Current Events in January 2015

A hysterectomy is a surgical operation to remove a woman's uterus. It's fairly common, with more than 600,000 of the operations completed in 2003, though the number has declined sharply since then.

But even with the decline, a new study suggests women getting a hysterectomy don't really need it. Researchers at the University of Michigan say about 20% of these operations are not medically necessary.

The study in the American Journal of Obstetrics and Gynecology makes the case for seeking alternatives to the surgery that leaves women unable to bear children. The authors say there are plenty of good alternatives that are underused.

In fact, those alternatives may be largely responsbile for the recent declines in this operation. Even so, the researchers estimate 1 in 3 women in the U.S. will have undergone the operation by age 60.

Declining numbers

“Over the past decade, there has been a substantial decline in the number of hysterectomies performed annually in the United States,” said senior author Daniel Morgan. “An earlier study found a 36.4% decrease in number of hysterectomies performed in the U.S. in 2010 compared to 2002. However, despite the decrease in numbers of hysterectomies in the U.S., appropriateness of hysterectomy is still an area of concern and it continues to be a target for quality improvement.”

Why do doctors recommend a hysterectomy? The researchers say a majority – about 68% – are for benign conditions, like excessive or painful bleeding. An estimated 10% are to treat cancer.

In many of the benign cases the American Congress of Obstetricians and Gynecologists has recommended alternatives to hysterectomy – things like hormonal management or a minimally invasive gynecological procedure called operative hysteroscopy.

Missing alternatives

Just how often do doctors suggest alternatives to hysterectomy? The Michigan researchers looked at the medical records of 3,397 women who underwent hysterectomies for benign conditions. Upon examining the data they discovered that nearly 40% of women did not have documentation of alternative treatment before having the operation.

Fewer than 30% received medical therapy, while 24% had other minor surgical procedures before the hysterectomy.

When alternative treatment did occur, the patient was more likely to be younger – under age 40.

Underutilized

“This study provides evidence that alternatives to hysterectomy are underutilized in women undergoing hysterectomy for abnormal uterine bleeding, uterine fibroids, endometriosis, or pelvic pain,” Morgan said.

A hysterectomy is a major surgery that is not without risk. According to the National Institutes of Health, risks include allergic reactions to medicines, trouble breathing, blood clots, bleeding, infection and injury to nearby body areas.

It can also be costly. The Healthcare Bluebook says a total abdominal hysterectomy normally costs close to $12,000.

Obviously the decision to have a hysterectomy is one to be made in consultation with your doctors. And it might not be a bad idea to seek a second opinion.

The U.S. economy appears to have turned into a job machine.

Figures released by the Labor Department (DOL) show 250,000 payroll positions were created in December as the unemployment rate dropped 0.2% -- to 5.6%.

At the same time, though, the civilian labor force participation rate edged down 0.2% last month to 62.7%. Since April, the participation rate has remained within a narrow range of 62.7 to 62.9%. The employment-population ratio was 59.2% for the third consecutive month, although the employment-population ratio is up by 0.6% over the year.

The strong December gain pushed monthly job growth in 2014 to an average of 246,000 compared with an average monthly gain of 194,000 in 2013.

Winners and losers

Employment in professional and business services rose by 52,000 in December, led by administrative and waste services (+35,000), computer systems design and related services (+9,000), and architectural and engineering services (+5,000). Employment in accounting and bookkeeping services declined (-14,000).

Construction added 48,000 jobs as specialty trade contractors gained 26,000 position, equally split between residential and nonresidential contractors. Employment also increased in heavy and civil engineering construction (+12,000) and in nonresidential building (+10,000).

Employment in food services and drinking places increased by 44,000, while health care added 34,000 jobs and manufacturing employment rose by 17,000. Manufacturing added an average of 16,000 jobs per month in 2014, compared with an average gain of 7,000 jobs per month in 2013.

Who's working and who's not

The unemployment rate for adult women fell 0.2% in December to 5.0%, while the rates for adult men (5.3%), teenagers (16.8%), whites (4.8%), blacks (10.4%), Hispanics (6.5%) and Asians (4.2%) were little-changed.

The number of long-term unemployed (those jobless for 27 weeks or longer) was essentially unchanged at 2.8 million and accounted for 31.9% of the unemployed. Over the year, the number of long-term unemployed has declined by 1.1 million.

The number of people employed part time for economic reasons (sometimes referred to as involuntary part-time workers) was little changed in December at 6.8 million. These individuals, who would have preferred full-time employment, were working part time because their hours had been cut back or because they were unable to find a full-time job.

The full report may be found on the DOL website.

Any magazine or website discussing celebrity gossip is pretty much guaranteed to publish regular stories (often illustrated by wince-inducing photographs) on the theme “Famous person's plastic surgery goes horribly wrong.”

This week, for example, former “Teen Mom” reality TV star Farrah Abraham tweeted a photo (not for the easily squeamish) showing the result of her own badly botched lip surgery; her upper lip is swollen to grotesque proportions, presumably an allergic reaction either to anesthetic, as she suggested to celebrity-gossip site TMZ, or to the silicone injected into her lip.

Such problems aren't remotely limited to reality TV stars, or celebrities in general. A few days before Farrah Abraham shared the results of her own botched cosmetic-surgery procedure, the American Society of Plastic Surgeons (ASPS) launched what it calls “a new public safety campaign” to “help consumers understand how to make informed decisions about plastic surgery.” As part of the campaign, the ASPS is also highlighting examples of “surgery gone wrong” – and botched plastic surgeries can't always be fixed, either.

Botched surgeries

Dr. Scot Glasberg, president of the ASPS, said that the campaign came about in part because ASPS members were seeing larger numbers of new patients seeking to fix earlier, botched surgeries. “Plastic surgery is real surgery and patients need to do their homework before they undergo any plastic surgery procedure,” Glasberg said. “People spend more time selecting the model and color of a car than they do selecting their plastic surgeon. That needs to change.”

In all fairness, few people are accustomed to “shopping for surgeons” the same way they shop around for consumer goods and services. If someone does want plastic surgery, what does selecting a plastic surgeon actually entail? ConsumerAffairs asked Glasberg about this.

“There are two big questions [a potential plastic surgery patient] needs to ask,” Glasberg said. “The first is: are you a board-certified plastic surgeon? The ABPS, the American Board of Plastic Surgery, is the only certifying agency …. the second question is, is this facility accredited?”

If the answer to both questions is “yes,” then Glasberg recommends you ask another round of questions, including: how many procedures has that surgeon done? You should also ask to see before-and-after photos of previous procedures, and also ask to speak to some of the surgeon's previous patients. If a potential surgeon will not let you see photos of his or her prior work, or speak with prior recipients of it, that's a bad sign.

Risks & complications

You should also about the risks associated with a given procedure. “Ask the surgeon, what are the risks? What are the complications? And if you hear the phrases 'There are no risks' or 'I never have complications,' walk away,” Glasberg said. “That's too good to be true …. every medical procedure has risks.”

A potential plastic-surgery recipient should also have a good idea of what can and cannot be done. “Sometimes you'll hear somebody say 'I want surgery to look exactly like X celebrity, for example – that's not possible,” Glasberg said. There's also the possibility that a relatively commonplace and safe plastic-surgery procedure is not feasible for a specific patient, due to that patient's own medical history. “There might be medical reasons why a procedure can't be done,” Glasberg said.

The American Society of Plastic Surgeons maintains an online listing of board-certified plastic surgeons in the U.S. and Canada.

“Everything in moderation,” the old saying goes. It particularly applies to alcohol consumption.

In recent years health officials have worried about the increasing tendency of some people to “binge” drink, consuming multiple alcoholic beverages in a short period of time. This pattern often develops during the college years.

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men in about 2 hours.

Many of the dangers of binge drinking are fairly obvious. Accidents are much more likely when you are intoxicated. Over time, binge drinking can bring on serious health effects.

Alcohol poisoning

One often-overlooked danger, health officials say, is binge drinkers might die of alcohol poisoning. A new report from the Centers for Disease Control and Prevention (CDC) reveals that more than 2,200 people in the U.S. die each year from alcohol poisoning – consuming too much alcohol in too short a period of time.

When this happens it often results in very high levels of alcohol in the body, which can shut down critical areas of the brain that control breathing, heart rate, and body temperature - resulting in death.

A lot of people are at risk, perhaps more than you might think. The CDC says more than 38 million U.S. adults report binge drinking an average of 4 times per month, consuming an average of 8 drinks per binge.

CDC scientists analyzed deaths from alcohol poisoning among people aged 15 and older, using multiple cause-of-death data from the National Vital Statistics System for 2010-2012. Alcohol showed up as a contributing factor in about 30% of the deaths.

While that's more than the researchers were expecting to find, they conclude that the actual number is probably higher.

"Alcohol poisoning deaths are a heartbreaking reminder of the dangers of excessive alcohol use, which is a leading cause of preventable deaths in the U.S.," said CDC Principal Deputy Director Ileana Arias. "We need to implement effective programs and policies to prevent binge drinking and the many health and social harms that are related to it, including deaths from alcohol poisoning."

Make it cost more

Researchers at Boston University who have studied binge drinking from a policy angle say higher taxes on alcoholic beverages may be the answer.

The study found that a 1% increase in alcohol beverage prices from taxes resulted in a 1.4% decrease in the proportion of adults who binge drink. Most previous studies have examined the effect of taxes on average consumption, while the effect of taxes on high-level drinking has been controversial.

"This is really significant for public health," said lead author Ziming Xuan.

Xuan says binge drinking causes more than half of nearly 90,000 alcohol-attributable deaths in the U.S. each year, and accounts for three-quarters of the $224 billion in annual economic costs.

The study shows that as combined alcohol taxes rise, binge drinking rates fall, with taxes accounting for some 20% of the difference in binge drinking prevalence rates across the states.

The state with the highest beer combined taxes - Tennessee--had the lowest binge drinking rate in 2010, the study found. Conversely, states with low alcohol taxes, such as Montana, Wisconsin and Delaware, had relatively high binge drinking rates.

A ferocious virus is storming through North America, felling U.S. citizens at a rate higher than ever measure by the Gallup research organization.

Ebola? No, flu. Americans nearly came unhinged when a handful of Ebola victims showed up for treatment last year but that was a mere drop in the ocean compared to the flu.

Gallup reports that an average 4.0% of Americans reported being sick with flu on any given day in December -- more than all previous Decembers since Gallup began tracking the flu daily in 2008, and one of the highest rates for any month over the past 7 years. The all-time high is 4.7%, measured in January 2013.

Given that reports of having the flu are typically highest in January or February, the 2013-2014 flu season could end up being the worst flu season in Gallup's records. However, it may also be that the flu is peaking early this season, as happened in 2009-2010, when the flu peaked in October amid the outbreak of the H1N1 flu virus.

As we reported earlier this week, the flu is already being blamed for the deaths of 15 children and the Centers for Disease Control and Prevention has found the flu "widespread" in 43 states. Nationwide, the CDC reports that 5.9% of doctor visits involved flu-like symptoms in the last week of December, up from 4.3% in the same week in 2013.

At the CDC, director Dr. Tom Frieden says that however severe the season turns out to be, Americans need to be prepared.

“We can save lives with a three-pronged effort to fight the flu: vaccination, prompt treatment for people at high risk of complications, and preventive health measures, such as staying home when you’re sick, to reduce flu spread,” Frieden said.

This year's vaccine is not as effective as in some previous years because the flu virus continued evolving after the vaccine was formulated, so some strains don't respond to the vaccine. But that's no reason to skip getting a flu shot, CDC officials caution.

According to its study of the 2012-2013 flu season, the CDC estimates that the flu vaccine prevented 79,000 hospitalizations and 6.6 million illnesses. Still, more than 381,000 Americans were hospitalized because of flu-related illness during that season.

May be understated

The Gallup-Healthways Well-Being Index asks Americans each day whether they were sick with the flu "yesterday." This differs from the U.S. Centers for Disease Control and Prevention's measure, which tracks influenza infections reported from doctors and hospitals. However, Gallup's data closely conform with CDC data for December. 

In December, an average 11.6% of Americans reported they "were sick with a cold yesterday," the highest percentage Gallup has found for any month since 2008. Prior to December 2014, the highest rate was 10.8% in January 2013. The highest December reading before this year was in 2008, when an average 10.3% of Americans reported being sick with a cold.

Generally, about three times as many Americans report having a cold as report having the flu.

It is possible that Gallup's measures of daily cold and flu underestimate the true infection rate, because those who were sick the day before may be less likely to respond to a phone survey than those who were not sick.

Additionally, it may be difficult for people to accurately self-diagnose the medical distinction between the flu and a cold, given the similarity in the symptoms of both conditions. Still, year-over-year comparisons provide useful information about the relative prevalence of flu and colds in the U.S. population.

Another good sign that the economy is back on track comes in news from Challenger, Gray & Christmas that job cuts declined for a second straight month in December.

According to the outplacement consultancy, U.S.-based employers announced plans to reduce payrolls by 32,640 -- the third lowest monthly total of 2014 -- and down 9.2 percent from 35,940 planned reductions in November.

All told, 2014 saw the fewest planned job cuts since 1997.

Last year's total of 483,171 announced job cuts is down 5.0% from the 509,051 cuts tracked in 2013 and the lowest annual total since 434,350 job cuts were recorded in 1997.

“Layoffs aren’t simply at pre-recession levels; they are at pre-2001-recession levels” said John A. Challenger, chief executive officer of Challenger, Gray & Christmas. “This bodes well for job seekers, who will not only find more employment opportunities in 2015, but will enjoy increased job security once they are in those new positions.”

Computer industry leads the cut parade

In 2014, the top three job-cutting industries of the year are all examples of sectors that are, for all intents and purposes, enjoying the fruits of expansion. However, various companies for various reasons made significant cuts to their payrolls.

Despite the overall strength of the tech sector, employers in the computer industry saw the heaviest downsizing of the year, announcing a total of 59,528 planned terminations -- a surge of 69% from a year ago, when they cut 35,136 jobs. A large portion of the pink slips came from tech giants Hewlett Packard and Microsoft, where both are attempting to become more nimble in a very competitive market.

Job cuts in the retail sector fell 11% in 2014, but the industry still ranked second with 43,783 reductions announced during the year -- including 2,195 in December. The third-ranked health care sector also saw fewer firings last year, going from 52,637 job cuts in 2013 to a 2014 total of 38,359.

Overall, 16 of the 28 industries tracked by Challenger saw fewer job cuts in 2014, with an average decline of 34%. The insurance industry experienced the biggest decline, with job cuts falling 65% from 6,519 in 2013 to 2,259 last year.

The largest increases in job cuts occurred among employers in the entertainment industry and electronics; job cuts more than doubled in both. In the entertainment and leisure industry, job cuts jumped 125% from 2013, while reductions in the electronics industry shot up 120%.

Initial claims

Following last week's unexpected surge, the number of people filing first-time applications for unemployment benefits fell last week.

The Labor Department (DOL) reports there were a seasonally adjusted 294,000 initial jobless claims submitted in the week ending January 3, down 4,000 from the previous week.

While DOL says there were no special factors affect this week's initial claims, analysts at Briefing-com say there have been anecdotal reports of increased job-cutting in the energy sector due to low oil prices.

The 4-week moving average, which is less volatile than the weekly tally and considered a more accurate barometer of the labor market, fell 250 -- to 290,500.

The complete report is available on the DOL website.

Eillien's Candies is recalling various sizes and brands of Walnut Pieces.

The products may be contaminated with Salmonella.

The company says it has not received any reports of illnesses in connection with the recalled items.

The recalled products were sold in stores in Arkansas, Colorado, Florida, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Michigan, Minnesota, Missouri, Montana, North Dakota, New York, Nebraska, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, South Dakota, Utah, Washington, West Virginia, Wisconsin and Wyoming,

The BEST BY DATES can be found on the back of the bags.

Item Description:

Consumers who have purchased the items with the BEST BY DATES listed above should not consume them and should return them to the place of purchase for a full refund or replacement.

Consumers with questions about the above recall may may contact Eillien’s Candies customer service toll-free at 800-448-1556 Monday through Friday 6:00 AM – 5:00 PM, CT.

A U.S. Department of Agriculture (USDA) sponsored analysis of fast food over a 17-year period has some good news and some not-so-good news for consumers trying to stick to a healthy diet.

While the overall trend in restaurants has been to increase portion size, as a way to compete for customers, fast food restaurants, for the most part, haven't taken part.

Researchers at the USDA Human Nutrition Research Center on Aging at Tufts University found little change in fast food portion sizes and product formulation between 1996 and 2013.

Calories, sodium & fat

They also found that average calories, sodium, and saturated fat didn't change much, meaning they remain at pretty high levels. But they did observe a consistent drop in the trans fat found in French fries. In some ways, fast food restaurants are doing a better job than the rest of the restaurant industry.

"There is a perception that restaurants have significantly expanded their portion sizes over the years, but the fast food we assessed does not appear to be part of that trend," said Alice Lichtenstein, director of the Cardiovascular Nutrition Laboratory at the USDA HNRCA. "Our analysis indicates relative consistency in the quantities of calories, saturated fat, and sodium.”

That said, some fast food chains are serving up healthier fare than others. And while most chains now have salads and wraps on their menu for health-conscious customers, that's not what tends to get ordered most.

Combo meals

So the researchers looked at burgers and fries, particularly the items frequently sold together as a meal. Lichtenstein says these meals often push the limits of what we should be eating to maintain a healthy weight and sodium intake.

"For example, among the three chains, calories in a large cheeseburger meal, with fries and a regular cola beverage, ranged from 1144 to 1757 over the years and among restaurants, representing 57% to 88% out of the approximately 2000 calories most people should eat per day," Lichtenstein said. "That does not leave much wiggle room for the rest of the day."

Using the researchers' 2013 data, calorie content of the cheeseburger meal among the three chains represented 65% to 80% of a 2,000 calorie per day diet and sodium content represented 63% to 91% of the recommendation.

Pay particular attention to sodium content. The U.S. Dietary Guidelines for Americans recommend adults limit their salt intake to a maximum of 2,300 milligrams per day.

Depending on the chain, between 1996 and 2013, eating a single 4 ounce cheeseburger could have accounted for 1100 to 1450 mg of daily sodium representing 48% to 63% of target limits.

The researchers focused on four popular menu items – cheeseburgers, fries, grilled chicken sandwiches and regular cola.

Lower trans fat

Over the years there were only small fluctuations in calorie content and the amount of saturated fat and sodium found in these products. The notable exception was fries, which decreased first in saturated fat in 2001 and then trans fat, most likely due to changes in the fat used to cook them.

"The decline in trans fat we saw between 2005 and 2009 appears to be related to legislative efforts," Lichtenstein said. "The success of New York City's trans fat ban and others like it, suggest it is worth pursuing these types of approaches because they make the default option the healthier option. Of course, it is important to note that the healthier option in terms of fat does not translate into lower calories or less salt."

The researchers continue to see fast food restaurants as contributing to America's obesity epidemic and say the industry could help by downsizing portions and cutting back on fat and sodium. But they conclude on a note of optimism.

"From what we hear some fast-food chains are heading in that direction and also introducing new healthier options,” Lichtenstein said. “If taken advantage of, these changes should help consumers adhere to the current dietary recommendations."

In other words, consumers have to make the healthier choice. Eating at McDonald's does not have to result in consuming 1,500 calories in one sitting. McDonald's Southwest Salad with grilled chicken contains 290 calories – adding balsamic dressing only increases it to 325 calories.

Nearly a-quarter million people found work in the private sector last month.

According to the ADP National Employment Report, the economy created 241,000 jobs during December.

The report, produced by the payroll concern and Moody's Analytics, measures the change in total nonfarm private employment each month on a seasonally-adjusted basis.

"December delivered another strong number well above 200,000 to close out a solid year of employment growth with over two and a half million jobs added," said Carlos Rodriguez, president and CEO of ADP. "Small businesses continued to lead the way, but mid-sized and large companies also showed solid gains."

Businesses with 49 or fewer employees increased the number of jobs by 106,000 jobs in December, compared with 99,000 in November. Employment among companies with 50-499 employees rose by 70,000, versus 73,000.

Employment at large companies -- those with 500 or more employees -- increased went from 54,000 in November to 66,000 jobs last month, while companies with 500-999 employees added 22,000 jobs, 10,000 more than the month before. Companies with over 1,000 employees added 43,000 jobs.

A manufacturing boost

Employment in goods-producing industries rose by 46,000 jobs in December, with manufacturing adding 26,000 jobs up from 40,000 jobs for the second highest monthly total of 2014. The construction industry added 23,000 payroll positions.

Service-providing employment rose by 194,000 jobs last month. Professional/business services contributed 69,000 jobs, wile trade/transportation/utilities grew by 44,000, and financial activities added 16,000 jobs -- the largest monthly gain in that sector for 2014.

With businesses across all industries and sizes adding to payrolls, Moody's Analytics Chief Economist Mark Zandi says that at the current pace of job growth, “the economy will be back to full employment by this time next year."

Mortgage applications plunged 9.1% from two weeks earlier in the week ending January 2.

The most recent week’s results from the Mortgage Bankers Association’s (MBA) Weekly Mortgage Applications Survey include an adjustment to account for the New Year’s Day holiday, while the previous week’s results were adjusted for the Christmas holiday.

The decline in the Refinance Index was even sharper -- 12% from two weeks ago, with the refinance share of mortgage activity increasing to 65% of total applications from 63% in the previous period.

The adjustable-rate mortgage (ARM) share of activity dropped to 4.9% of total applications, while the FHA share increased to 9.3%. The VA share rose to 10.7% this week, and the USDA share of total applications held steady at 0.9%.

Contract interest rates

• The average contract interest rate for 30-year fixed-rate mortgages (FRMs) with conforming loan balances ($417,000 or less) fell 3 basis points -- from 4.04% to 4.01%, with points decreasing to 0.28 from 0.35 (including the origination fee) for 80% loan-to-value ratio (LTV) loans. The effective rate decreased from last week.
• The average contract interest rate for 30-year FRMs with jumbo loan balances (greater than $417,000) dropped to 3.99% from 4.05%, with points slipping to 0.24 from 0.37 (including the origination fee) for 80% LTV loans. The effective rate decreased from last week.
• The average contract interest rate for 30-year FRMs backed by the FHA inched down 1 basis point to 3.81%, with points decreasing to -0.03 from 0.08 (including the origination fee) for 80% LTV loans. The effective rate decreased from last week.
• The average contract interest rate for 15-year FRMs decreased to 3.24% from 3.32%, with points decreasing to 0.30 from 0.36 (including the origination fee) for 80% LTV loans. The effective rate decreased from last week.
• The average contract interest rate for 5/1 ARMs was down 7 basis points to 3.19%, with points increasing to 0.51 from 0.48 (including the origination fee) for 80% LTV loans. The effective rate decreased from last week.

The survey covers over 75% of all U.S. retail residential mortgage applications.

Full Tilt Ice Cream of Seattle, Wash., is recalling all Dairy Based Ice Cream flavors (except the non-dairy frozen desserts), sold under the Full Tilt brand.

The products may be contaminated with Listeria monocytogenes

No illnesses have been reported to date.

The products were distributed in Oregon and Washington through grocery stores and retail scoop shops, and sold in 16oz paper containers with a 7 digit code ending in 14x (ie: 0219142), as well as 1.5 gallon and 3 gallon plastic gallon tubs produced before 12/19/2014.

The following products are being recalled:

Consumers who have purchased Full Tilt are urged to return it to the place of purchase for a full refund.

Consumers with questions may contact the company at 1-206-963-5038 between 9am and 4pm PST Monday thru Friday.

Happy Apples is expanding its earlier recall of caramel apples to include Kroger Brand caramel apples with a best use by date of September 15 – November 18th 2014.

The products may be contaminated with Listeria monocytogenes.

Kroger brand caramel apples are sold in single packs and 3-packs and each package has a best use by date on the front of the label. The products were distributed in Arizona, Alaska, Kansas, Idaho, Louisiana, Montana, Missouri, Nebraska, Nevada, Oregon, Texas, Utah, Washington and Wyoming.

Consumers who have any product may return it to the store where purchased or dispose of them in a secure container to avoid potential contamination in animals.

Consumers with questions may contact the company at 636-584-6001 Monday through Friday during normal business hours or by email at customercare@happyapples.com.