CDC Recommends Ladder Safety App: That Beats Apple’s 5 Star Rating

The CDC is recommending apps to help workers identify ladder selection, positioning, accessorizing, and safe use. The data seems clear

Falls are a persistent hazard found in all occupational settings. A fall can occur during the simple acts of walking or climbing a ladder to change a light fixture or as a result of a complex series of events affecting an ironworker 80 feet above the ground. According to the 2009 data from the Bureau of Labor Statistics, 605 workers were killed and an estimated 212,760 workers were seriously injured by falls to the same or lower level.

I wonder if the app maker is sending users notifications to rate this app? You know rate this app now.

Notes & Links: October 11, 2013

The court intervenes to save a child with cancer, and Make Adams lose his mind over it
Science Blogs Respectful Insolence examine the of an Ohio Court ruling that the hospital could not force a 10 year old Amish girl against the wishes of her parents to receive chemotherapy. This was later over turned by an Appellate Court. 

This is a longish article and an in-depth analysis of the case, the history, and the response of a one Mike Adams whose argument revolves around quotes like this…

The chemotherapy agents used today are, in fact, derived from the research of Nazi scientists and the chemical conglomerate known as IG Farben, which was later broken up into multiple companies, including Bayer, the modern-day pharma company. For example, the chemo drug thalidomide is actually an off-shoot of Nazi chemical weapons research.
Based on my research into all this, it is my opinion that the Akron Children’s Hospital is engaged in heinous crimes against children

WTF? If you need to get the blood pressure up read this. Or better yet if you want to see how the ignorant can use the internet to drive a message the kills jump to the link above. 

Getting estimated for insurance costs int he exchange, Indiana edition
Arron Carroll at The Incidental Economist looks at window shopping for health insurance in Indiana. I know I know yet another ACA ObamaCare post screaming from their individual position pulpit. Not so fast this is good stuff. Here is the money shot. 

Silver plans for an individual range from $278 to $301 a month (before subsidies). This is far less than what the state released a while ago. For a family like mine, silver plans range from $938 to $1018 a month (before subsidies). What’s more, even the gold plans range from only $1175 to $1329 a month.

Since we know that the average employer sponsored health insurance plan for a family in the US is $16,351, that means the most expensive gold plan on the exchange, at $15,948, is cheaper. Let me say that again: The most expensive plan I could find for a family line mine on the Indiana Health Insurance Exchange is less expensive than the average employer sponsored health insurance plan in the US.

How to cope with an aging population
The Lancet reviews data from Global AgeWatch Index 2013 with recommendations on what this means for the world. Some of their more interesting points are:

  • High-income countries did the best Sweden, Norway for all domains income security, health status, employment, education and an enabling environment. 
  • South Korea was 67th overall though ranked at 8th for health but crap income security
  • Interestingly life expectancy increased by 4.7 years for men and 5.2 years for women from 1991 to 2009. But healthy life expectancy stayed the same overall. So we may live longer but suffer more and cost more. 
  • Elderly patients are excluded from clinical trials
  • Consider the steep upward curve of older population in India, Indonesia, Mexico, and Russia. That population will double in the next 40 years. 

Better data are needed to gauge success (in terms of wellbeing) of interventions to address the long-term needs of an ageing population, and track progress on morbidity compression. Although a promising start, The Global AgeWatch Index was only able to provide rankings for 91 countries, including just seven from Africa. By 2050, more than 20% of the global population will be older than 60 years and 80% will live in low-income and middle-income countries. Success in other medical specialties means that the world’s population is getting old. To allow it to do so gracefully will require early investment and cooperation between health and social care.

CDC MMWR announcement in the face of the lapse in government funding.

Yet another victim of ass clown politicians. 

Academic Medical Centers and the The Coming Physician Shortage
David Kroll a contributor to Forbes is attending the Forbes Healthcare Summit: Empowering thePatient Revolution. The gist of Kroll’s article is large academic medical centers are in congestive areas, no parking, long drives, and dependent on Medicare. Great quote

I’d add that once they do find parking, patients are also frustrated by trying to navigate the complex array of buildings that have metastasized willy-nilly over the history of the institution. What academic medical centers must do, Rothman said, is go to the patient and pay more attention to customer convenience.

struggle with the idea of nice waiting area’s featuring WiFi and Miles van de Rohe designed furniture will not drive outcomes. Though I am in full support of the need to solve problems patients are seeking to solve as in convenience etc. So when Kroll says the following I would agree. It is about market expansion not market gloss

In my home, Durham, North Carolina, Duke University Medical Center has been aggressively opening primary care centers around the area. My walk-in urgent care clinic is barely a mile from my home, has plentiful, free parking, and I’ve never waited more than 30 minutes to see a healthcare provider. That’s the kind of thing that urban medical centers will need to do to remain sustainable.


Tobacco Data Stars Are Aligned: Trending, Spending, Using, and Reality

Our neatly tied digital world allows for connections that create new insights, quickly. At another point in time readily seeing connections may not have happened. We as a nation have become less mass market centric and more Facebook likes and friends, our Twitter Stream and followers, and blog readers. Within this silo of small community connections are where sometimes bigger pictures can be drawn. Insights made. And to use a common definition of insights we make ‘discontinuous discoveries’. 

Just to be real, this is no eureka moment in the tub. This is just connecting the dots on a large digital canvas while looking at small places. 

Two weeks ago I posted a link to a paper published in Journal of Medical Internet Research (JMIR) “Using Twitter to Examine Smoking Behavior and Perceptions of Emerging Tobacco Products“. 

The paper uses Twitter to look deep inside the person and their motivations, reaction, and driving forces. The authors identified new tobacco trends and discussions while keeping in sight the positive and negative sentiments regarding tobacco. The authors identified the highest correlates of positive sentiment, the hookah and e-cigarettes. 

A day later Stuart Elliott Media & Advertising column in the NY Times published this “E-Cigareets Makers’ Ads Echo Tobacco’s Heyday“. The article pointed out e-cigarette companies are spending more dollars on television commercials and sales in this category will reach $1.7 billion buy the end of 2013. Elliott points out they are spending on promotions, events, sample giveaways, and print ads like the olden times. How can one forget the glamorous and vaccine hater Jenny McCarthy. She is a spokesperson for e-cigareets. You should now think those ads for Chesterfield using Ronald Regan. The worry is we’re returning to a time when cigarette were glamorous. 

MMWR in the Weekly on September 6 had the following data: Notes from the Field: Electronic Cigarette Use Among Middle and High School Students US 2011-2012. CDC offers this data:

During 2011–2012, among all students in grades 6–12, ever e-cigarette use increased from 3.3% to 6.8% (p<0.05) (Figure); current e-cigarette use increased from 1.1% to 2.1% (p<0.05), and current use of both e-cigarettes and conventional cigarettes increased from 0.8% to 1.6% (p<0.05). In 2012, among ever e-cigarette users, 9.3% reported never smoking conventional cigarettes; among current e-cigarette users, 76.3% reported current conventional cigarette smoking.

Among middle school students, ever e-cigarette use increased from 1.4% to 2.7% during 2011–2012 (p<0.05) (Figure); current e-cigarette use increased from 0.6% to 1.1% (p<0.05), and current use of both e-cigarettes and conventional cigarettes increased from 0.3% to 0.7% (p<0.05). In 2012, among middle school ever e-cigarette users, 20.3% reported never smoking conventional cigarettes; among middle school current e-cigarette users, 61.1% reported current conventional cigarette smoking.

Among high school students, ever e-cigarette use increased from 4.7% to 10.0% during 2011–2012 (p<0.05); current e-cigarette use increased from 1.5% to 2.8% (p<0.05), and current use of both e-cigarettes and conventional cigarettes increased from 1.2% to 2.2% (p<0.05). In 2012, among high school ever e-cigarette users, 7.2% reported never smoking conventional cigarettes; among high school current e-cigarette users, 80.5% reported current conventional cigarette smoking.

Randye Hoder writing on the Motherlode column in the NY Times “E-Cigarette Marketers Have an Eye on Teens” presents us with some boots on the ground observations. 

I was standing outside our neighborhood ice cream shop one recent evening when I noticed a plume of smoke rise above a gaggle of teenagers waiting in line ahead of me.

“Wow,” I thought, “that takes some serious chutzpah.” These kids were smoking in public without the fear of getting caught.

A few minutes later, I realized that it wasn’t actually smoke coming out of their mouths; it was vapor, being inhaled and exhaled from battery-operated electronic cigarettes

There we have it. Researchers using Twitter see trends in tobacco use using not only Twitter but linguistics, e-cigarette manufactures are spending large sums of money promoting their brands, CDC has data showing the growth of e-cigarette use among teens growing, and finally a mom sees it on the street. How long till the clinical trials show a link between e-cigarettes and disease? 

It could not be clearer the links between spending, use, trending and reality. Ten or fifteen years ago we may have had a study published by the CDC showing the growth of teen smoking and perhaps if we dug deeper we could find how much marketing dollars were spent. And we may have mothers complaining about the corner store selling cigarettes to teens. But we have within a matter of two weeks. Data/knowledge dropped in our digital laps neatly tied in a bow. The data shows trending, spending, using, and reality. 

This is not about tobacco killing us but about small discreet data points that give us something resembling big data and a way to speak to this growing demographic that we have never had before. The question becomes one of what do we do with this, how will we turn this around, and who will do it?