Current Events in November 2012

Boehringer Ingelheim Pharmaceuticals is conducting a nationwide recall of a single manufacturing lot of Pradaxa (dabigatran etexilate mesylate), 75mg 60 US, NDC 0597- 0149-54, lot 201900, Exp January 2015.

Pradaxa is used to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF).

The recall is being conducted due to a potential packaging defect on this lot that may compromise the bottle integrity. A damaged bottle could allow moisture to get into the bottle and, thus, may impair the quality of Pradaxa.

As a consequence a patient may not receive a fully effective dose of Pradaxa 75mg, which would increase his or her risk of experiencing an ischemic stroke. Boehringer says the risk is small -- not zero. Therefore Pradaxa is being recalled at the patient level as a precautionary measure.

Actions for patients

Patients should continue to take the product as directed until they obtain replacement to assure there is no interruption of therapy.

The company says it believes most of the potentially affected bottles have been returned, but if a person has or receives a bottle of Pradaxa 75mg from the potentially affected lot he should return it to the pharmacist as soon as possible for replacement at no charge.

Information has been sent to pharmacists alerting them of the details pertaining to this recall. As described in the recall communications, pharmacists who may have dispensed Pradaxa capsules to patients from manufacturing lot 201900 are instructed to contact those patients to return the product lot back to the pharmacy.

Distributors/retailers that have not received a recall packet should contact GENCO Pharmaceutical Services, 6101 North 64th Street, Milwaukee, WI 53218.

The current medication you're using to treat rheumatoid arthritis (RA) not working? You may have an alternative.

The U.S. Food and Drug Administration (FDA) has approved Xeljanz (tofacitinib) to treat adults with moderately to severely active RA who have had an inadequate response to, or who are intolerant of, methotrexate.

RA is an autoimmune disease, in which the body's immune system mistakenly attacks healthy tissue leading to inflammation of the joints and surrounding tissues. According to the Centers for Disease Control and Prevention, RA affects an estimated 1.5 million Americans. Xeljanz, a pill taken twice daily, works by blocking molecules called “Janus kinases,” which are important in the joint inflammation of RA.

A new treatment option

“Xeljanz provides a new treatment option for adults suffering from the debilitating disease of RA who have had a poor response to methotrexate,” said Badrul Chowdhury, M.D., Ph.D., director of the Division of Pulmonary, Allergy, and Rheumatology Products in the FDA’s Center for Drug Evaluation and Research.

Xeljanz is being approved ahead of the product’s prescription drug user fee goal date of Nov. 21, 2012, the date the agency was scheduled to complete review of the drug application.

The safety and effectiveness of Xeljanz were evaluated in seven clinical trials in adult patients with moderately to severely active RA. In all of the trials, patients treated with Xeljanz experienced improvement in clinical response and physical functioning compared to patients treated with placebo.

Risk of infection

The use of Xeljanz was associated with an increased risk of serious infections, including opportunistic infections (infections that occur primarily when the immune system is suppressed), tuberculosis, cancers and lymphoma. Xeljanz carries a Boxed Warning regarding these safety risks. Xeljanz treatment is also associated with increases in cholesterol and liver enzyme tests and decreases in blood counts.

The FDA approved Xeljanz with a Risk Evaluation and Mitigation Strategy (REMS), which consists of a Medication Guide advising patients about important safety information and a communication plan to inform health care providers about the serious risks associated with Xeljanz.

Post-marketing study required

To study the long-term effects of Xeljanz on heart disease, cancer, and serious infections, the FDA is requiring a post-marketing study that will evaluate two doses of Xeljanz and include a group of patients on another approved treatment to serve as a comparison.

The most common adverse reactions in clinical trials were upper respiratory tract infections, headache, diarrhea, and inflammation of the nasal passage and the upper part of the pharynx.

Xeljanz is marketed by New York-based Pfizer Inc.

With an aging baby boom population joint replacement surgeries are becoming more common -- especially hip replacement.

While improvement in techniques has resulted in faster recovery time, doctors at Loyola University Health Center in Chicago say one technique in particular -- the anterior approach -- is producing startling results.

They point to patient Sean Toohey, who they say underwent a total hip replacement using the anterior approach. The morning after the procedure, he walked up half a flight of stairs at the hospital.

Speedy recovery

That afternoon, he progressed from a walker to crutches to a cane. And 15 days after his surgery, they say, he returned to work, no longer hobbled by a severely arthritic hip that had been bone-on-bone.

"My brother, who has had both hips replaced, was very jealous of my outcome," Toohey said.

Toohey's surgeon, Dr. Harold Rees, used the new technique that results in less pain, faster recovery and better mobility. Rees says he now uses the anterior approach in all primary hip-replacement surgeries, which he performs at Loyola’s main campus in Maywood and at Loyola’s Gottlieb Memorial Hospital in Melrose Park.

Total hip replacement involves removing a diseased or damaged hip joint and replacing it with an artificial one. These hip prostheses are made up of a ball, usually composed of metal or ceramic, and a socket, which has a liner made of plastic, ceramic or metal. Everything is designed to be accepted by the body and resist years of wear.

How it's done

What makes the anterior approach different is how the surgeon approaches the joint. The surgery is performed through the front, or anterior of the hip, rather than the back. And rather than cutting through muscles and tendons, the surgeon goes between them to gain access to the hip joint. The anterior approach incision is only about 2 ½ inches long.

Patients like Toohey like the procedure because there's less pain during recovery because the muscles and tendons have not been cut and the patient does not sit on the incisions. There's also a lower risk of dislocating the new hip.

Rees says most hip replacements still are done using other approaches, and many hospitals do not offer the anterior approach. But the anterior approach is becoming increasingly popular, and Rees predicts that within five to 10 years it will become the predominant technique.

It's no secret that physically active people feel better. But here’s something to consider: physically active people are likely to fell better -- longer.

A study by a team of researchers led by the National Cancer Institute (NCI) found that leisure-time physical activity is associated with longer life expectancy -- even at relatively low levels of activity and regardless of body weight. The study, which found that people who engaged in leisure-time physical activity had life expectancy gains of as much as 4.5 years, appeared Nov. 6, 2012, in PLOS Medicine.

More is better

In order to determine the number of years of life gained from leisure-time physical activity in adulthood -- which translates directly to an increase in life expectancy -- researchers examined data on more than 650,000 adults. These people, mostly age 40 and older, took part in one of six population-based studies that were designed to evaluate various aspects of cancer risk.

The U.S. Department of Health and Human Services recommends that adults ages 18 to 64 engage in regular aerobic physical activity for 2.5 hours at moderate intensity -- or 1.25 hours at vigorous intensity -- each week. Moderate activities are those during which a person could talk but not sing. Vigorous activities are those during which a person could say only a few words without stopping for breath.

After accounting for other factors that could affect life expectancy, the researchers found that life expectancy was 3.4 years longer for people who reported they got the recommend level of physical activity. People who reported leisure-time physical activity at twice the recommended level gained 4.2 years of life. In general, more physical activity corresponded to longer life expectancy.

The researchers even saw benefit at low levels of activity. For example, people who said they got half of the recommended amount of physical activity still added 1.8 years to their life.

A strong relationship

"Our findings highlight the important contribution that leisure-time physical activity in adulthood can make to longevity," said study author Steven Moore, Ph.D., of NCI's Division of Cancer Epidemiology and Genetics, and lead author of the study. "Regular exercise extended the lives in every group that we examined in our study -- normal weight, overweight, or obese."

The researchers found that the association between physical activity and life expectancy was similar between men and women, and blacks gained more years of life expectancy than whites. The relationship between life expectancy and physical activity was stronger among those with a history of cancer or heart disease than among people with no history of cancer or heart disease.

The researchers also examined how life expectancy changed with the combination of both activity and obesity. Obesity was associated with a shorter life expectancy, but physical activity helped to mitigate some of the harm. People who were obese and inactive had a life expectancy that was between five to seven years shorter (depending on their level of obesity) than people who were normal weight and moderately active.

Physical activity has been shown to help maintain a healthy body weight, maintain healthy bones, muscles and joints, promote psychological well-being, and reduce the risk of certain diseases, including some cancers.

"We must not underestimate how important physical activity is for health - even modest amounts can add years to our life," said I-Min Lee, M.D., Sc.D., professor of Medicine, Harvard Medical School, Cambridge, Mass., and senior author on the study.

The American household is changing. While the empty nest is not exactly a thing of the past, it is being supplemented by “boomerang” kids and even parents moving in with their children.

While you might think the economy is shaping this trend, it isn't entirely. In fact, the trend began in the early 90s and has increased 60 percent since then, according to the U.S. Census Bureau.

But the economy undoubtedly plays a role. Baby boomers are living longer and are faced with deteriorating pensions, a questionable Social Security system and ever-increasing healthcare costs.

At the same time, college debt and the increased cost of living mean that many children move back home after college and stay for several years. Multigenerational living is becoming the new normal.

Homebuilders respond

So as the homebuilding industry slowly recovers, not all builders are going back to turning out cookie cutter tract houses in sprawling subdivisions. Some are beginning to incorporate multigenerational living into home design.

In Tampa, Fla., homebuilder Lennar has created a concept it calls Next Gen - The Home Within a Home. It includes a separate suite with its own entrance, eat-in kitchenette, bedroom, bathroom, laundry room and living room. These homes are being built in a number of subdivisions around the Tampa area.

The idea is actually an old one. Until the middle of the 20th century parents often lived with their adult children, assuming active roles in the family. The idea seems to be coming full circle.

Return to interdependence

"We are seeing the nuclear family going back to the interdependence of the extended family,” said John Graham, Professor of Marketing and International Business at University of California Irvine. “For the last 50 years the American ideal was the nuclear family living independently, but with the economic changes of recent decades that no longer is the solution of choice."

In fact, multigenerational living is still the norm in most countries. Graham thinks the fact that it's regaining popularity in the U.S. is a positive development.

“I am happy to see progressive builders like Lennar addressing this change," Graham said.

Sherry and Timothy Biggs of Tampa say they considered resale homes but in the end selected one of the Lennar homes because, they said, it not only cost a great deal less but also gave her parents, who were moving in with them, a sense of privacy.

"My parents are in their 60's and this home design appealed to their needs as well as ours," Gibbs said. "They have their own separate entrance and suite which allows them to enjoy their independence."

In business does it pay to be avant garde or boundary pushing, or is it safer to follow other business models that have already been successful?

That’s what the Mexican eatery Chipotle is asking itself, as the company’s founder Steve Ells notes the restaurant chain is not growing as fast it has in the past. Could it be due to a disproportionate advertising focus on how different Chipotle is, rather than branding itself as a good place to get a quick bite?

Since Chipotle opened in 1993, it has always branded itself like a restaurant rather than a fast-food place, and most of its marketing has focused on the company's organic ingredients and natural food selections.

By practically inventing the fast-casual dining experience, Chipotle’s image of breaking the mold and creating an entirely new dining category may have turned the restaurant into a niche eatery, which probably wasn't the company's intention.

Fitting the mold

Steve Ells, Chipotle’s founder, said the company is seriously thinking about following the traditional fast-food mold—a la McDonalds and Burger King—by adding drive through services and creating TV commercials that focus less on Chipotle being an organic alternative and more on it being an everyday fast-food restaurant.

It’s possible that Ells’ game plan is to remove some of the health food association to help change the company from a niche brand to a restaurant that caters to the everyday Jose and Josephine.

Ells also said new menu items are possible and the restaurant may add food options that appeal to a broader range of consumers and pallets. He’s also considering adding a breakfast menu in the near futre.

It’s also been rumored that Chipotle may downscale its fast-casual approach and go the traditional fast-food route by speeding up the ordering process and moving at a quicker pace to bring in more customers.

Whether this will provide the restaurant the jolt it’s looking for remains to be seen, as Chipotle sales numbers have decreased by a few percentage points during the second quarter.

Cutting back

This could easily be attributed to consumers choosing to spend less on eating out, or it could be because consumers have more dining options than before. But either way Chipotle has noticed declining growth and it's eager to change that very quickly.

It’s safe to say that most food chains probably wouldn’t fret too much about a small drop in sales numbers, but since Chipotle has seen nothing but growth pretty much since its opening, a shift in sales undoubtedly has the company on guard.

Although the restaurant could be making these changes in the near future, Chipotle executives say it won’t totally thow out its usual branding approach.

“We’ve always been very sort of focused on doing our marketing kind of different, said Alex Spong of Chipotle in an interview with BusinessWeek.

“That model has allowed us to have consistent sales growth. While we may tweak some things here or there, I think it’s important that the takeaway is, we’re not pivoting from our strategy," he said.

Ells hasn’t said these changes are written in stone, and at this point he is simply going back to the drawing board to figure out his next move.

Many industry experts believe drive-through service is smart for any location that wants to maximize business, and adding breakfast items to menus seems to be the new wave for many eateries like Subway, which just added a string of breakfast sandwiches to its menus.

And on the heels of Chipotle are other fast-casual Mexican restaurants like Baja Fresh, Qdoba, Panchero’s Mexican Grill and Moe’s Southwest Grill.

Of course none of these restaurants has caused Chipotle a great deal of heartburn yet, but some have already separated themselves by not appearing to be as niche or as high-end as Chipotle.

Feeding everyman

Let’s face it, although places like McDonald’s and Burger King aren’t the best when it comes to décor or offering the healthiest menu items, they’ve managed to brand themselves as the common man’s eatery, without seeming vastly inferior to other fast food places.

So it could be bad news for those Chipotle fans that believe the company is doing everything perfectly, because many consumers like the way the restaurant operates. They also admire the fact that Chipolte considers itself a notch or two above Wendy’s or McDonald’s.

But whether you want the restaurant to change or not, the company will most likely raise prices, so consumers should expect to shell out more cash for those Quesadillas they love.  

“We don’t have any specific plans to increase menu prices next year, but with inflationary expectation related to the summer drought looming —we remain open to the possibility of a price increase next year,” said Chipotle’s CFO John Hartung.

“So the combined inflation in Q4 and next year is expected to be in about the mid-single-digit range. Should that kind of inflation materialize, we will consider price increase to help offset the impact,” he said.

Suzuki makes a great motorcycle, we're told, and it's the No. 1 automaker in India. But its sales in the U.S. have been barely detectable the last few years and now the company says it's packing up and shipping out. 

American Suzuki Motor Corp., Suzuki's sole U.S. distributor, said today it has filed for Chapter 11 bankruptcy and will stop selling new cars immediately. It said it will continue to honor warranties and provide parts for Suzukis already on the road.

The company blamed the decision on poor sales, high costs and stringent safety and pollution regulations. Customers haven't exactly been ecstatic about their cars so the company's demise may not result in public outbursts of remose.

"My car is a Forenza Station Wagon 2006. In 2008, the dealer replaced my transmission. Now 4 years later, I need another one," Deborah of Matthews, N.C., wrote in a ConsumerAffairs posting recently. "I contacted the corporate office and they said they couldn't do anything for me. ... There is no way a car should need two transmissions in 6 years."

Deborah was far from the only consumer to experience serious transmission problems without receiving any help from Suzuki. David of Gulfport, Miss., bought a 2008 Firenza with a 100,000-mile drive-train warranty for his daughter, who took it to Hawaii.

"Once there, the transmission started having problems so she took it to the only Suzuki dealer on the island. They said they would not honor the warranty because Suzuki would not let them have any 2008 models?" David said. "Something needs to be done about this. My daughter can barely afford to live there, let alone pay for a new transmission."

Suzuki started selling cars in the U.S. in 1985 and sold a high of 102,000 vehicles in 2007. But its growth was sidelined by the financial crisis of 2008 and never quite got back on track. The company sold just 26,000 in the last year.

Suzuki began a slow disappearing act earlier this year when it skipped several major auto shows, suspended its social media activity and slashed national television advertising. It also dropped 32 dealers last year and even canceled its subscription to J.D. Power & Associates’ customer satisfaction data.

The company's cars often came in near the bottom of governmental and independent safety te

Porsche drivers, check your rearview mirror. Renault is reviving its Alpine sports car marque in partnership with Caterham, the British racing-car company.

Carlos Ghosn, CEO of Renault and Tony Fernandes, Chairman of Caterham Group, said the companies are joining forces to develop stylish, high-performance sports cars, part of Renault's strategy to move upscale a bit.

It's expected to be about four years before the first models roll off the line and there's no word on when -- or, for that matter, if -- they will be sold in the U.S.

"The future vehicles will be distinctive, differentiated, and carry the respective DNA of Alpine and Caterham Cars, the automotive division of Caterham Group," the companies said in a joint statement. They will be built at the Alpine plant in Dieppe, Normandy, in France.

“The global market for specific sports cars is an important and vivid market with more than 700,000 vehicles expected in 2015. Between 2009 and 2015, an increase of 50% is expected, including 15% in Europe between 2012 and 2015,” said  Ghosn.

Tony Fernandes, Caterham Group Chairman, added: “I have not felt as excited about a new venture since I launched AirAsia in 2001. We know the markets we are going into and, particularly in my playground in Asia, there is a huge opportunity to replicate the AirAsia model and give consumers access to exciting, affordable products that marry our interests in F1 and technology and help make their dreams come true.”

Most of Caterham's current output consists of super-light cars intended for use only on the track. The Alpine, like the 1970s model pictured above, was a highly popular, mid-prices sports car suitable for everyday driving but beefy enough to trounce Porsche, Lancia and Ford, taking all three top spots in the 1971 Monte Carlo rally.  

Production of the Alpine ground to a halt in 1996. Renault announced plans to revive it in 2007 but later canceled those plans. 

Before shoppers head out in search of bargains on Black Friday, they have plenty of chances to research advertised deals at their retailer of choice. It seems there are more Black Friday deal sites than in previous years.

One of the latest is the 2012 Black Friday and Cyber Monday Hub from Ben's Bargains. It's been designed to cut through fake “good” deals and help consumers uncover only the best, real online Black Friday and Cyber Monday deals.

For example, consumers often complain that after standing in line waiting for a store to open, they find that the “door-buster” special that drew them to the store has already sold out. Others say that some online and in-store deals come with conditions that make the deal less attractive.

Early start

With more retailers ramping up early this year, the company says its Hub will inclusively showcase the exceptional early bird deals and carefully selected Black Friday specials that are each validated for authenticity and true savings. Each deal, the company says, will be verified by a team of bargain hunters.

“The holiday shopping season is already upon us, and we’ve seen a range of notable to less than impressive holiday deals come to light,” said Phong Vu, Managing Director of Ben’s Bargains. “Because we monitor online deals 24/7, all year long, we have a keen sense for what makes a great deal and what makes a not-so-great deal. This becomes especially important during the holiday season when shoppers are overwhelmed with ‘deals, sales, and specials.’ We’ll help them look past the hype and focus on deals that offer real value.”

Among the deals listed today is a Kenneth Cole Reaction Shawl Men's Cardigan for $22 at Macy's. Or a washable USB computer Keyboard for $20 at Best Buy.

In addition to human-verified deals, the company says the Hub will include consumer buying guides, print ad scans, and retailer schedules for Black Friday and Cyber Monday.  

If you're in the market for a used car you can expect to pay more, especially if you live in the eastern half of the U.S.

The National Automobile Dealers Association (NADA) projects prices of used cars, up to eight years old, will go up between 0.5 and 1.5 percent between now and the end of the year. You can blame Hurricane Sandy.

"The loss of used-vehicle supply and the increase in replacement demand after Hurricane Sandy will have the greatest impact on used-vehicle prices in December," said Jonathan Banks, executive automotive analyst with the NADA Used Car Guide.

Katrina experience

While no two storms are alike, NADA points out that the flood damage caused by Hurricane Katrina, which cut a devastating swath across the Gulf region in late August 2005, offers insight into the impact that Hurricane Sandy could have on used-vehicle prices.

The reduction in the supply of used vehicles and increase in demand resulting from Katrina led to used-vehicle prices increasing by as much as three percent or $309 over the four month period following the storm's landfall.

"Although Sandy's reach encompassed an area with a greater population density than Katrina, the number of vehicles damaged by flooding doesn't appear to be as high as the number lost to Katrina," Banks said.

This is supported by initial damage estimates for Hurricane Sandy, which place insured losses for the storm between $10 and $20 billion, according to EQECAT, Inc., a catastrophe risk analytics company based in Oakland, Calif. The total loss is projected to be between $30 to $50 billion, according to EQECAT.

Lots of vehicles

New York and New Jersey rank in the top 15 U.S. states in terms of overall vehicles in operation and new-vehicle dealerships. In addition, both states have large populations and high population-density ratios. Each state also has a larger population of cars than trucks and import brands comprise a significant share of overall vehicle sales.

"Regionally, the concentrated damage that occurred in New Jersey and New York mean that used-vehicle prices, particularly for import and luxury cars, will most likely increase beyond NADA's national level expectations," Banks said.

Banks added that prices for large pickup trucks should also increase towards the high end of NADA's predicted range as contractors and other service-related professionals will need to replace vehicles required to support their livelihoods and because supply for the segment is already constrained.

Avoiding flooded cars

Because of Hurricane Sandy, consumers shopping for a used car must exercise caution against being sold a flood-damaged vehicle. Unscrupulous sellers often clean up vehicles exposed to flood waters and resell them to unsuspecting buyers.

Exposure to flood water can cause some parts to corrode, leading to expensive repairs later on. Most flood-damaged cars are totaled and destroyed, but a few always end up on the used car market.

Your nose can often tell you if a car has been in a flood. If you smell any trace of mold or mildew in the interior, it's best to keep looking.

Also, look for signs of rust under carpet or around metal fixtures, such as where seatbelts are attached to the floor. Finally, look for water stains on carpet and upholstery.

When you looked at last month's employment report, it didn't show much of a gain in seasonal jobs with major retailers. The job gains in October were just slightly more than October 2011.

Many families count on those part-time holiday jobs to supplement their income during the most expensive time of the year. And even though job creation was modest last month, a report from the outplacement firm Challenger, Gray & Christmas suggests hiring will accelerate this month and next.

“It is likely that a lot more of the holiday hiring plans announced by national retailers, including J.C. Penney, Kohl’s, Best Buy and Macy’s, will show up in the November hiring figures,” said John A. Challenger, chief executive officer of Challenger, Gray & Christmas.

The wild card in all of this, of course, is Hurricane Sandy and how the storm's devastation in the New York metro and elsewhere will impact hiring on the east coast.

“There is a good chance that many people in the region will still be trying to rebuild their lives when the peak holiday shopping season starts in a few weeks,” Challenger said. “Buying Christmas presents could fall pretty low on the list of priorities, which may mean that retailers in this area – many of whom are also facing significant damage – may hold off on planned holiday hiring.”

If you are in search of part-time employment for the holiday season, here is a list of national retailers that have already announced plans to bring on temporary employees and the number of jobs they hope to fill:

• Target; 90,000
• Macy's; 80,000
• Kohl's; 52,700
• Walmart; 50,000
• Amazon; 50,000
• Toys R Us; 45,000
• JC Penney; 40,000
• Party City; 20,000
• FedEx; 20,000
• GameStop; 17,000
• Best Buy; 14,000
• Hickory Farms; 5,225

In addition, neighborhood “mom and pop” retailers may also take on some extra seasonal help and these jobs shouldn't be overlooked. But finding them may require a longer search.

“Even before Hurricane Sandy, there was little evidence to suggest that retailers would return to the pre-recession levels of seasonal hiring, when retail employment gains averaged more than 720,000 extra workers added over the final three months of the year,” Challenger said.

You've been watching the real estate market and interest rates and have decided now may be the right time to buy a home.

Prices are still low but are moving up. Interest rates remain near all-time lows, thanks to the Federal Reserve's latest round of stimulus. If you can get the house you want at the price you want and the interest rate you want, maybe now is the right time to pull the trigger.

But what are the people who are selling their homes thinking? How desperate are they, or are they growing more confident as the market recovers? Knowing the answer to that might help you drive a better bargain.

Inside information

Fortunately for would-be homebuyers, Redfin, a national real estate broker, has released a survey of homeowner sentiment, focusing on homeowners who intend to sell. The data can give buyers some insight into their negotiating partners.

The survey shows 83 percent believe they would get a better price by waiting one to two years, up from 80 percent in the third quarter. That could suggest sellers are less motivated. Unless circumstances require them to sell now, they may be willing to wait.

The percentage of people considering renting their homes instead of selling has also fallen slightly, from 46 to 43 percent. That suggests rising confidence they will be able to get an acceptable price.

Thirty-one percent intend to price their home higher than comps. That's the same percentage as last quarter and again, suggests growing confidence among sellers.

Cash is king

Interestingly, 37 percent would choose an all-cash offer over higher offers with conventional or FHA financing. This shows that cash is still king in real estate and if you can bring cash to the table, your chances of getting a good deal are much better.

Only 40 percent are selling because of economic concerns, down from 49 percent last quarter. That suggests fewer homeowners are feeling the pressure to sell, meaning the buyer loses a little leverage.

Not many people believe it's a good time to sell – 15 percent rather than 13 percent in the last survey. So those who are selling probably have some other reason. Advantage buyer.

Conversely, 58 percent said they believe now is a good time to buy, down from 61 percent in the third quarter. With declining interest rates that can only mean sellers recognize declining inventory and rising prices make it a bit more competitive for buyers. Advantage seller.

Growing confidence

Redfin says the changes in the numbers were small, but consistent with a trend of sellers being more confident about their chances in the market, a little less interested in alternatives to selling, such as renting out the home, and a little less concerned about the economy. If these trends continue over the next few quarters 2013 could possibly result in an easing of the big inventory squeeze that has made headlines throughout 2012.

"At this point in the housing market, the only opinion that matters is that of the would-be sellers trying to decide whether to put their home on the market," said Redfin CEO Glenn Kelman. "Economists agree that the market hit bottom some time earlier this year and low interest rates have brought out more buyers than we've seen in years, but most sellers decided to wait for better prices. These attitudes aren't changing dramatically from one quarter to the next, but the direction has been remarkably consistent among both buyers and sellers: the market is slowly tilting in sellers' favor."

For buyers, that may mean the window of opportunity that has existed the last several months is beginning to close ever so slightly.

Excel Industries of Hesston, KS, is recalling about 18,000 Hustler and BigDog lawn mowers.

The fuel tank vent valve fitting can fail to seal and cause a fuel leak, posing a fire hazard. The firm is aware of 152 incidents of vent valve fittings failing. No injuries or property damage have been reported.

The Hustler and BigDog brand riding or walk-behind lawn mowers were sold in the following colors: Hustler models in yellow; BigDog models in red. They have large mowing decks ranging from 36 to 72 inches. Model name and serial numbers can be found on a tag located on the left side of the frame in the front of the mower's fender.

The following model names, serial numbers and types of lawn mower are included in this recall:

The mowers, manufactured in the U.S., were sold at: Hustler and BigDog dealers nationwide from September 2010 to May 2012 for between $2,900 and $21,000

Consumers should immediately stop using the recalled lawn mowers and contact a Hustler or BigDog dealer to schedule an appointment for a free repair. Excel is contacting its customers directly.

Consumer may contact Excel Industries; (800) 748-8223, 8 a.m. to 5 p.m. CT Monday to Friday.

Home prices went down slightly on a national basis last month, but mainly because more distressed properties were sold. The latest report from CoreLogic shows the average price dipped by 0.3 percent from August.

Still, when you analyze home prices over the last 12 months September's results are up a robust five percent over September 2011, suggesting that the housing market is slowly recovering. The Home Price Index (HPI) analysis from CoreLogic shows that all but seven states are experiencing year-over-year price gains.

Better than expected

“Home price improvement nationally continues to outpace our expectations, growing five percent year-over-year in September -- the best showing since July 2006,” said Mark Fleming, chief economist for CoreLogic. “While prices on a month-over-month basis are declining, as expected in the housing off-season, most states are exhibiting price increases. Gains are particularly large in former housing bubble states and energy-industry concentrated states."

That's another bullish indicator for the housing market, as once devastated metros begin to experience healthy price appreciation. The forecast is also fairly bullish.

The CoreLogic Pending HPI indicates that October 2012 home prices, including distressed sales, are expected to rise by 5.7 percent on a year-over-year basis from October 2011 and fall by 0.5 percent on a month-over-month basis from September 2012 as sales exhibit a seasonal slowdown going into the winter.

Without including distressed sales, CoreLogic predicts October 2012 house prices will rise 6.3 percent year-over-year from October 2011 and by 0.2 percent month-over-month from September 2012.

Better market fundamentals

“Home prices are responding to better market fundamentals, such as reduced inventories and improved buyer demand,” said Anand Nallathambi, president and CEO of CoreLogic. “So far this year, we’re seeing clear signs of stabilization and improvement that show promise for a gradual recovery in the residential housing market.”

What is significant about the housing recovery is its organic nature. Since 2010 there have been no government incentives, such as the first-time buyer's tax credit, to boost sales. Sales and prices have increased largely in spite of much tougher lending standards that have prevented many buyers from qualifying for a mortgage.

In September, the five states with the highest home price appreciation are Arizona, Idaho, Nevada, Hawaii and Utah. Prices are still falling, however, in Rhode Island, Illinois, New Jersey, Alabama and Delaware.

What is it about young adults, their doctors and high blood pressure?

According to findings presented at the American Heart Association's Scientific Sessions 2012 that adults 18-24 years old with high blood pressure were 28 percent less likely to be diagnosed during doctor visits than those 60 and older.

"These young patients come to the clinic and their blood pressure is recorded," said Heather Johnson, M.D., lead researcher of the study. "They have high blood pressure, but there's no documentation of a diagnosis. We wanted to find out why."

Ignoring the obvious?

Researchers examined electronic health records of 13,593 men and women who were at least 18 years old. All had visited their doctor at least twice within the previous three years in an outpatient, non-urgent care setting, and had multiple elevated blood pressures that met guideline criteria for a hypertension diagnosis.

Yet, after four years of visiting their doctors and accounting for other factors:

• 67 percent of 18- to 24-year-olds remained undiagnosed compared with 54 percent of people 60 and older.
• 65 percent of 25- to 31-year-olds were undiagnosed.
• 59 percent of 32- to 39-year-olds were still living with undiagnosed high blood pressure.

Diagnosis disparity

Furthermore, young adults were less likely to be diagnosed if they actively smoked and if they had a mild stage of hypertension, said Johnson, an assistant professor of medicine in the division of cardiology at the University of Wisconsin School of Medicine and Public Health in Madison.

Conversely, a high blood pressure diagnosis was more likely for minorities, young adults with diabetes, severe high blood pressure, and who made more clinic visits to primary care and specialty providers.

Family practice physicians were less likely to diagnose high blood pressure than Internal Medicine physicians; however, female doctors were more likely to diagnose high blood pressure in young adults.

High blood pressure is a major risk factor for heart attack and stroke. While more prevalent in older Americans, about 29 percent of all U.S. adults have hypertension, according to American Heart Association statistics. About 11 percent of men and 7 percent of women 20-34 years old have high blood pressure.

A controllable condition

"We know that once high blood pressure is diagnosed and young adults receive the treatment they need, they can achieve pretty high control rates," Johnson said. Because researchers examined patient records from a large academic group practice in the Midwest, some of the predictors may vary among different healthcare systems and geographic regions, Johnson said.

Nevertheless, multiple factors must change. "Patient factors play a role, provider factors play a role, along with the healthcare system," she said. "You can't blame one component. They all must work together to diagnose and manage high blood pressure in young patients."

Johnson said she hopes the findings will "guide both patient and provider to make elevated blood pressure one of the key things to focus on during the visit."

The Avalon Effect Inc., a Franklin, TN-based company, has run afoul of the U.S. Food and Drug Administration (FDA) for its marketing of a light therapy product that claims to cure or treat symptoms of fungal meningitis, methicillin-resistant Staphylococcus aureus (MRSA), concussions, Lyme disease and other diseases.

An FDA Warning Letter advises company CEO Mike Haarlander that the company’s Quantum Series Personal Wellness Pack is a medical device under the Federal Food, Drug, and Cosmetic Act (Act) because it is intended to prevent, diagnose, treat, or cure a disease, or to affect the body.

Multiple violations alleged

According to the letter, claims on the company’s Website and other linked Websites cause the product to violate the Act because the company does not have an approved application to market the device or an exemption to investigate the device for purposes of safety and effectiveness.

The device also is misbranded because, the FDA maintains, the company did not submit a 510(k) notifying the FDA of its intent to introduce the device into commercial distribution.

“Consumers should be aware that, especially during disease outbreaks or other public health crises, they may see opportunistic advertisements for products touted as cures or treatments,” said Steve Silverman, director of the Office of Compliance at FDA’s Center for Devices and Radiological Health. “Bogus medical claims can actually harm consumers by causing them to delay seeking treatments that have been proven to be safe and effective. Consumers should carefully evaluate and discuss the claims with their health care providers.”

Illegal marketing

The FDA notified the company of possible marketing violations on Aug. 15, 2012. In its Sept. 21, 2012, response, The Avalon Effect said that the company did not intend for any of its products to be used in the treatment, cure, mitigation, prevention or diagnosis of any disease.

But FDA says a review of the company’s Website and directly linked Websites identified specific claims regarding the Quantum Series Personal Wellness Pack causing it to meet the device definition. Because the device is not cleared or approved, the product is being marketed illegally.

The agency says the company needs to take prompt action to correct the violations and warns that failure to do so may result in a regulatory action being taken against it.

LG Sourcing of North Wilkesboro, NC, is calling about 37,000 Master Forge gas grills.

If improperly installed, the hose connecting the gas tank and regulator to the burner control can touch the burner box and cause the hose to melt and rupture when the grill is lit. This poses a fire and burn hazard.

There have been two reports of hoses melting and rupturing, but no reports of injuries.

This recall involves Master Forge four-burner gas grills with a single-door base. "Master Forge" is written on the grill's hood. The model number GD4825 is located on a label inside the door of the grill's base. "Item 94227" is written on the cover of the instruction manual.

The grills, manufactured in China, were sold exclusively at: Lowe's stores nationwide from November 2011 through May 2012 for about $270.

Consumers should immediately stop using the grill and inspect it to make sure that the gas hose runs along the outside of the grill cabinet and passes through the round hole in the side panel. Consumers should contact Guangdong Vanward Electric for revised instructions and a warning label to apply to the grill that shows how to properly install the hose and the regulator.

For additional information, consumers should contact Guangdong Vanward Electric toll-free at (888) 584-3648 between 8 a.m. through 6 p.m. ET Monday through Friday.

Britax is recalling certain 55,455 convertible child restraints:

• Models: Boulevard 70 G3, Advocate 70 G3, and Pavilion 70 G3.
• Model Numbers: E9LJ91A, E9LJ91M, E9LJ91S, E9LJ92E, E9LJ93P, E9LJ93S, E9LK91A, E9LK31A, E9LK31Q, E9LK32D, E9LK32Z, E9LK33Q, E9LL11A, E9LL11Q, E9LL12D, E9LL12Z, E9LG81A, E9LG83N, E9LG83P, E9LG83X, E9LG83Y, E9LL21A, E9LL23P, E9LL23Y.

The seats, manufactured from June 2012 through August 2012, have a softer chest pad material that may be bitten or chewed into pieces by a child using the seat. If the child bites off a piece of the softer pad, it could be a choking hazard, resulting in injury or death.

Britax will provide owners with replacement HUGS pads that are made from a firmer material and instructions on how to replace the pads free of charge. Owners may remove the HUGS pads and continue using the seat until replacement pads are received.

The safety recall is expected to begin shortly.

Owners may contact Britax Customer Service Department at 1-888-427-4829 with questions or to request replacement pads in the event their restraint is not already registered with Britax.