The Risk Of Complications From Breast Reconstruction

The Risk Of Complications From Breast Reconstruction.
The overall gamble of complications from soul reconstruction after knocker removal is only slightly higher for older women than for younger women, a creative study indicates. Researchers looked at observations from nearly 41000 women in the United States who had one breast removed between 2005 and 2012. Of those patients, about 11800 also underwent heart of hearts reconstruction. Patients venerable 65 and older were less likely to have titty reconstruction than younger women immunity. About 11 percent of older women chose to have the surgery compared to nearly 40 percent of women under 65, the office found.

Women who had chest reconstruction had more complications - such as longer sanatorium stays and repeat surgeries - than those who did not have tit reconstruction. However, overall complication rates after teat reconstruction were similar. About 7 percent of older women had complications, while slight more than 5 percent of younger women did. One blockage was the risk of blood clot-related complications after core reconstruction that used a patient's own tissue as an alternative of implants.

Harm Of Overly Tight Control Of Blood Sugar Level

Harm Of Overly Tight Control Of Blood Sugar Level.
Many older woman in the street with diabetes may be exposed to potency wickedness because doctors are trying to living overly tight control of their blood sugar levels, a experimental study argues. Researchers found that nearly two-thirds of older diabetics who are in ill-fated health have been placed on a diabetes management regimen that strictly controls their blood sugar, aiming at a targeted hemoglobin A1C unalterable of less than 7 percent cytotec bisa di beli diapotik surabaya. But these patients are achieving that purpose through the use of medications that neighbourhood them at greater risk of hypoglycemia, a revenge to overly low blood sugar that can cause abnormal heart rhythms, and dizziness or forfeiture of consciousness, the researchers said.

Further, tight diabetes mastery did not appear to benefit the patients, the researchers report Jan 12, 2015 in JAMA Internal Medicine. The share of seniors with diabetes in straitened health did not change in more than a decade, even though many had undergone years of hostile blood sugar treatment. "There is increasing trace that tight blood sugar control can cause abuse in older people, and older people are more susceptible to hypoglycemia," said leading position author Dr Kasia Lipska, an subsidiary professor of endocrinology at Yale University School of Medicine.

So "More than half of these patients were being treated with medications that are uncongenial to benefit them and can cause problems". Diabetes is routine among people 65 and older. But doctors have struggled to come up with the best headway to manage diabetes in seniors alongside the other fitness problems they typically have, researchers said in curriculum vitae information with the study. For younger and healthier adults, the American Diabetes Association has recommended psychoanalysis that aims at a hemoglobin A1C destroy of lower than 7 percent, while the American Association of Clinical Endocrinologists recommends a object of turn down than 6,5 percent, the authors noted.

The A1C test provides a conceive of of your average blood sugar levels for the past two to three months. By closely controlling blood sugar levels, doctors craving to stave off the complications of diabetes, including implement damage, blindness, and amputations due to nerve hurt in the limbs. In this study, the authors analyzed 2001-2010 evidence on 1,288 diabetes patients 65 and older from a US survey. The patients were divided into three groups based on their strength status: About half were considered less hale despite their diabetes; 28 percent had complex/intermediate health, in that they also suffered from three or more other lasting conditions or had difficulty performing some fundamental daily activities.

The Best Defense Against Influenza Is Vaccination

The Best Defense Against Influenza Is Vaccination.
The 2013 flu occasion is living up to its move forward billing as one of the worst in years. In Boston, where four flu-related deaths have been reported, Mayor Thomas Menino declared a governmental of difficulty on Wednesday, and officials are working to set up emancipated flu-vaccine initiatives. The borough has already recorded 700 confirmed cases of flu, compared to 70 cases for all of in the end year, according to Boston decimal point com curves weight loss plan. At Lehigh Valley Hospital in Salisbury Township, PA, a tent has been set up extreme the predicament department because the medical center is struggling with a burgeoning number of flu cases, lehighvalleylive jot com reported.

And in Chicago, Northwestern Memorial Hospital has recorded a 20 percent widen in flu patients every day, ABC News reported. The 2012-2013 flu opportunity got off to an prehistoric start, and it's only getting worse as ne plus ultra flu season nears. "As we moved into the end of December and January, vim has really picked up in a lot more states," Tom Skinner, a spokesman for the US Centers for Disease Control and Prevention, told HealthDay.

According to the example CDC statistics, which repayment through Dec 29, 2013 a perfect of 41 states were reporting widespread flu activity. There have been 18 flu-related deaths of children so far. The main race so far this year is H3N2. "In years lifestyle when we have seen an H3N2 dominate, we be inclined to see more severe illness in young kids and the elderly".

Special care for elderly pets

Special care for elderly pets.
Old discretion seems to stoolie up on pets just as it does in people. Long before you wait for it, Fido and Snowball are no longer able to bolt out the door or rush onto the bed. But with routine visits to the vet, equiangular exercise and good weight control, you can help your beloved treasured ward off the onset of age-related disease, one veterinary adroit suggests nonton online sex japan lingkuhan. "Aging pets are a lot like aging people with regard to diseases," Susan Nelson, a Kansas State University second professor of clinical services, said in a university bulletin release.

Diabetes, chronic kidney disease, cancer, osteoarthritis, periodontal condition and heart disease are among the problems pets phizog as they grow older. "Like people, routine exams and tests can hand detect some of these problems earlier and make curing more successful," Nelson added, making a special reference to heartworm taboo and general vaccinations. "It's also important to stir closely with your veterinarian," Nelson said, because "many pets are on more than one epitome of medication as they age, just like humans".

Cats between 8 and 11 years (equal to 48 to 60 in kindly years) are considered "senior," while those over the duration of 12 fall into the category of "geriatric". For dogs it depends on weight: those under 20 pounds are considered chief at 8 years, and geriatric at 11 years. Those 120 pounds and up, however, are considered older at 4 years and geriatric at 6 years, with a sliding age-scale applied to canines between 20 and 120 pounds.

Excessive Consumption Of Diet Drinks Can Cause To Depression

Excessive Consumption Of Diet Drinks Can Cause To Depression.
Older adults who down several nutriment drinks a broad daylight may have a heightened endanger of developing depression, a unripe study suggests. Researchers found that of more than 260000 older adults in a US survey, those who had at least four quotidian servings of artificially sweetened soda, iced tea or fruit slug were at increased gamble of being diagnosed with depression in the next decade. People with a taste for sugar-sweetened drinks also showed a higher despair risk versus those who avoided the beverages fertility. But the relation was weaker than the one between diet drinks and depression, according to the study, which was released Jan 8, 2013.

On the other hand, coffee lovers had a measure disgrace depression risk than people who typically passed on the java. What it all means, however, is anyone's guess. "This to all intents and purposes creates more questions than it answers," said Eva Redei, a professor of psychiatry at the Northwestern University Feinberg School of Medicine in Chicago. And it decidedly is not thinkable to couple the condemn on diet drinks themselves, based on these findings solitary who was not involved in the study.

Caution is in order, agreed study boss Dr Honglei Chen, an investigator at the US National Institute of Environmental Health Sciences. "The on is introductory and more investigation into the topic is needed". But the findings are "intriguing," and are in harmony with a small but growing number of studies linking artificially sweetened drinks to poorer health.

The results were released by the American Academy of Neurology, in advance of its annual caucus in San Diego in March 2013. The findings are based on more than 260000 Americans venerable 50 to 71 who reported on their usual beverage habits. About a decade later, they were asked whether they'd been diagnosed with recession in the old times several years.

Scientists Recommend Physical Training Schedule

Scientists Recommend Physical Training Schedule.
Older women are physically languid for about two-thirds of their waking hours, according to original research. But that doesn't norm they're just sitting still. Although women in the meditate on appeared to be inactive for a super portion of the day, they frequently moved about in short bursts of activity, an usual of nine times an hour elcafort use for libido. "This is the commencement part of an ongoing study, and the first paper to look at the patterns of venture and sedentary behaviors," said lead author Eric Shiroma, a researcher at Brigham and Women's Hospital, in Boston.

And "Some fact-finding says that sitting for covet periods is destructive and the recommendation is that we should get up every 30 minutes, but there's little hard matter available on how much we're sitting and how often we get up and how measures such as these affect our trim risks". Results of the study are published as a letter in the Dec 18, 2013 flow of the Journal of the American Medical Association.

Previous studies have suggested that the more nation sit each day, the greater their chance for chronic health problems, such as heart disease, diabetes and cancer. The stylish study included more than 7000 women whose standard age was 71 years. For almost seven days, the women wore devices called accelerometers that gauge movement. However, the machine can't tell if someone is standing or sitting, only if they're still or moving.

The women wore the devices during their waking hours, which averaged thorough to 15 hours a day.A discontinuity in stationary (inactive) behavior had to include at least one minute of movement, according to the study. On average, the women were physically lifeless for 65,5 percent of their day, or about 9,7 hours. The ordinary thousand of sedentary periods during the day was 86, according to the study.

Antiretroviral Therapy Works, And HIV-Infected People Live Long

Antiretroviral Therapy Works, And HIV-Infected People Live Long.
Better treatments are extending the lives of family with HIV, but aging with the AIDS-causing virus takes a knell that will doubt the salubriousness care system, a new report says horny girls in umhlanga durban looking for sex. A look into of about 1000 HIV-positive men and women ages 50 and older living in New York City found more than half had symptoms of depression, a much higher grade than others their time without HIV.

And 91 percent also had other inveterate medical conditions, such as arthritis (31 percent), hepatitis (31 percent), neuropathy (30 percent) and cheerful blood strength (27 percent). About 77 percent had two or more other conditions. About half had progressed to AIDS before they got the HIV diagnosis, the explosion found. "The orderly report is antiretroviral therapies are working and plebeians are living.

If all goes well, they will have life expectancies similar to those without HIV," said Daniel Tietz, manager director of the AIDS Community Research Initiative of America. "But a 55-year-old with HIV tends to front equal a 70-year-old without HIV in terms of the other conditions they necessity treatment for," he said Wednesday at a meeting of the Office of National AIDS Policy at the White House in Washington, DC.

The delving included interviews with 640 men, 264 women and 10 transgender people. Dozens of experts on HIV and aging attended the meeting, which was intended to point out the needs of older adults with HIV and to search ways to look up services to them. Currently, about 27 percent of those with HIV are over 50. By 2015, more than half will be, said the report.

Because of their staunch needs, this poses challenges for blatant trim systems and organizations that be of assistance seniors and society with HIV. HIV can be isolating. Seventy percent of older Americans with HIV spend alone, more than twice the take to task of others their age, while about 15 percent live with a partner, according to the report.

In Different Life Years Self-Esteem Varies Considerably

In Different Life Years Self-Esteem Varies Considerably.
Self-esteem increases as community flower older, but dips when public are in their 60s, although those who make more money and are healthier show to retain better views of themselves, researchers have found anti ki langi t. In the study, published in the April promulgation of the Journal of Personality and Social Psychology, researchers surveyed 3617 US adults elderly 25 to 104, worrisome to reach all of them four times between 1986 and 2002.

So "Self-esteem is interconnected to better health, less criminal behavior, decrease levels of depression and, overall, greater name in life," the study's lead author, Ulrich Orth, said in a front-page news release from the American Psychological Association. "Therefore, it's substantial to learn more about how the average person's self-esteem changes over time".

Young populace had the lowest self-esteem, but it grew as people aged, peaking at about time 60. Women had lower self-esteem than men, on average, until they reached their 80s and 90s, the deliberate over authors found.

Wealth and form played major roles in boosting self-esteem, especially in older people. "Specifically, we found that masses who have higher incomes and better salubrity in later life tend to maintain their self-esteem as they age. We cannot advised of for certain that more wealth and better health directly head to higher self-esteem, but it does appear to be linked in some way.

For example, it is possible that mine and health are related to feeling more independent and better able to contribute to one's house and society, which in turn bolsters self-esteem". As to why conceit peaks in middle-age and then often drops as people get older, the researchers suggested several theories.

The New Reasons Of Spinal Fractures Are Found In The USA

The New Reasons Of Spinal Fractures Are Found In The USA.
Older adults who get steroid injections to disburden decrease back and member bore may have increased odds of suffering a spine fracture, a new burn the midnight oil suggests June 2013. It's not clear, however, whether the care is to blame, according to experts. But they said the findings, which were published June 5, 2013 in the Journal of Bone and Joint Surgery, suggest that older patients with plebeian bone density should be heedful about steroid injections startvigrxplus.top. The remedying involves injecting anti-inflammatory steroids into the breadth of the spine where a nerve is being compressed.

The source of that compression could be a herniated disc, for instance, or spinal stenosis - a health community in older adults, in which the open spaces in the spinal column drop by drop narrow. Steroid injections can bring temporary ordeal relief, but it's known that steroids in general can cause bone density to curtailment over time. And a recent study found that older women given steroids for spine-related pang showed a quicker rate of bone loss than other women their age.

The redesigned findings go a step further by showing an increased breaking risk in steroid patients, said Dr Shlomo Mandel, the outrun researcher on both studies. Still the study, which was based on medical records, had "a lot of limitations. I want to be particular not to involve that people shouldn't get these injections," said Mandel, an orthopedic medical doctor with the Henry Ford Health System in Detroit.

The findings are based on medical records from 3000 Henry Ford patients who had steroid injections for spine-related pain, and another 3000 who got other treatments. They were 66 years old, on average. Overall, about 150 patients were later diagnosed with a vertebral fracture.

Vertebral fractures are cracks in grudging bones of the spine, and in an older full-grown with coarse bone throng they can happen without any main trauma. On average, Mandel's span found, steroid patients were at greater imperil of a vertebral breakage - with the risk climbing 21 percent with each exact of injections. The findings do not prove that the injections themselves caused the fractures, said Dr Andrew Schoenfeld, who wrote a commentary published with the study.

Treatment Of Diabetes In The Elderly

Treatment Of Diabetes In The Elderly.
Better diabetes curing has slashed rates of complications such as ticker attacks, strokes and amputations in older adults, a remodelled con shows. "All the event rates, if you look at them, all things is a lot better than it was in the 1990s, dramatically better," said study novelist Dr Elbert Huang, an associate professor of drug at the University of Chicago neosizexl.life. The study also found that hypoglycemia, or low blood sugar - a part effect of medications that control diabetes - has become one of the acme problems seen in seniors, suggesting that doctors may basic to rethink drug regimens as patients age.

The findings, published online Dec 9, 2013 in JAMA Internal Medicine, are based on more than 72000 adults grey 60 and older with variety 2 diabetes. They are being tracked through the Kaiser Permanente Northern California Diabetes Registry. Researchers tallied diabetic complications by seniority and size of patch with the disease. People with exemplar 2 diabetes, the most common form of the disease, have too much sugar in the blood.

It's estimated that heavy-handedly 23 million forebears have type 2 diabetes in the United States, about half of them older than 60. Many more are expected to lay open diabetes in coming years. In general, complications of diabetes tended to deteriorate as woman in the street got older, the study found. They were also more onerous in people who'd lived with the disease longer. Heart illness was the chief complication seen in seniors who'd lived with the disease for less than 10 years.

For every 1000 seniors followed for a year, there were about eight cases of enthusiasm plague diagnosed in those under age 70, about 11 cases in those in their 70s, and ineptly 15 cases for those aged 80 and older. Among those venerable 80 or older who'd had diabetes for more than a decade, there were 24 cases of love disease for every 1000 public who were followed for a year. That's a big drop from just a decade ago, when a prior studio found rates of heart disease in elderly diabetics to be about seven times higher - 182 cases for every 1000 living souls followed for a year.

Older Men Still Consider Sex An Important Part Of Their Lives

Older Men Still Consider Sex An Important Part Of Their Lives.
Life for men venerable 75 or older doesn't poor an end to sex, according to an Australian study. The researchers found that almost a third of these older men were sexually lively at least once a year - including about 1 in 10 men ancient 90 to 95. What's more, many older men who are sexually brisk guess they'd young lady to be having more sex. Others are forgoing shagging due to condition issues, low testosterone levels or simply a be of partners m. The study, based on a survey of Australian men grey 75-95, most of whom were married or living with a partner, found that younger seniors were busiest of all: 40 percent of those age-old 75-79 said they'd had copulation in the past twelve months.

But even amidst those aged 90-95, 11 percent reported sexual movement with someone else over the prior year. "Although many people, including some clinicians, maintain to believe that sexual activity is not important to older people, our think over shows this is not the case. Even in the 10th decade of life, 1 in 5 men still considered mating important," said research lead author Zoe Hyde, a researcher at the University of Western Australia.

The findings appear in the Dec 7, 2010 pay-off of the Annals of Internal Medicine. Several studies in modern years have tried to analyze sexuality in older people, who are every so often expropriated to have little or no interest in sex. The lionization of Viagra and related drugs seems to suggest that's hardly the case, but compact numbers have been tough to find.

However, one 2007 cramming in the New England Journal of Medicine reported that a bit more than half of kin surveyed in the US aged 65-74 reported new sexual activity, as did 26 percent of those aged 74-85. In the redesigned study, researchers examined the results of a sexuality muse about of almost 2,800 Australian men who didn't red-hot in nursing homes or other health-care facilities.

Among other things, the researchers asked the men if they'd had sensuous activity with a partner - not of course intercourse - within the past year. Overall, private to 49 percent of men aged 75 to 95 considered going to bed at least "somewhat important," and just under 31 percent had been sexually agile with another person at least once during the previous year.

Vitamin b12 affects fractures

Vitamin b12 affects fractures.
Older men with unhealthy levels of vitamin B-12 are at increased imperil for bone fractures, a rejuvenated study suggests. Researchers measured the levels of vitamin B-12 in 1000 Swedish men with an common seniority of 75. They found that participants with low levels of the vitamin were more odds-on than those with normal levels to have suffered a fracture helpedalt.com. Men in the set with the lowest B-12 levels were about 70 percent more likely to have suffered a cleavage than others in the study Dec 2013.

This increased danger was primarily due to fractures in the lumbar spine, where there was an up to 120 percent greater endanger of fractures. "The higher risk also remains when we select other risk factors for fractures into consideration, such as age, smoking, weight, bone-mineral density, untimely fractures, earthly activity, the vitamin D content in the blood and calcium intake," deliberate over author Catharina Lewerin, a researcher at the Sahlgrenska Academy at the University of Gothenburg, in Sweden, said in a university account release.

Elderly after injury

Elderly after injury.
Seniors who diminished an wound are more likely to regain their independence if they consult a geriatric specialist during their medical centre stay, researchers report in Dec 2013. The swot included people 65 and older with injuries ranging from a youth rib fracture from a fall to multiple fractures or run trauma suffered as a driver, passenger or pedestrian in a conveyance accident weight. A year after discharge from the hospital, the patients were asked how well they were able to behave daily activities such as walking, bathing, managing finances, light up housework and shopping.

Those who had a consultation with a geriatrician during their convalescent home stay were able to return to about two-thirds more daily activities than those who did not, according to the workroom published recently in the Journal of the American Medical Association (JAMA) Surgery. "Trauma surgeons have hanker struggled with the fragility of their older trauma patients who have much greater haleness risks for the same injuries skilled by younger patients," senior study author Dr Lillian Min, an helper professor in the division of geriatric cure-all at the University of Michigan Medical School, said in a university information release.

The Risks Of With Polycystic Ovary Syndrome

The Risks Of With Polycystic Ovary Syndrome.
Women with polycystic ovary syndrome (PCOS) are at increased danger for a include of straight-faced health problems, reborn research suggests. "PCOS has profound implications for a women's reproductive health, as well as her long-term jeopardy of chronic illness," wrote observe author Dr Roger Hart, of the University of Western Australia and Fertility Specialists of Western Australia, both in Perth. PCOS is the most reciprocal hormone mix in women of reproductive age. The fitness causes an imbalance of hormones that causes a sort of symptoms, including excess weight, irregular periods, infertility and an overgrowth of body and facial hair reviews. As many as 5 million American women have the condition, according to the US Office on Women's Health.

Ways To Help Prevent Falls In The Home

Ways To Help Prevent Falls In The Home.
For American seniors, a capitulate can have disabling or even destructive consequences. And a rejuvenated study finds that the rebuke of older people who suffer a fall is actually on the rise. A fact-finding team led by Dr Christine Cigolle, of the University of Michigan Medical School in Ann Arbor, tracked nationalistic details from adults aged 65 and older. They found that the several of older adults with at least one self-reported diminution in the past two years rose from about 28 percent in 1998 to about 36 percent in 2010 provillusshop com. "Contrary to our hypothesis, we observed an growth in declivity prevalence among older adults that exceeds what would be expected owing to the increasing time of the population," the researchers said.

According to Cigolle's team, falling remains the most general cause of wrong among older Americans, and it's believed that about one-third of seniors will allow a fall each year. Two experts stressed that there are ways seniors can further their odds for a tumble, however. "Interactive revelatory programs that teach senior citizens how to strengthen their muscles and remain aware of their balance are important to help this population better their balance and strength and, thus, decrease their risk of falls," said Grace Rowan, a registered tend and leader of the falls restraint program at Winthrop-University Hospital in Mineola, NY Dr Matthew Hepinstall parts at the Center for Joint Preservation and Reconstruction at Lenox Hill Hospital in New York City.

The Number Of Eye Diseases Is High Among Latino Americans

The Number Of Eye Diseases Is High Among Latino Americans.
Latino Americans have higher rates of visual impairment, blindness, diabetic vigil c murrain and cataracts than whites in the United States, researchers have found. The opinion included facts from more than 4,600 participants in the Los Angeles Latino Eye Study (LALES) herbal. Most of the office participants were of Mexican descent and venerable 40 and older.

In the four years after the participants enrolled in the study, the Latinos' rates of visual lessening and blindness were the highest of any ethnic organize in the country, compared to other US studies of various populations. Nearly 3 percent of the chew over participants developed visual reduction and 0,3 percent developed blindness in both eyes. Among those superannuated 80 and older, 19,4 percent became visually impaired and 3,8 percent became awning in both eyes.

The swot also found that 34 percent of participants with diabetes developed diabetic retinopathy (damage to the eye's retina), with the highest rank amidst those aged 40 to 59. The longer someone had diabetes, the more liable they were to bare diabetic retinopathy - 42 percent of those with diabetes for more than 15 years developed the lustfulness disease.

Participants who had visual impairment, blindness or diabetic retinopathy in one liking at the start of the study had maximum rates of developing the condition in the other eye, the study authors noted. The researchers also found that Latinos were more favourite to develop cataracts in the center of the ogle lens than at the edge of the lens (10,2 percent versus 7,5 percent, respectively), with about half of those elderly 70 and older developing cataracts in the center of the lens.

Living With HIV For People Over 50 Years

Living With HIV For People Over 50 Years.
One January era in 1991, occupation lady of the press Jane Fowler, then 55, opened a communication from a health insurance company informing her that her request for coverage had been denied due to a "significant blood abnormality". This was the inception inkling - later confirmed in her doctor's shtick - that the Kansas City, Kan, best had contracted HIV from someone she had dated five years before, a mortals she'd been friends with her unmixed adult life treatment. She had begun seeing him two years after the end of her 24-year marriage.

Fowler, now 75 and bracing thanks to the advent of antiretroviral medications, recalls being devastated by her diagnosis. "I went quarters that light of day and literally took to my bed. I thought, 'What's growing to happen?'" she said. For the next four years Fowler, once an animated and successful writer and editor, lived in what she called "semi-isolation," staying mostly in her apartment. Then came the dawning establishment that her isolation wasn't portion anyone, least of all herself.

Fowler slowly began reaching out to experts and other older Americans to be taught more about living with HIV in life's later decades. By 1995, she had helped co-found the National Association on HIV Over 50. And through her program, HIV Wisdom for Older Women, Fowler today speaks to audiences nationwide on the challenges of living with the virus. "I incontestable to symbolize out - to put an old, wrinkled, white, heterosexual physiognomy to this disease," she said. "But my dispatch isn't age-specific: We all insufficiency to dig that we can be at risk".

That implication may be more high-priority than ever this Wednesday, World AIDS Day. During a up to date White House forum on HIV and aging, at which Fowler spoke, experts presented untrained data suggesting that as the HIV/AIDS universal enters its fourth decade those afflicted by it are aging, too.

One report, conducted by the AIDS Community Research Initiative of America (ACRIA), distinguished that 27 percent of Americans diagnosed with HIV are now ancient 50 or older and by 2015 that part could double. Why? According to Dr Michael Horberg, immorality seat of the HIV Medicine Association, there's been a societal "perfect storm" that's led to more HIV infections among consumers in middle age or older.

And "Certainly the rise of Viagra and equivalent drugs to treat erectile dysfunction, population are getting more sexually active because they are more able to do so," Horberg said. There's also the appreciation that HIV is now treatable with complex drug regimens, he said, even though these medicines often come with onerous subsidiary effects. For her part, Fowler said that more and more aging Americans hit upon themselves recently divorced (as she did) or widowed and back in the dating game.