Michael.Massing + cost   113

Adherence to Continuous Positive Airway Pressure Therapy (ATS Journals)
Claustrophobia
Although, in general, side effects have not consistently deterred use of CPAP, there have been reports that the sensation of claustrophobia may interfere with use (2, 11). In a prospective study, participants who used CPAP for more than 5 hours per night had a significant decrease in claustrophobic tendencies compared with those using it for shorter periods. Those using CPAP for fewer than 2 hours per night had the greatest variability in CPAP use and a higher level of self-reported claustrophobia on a measure of claustrophobic tendencies. A score greater than 25 on the modified Fear and Avoidance Scale predicted that the patient was twice as likely to use CPAP for fewer than 2 hours per night.
OSA  obstructive  sleep  apnea  CPAP  continuous  positive  airway  pressure  cost  benefit  healthcare  adherence  claustrophobia  initiation  adoption  embrace 
july 2016 by Michael.Massing
OSA as a Progressive Disorder - Dental Sleep Corner
The increased frequency of apneas further exacerbates the patient’s condition by promoting obesity, a key anatomical cause of OSA. In his 2011 book, The Sleep Doctor’s Diet Plan: Lose Weight Through Better Sleep, Breus outlines the connection between sleep deprivation and weight gain in four steps:

As patients become more sleep-deprived, their metabolic rate begins to fall.
Increased wakefulness leads to elevated levels of cortisol, the so-called “fight or flight” hormone.
This leads to increased levels of ghrelin, the hormone that tells us to eat, and a decrease in leptin, the hormone that tells us we’re full.
Patients begin to crave high-fat, high-carbohydrate foods, which elevates their serotonin levels.
Along the way, Breus adds, patients become more likely to develop atrial fibrillation, a common form of arrhythmia, and refractory hypertension, a type of hypertension that does not respond well to medication.
comorbidities  risk  progression  obesity  cortisol  ghrelin  endocrine  OSA  obstructive  sleep  apnea  CPAP  continuous  positive  airway  pressure  cost  benefit  healthcare  adherence 
july 2016 by Michael.Massing
CPAP Compliance—Fact and Fiction - Sleep Review
After a CPAP trial,48 70% to 80% of patients accept CPAP and 5% to 37% of those will eventually abandon CPAP. Lack of benefit was the main reason for abandoning CPAP in 25% of patients.66 Other reasons included anxiety, inconvenience, noise, difficulty falling asleep, mask discomfort, frequent nocturnal awakenings, and partner complaints.40 Price was a problem in 28% of patients and 10% stopped using CPAP mostly because of financial problems.63,67 Side effects were reported equally in both compliant and noncompliant patients. It seems that tolerance of these side effects is lower in patients with mild OSA (AHI <15).17

Compliance with CPAP usage with regard to patients with OSA may not be lower than in other diseases. It is known that compliance with inhalers in bronchial asthma and medication in hypertension is less than 50%.68,69 In a study70 of patients prescribed long-term supplemental oxygen of more than 15 hours per day, the compliance rate was only 45%. Epileptic patients were compliant with their medication only 39% of the time71 and similar results were noted with other chronic diseases.

A presumed CPAP compliance of well over 50%, at least in Europe, seems better than compliance for most chronic diseases.47 An important point is that it is much more convenient to take a tablet or use an inhaler than to use CPAP all night every night. To have to use CPAP “appears to be a life sentence to a bulky, unsightly, external appendage, rather like a colostomy bag—it may be necessary but it certainly isn’t romantic.”72 Nevertheless, while CPAP compliance can be improved, it may not be “low” after all.
OSA  obstructive  sleep  apnea  CPAP  continuous  positive  airway  pressure  cost  benefit  healthcare  adherence  flexible  bilevel  auto-CPAP  APAP 
july 2016 by Michael.Massing
CPAP Compliance, What is this stuff? - Sound Oxygen Service
There have been several studies showing that the medical costs of a patient with OSA drop by about 50% if they are compliant with their CPAP machine....

We will work with you to get you through your compliance period and beyond. As a matter of fact Sound Oxygen Service has a compliance rate of over 90%. The industry status quo has shown to have a compliance rate of as little as 40% in some places.

We go the extra mile so you don’t have to

Getting you compliant is what we do. Whether we have to set you up at your home, fit you with a new mask, come and show you how to fit your mask, or come and re-teach how the machine works; we will help you become compliant and get the most out of your CPAP therapy.
OSA  obstructive  sleep  apnea  CPAP  continuous  positive  airway  pressure  cost  benefit  healthcare  adherence  service  value-added 
july 2016 by Michael.Massing
Empagliflozin Slows Progression of Renal Disease in Diabetes
Dr Wanner noted, however, that the EMPA-REG trial lasted only 3 years, "so we are certainly looking to the future for more on this."

And both he and discussant of the findings at ADA, endocrinologist and epidemiologist, William Herman, MD, MPH, of the University of Michigan, Ann Arbor, stressed that the results are applicable only "to the population studied in the EMPA-REG trial" (ie, older patients with type 2 diabetes at high cardiovascular risk).

Currently, about a third of the population of type 2 diabetes fall into that category, Dr Herman said....

But Dr Herman pointed out in his talk that "the absolute differences are relatively small" in EMPA-REG and the number needed to treat with empagliflozin to achieve the renal benefits was 200.

In addition, it's possible that the findings "had to do with medications not administered," he said. "So it may not be a benefit of empagliflozin but the fact that those in the empagliflozin group did not receive medications causing harm [as patients in the trial were also allowed certain other standard therapies for diabetes]."

Overall, as well as the demonstrated renal effects, empagliflozin is "moderately effective" at lowering HbA1c and results in a 2- to 3-kg reduction in body weight, with no issue with hypoglycemia, although it does increase the risk of genitourinary infections, Dr Herman surmised....

"The range of cost between a generic established evidence-based oral therapy like metformin, the sulfonylureas, and now pioglitazone and the new agents is 100-fold. That is a big increase for, in some cases, a modest theoretical or practical advantage. So it's a problem for physicians and patients in the US."
kidney  renal  disease  drug  effects  benefit  clinical  trial  peer-reviewed  research  in  vivo  human  NNT  risk  cost  pharma  caveat 
july 2016 by Michael.Massing
D-is-for-Diabetes: Medicare's Competitive Bidding Program Puts Beneficiaries' Lives at Risk
The Forum built upon the GAO's analysis by examining access to diabetes testing supplies for Medicare beneficiaries living with diabetes and requiring insulin therapy.  Working with some of the nation's leading endocrinologists,* the Forum's study found that the Competitive Bidding Program disrupted beneficiaries' ability to access diabetes testing supplies, and this disruption was associated with an increase in mortality, higher hospitalization rates and inpatient costs.

"Self-monitoring blood glucose supplies are a critical component of diabetes care among insulin-treated individuals and the value of safe, effective testing supplies cannot be underestimated," said Jaime Davidson, M.D., clinical professor of Medicine at the University of Texas Southwestern Medical Center, and an author of the study. "We are particularly concerned about the disruption we detected in our analysis given the predominant use of rapid- and short-acting insulin by Medicare beneficiaries, who are at significantly greater risk for hypoglycemia than younger individuals with insulin-treated diabetes."

"We are troubled that CMS failed to detect these 'unintended' consequences and, instead, reported that the program was a success," said Gary A. Puckrein, Ph.D., president and CEO of the National Minority Quality Forum and a study author. "Based on our findings and employing the safety monitoring protocols commonly used to protect human subjects, we believe policymakers should immediately suspend the program until CMS can demonstrate its ability to effectively monitor the effects of the program, correct the structural flaws causing this problem and ensure that the lives of America's greatest generation are no longer at risk." 

The ahead of print article "Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis" can be found online: Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis . The full article will also be published here: http://dx.doi.org/10.2337/dc15-1264.
watchdog  diabetes  insulin-dependent  SMBG  supplies  cost  benefit  mortality  hospitalization  competitive  bidding  Medicare  in  vivo  situ  human  peer-reviewed  research  health  disparities  healthcare 
may 2016 by Michael.Massing
Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis | Diabetes Care
RESEARCH DESIGN AND METHODS The study population consisted of insulin users: 43,939 beneficiaries in the nine test markets (TEST) and 485,688 beneficiaries in the nontest markets (NONTEST). TEST and NONTEST were subdivided: those with full self-monitoring of blood glucose (SMBG) supply acquisition (full SMBG) according to prescription and those with partial/no acquisition (partial/no SMBG). Propensity score–matched analysis was performed to reduce selection bias. Outcomes were impact of partial/no SMBG acquisition on mortality, inpatient admissions, and inpatient costs.

RESULTS Survival was negatively associated with partial/no SMBG acquisition in both cohorts (P < 0.0001). Coterminous with CBP (2010–2011), there was a 23.0% (P < 0.0001) increase in partial/no SMBG acquisition in TEST vs. 1.7% (P = 0.0002) in NONTEST. Propensity score–matched analysis showed beneficiary migration from full to partial/no SMBG acquisition in 2011 (1,163 TEST vs. 605 NONTEST) was associated with more deaths within the TEST cohort (102 vs. 60), with higher inpatient hospital admissions and associated costs.

CONCLUSIONS SMBG supply acquisition was disrupted in the TEST population, leading to increased migration to partial/no SMBG acquisition with associated increases in mortality, inpatient admissions, and costs. Based on our findings, more effective monitoring protocols are needed to protect beneficiary safety.

Received June 12, 2015.
Accepted January 9, 2016.
© 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis
Gary A. Puckrein, Gail Nunlee-Bland, Farhad Zangeneh, Jaime A. Davidson, Robert A. Vigersky, Liou Xu, Christopher G. Parkin, David G. Marrero
Diabetes Care 2016 Mar; http://dx.doi.org/10.2337/dc15-1264
diabetes  insulin-dependent  SMBG  supplies  cost  benefit  mortality  hospitalization  competitive  bidding  Medicare  in  vivo  situ  human  peer-reviewed  research 
may 2016 by Michael.Massing
Best Low-Cost Phone Plans - Consumer Reports
How much service do you need?
1. First see whether a 500MB to 1GB data plan is enough for you. It will be for many consumers, especially if you confine your cellular-data activities mostly to browsing the Web, using news and e-book apps, and sending and reciving e-mails without large attachments. Save video calls, media streaming, and big-file uploads for when you have Wi-Fi access.

2. If you stream a fair amount of music and video on the road, such as during your commute to work or on business trips, you'll probably need 2GB to 3GB per month.

3. If your eyes are permanently glued to Netflix, YouTube, and other other data-draining activities, you might want to consider a high-limit or unlimited data plan.—M.G.
mobile  phone  plans  cost  comparison  major  carriers  data 
october 2015 by Michael.Massing
HOPE NOW - Support and Guidance for Homeowners
Note IP restrictions. Need for permission would depend on sources, use.
modification  mortgage  trends  statistics  foreclosure  cost  accounting  industry  data 
january 2015 by Michael.Massing
HAMP Mortgage Bailout Costs, Foreclosures Could Rise Sharply | National Legal and Policy Center
[HAMP opposition reports on official oversight statistics.]

The default rate for participants in the 90-day trial phase, for example, has been close to 40 percent, a staggering figure by any yardstick. Indeed, as of March 31, 2013, about half of the more than 2 million total HAMP modifications had resulted in cancellation. Around 775,000 of these cancellations occurred during the trial phase and the remainder occurred in the permanent phase....

[In the] latest SIGTARP report, released on January 29[:] Of the nearly 2.1 million total HAMP trial modifications conducted during calendar years 2009-13, around 780,000, or 37 percent, of borrowers had dropped out or were removed. Of the 1.28 million trial loans converted to permanent status as of December 31, 2013, nearly 360,000, or 28 percent, had re-defaulted. And of the more than 900,000 remaining permanent loans, 894,410 were active and 23,790 were paid off. As five-year terms expire, sizable numbers of the active borrowers also may default because of interest rates resetting at higher [historical market rates, as dictated by program terms.]
....
Payments to mortgages servicers and investors already have cost taxpayers more than $5 billion.
modification  foreclosure  cost  accounting  mortgage  HAMP  data 
january 2015 by Michael.Massing
Deleveraging the American Homeowner: The Failure of 2008 Voluntary Mortgage Contract Modifications by Alan M. White :: SSRN
Many modifications involve capitalizing unpaid interest and fees and reamortizing the loan. This occurred in 68% of loan modifications.
mortgage  modification  capitalization  interest  research  refereed  cost  foreclosure  data 
january 2015 by Michael.Massing
Identification of barriers to appropriate diet... [Diabetes Ther. 2011] - PubMed - NCBI
The survey was administered to 98 patients with a mean age of 51.98 years, a mean duration of diabetes of 9.76 years, and a mean hemoglobin A1c of 7.99%. When asked to rate factors most important in food selection, the highest mean responses were taste (3.97 out of 5) and cost (score of 3.94 out of 5). Barriers that the majority of respondents agreed or strongly agreed were important included: stress causing over-eating or unhealthy food choices, difficulty resisting the temptation to eat unhealthy food, and healthy food being too expensive. The Cronbach's Alpha for the subscales of food selection, importance of life challenges, and barrier were 0.673, 0.853, and 0.786, respectively.
CONCLUSIONS:
In a low-income, urban, predominantly African American and Caucasian diabetic population, cost of healthy food, stress-related inappropriate eating, and the temptation to eat unhealthy food were the most frequently reported barriers to healthy eating. Diabetes education programs serving similar populations should evaluate the presence of these barriers. The survey instrument was a reliable measure of the constructs it purported to measure.
diabetes  food  barriers  compliance  self  care  cost  taste  peer-reviewed  research  behavioral  behavior  attitude  treatment  factor  etiology  risk  public  health 
january 2014 by Michael.Massing
Free 20GB Pogoplug Cloud Storage for life (no file size limit) - RedFlagDeals.com Forums
...sounds like from the cnet comments that if you have an existing account you can contact Pogoplug to get it on this extra space too.
I can confirm this. Asked about increasing my storage from 10gb to 20gb, got a return email the next day and boom, 10gb extra storage in my account.
support@pogoplug.com
cloud  online  storage  web  service  pricing  cost  comparison  competitive  customer  special  offer  Pogoplug 
november 2013 by Michael.Massing
Deck Defense | Decks | House Exterior | This Old House - 2
Time and Materials
Most homeowners do the work themselves because they can save money. The materials for a 20x20-foot deck will run between $80 and $120, plus another $80 or so to rent a power washer for a day. What's more, the actual work takes just two days — one to clean the surface and another to apply the finish. But you will have to wait three to five days after cleaning for the deck to dry so the finish will penetrate fully. If you don't have the time to do it yourself, you can hire a deck-maintenance contractor. But the relative newness of this specialty means most of the pros don't have much experience. That makes checking references and visiting past jobs especially crucial. And because most pros have their favorite products, you'll probably have little say about the ones used on your deck. Expect to pay between 60 cents and $1 per square foot for materials and labor — up to $400 for a 20x20-foot deck
housekeeping  deck  oil  maintenance  cost  DIY 
october 2013 by Michael.Massing
Benefits On Health Marketplace Plans Will Be Similar But Costs Will Vary - Kaiser Health News
Individuals and families with incomes up to 400 percent of the federal poverty level ($45,960 for an individual and $94,200 for a family of four in 2013) may be eligible for federal tax credits to help pay premiums.

Consumers "can use the premium subsidy to purchase any plan," says Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities.

If your income increases during the year, you may no longer qualify for the same level of assistance, but you won't have to switch plans. However, you may have to repay any overpayments that were made to insurers if your projected income turns out to be higher than your actual income. On the other hand, if your income falls, you may be eligible for a larger tax credit. That's why it's important to report any income changes to the exchange promptly.

A second type of subsidy available on the exchanges will reduce the amount that people owe in co-payments, deductibles and other out-of-pocket costs. The cost-sharing subsidy is available to individuals and families with incomes up to 250 percent of the poverty level ($28,725 for an individual and $58,875 for a family of four in 2013). To qualify for this subsidy, you must buy a silver plan, Park says. If your income changes, however, you won't be responsible for any overpayments.
cost  subsidy  sharing  Obamacare  ACA  PPACA  Affordable  Care  Act  choice  plan 
october 2013 by Michael.Massing
Study: Half who now buy health insurance to get subsidy | Hawaii Tribune Herald
The tax credits, available on a sliding scale based on family income, will be offered to people who don’t have access to affordable coverage through their jobs and buy policies through the new state markets.

Those making between 100-400 percent of the federal poverty level — between $11,500 and $46,000 for an individual and $23,550 and $94,200 for a family of four — are eligible for some level of help.

Families on the low end of the scale will pay 2 percent of their income for a benchmark plan, while those on the upper end will pay 9.5 percent.

It’s expected that a clear majority of customers in the new markets will be eligible for tax credits. That’s because the pool will also include uninsured people, who tend to have lower incomes than those who can currently afford to buy their own coverage. The share will vary from state to state.

HHS Secretary Kathleen Sebelius recently estimated that in Texas, as many as 9 in 10 people buying coverage in the new market will get a break on costs.
Obamacare  ACA  PPACA  healthcare  health  insurance  exchange  marketplace  premium  cost  estimate  subsidy  Silver  individual  private  income  threshold  criterion  from twitter
august 2013 by Michael.Massing
Do Lifestyle Changes Reduce Serious Outcomes in Diabetes? — NEJM
The participants who received intensive lifestyle modifications experienced other benefits when compared to the diabetes education and support group, including decreased depressive symptoms, less self-reported retinopathy, and decreased risk of kidney disease. Compared to the diabetes support and education group, the intensive lifestyle intervention reduced the average number of hospitalizations per year and the average number of medications per year. Hospitalizations were reduced by 11.9% from 0.193 to 0.17 hospitalizations per year, which translated into savings of $294 per year and $2,600 discounted over 10 years. Moreover, the number of medications was reduced by 6.3% from 4.9 to 4.6 medications per year, translating into a savings of $278 per year and $2,487 discounted over 10 years. Average costs per year were $8,807 for the control group vs. $8,205 for the intervention group, leading to a significant reduction of $602 per year and $5,378 discounted over 10 years. Significant reductions in hospitalizations occurred mainly among CV and pulmonary hospitalization, and significant reductions in medications occurred mainly among diabetes, lipid-lowering and antihypertensive medications. The study ultimately shows that obese or overweight people with type 2 diabetes should increase the amount that they exercise and increase their weight loss.
peer-reviewed  research  cardiovascular  risk  diabetes  obesity  human  in  vivo  physical  activity  type  2  T2D  correlation  support  treatment  self  care  education  depression  comorbidities  intensive  lifestyle  intervention  retinopathy  kidney  disease  hospitalization  morbidity  healthcare  cost  economics  harm  reduction  behavioral  change  management  behavior  tight  control  exercise  body  fat  clinical  trial  stress  distress  factor  therapy  etiology  mitigation  prevention  symptoms  late-stage  complications  benefit  situ 
june 2013 by Michael.Massing
Is There a Cure? :: Diabetes Self-Management
Unfortunately, the research looking for cures or treatments is contaminated by the larger goal of making money. Surgeons profit from bariatric surgery, drug companies from drugs, equipment makers from needles and glucose strips, but nobody except people with diabetes profits from effective self-management. And we don’t have a lot of money to fund studies or research better methods.
diabetes  profit  research  medical  pharma  T  type  1  T1D  cost  benefit  social  responsibility  T2D  2  cure  big  pharmaceutical  industry  healthcare  economics  autoimmune  ethics  self  care  David  Spero  peer-reviewed  evidence 
february 2013 by Michael.Massing
Breakthrough or Tease? :: Diabetes Self-Management
Does it seem too good to be true that a 90-year-old drug could restore insulin production in people with Type 1 diabetes? Should Faustman’s lab receive funding from JDRF or the National Institutes of Health rather than relying on private donations? Should pharmaceutical companies help fund studies like this one, even though the drug being tested is already on the market with no patent (and therefore couldn’t bring large profits to any company)?
diabetes  profit  research  medical  pharma  beta  cell  regeneration  pancreas  T  type  1  T1D  cost  benefit  social  responsibility  subvention  subsidy  big  pharmaceutical  industry  Denise  Faustman  insulin  production  peer-reviewed 
february 2013 by Michael.Massing
Cost Of Video Minute |
There are the ballpark figures that we often use to start the project discovery process are the following:

$3,000 -$6,000 per minute of production
$5,000 – $20,000 up to 3 minutes of video
$8,000 for a basic 60 – 90 second motion graphic video with voice over
$18,000 for a 2 actor three minute spot
There are too many variables to give an exact quote on the spot. Do we end up at these prices? Usually not. As the project scope gets defined and budgets are revealed, all parties move to a certian point of agreement. Project A at $x,xxx.xx dollars. Sometimes the client gives in on production requirements and the producution company gives a little on price or hours to complete the project.

Lets take a look at ten basic cost drivers for video production that Xcelus Studios factors into every project quote:

1. Project Management

2. Script Development

3. Talent
On-screen Actor(s)
Voice over artist
Union or non-Union
Extras
Customers (Release form required)

4. Video Assets
Images needed
Stock photos (Royalty free)
Licensed photos
Custom photography
Video
Stock video (Royalty free)
Licensed video
Illustrations/3d elements
Create
Purchase 3D models

5. Special Effects/Animations

6. Location

Studio rental
Fees and permits
Local or travel
Building rental

7. Music
Stock music (Royalty free)
Custom score

8. Crew
DP Director of Photography
Camera operator(s)
Lighting
Sound
Grip

9. Rendering and compression time

10. Overhead
Equipment (Cameras, Lights, Sound, Studio, Computers, Software)
Insurance (Liability and Workers Compensation)
Rent

You can see that there are can be a number of cost elements to developing high quality video. However, not every video project requires all of the cost elements described. We have produced several $5,000 – $8,000 videos without leaving our building using voice over, stock photos, stock music and motion graphics.
video  production  cost  per  minute  writing  studio 
september 2012 by Michael.Massing
Cost of Corporate Video Production - Get Prices and Information - CostHelper.com
Video production services are sometimes available a la carte and typically cost $45 -$250 per hour. Goodheart Media Services in New Hampshire offers videographers for $250 per hour (for the first two hours, or $75 per hour afterward), while Memories Videography in Virginia offers film editing services at $90 per hour.
Script writing services typically cost around 10% of the video budget, or a fixed fee as determined by the writer. Script Services by Bruce Miller ranges from $150 to $180 per finished minute for video scripts.
video  production  cost  per  minute  writing  freelance 
september 2012 by Michael.Massing
Pricing Corporate Videos, Phoenix, Arizona
Basic Training and Events [cost range for finished video minute]
low $50 high $250
video  production  cost  per  minute 
september 2012 by Michael.Massing
A National US Study of Posttraumatic Stress Disorder, Depres... : Annals of Surgery
Objective: To examine factors other than injury severity that are likely to influence functional outcomes after hospitalization for injury.
Summary Background Data: This study used data from the National Study on the Costs and Outcomes of Trauma investigation to examine the association between posttraumatic stress disorder (PTSD), depression, and return to work and the development of functional impairments after injury.
Method: A total of 2707 surgical inpatients who were representative of 9374 injured patients were recruited from 69 hospitals across the US. PTSD and depression were assessed at 12 months postinjury, as were the following functional outcomes: activities of daily living, health status, and return to usual major activities and work. Regression analyses assessed the associations between PTSD and depression and functional outcomes while adjusting for clinical and demographic characteristics.
Results: At 12 months after injury, 20.7% of patients had PTSD and 6.6% had depression. Both disorders were independently associated with significant impairments across all functional outcomes. A dose-response relationship was observed, such that previously working patients with 1 disorder had a 3-fold increased odds of not returning to work 12 months after injury odds ratio = 3.20 95% (95% confidence interval = 2.46, 4.16), and patients with both disorders had a 5-6 fold increased odds of not returning to work after injury odds ratio = 5.57 (95% confidence interval = 2.51, 12.37) when compared with previously working patients without PTSD or depression.
Conclusions: PTSD and depression occur frequently and are independently associated with enduring impairments after injury hospitalization. Early acute care interventions targeting these disorders have the potential to improve functional recovery after injury.
mental  health  care  intervention  prevention  economics  social  cost  benefit  PTSD  depression  efficacy 
june 2012 by Michael.Massing
Clear Spot 4G Apollo Review & Rating | PCMag.com
The only other service provider to offer a comparable plan is Sprint, where $44.99 per month will get you unlimited 4G data and 3GB of 3G data. But that plan requires a two-year contract. With Clear, on the other hand, you can pay on a month-to-month basis. There’s a $35 activation fee involved, but that's only charged once; after that, you only have to pay for months where you're using the device. If you’re paying month-to-month, you also have the option of leasing the Apollo for $6 per month rather than buying it.

Manufactured by Gemtek, the Apollo is a big black box. At 3.4 by 3.4 by .7 inches (HWD) and 4.4 ounces, it’s the biggest hotspot I’ve seen recently, but it’s still plenty portable. Plus, all that space allows for a large 2200 mAh battery, which makes for some excellent battery life. I was able to get 6 hours and 36 minutes of solid 4G streaming on one charge.
wireless  Internet  broadband  cost  comparison 
june 2012 by Michael.Massing
NetZero teams up with Clear to offer free mobile broadband, kind of | Dialed In - CNET Blogs
NetZero announced today two mobile wireless data solutions including a mobile hot-spot router and a USB modem, called NetZero 4G Hotspot and NetZero 4G Stick, respectively. Both of these devices are 4G-only and will access the Internet via Clear's 4G wireless coverage. The NetZero 4G Hotspot is actually a rebranded version of the Clear Spot Apollo 4G and offers exactly the same feature set.
Clear has been offering mobile 4G cellular Internet for a few years with unlimited data plans starting at around $35 per month. NetZero's 4G Internet solutions, however, come with monthly data caps that top at 4GB for $50. There are also three other monthly data plans that cost $10 (500MB cap), $20 (1GB cap) and $35 (2GB cap). The sweet spot of NetZero's offerings is the free data plan that includes 200MB per month. At full 4G speed, you can actually burn through 200MB in just less than 20 seconds, however.
NetZero is aware of this and provide users an option to manually throttle down the connection speed to either stay in the free zone or the more affordable data plans. To do this, you just need to log into your NetZero online account and change the speed settings between the range of 1Mbps/down 234Kbps/up and 10Mbps/down 1.5Mbps/up.
NetZero's new 4G Internet service is available now with the 4G Mobile Hotspot and 4G Stick and cost $99.95 and $40.95. NetZero says there's no contract required and no other fees involved. The equipment price also includes a one-year free trial of 4G mobile Internet access.
broadband  wireless  speed  comparison  usage  cost  free  monitoring  self  throttling 
june 2012 by Michael.Massing
Verizon Raises Prices On Faster FiOs Quantum Web Service - Bloomberg
Verizon's basic 15-megabit-per-second rate will carry the same price of $99 a month for triple play, which includes phone and television service. ...
Comcast Corp. (CMCSA), the largest U.S. cable provider, offers rates of as much as 105 megabits [Internet only] for $199.95 a month, according to the company’s website. Cablevision Systems Corp. (CVC), the fifth- largest cable carrier, offers speeds of as much as 50 megabits, with an “ultra” package that boosts it to 101 megabits, for $104.95.
cable  broadband  speed  comparison  cost  Internet 
june 2012 by Michael.Massing
JAMA Network | Archives of General Psychiatry | National Patterns in Antidepressant Medication Treatment [a.k.a. National Patterns and Antidepressant Prescribing]
From 1996 to 2005, there was a marked and broad expansion in antidepressant treatment in the United States, with persisting low rates of treatment among racial/ethnic minorities. During this period, individuals treated with antidepressants became more likely to also receive treatment with antipsychotic medications and less likely to undergo psychotherapy.

In the United States, there has been a recent increase in the percentage of persons receiving mental health treatment each year. Among nonelderly adults, the percentage increased from 12.2% in 1990-1992 to 20.1% in 2001-2003.1 Several factors may have contributed to this trend, including a broadening in concepts of need for mental health treatment,2 campaigns to promote mental health care,3 and growing public acceptance of mental health treatments.4

In parallel with growth in mental health service usage, psychotropic medications have become increasingly prominent in treatment. The percentage of the US population using at least 1 psychotropic medication increased from 5.9% in 1996 to 8.1% in 2001.5 Among the psychotropic drugs, antidepressants are the most frequently prescribed medications.6 - 7 In 2005, antidepressants surpassed antihypertensive agents to become the most commonly prescribed class of medications in office-based6 and hospital outpatient–based7 medical practice.

Antidepressant use by adults and youths has increased in the United States. According to the National Health and Nutrition Examination Surveys, the monthly rate of antidepressant use among adults increased from 2.5% in 1988-1994 to 8.1% in 1999-2001.8 Data from the National Comorbidity Surveys indicate that among adults aged 15 to 54 years, use of an antidepressant in the last year because of mental health reasons increased from 2.2% in 1990-1992 to 10.1% in 2001-2003.9 Medical Expenditure Panel Survey (MEPS) data reveal that annual antidepressant use among youths younger than 19 years increased from 1.3% in 1997 to 1.8% in 2002.
psychotherapy  mental  health  medical  research  cost  economics  use  data  treatment  psychotropic  drug  healthcare  medicalization  pharmacization  youth  children  culture 
may 2012 by Michael.Massing
Where has all the psychotherapy gone?
While medication is an appropriate part of a treatment plan for many mental health disorders, psychotherapy has been documented as the preferred treatment for many common psychological disorders. A growing body of literature demonstrates the efficacy of several forms of psychotherapy for these disorders.

Notwithstanding that evidence, however, some disturbing trends in mental health treatment patterns from 1998 to 2007 are reported in the U.S. government’s Medical Expenditure Panel Surveys.

While the percentage (3.37) of Americans who receive outpatient mental health care in 2007 is very similar to the proportion of those (3.18 percent) receiving such treatment in 1998, the pattern of that care has changed. Overall there has been a decrease in the use of psychotherapy only, a decrease in the use of psychotherapy in conjunction with medication and a big increase in the use of medication only.

In 2008, 57.4 percent of patients received medication only, indicating that compared with treatment patterns in 1997, approximately 30 percent fewer patients received psychological interventions. This trend was noted particularly among those with anxiety, depression and childhood-onset disorders.

For children being treated, 58.1 percent received medication alone and no other interventions! There has been a dramatic increase in prescribing psychotropic medications, including antipsychotics, to children and adolescents, even though research to support the safety and usefulness of some of these medications is lacking. Indeed, the U.S. Food and Drug Administration publicly concurred with a 2004 finding from controlled clinical trials that the use of nine common antidepressants increased the risk of suicidal thoughts and actions in pediatric patients.

Several reasons account for this shift in the focus of care for individuals with mental health disorders, beginning with the rise of the managed behavioral health-care industry in the 1990s. This burgeoning industry developed strategies to reduce the costs associated with the mental health and substance abuse benefits portion of both public and private health insurance plans. Over time, management of these benefits has resulted in controlling provider fees, strict limitations on episodes of inpatient care and reduction in the average number of outpatient visits per patient treated.

Interestingly, prescription drugs are not typically part of the costs managed by these carve-out plans. By 2006, the costs of psychotropic drugs accounted for 51 percent of mental health care spending. Per capita expenditure for psychotropic medications tripled from 1996 to 2006.

In addition to these market forces, other contributing factors have shaped our current mental health care delivery systems. One factor in particular has had a huge impact on the increasing reliance on psychotropic medications: aggressive marketing by the pharmaceutical houses, augmented by their ability since the late 1990s to advertise directly to consumers. Pharmaceutical companies constantly make information available to the public about the benefits of a variety of medications. In 2005, these companies spent $4.2 billion on direct-to-consumer advertising and a whopping $7.2 billion on promotion to physicians — nearly twice what they spent on research and development (A. Shaw, 2008).
psychotherapy  mental  health  medical  research  cost  economics  treatment  psychotropic  drug  efficacy  healthcare 
may 2012 by Michael.Massing
Medical Expenditure Panel Survey Topics
Expenditures for Treatment of Mental Health Disorders among Young Adults Ages 18-26, 2007-2009: Estimates for the U.S. Civilian Noninstitutionalized Population
Statistical Brief #358
Top 10 Most Costly Conditions among Men and Women, 2008: Estimates for the U.S. Civilian Noninstitutionalized Adult Population, Age 18 and Older
Statistical Brief #331
Health Care Expenditures for Adults Ages 18-64 with a Mental Health or Substance Abuse Related Expense: 2007 versus 1997
Statistical Brief #319
Anxiety and Mood Disorders: Use and Expenditures for Adults 18 and Older, U.S. Civilian Noninstitutionalized Population, 2007
Statistical Brief #303
The Five Most Costly Medical Conditions, 1997 and 2002: Estimates for the U.S. Civilian Noninstitutionalized Population
Statistical Brief #80
Antidepressant Use in the U.S. Civilian Noninstitutionalized Population, 2002
Statistical Brief #77
Trends in Antidepressant Use by the U.S. Civilian Noninstitutionalized Population, 1997 and 2002
Statistical Brief #76
Outpatient Prescription Medicines: A Comparison of Expenditures by Household-Reported Condition, 1987 and 2001
Statistical Brief #43
mental  health  data  statistics  demographics  cost  spending  prescription  drug 
may 2012 by Michael.Massing
Drug Helps Diabetics, Trial Finds | Annals of Internal Medicine 2010 | via NYTimes.com
Experts who were not involved in the multi-center trial agreed larger trials were needed, and said the impact of the drug on blood glucose levels[—.5% reduction in A1c over three months at the highest tested dose of 4g daily—]was moderate. But they said the findings were exciting because they suggested Type 2 diabetes could be treated by targeting the underlying inflammation....
Since atherosclerosis is also considered an inflammatory state, this approach may also potentially reduce the risk of cardiovascular complications associated with diabetes...
Salsalate sells for less than a quarter a pill, and does not present the opportunity for profit that would attract large pharmaceutical companies to do the research...
The patients continued with their regular Type 2 diabetes treatment regimen throughout the study.
salsalate  drug  effects  risk  benefit  cost  treatment  self  care  medical  research  peer-reviewed  pharmaceutical  profit  greed  capitalism  what.I'm.reading  diabetes  efficacy  T2D  type  2 
april 2012 by Michael.Massing
How Google Drive will compare to Dropbox | ZDNet
Unlike the other cloud systems, Dropbox doesn’t need a Web-browser interface. It will run natively on almost any PC, including Linux or devices running Android or iOS.

What I really like about Dropbox is that I can use it just like it was any other network drive with my file manager. Unlike the other services, there are no extras. Dropbox offers file storage without any frills. On the other hand, sometimes that’s all you need and since it lets you easily get to your most important files no matter what device you’re using I find it extremely handy.
online  cloud  storage  comparison  hatmandu  cost  capacity  per  GB  Intel  Java 
april 2012 by Michael.Massing
Apple iCloud: What it is, and What it Costs | PCWorld
iCoud does not replace local storage on iPhones, iPads and iPod Touches. What it does is keep your data in sync between any Apple device or PC that you own. For example, if you're writing a document in Pages on an iPad, that document will automatically be available for editing on your iPhone or a PC, with no need to transfer files by e-mail or USB.

iCloud also remembers your device's settings, apps, home screen layouts, ring tones and text messages, so all of that information is available if you upgrade or replace your iPhone or iPad. Think of it like the backup function in iTunes, but through the Internet instead.

Which apps use iCloud?

Apple iCloud: What It is, and What it CostsApple's iWork productivity software -- Pages, Numbers and Keynote -- can sync documents through iCloud. Contacts, Calendar and Mail will also be updated automatically across multiple devices. A new service called Photo Stream allows you to download your 1,000 most recent photos to a computer or other iOS device for 30 days. You can also store a device's entire camera roll in iCloud for longer.

Third-party apps will be able to use iCloud as well. Rovio, for instance, could make Angry Birds data available across devices so your iPhone and iPad will show the same progress through the game. It's up to developers to implement these kinds of features.

What's included for free, and what costs extra?

Apple will provide 5 GB of iCloud storage for free, but iTunes music, apps, books and Photo Stream don't count against that total. iCloud storage is consumed by documents, mail, app data, your full camera roll, settings and other device information. Additional storage costs $20 per year for 10 GB, $40 per year for 20 GB and $100 per year for 50 GB.

Apple suggests that 5 GB of storage should suffice, but that depends largely on whether you're storing lots of photos and videos on your Camera Roll, and how much app data you're backing up. The former should be easy to determine -- you can already see in iTunes how much data is used by photos and video -- but the latter will be harder to pin down until we see how many developers adopt the service.
online  cloud  data  sync  comparison  cost  photo  storage  streaming  Intel  Java  hatmandu 
april 2012 by Michael.Massing
AT&T and Verizon keep data plan pricing the same for the new iPad (update) | The Verge
AT&T will continue to offer a 250MB plan for $14.99, a 3GB plan for $30, and a 5GB plan for $50. Verizon counts with its standard 2GB for $30, 5GB for $50, and 10GB for $80 plans[, and a new 1GB for $20 plan.]
4G  LTE  service  plan  cost  iPad 
march 2012 by Michael.Massing
Verizon's 4G LTE iPads will hot spot at launch, but not AT&T's | Apple - CNET News
As with other tablets that Verizon carries, the monthly data plan will include portable hotspot use, unlike the stipulation for smartphone hotspot use, which costs an extra $20 per month. Verizon's monthly data plans for the iPad will span 1GB of data for $20, 2GB for $30, 5GB for $50, and 10GB for $80.
phones  Pad  data  plan  cost  service  VoIP  telephony 
march 2012 by Michael.Massing
Giving Up on Weight Loss | Kahn, R. Health Affairs 2012-01 | via Diabetes Self-Management
Richard Kahn, formerly the chief medical officer of the American Diabetes Association, claims that we don’t know enough right now about the biological processes underlying the body’s regulation of weight to develop effective weight-loss programs that can be applied on a large scale. In the meantime, he writes, public health officials and medical groups should concentrate on finding ways to help people control their diabetes once it develops. This, he believes, is a better use of valuable time and research dollars, since effectively controlling blood glucose levels has shown to be sustainable and leads to a greatly reduced risk of diabetes complications....
As an article published at DiabetesInControl.com notes, several doctors associated with Boston’s Joslin Diabetes Center released a statement indicating strong disagreement with Kahn. Osama Hamdy, medical director of the center’s Obesity Clinical Program, asserted that Kahn was advocating “a surrender in the face of one of the greatest threats to public health the world faces.” Hamdy goes on to say that while maintaining weight loss is “a lifelong battle,” Joslin programs have shown that weight loss can be sustained for long periods of time. One program, he notes, led to a 50% reduction in diabetes medicines taken by participants and a 27% reduction in overall health-care costs....
Is it foolish to suppose that programs administered by a leading diabetes research center can be effectively duplicated across the country? Or is Kahn’s approach too pessimistic — or even, as one writer suggests, possibly distorted by ties to diabetes drug manufacturers?
[The ADA's conservatism on preventive strategies and intimacy with the post-diagnosis treatment industry has long been a thorn in the side of many.—DMM]
body  fat  weight  loss  diabetes  prevention  what.I'm.reading  maintenance  self  care  glucose  behavior  hatmandu  T2D  research  correlation  health  cost  benefit  economics  behavioral  treatment  intervention 
february 2012 by Michael.Massing
Navigating the Diabetes Insurance Highway
[Having received an inappropriately substituted prescription in an effort to lower their copay, the patient and his wife] sat for two days at home without insulin administration, choosing not to test his glucose since they knew they didn't have a way to inject the insulin, until the Home Health nurse arrived.
The Home Health nurse reviewed syringe technique with the patient and they ultimately chose to go with the pen. The Home Health nurse expedited the original Rx and reviewed the sliding scale and glucose results from fingersticks. The patient is doing well....
Navigating what doctors prescribe and what insurance companies charge for co-pays can be a major problem. Copays can range from no cost to more than $100, depending on which tier the medication is in....
With the difficulty of navigating...benefits, co-pays and different tiers, following up with patients is imperative. The Home Health nurse visit truly averted disaster.
diabetes  insulin  nursing  home  healthcare  services  health  cost  economics  insurance  glucose 
february 2012 by Michael.Massing
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