American Idol: Women Face Sudden-Death Round

American Idol

By Jamie Bufalino

02/20/2013 at 11:00 PM EST

Mariah Carey

Mario Anzuoni/Reuters/Landov

American Idol threw yet another new twist at its 40 remaining contestants: a sudden-death round.

"One song, one chance, no mercy," Ryan Seacrest said as the first group of 10 female contestants gathered in Las Vegas to try to finally sing their way – in front of a boisterous studio audience – through to the "America votes" phase of the competition.

Five women moved on, five went home.

Kentucky high school junior Jenny Beth Willis, whose rendition of a Trisha Yearwood song earned mixed reviews from the judges, was the first up. Although Keith Urban appreciated her "effortless confidence," Nicki Minaj said her performance lacked excitement (a comment that elicited the first audience boos of the season). Final result: It was the end of the road for Willis.

Tenna Torres, 28, – who attended Mariah Carey's camp for kids as a youngster – took the stage next and impressed the judges with her take on the Natasha Bedingfield's "Soulmate." But she lost style points with Minaj, who didn't like one particular aspect of her look. "Lose the hair," said Minaj, who felt the contestant's coif aged her. Final result: She made it through to the Top 20.

The three most powerful performances of the night all made it to the next round: Nashville's Kree Harrison, who despite taking a decidedly plain-Jane approach to styling, wowed the judges with her version of Patty Griffin's "Up to the Mountain." "You sang the hell out of that song," said Carey.

Angela Miller, 18, of Massachusetts, belted out Jessie J's hit "Nobody's Perfect." But she pretty much was.

And Amber Holcomb, an assistant teacher from Texas, closed the show with a rousing (and well received) rendition of "My Funny Valentine."

For the final spot of the night, it came down to Anchorage, Alaska, resident Adriana Latonio, 17, who tackled Aretha Franklin's "Ain't No Way," and Shubha Vedula, a Michigan high school senior who sang Lady Gaga's "Born This Way."

Although the judges saw potential in both contestants, they ultimately picked Lantonio's powerhouse vocals in a final emotional moment.

Thursday will bring out the guys. The first round of 10 will take the stage to try to make the top 20 – but once again, five will go home.

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Doc groups issue list of overused tests, therapies

WASHINGTON (AP) — Don't be afraid to question your doctor and ask, "Do I really need that?"

That's the advice from leading medical groups who came up dozens of tests and treatments that physicians too often prescribe when they shouldn't.

No worrisome stroke signs? Then don't screen a healthy person for a clogged neck artery, the family physicians say. It could lead to risky surgery for a blockage too small to matter.

Don't routinely try heartburn medicine for infants with reflux, the pediatric hospitalists say. It hasn't been proven to work in babies, and could cause side effects.

Don't try feeding tubes in people with advanced dementia, say the hospice providers. Helping them eat is a better option.

These are examples of potentially needless care that not only can waste money and time, but sometimes can harm, says the warning being issued Thursday from medical specialty groups that represent more than 350,000 doctors.

Too many people "think that more is better, that more treatment, more testing somehow results in better health care," said Dr. Glen Stream, former president of the American Academy of Family Physicians, which contributed to the list. "That really is not true."

The recommendations are part of a coalition called Choosing Wisely, formed by the American Board of Internal Medicine Foundation. Participating medical societies were asked to identify five tests or treatments that are commonly overused in their specialty. The list is aimed at doctors and includes references to published studies. Consumers Reports and other consumer groups are publicizing the information in more patient-friendly terms.

Last year, the coalition listed 45 overused tests and treatments. It included some of the best known examples, such as too much imaging for back pain and repeating colonoscopies too frequently.

This year's list adds 90 more overused kinds of care. Some are the result of doctors' habits, hard to overcome despite new evidence, Stream said. Others come about because patients demand care they think they need.

Some other examples:

—Don't use opioid painkillers for migraines except as a last resort, say the neurologists. There are better, more migraine-specific drugs available without the addictive risk of narcotics. Plus, frequent use of opioids actually can worsen migraines, a concept known as rebound headache.

—Just because a pregnant woman misses her due date, don't race to induce labor if mom and baby are doing fine, say the obstetricians. Inducing before the cervix is ready often fails, leading to an unneeded C-section. "Just being due by the calendar doesn't mean your body says you're due," Stream notes.

—Don't automatically give a child a CT scan after a minor head injury, say the pediatricians. About half of children who go to the ER with head injuries get this radiation-heavy scan, and clinical observation first could help some who don't really need a CT avoid it.

—And don't leave an implanted heart-zapping defibrillator turned on when a patient is near death, say the hospice providers. This technology clearly saves lives by guarding against an irregular heartbeat. But if someone is dying of something else, or is in the terminal stages of heart disease, it can issue repeated painful shocks, to no avail. Yet fewer than 10 percent of hospices have formal policies on when to switch off the implants.

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Wall Street ends down sharply after Fed minutes

TORONTO, Feb 20 (Reuters) - Canada's Rebecca Marino, a rising star in women's tennis, stepped away from the sport in search of a normal life on Wednesday, weary of battling depression and cyber-bullies. Ranked number 38 in the world two years ago, the 22-year-old admitted she had long suffered from depression and was no longer willing to make the sacrifices necessary to reach the top. "After thinking long and hard, I do not have the passion or enjoyment to drive myself to the level I would like to be at in professional tennis," Marino explained in a conference call. ...

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India Ink: A Personal Nightmare of Assault in India

In a hotel in southern India, in the midst of a dreamless sleep, I awoke inside a nightmare. I heard someone screaming. I’m not sure how much time passed before I realized that it was my scream.

I had traveled to India on behalf of a U.S.-based organization to film a documentary about political street theatre and how art is used as a tool for social change. It was the continuation of field research that I had begun as a William J. Fulbright Scholar. As a second-generation American born to parents who emigrated from India, I felt a sense of pride that I could use my role as a filmmaker to serve as a cultural ambassador between the two largest democracies in the world.

But I found myself awake in this nightmare, with a man violently gripping my mouth shut, attempting to rape me. I was biting and kicking, using every ounce of my energy to fight for my life. My mouth was badly bleeding and in the struggle we fell to the floor. He continued to violently grab my face, and said, “Shalini, don’t shout.” He knew my name. I recognized him as the hotel waiter who served my dinner that night.

I continued to scream and fight incessantly, until finally he relented. He picked up his lungi and said, “I’ll leave. Don’t tell the manager.” Then he ran out and shut the door. Did he really think he could try and rape me in my sleep, without protest and that I wouldn’t tell? Yes. He did. He counted on the fact that he lived in a culture that blamed the victim — that the stigma associated with sexual assault would force a woman to keep quiet. And although I had escaped the worst-case scenario, and prevented a rape, the nightmare was far from over.

In the days that followed, bruised and battered, with excruciating body pain, I managed to shuttle to and from government hospitals to be examined and police stations to file reports. I was well acquainted with India’s bureaucratic process, and in spite of my injuries, I wanted to make sure I had filled out all the paperwork correctly to obtain “justice.”

For several weeks, I tried to get a response from several American and Indian bureaucracies, but they all responded the same way: by doing nothing. Despite my formal complaints, in which I detailed the attack in full, these institutions offered no assistance – not even a single follow up call. I was devastated. I traveled to India on part of an American organization, and received no mental, physical or emotional support. As someone who has committed my life to artistic expression and social justice, I have never felt so voiceless.

Rape and sexual assault are not isolated incidents in a woman’s life. The physical wounds can heal, but the psychological and social stigma associated with rape can keep a woman from reaching her highest potential. My mother had always raised me with the idea that I could lift myself up from my bootstraps and follow my dreams. But in the years following the sexual assault, I suffered the worst depression that I had ever known. I finally sought out a free clinic for survivors. The counselor explained to me, “You have something called post-­‐traumatic stress disorder (PTSD). You have the stuff soldiers have coming home from a war.” Had I not found someone who could diagnose me with PTSD, and tell me this was a real and treatable condition, this assault may have held me back for life.

The recent gang rapes in India are a reminder to all of us that the rapists are not the only persons who are guilty. The onlookers, the institutions that turn a blind eye, and fail to implement comprehensive policies to address sexual assault are complicit in the violence. When these crimes are swept under the carpet, it perpetuates a culture of silence, a culture that blames the victim.

In the mainstream coverage of the recent gang rape in India, there is a kind of colonial mentality to view these men as savages, and to see India as a place that oppresses women. But looking at figures in the U.S., every two minutes a woman is sexually assaulted. One in four American women suffer rape or attempted rape by the time they reach college.

When I first started to share my story, I was astounded by just how many women began sharing their stories with me. It was like a common secret that we were all hiding. And I grieved not just for my own loss of innocence, but also for just how ordinary my story is, for the invisible war that is happening against women everyday. Sexual violence against women is ubiquitous. It happens to women everywhere, however educated, however empowered, across boundaries of race, class, and nationality.

We can longer wait for the death of another woman to break the silence of so many victims of sexual violence. U.S. and Indian institutions must move quickly to implement comprehensive policies regarding education, training, and support as well as clearly defined medical and legal protocol to deal with women who are sexually assaulted at home and abroad.

Healing from this traumatic event has been a journey towards deep compassion for myself, for my attacker, and for the people and institutions that betrayed me in my time of need. This story is for the courageous women who have been betrayed by the institutions they loved and served. This story is for the 40,000 women in India who are still waiting for justice for sexual assault. My case is among them. And in the silence, I can hear their scream.

Shalini Kantayya is the director of 7th Empire Media and a 2000 Fulbright Scholar.

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What's Next for Mindy McCready's Two Young Boys?

By Steve Helling

02/19/2013 at 07:00 PM EST

Mindy McCready's apparent suicide on Sunday has left her two young sons in custodial limbo.

The boys – Zander, 6, and Zayne, 10 months – had been in state custody since Feb. 7, when McCready called police to ask for help in making her father and stepmother leave her home. When police arrived, McCready appeared to be intoxicated, according to a Department of Human Services report.

In a subsequent petition, the singer's father, Tim McCready, asked the court to order her to undergo mental health and substance abuse evaluation and treatment, alleging that his daughter, who had recently lost her boyfriend, "hasn't had a bath in a week ... screams about everything ... [is] very verbally abusive to Zander."

After a judge granted the petition, the children were quickly removed and placed into foster care. Although McCready was released from treatment, the boys remained in state custody.

At the time, Zander's father, Billy McKnight, requested custody of his son. "My son needs me," he told PEOPLE on Feb. 8. "I'm married, working and successful. I'm on the right track and proud of it. I've been sober for years. I just want my son."

But McCready's mother and stepfather, Gayle and Michael Inge, also want custody of the children – and authorities seem to agree.

In a proposed order sent to Circuit Judge Lee Harrod, the Department of Human Services proposed that the Inges might be a better fit for the children, claiming that they have "a substantial relationship." The Inges had custody of Zander for much the past few years, during McCready’s rehab and jail stints.

With McCready's death, the judge will have to determine what is in the children's best interest. A custody hearing has been scheduled for April 5.

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Drug overdose deaths up for 11th consecutive year

CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.

"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.

In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.

The report appears in Tuesday's Journal of the American Medical Association.

It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.

Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.

They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.

Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.

Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.

The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.

The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.

Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.

"But at some point, people using these drugs are going to become more aware of the dangers," he said.

Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.

One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.

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Stobbe reported from Atlanta.

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Online:

JAMA: http://www.jama.ama-assn.org

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com

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Asian shares hit 18-month high on growth hopes

TOKYO (Reuters) - Asian shares rose to their highest since August 2011 on Wednesday after an improving global economic outlook boosted world equities overnight, encouraging investors to take on risk.

The MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> added 0.7 percent, rose for a third day in a row, led by a 1.7 percent gain in its technology sector <.miapjit00pus>. The index has risen 4 percent so far this year.

Asian shares have been on an uptrend as risks from the euro zone debt crisis the U.S. fiscal crisis abated and signs of tepid recovery emerged in major economies including China. Corporate earnings have also been generally positive.

"A shift to cyclicals from defensives has come to a full circle and investors are now looking at sector-specific factors within an asset class, selecting those with a tight supply/demand outlook," said Naohiro Niimura, a partner at research and consulting firm Market Risk Advisory.

News of possible fresh mergers boosted U.S. stocks on Tuesday, pinning the benchmark Standard & Poor's 500 Index <.spx> near a five-year high, while a stronger-than-expected rise in the German ZEW investor sentiment index to a three-year high supported European stocks.

Australian shares rose 0.4 percent, extending a rally that has taken the market to 4-1/2 year highs, with financials and retailers supporting prices. The Australian market has risen nearly 10 percent this year.

"There's a few good earnings reports but I think it's this hunt for yield that continues to push our market higher," Weston said. "I think that's keeping the support; the market doesn't want to go down and you just don't want to be missing out."

South Korean shares <.ks11> outperformed with a 1.5 percent jump to hit a one-month high, as foreigners stepped up buying and a pause in the yen's falling trend soothed sentiment.

"The KOSPI had decoupled with global equities in January because of currency moves and foreign selling. But this is changing with the pace of currency changes easing," Shawn Oh, an analyst at Daishin Securities, said of Seoul shares.

Positive growth in Southeast Asia has drawn foreign investors, keeping regional stocks robust. The Philippines stock market <.psi> extended gains to a record high while Bangkok's SET index <.seti> hit a fresh 18-year high.

The rise in equities weighed on assets perceived as safe-haven, such U.S. Treasuries and gold on Tuesday. Spot gold inched up 0.2 percent to $1,607.94 an ounce, but hovered near a six-month low hit the day before.

London copper climbed 0.6 percent to $8,095 a metric ton, off Tuesday's three-week lows.

Tokyo's Nikkei stock average <.n225> added 0.7 percent, after touching a 52-month high. <.t/>

The yen remained jittery, swinging in narrow ranges on concerns Japan may not be able to pursue as strong a reflationary policy mix as previously thought.

A week-long delay in the government nominating a new Bank of Japan governor fuelled talk of friction between the prime minister and the finance minister over who should run a central bank charged with taking bold action to reignite the economy.

The dollar eased 0.1 percent to 93.49 yen, still near its highest since May 2010 of 94.465 hit on February 11. The euro was up 0.1 percent to 125.36 yen. It touched a peak since April 2010 of 127.71 yen on February 6.

Sterling was under pressure on growing speculation the UK could soon lose its prized triple-A credit rating. Sterling traded at $1.5444, having plumbed a seven-month low at $1.5414 in New York.

"Markets continued to consolidate while reallocation trades helped risky assets to outperform and the USD to come under some pressure," said Sebastien Galy, strategist at Societe Generale, said in a note to clients.

"Fears regarding the UK are steadily rising, reinforcing a bearish tendency...We remain short GBP, CHF, JPY and AUD," he said, adding that the market will use any bearish excuse to sell the yen.

Japan logged its biggest monthly trade deficit on record in January, underscoring the country's deteriorating trade balances and accenting the yen's weak fundamental trend.

Investors remained wary of the possible U.S. federal spending cuts and outcome of the upcoming Italian election, limiting losses in sovereign bonds.

The ZEW report was a positive sign ahead of the more important euro zone flash PMIs on Thursday and Germany's IFO business sentiment on Friday, said Vassili Serebriakov, a strategist at BNP Paribas.

U.S. crude steadied around $96.70 a barrel but Brent eased 0.2 percent to $117.34.

(Additional reporting by Thuy Ong in Sydney and Hyunjoo Jin in Seoul; Edting by Eric Meijer)

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India Ink: Kalyan Anand, the Sadhu From Madhya Pradesh

Why do millions of Indians, sometimes entire villages, brave the crowds to attend the Kumbh Mela? India Ink interviewed some of the estimated 100 million pilgrims who traveled to this year’s Kumbh Mela at Allahabad, Uttar Pradesh, a 55-day pilgrimage during which Hindus take a holy dip in the Ganges River to wash away their sins.

Kalyan Anand, 46, a sadhu from Chitrakoot town of Madhya Pradesh was one among them. This is what he had to say.

Why did you come to the Kumbh Mela this year? Is this your first time?

I have been coming to the Kumbh for 20 years now. I have gone everywhere there is a Kumbh – Ujjain, Nashik, Haridwar and Allahabad. The purity of River Ganges never ceases to fascinate me. I come to each Kumbh to try and make myself as pure as Mother Ganges.

How have you found it so far?

This one is particularly crowded. They have significantly restricted the bathing area for the sadhus to accommodate the common folk. That is a disappointment. But otherwise, the energy in a Kumbh is always infectious.

Describe your journey to the Kumbh. Did you travel alone? How long did it take?

I travel with my ashram wherever I go.

What does religion mean to you? Do you consider yourself a religious person?

Internal cleansing – that is the basis of religion. Our ancestors strived for it. We should all too. It becomes our inherent responsibility. When everyone on this earth is conscious of his sins, imagine how pure the world will become? Just the mere knowledge will ensure you don’t err in the future.

Who do you think is going to win the 2014 election? Have you ever cast a vote?

We are people who are beyond these things. I haven’t cast a vote all my life.

(The interview was translated from Hindi.)

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Mindy McCready: Under Police Scrutiny at Time of Suicide?

By Steve Helling and Mike Fleeman

02/18/2013 at 06:00 PM EST

Mindy McCready and David Wilson

Courtesy Mindy McCready

When Mindy McCready talked to police in recent weeks, her account of how her boyfriend came to be found with a fatal gunshot wound to the head concerned police, a law enforcement source tells PEOPLE.

"At first, she said she hadn't heard the gunshot because the TV was too loud. Then she said she had heard the gunshot," the source says. "So obviously there were a lot of questions, and the Sheriff was asking for clarification."

But before investigators could re-interview her, the long-troubled country singer also would die under eerily similar circumstances, her body discovered at the same Heber Springs, Ark., house just feet away from where David Wilson died.

McCready's death was blamed on what "appears to be a single self-inflicted gunshot wound," the Cleburne County Sheriff's Office said in a statement.

This differed from how the sheriff characterized Wilson's case. His cause and manner of death still have not been established by the coroner. It was McCready's publicist, and not a law enforcement official, who announced that Wilson had died of a self-inflicted gunshot wound.

After Wilson's death, McCready, 37, spoke to investigators three times, but they didn't feel as if they were through with her.

"At no point did [police] tell her she was a suspect, and she wasn't officially one," says the source. "But she knew that some of her answers didn't stand up to questioning. She was very cooperative, but she just wasn't making a lot of sense."

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Hip implants a bit more likely to fail in women

CHICAGO (AP) — Hip replacements are slightly more likely to fail in women than in men, according to one of the largest studies of its kind in U.S. patients. The risk of the implants failing is low, but women were 29 percent more likely than men to need a repeat surgery within the first three years.

The message for women considering hip replacement surgery remains unclear. It's not known which models of hip implants perform best in women, even though women make up the majority of the more than 400,000 Americans who have full or partial hip replacements each year to ease the pain and loss of mobility caused by arthritis or injuries.

"This is the first step in what has to be a much longer-term research strategy to figure out why women have worse experiences," said Diana Zuckerman, president of the nonprofit National Research Center for Women & Families. "Research in this area could save billions of dollars" and prevent patients from experiencing the pain and inconvenience of surgeries to fix hip implants that go wrong.

Researchers looked at more than 35,000 surgeries at 46 hospitals in the Kaiser Permanente health system. The research, published Monday in JAMA Internal Medicine, was funded by the U.S. Food and Drug Administration.

After an average of three years, 2.3 percent of the women and 1.9 percent of the men had undergone revision surgery to fix a problem with the original hip replacement. Problems included instability, infection, broken bones and loosening.

"There is an increased risk of failure in women compared to men," said lead author Maria Inacio, an epidemiologist at Southern California Permanente Medical Group in San Diego. "This is still a very small number of failures."

Women tend to have smaller joints and bones than men, and so they tend to need smaller artificial hips. Devices with smaller femoral heads — the ball-shaped part of the ball-and-socket joint in an artificial hip — are more likely to dislocate and require a surgical repair.

That explained some, but not all, of the difference between women and men in the study. It's not clear what else may have contributed to the gap. Co-author Dr. Monti Khatod, an orthopedic surgeon in Los Angeles, speculated that one factor may be a greater loss of bone density in women.

The failure of metal-on-metal hips was almost twice as high for women than in men. The once-popular models were promoted by manufacturers as being more durable than standard plastic or ceramic joints, but several high-profile recalls have led to a decrease in their use in recent years.

"Don't be fooled by hype about a new hip product," said Zuckerman, who wrote an accompanying commentary in the medical journal. "I would not choose the latest, greatest hip implant if I were a woman patient. ... At least if it's been for sale for a few years, there's more evidence for how well it's working."

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Online:

Journal: http://www.jamainternalmed.com

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