Distracted by Their Smartphones, Pedestrians Are Landing in the ER

 Talking and texting on your smartphone is a big no-no for drivers, but new research suggests the same should be true for pedestrians.

According to one database, more than 2,500 men and women went to an emergency room for head and neck injuries sustained while using a smartphone between 1998 and 2017. When that number is extrapolated to include the whole country, the total is likely to be more than 76,000 people.

“As an emergency physician, I have personally taken care of patients that have walked into traffic, fallen in holes and other dangerous situations while on a phone,” said Dr. Teresa Murray Amato, chair of emergency medicine at Long Island Jewish, in Forest Hills, N.Y.

The dangers of smartphone distraction are heightened by not paying attention to the environment and situation you’re in, said Amato, who had no role in the study.

The researchers make the same point.

“People are not paying attention and getting head and neck injuries because they’re walking with a cellphone, and fall and break their nose or jaw,” said lead researcher Dr. Boris Paskhover, from the department of otolaryngology–head and neck surgery at Rutgers New Jersey Medical School, in Newark.

When people are walking, they’re looking at their phone and not their surroundings. “If you’re not paying attention to where you’re walking and what you are doing, you can get injured,” he said.

Amato agreed that people who are texting or looking at their phones while doing other tasks, such as walking, are at a higher risk of head and neck injuries.

“These injuries are more likely to be caused by tripping, falling or walking into an object,” she said.

Injuries caused by distraction due to cellphones can be quite serious and cause permanent damage, Amato noted.

This study only looked at head and neck injuries from one database, but Paskhover said that injuries to arms, legs and other body parts — and even deaths — have occurred while walking and being distracted by a cellphone.

Most people understand the dangers of texting and driving, Amato said, but the risk of serious head injuries associated with walking while using a cellphone may be underrated.

The most common injuries were to the head (33%), face, including eyelid, eye area and nose (33%), and neck (13%), the researchers found.

Cuts and scrapes were the most common complaint, but about 18% of patients suffered internal organ injury.

Most of those injured were between ages 13 and 29 (60%). For those under 13, most injuries were caused by the cellphone itself (82%), such as a phone battery exploding.

Among people aged 50 to 64, however, most injuries were from using a cellphone while walking (68%). For those over 65, using a cellphone while walking accounted for more than 90% of the injuries, the researchers said.

The only way to prevent these injuries is to not keep your nose glued to your phone or your ears blocked by headphones, but to pay attention to the world around you, Paskhover said.

The report was published online Dec. 5 in JAMA Otolaryngology–Head and Neck Surgery.

SOURCES: Boris Paskhover, M.D., department of otolaryngology–head and neck surgery, Rutgers New Jersey Medical School, Newark, N.J.; Teresa Murray Amato, M.D., chair, emergency medicine, Long Island Jewish, Forest Hills, N.Y.; Dec. 5, 2019, JAMA Otolaryngology–Head and Neck Surgery, online

https://consumer.healthday.com/health-technology-information-18/cellphone-health-news-729/distracted-by-their-smartphones-pedestrians-are-landing-in-the-er-752779.html

November was healthcare’s second strongest hiring month of 2019

The federal government’s November jobs report highlights healthcare industry’s resiliency, with monthly job growth the second highest it’s been all year.

Healthcare industry added an impressive 45,200 jobs in November, according to preliminary estimates from the U.S. Bureau of Labor Statistics. That’s up significantly from an unusually weak October in which the industry made just 11,900 new hires, a number the BLS revised downward from its original estimate. It’s also the highest healthcare hiring since March, when the industry added 49,900 jobs.

While strong, one weak spot in last month’s healthcare hiring was skilled-nursing facilities, which shed 1,700 jobs. That’s a steeper drop than in October, in which the already weak sector shed 1,300 jobs. Skilled-nursing hiring was likely impacted in both months by a new CMS payment model that has prompted layoffs in the skilled nursing sector.

The ambulatory sector comprised three-quarters of healthcare’s new hires last month, which is typical. Within that, physicians’ offices added 16,100 jobs, a noteworthy improvement after having shed 700 jobs in October. Dentists’ offices saw a rebound, too, adding 6,400 jobs after losing 3,600 in October. Home health grew by 8,500 jobs, compared with 4,200 last month. Outpatient care centers added 1,700 jobs, down from 3,400 in October.

The only ambulatory sector that lost jobs last month was in the offices of other health practitioners, which shed 2,400 jobs. Hospitals added 9,900 jobs in October, which is closer to the norm for the sector. Hospitals added just 2,100 jobs in October, which was abnormally low.

Residential mental health facilities added 1,200 jobs in November, and community care facilities for the elderly added 1,400 jobs. Medical and diagnostic laboratories added 2,100 jobs, down from 3,000 in October.

The healthcare sector has added 414,000 jobs over the past 12 months, according to the BLS.

Across all industries, manufacturing had the strongest November, having added 54,000 jobs. That marked a strong rebound after losing 43,000 in October. The BLS noted that the shift reflected the return of workers who were on strike in October. More than 76% of manufacturing’s new hires were in motor vehicle parts. Leisure and hospitality also had a strong November, having added 45,000 jobs during the month. Professional and technical services added 30,600 jobs.

The overall unemployment rate ticked down to 3.5% in November compared with 3.6% in October. Total nonfarm payroll employment rose by 266,000 jobs, far exceeding analysts’ expectations and up significantly from an estimated 128,000 in October.

The BLS noted that job growth has averaged 180,000 per month in 2019, compared with an average monthly gain of 223,000 in 2018.

https://www.modernhealthcare.com/providers/november-was-healthcares-second-strongest-hiring-month-2019

MedPAC thinks hospice payments are too high

The Medicare Payment Advisory Commission is expected to vote against a pay increase for hospice in January.

Medicare hospice payments are probably too high, MedPAC’s staff said at a meeting on Friday. Their research found that access to care is trending upward, while quality seems to have improved slightly. Hospices also have steady access to capital and robust Medicare margins—12.6% overall—so there’s little reason to worry that beneficiaries’ access to care would be hurt by financial problems anytime soon.

“The hospice rates may be higher than needed to ensure appropriate access to care,” said Karen Neuman, a principal policy analyst for MedPAC.

The commission will likely recommend to Congress that they shouldn’t increase the conversion factor, or base payment amount, for hospices. Most MedPAC members also favor reducing the hospice aggregate cap by 20% and instituting a wage adjustment for 2021.

Their proposed recommendation was met with opposition from hospice providers.

“(The National Hospice and Palliative Care Organization) does not support today’s MedPAC recommendation to modify the hospice aggregate cap,” said Edo Banach, president and CEO of NHPCO. “NHPCO shares MedPAC’s goals, but this approach appears overly broad and likely to lead to a decrease in hospice access for patients and families. In the short term, we urge MedPAC to use a targeted approach that will have a higher likelihood of rewarding high quality, punishing low quality, and increasing access.”

Lowering the aggregate cap and wage adjustment would help level the playing field for hospice providers, generate cost savings and target the most profitable hospices with payment cuts.

These changes wouldn’t affect most providers because the hospices with the highest margins are mainly free-standing and for-profit providers. Those providers are disproportionately costly because their average lengths of stay are much higher.

“Hospice margins increase with the length of stay,” said Neuman.

Not-for-profit hospices have an average length of stay of 68 days, while for-profit hospices have an average length of stay of 110 days. Likewise, free-standing hospices have an average length of stay of 92 days compared to just 70 and 57 days for home health- and hospital-based hospices, respectively.

“For the same diagnosis, there tends to be a longer length of stay for the for-profits,” said Dr. Jaewon Ryu, president and CEO of Geisinger. “They also tend to enroll folks who (are more likely) to have a longer length of stay.”

For-profit hospices have different patient mixes than other hospices, but it’s not clear whether that’s driven by the types of referrals they receive—or solicit—or if they’re choosing to admit patients that are more likely to stay longer, he said.

Some commission members also wanted to know more about high live-discharge rates among hospices that have exceeded the annual cap on hospice payments—hospices that go over the cap must repay Medicare for the overages.

Most live discharges result from patients opting out of hospice or because they’re no longer terminally ill, according to MedPAC’s research. But there are questions about what’s driving patients to leave hospice care.

“Is the beneficiary choosing not to enroll? Is the beneficiary being encouraged to leave hospice?” said Neuman.

Some larger hospice organizations track how close they are to the aggregate cap and their average length of stay, said James Mathews, executive director of MedPAC. They even adjust their business practices to make sure they don’t exceed the limits.

“They are able to change their referral sources . . . if they start to see they’re having cap issues,” said Mathews. “They might seek referrals from hospitals who are more likely to have shorter lengths of stay.”

Several MedPAC members lamented that Medicare’s hospice benefit hadn’t changed much since it was created for cancer patients in the early 1980’s, even though the needs of Medicare beneficiaries and medical practice have transformed.

It’s time to rethink the design of the benefit in light of the “changing demography of end-stage disease, and an aging and increasingly disease-burdened society,” said Dr. Jonathan Perlin, president of clinical services and chief medical officer of HCA Healthcare.

https://www.modernhealthcare.com/hospice/medpac-thinks-hospice-payments-are-too-high

Short-term radon test kits not effective in measuring radon gas exposure

As awareness increases about the health danger of radon gas, more people are making the decision to test their homes for the deadly gas. A University of Calgary led study finds the only reliable way to measure exposure to radon gas is with a long-term testing kit, which takes readings within the home for 90 or more days.

“Radon gas levels can fluctuate wildly day to day,” says Dr. Aaron Goodarzi, PhD, assistant professor in the departments of Biochemistry & Molecular Biology and Oncology and member of the Arnie Charbonneau Cancer Institute at the Cumming School of Medicine (CSM). “Short term tests can give a false sense of alarm, or worse, a false sense of security as they cannot precisely predict long term exposure.”

Researchers placed two test kits, a short term (five-day) and long term (90-day) in the same homes. Tests were conducted during summer and winter months. Findings showed the short-term kits were imprecise up to 99 percent of the time when compared to a long term test.

Radon is a known carcinogen. Health Canada lists radon as the number one cause of lung cancer in non-smokers. The gas is naturally occurring, colourless, and odorless. It can accumulate to unnaturally high and dangerous levels in homes. Health Canada has promoted the use of long-term testing kits for some time.

“Our recommendation was based on research from international authorities including the US and Europe,” says Kelley Bush, manager, radon education and awareness Health Canada. “This research is critical because it provides Canadian data that confirms the value of long term testing.”

Goodarzi has also been working with the Real Estate Council of Alberta (RECA) to educate realtors against using short term radon kits for real estate transactions.

“RECA is appreciative of the assistance provided by Dr. Goodarzi in the development of education enabling real estate professionals to advise buyers and sellers to take radon into consideration during the purchase and sale of a home, in the absence of reliable short-term testing,” says Joseph Fernandez, director of education programs at RECA. “All real estate professionals have completed radon related education and new professionals will be required to complete it before entering the real estate profession.”

The findings also show the Prairies are home to the second highest radon exposed population on Earth. The pan-Canadian scientist and physician led Evict Radon research initiative is now recruiting participation from all Canadians.

The research is aimed at gathering as much data as possible to understand and ultimately defeat Canadian’s exposure to radon problem.

“We need to know exactly what factors influence high and low radon in Canadian homes. It’s not just in the Prairies, we know of high concentrations in areas throughout the country,” says Goodarzi. “This is easily one of the most preventable forms of environmentally-caused cancer. We have already learned so much from the work we’ve done in Alberta and Saskatchewan to test for and mitigate radon. We plan to build on that.”

In addition to the data gathered on short-term testing kits, Goodarzi’s team was also able to get a better understanding of how the size, design and age of home are related to radon gas exposure.

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Story Source:

Materials provided by University of Calgary. Original written by Kelly Johnston. Note: Content may be edited for style and length.

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Journal Reference:

1. Fintan K. T. Stanley, Jesse L. Irvine, Weston R. Jacques, Shilpa R. Salgia, Daniel G. Innes, Brandy D. Winquist, David Torr, Darren R. Brenner, Aaron A. Goodarzi. Radon exposure is rising steadily within the modern North American residential environment, and is increasingly uniform across seasons. Scientific Reports, 2019; 9 (1) DOI: 10.1038/s41598-019-54891-8

https://www.sciencedaily.com/releases/2019/12/191204124605.htm

BPA levels in humans dramatically underestimated

Researchers have developed a more accurate method of measuring bispehnol A (BPA) levels in humans and found that exposure to the endocrine-disrupting chemical is far higher than previously assumed.

The study, published in the journal The Lancet Diabetes & Endocrinology on Dec. 5, provides the first evidence that the measurements relied upon by regulatory agencies, including the U.S. Food and Drug Administration, are flawed, underestimating exposure levels by as much as 44 times.

“This study raises serious concerns about whether we’ve been careful enough about the safety of this chemical,” said Patricia Hunt, Washington State University professor and corresponding author on the paper. “What it comes down to is that the conclusions federal agencies have come to about how to regulate BPA may have been based on inaccurate measurements.”

BPA can be found in a wide range of plastics, including food and drink containers, and animal studies have shown that it can interfere with the body’s hormones. In particular, fetal exposure to BPA has been linked to problems with growth, metabolism, behavior, fertility and even greater cancer risk.

Despite this experimental evidence, the FDA has evaluated data from studies measuring BPA in human urine and determined that human exposure to the chemical is at very low, and therefore, safe levels. This paper challenges that assumption and raises questions about other chemicals, including BPA replacements, that are also assessed using indirect methods.

Hunt’s colleague, Roy Gerona, assistant professor at University of California, San Francisco, developed a direct way of measuring BPA that more accurately accounts for BPA metabolites, the compounds that are created as the chemical passes through the human body.

Previously, most studies had to rely on an indirect process to measure BPA metabolites, using an enzyme solution made from a snail to transform the metabolites back into whole BPA, which could then be measured.

Gerona’s new method is able to directly measure the BPA metabolites themselves without using the enzyme solution.

In this study, a research team comprised of Gerona, Hunt and Fredrick vom Saal of University of Missouri compared the two methods, first with synthetic urine spiked with BPA and then with 39 human samples. They found much higher levels of BPA using the direct method, as much as 44 times the mean reported by the National Health and Nutrition Examination Survey (NHANES). The disparity between the two methods increased with more BPA exposure: the greater the exposure the more the previous method missed.

Gerona, the first author on the paper, said more replication is needed.

“I hope this study will bring attention to the methodology used to measure BPA, and that other experts and labs will take a closer look at and assess independently what is happening,” he said.

The research team is conducting further experiments into BPA measurement as well as other chemicals that may also have been measured in this manner, a category that includes environmental phenols such as parabens, benzophenone, triclosan found in some cosmetics and soaps, and phthalates found in many consumer products including toys, food packaging and personal care products.

“BPA is still being measured indirectly through NHANES, and it’s not the only endocrine-disrupting chemical being measured this way,” Gerona said. “Our hypothesis now is that if this is true for BPA, it could be true for all the other chemicals that are measured indirectly.”

This study was supported by grants from the National Institutes of Health.

make a difference: sponsored opportunity

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Story Source:

Materials provided by Washington State University. Original written by Sara Zaske. Note: Content may be edited for style and length.

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Journal Reference:

1. Roy Gerona, Frederick S vom Saal, Patricia A Hunt. BPA: have flawed analytical techniques compromised risk assessments? The Lancet Diabetes & Endocrinology, 2019; DOI: 10.1016/S2213-8587(19)30381-X

https://www.sciencedaily.com/releases/2019/12/191205183417.htm

BeiGene agrees to allow Amgen to accumulate additional shares

Citing an increase in the number of outstanding shares due to option exercises and vesting of restricted share units, BeiGene (NASDAQ:BGNE) and cancer collaboration partner Amgen (NASDAQ:AMGN) have agreed to increase the number of shares allowable to the latter in order for it to maintain its 20.5% stake.

https://seekingalpha.com/news/3524559-beigene-agrees-to-allow-amgen-to-accumulate-additional-shares

J&J CAR T nabs accelerated review status in U.S. for multiple myeloma

The FDA designates Johnson & Johnson (NYSE:JNJ) unit Janssen Pharmaceuticals’ CAR T candidate JNJ-682284528 (JNJ-4528) a Breakthrough Therapy for the treatment of relapsed/refractory multiple myeloma.

Breakthrough Therapy status provides for more intensive guidance from the FDA on development, the involvement of more senior agency personnel and a rolling review of the marketing application.

https://seekingalpha.com/news/3524575-j-and-j-car-t-nabs-accelerated-review-status-in-u-s-for-multiple-myeloma