Wednesday, February 13, 2008
The cost of diagnosing and treating back and neck problems rose substantially over the past decade, but Americans might not be getting their money's worth, a study suggests today.
Back and neck problems are among the main reasons for doctor visits, the authors write in the Journal of the American Medical Association. In a 2002 survey of U.S. adults, the authors write, just over a quarter of respondents said they'd had lower back pain in the previous three months.
The researchers analyzed data from an annual government survey of a representative sample of the U.S. adult population. Participants were asked to report all health conditions, including back and neck problems. The researchers also used data from related surveys of doctors and pharmacists to estimate how much money was spent on various health conditions.
From 1997 through 2005, the average medical expenditure for respondents who said they had spine problems was 73% greater than that of those who didn't, the authors write.
After adjusting for inflation, medical expenditures by Americans with back or neck problems rose an estimated 65% from 1997 through 2005, more rapidly than health expenditures by Americans overall, the authors write. Yet, they say, the estimated proportion of people with spine problems who reported having physical function limitations rose from 20.7% to 24.7% during that same period.
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"As we're spending a lot of money on spine problems, we would expect that that investment would be commensurate with improvements in spine problems," said lead author Brook Martin, a research scientist in orthopedics and sports medicine at the University of Washington.
Alan Hilibrand, speaking for the American Academy of Orthopaedic Surgeons, challenged Martin's conclusion that spending on spine problems has outpaced overall medical spending. Hilibrand, an orthopedic surgery professor at the Temple University School of Medicine in Philadelphia, pointed out that the difference in health care expenditures for people with spine problems and those without was 72% in 1997 and 73% in 2005.
In 2005, most of the differences in expenditures between those reporting spine problems and those who did not were in three areas: outpatient services, inpatient services and prescription drugs, the researchers write. The greatest rise in absolute dollars from 1997 through 2005 was for outpatient visits, which accounted for $30.8 billion — 36% — of spine-related medical expenditures in 2005.
Other increases might be a result of such factors as medical imaging and diagnostic tests, spinal injections and spinal fusion surgery, the authors write. They concluded that the USA might be able to safely reduce spending for spine problems without harming Americans' health.
"I think the article is timely," University of Pittsburgh geriatrician Debra Weiner said. "When I saw it, I said, 'Yep, this is what people need to hear.' "
In a study published in 2006, Weiner and her co-authors concluded that doctors were increasingly ordering often unnecessary MRIs for Medicare patients with lower back pain. "Doctors are not taught in medical school or their post-medical school training about how to evaluate people with back pain," says Weiner, director of the Older Adult Pain Management Program at her university. "Because they are not taught, the fallback position is often advanced imaging, like MRIs."
Yet, she says, older people who don't have back pain often have MRIs that look similar to those of back pain patients who end up having surgery.
Says Martin: "Nobody has a good answer for how much is too much" treatment for spine problems.
After 100 days, WGA members vote overwhelmingly to go back to work
The strike is over.
Hollywood's costly 100-day walkout came to a widely welcomed end Tuesday after members of the Writers Guild of America voted overwhelmingly to go back to work.
More than 90% of the 3,775 writers who cast ballots in Los Angeles and New York voted to immediately end the work stoppage, capping the entertainment industry's most contentious labor dispute in recent history.
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"Rather than being shut out of the future of content creation and delivery, writers will lead the way as TV migrates to the Internet and platforms for new media are developed," said Patric M. Verrone, president of the WGA, West.
On Feb. 25, writers are expected to ratify a new three-year contract that ensures them a stake in the revenue generated when their movies, television shows and other creative works are distributed on the Internet. Whether the benefits from the new contract will be enough to offset the income writers and others lost because of the strike is a matter of debate.
Steven Beer, an entertainment attorney at Greenberg Traurig, predicted that working writers may have fewer opportunities as studios use the strike as a means to cut programming budgets, greenlight fewer pilots, reduce fees and limit the number of production deals on their lots.
"Writers got hard-fought and well-earned improvements, but it could be tougher sledding for the rank and file in the future," he said.
Other experts believe the writers won a victory that transcends any financial gains.
"It was a defining moment," said economist Harley Shaiken, a professor at UC Berkeley who specializes in labor issues. "It showed that a very disparate group of individuals could act with real solidarity -- and that packed real economic power."
The walkout, which began Nov. 5, proved to be far more economically damaging than the studios had expected, shutting down more than 60 TV shows, hampering ratings and depriving the networks of tens of millions in advertising dollars.
Labor experts said the crippling effect of the strike helped writers achieve gains they might not have otherwise attained.
The new contract gives them residual payments for shows streamed over the Internet and secures the union's jurisdiction for programming created for the Web.
"They successfully faced down six multinational media conglomerates and established a beachhead on the Internet," said Jonathan Handel, former associate counsel for the Writers Guild of America, West and an attorney at TroyGould. "When you consider what they were initially offered and the enormous odds they faced, that's quite an achievement."
Handel noted that studios had originally balked at writers' demands for new-media residuals, proposing a multiyear study instead.
Yet the new contract falls short of what writers were initially seeking.
"It's a good deal but not a great one," said Handel, adding that both sides made key compromises.
For example, writers received guarantees that any guild member hired to create original shows for the Web would be covered under a union contract. But the tentative contract enables studios to hire nonunion writers to work on low-budget Internet shows, giving them the flexibility they sought to compete in the burgeoning world of Web entertainment.
The writers agreement was largely patterned after a recent deal studios made with directors. Writers, however, got some important improvements, especially in pay for shows that are streamed on advertising-supported websites.
Writers were unsuccessful, however, in their efforts to shorten the 17-to-24-day window that studios have to stream their shows for promotional purposes without paying residuals. Many writers complained that most viewers watched repeats online within days after a program was initially broadcast.
With the strike now over, economists are tallying up the cost to the industry and the Los Angeles region. Measuring the financial losses is inherently difficult and estimates vary widely.
Jack Kyser, chief economist for the Los Angeles County Economic Development Corp., estimates the walkout cost the local economy more than $3 billion. Of that total, an estimated $772 million came from lost wages for writers and production workers, $981 million from various businesses that service the industry, including caterers and equipment rental houses, and $1.3 billion from the ripple effect of consumers not spending as much at retail shops, restaurants and car dealers.
Still, the total is relatively small considering that the L.A. economy generates $1.3 billion a day.
The entertainment industry employs about 250,000 in the Los Angeles region, including thousands who are self-employed.
Orlando (dbTechno) - International Space Station astronauts were quite busy on Sunday getting ready for the first spacewalk since the arrival of the NASA space shuttle Atlantis, which brought with it the European Space Agency module Columbus. The spacewalk had to be delayed due to health issues with German astronaut Hans Schlegel.
Schlegel has been replaced by Stanley Love.
Love and Rex Walheim will perform tasks to get the International Space Statioin and the European Space Agency’s Columbus laboratory ready for installation.
They will have to install the Power Data Grapple Fixture on Columbus, as well as other tasks.
Schlegel and Pilot Alan Poindexter will coordinate the spacewalk from inside the orbiting complex according to NASA.
The European Sapce Agency stated that the current health condition of Schlegel is “not life or mission threatening in any way, but that could affect his efficiency during a spacewalk.”
It is possible that Schlegel will rejoin Rex Walheim for a second spacewalk. NASA has not given any further information though on the matter.
American and European astronauts inaugurated the Columbus science laboratory, the newest addition to the International Space Station and Europe’s largest contribution. The 14-ton module, which cost about $2 billion, was delivered last weekend and installed Monday during a spacewalk. It will expand the range of zero-gravity experiments aboard the station. NASA also said a section of thermal blanket that pulled free during the shuttle’s climb to orbit last week did not need repair and would adequately protect the shuttle during re-entry next week.
Yahoo on Tuesday introduced a new service called oneConnect, which will combine e-mail, instant messaging, text messaging, and social networking in one mobile platform.
The company plans to roll out oneConnect as part of Yahoo Go 3.0 -- an all-in-one mobile offering -- and Yahoo's new mobile home page in the second quarter of this year. In the meantime, Yahoo is showcasing oneConnect at the Mobile World Congress conference in Barcelona this week.
One of the more impressive features of oneConnect is a socially-connected address book, which will allow users to transfer activities from social networks, professional networks, and communities to their address book. For example, users will be able to stay on top of when a contact updates their status or uploads a photo to their profile.
Yahoo will also offer integrated mobile messaging. That means any messaging service provider will be able to use Yahoo's application program interfaces to integrate with oneConnect's messaging feature, according to the company. Yahoo said it will use an open communications platform to give users the freedom to send e-mail, instant messages, text messages, and access social networks through a single application.
Users may potentially be able to access both their personal and work messaging services. Yahoo also said it's in discussions with DataViz, which specializes in mobile access to Microsoft Exchange e-mail accounts and Microsoft Office documents. The two would team up to develop widget versions of DataViz's RoadSynch and Documents To Go applications.
Other features in oneConnect include the ability to set up messaging shortcuts to get in touch with people more quickly; a social contact card for collecting relevant information about contacts; and a location-sensing capability for locating, chatting, and exchanging information with nearby oneConnect users.
Yahoo expects oneConnect to support hundreds of mobile devices and mobile browsers worldwide.
