Current Events in February 2013

The incidence of autism has been growing at an alarming rate but the cause of the disorder has been unclear. However, a new study finds that folic acid supplements taken by the mother may provide some protection for the developing fetus.

The study, appearing in the February 13 issue of JAMA, included about  85,000 Norwegian children. It found that maternal use of supplemental folic acid from 4 weeks before to 8 weeks after the start of pregnancy was associated with a lower risk of autistic disorder in children.

The apparent benefit that was found in early pregnancy was not, however, present for folic acid use in mid-pregnancy.

“Our main finding was that maternal use of folic acid supplements around the time of conception was associated with a lower risk of autistic disorder," the researchers said. "This finding does not establish a causal relation between folic acid use and autistic disorder but provides a rationale for replicating the analyses in other study samples and further investigating genetic factors and other biological mechanisms that may explain the inverse association.” 

Folic acid supplementation has long been recommended for use around the time of conception because of evidence that it reduces the risk of neural tube defects in children.

This protective effect has led to mandatory fortification of flour with folic acid in several countries, and it is generally recommended that women planning to become pregnant take a daily supplement of folic acid starting one month before conception.

Study details 

Pal Surén, M.D., M.P.H., of the Norwegian Institute of Public Health, Oslo, and colleagues conducted the stsudy, which used a sample of 85,176 children was derived from the population-based, prospective Norwegian Mother and Child Cohort Study (MoBa).

A total of 270 children (0.32 percent) in the study sample have been diagnosed with autism spectrum disorders (ASDs): 114 (0.13 percent) with autistic disorder, 56 (0.07 percent) with Asperger syndrome, and 100 (0.12 percent) with pervasive developmental disorder-not otherwise specified (PDD-NOS).

The researchers found that there was an inverse association between folic acid use and subsequent risk of autistic disorder. Autistic disorder was present in 0.10 percent (64/61,042) of children whose mothers took folic acid, compared with 0.21 percent (50/24,134) in children whose mothers did not take folic acid, representing a 39 percent lower odds of autistic disorder in children of folic acid users.

Characteristics of women who used folic acid within the exposure interval included being more likely to have college- or university-level education, to have planned the pregnancy, to be nonsmokers, to have a pre-pregnancy body mass index below 25, and to be first-time mothers.

“No association was found with Asperger syndrome or PDD-NOS, but power was limited. Similar analyses for prenatal fish oil supplements showed no such association with autistic disorder, even though fish oil use was associated with the same maternal characteristics as folic acid use,” the authors write.

Just about everyone has by now learned the hard way that photos posted to Facebook and other social sites may never go away. Sure, you may be able to remove them from your timeline but chances are, they're still floating around out there somewhere, just waiting to pop up at the worst possible time. You know the kind of photos we're talking about.

Snapchat is one of a number of new products designed to attack the problem. Basically, the iPhone and Android app puts the time element -- and, of course, the visual element -- back into the chat concept. Snapchat lets you send a photo or brief video to one or more friends. After they look at it for a few seconds, it disappears.

"The allure of fleeting messages reminds us about the beauty of friendship -- we don't need a reason to stay in touch," is how Snapchat explains it. "There is value in the ephemeral. Great conversations are magical. That's because they are shared, enjoyed, but not saved."

“It became clear how awful social media is,” said one of Snapchat’s founders, Evan Spiegel, 22. “There is real value in sharing moments that don’t live forever.”

Of course, nothing is ever quite as simple as we might hope. The fleet-of-finger recipient may be able to grab a screenshot of the image you send. Snapchat says it will warn you if this happens but that's about it, as far as remedies go. 

It's still true, of course, that the safest way to keep potentially embarrassing images private is to keep them to yourself. 

It should also be noted that Snapchat states in its terms of service that it is not intended to be used by children, but doesn't take any steps to verify users' age. Parents still need to monitor their offsprings' online activities.

Other apps

There's actually quite a land rush in the private-app business these days. Several new companies are offering interesting ways to boost online privacy.

Wickr, whose motto is "Leave no trace," is an iPhone app that claims to provide "military-grade encryption of text, picture, audio and video messages" and to let you control who can read your messages and for how long.

Vidburn, which seems determined to communicate only through pictures (sort of like IKEA) promises you can, "Share goofy videos with your friends that self-destruct after being watched."

Poke, an app produced by none other than Facebook, garnered this review in the Apple apps store: "Huge ripoff of snapchat! Good app but why try and copy what already exists? Make something original. I think I'll stick with snapchat at least until this goes big." That pretty well says it.

Pepsi's Mountain Dew has brewed up a new concoction that it hopes will become the morning drink of choice for millennial males. It's called Kickstart and it comes complete with juice flavors, caffeine and a dollop of vitamins B and C.

A massive ad campaign kicks off Feb. 25 and ad industry insiders say it's built around a "Chasing Sunrise" theme. 

"This is an opportunity to drive some loyalty by putting out a comprehensive, differentiated morning solution," said Emily Silver, marketing director at Mountain Dew, as quoted by Advertising Age. And yes, marketing people really do talk like that.

What's she saying, we think, is that Kickstart combines the fruit flavor, vitamins, sugar and caffeine that you would normally get from a small cup of coffee and a glass of juice. That makes it "comprehensive," see?

And then, of course, it's "differentiated" because, well, it's not a cup of coffee or a glass of orange juice. It's something different, if you can consider a can of soda different.  

Not just a dream

According to Ms. Silver, this is not just something the marketing folks dreamed up in a Mad Men-like brainstorming session in some modern-day Don Draper's office. She says the company's research found that quite a few millennials were already blending Mountain Dew with fruit juice for their morning pick-me-up.

The Taco Bell chain was already on the case. It was offering a drink called Mountain Dew A.M., a blend of Mountain Dew and Tropicana orange juice.

The appeal of the mixture, apparently, is that it's relatively light yet flavorful. It's not a huge blast of caffeine like an energy drink and not quite as sugary as a full-strength Mountain Dew.

It's also a guy thing, appealing mostly to millennial males, who range in age from about 15 to 30. They're old enough to need a boost in the morning but not yet so decrepit they feel the need to glug down a venti latte or two.

Although we suspect the food police will not be happy with the idea of guzzling carbonated drinks in the morning, Kickstart packs a fairly light punch, just 80 calories compared to 240 in that venti latte with 2% milk. It will supply about 90 milligrams of caffeine in each 16-ounce can, compared to about 330 in a 16-ounce bucket of coffee.

So, whether this is something younger guys are eager to get their hands on remains to be seen. But it's certainly something Pepsi hopes will take off. It is, after all, an "underdeveloped daypart" as one marketing type put it, meaning that most of us don't now quaff soda in the morning.

Small-business owners were a little more confident about the economy in January -- with the emphasis on “a little.”

The National Federation of Independent Business (NFIB) Small Business Optimism Index rose just 0.9 points last month -- to 88.9, failing to regain the losses caused by the “fiscal cliff” scare.

Expectations for improved business conditions increased by five points, but remain overwhelmingly low -- negative 30 percent -- the fourth lowest reading in survey history. Actual job creation and job creation plans improved nominally, but still not enough to keep up with population growth.

“The Optimism Index barely budged in January,” said NFIB chief economist Bill Dunkelberg. “The only good news is that it ‘budged’ up, not down. If small businesses were publicly traded companies, the stock market would be in shambles. While corporate profits are at record levels as a share of GDP, small businesses are still struggling to turn a profit.”

Dunkelberg says news the economy actually contracted in the fourth quarter of 2012, it's no surprise that more small firms expect their real sales volumes to fall, few have plans to invest in new inventory, and hardly any owners are expanding or hiring. “Owner pessimism is certainly not surprising in light of higher taxes, rising health insurance costs, increasing regulations and just plain uncertainty,” he adds. “The president will address the state of our nation tonight, but he apparently won’t have much that’s positive to relay to our small-business community -- not while the pall of uncertainty over economic policy continues to depress investment spending and growth.”

Optimism Index highlights

• Sales: Sales trends remain overwhelmingly negative for small employers, with still more owners reporting declining sales than experiencing positive sales trends. The net percent of all owners (seasonally adjusted) reporting higher nominal sales over the past three months improved 1 point in January, landing at a negative nine percent.
• Job Creation: Job creation was positive in January, but ever-so-slight. Overall, 11 percent of surveyed owners (unchanged) reported adding over the past few months, and nine percent reduced employment (down 4 points), seasonally adjusted. But the vast majority—the remaining 80 percent of owners—made no net change in employment.
• Inventories: The pace of inventory reduction continued in January, with a net negative seven percent of all owners reporting growth in inventories (seasonally adjusted), 3 points better than December, but still more owners reducing stocks than adding to them.
• Capital Spending: The frequency of reported capital outlays over the past six months rose three points -- to 55 percent. Of those making expenditures, 39 percent of owners reported spending on new equipment (up three points), 21 percent acquired vehicles (up three points), and 12 percent improved or expanded facilities (down one point). Five percent acquired new buildings or land for expansion (down one point) and 11 percent spent money for new fixtures and furniture (unchanged). Overall, there was no sign that capital spending might be returning to levels more consistent with past recovery periods.

So, just how much good do Ritalin and other drugs prescribed to treat attention-deficit hyperactivity disorder (ADHD) actually do? Not much, according to investigators at Johns Hopkins Children's Center.

According to a study published in the Journal of the American Academy of Child & Adolescent Psychiatry, nine out of 10 young children with moderate to severe ADHD continue to experience serious, often severe symptoms and impairment long after their original diagnoses and, in many cases, despite treatment.

The investigators say the study -- the largest long-term analysis to date of preschoolers with ADHD -- sheds much-needed light on the natural course of a condition that is being diagnosed at an increasingly earlier age.

"ADHD is becoming a more common diagnosis in early childhood, so understanding how the disorder progresses in this age group is critical," says lead investigator Mark Riddle, M.D., a pediatric psychiatrist at Johns Hopkins Children's Center. "We found that ADHD in preschoolers is a chronic and rather persistent condition, one that requires better long-term behavioral and pharmacological treatments than we currently have."

Struggle continues

The study shows that nearly 90 percent of the 186 youngsters followed continued to struggle with ADHD symptoms six years after diagnosis. Children taking ADHD medication had just as severe symptoms as those who were medication-free, the study found.

Children with ADHD, ages 3 to 5, were enrolled in the study, treated for several months, after which they were referred to community pediatricians for ongoing care. Over the next six years, the researchers used detailed reports from parents and teachers to track the children's behavior, school performance and the frequency and severity of three of ADHD's hallmark symptoms -- inattention, hyperactivity and impulsivity. The children also had full diagnostic workups by the study's clinicians at the beginning, halfway through and at the end of the research.

Symptom severity scores did not differ significantly between the more than two-thirds of children on medication and those off medication, the study showed. Specifically, 62 percent of children taking anti-ADHD drugs had clinically significant hyperactivity and impulsivity, compared with 58 percent of those not taking medicines. And 65 percent of children on medication had clinically significant inattention, compared with 62 percent of their medication-free counterparts.

Questions remain

The investigators caution that it remains unclear whether the lack of medication effectiveness was due to suboptimal drug choice or dosage, poor adherence, medication ineffectiveness per se or some other reason.

"Our study was not designed to answer these questions, but whatever the reason may be, it is worrisome that children with ADHD, even when treated with medication, continue to experience symptoms, and what we need to find out is why that is and how we can do better," Riddle says.

Children who had oppositional defiant disorder or conduct disorder in addition to ADHD were 30 percent more likely to experience persistent ADHD symptoms six years after diagnosis, compared with children whose sole diagnosis was ADHD.

ADHD is considered a neurobehavioral condition and is marked by inability to concentrate, restlessness, hyperactivity and impulsive behavior. It can have profound and long-lasting effects on a child's intellectual and emotional development, Riddle says. It can impair learning, academic performance, peer and family relationships and even physical safety. Past research has found that children with ADHD are at higher risk for injuries and hospitalizations.

More than seven percent of U.S. children are currently treated for ADHD, the investigators say. The annual economic burden of the condition is estimated to be between $36 billion and $52 billion, according to researchers.

There's little dispute that most of us use too much salt. If you're a doubter, just check the nutrition labels of the foods you eat. Get out your calculator and add up the amount of salt in each product. That that should convince you.

And that doesn't even take into consideration what you pour of of a salt shaker at every meal.

Need a good reason to cut back on sodium? How about your life? New research in the American Heart Association journal Hypertension finds less sodium in the U.S. diet could save 280,000 to 500,000 lives over 10 years.

Using computer simulations and models, researchers projected the effects of small (about five percent of a teaspoon of salt per person per day), steady annual reductions of sodium consumption in the U.S. diet, reducing sodium consumption by 40 percent -- to about 2,200 mg/day over 10 years.

Key findings

Researchers also found:

• A gradual reduction in sodium consumption by 40 percent to about 2,200 mg/day over 10 years is projected to save hundreds of thousands of lives – between 280,000 and 500,000 depending on the modeled assumptions.
• About 60 percent more deaths could be averted over this time period if these same reductions could be achieved more quickly (500,000 to 850,000 lives).

Three-pronged approach

Three research groups contributed to the study, each using a different approach for their simulation.

One approach used observational cardiovascular outcome follow-up data, while the other two based their projections on established evidence that salt reduction lowers blood pressure. These two groups inferred the cardiovascular effects of reducing sodium from data about the relationship of blood pressure to cardiovascular disease.

"The research groups used the same target populations and baseline death rates for each projection, and our study found that the different sources of evidence for the cardiovascular effects of sodium led to similar projected outcomes," said Pamela Coxson, Ph.D., lead author of the study and a mathematics specialist in the department of medicine at the University of California San Francisco (UCSF).

"It is helpful when three research groups use different approaches and come up with similar results," said Kirsten Bibbins-Domingo, Ph.D, M.D., senior author of the study and associate professor of medicine at UCSF and director of the UCSF Center for Vulnerable Populations.

Cutting back

The three approaches included a gradual reduction of sodium by 40 percent, instant reduction of sodium by 40 percent or instant reduction of sodium to no more than 1500 mg/day. According to the researchers, only the first scenario -- gradual population-wide reduction of sodium by 40 percent over ten years -- is a potentially achievable public health goal.

Currently the U.S. food supply makes it difficult for consumers to choose lower sodium foods and achieve recommended daily levels. Americans consume an average 3,600 mg of sodium a day, with about 80 percent coming from commercially prepared and processed foods, according to the researchers.

Excessive sodium intake contributes to high blood pressure, which increases the risk of heart attacks, strokes and other cardiovascular diseases. In the U.S, cardiovascular disease is the leading cause of death, and nearly half of these deaths are related to high blood pressure.

Everybody wins

"These findings strengthen our understanding that sodium reduction is beneficial to people at all ages," Coxson said. "Even small, gradual reductions in sodium intake would result in substantial mortality benefits across the population."

"Such gradual reductions could be achieved through a combination of consumer education and food labeling, but should likely also include regulation to assure that lower sodium options are available for US consumers," said Bibbins-Domingo.

The American Heart Association recommends consuming less than 1,500 mg of sodium daily, and has called on the Food and Drug Administration to lower the daily value for sodium and set limits on the amount of sodium foods can contain.

The association also favors robust sodium standards for foods served in schools and purchased by governments and encourages the food industry to make meaningful efforts at reducing sodium which would provide consumers with greater choice in foods and a healthier overall food environment. There are a number of healthy recipes and tips for helping you reduce salt in your diet.

United Air Lines has been fined $130,000 for violating federal rules last May by not informing passengers on an aircraft delayed at Chicago’s O’Hare International Airport that they had an opportunity to leave the plane as it sat at the gate with the door open.

According to the U.S. Department of Transportation (DOT), United violated a provision of its airline consumer protection rule requiring that if passengers on a delayed flight have the opportunity to leave the aircraft, the carrier must inform them that they can deplane. Announcements that passengers can leave the plane must be made 30 minutes after the scheduled departure time and every 30 minutes afterward.

“It’s very simple -- if a plane is delayed at the gate and it’s possible for passengers to leave, the airline must tell them of their rights,” said U.S. Transportation Secretary Ray LaHood. “We adopted our tarmac delay rules to protect passengers’ rights and will continue to take enforcement action when necessary.”

Failure to notify

United Flight 881 was scheduled to fly from O’Hare to Tokyo’s Narita International Airport on May 7, 2012. The aircraft was pushed back at 12:38 p.m. but returned to a gate at 2:25 for maintenance, at which time the doors were opened. However, United failed to make an announcement notifying passengers of that opportunity to leave the plane as required by DOT’s rules.

The aircraft doors were closed again at 3:10, but because of another mechanical problem the flight was canceled and passengers deplaned at 5:22 p.m. Three passengers on board the flight filed complaints with the Department’s Aviation Consumer Protection Division regarding the delay.   

It seems that after every special occasion holiday, like Valentines or Mother's Day, we hear from irate consumers who ordered flowers through a third-party entity with a website or 1-800 number.

Last May, for example, we heard from a very unhappy Deana, of Manassas, Va., who says she had placed an order through Just Flowers.

"I ordered flowers for my mom for Mother's Day for $65," Deana wrote in a ConsumerAffairs post. "They weren't delivered. Today is Wednesday, May 16. I spent in excess of 90 minutes on the phone with JustFlowers.com, only to be told that the flowers were delivered, that no one was home and they were left on her porch. She was home all day Sunday. She has a locked gate. No one gets to her front porch unless the gate is unlocked and they are allowed entry. So at this point in my day, I've spent 90 minutes trying to get a refund only to be told that they will investigate and determine if I am owed a refund."

Surprise! And not the good kind

Sometimes the flowers arrive and they aren't at all what was expected.

Time and again consumers use Internet-based middlemen to order flowers and end up disappointed. They can avoid the disappointment, in many cases, by simply dealing directly with a local florist, just as the middlemen do. In this day and age, there is no excuse not to.

What consumers don't always realize is that online florists have no flowers of their own. When they get an order for a floral arrangement in a particular city, they contact a local florist and make arrangements for the delivery. In many cases they work out a discount with the local florist, or mark up their price significantly.

Because the middleman is just another layer in the transaction, it increases the chances of something falling through the cracks. In some cases either the wrong thing gets delivered or nothing gets delivered at all.

Early days of the web

These florist middlemen mostly date back to the early days of the Internet. Then, not that many local businesses like florists had websites. Now, most do, making it easy to deal with them directly.

Visit the florists' web sites so you can see photographs of their products and perhaps even see a price list. While some sites may provide a way to order online, you might consider calling the florist and speaking with someone about what you are looking for. If the conversation doesn't give you a level of comfort with that particular florist, call another, until you are satisfied.

It also stands to reason that a local florist will be more diligent in fulfilling the order of one of its own customers rather that one they received from a middleman. Just a little more effort on your part will avoid embarrassment on a special day and probably make you a hero.

A report by the Conference Board has gotten a lot of attention as it suggests an increasing number of Americans are putting off retirement. The report focuses mainly on economic reasons.

The business group noted a huge spike in the number of 45 to 60 year-olds saying they planned to delay retirement -- from 42 percent in 2010 to 62 percent in 2012.

"It's disconcerting that the two years in which the U.S. economy seemed to finally, if fitfully, turn the corner also left so many more workers compelled to change their retirement plans late in their careers," said Gad Levanon, Director of Macroeconomic Research at The Conference Board and a co-author of the report.

Putting off retirement

Those who've experienced a job loss, salary cut, or significant decline in home price are much more likely to have plans for delaying retirement. Overall, the report sees this as a negative development for those involved.

Just the title of the report, "Trapped on the Worker Treadmill," is dark and gloomy. It makes the assumption that most employees hate their jobs and find getting up every day and going to work to be a "daily grind."

For companies, it can be a mixed blessing. It can keep an experienced work force in place a while longer but also hamper efforts to cut costs. Staff reductions normally carried out through attrition will now require more buyouts. It can also be an obstacle to younger employees just entering the work force.

Good reasons to keep working

While the report focuses on the negative aspects of delayed retirement, there are also some pretty good reasons to stay on the job, assuming you don't hate it.

For one thing it gives you more time to build your nest egg. Assuming the children are independent and your mortgage payment is low, along with the rest of your expenses, your 60s are an opportune time to sock money away.

The longer you work, the fewer years you will be dependent on your retirement savings. By law you are not required to being withdrawing retirement funds until age 70 and a half. However, just because you are withdrawing the money from the tax deferred account, it doesn't mean you are required to spend it -- you just have to pay taxes on it.

Reduced benefits

The longer you can put off drawing Social Security, the larger your monthly payments will be. If you start your Social Security benefits at age 62, you will permanently reduce the amount of money you will receive by as much as 30% than if you had waited just four more years till the normal or full retirement age for most baby boomers.

If you don't think you can put it off to age 66, there is still an advantage to postponing it as long as possible. With each year between 62 and your full retirement age of 66 or 67, the reduction in your benefits is not as great.

If you are married and you expect your benefit to be higher than your spouse's, you should probably consider waiting. If you die first, you spouse has the option to receive your monthly amount if it's higher than his or her own. The benefit payments, however, will be less than they could have been for the rest of our spouse's life as a result of you opting to take early benefits.

Tax implications

Receiving early benefits also has important tax ramifications. If you plan to work in retirement and have a good income, there's a tax penalty on Social Security benefits between age 62 and 66. After age 66, you can earn as much as you want without affecting your benefits.

If you have group health coverage provided by an employer, you might think twice before giving that up. At age 65 you can begin Medicare coverage, but until then, you'll probably need some kind of coverage. Getting individual coverage is very expensive.

Another thing to consider is your social life. Many people don't realize it but work is a huge part of their life, especially if they have been with one employer for a long time. You may get tired of your co-workers from time to time, but decide if you are ready to end those daily relationships and how you will replace them.

Finally, think about what you expect from retirement. What, exactly, are you going to do with your time? A 2001 survey by SunAmerica found a majority of respondents said they planned to work in some capacity in retirement. For many, working at a job you enjoy isn't really work.

The Center for Science in the Public Interest (CSPI), also known as the food cops, is taking on the Girl Scouts.

According to the group, “it's bad enough that the Girl Scouts of the USA sells cookies to raise money, but it shouldn't pretend that its new 'Mango Crèmes with NutriFusion' are nutritionally equivalent to fruit.

CSPI says the cookies at issue are 98 percent white flour, sugar, palm oil and dextrose (sugar made from corn). Yet marketing copy on the manufacturer's Website claims that its filling has "all the nutrient benefits of eating cranberries, pomegranates, oranges, grapes, and strawberries!"

Misleading marketing

In a letter to Girl Scouts of America CEO Anna Maria Chávez, CSPI says that by marketing these new cookies as a "delicious new way to get your vitamins," the Girl Scouts is misleading its young members and undermining their health.

Besides flour, sugar, palm oil, and dextrose, the remaining 2 percent of Mango Crèmes with NutriFusion includes corn syrup, leavening, natural and artificial flavor, corn starch, salt, and coconut, followed by "nutrients from natural whole food concentrate (cranberry, pomegranate, orange, grape, strawberry, shitake mushrooms)." Soy lecithin, citric acid, malic acid, and annatto color round out the list of ingredients.

A serving of three cookies has 180 calories, 4 grams of saturated fat, and less than a gram of fiber. CSPI says the tiny amounts of nutrients from fruit concentrate don't make the cookies remotely equivalent to fruit of any kind.

"The Girl Scouts should promote healthy eating through all of its educational activities, including fundraising," wrote CSPI's executive director Michael F. Jacobson and nutrition policy director Margo G. Wootan. "Sweet baked goods, including cookies, are a leading source of calories, sugars, and fats in Americans' diets."

"If there were a badge for misleading marketing I'm afraid the Girl Scouts of the USA just earned it," Wootan concluded.

Girl Scouts respond

According to a spokeswoman for the Girl Scouts, the organization and its licensed bakers are “very careful to ensure the accuracy and truthfulness of all statements made regarding all Girl Scout Cookie varieties.”

Michelle Tompkins points out that Mango Crèmes with Nutrifusion includes fruit derived nutrient benefits. “The Mango Crème,” she notes, “is not the first Girl Scout Cookie produced that includes a benefit associated with an added ingredient, or a benefit associated with a reduced or removed ingredient.”

Tompkins concludes, “all Girl Scout cookies should be considered an occasional treat and eaten in moderation.”

If you think just keeping a good credit record is enough to get you favorable terms for a loan -- think again.

A study of the U.S. credit reporting industry by the Federal Trade Commission (FTC) found that five percent of consumers had errors on one of their three major credit reports that could lead to them paying more for such things as auto loans and insurance.

Overall, the study on credit report accuracy found that one in five consumers had an error on at least one of their three credit reports.

“These are eye-opening numbers for American consumers,” said Howard Shelanski, Director of the FTC’s Bureau of Economics. “The results of this first-of-its-kind study make it clear that consumers should check their credit reports regularly. If they don’t, they are potentially putting their pocketbooks at risk.”

Errors abound

The study, in which participants were encouraged to use the Fair Credit Reporting Act (FCRA) process to resolve any potential credit report errors, also found that:

• One in four consumers identified errors on their credit reports that might affect their credit scores;
• One in five consumers had an error that was corrected by a credit reporting agency (CRA) after it was disputed, on at least one of their three credit reports;
• Four out of five consumers who filed disputes experienced some modification to their credit report;
• Slightly more than one in 10 consumers saw a change in their credit score after the CRAs modified errors on their credit report; and
• Approximately one in 20 consumers had a maximum score change of more than 25 points and only one in 250 consumers had a maximum score change of more than 100 points.

Karla of Louisville, KY, knows what it's like to deal with erroneous credit reporting. "I have been fighting for nearly a year to get Equifax to correct mine and my husband's credit reports," she writes in a ConsumerAffairs post. "They are reporting a mortgage delinquency on both our reports for May 2008 and on my husband's report, only for October 2009. This is a joint account; shouldn't reported info be the same on both reports? Neither delinquency ever existed!"

Jacob of Alexandria, VA, wants his life back -- literally. "I recently applied for a credit card with Capitol One and I received the following response from them on 1/26/2013: 'Based on the credit report from TransUnion for Jacob **, applicant is reported as deceased,'" he says in a post on ConsumerAffairs. Jacob wants to know how this is going to be corrected.

“Your credit report has information about your finances and your bill-paying history, so it’s important to make sure it’s accurate,” said Charles Harwood, Acting Director of the FTC’s Bureau of Consumer Protection. “The good news for consumers is that credit reports are free through annualcreditreport.com, and if you find an error, you can work with the credit reporting company to fix it.”

First-of-its kind study

The FTC report is the first major study that looks at all the primary groups that participate in the credit reporting and scoring process: consumers; lenders/data furnishers (which include creditors, lenders, debt collection agencies, and the court system); the Fair Isaac Corporation, which develops FICO credit scores; and the national credit reporting agencies (CRAs).

It is based on work with 1,001 participants who reviewed 2,968 credit reports with a study associate who helped them identify and correct possible errors on their credit reports.

Consumers in the study were selected to match the demographic and credit score information of the general public, and participants were encouraged to dispute errors that could affect their credit standing. Credit reports with potential errors identified by study participants were sent to Fair Isaac (FICO) for rescoring.

After completing the FCRA dispute process, study participants were provided with new credit reports and credit scores. The original reports were then compared with the new reports. If any modifications were made as a result of the disputes, the impact of errors on the consumer’s credit score was determined.

Consumer resources

The FTC has a wide range of general information for consumers on credit reporting issues, including Free Credit Reports, Disputing Errors on Credit Reports and Your Source for a Truly Free Credit Report? AnnualCreditReport.com, as well as a new consumer blog posted titled It Pays to Check Your Credit Report.

It also has information available on how credit scores affect the price of credit and insurance and what consumers need to know about their credit reports when looking for a job. Finally, the FTC has a video for consumers on how to get a free credit report.

Fire struck the Carnival cruise ship Triumph off the coast of Mexico's Yucatan Peninsula Sunday morning, leaving it dead in the water as U.S. Coast Guard ships rushed to its rescue.

The fire was quickly contained by the ship's automatic extinguishers and no injuries were reported among the 3,143 passengers and 1,086 crew members, the cruise line said.

Reports said electricity, water and sewage systems were working on at least half the ship and there was adequate food and water.

The ship was heading back to Galveston, Texas, when the fire broke out. Now, tugs are towing the vessel to Progreso, Mexico, the closest port. It's expected to arrive there Wednesday. Passengers will be flown back to the United States.

Carnival said passengers will get a full refund, credit that can be used toward a future trip and reimbursement for all expenses, except casino and gift shop purchases, for their current trip.

The vessel's next two departures, scheduled for Monday and Saturday, have been canceled. Those slated to be on those trips will get full refunds and discounts toward future cruises, the cruise line said.

Smaller disasters

It's the latest large-scale mishap to afflict Carnival after the Costa Concordia disaster off the coast of Italy just over a year ago. But while major accidents are relatively rare, consumers tell of endless smaller difficulties and disasters aboard Carnival ships.

"I thought Carnival had reached the maximum level of incompetence and indifference with the Costa Concordia. They outdid themselves on the Magic cruise out of Galveston 20-27 January," John of Houston said in a ConsumerAffairs posting. "Debarkation was a nightmare. After leaving our room at 7:00 AM, our group of 35 did not get out of the terminal until after 1:00 PM. We were treated like cattle. People were driven up and down the huge terminal like animals.

"One elderly gentleman fell down in front of me. The only thing that saved him was he fell on top of his luggage. I watched him struggle for several minutes until he could stand again. No one could help him. I couldn't because  we were blocked in the line by chains. We stood in line for over three hours with no water and no trips to the restroom."

Mark of Dallas was also miffed about his experience.

"My friends, partner and I were on the Carnival Glory cruise ship which, before even embarking, was marred by miscommunication, disorganization and mechanical failures that delayed our departure and caused us to miss or be late to ports-of-call and pre-booked excursions to be cancelled without warning. My phone then was stolen, guest services was a joke, and the experience left much to be desired overall," he said.

Patrick of Albuquerque also found the Glory less than glorious.

URGENT NOTICE. That was the heading of an email my wife and I received five days before our cruise on Carnival Glory, which we had planned eight months in advance. At the last minute Carnival told all the passengers that ALandChuck.travel, the biggest GLBT travel agency in the US, was hosting "Drag Stars at Sea" on our sailing and had booked a large group. The email cautioned that those wishing to dress in drag would do so. ... I'm sure that Carnival had been working with this travel agency for months. Carnival should have notified all passengers as soon as they started working with this travel agency in case customers wished to cancel or change their sailing.

The URGENT NOTICE from Carnival offered to give a full refund of their cruise fare, as well as reimbursement for any non-refundable travel related expenses, but this was a cruise we had planned for eight months. I worked frantically with my travel agency to rebook on another ship. But apparently, many others booked on the Carnival Glory were trying to do the same thing and it was very difficult. 

Mini Coopers used to be novelties. Mini drivers waved at each other and often fielded questions from the curious at service stations and other public venues.

But now the little Minis are everywhere and are getting to be a pretty mighty force in the U.S. car business, selling a record 66,1223 vehicles last year, 15 percent more than the previous year. It's also more cars than veteran brands like Jaguar, Land Rover and Porsche sold.

Mini's growth over the last 11 years is evident at the National Automobile Dealers Association convention in Orlando, where the brand had its own dealer get-together this year for the first time ever, according to Automotive News reporter Diana T. Kurylko.

Mini has come of age and it’s now a mature brand, said Jim McDowell, who heads Mini USA, Kurylko reported.

Mini has 115 dealers in the United States, and with the addition of the Paceman coupe in March, will have seven vehicles -- more than the other marques mentioned above.

Cute but not always cuddly

The little cars are not without their issues, of course, and have their share of major problems, including engine and transmission failures, readers tell us.

"I almost feel as though I should apologize to all of you. I bought my 2003 Mini in December 2002 and feel now that I should have warned you all away," said Linda of Memphis in a ConsumerAffairs posting. "It is an adorable car and fun to drive, but I've had more problems with it than with all of the other vehicles I've ever owned combined."

Linda said she's replaced the power steering motor three times but, even worse, suffered a transmission failure at 45,000 miles. Fortunately, the dealer replaced it at no charge even though the car was out of warranty at that point.

"J" of Redlands, Calif., complained of thermostat problems, electrical issues and expensive tune-ups and oil changes.

"I have had more problems with this Mini Cooper than I have had for any other car in my life. I'm beginning to believe this product is a lemon, a true sour lemon. After it is fixed, I am trading the damn car in," he said.

On the other hand, some Mini Cooper owners just keep buying the things. A colleague here at ConsumerAffairs has had four Minis, including the very clean "S" convertible pictured above. One suffered an engine failure at 40,000 miles but the dealer, Mini of Sterling, Va., repaired it free of charge even though it was not under warranty. The others have led uneventful lives, except for the one that washed away in Hurricane Sandy.

"Hang around Mini Cooper enthusiasts and they'll tell you to buy 'em new, run 'em hard and get rid of them at the three-year mark," the proprietor of  an independent service center in Los Angeles told us.  Also, use synthetic oil and change it every 3,000 miles, regardless of what the manual says.

New generation

At the Orlando meeting, dealers learned of plans for Mini's second generation, coming next year. Not much has leaked out but the company's goal is obviously to try to hang onto its loyalists even as they outgrow the smaller Mini models.

Over the last few years, the company has turned out a crossover, the Countryman, and a small station wagon, the Clubman, and has added a two-seater Coupe.

Its newest model, the Paceman, perhaps offers a look at where Mini is headed. It's a little bigger and a lot more rakish than the original Cooper and is the first Mini sedan to offer all-wheel drive -- an attempt to appeal to driving enthusiasts who disdain the front-wheel drive offered in most Mini Coopers.

Mini is, of course, a BMW company and is an important element in BMW's growth plans. It's a way for BMW to sell to consumers who aren't quite ready to spend the kind of money a BMW demands but don't want to settle for a dull econocar. 

The Macmillan publishing house has agreed to pay about $20 million to settle ebook price-fixing charges. It's the last of five publishers to settle the charges. 

Under the terms of the proposed settlement, Macmillan would create a settlement fund totaling $20 million from which claims to consumers who purchased e-books would be paid. In addition, the publisher has agreed to lift restrictions on discounting for e-books and will not be allowed to enter into new agreements restricting prices until December 2014.

Hagens Berman Sobol Shapiro, a Seattle consumer-rights law firm, 33 state Attorneys General and the U.S. Department of Justice (DOJ) reached the settlement Friday.

The settlement resolves claims filed by the DOJ, numerous state governments, and a class-action suit brought by Hagens Berman on behalf of a nationwide class of consumers.

Earlier, Hachette Book Group Inc., HarperCollins Publishers L.L.C. and Simon & Schuster Inc. agreed to pay a total of more than $69 million to consumers to resolve the claims. Hagens Berman’s complaint estimated that the scheme may have increased the prices of many e-books by as much as 50 percent by eliminating the ability of retailers to offer discounts.

Macmillan was the last of five defendant publishers to settle claims brought by the DOJ. In that case, Apple is the only remaining defendant, with a trial scheduled for June, 2013. In the consumer class-action case, Penguin and Apple have not agreed to a settlement.

The settlement must be approved by the court before funds can be distributed.

Last weekend, the Northeast received huge amounts of snow, up to 35 inches in some parts, and just to get an idea of how much impact that amount of snow has, here are some numbers: 

Over 5,000 flights were cancelled over the weekend, 635,000 people lost their power and at least 11 people died in the storm.

But thankfully, the storm has passed and now it’s just about power being restored and life returning to a semblance of normalcy, but even before that happens, many people have been taking out their shovels to dig their way out. 

But in doing so, it’s important to shovel safely. Lots of people have passed away  while shoveling, which proves there’s a right and wrong way to go about removing  snow from your staircase, driveway or porch.

Experts say people should avoid shoveling heavy and wet snow, because the combination of the cold weather and the physical strain from lifting that snow could cause a heart attack.

Who shouldn't shovel

Experts from the Bluhm Cardiovascular Institute in Chicago say heavy smokers, those who are considered obese, people who don’t get a lot of exercise, people over 50 years of age and those who have a history of cardiovascular disease, should speak to their doctors before taking on a shoveling project.

And although shoveling can quickly cause a person to sweat and become overheated, experts say you should still dress in layers and don’t take off your jacket. And if you find yourself a little hot and uncomfortable while shoveling, it’s best to take a small break and cool down, instead of taking off any clothing.

Experts also say to start slowly and pace yourself, as jumping right into shoveling a big amount of snow and trying to do it quickly can increase the chances of  overexertion. In fact, the Bluhm Institute says you should approach shoveling as you would any other physical activity, by stretching first and gradually beginning the activity instead of starting off at full speed.

People also shouldn’t shovel on an empty stomach, experts say. They should eat small meals to maintain their energy.

But you should avoid eating heavy meals before shoveling, because digestion puts added strain on the heart. You should also avoid drinking caffeinated beverages for the very same reason.

Additionally, if a snowstorm produces heavy snow, its best to push it rather than lift it, so using a push broom or simply pushing the snow with the edge of your shovel is better for your heart and will lower the chances of you becoming overexerted, doctors say.

And although you may not associate drinking a lot of fluids with cold weather, it’s important to do so when shoveling, since many people have suffered from dehydration.

Back injuries

A lot of folks have also suffered from back injuries while shoveling, which can easily be prevented if you follow a few easy steps.

David Kingwater, a chiropractor in Whitesboro, NY., says lowering your chances of injury during shoveling can be as simple as just choosing the right shovel.

“The ergonomic shovels if people have seen them, those are the shovels that have the bent handles,” he told a local news outlet. “They are bent so you can shovel while standing upright you don’t have to bend over as far, again placing excess stress on your lumbar spine.”

And many people opt for snow blowers since they obviously remove snow faster and much easier, but there are still some very important safety tips to remember when using them, experts say.

According to the Michigan Institute for Public Safety Education, it’s important that you remove any debris before taking on the snow, since the potential of blowing an object that’s either sharp or hard and striking someone is very high.

Also, you should never blow the snow towards your vehicle or towards a person, say experts, and be sure to never leave the snow blower running if you have to step away for a few seconds.

Safety experts also say to remove the spark plug wire before doing any repairs on your snow blower or if you have to make any modifications to the equipment.

And when shoveling, the Institute says to stretch for a few minutes so you can properly loosen up your arms, back, shoulder, neck and leg muscles, and you should also breathe in while lifting the snow and breathe out while tossing it.

But if you do lift the snow, you should bend your knees and straighten your back while doing it, and be sure not to twist your body, as this too can cause muscle injuries, experts say.

So although most have survived the Northeast blizzard, it’s pretty safe to assume that we haven’t experienced our last snowstorm this winter,which means you should remember these small saftey tips the next time you're shoveling, because clearing your property so people can walk safely shouldn’t mean putting yourself at risk while doing it.

Digging out of three feet of snow is just part of the problem for residents of the Northeast who got pounded by a blizzard over the weekend. If the power is out, you have the additional concern about keeping your refrigerated food safe.

"Major winter storms that bring heavy snow, ice and strong winds can impact food safety," said Food Safety and Inspection Service Administrator Al Almanza.

FSIS offers these steps to follow after a weather emergency:

• Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature.
• The refrigerator will keep food safely cold for about four hours if it is unopened. A full freezer will hold the temperature for approximately 48 hours (24 hours if it is half full) and the door remains closed.
• Discard refrigerated perishable food such as meat, poultry, fish, soft cheeses, milk, eggs, leftovers and deli items after 4 hours without power.
• Food may be safely refrozen if it still contains ice crystals or is at 40° F or below when checked with a food thermometer.
• Never taste a food to determine its safety.
• Obtain dry or block ice to keep your refrigerator and freezer as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18-cubic-foot full freezer for 2 days.
• If the power has been out for several days, check the temperature of the freezer with an appliance thermometer. If the appliance thermometer reads 40° F or below, the food is safe to refreeze.
• If a thermometer has not been kept in the freezer, check each package of food to determine its safety. If the food still contains ice crystals, the food is safe.
• When in Doubt, throw it Out!

The world is a pretty treacherous place, even the world that's bounded by the four walls of your home. Most accidents happen in the home, after all, with the bathroom and the kitchen topping the list of hazardous locales.

Seniors are especially vulnerable to injuries, especially falls -- the leading cause of fatal injuries for Americans 65 and older.  In fact, more than 18,000 older Americans die every year because of a fall, and the rate has risen dramatically over the last 10 years.

Pretty serious, no? Unfortunately, it's not all that easy to find reliable information on preventing falls, although it's plenty easy to find page after page of ads and product listings, many of dubious value.

Common sense

Take grab bars, for example. These are the simplest and most straightforward way to make bathrooms and other treacherous locations a bit safer for those whose balance isn't what it used to be.

Installation is pretty straightforward, requiring little more than a drill and some common sense. But like many safety devices, grab bars can be dangerous if installed improperly -- or, worse yet, not installed at all.

The latest trend in grab bars seems to be suction cup models that are ballyhooed on Amazon and just about everywhere else. All you have to do, we're told, is slap them up on the wall and forget about them.

There is, of course, the little matter of whether the things will actually remain attached to the wall if a consumer grabs one to break a fall.

Since safety is the primary goal and since there are numerous local and federal regulations and standards governing grab bars, we turned to Google to see what we could learn, with somewhat frustrating results.

Not long ago, Google was still a search engine that would return all kinds of information on a topic. Now it's a shopping service and not a very good one for a consumer trying to find unbiased, reliable information. Hoping things would be different this time, we typed "grab bar safety" in Big G's search box.

The results were, as expected, page upon page of ads and product listings  helpfully organized under the heading "Shop for grab bar safety on Google." The most notable ad was moronically headed "ADA Approved Grab Bars."

This, persumably, refers to the Americans With Disabilities Act (ADA), a body of law that protects the rights of disabled Americans. The ADA is not an agency and thus not in the business of approving or disapproving commercial products, but deception and sugar-coating is all too common in advertising aimed at seniors, so perhaps we shouldn't be surprised. 

Super Grip

At the top of the "organic" -- meaning unpaid -- Google listings was Amazon, which informs us it has 3,771 listings for grab bars.

We took a look at the first one -- the "Ideaworks Super Grip Bath Handle w/ Color Change Safety Indicator," a little number that goes for $9.04 and even includes an indicator that supposedly changes color to assure us that the handle is firmly gob-smacked onto the wall.

"This safety handle will assist you to get in and out of a slippery bathtub. Two suction cups will secure this handle on the side of your bathtub or shower wall and allow you to get a good grip. ...  It instantly installs using suction, without requiring holes, tools, screws or permanent installation."

Sounds too good to be true? Yes, well, read on a bit and buried in the gee-whiz sales copy, you'll find this: "Use for stability only. Not intended to support full body weight."

Hmmm ... so in other words, it's fine as long as you don't trip and fall. 

Attractive nuisance

Stick-on contraptions like this could be said to fall under the "attractive nuisance" category -- a somewhat obscure term that refers to things that entice us into dangerous activity. The usual examples include unfenced swimming pools, playgrounds on a busy street and handrails that collapse when you lean on them.

While you may not be able to put up a truly safe grab bar for $9.04, you can find perfectly suitable ones for just a few dollars more -- the Medline 12-inch grab bar is only $13.47 on Amazon. Installed properly, this bar will actually do what you want it to -- support your weight if you trip or lose your balance.

The devil, as always, is in the details. The bar needs to be mounted properly -- and that means attaching it to the studs behind the wall. Thanks to DuckDuckGo, a search engine that is not just shopping effluvia, we found an excellent set of step-by-step instructions on the Natural Handyman site. 

The site doesn't sugar-coat the situation and notes that the proper mounting method depends on the anticipated use. If a very heavy person is going to be putting his or her full weight on the bar routinely, simply screwing the bar to the wall studs may not be adequate and some reinforcement may be needed, the site cautions.

Anyone who has seen a grab bar pulled out of a wall will appreciate this caution.

It should also be noted that there may be local building code regulations in your area covering grab bars. It's important to comply with these regulations, for insurance reasons if nothing else.

Keeping seniors safe

Grab bars aren't the only safety measures suitable for seniors, of course. There is still plenty of solid information on the Web, though too much of it is now buried under the onslaught of advertising and search-engine-optimization wizardry that has turned Google into a treacherous swamp of hucksterism. 

One excellent source of information is the National Council on Aging, which, among other things, outlines six steps you can take to make the home front safer for seniors.  AARP also has a lot of good information on preventing falls.

Whatever you decide to do or not do, it's worth remembering there are no shortcuts to safety. On the other hand, there are tremendous benefits to doing the job right.

When it comes to describing our parents or the people that took care of us, it’s often futile to try and come up with the proper words that explain what they’ve done for us and in many cases what they continue to do.

And one thing that a lot of parents have taught many of us is how to be independent and how to do things on our own.

In many cases Mom and Dad gave us that ever-so-needed nudge that finally got us out of the nest and off the cliff, so we could test our own flying capabilities and see just how far we could go.

But fast forward to the present, when you’ve tested those wings over and over and found out they’re pretty darn good thanks to your parents, and now that same independence they taught you growing up is harder for them to maintain for themselves, especially since they’ve gotten much older and find it harder to do some of the things they used to.

Of course, in some cases a senior person living alone just isn’t the right course of action, and in other instances it’s completely safe, especially with the help of certain gadgets.

Fortunately, there's a countless amount of those gadgets out there, both electronic and non-electronic, that can make it easier for older adults to do those everyday things they more than likely want to keep doing without any help.

Med Reminder

One product to help seniors keep living independently comes in the way of a digital watch.

The Med Reminder Watch, priced at $79.95 on the retail site First Street, has up to eight alarms that ring each time a prescription is supposed to be taken. In addition to the alarms, the face of the watch will show a message that the user can customize.

These days, there are a lot of electronic pill cases on the market, but the good thing about using a watch as a reminder is that it stays with you wherever you go, so you can be alerted no matter what time of day it is. 

Also, using a watch is oftentimes less expensive than getting an electronic pill case.

The makers of the watch say it's easy to program and doesn’t require a lot of technical know-how and also comes with vibrating alarms for those who may have hearing problems.

Exercise peddler

Then there’s the Medical Deluxe Folding Exercise Peddler, which is useful for seniors looking to stay in shape and keep active, since it’s designed to be low-impact and safe on one’s knees and joints.

The bottom of the peddler is made of a special rubber material that the company says is anti-slip to prevent the machine from sliding and the user being injured. There’s no assembly required, so it pretty much just has to be unpacked, unfolded and then you’re ready to go.

The amount of resistance on the device can be adjusted like traditional exercise bikes, but what’s different with this peddler and others like it, is its light weight since it’s only a frame and not a full bicycle with handlebars or wheels.

The exercise machine can be purchased at several popular retail outlets like Target and Walmart for under $30, which is a pretty good buy considering the peddler serves almost the same purpose as the more expensive exercise bikes.

Dignity mug

And the least expensive among these products, but still very useful is the Granny Jo Dignity Mug, that sells for about $7 on Amazon.

What I love about this mug is its two handles on either side, which makes picking up a heavy and hot cup of coffee or tea much easier, especially for those seniors who may not be strong enough or have a powerful enough grip to hold it. The Granny Jo is also great for people who suffer from constant tremors.   

In addition, the mug allows those who merely want a nice hot drink, but can’t do so, a chance to have more control of the mug overall and prevent dangerous spills that can cause bad burns.

So all and all, there are a lot of nifty tools on the market to help seniors remain independent, and the items mentioned here are just scratching the tip of the retail iceberg.

But yet and still, it’s nice to know that many companies continue to be innovative when it comes to designing products that assist our beloved parents, because we want them to enjoy their lives as much as possible.

Credit counseling agencies have always had a fairly good reputation. If you find yourself loaded with debt, these non-profit agencies can often help you develop a plan so you can pay off your debt.

That's different from a debt settlement or debt resolution company. These for-profit entities negotiate directly with creditors in an attempt to reduce a consumer's indebtedness.

They take a completely different approach than a credit counselor. In fact, one debt settlement company airs a commercial urging consumers to avoid credit counselors because "they work for the credit card companies."

While consumers should exercise extreme caution when considering any debt settlement company, the commercial has a point, according to CreditCards.com, which has just produced an exhaustive analysis of credit counselors.

Conflict of interest

"Credit counselors can have a built-in conflict of interest," said Fred Williams, senior reporter at CreditCards.com.

That's because a credit counselor's objective is to develop a plan for the consumer to repay their debt, in full, to the credit card company. In addition to receiving a small fee from the consumer, the agency also receives a small portion of the consumer's monthly payment to the credit card company.

"These agencies wear their nonprofit status like a halo, but the reality is that they are taking in large sums of money from people who are struggling financially," CreditCards.com Editor in Chief Daniel P. Ray said. "We think it is important to look at their performance and ask why fundamental information about them is kept under wraps."

Marginally effective

Ray says credit counseling is a marginally effective life preserver, failing more than half the time. Almost no counseling agencies publish information about their failure rates. Ray says that makes it difficult for clients to improve their chances of success.

While credit counseling associations are supposed to set standards in the industry and make sure that members are non-profit, Williams found that's not always the case.

"We found a case where the IRS had revoked an agency's non-profit status but the agency was still a member of an association whose members were only supposed to be non-profit," he said.

CreditCards.com found agencies no longer qualifying as nonprofits may still keep the designation for years during lengthy, secret appeals to the IRS. It says two of the ten largest agencies fought revocation of their status for more than five years, behind a shield of IRS privacy rules.

Industry consolidation

Face-to-face counseling is being replaced by phone and Internet service as consolidation has become a trend. Hundreds of small counseling agencies have been absorbed in recent years, while the 10 largest agencies have grown to a combined $400 million in annual revenue.

As credit counseling has become a bigger enterprise, the people who work for the agencies can do quite well. Median pay for top executives at the 10 largest agencies is about $353,000, according to CreditCards.com, putting several CEOs among the top one percent of U.S. incomes.

However, this is not to say consumers shouldn't consider credit counseling.

"Some agencies do a lot of good work, but you can't go into a relationship blindly, Williams said.

How to choose

But how is a consumer supposed to know whether one credit counseling agency is going to be helpful and another isn't? In many ways, it's like any other consumer decision. You have to do research and, in many cases, go with your instinct.

"If it looks like working with a credit counselor is the way to go, the best advice I could give is to talk to the individual at the agency you would be working with. If they genuinely seem interested in doing what's best for you, that's a good sign. If they simply want to sign you up for a plan, that's a red flag."

The two main alternatives to credit counseling are debt settlement and bankruptcy, both of which have plenty of downside as well. Unfortunately, there are no easy answers to dealing with unmanageable debt.

Contrary to what financial industry lobbyists would have us believe, however, many consumers who should file for bankruptcy protection don't do so. If you have suffered irreparable financial harm because of job loss, serious illness or caregiving responsibilities, bankruptcy may be the best option. Talk to an attorney to learn more.