Hip replacement reduces heart failure, depression and diabetes risk

Public release date: 22-Mar-2013
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Contact: Lauren Pearson Riley
pearson@aaos.org
708-227-1773
American Academy of Orthopaedic Surgeons

Study supports the value of THR in aiding long-term health at minimal cost

CHICAGO In addition to improving life quality and diminishing pain, total hip replacement (THR) is associated with reduced mortality, heart failure, depression and diabetes rates in Medicare patients with osteoarthritis, according to a new study presented today at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). The procedure also is cost effective with the 7-year costs of THR only $6,366 higher than the cost of treating an osteoarthritis patient for hip pain without THR.

"The study has demonstrated that THR confers a potential long-term benefit in terms of prolonged lifespan and reduced burden of disease in Medicare patients with osteoarthritis of the hip," said lead study author Scott Lovald, PhD, a researcher at Exponent, Inc.

While the short-term benefits of THR are well known and documented, less information exists on the long-term effects, cost and value of the surgery.

Using Medicare codes, researchers identified more than 43,000 patients with osteoarthritis of the hip from 1998 to 2009. These patients were divided into two groups those receiving THR and those not receiving THR. The researchers followed all of the patients for at least one year, and nearly 24,000 for seven years, looking at annual Medicare payments, mortality, and new diagnoses of congestive heart failure, ischemic heart disease, artherosclerosis (hardening and narrowing of the arteries), diabetes and depression. The data was adjusted for differences in age, sex, race, buy-in status, region and Charlson score (standard quantification of the number and severity of comorbidities a patient presents with).

Among the results:

• The THR patients had a consistently lower mortality risk less than 52 percent of that in the non-THR group.
• Heart failure was similar between groups in the first year, but there was a consistent reduced risk (risk was between.85 and .92 of the risk for the non-THR group) at 3-to-7 years following surgery.
• THR patients had a reduced risk of diabetes at one and three years.
• THR patients had a reduced rate of depression starting at three years post THR surgery.

The THR patients in the study did have an increased risk of ischemic heart disease and atherosclerosis at one year, and an increased risk of "cardiovascular disease unspecified" over all time points.

The seven-year cumulative average Medicare payment for all medical care was $82,788 for non-THR patients and $89,154 for THR patients, for a difference of $6,366. The actual average per-patient THR cost is expected to be much less than $6,366 when differences in costs incurred due to prescription pain medications are taken into account.

"Joint (replacement) has been proposed as possibly cost-saving in the management of disability related to arthritis," said Lovald. "This study provides supporting data to evaluate the cost-effectiveness of THR."

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Learn more: AAOS.org

Follow us on Facebook.com/AAOS1 and Twitter.com/AAOS1.

A Nation in Motion

More than one in four Americans have bone or joint health problems, making them the greatest cause of lost work days in the U.S. When orthopaedic surgeons restore mobility and reduce pain, they help people get back to work and to independent, productive lives. Orthopaedic surgeons provide a great value, in both human and economic terms; and access to high-quality orthopaedic care keeps this "Nation in Motion." To learn more, to read hundreds of patient stories or to submit your own story, visit ANationinMotion.org.

For more information on bone and joint health, visit Orthoinfo.org.

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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Public release date: 22-Mar-2013
[ | E-mail | Share ]

Contact: Lauren Pearson Riley
pearson@aaos.org
708-227-1773
American Academy of Orthopaedic Surgeons

Study supports the value of THR in aiding long-term health at minimal cost

CHICAGO In addition to improving life quality and diminishing pain, total hip replacement (THR) is associated with reduced mortality, heart failure, depression and diabetes rates in Medicare patients with osteoarthritis, according to a new study presented today at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). The procedure also is cost effective with the 7-year costs of THR only $6,366 higher than the cost of treating an osteoarthritis patient for hip pain without THR.

"The study has demonstrated that THR confers a potential long-term benefit in terms of prolonged lifespan and reduced burden of disease in Medicare patients with osteoarthritis of the hip," said lead study author Scott Lovald, PhD, a researcher at Exponent, Inc.

While the short-term benefits of THR are well known and documented, less information exists on the long-term effects, cost and value of the surgery.

Using Medicare codes, researchers identified more than 43,000 patients with osteoarthritis of the hip from 1998 to 2009. These patients were divided into two groups those receiving THR and those not receiving THR. The researchers followed all of the patients for at least one year, and nearly 24,000 for seven years, looking at annual Medicare payments, mortality, and new diagnoses of congestive heart failure, ischemic heart disease, artherosclerosis (hardening and narrowing of the arteries), diabetes and depression. The data was adjusted for differences in age, sex, race, buy-in status, region and Charlson score (standard quantification of the number and severity of comorbidities a patient presents with).

Among the results:

• The THR patients had a consistently lower mortality risk less than 52 percent of that in the non-THR group.
• Heart failure was similar between groups in the first year, but there was a consistent reduced risk (risk was between.85 and .92 of the risk for the non-THR group) at 3-to-7 years following surgery.
• THR patients had a reduced risk of diabetes at one and three years.
• THR patients had a reduced rate of depression starting at three years post THR surgery.

The THR patients in the study did have an increased risk of ischemic heart disease and atherosclerosis at one year, and an increased risk of "cardiovascular disease unspecified" over all time points.

The seven-year cumulative average Medicare payment for all medical care was $82,788 for non-THR patients and $89,154 for THR patients, for a difference of $6,366. The actual average per-patient THR cost is expected to be much less than $6,366 when differences in costs incurred due to prescription pain medications are taken into account.

"Joint (replacement) has been proposed as possibly cost-saving in the management of disability related to arthritis," said Lovald. "This study provides supporting data to evaluate the cost-effectiveness of THR."

###

Learn more: AAOS.org

Follow us on Facebook.com/AAOS1 and Twitter.com/AAOS1.

A Nation in Motion

More than one in four Americans have bone or joint health problems, making them the greatest cause of lost work days in the U.S. When orthopaedic surgeons restore mobility and reduce pain, they help people get back to work and to independent, productive lives. Orthopaedic surgeons provide a great value, in both human and economic terms; and access to high-quality orthopaedic care keeps this "Nation in Motion." To learn more, to read hundreds of patient stories or to submit your own story, visit ANationinMotion.org.

For more information on bone and joint health, visit Orthoinfo.org.

---

[ | E-mail | Share ]

?

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Source: http://www.eurekalert.org/pub_releases/2013-03/aaoo-hrr031913.php

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Should You Invest in a Bad 401(k) or 403(b)? @ Financial Ramblings

I?ve been fortunate. Over the years, my employers have offered excellent retirement plans. But for many, that?s not the case.

If your 401(k) or 403(b) plan stinks ? due to high fees, lack of appropriate investment options, or both ? what should you do?

Should you still contribute? Or should you just fund an IRA and then move on to investing in a taxable account? Today I want to take a closer look at the options and offer some suggestions.

For starters, your retirement plan at work offers two main advantages:

1. additional tax-advantaged investment space, and
2. the possibility of matching contributions.

Currently, IRA contribution limits stand at $5,500/year, whereas 401(k) and 403(b) contribution limits are $17,500/year. So your limits at work are more than 3x higher. That?s a pretty nice option to have.

Of course, you can do both. So? Ignoring catchup contributions, this gives you the ability to stash a combined total of up to $23k/year in tax-advantaged accounts.

As for employer matches, many plans will match 50%-100% of your contributions up to a certain level. This is free money, and you should almost always take it.

In very general terms, when thinking about long-term (retirement) savings, I would prioritize things like this:

• Fund your retirement plan at work up to your employer?s match
• Max out your IRA (traditional or Roth, depending on your circumstances)
• Go back to funding the employer plan up to the limit unless it?s truly horrid
• If you?re still looking to invest, continue to do so in a taxable account

So? Once you?ve captured the matching funds, I would lean toward switching to an IRA as this gives you absolute control over your money. From there, I would likely switch back to the employer plan up to the max due to the tax benefits.

As for what constitutes a ?truly horrid? plan, that depends on a number of factors (tax brackets, type of investments held, etc.) ? but I would likely tolerate at least 0.50%-0.75% in added costs in exchange for the tax benefits.

If the investment choices are limited, you can always settle on the ?least bad? and then balance things out in other accounts. Remember, when allocating your portfolio, you should look at the whole pot of money vs. trying to hit the proper allocation within each individual account.

As for the traditional vs. Roth debate, please see my earlier discussion of tax diversification. The benefits of tax diversification apply to both you work-related retirement plan and your IRA(s).

Another consideration: If you ever change employers, you can roll your retirement plan into an IRA and extricate yourself from whatever negatives you?ve been dealing with. Thus, you may not be stuck with those high fees or limited choices for life.

Just keep in mind? If you?re planning on retiring between ages 55 and 59.5, it?s better to have your money in a 401(k) or 403(b) than an IRA because you can take distributions without incurring an early withdrawal. With an IRA, you have to wait until 59.5 (or jump through other hoops) to avoid the penalty.

Note: Just so you?re aware, much of the discussion above applies equally well to 457(b) plans. However, these rarely offer matching contributions so I?d be less likely to put them at the top of the list.

Filed Under: Investing

Topic(s): 401(k), 403(b), 457(b), retirement, roth ira, traditional ira

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Source: http://www.financialramblings.com/archives/invest-in-a-bad-401k-or-403b/

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HTC One launch delayed, suppliers no longer see HTC as a 'tier-one' manufacturer

The uphill battle for HTC continues. The proposed savior for the struggling company, the HTC One, now faces delays due to problems with component suppliers. The problem lies with one of the main selling points of the upcoming flagship phone - the "ultrapixel" camera. With the significant loss of profits and decrease in shipments HTC has had, an unnamed executive tells the WSJ that they are no longer considered a "tier-one" customer. This means they don't have the priority they once did with their parts suppliers, and are currently running short on components for the HTC One's camera and metal case.

It's worth noting that suppliers have not mentioned anything of the sort, and it's possible that frustrations have company executives a little emotional. This certainly seems the case with CEO Peter Chou, who The Verge tells us has stated he would step down if the HTC One "fails to become a hit with consumers". It's also hard to determine what a "hit with consumers" is. Focus Taiwan reports that pre-orders for the HTC One have exceeded the companies target, which sounds fairly successful to us. In short, we're not going to read too much into this one.

While there are still no concrete dates, HTC promises to start fulfilling pre-orders at the end of March in select markets, with a wider rollout scheduled for sometime in April. The HTC One's release is inching ever closer towards a confirmed release date of its strongest competitor, which could take away a much needed edge it would have with an earlier release.

Will fans wait it out through expected delays, or will we see potential buyers jumping ship for something else? Read the review and discuss in the forums.

Source: WSJ

Source: http://feedproxy.google.com/~r/androidcentral/~3/YTqcy-qfiBg/story01.htm

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Netgear High Speed Cable Modem (CMD31T)

With Internet broadband service, an ISP provides customers with the cable or DSL modem they need for Internet access. Customers are typically charged a monthly fee to lease this equipment.? Did you know that with most broadband service, you have the option to purchase your own cable or DSL modem and save yourself that added cost? Netgear's High Speed Cable Modem (CMD31T) is a great choice for those who want to make the plunge.

If you pay a monthly fee to lease a cable modem, buying a modem will eventually pay for itself. The average price at least for my ISP is just about $3.00 per month to lease a cable modem. Since?Netgear's cable modem?supports all the major cable service providers, this means that even if you swap providers, the unit should pay for itself in a couple of years.

I recently tested Netgear's High Speed Cable Modem, swapping it for the Ubee cable modem I lease from my provider. For those of you who don't mind doing a little configuring and troubleshooting of your Internet connection, buying the CMD31T is a good way to (eventually) offset cable costs.

Of course, the downside of owning your own cable modem is that Netgear gives you a one-year warranty in case something goes wrong with the device. If your ISP's cable modem goes, they will just replace it. If the Netgear cable modem breaks and the warranty is up, you have to either lease one from your provider or buy your own again.

Specs and Design
The CMD31T is a slim, white, rectangular device that looks a lot like a small router. The modem ships with a stand so it can operate horizontally or vertically. Also included in the package are an Ethernet cable, power adapter, and instruction guide. It's also rather small and light measuring 6.9 by 4.5 by 1.2 inches (HWD), and weighs 0.68 of a pound.

The stand is actually comprised of two plastic feet that sit in the airflow vents on the housing. Surprisingly, the little feet took some time to get in place.

The modem only has one Gigabit Ethernet LAN port. You can use this port to connect to a wireless router. There's also a female "Y" connector?the coaxial connector for the Internet cable service.

The front panel has several LEDs which indicate the status of Ethernet as well as downstream and upstream traffic. The LEDs change color according to activity. For example, the Ethernet LED has a 1Gbps connection when it's solid green, 100Mbps when it glows amber, and turns red if connected to a device that only supports 10Mbps (pretty rare, nowadays).

The upstream/downstream traffic LEDs change color based on which channel the upstream or downstream traffic uses. If the "US1/2" LED is lit solid amber, that means the upstream link is using channel 1. There are a lot of different color possibilities to interpret but Netgear provides a chart so you can tell what's happening with your traffic. Suffice to say, you know everything is in working order when all the LEDs are green, at least with most cable broadband connections.

The CMD31T is DOCSIS 3-compliant. DOCSIS is a standard for transferring high-speed data over coaxial cable. Most ISPs providing cable Internet should be using DOCSIS 3. It's important to find out for sure and make sure you buy the right cable modem.

Fortunately, a DOCSIS 3 cable modem such as the CMD31T is backwards-compatible with older DOCSIS technology.

Another great feature of the CMD31T is that it supports IPv6, so it's ready as an ISP and the Internet as a whole transition to IPv6.

Setup
I disconnected my old cable modem and swapped in the Netgear modem. The instruction guide gives newbies an illustration on how the cable modem should connect. The device took about 15 minutes to fully boot and then a bit longer as I waited for the power and online LEDs to turn solid green (something you want to see on the modem before moving forward with the setup.)

The modem's directions then instruct customers call their ISP once the power and online LEDs are green? because the ISP has to activate the new modem.

Before I even contacted my provider, my wireless router, which I had already connected to the Netgear? modem, detected an active Internet (WAN) connection?which is good. However, when trying to Internet browse, I was stopped by a walled garden page from my provider instructing me to call them to give them the MAC address of my new cable modem.

So, when you swap out your cable modem, your ISP will likely be able to detect you did, and you will have to call them so they can allow the new device access to their service. Such tight control is actually necessary so the ISP's network isn't compromised.

Once I contacted my ISP, I waited about half an hour (although activation can often take up to an hour). I still however, could not browse the Internet when connected wirelessly to my router. I knew that the Netgear cable modem was activated because if I connected my computer directly to the LAN port of the CMD31T, I was able to get on the Internet.

I ran through the Internet connection setup wizard on my wireless router. This re-synced the router with my Internet connection, and I was back up and running.

Netgear CMD31T Interface
I accessed the CMD31T's web GUI by simply pointing a browser to the default IP address of the device (192.168.100.1) and using the default credentials: admin, and "password" for login username and password.

The interface is locked in pretty tightly with my ISP's service. All I could see was some information about the connection such as the connectivity state, downstream channel frequency and other information most users will care nothing about. The only administrative tasks you can really do with the cable modem are change the password and view an event log?handy, for troubleshooting Internet connection problems or keeping track of Internet downtime.

The fact that you can't really manage the cable modem is fine. All of your network administration such as setting up Wi-Fi, port forwarding, content filtering, parental controls, and so on, should be performed on your wireless router, not the cable modem.

Performance
I was curious to find out if there was any performance difference between using my provider's leased cable modem and the Netgear modem. I measured my internet bandwidth using speedtest.net first with the provider's Ubee modem and then with the Netgear cable modem.

With the Ubee modem, speedtest.net measured download speed at 19.25Mbps and upload at 0.98Mbps.

With the Netgear CMD31T, download was a bit slower at 14.39Mbps and upload was 0.99Mbps.

While my download speed registered slightly slower with the Netgear modem in place, the difference is not significant enough to impact my web browsing. In fact, it's impossible to say if the Netgear modem caused the slightly slower download bandwidth because I tested later on in the day when the service in my area could have had more users accessing it. It's hard to pinpoint the exact cause of the slower download number, but I did not notice any slower browsing experience or doing tasks like gaming or Skype-ing.

Good Alternative to Leasing
Netgear's High Speed Cable Modem is a good alternative for anyone looking to avoid paying leased equipment fees to their ISP. This modem is relatively easy to setup and works with the major ISPs including Time Warner Cable, Cablevision, Charter, Comcast, Cox, and others.

If you are not thrilled about the idea of doing a little work to get your own cable modem set up and prefer to just leave alone the equipment the ISP's technician set up when you first got your service, then you may not want to go with a device like the CMD31T. If you don't mind putting in a minimal amount of networking elbow grease and are delighted with paying your provider that many fewer dollars a month, check out the CMD31T. It's a four-star Editor' Choice for networking hardware.

Source: http://feedproxy.google.com/~r/ziffdavis/pcmag/~3/SBWWXiPXORM/0,2817,2416797,00.asp

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Online resources for a school psychology student at PCOM ...

Happy Monday! ?Today I thought I would compile a list of great resources to use as a school psychology student. ?My professors have recommended many helpful online resources to my cohort to help with our education as well as for us to reference throughout our careers.? Here are some great websites to check out!

First and foremost, I recommend the NASP (National Association of School Psychologists) website.? Many of us are members and several of us attended the NASP conference in Philadelphia last year.? PCOM pays for our student membership this year, which gives us access to multiple school psychology resources and helps connect us to the professional community in which we will one day be working.? I also recommend following NASP?s Facebook page.? There are daily posts including advice from professionals, current education news, and internship/job postings.?

Joining your local state school psychology association is also a great way to network with professionals in the field, get information on state conferences and workshops, and become involved in state leadership roles.? Many people in my cohort live in Pennsylvania and New Jersey and each state has its own school psychology association.

What Works Clearinghouse is an initiative of the Institute of Education Sciences at the Department of Education that provides quality research on numerous educational programs and policies and their effectiveness. PaTTAN offers a lot of great resources to those in the education field.??PaTTAN provides information about professional training, downloadable instructional materials, and legal information about state and federal laws pertaining to education.? Intervention Central provides RTI (Response to Intervention) resources for academic and behavioral interventions.? There are many free manuals and resources available for download. PCOM also provides many resources for us as students.? Listed below are several pages that I have found useful since beginning my education here.? While our professors do a great job of preparing us for upcoming proficiency assessments, this page has basic information about the program sequence and course descriptions for those who like to see what's coming up next semester or year (like me!). When researching for a project or paper, the Psychology Guide on the library website is easy to use and provides a variety of great articles.? The Psychology liaison librarians are always quick to respond to emails and very helpful if I need to retrieve an article that is not available online. I have visited PCOM?s financial aid website many times.??The website contains information about how to apply for financial aid, financial planning tips, and many other resources regarding the funding of your education and budgeting.? The financial aid office is also very helpful when trying to figure out the student loan situation.

I worked at the Office of Student Affairs for a few semesters and the people here rock!? Professional, academic, and personal support is provided.? You can find out more about clubs and organizations offered at PCOM as well as how to get involved in a Federal Work Study job.? Also, if you are ever in need of a sugar boost, the candy bowl is usually full???

Source: http://abcsofschoolpsychology.blogspot.com/2013/03/online-resources-for-school-psychology.html

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Source: http://estes86.typepad.com/blog/2013/03/online-resources-for-a-school-psychology-student-at-pcom.html

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My reoccurring headaches are finally healed

Neck pain or upper back pain can cause reoccurring headaches. I have felt headaches since I can remember, but I never really tried to find the source of them. The biggest mistake I have ever made is to accept my headaches. If I hadn't done that, I might have found the answer sooner. I don?t really know how I came across this link www.uppercervicalhealthcentersboise.comneck-pain. But there, I found the answer I desperately needed. This health center had the answer for my headaches. My neck pain and the headaches were caused from the spinal problems I didn?t know I had. I am glad that this clinic had the right answers. They were able to restore my health.?

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Source: http://www.knupnet.com/latest-health-news/my-reoccurring-headaches-are-finally-healed/

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Egypt sees domestic wheat output of 9.475 mln tonnes this season

CAIRO (Reuters) - Egypt expects wheat production of around 9.475 million tonnes this season if good weather conditions continue, the state news agency quoted Agriculture Minister Salah Abdel Momen as saying on Monday.

Abdel Momen added that Egypt needed 9 million tonnes of wheat to guarantee production of the cheapest form of subsidised bread that is sold for less than 1 U.S. cent per loaf.

Egypt harvested 8.69 million tonnes of wheat in summer 2012, up 4 percent from the 8.37 million tonnes in 2011, according to the United Nations' Food and Agriculture Organisation.

Egypt has endured more than two years of political and economic instability, making it harder for the country to arrange payment for wheat imports. Its pace of purchases has slowed since the start of the year.

The country's strategic stocks of wheat, both imported and local, have fallen to 2.207 million tonnes, enough to last 89 days, a cabinet report said last week. This compares to 2.292 million tonnes, or 95 days' cover, reported on February 27.

International traders say that even with a brighter harvest outlook, the country will need to buy further significant amounts to maintain minimum stock levels prior to its harvest being ready for consumption.

Food supply is a politically-sensitive issue in Egypt, where rising food prices are being passed on to struggling consumers and shortages have provoked unrest in the past.

Source: http://news.yahoo.com/egypt-sees-domestic-wheat-output-9-475-mln-153622862--business.html

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