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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M&A deals lift Wall Street shares nearer a record high

NEW YORK (Reuters) - U.S. stocks rose on Tuesday as this year's ongoing surge in merger activity suggested investors were still finding value in the market even as indexes closed in on all-time highs.

Office Depot Inc surged 9.4 percent to $5.02 after a person familiar with the matter said the No. 2 U.S. office supply retailer was in advanced talks to merge with smaller rival OfficeMax Inc , which jumped more than 20 percent.

News of the potential move came just days after Berkshire Hathaway and a partner agreed to acquire H.J. Heinz Co for $23 billion, and following a revised $20 billion takeover of Mexican brewer Grupo Modelo by Anheuser-Busch InBev .

Deal activity has helped equities resist a pullback as investors use dips in stocks as buying opportunities. The S&P is up about 7 percent so far in 2013 and has climbed for the past seven weeks in its longest weekly winning streak since January 2011, though most of the weekly gains have been slim.

The Dow industrials closed 0.9 percent away from their record high while S&P 500 was 2.2 percent off its peak.

"Deals are good for the market," said Frank Lesh, a futures analyst and broker at FuturePath Trading LLC in Chicago. "The fact that they're being done is a positive."

More than $158 billion in deals has been announced so far in 2013, more than double the activity in the same period last year and accounting for 57 percent of global deal volumes, according to Thomson Reuters Deals Intelligence.

The Dow Jones industrial average <.dji> gained 53.91 points, or 0.39 percent, to 14,035.67. The Standard & Poor's 500 Index <.spx> gained 11.15 points, or 0.73 percent, to 1,530.94. The Nasdaq Composite Index <.ixic> gained 21.56 points, or 0.68 percent, to 3,213.59.

Other stocks in the office supplies sector also rose. Larger rival Staples Inc shot up 13.1 percent to $14.65 as the best performer on the S&P 500.

"Equity investors have to be encouraged by M&A since, if the number crunchers are offering large premiums, that shows how much value is still in the market," said Mike Gibbs, co-head of the equity advisory group at Raymond James in Memphis, Tennessee.

On the downside, health insurance stocks tumbled, led by a 6.4 percent drop in Humana Inc to $73.01. The company said the government's proposed 2014 payment rates for Medicare Advantage participants were lower than expected and would hurt its profit outlook.

UnitedHealth Group lost 1.2 percent to $56.66. The Morgan Stanley healthcare payor index <.hmo> dropped 1.2 percent.

Wall Street's strong start to the year was fueled by better-than-expected corporate earnings, as well as a compromise in Washington that temporarily averted automatic spending cuts and tax hikes that are predicted to damage the economy.

The compromise on across-the-board spending cuts postponed the matter until March 1, at which point the cuts take effect. Ahead of the debate over the cuts, known as sequestration, further gains for stocks may be difficult to come by.

Some investors say the debate could be the catalyst for a long anticipated sell-off after the market's recent strong run.

Carter Worth, a technical analyst at Oppenheimer, pointed to the "especially complacent action of the past six weeks," noting that, as of Friday, stocks have gone 33 sessions without a dip of more than 1.5 percent.

"We would be selling aggressively into the market's current strength," he said in a research note.

Economic data showed the NAHB/Wells Fargo Housing Market index unexpectedly edged down to 46 in February from 47 in the prior month as builders faced higher material costs.

According to the Thomson Reuters data through Monday morning, of the 391 companies in the S&P 500 that have reported results, 70.1 percent have exceeded analysts' expectations, compared with a 62 percent average since 1994 and 65 percent over the past four quarters.

Fourth-quarter earnings for S&P 500 companies have risen 5.6 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

Express Scripts rose 2.5 percent to $56.98 after the pharmacy benefits manager posted fourth-quarter earnings.

About two stocks rose for everyone that fell on the New York Stock Exchange and Nasdaq. About 6.48 billion shares changed hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, in line with the daily average so far this year.

(Additional reporting by Chuck Mikolajczak Ryan Vlastelica and Rodrigo Campos; Editing by Chizu Nomiyama, Kenneth Barry and Nick Zieminski)

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Chavez back in Venezuela, on Twitter with four million followers

CARACAS (Reuters) - After Hugo Chavez spent two months out of the public eye for cancer surgery in Cuba, the Venezuelan government hailed his homecoming on Monday and said the president had achieved another milestone - 4 million followers on Twitter.

The 58-year-old flew back from Havana before dawn and was taken to a military hospital. No new details were given on his health, and there were no images of his arrival. Officials say his condition remains delicate.

The normally loquacious socialist leader, who is struggling to speak as he breathes through a tracheal tube, took to Twitter with a passion back in April 2010, tweeting regularly and encouraging other leftist Latin American leaders to do likewise.

His @chavezcandanga account quickly drew a big mixed following of fans, critics and others just curious to see how his famously long speeches and fiery anti-U.S. invective would work within the social media network's 140-character limit.

But as he fought the cancer and underwent weeks of grueling chemotherapy and radiation therapy, he began to tweet less and less frequently, before stopping altogether on November 1.

Early on Monday morning, he made his reappearance.

"It was 4:30, 5 a.m. He got to his room and surprised everyone: rat-tat-tat, he sent three or four messages, and at that moment fireworks began to go off around the country," Vice President Nicolas Maduro said in a televised cabinet meeting.

During the day, Maduro added, the president's number of followers had shot up to well over four million.

"It's incredible, in just a few hours ... he's the second most-followed president in the world (after Barack Obama), and the first if we make the comparison by per capita," he said.

Obama has more than 27 million Twitter followers and is No. 5 most followed globally. Chavez is Twitter's No. 190 globally.

4TH MILLION FOLLOWER

Maduro said Chavez's four millionth follower was a 20-year-old single Venezuelan woman named Alemar Jimenez from the gritty San Juan neighborhood in downtown Caracas, near the military hospital where the president arrived earlier in the day.

"She's one of the golden generation of youth who support the fatherland and have been waiting with growing love for commander Hugo Chavez," Maduro said, before presenting a dazzled-looking Jimenez to the cameras and giving her a bunch of flowers.

"We were really emotional" she said, recounting how she was with her mother when they heard Chavez had returned. "I sent him a message on Twitter saying he must get better."

There are still big questions over the president's health. He could have come back to govern from behind the scenes, or he may be hoping to ease political tensions and pave the way for a transition to Maduro, his preferred successor.

Chavez has often ordered followers to fight back against opposition critics of his self-styled revolution by using social media, leading from the front himself on Twitter and referring to the Internet as a "battle trench."

As his ranks of followers grew, Chavez said he hired 200 assistants to help him respond to messages - which he said were a great way to receive first-hand the requests, demands, complaints and denunciations of citizens in the thousands.

During his re-election campaign last year, the government launched an SMS text message service that forwards his tweets to cellphones that lack Internet service, broadening their reach to the poorest corners of the South American country.

"He's a communication revolution!" Maduro said, later unbuttoning his shirt on TV to show he was wearing a T-shirt bearing Chavez's eyes emblazoned across his chest.

For the tens of thousands who signed up on Monday to follow Chavez on Twitter, it is unclear how much will be posted there in the weeks and months ahead. Venezuela's 29 million people are mostly wondering something similar.

(Additional reporting by Diego Ore; Editing by Todd Eastham)

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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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Yen firmer but near lows, Asian shares capped

TOKYO (Reuters) - The yen remained near recent lows on Tuesday, as attention turned to the appointment of a new Bank of Japan governor.

Regional share markets held to tight ranges as the absence of catalysts and a holiday in the U.S. overnight capped demand.

The yen, which has dropped 20 percent against the dollar since mid-November, fell further at the start of the week after financial leaders from the G20 promised not to devalue their currencies to boost exports and avoided singling out Japan for any direct criticism.

The choice of the next BOJ governor and two deputies has drawn market attention as a gauge to how strongly Prime Minister Shinzo Abe is committed to reflating the economy. The G20's message was that as long as Japan pursues aggressive monetary easing to achieve that goal, a weaker yen as a result of such domestic monetary policy will be tolerated, analysts say.

"But that means that some other economy's monetary conditions have been tightened," said Barclays Capital in a note.

"Japan hasn't even changed its policy stance thus far, and the effect of expectations of a looser setting have led to limited moves in domestic interest rates, but the sell-off of the JPY has been marked and has clearly caused unease in other economies."

Market reaction was muted to the release of the minutes of the BOJ's January 21-22 meeting, when the bank set a 2 percent inflation target and pledged to an open-ended quantitative easing from 2014, but the yen was bought when Finance Minister Taro Aso told reporters Japan has no plans to buy foreign currency bonds as part of monetary easing, a trader said.

The dollar was down 0.2 percent to 93.75 yen, but remained near its highest since May 2010 of 94.465 hit on February 11. The euro also eased 0.3 percent to 125.05 yen, below its peak since April 2010 of 127.71 yen touched on February 6.

The MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> was nearly flat.

The Nikkei stock average <.n225> opened down 0.6 percent, after closing up 2.1 percent on Monday to approach its highest level since September 2008 of 11,498.42 tapped on February 6. <.t/>

Australian shares <.axjo> inched down 0.1 percent on the back of weakness in metals prices, with investors focusing on local corporate earnings for direction after a three-month rally that has taken the market to 4-1/2 year highs.

Seoul shares <.ks11> opened little changed, and were expected to struggle to find momentum on worries about the weak yen.

"The market has been taking a breather recently after staging a recovery earlier this month," said Lee Jae-man, an analyst at Tong Yang Securities in Seoul. "The weaker yen has been priced in to some extent, and the pace of its fall is expected to slow down."

Disappointing earnings pushed European shares lower on Monday for a third straight session of losses while U.S. markets were closed for the President's Day holiday.

The euro was steady around $1.3348. The currency eased slightly on Monday after European Central Bank President Mario Draghi said in a speech at the European Parliament that "the exchange rate is not a policy target but is important for growth and price stability" and that its rise is "a risk."

The risk of an inconclusive outcome in Italy's election this weekend added to investor concerns.

Sterling hovered near a seven-month low against the dollar touched on Monday after a key policymaker made comments about the need for further weakness, while recent poor data has spurred worries of another British recession.

U.S. crude fell 0.4 percent to $95.47 a barrel.

(Additional reporting by Hyunjoo Jin and Miyoung Kim in Seoul; Editing by Shri Navaratnam)

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Ecuador's Correa cruises to re-election victory

QUITO (Reuters) - Ecuadorean President Rafael Correa swept to a re-election victory on Sunday that allows him to strengthen state control over the OPEC nation's economy and gives a timely boost to Latin America's alliance of socialist leaders.

The charismatic leftist had 57 percent support compared with 24 percent for runner-up Guillermo Lasso, with almost 40 percent of votes counted. The electoral authority said it did not expect the results to change significantly.

"Nobody can stop this revolution," a jubilant Correa told supporters from the balcony of the presidential palace, after claiming victory.

"The colonial powers are not in charge anymore. You can be sure that in this revolution it's Ecuadoreans in control."

The combative, U.S.-trained economist took power in 2007 and has won strong support among the poor by using booming oil revenues to build roads, hospitals and schools in rural areas and shantytowns.

"Our Ecuador needs a president like Rafael Correa. He has been strong and has not allowed anyone to intimidate him," said Julieta Moira, 46, who is unemployed, as she celebrated outside the presidential palace. "I'm very excited, happy and thankful."

Supporters also gathered in a park in the upscale north end of Quito, waving the signature neon-green flags of Correa's Alianza Pais party.

DEDICATES WIN TO CHAVEZ

Correa, 49, may now be in line to become Latin America's main anti-American voice and de facto leader of the ALBA bloc of leftist governments as Venezuelan President Hugo Chavez has been silenced during his battle with cancer.

Correa said he dedicated his victory to Chavez.

The principal challenge in Correa's new four-year term will be wooing investors needed to boost stagnant oil production and spur the mining industry. A $3.2 billion debt default in 2008 and aggressive oil contract negotiations scared off many.

Critics view Correa as an authoritarian leader who has curbed media freedom and appointed aides to top posts in the judiciary.

"This government has not given us anything good, only insults and taxes. We're tired of all that. I'm concerned that this government has alliances with communist countries," said Celeste Guerrero, a 68-year-old pensioner in Guayaquil.

Even some supporters disapprove of his tempestuous outbursts, confrontations with media and bullying of adversaries.

But the fractured opposition failed to make a consolidated challenge. It fielded seven candidates, making it easy for Correa, and he is now on track for a decade in office.

That is rare stability in a country where three presidents were pushed from office by coups or street protests in the decade before Correa took power in 2007.

He is already the longest-serving president since the return to democracy in the 1970s following a military dictatorship.

Correa's success has hinged in part on high oil prices that allowed for liberal state spending, including boosting cash handouts to 2 million people, and spurred solid economic growth.

He is likely to continue spending heavily to maintain his popularity, but state revenues would dry up if oil prices fell.

He now hopes to diversify the economy away from its dependence on oil, in part by bringing in new investment for the mining sector. Despite promising reserves of gold and copper, mining operations have barely gotten off the ground.

In a news conference on Sunday after polls closed, Correa played down the need for more foreign investment. He insisted the ultimate goal was to ensure economic growth rather than "mortgaging" the country to bring in cash from abroad.

"We welcome foreign investment, and we're already getting plenty of it," Correa said. "Ecuador is one of the most successful economies in Latin America."

Lasso, a wealthy ex-banker and Correa's closest rival, had tried to woo voters with promises of lower taxes. He congratulated Correa on his victory but also took pride in his Creo party taking a quarter of the vote.

"We are now the second-largest political force in the country," said Lasso, who was beaming despite losing.

CONGRESS BATTLE

The other six opposition candidates included former Correa ally Alberto Acosta, former President Lucio Gutierrez and banana magnate and five-time presidential candidate Alvaro Noboa.

Pollsters say some of them focused their campaigns too much on attacking Correa and failed to put forward concrete proposals to entice voters.

Ecuadoreans also chose a new Congress on Sunday.

The Alianza Pais party was expected to win a majority in the legislature, which would let Correa push ahead with controversial reforms, including a media law and changes to mining legislation, without having to negotiate with rivals.

The results of the vote for Congress are not expected to be known for several days, but Correa said he was confident.

"I think we are going to get a majority and we will manage that majority with great responsibility," he told Latin America's Telesur TV network, set up by Chavez and his allies as an alternative to established media.

Correa never shies away from a fight, be it with international bondholders, oil companies, local bankers, the Catholic Church or media that criticize his policies.

He vowed on Sunday to expand state regulations over media groups he has called "dogs" and "hired assassins."

"One of the things we have to fix is an unethical and unscrupulous press that wants to judge, legislate and govern," Correa said. "That goes against the rule of law and we will not allow it."

His criticism of the U.S. "empire" and his clashes with foreign investors and the World Bank have fueled Correa's popularity as a strong-minded leader who stands up to foreign powers that many say meddled in Ecuador's affairs for decades.

He took the global limelight last year when he granted asylum to WikiLeaks' founder Julian Assange. Critics say he did it to brush off accusations that he is curbing freedom of expression in Ecuador.

(Additional reporting by Jose Llangari and Eduardo Garcia in Quito and Yuri Garcia in Guayaquil; Editing by Kieran Murray, Andrew Cawthorne and Eric Beech)

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Mindy McCready Is Dead in Apparent Suicide

Breaking News

By Steve Helling

02/17/2013 at 09:30 PM EST

Country singer Mindy McCready has committed suicide, multiple sources close to her tell PEOPLE. She was 37.

Professionally, McCready was best known for her multi-platinum debut album Ten Thousand Angels. In recent years, it's been the singer's personal troubles making headlines, though she was attempting to reestablish her music career. In 2010, McCready released a new album titled I'm Still Here.

She is survived by her son Zander, 6, with ex Billy McKnight, and Zayne, 10 months.

In January, McCready's life partner and Zayne's father, singer-songwriter David Wilson died of a self-inflicted gunshot wound. Just three weeks later, a judge ordered McCready to be committed to a treatment facility to cope with mental health and alcohol issues and her sons were placed in foster care.

Story developing …

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UN warns risk of hepatitis E in S. Sudan grows

GENEVA (AP) — The United Nations says an outbreak of hepatitis E has killed 111 refugees in camps in South Sudan since July, and has become endemic in the region.

U.N. refugee agency spokesman Adrian Edwards says the influx of people to the camps from neighboring Sudan is believed to be one of the factors in the rapid spread of the contagious, life-threatening inflammatory viral disease of the liver.

Edwards said Friday that the camps have been hit by 6,017 cases of hepatitis E, which is spread through contaminated food and water.

He says the largest number of cases and suspected cases is in the Yusuf Batil camp in Upper Nile state, which houses 37,229 refugees fleeing fighting between rebels and the Sudanese government.

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