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Passenger Travel Facts and Figures 2014

September 30, 2014 Comments off

Passenger Travel Facts and Figures 2014
Source: Bureau of Transportation Statistics

The U.S. Department of Transportation’s Bureau of Transportation Statistics (BTS) today released Passenger Travel Facts and Figures 2014, a snapshot of the characteristics and trends of personal travel in the United States; the network over which passenger travel takes place; and the related economic, safety, and environmental implications. The 77-page report summarizes the basic demographic and economic characteristics of the United States that contribute to the demand for passenger travel; examines travel patterns by trip purpose, transportation mode, and household characteristics; provides a picture of the passenger transportation system in 2005 and 2011 and summarizes movement on the system by transportation mode and congestion impacts; discusses the economic characteristics of passenger travel and tourism and discusses the safety, energy, and environmental impacts of passenger travel. It is intended as a companion to Freight Facts and Figures, which is produced jointly by BTS and the Federal Highway Administration (FHWA)

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Personal and Parental Weight Misperception and Self-Reported Attempted Weight Loss in US Children and Adolescents, National Health and Nutrition Examination Survey, 2007–2008 and 2009–2010

September 30, 2014 Comments off

Personal and Parental Weight Misperception and Self-Reported Attempted Weight Loss in US Children and Adolescents, National Health and Nutrition Examination Survey, 2007–2008 and 2009–2010
Source: Preventing Chronic Disease (CDC)

Introduction
The objective of our study was to describe perceptions of child weight status among US children, adolescents, and their parents and to examine the extent to which accurate personal and parental perception of weight status is associated with self-reported attempted weight loss.

Methods
Our study sample comprised 2,613 participants aged 8 to 15 years in the National Health and Nutrition Examination Survey from the 2 most recent consecutive cycles (2007–2008 and 2009–2010). Categories of weight perception were developed by comparing measured to perceived weight status. Multivariable logistic regression analyses were used to examine the association between weight misperception and self-reported attempted weight loss.

Results
Among children and adolescents, 27.3% underestimated and 2.8% overestimated their weight status. Among parents, 25.2% underestimated and 1.1% overestimated their child’s weight status. Logistic regression analyses showed that the odds of self-reported attempted weight loss was 9.5 times as high (95% confidence interval [CI]: 3.8–23.6) among healthy-weight children and adolescents who overestimated their weight status as among those who perceived their weight status accurately; the odds of self-reported attempted weight loss were 3.9 (95% CI, 2.4–6.4) and 2.9 (95% CI, 1.8–4.6) times as high among overweight and obese children and adolescents, respectively, who accurately perceived their weight status than among those who underestimated their weight status. Parental misperception of weight was not significantly associated with self-reported attempted weight loss among children and adolescents who were overweight or obese.

Conclusion
Efforts to prevent childhood obesity should incorporate education for both children and parents regarding the proper identification and interpretation of actual weight status. Interventions for appropriate weight loss can target children directly because one of the major driving forces to lose weight comes from the child’s perception of his or her weight status.

Nearly One in Four Employers Say Private Health Insurance Exchanges Could Provide a Viable Alternative for Full-Time Active Employees in 2016

September 30, 2014 Comments off

Nearly One in Four Employers Say Private Health Insurance Exchanges Could Provide a Viable Alternative for Full-Time Active Employees in 2016
Source: Towers Watson

Results of a July 2014 survey of midsize to large employers by global professional services company Towers Watson (NYSE, NASDAQ: TW) showed that 28% said they had already extensively evaluated the viability of private exchanges. Nearly one in four (24%) said private exchanges could provide a viable alternative for their active full-time employees as soon as 2016.

The results are from the 2014 Towers Watson Health Care Changes Ahead Survey, which was completed by 379 employee benefit professionals from a variety of industries and reflect health care benefit decisions for 2016 – 2017.

The survey also revealed that the top three factors that would cause employers to adopt a private exchange for full-time active employees are:

  • Evidence they can deliver greater value than their current self-managed model (64%)
  • Adoption of private exchanges by other large companies in their industry (34%)
  • An inability to stay below the excise tax ceiling as 2018 approaches (26%)

Lack of Publicly Available Scientific Evidence on the Safety and Effectiveness of Implanted Medical Devices

September 30, 2014 Comments off

Lack of Publicly Available Scientific Evidence on the Safety and Effectiveness of Implanted Medical Devices
Source: Journal of the American Medical Association

Importance
Under the 510(k) process, the US Food and Drug Administration (FDA) clears about 400 implanted medical devices that are considered moderate to high risk for market each year without requiring clinical testing. Instead, the FDA requires the applicant to provide scientific evidence that the new device is “substantially equivalent” to a device or devices already on the market (predicate devices). Companies are legally required to submit the evidence to the FDA and to make publicly available at least a summary of the evidence.

Objective
To assess the types of scientific evidence used to determine substantial equivalence, safety, or effectiveness for a representative sample of implanted medical devices; the number of predicates for each implant; and whether this evidence was publicly available.

Design
Using FDA databases, we determined the device categories of the first 5 implanted medical devices cleared through the 510(k) process in 2008: cardiovascular, dental, general and plastic surgery, neurological, and orthopedic. We then identified the first 2 implanted medical devices approved in each of the 5 categories for each year from 2008 through 2012. The sample of 50 devices included, for example, total hip implants, vascular embolization devices, and surgical mesh. We also identified the 1105 predicates the manufacturers listed for these devices.

Main Outcomes and Measures
For each implanted medical device and its predicates, we determined whether clinical or nonclinical scientific evidence was provided to the FDA to support the claim of substantial equivalence and whether this evidence was publicly available. We also determined if safety or effectiveness data were provided.

Results
Scientific data to support the claim of substantial equivalence were publicly available for 8 of the 50 newly cleared implants (16%) and 31 of their 1105 listed predicates (3%). Most of the evidence was nonclinical data; some of the data also evaluated safety or effectiveness.

Conclusions and Relevance
Despite the legal requirement that scientific evidence of substantial equivalence be publicly available for medical devices cleared by the FDA through the 501(k) process, such information is lacking for most implanted medical devices cleared between 2008 and 2012, as well as for their predicates.

Climate Change: Challenges and Opportunities for Global Health

September 30, 2014 Comments off

Climate Change: Challenges and Opportunities for Global Health
Source: Journal of the American Medical Association

Importance
Health is inextricably linked to climate change. It is important for clinicians to understand this relationship in order to discuss associated health risks with their patients and to inform public policy.

Objectives
To provide new US-based temperature projections from downscaled climate modeling and to review recent studies on health risks related to climate change and the cobenefits of efforts to mitigate greenhouse gas emissions.

Data Sources, Study Selection, and Data Synthesis
We searched PubMed from 2009 to 2014 for articles related to climate change and health, focused on governmental reports, predictive models, and empirical epidemiological studies. Of the more than 250 abstracts reviewed, 56 articles were selected. In addition, we analyzed climate data averaged over 13 climate models and based future projections on downscaled probability distributions of the daily maximum temperature for 2046-2065. We also compared maximum daily 8-hour average with air temperature data taken from the National Oceanic and Atmospheric Administration National Climate Data Center.

Results
By 2050, many US cities may experience more frequent extreme heat days. For example, New York and Milwaukee may have 3 times their current average number of days hotter than 32°C (90°F). The adverse health aspects related to climate change may include heat-related disorders, such as heat stress and economic consequences of reduced work capacity; and respiratory disorders, including those exacerbated by fine particulate pollutants, such as asthma and allergic disorders; infectious diseases, including vectorborne diseases and water-borne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; and mental health disorders, such as posttraumatic stress disorder and depression, that are associated with natural disasters. Substantial health and economic cobenefits could be associated with reductions in fossil fuel combustion. For example, the cost of greenhouse gas emission policies may yield net economic benefit, with health benefits from air quality improvements potentially offsetting the cost of US carbon policies.

Conclusions and Relevance
Evidence over the past 20 years indicates that climate change can be associated with adverse health outcomes. Health care professionals have an important role in understanding and communicating the related potential health concerns and the cobenefits from reducing greenhouse gas emissions.

UK — Guidance: Progress on premature deaths of people with learning disabilities

September 30, 2014 Comments off

Guidance: Progress on premature deaths of people with learning disabilities
Source: Department of Health

This report shows progress against the 18 recommendations in the Confidential Inquiry into premature deaths of people with learning disabilities both locally and nationally.

It also recognises that more needs to be done including all local areas:

  • participating fully in the Self-Assessment Framework and act on its results
  • securing the provision of named care co-ordinators
  • ensuring reasonable adjustments are made and audited

Catching Up: Latino Health Coverage Gains and Challenges Under the Affordable Care Act

September 29, 2014 Comments off

Catching Up: Latino Health Coverage Gains and Challenges Under the Affordable Care Act
Source: Commonwealth Fund

For decades, Latinos have had the highest uninsured rates of any racial or ethnic group in the United States. Less than one year after the Affordable Care Act’s health insurance marketplaces opened for enrollment, the overall Latino uninsured rate dropped from 36 percent to 23 percent, according to the Commonwealth Fund Affordable Care Act Tracking Survey, conducted April 9 to June 2, 2014. However, the high uninsured rate among Latinos in states that had not expanded their Medicaid program at the time of the survey—33 percent—remained statistically unchanged. These states are home to about 20 million Latinos, the majority of whom live in Texas and Florida.

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