

Yes, and it was also more sensitive at detecting pre-cancerous lesions — according to a large prospective trial published in the New England Journal of Medicine. The DNA test’s sensitivity was 92.3 per cent compared to 73.8 per cent with FIT. However, the test also led to significantly more false-positives. Lead study author Thomas Imperiale:

 

IMPERIALE:

My sense is that the science is only going to continue to improve, so I think the hope going forward with the technology is that, at some point, another battery of markers may perform more specifically.

 

SARAH:

That was Dr Thomas Imperiale from Indiana University, who said that the test is currently under investigation by the FDA.

 

PETER:

OK well right now there are three different screening tests being recommended: colonoscopy, sigmoidoscopy and FIT. And each country has its own preference, doesn’t it? So how might this new test fit in to the picture?

 

SARAH:

Dr. Imperiale said countries will have to decide individually, by looking at the pro’s and cons of each approach. One advantage with the DNA test is that, like FIT, it’s non-invasive but being more sensitive you could perhaps do it less frequently:

 

IMPERIALE:

To be able to tell that, we’re going to have to take the data from this study and other studies and put those into models that will project the number of cancers detected, the number of cancers prevented, mortality reduction, incidence reduction, effectiveness and cost-effectiveness. I’m sure we’re going to see results sometime in 2014 and that will give people a better sense of what the trade-offs are. Our guess is that the test can be less frequently applied than annually, but we need those analyses to be able to say that.

SARAH:

Thomas Imperiale, from Indianapolis.



SEGMENT 5: E-cigarettes not associated with smoking cessation or reduced cigarette consumption 

 

PETER:

The use of e-cigarettes was not associated with quitting smoking or even reducing cigarette consumption after one year, and these data, reported in JAMA Internal Medicine, come from the second longitudinal study to show this:

 

SARAH:

Yes, the study authors analysed questionnaires filled out by nearly 1000 smokers, 88 of whom mentioned using e-cigarettes. After one year, there was no difference in cessation or consumption whether smokers used e-cigarettes or not:

 

LING:

Really, in contrast to the very aggressive advertising and marketing messages that are out there, we really don’t have good scientific evidence to support those claims that the product is going to help you quit smoking 

 

SARAH:

That was senior study author Dr. Pamela Ling from the University of California in San Francisco. The team also published another study on advertising for e-cigarettes on the web:

 

LING:

We found over 90 per cent of the websites make health claims about the products, that 64 per cent of the websites made claims about smoking cessation and 22 per cent of the websites actually feature doctors on them. So it’s not surprising that people think that the product is for smoking cessation and that it will make them healthier.

 

SARAH:

And Dr. Ling added that e-cigarette use is still a bit of a hazy area…

 

LING:

There certainly is still need for more research on this topic. You know our study didn’t recruit electronic cigarette users because they were using the product or because they were trying to quit --our study was really focusing on a naturalistic group of smokers that use the product for whatever reason they wanted to, and followed them over time. But it gives a perspective on what might happen in a real world type of setting.

 

SARAH:

Pamela Ling from the University of California.

 

PETER:

Hmm, so far, so it doesn’t look as if e-cigarettes are better than nicotine patches for quitting?

 

SARAH:

No. And their toxicity is still unclear too. So really, the jury’s still out for now on the benefits of e-smoking, whatever the adverts try to tell you.

 

IN BRIEF 1: Information on HbA1c levels provides little additional information in predicting cardiovascular risk

 

PETER:

Finally, in brief: measuring blood levels of glycated haemoglobin (HbA1C) provided very little additional information in predicting the risk of cardiovascular diseases, compared to assessing conventional risk factors such as smoking and cholesterol levels. These are the conclusions of a study, published in JAMA, which followed over 300,000 adults without a known history of diabetes or cardiovascular disease to begin with.

 

IN BRIEF 2: Improving cooking fuels and kitchen ventilation associated with better lung health

 

PETER:

Improving cooking fuels by using biogas and improving kitchen ventilation, were both associated with better lung function and reduced chronic obstructive pulmonary disease. That’s the finding of research, reported in PLOS Medicine, that looked at around 1000 villagers in China, who were offered to change either their cooking fuels, their ventilation system or both. The study compared people who adopted these changes with those who continued with their regular habits, and followed for them for over nine years.


PETER:

That's all from MDFM for now. Sarah Maxwell and I will be back with more next week, so until then from me Peter Goodwin, goodbye!

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