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Heat Illness and Death Among Workers — United States, 2012–2013

August 28, 2014 Comments off

Heat Illness and Death Among Workers — United States, 2012–2013
Source: Morbidity and Mortality Weekly Report (CDC)

Exposure to heat and hot environments puts workers at risk for heat stress, which can result in heat illnesses and death. This report describes findings from a review of 2012‒2013 Occupational Safety and Health Administration (OSHA) federal enforcement cases (i.e., inspections) resulting in citations under paragraph 5(a)(1), the “general duty clause” of the Occupational Safety and Health Act of 1970. That clause requires that each employer “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees” (1). Because OSHA has not issued a heat standard, it must use 5(a)(1) citations in cases of heat illness or death to enforce employers’ obligations to provide a safe and healthy workplace. During the 2-year period reviewed, 20 cases of heat illness or death were cited for federal enforcement under paragraph 5(a)(1) among 18 private employers and two federal agencies. In 13 cases, a worker died from heat exposure, and in seven cases, two or more employees experienced symptoms of heat illness. Most of the affected employees worked outdoors, and all performed heavy or moderate work, as defined by the American Conference of Governmental Industrial Hygienists (2). Nine of the deaths occurred in the first 3 days of working on the job, four of them occurring on the worker’s first day. Heat illness prevention programs at these workplaces were found to be incomplete or absent, and no provision was made for the acclimatization of new workers. Acclimatization is the result of beneficial physiologic adaptations (e.g., increased sweating efficiency and stabilization of circulation) that occur after gradually increased exposure to heat or a hot environment (3). Whenever a potential exists for workers to be exposed to heat or hot environments, employers should implement heat illness prevention programs (including acclimatization requirements) at their workplaces.

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Recent Declines in Nonmarital Childbearing in the United States

August 28, 2014 Comments off

Recent Declines in Nonmarital Childbearing in the United States
Source: National Center for Health Statistics

Key findings
Data from the National Vital Statistics System and the National Survey of Family Growth

  • Nonmarital births and birth rates have declined 7% and 14%, respectively, since peaking in the late 2000s.
  • Births to unmarried women totaled 1,605,643 in 2013. About 4 in 10 U.S. births were to unmarried women in each year from 2007 through 2013.
  • Nonmarital birth rates fell in all age groups under 35 since 2007; rates increased for women aged 35 and over.
  • Birth rates were down more for unmarried black and Hispanic women than for unmarried non-Hispanic white women.
  • Nonmarital births are increasingly likely to occur within cohabiting unions—rising from 41% of recent births in 2002 to 58% in 2006–2010.

See also: National and State Patterns of Teen Births in the United States, 1940–2013 (_DF)

An Overview of 60 Contracts That Contributed to the Development and Operation of the Federal Marketplace

August 27, 2014 Comments off

An Overview of 60 Contracts That Contributed to the Development and Operation of the Federal Marketplace
Source: U.S. Department of Health and Human Services, Office of Inspector General

Summary

WHY WE DID THIS STUDY
The Patient Protection and Affordable Care Act required the establishment of a health insurance exchange (marketplace) in each State. For States that elect not to establish their own marketplaces, the Federal Government is required to operate a marketplace on behalf of the State. A marketplace is designed to serve as a one-stop shop where individuals can obtain information about their health insurance options, determine eligibility for insurance affordability programs, and select the plan of their choice. CMS operates the Federally Facilitated Marketplace (Federal Marketplace). CMS relied-and continues to rely extensively-on contractors to operate the Federal Marketplace. This report is the first in a series that will address the planning, acquisition, management, and performance oversight of Federal Marketplace contracts, as well as various aspects of Federal Marketplace operations. This report provides descriptive and financial data on 60 contracts related to the development of the Federal Marketplace at HealthCare.gov.

HOW WE DID THIS STUDY
CMS identified 60 contracts (“the contracts”) related to the development and operation of the Federal Marketplace. Not all of these contracts were awarded solely for the purpose of the Federal Marketplace. To determine the estimated value of the contracts and the amount obligated for the contracts as of February 2014, OIG analyzed contract, order, and modification documentation provided by CMS for the 60 contracts. We calculated the total obligation and expenditure amounts related to the Federal Marketplace portions of each contract by summarizing the financial accounting transactions that CMS identified as related to the Federal Marketplace for each contract. These financial accounting transactions (obligations and expenditures) include all transactions that CMS processed through its Healthcare Integrated General Ledger Accounting System (HIGLAS) as of February 28, 2014, that CMS had provided to us as of June 18, 2014.

SUMMARY
The 60 contracts related to the development and operation of the Federal Marketplace started between January 2009 and January 2014. The purpose of the 60 contracts ranged from health benefit data collection and consumer research to cloud computing and Web site development. The original estimated values of these contracts totaled $1.7 billion; the contract values ranged from $69,195 to over $200 million. Across the 60 contracts, nearly $800 million has been obligated for the development of the Federal Marketplace as of February 2014. As of that date, CMS had paid nearly $500 million for the development of the Federal Marketplace to the contractors awarded these contracts.

CDC Digital Press Kit: Ebola Outbreak – 2014

August 27, 2014 Comments off

CDC Digital Press Kit: Ebola Outbreak – 2014
Source: Centers for Disease Control and Prevention

CDC is rapidly increasing its ongoing efforts to curb the expanding West African Ebola outbreak and deploying staff to four African nations currently affected: Guinea, Sierra Leone, Liberia, and Nigeria.

This is the largest Ebola outbreak in history and the first in West Africa. The outbreak in West Africa is worsening, but CDC, along with other U.S. government agencies and international partners, is taking active steps to respond to this rapidly changing situation.

CDC elevated its Emergency Operations Center (EOC) to a Level 1 activation, its highest level, because of the significance of the outbreak in West Africa.
CDC is surging our response with the current challenges that we are facing. CDC is sending additional CDC disease control specialists into the four countries.

Age Differences in Visits to Office-based Physicians by Patients With Diabetes: United States, 2010

August 26, 2014 Comments off

Age Differences in Visits to Office-based Physicians by Patients With Diabetes: United States, 2010
Source: National Center for Health Statistics

Key findings
Data from the National Ambulatory Medical Care Survey

  • Office-based physician visits by patients with diabetes increased 20%, from 94.4 million in 2005 to 113.3 million in 2010, but the rate did not change between 2005 and 2010.
  • The visit rate for diabetes increased with age and averaged 1,380 visits per 1,000 persons aged 65 and over in 2010.
    A majority of visits made by patients with diabetes (87%) were by those with multiple chronic conditions, and the number of chronic conditions increased with advancing age.
  • Medications were prescribed or continued at a majority of visits (85%) made by patients with diabetes, with the number of medications prescribed or continued increasing as age increased.

Administration takes steps to ensure women’s continued access to contraception coverage, while respecting religious-based objections

August 25, 2014 Comments off

Administration takes steps to ensure women’s continued access to contraception coverage, while respecting religious-based objections
Source: U.S. Department of Health and Human Services

Today, the Administration took several steps to help ensure women, whose coverage is threatened, receive coverage for recommended contraceptive services at no additional cost, as they should be entitled to under the Affordable Care Act. The rules, which are in response to recent court decisions, balance our commitment to helping ensure women have continued access to coverage for preventive services important to their health, with the Administration’s goal of respecting religious beliefs. The first administration action announced today maintains the existing accommodation for certain religious non-profits, but also creates an additional pathway for eligible organizations to provide notice of their objection to covering contraceptive services. In addition, the Administration is soliciting comment on how it might extend to certain closely held for-profit companies the same accommodation that is available to non-profit religious organizations, while continuing to urge Congress to take action to ensure women’s access to contraception services.

Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies

August 25, 2014 Comments off

Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies
Source: Substance Abuse and Mental Health Services Administration

Summarizes the evidence base on the clinical and cost effectiveness of different types of crisis services, and presents cases studies of different approaches states are using to coordinate, consolidate, and blend funding sources to provide robust crisis services.

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