Beta Blockers May Calm Nerves, Keeping Them Banned by PGA and L.P.G.A.

Greg Norman, winner of 91 tournaments worldwide, remembers a time when panic attacks on the elite golf circuit were often alleviated with the illicit use of a common heart and blood pressure medicine, the beta blocker.

“In my day, lots of guys were on beta blockers,” Norman, 57, said in an interview at the P.G.A. Championship in August. “It wasn’t openly acknowledged, but it was obvious to the rest of us. A guy’s personality would change. In practice rounds or friendly matches, we’d see the real guy under stress. Then in competition, he was like a different, calmer person. Those guys were trying to take the nerves out of the game. But nerves are very much a part of the game.”

Norman was far from the only one with the tacit understanding that beta blockers, also prescribed for stage fright, were part of big-time golf. So in 2008, when the PGA and L.P.G.A. Tours were establishing their antidoping programs, beta blockers were included on the banned substance lists.

The little pill that inadvertently, or not so inadvertently, soothes the jitters and helps settle the bets in a recreational weekend match — nearly one in three Americans have high blood pressure, so it might be resolving a lot of $5 wagers — is strictly policed when the PGA Tour paydays top $1 million.

The permissibility of beta blockers in golf’s top level has come into focus anew this week. Charlie Beljan won a PGA Tour event Sunday, two days after being hospitalized with a panic attack. Beljan, who said that this week he was going to consult doctors near his home in Arizona, might be treated with medication to prevent future panic attacks. But in competition, he will not be allowed to take certain medications, like beta blockers, without applying for a therapeutic use exemption, which requires a review by an independent panel of doctors.

Dr. Nicole Danforth, a psychiatrist, the medical director of Massachusetts General Hospital’s sports psychology program and a former professional golfer, said, “I think beta blockers could treat the yips, and I think the tours think so, too, or they wouldn’t ban them.”

Beta blockers are prohibited in many sports other than golf, including Olympic sports. The PGA Tour took its lead from the United States Anti-Doping Agency and the World Anti-Doping Agency in adding beta blockers to its list.

“One of the many pharmacological uses of beta blockers is the steadying of hand tremors,” said Andy Levinson, the executive director of the PGA Tour’s antidoping program. “Anything requiring fine motor skills could be affected, something necessary in sports like archery or golf.”

At the 2008 Beijing Olympics, Kim Jong-su of North Korea had to return the silver medal he won in the 50-meter pistol event and the bronze he won in the 10-meter air pistol event after testing positive for propranolol, a beta blocker.

For millions of Americans who take beta blockers, enhancing athletic performance is far from the purpose. Beta blockers are heart medicines meant to control blood pressure, slow the heartbeat and treat a variety of other heart conditions. That they might help calm nerves in a pressure situation is almost an accidental side effect.

“It so happens that the response to an anxiety-producing situation is also driven by the sympathetic nervous system that the beta blocker is trying to control for the good of the patient’s heart,” said Dr. Binoy K. Singh, the associate chief of cardiology at Lenox Hill Hospital in New York.

But Singh said he knew of no long-term, randomized clinical trials measuring beta blockers’ effectiveness in resolving anxiety or improving performance in pressure situations, even if he has had patients tell him they have noticed a calmness in those settings.

There is, in fact, no universal agreement on whether beta blockers help or hurt in some athletic situations.

“Some level of anxiety is good for performance,” said Richard Ginsburg, a sports psychologist at the Harvard Medical School and Massachusetts General Hospital. “It keeps you on your game. A beta blocker can take away some edge, mellow you too much.”

Danforth, who twice played in the United States Women’s Open, agreed, though she added that beta blockers, purely from a golf perspective, had been likened to the stabilizing advantage some find using a long putter.

There are medical concerns for those who acquire beta blockers without a prescription, perhaps through the plethora of Web sites selling the drugs. Singh said there was a serious risk for people using beta blockers without a genuine, long-term medical need for them.

“They are a very powerful class of drugs that have enormous impact on essential bodily functions,” he said. “They are not without adverse effects.”

Beta blockers are far from the primary treatment for panic attacks. There are a variety of medications, doctors said, and there are multiple treatments that do not involve drugs. Among the most effective treatments has been cognitive behavioral therapy. Some anti-anxiety drugs, like Xanax or Valium, are not on most prohibited substance lists, including the one used by the PGA Tour.

But if a golfer on the PGA or L.P.G.A. Tours can prove a documented medical condition that requires the use of a prohibited substance, an exemption is granted. Levinson said a beta blocker exemption had been granted.

When it comes to the recreational golfing community, no doctors said they had a patient who requested a beta blocker prescription to help with the frustrations and strain of playing golf. Singh, who said he was a golfer who had played in stressful weekend matches, was asked if he had ever been tempted to take a beta blocker for the benefits it might bring to his scorecard.

“No, but I would have benefited from a better golf game,” he said.

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BP to Admit Crimes and Pay $4.5 Billion in Gulf Settlement

LONDON — BP, the British oil company, said Thursday it would pay $4.5 billion in fines and other payments to the United States government and plead guilty to 14 criminal charges in connection with the giant oil spill in the Gulf of Mexico two years ago.

US Coast Guard, via Associated Press

An explosion in 2010 on the Deepwater Horizon drilling rig in the Gulf of Mexico that was connected to a well owned by BP killed 11 workers and spilled millions of barrels of oil.

The payments include a $4 billion fine to be paid over five years, with much of it to go to government environmental agencies, BP said in a statement.

As part of the settlement, BP pleaded guilty to 11 felony misconduct or neglect charges related to the deaths of 11 people in the Deepwater Horizon accident in 2010, which unleashed millions of barrels of oil into the gulf.

A law enforcement official familiar with the case also said that two BP employees would be charged with manslaughter in the case. The United States attorney general, Eric H. Holder Jr., was scheduled to hold a news conference in New Orleans later Thursday.

“Today’s agreement is consistent with BP’s position in the ongoing civil litigation that this was an accident resulting from multiple causes, involving multiple parties, as found by other official investigations,” the company said in a news release.

The company said earlier Thursday it was in advanced talks with the United States about settling all criminal claims stemming from the spill.

Even with a settlement on the criminal claims, BP would still be subject to other claims, including federal civil claims and claims for damages to natural resources.

In particular, this settlement does not include what is potentially the largest penalty: fines under the Clean Water Act. The potential fine for the spill under the Clean Water Act is $1,100 to $4,300 per barrel spilled. That means the fine could be as much as $21 billion, according to Peter Hutton of RBC Capital Markets in London.

BP repeatedly said it would like to reach a settlement with claimants if the terms were reasonable. The unresolved issue of the claims has been weighing on BP’s share price as the oil company has been under pressure from investors to move on from the disastrous oil spill that had hurt the company’s reputation and finances.

An explosion in 2010 on the Deepwater Horizon drilling rig in the Gulf of Mexico that was connected to a well owned by BP killed 11 oil workers and spilled millions of barrels of oil into the surrounding water.

BP in March agreed with the lawyers for plaintiffs to settle claims on economic loss, including from the local seafood industry, and medical claims stemming from the oil spill. BP said at the time it expected the cost of that settlement to be about $7.8 billion, which it will pay from a trust the company set aside to cover such costs.

The company returned to profitability in the third quarter and increased its dividend, it said in October. It has been shrinking as it sold assets to raise funds to pay for costs related to the oil spill.

Stanley Reed contributed reporting from London. Charlie Savage contributed from Washington.

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Pelosi decides to remain as House Democratic leader

Former House speaker Nancy Pelosi said Wednesday she will run to keep her job as the Democratic leader in the House.

WASHINGTON -- Nancy Pelosi, the liberal San Francisco congresswoman who became the first woman speaker of the House, will seek to remain the Democratic leader in the next Congress.

Pelosi made the announcement Wednesday to a packed meeting of her caucus.

"They say a picture is worth a million words. Well this picture is worth millions of aspirations of the American people," Pelosi told the gathering, according to a Democratic leadership aide in attendance at the closed meeting. "This new class makes our caucus historic. The first time in legislative history that a caucus will be a majority of women and minorities."

"The message is clear from the American people. They want us to work together to get things done. And that's what these folks are here to do. Just like all of you.

"We may not have the gavel, but as I can see in this room, we have the unity," Pelosi said, according to the leadership aide, who asked for anonymity to discuss the private meeting.

PHOTOS: Reactions to Obama's victory

Pelosi had been mum about her plans after Democrats failed to win the majority in Tuesday’s election.

A champion campaign fundraiser, Pelosi is regarded as a polarizing figure. Elected to the House in 1987, she was chosen by the Democratic rank and file in 2002 to succeed Richard A. Gephardt of Missouri as minority leader, becoming the first woman to head a party in either chamber of Congress, as well as the first top party leader in the House from California.

In 2007, she became speaker — and the first Californian to head the House — overseeing passage of the most far-reaching healthcare overhaul since the creation of Medicare, an economic stimulus program, and the revamping of financial regulations, often with little or no Republican support.  But while she — and her Democratic majority — ruled the House, she became a favorite Republican campaign target as evidence of what's wrong with Washington. In 2010, she ran again for minority leader after Democrats lost control of the chamber, but has stayed around in hopes of leading her party back to the majority.

Republicans welcomed the prospect of continuing to have Pelosi as a target.

"There is no better person to preside over the most liberal House Democratic Caucus in history than the woman who is solely responsible for relegating it to a prolonged minority status," said Paul Lindsay, a spokesman for the House GOP campaign arm. "This decision signals that House Democrats have absolutely no interest in regaining the trust and confidence of the American people who took the speaker’s gavel away from Nancy Pelosi in the first place."

PHOTOS: America goes to the polls

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Still on the Lam, John McAfee Says He's Now In Disguise

It doesn’t sound like much of a disguise, but John McAfee is doing his best to change his appearance as he continues to evade the police in Belize.

In a case that seems to get more bizarre by the day, the 67-year-old has continued to call me with semi-hourly updates. The latest disclosure: He claims to have dyed his hair, eyebrows, beard, and mustache jet black.

“I have modified my appearance in a radical fashion,” McAfee said, “I’ll probably look like a murderer, unfortunately.”

The American antivirus pioneer is wanted for questioning in connection with the murder of Gregory Faull, 52, an American expatriate and neighbor of McAfee’s. They both have beachside properties on the island of Ambergris Caye, about 20 miles off the Belize coast. Faull was found dead, face up in a pool of blood, in his villa Sunday morning, shot once in the back of the head. Faull had complained about the barking of McAfee’s dogs — McAfee kept 11 at his beachside compound — and four of those dogs were poisoned Friday night.

When police arrived at McAfee’s property Sunday afternoon to question him, McAfee hid, he says, burying himself in sand and covering his head with a cardboard box. He says he spent 18 hours hiding on his property before slipping away.

He has been running ever since, he says, riding in boats, huddling on the floorboards of taxis, sleeping in a bed that he said was infested with lice.

Since going into hiding, McAfee has repeatedly denied that he had anything to do with Faull’s death. He says that he does not want to give himself up to authorities because he is afraid they will torture or kill him.

He’s convinced that, while he’s away from his compound, the police will plant incriminating evidence unrelated to Faull’s murder. “The police have been to my house seven times,” he said. “I expect them to uncover a cache of fully automatic weapons, four tons of cocaine. Maybe a Soviet submarine.”

The authorities, meanwhile appear to be trying to put pressure on McAfee by arresting friends and associates, according to two sources (who are not McAfee). Since Sunday, police have detained one of McAfee’s bodyguards, William Mulligan; his groundskeeper, Cassian Chavaria; and a local taxi driver, Cesar Trapp.

McAfee said he is outraged by the detentions: “This is exactly what happened to Soviet dissidents when Stalin took power. If they could not catch the man himself, they rounded up all of his friends.”

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Actor Channing Tatum dubbed People’s sexiest man alive

NEW YORK (Reuters) – Actor Channing Tatum, who set female hearts fluttering in the summer movie hit “Magic Mike”, was named the sexiest man alive by People magazine on Wednesday.

“My first thought was, ‘Y’all are messing with me,” Tatum told the magazine after hearing the news.

The 32-year-old actor, who is married to actress Jenna Dewan-Tatum, is training to play an Olympic athlete in his upcoming film, “Foxcatcher”.

The couple, who have been married since 2009, are ready to start a family, according to People.

“The first number that pops into my head is three, but I just want one to be healthy and then we’ll see where we go after that,” he told the magazine.

Tatum joins a long list of Hollywood heartthrobs who also have also received the “sexiest man” title from the magazine including Brad Pitt, Johnny Depp, Ryan Reynolds, George Clooney and Matt Damon.

(Reporting by Patricia Reaney; Editing by Maureen Bavdek)

Celebrity News Headlines – Yahoo! News

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Drug Compounders Get Help on Capitol Hill

WASHINGTON — Despite two decades of dire health warnings and threats of federal intervention, the specialty drugmakers at the center of the nation’s deadly meningitis outbreak have repeatedly staved off tougher federal oversight with the help of powerful allies in Congress.

Over the years, industry friends like Tom DeLay, the former House Republican leader from Texas, have come to its defense. Even Senator Edward M. Kennedy, regarded as the strongest health care advocate in Congress in recent times, dropped efforts to impose new safeguards.

But the pharmacists known as compounders are now facing their biggest regulatory threat as they confront questions on Wednesday and Thursday at Congressional hearings on the deadly outbreak. The question is whether Congress will move to oversee the niche industry more aggressively.

“A lot of the blame for the meningitis situation lies at Congress’s door,” said Larry D. Sasich, a research pharmacist who has written about compounders’ safety record. For specially mixed drugs that fall into a gray area of federal law, he said, “the protections for your cat or dog are stronger than for your wife and children.”

By Washington standards, the industry’s financial clout is not terribly large. The main trade group, the International Academy of Compounding Pharmacists, has spent $1.1 million on lobbying in the past decade, while major players in the business have given at least $300,000 to candidates since 2008, according to data from the Center for Responsive Politics, a research group in Washington.

But by positioning itself as a more affordable, community-based alternative to huge drug manufacturers, compounders have attracted broad support from politicians. They have become popular among proponents of hormone therapy to slow aging and advocates for the autistic, who often distrust the traditional pharmaceutical industry, and rely on compounders’ tailor-made blends.

If history is a guide, it often takes a disaster to get real change in the law.

In 1938, Congress passed the Food, Drug and Cosmetic Act after a drug company mixed an antibiotic with a toxic solvent and more than 100 people were killed, many of them children. In 1962, it amended that act to effectively create the modern drug approval system after thalidomide, a German drug intended to treat morning sickness in pregnant women, caused severe birth defects in Europe, said Kevin Outterson, an associate professor of law at Boston University.

Experts say the magnitude of the current crisis, in which more than 400 people have been sickened with meningitis and 32 have died, may finally spur action. This week’s hearings are expected to include testimony from the head of the Food and Drug Administration and the head of the Massachusetts pharmacy that produced the tainted drug.

Much of the scrutiny has focused on lax oversight by state boards and the Food and Drug Administration. But public health and drug industry experts say Congress is partly to blame for failing to clearly define the F.D.A.’s authority to police the practice.

A familiar cycle has played out in Washington since the 1990s: Publicity over illnesses or deaths from compounding drugs prompts outrage. Expert witnesses warn of the dangers of an unregulated industry. Proposals to fix the system follow. Then nothing happens.

“The public is at risk, an alarming great risk,” one pharmacist warned in 2003 Senate testimony after one person died and five more fell ill from contaminated medicine in 2002 produced by a South Carolina pharmacy.

Compounding, the practice of mixing medicines for individual patients, has grown in recent decades, helping fill gaps during drug shortages and offering cheaper versions of commercial drugs. But it has also become prone to abuse, with some pharmacies becoming, in effect, mini-drug manufacturers.

While the F.D.A. has clear authority to regulate drug manufacturers, state authorities have the main jurisdiction over pharmacies. Determining which category a company falls into is difficult because compounders are not required to give the F.D.A. access to their books.

Ultimately, stronger regulation has been stymied by sharp opposition from the industry and its defenders in Congress, both Democrats and Republicans, many of whom have compounders in their districts.

In 2008, the F.D.A. challenged what it said were misleading claims by compounders that their hormone therapy for older women was safer and more natural than that of big drug makers; it was met with staunch opposition, including objections from Suzanne Somers, the celebrity anti-aging advocate. The agency eventually prevailed.

Hundreds of members of Congress have attended conferences or taken part in charitable events and letter-writing campaigns organized by the International Academy of Compounding Pharmacists. The trade group said recently that its Congressional supporters had surged in recent years and that compounding had “gone from being a little-known practice to having a strong and steady presence in Washington.”

Texas, home to many compounding pharmacies and their main trade lobbying group, has been an important base of support, producing industry allies like Mr. DeLay and Representative Joe L. Barton, a Texas Republican.

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Mike D'Antoni plans to coach Lakers on Sunday

Mike D'Antoni won NBA coach of the year in his first full season as head coach of the Phoenix Suns. (Jeff Gross / Getty Images)

By T.J. Simers

November 13, 2012, 8:36 a.m.

Just finished interviewing new Lakers Coach Mike D’Antoni by telephone, and how’s that for a fine start in town — he's talking to Page 2.

It’s going to take a little while to transcribe tape and write a column, but here’s how we began Tuesday morning.

"Got bad news for you, Mike. You’re losing 73% to 11% to Phil Jackson in a poll of who people would like to see coaching the Lakers."

D’Antoni laughs. "I’ve got some really close friends who are Laker fans and they were disappointed I got the job."

Reminded that the fans in Staples Center have been chanting, "We want Phil," D’Antoni says, "They can’t chant, 'We want Mike,' because they got him."

D’Antoni is still recovering from reconstructive surgery on his right knee. He’s getting around now with one crutch or a cane.

He will fly to Los Angeles on Wednesday, meet his team Thursday and says he’s probably aiming to make his Lakers coaching debut Sunday.

"When I feel better I’ll start coaching, and I think miraculously I’ll start feeling better when Steve [Nash] is feeling better," he says. "I’ve already tried coaching without him and that didn’t work out too well, so I’m thinking I’ll be smart this time."

If the tape recorder batteries hold up, more to come soon.

ALSO:

Phil Jackson gets call from Lakers and it's not what he expected

Lakers players surprised but enthused by hiring of Mike D'Antoni

It's unanimous: Lakers' selection of Mike D'Antoni over Phil Jackson is wrong

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First Look at Jawbone's All New Up Fitness Tracking Bracelet

Jawbone’s Up was one of the hottest gadgets on the market in 2011 — until it cratered and had to be recalled. The activity tracker — an Yves Behar-designed wristband that sent data to a slick iOS app — was an immediate hit, but it succumbed to a slow burn as band after band failed. The company ultimately took the bracelet off the market and offered refunds to anyone who bought one. Now it’s back, re-thought, re-architected and (most importantly) re-engineered. It goes on sale today, and will cost $129.

The bracelet comes in eight colors and is designed to be worn both during the day and at night while sleeping. It tracks movements and counts steps to estimate calories burned and, at night, uses its motion sensors to track the amount of time the wearer sleeps and how much of that was deep versus light sleep. The new Up has a much more robust iOS app, with new features like a bar-code scanner for inputting meals and a power-nap setting that will let the wearer safely snooze for 27 minutes mid-day before the alarm goes off. The app has also been redesigned, and it’s got a lot more information at your fingertips than it did previously. While the initial design was pretty, it wasn’t quite as up front with details, like deep versus light sleep. The app is also pushing updates to wearers now, suggesting that you may want to go take a walk, for example. Additionally, if you go for a bike ride or swim or some other activity, you can enter that into the app.

But the real improvements are to the band itself, and its success or failure depends entirely on whether or not Jawbone has managed to fix the problems that plagued the previous model. Jawbone says it identified two critical flaws that it has subsequently fixed. The first was improper bonding, which Jawbone says was the core issue. Water was able to penetrate the band’s exterior and hit the circuit board, where it rapidly oxidized the bracelet’s capacitors. There was also a secondary issue related to pliancy. The company says it found that cracks and fissures could appear on the circuit board over time. In response, Jawbone improved the bonding process and gave the board more flexibility. The company says it developed its own tests for waterproofing that exceed the IPX5, IPX6 and IPx7 industry standards for watches to take into account things like water temperature and soap content.

In Wired’s demo of the new Up, the internal electronic band is indeed far more battened down than last year’s model. Much of what had been done by hand is now machine made, the band has as a new protective coating, and there are visibly fewer joints and exposed areas. It was difficult to tell whether or not the band is more pliable, but the overall build quality is noticeably better. The big question is: Were the fixes enough? We’ll find out soon. Wired is getting a unit in for testing and will have a review in the coming weeks.

Mat Honan is a senior writer for Wired's Gadget Lab and the co-founder of the Knight-Batten award-winning Longshot magazine.

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Day-Lewis heeded inner ear to find Lincoln’s voice

LOS ANGELES (AP) — A towering figure such as Abraham Lincoln, who stood 6 feet 4 and was one of history’s master orators, must have had a booming voice to match, right? Not in Daniel Day-Lewis‘ interpretation.

Day-Lewis, who plays the 16th president in Steven Spielberg‘s epic film biography “Lincoln,” which goes into wide release this weekend, settled on a higher, softer voice, saying it’s more true to descriptions of how the man actually spoke.

“There are numerous accounts, contemporary accounts, of his speaking voice. They tend to imply that it was fairly high, in a high register, which I believe allowed him to reach greater numbers of people when he was speaking publicly,” Day-Lewis said in an interview. “Because the higher registers tend to reach farther than the lower tones, so that would have been useful to him.”

“Lincoln” is just the fifth film in the last 15 years for Day-Lewis, a two-time Academy Award winner for best actor (“My Left Foot” and “There Will Be Blood”). Much of his pickiness stems from a need to understand characters intimately enough to feel that he’s actually living out their experiences.

The soft, reedy voice of his Lincoln grew out of that preparation.

“I don’t separate vocal work, and I don’t dismember a character into its component parts and then kind of bolt it all together, and off you go,” Day-Lewis said. “I tend to try and allow things to happen slowly, over a long period of time. As I feel I’m growing into a sense of that life, if I’m lucky, I begin to hear a voice.

“And I don’t mean in a supernatural sense. I begin to hear the sound of a voice, and if I like the sound of that, I live with that for a while in my mind’s ear, whatever one might call it, my inner ear, and then I set about trying to reproduce that.”

Lincoln himself likely learned to use his voice to his advantage depending on the situation, Day-Lewis said.

“He was a supreme politician. I’ve no doubt in my mind that when you think of all the influences in his life, from his childhood in Kentucky and Indiana and a good part of his younger life in southern Illinois, that the sounds of all those regions would have come together in him somehow.

“And I feel that he probably learned how to play with his voice in public and use it in certain ways in certain places and in certain other ways in other places. Especially in the manner in which he expressed himself. I think, I’ve no doubt that he was conscious enough of his image.”

Entertainment News Headlines – Yahoo! News

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Q & A: Weighing the Evidence

Q. My husband weighs twice as much as I do, yet we take the same dose of over-the-counter medications, as recommended on the packaging. Shouldn’t weight be a factor?

A. There is little information about using weight as a factor in adjusting doses of either prescription or over-the-counter medications, said Dr. Steven A. Kaplan, director of the Iris Cantor Men’s Health Center at NewYork-Presbyterian/Weill Cornell hospital.

“We are beginning to study different responses by weight,” he said, but he and other researchers have reached no conclusions on recommendations for therapy.

“In my own field, urology,” he added, “my opinion is that it is more likely for the recommended dose to be ineffective in a larger person rather than to be toxic in a thinner adult.”

Some prescription drugs, like chemotherapy agents, already have their dosages adjusted for weight because of their highly toxic nature. As for over-the-counter drugs, recommended doses generally tend to be weighted in favor of safety rather than efficacy, Dr. Kaplan said.

He and other doctors emphasized the importance of following package directions. For example, acetaminophen (like Tylenol) can present a life-threatening risk if the liver cannot process a high dose. If you find that the recommended dose does not work for you, Dr. Kaplan said, speak to your doctor.

C. CLAIBORNE RAY

Readers may submit questions by mail to Question, Science Times, The New York Times, 620 Eighth Avenue, New York, N.Y. 10018, or by e-mail to question@nytimes.com.

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