Do drunks have to go to the ER?

NEW YORK (Reuters Health) – With the help of a checklist, ambulance workers may be able to safely reroute drunk patients to detoxification centers instead of emergency rooms, according to a new study.

Researchers in Colorado found no serious medical problems were reported after 138 people were sent to a detox center to sleep it off, instead of to an ER.

In 2004, according to the researchers, it’s estimated that 0.6 percent of all U.S. ER visits were made by people without any problems other than being drunk. Those visits ended up costing about $ 900 million.

“Part of the issue has been – as it is in many busy ER departments – there’s a lot of chronic alcoholics that are brought in by ambulance, police or just come in. Often they are brought in because they have not committed a crime or there is limited space in our detoxification center. So the majority were brought to the ER department,” said Dr. David Ross, the study’s lead author from Penrose-St. Francis Health Services in Colorado Springs.

Ross said the ambulance company where he serves as medical director created the checklist with the help of the local detox center, which provided limited medical care by a nurse, and the local hospitals to reduce the number of drunks without medical needs being sent to the local ERs.

They created a checklist with 29 yes-or-no questions, such as whether the patient is cooperating with the ambulance worker’s examination and if the patient is willing to go to the detox center.

The patient was sent to the ER if the ambulance worker checked “no” on any question.

The researchers then went back to look at the patients they transported between December 2003 and December 2005 to see whether or not any of them ended up having serious medical problems at the detox center.

During that two year period, the ambulance workers transported 718 drunks. The detox center received 138 and the local ERs got 580.

Overall, 11 of the patients who were taken to detox were turned away because there was no room, their blood alcohol level exceeded the limit, their family came to pick them up or they were combative.

Another four patients at the detox center were taken to the ER because of minor complications, including chest and knee pain. However, there were no serious complications reported.

“We really believe that we did not miss anybody with a serious illness and injury that didn’t go to the ER as they should have,” said Ross.

But the researchers write in the Annals of Emergency Medicine that their study did have some limitations.

Specifically, the researchers did not plan in advance to do a study when they were creating the checklist, which means their findings are limited to whatever information was collected at the detox center and ERs.

Also, the number of people who were sent to the detox center in their study is relatively small, so it’s hard to tell how many serious complications they’d see among a larger group of people.

“We tried to estimate how likely we would have been to encounter a serious event… We estimated at most we’d encounter three serious adverse events (in 748 patients),” Ross told Reuters Health.

SOURCE: http://bit.ly/QgPCT5 Annals of Emergency Medicine, online November 9, 2012.

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Serious About Free Markets? Prove It

On Friday the Republican Study Committee, a policy shop for congressional Republicans, published a memo on how to fix copyright law. By Saturday afternoon the group’s executive director had pulled the memo, which had evidently failed to approach the subject with “all facts and viewpoints in hand.” This is Washington’s way of saying that an interest group hit the roof, and indeed, Ars Technica reports that lobbyists from the “content industry”—Hollywood and recording companies—pressured the group to renounce the memo.

Copyright being in fact broken, you can still read copies of the memo online. It lays out what copyright reform advocates have been saying for years. Copyright protections now extend 70 years past the life of the author; for a corporation, 95 years after publication. This, along with punitive laws on copyright violation, hinders creativity and innovation. These facts aren’t new. What’s new is the tone. Derek Khanna, the memo’s author, writes like an unashamed free marketeer, and in doing so manages to latch on to a larger point: Laws that help businesses often harm markets. From the memo:

Today’s legal regime of copyright law is seen by many as a form of corporate welfare that hurts innovation and hurts the consumer. It is a system that picks winners and losers, and the losers are new industries that could generate new wealth and added value. We frankly may have no idea how it actually hurts innovation, because we don’t know what isn’t able to be produced as a result of our current system. (Emphasis in the original.)

Radical stuff. There’s no one in Washington to lobby for industries that don’t exist yet, and ever so briefly, Khanna and the Republican Study Committee stepped into that breach. Then they stepped back, to gather more facts and viewpoints. Here’s one: Pro-business and pro-market are not the same thing. The most pleasant place for a business is not elbows-out in the middle of a free market, but sitting alone, atop a fat monopoly. Ask your local cable provider. The larger a business gets, the more it has to protect from the companies and industries that might follow it with something better or cheaper. And the best way to protect what you have is to have it written into law.

Real markets, with real competition, are most helpful to newcomers. Small businesses and new industries create new value. Once created, they, too, move to Washington to protect it. Witness the growth of Google (GOOG) and Facebook’s (FB) lobbying operations in the Capitol. Khanna describes extended copyright protection as rent-seeking—in his words, “non-productive behavior that sucks economic productivity and potential from the overall economy.” What’s true of Hollywood and the recording industry could be said of any established industry.

Luigi Zingales, a professor at the University of Chicago Booth School of Business and a regular contributor to Bloomberg View, points out that larger companies can lobby for special exemptions in the tax code. This creates complexity in the tax code, which punishes smaller businesses that can’t pay for tax lawyers and don’t have anyone’s buttonhole on Capitol Hill. Zingales prefers simple regulations and simple taxes, which are harder for lobbyists to game and easier for democracies to understand. He sees this as a bipartisan problem. The left is inclined toward more regulation, and the right is pro-business, rather than pro-markets.

The direction Khanna was headed—a defense of open, competitive markets at the expense of existing businesses—is still wide open space, claimed by no party. This summer, conservatives such as Timothy Carney at the Examiner and Yuval Levin at National Review urged Mitt Romney to back markets, not businesses. But he chose not to, even though he, in his day, disrupted existing markets of his own. Some enterprising Republican can still do it. Derek Khanna in 2016! He’s young. Maybe VP.

Businessweek.com — Top News

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Former Ivory Coast leader’s wife wanted by ICC

THE HAGUE, Netherlands (AP) — The International Criminal Court unsealed an indictment Thursday against former Ivory Coast President Laurent Gbagbo‘s wife on charges including murder, rape and persecution. It was the first time in the court’s 10-year history it has charged a woman.

The world’s first permanent war crimes tribunal said the arrest warrant was issued on Feb. 29 for former first lady Simone Gbagbo for crimes against humanity.

Her husband, Laurent Gbagbo, is already in custody at the court’s detention unit in The Hague facing similar charges stemming from his fight to retain power after losing a 2010 presidential election. If his wife is extradited, they could face justice together in an unprecedented husband-wife trial.

But a senior member of Ivory Coast President Alassane Ouattara‘s government, who requested anonymity because he wasn’t authorized to speak to the media, said Ivory Coast has already informed the ICC that the nation will not let her go.

“We informed them of this a long time ago,” he said.

The court’s chief prosecutor, Fatou Bensouda, urged Ivory Coast to extradite Gbagbo.

“The type of crimes committed in the aftermath of the 2010 elections did not happen by chance — they were planned and coordinated at the highest political and military levels and all those bearing the greatest responsibility must be held to account,” Bensouda said in a statement.

She said prosecutors continue to investigate crimes committed by both sides in Ivory Coast’s bloody power struggle and expect to issue further arrest warrants in the future.

“The investigations are objective, impartial and independent, and are conducted in strict accordance with the law,” she said.

Ivory Coast officials are holding the 63 year old under house arrest in the northwest town of Odienne. Last week, Ivorian prosecutor Noel Dje Enrike Yahau said lawyers had questioned Simone Gbagbo there for two days and that the domestic charges against her remained the same: genocide, blood crimes and economic crimes.

Unsealing the ICC arrest warrant issued nearly nine months ago appears to be a tactic by the court to put pressure on Ouattara’s administration to hand over Ms. Gbagbo.

If authorities in Ivory Coast want to prosecute her, they have to convince judges at The Hague tribunal that their case involves the same crimes she is charged with at the ICC. It is a court of last resort, meaning it only takes cases from countries unwilling or unable to prosecute them.

The international court said in the warrant that there is evidence pro-Gbagbo forces deliberately attacked perceived supporters of Ouattara in the aftermath of the election.

Judges who reviewed evidence supporting the charges against Ms. Gbagbo said they found “there are reasonable grounds to believe that Ms. Gbagbo bears individual criminal responsibility for the crimes … as ‘an indirect co-perpetrator.’”

The warrant called Gbagbo an “alter ego for her husband” with the power to make state decisions. It said there is evidence to suggest she “instructed the pro-Gbagbo forces to commit crimes against individuals who posed a threat to her husband’s power.”

Her husband was the first former head of state to be taken into custody by the court when he was extradited to The Hague by the Ivory Coast government last year.

Prosecutors say about 3,000 people died in violence by both sides after Gbagbo refused to concede defeat following the election. Ouattara finally took power in April 2011 with the help of French and U.N. forces.

Ivory Coast is not a member state of the court, but has voluntarily accepted its jurisdiction.

It is very rare for a woman to be charged by an international war crimes court. In the past, the Yugoslav war crimes tribunal convicted former Bosnian Serb President Biljana Plavsic of persecution and sentenced her to 11 years imprisonment.

The announcement of the arrest warrant and Ivory Coast’s refusal to hand over Gbagbo appeared likely to raise tensions between supporters of her husband and those who back Ouattara.

Moussa Toure Zeguen, a leader of the Gbagbo allies in exile in Ghana, said by phone from Accra that the former president’s supporters had no faith in the Ivorian authorities to give Simone Gbagbo a fair trial.

“We don’t trust them. The only thing that Ouattara is doing is revenge,” Zeguen said. “He wants to try us without trying any of the fighters from his side who also committed crimes. It is not fair, and this cannot bring reconciliation.”

____

Associated Press writers Rukmini Callimachi in Dakar, Senegal, and Robbie Corey-Boulet in Abidjan, Ivory Coast, contributed to this report.

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PlayStation Mobile Now Lets PS Vita Owners Create Their Own Games

Think you (or someone you know) has what it takes to write games for the PlayStation Vita? Sony just opened up its PlayStation Mobile game store to anyone who wants in. All you need is a half-decent Windows PC and a Vita, and the cash for a $ 99 developer fee — the same yearly price Apple charges.

​How PlayStation Mobile fits in

PlayStation Mobile isn’t the same thing as the PlayStation Store, where you can buy most PlayStation games and downloadable content. It’s more like a separate department that’s only on the PlayStation Vita and on PlayStation Certified Android devices like Sony’s smartphones and tablets.

In a nutshell, it’s Sony’s version of Xbox Live Indie Arcade, except that it’s for portable PlayStation consoles instead of home Xbox ones. It’s where small, indie studios can get their work published and featured, and where PlayStation Vita owners can look for unique, inexpensive game titles.

​How developers can get started

Game developers can start with PlayStation Mobile by registering on its developer site. After that, they download the PlayStation Mobile SDK (software development kit), and get to work on their games. Third-party software like the free Blender 3D modeling program can be used to create in-game art assets, while the SDK itself is powered by the open source Mono version of C#, the same programming language used by Xbox Live Indie Arcade’s XNA toolkit.

​How PlayStation Mobile compares to other game and app markets

For starters, the $ 99 annual fee and the cost of a PlayStation Vita or PlayStation Certified device put it right up there with Apple’s App Store in terms of up-front expense, except that you don’t have to buy a Mac to write things for it. This is a lot more than the $ 25 one-time fee to get in to the Google Play store, which you can use pretty much any computer and Android device to write for. On the other hand, anyone who’s considering writing PlayStation Vita games probably already owns a Vita to begin with.

Developers aren’t allowed to write non-game apps for PlayStation Mobile, unlike with most markets. Pretty much the only apps seen on the Vita so far are official licensed ones like YouTube and Flickr, while PlayStation Certified devices running the Android OS get their apps from the Google Play store anyhow.

Perhaps the strangest restriction? Developers don’t get to set their own games’ price. They instead specify a “wholesale price,” as though they were selling their games to Sony, and it decides how much to sell them for. In essence, the company chooses its own profit margin on a per-game basis, unlike most app markets’ 70/30 split. It also seems to be able to decide when and whether games go on sale.

​Success stories?

Rami Ismail told “The Story of Super Crate Box” on the PlayStation Blog, explaining how he and a fan managed to bring an iOS game that he’d already made to the PlayStation Vita on very short notice. He said the game “feels right at home” on the portable console, while Joystiq’s JC Fletcher calls the Vita port “the definitive version.” As for whether it’s selling well or not, though, we may have to wait to find out.

Jared Spurbeck is an open-source software enthusiast, who uses an Android phone and an Ubuntu laptop PC. He has been writing about technology and electronics since 2008.

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Tom Hanks, Will Farrell offer custom recordings

NEW YORK (AP) — Imagine having William Shatner supply your outgoing voicemail message. Or maybe you’d prefer Morgan Freeman coolly telling callers to wait for the beep. Or perhaps having Betty White joke around is more your speed.

All it takes is $ 299 and some luck.

The advocacy group Autism Speaks is offering custom-recorded messages from those celebrities as well as Will Ferrell, Carrie Fisher, Tom Hanks, Derek Jeter, Leonard Nimoy, Patrick Stewart and Ed Asner.

From Dec. 3 to Dec. 9, a limited number of 20-second long MP3 messages will be recorded by each celebrity on a first-come, first-served basis for fans to do with as they wish. All requests must be of the PG variety.

Asner, the curmudgeonly Emmy Award winner of “The Mary Tyler Moore Show” and “Lou Grant,” dreamed up the unusual fundraiser with his son Matt, who works for Autism Speaks.

“I think people will get a charge out of it,” says Asner, who is currently on Broadway in the play “Grace.” ”I’ll probably say, ‘What are you wearing?’ Or, ‘Take it off.’ Something like that.”

All proceeds will support autism research and advocacy efforts.

If he could get a message from one of the other stars participating, which would Asner want?

“I’m awfully stuck on Will Ferrell, having been subjected to him in ‘Elf,’” Asner says. “But they’re all such standouts — Patrick Stewart, Leonard Nimoy, Shatner. The list doesn’t stop. Even Betty White,” he adds about his “MTM” co-star. “She’s still got some good left in her.”

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“Irrational” factors may drive end of life access to radiation

NEW YORK (Reuters Health) – Access to radiation treatments to ease cancer symptoms in the last days of life may be driven by costs and other non-medical considerations, a new U.S. study concludes.

Researchers looking at Medicare claims over nearly a decade found that only a small proportion of cancer patients received radiation in their final 30 days of life, but of those who did get the treatment – typically used to ease pain and other symptoms in the terminal stages of the disease – one in five got more than the recommended number of doses.

“The use of radiation itself was low, what was high was the percentage of patients who were getting 10 days or more,” said Dr. Ashleigh Guadagnolo of the MD Anderson Cancer Center at the University of Texas, who led the study.

Guadagnolo declined to comment on whether the number of treatments was appropriate, but one cancer expert said that the study showed wasteful, irrational thinking behind some radiation therapy.

Dr. Otis Brawley, chief medical officer of the American Cancer Society, said that while radiation therapy for palliative care is reasonable, 10 or more treatments for patients during the last month of life is a “waste of resources.”

The conundrum, Brawley told Reuters Health, was that patients who received radiation got too much, but that too many patients who could have benefited from radiation got no therapy.

“This study shows there’s a lot of irrationality in how we treat patients,” said Brawley, who was not involved in the new work.

Doctors use radiation not only to blast away cancer cells and tumors when attempting to cure cancer, but also as an alternative to steroids and pain medications to relieve bleeding and painful symptoms when cancer spreads to the bones, brain and spine.

Many previous studies have focused on the use of chemotherapy at the end of a cancer patient’s life, but the new report, published Monday in the Journal of Clinical Oncology, is the first to examine how doctors use radiation with terminal patients, according to Guadagnolo’s team.

The researchers were interested specifically in what factors might determine when radiation treatment is given to terminal cancer patients, and especially whether Medicare payment policies have any influence on the treatment’s use.

So the researchers evaluated more than 202,000 Medicare claims for patients over age 65 who died from the five most common cancers in the U.S., including lung, breast, prostate, colorectal and pancreatic cancers between 2000 and 2007.

They assumed that most radiation treatments during a patient’s final 30 days were palliative, that is, meant to treat symptoms rather than to cure the cancer.

Overall, about 15,000 patients (a little more than seven percent) received radiation therapy in the last month of life. And of those, almost 18 percent spent more than 10 of their final 30 days getting radiation treatments.

Factors that were linked to receiving 10 or more treatments included being white, not receiving hospice care and being treated in a freestanding cancer treatment facility rather than a university-associated hospital.

The costs for patients who got radiation treatment amounted to an additional $ 3,453 per patient, on average. However, among those who were getting hospice care and radiation, the combined costs were $ 2,675 less than the costs for patients who got neither radiation nor hospice care.

Medicare caps payments for patients who elect hospice care at a daily rate that’s below what a radiation treatment would cost, the report points out. And a general decline in the use of radiation from 2000 to 2007 tracks with an increase in hospice use.

Besides cost, previous research has also found a variety of barriers to access in the use of radiation therapy at the end of life, including race, sex, household income, nursing home residence and travel time to a hospital, the authors note.

“The take home message for me from this study was that it’s not likely the case that we’re going to save money by forgoing radiation and in fact, radiation is probably a little bit underutilitzed,” Dr. Stephen Lutz, a radiation specialist at the Blanchard Valley Regional Cancer Center in Ohio, told Reuters Health. Lutz was not involved in the study.

Dr. Michael Steinberg, a radiation oncologist at the David Geffen School of Medicine at UCLA, said the costs need to be put into context. Many patients in his practice don’t want to be on narcotics or steroids that can cause many unpleasant side effects such as mental fogginess.

“(Narcotics and steroids) are not necessarily solutions, this is more like warehousing very old patients and something to be avoided, if you can control the pain with a short course of radiation, there is a value proposition,” said Steinberg, who was not involved in the new study.

On the other hand, radiation therapy to lessen cancer symptoms has limits since its pain-reducing effects can take days as opposed to hours for narcotics, noted Dr. Stephen Gripp, a radiation oncologist at the University Hospital Düsseldorf at Heinrich-Heine-University.

Plus, there’s the inconvenience factor.

“Radiotherapy (transport, positioning on the table, waiting) is annoying or even painful for terminally ill patients,” Gripp told Reuters Health in an email.

In past research, radiation oncologists have examined how many treatments are appropriate for end-of-life care and found in some cases, such as bone metastasis, a single treatment is just as effective in reducing pain as multiple treatments.

However, doctors tend to be reluctant to use fewer treatments for patients who are near death, Lutz said, because they are unsure how long the patient will survive and benefit from the treatments.

In 2011, the American Society for Radiation Oncology, a trade group, published guidelines to help doctors reduce the number of treatments for patients with bone metastasis.

The study was unable to “tell why patients got radiation; nor do we have any data in this study on what benefit they received or whether it improved their quality of life,” Guadagnolo told Reuters Health.

The study had other shortcomings, Steinberg noted.

“When you look at cost – why do these patients cost more to get the radiation – it’s not just because of the radiation, they’re typically getting a lot of other things as well,” Steinberg said.

Experts said that the long-term risks for radiation therapy in terminal patients were negligible, and most patients wouldn’t survive to see any longer-term side effects.

“This is more about a broken payment system than anything about radiation overdose,” Steinberg concluded.

SOURCE: http://bit.ly/UR8kwk Journal of Clinical Oncology, online November 19, 2012.

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Twinkies liquidation is approved

21 November 2012 Last updated at 16:27 ET

A US bankruptcy judge has given the go-ahead for the liquidation of Hostess Brands, owner of some of the country’s best known food brands, including cream-filled sponge snack Twinkies.

The hearing was delayed from Monday to allow for last-ditch talks with unions, but those failed.

As a first step in the liquidation of the company, Hostess is expected to lay off about 15,000 of its employees.

But Hostess’ advisers are confident that parts of the business can be sold.

In a statement, the company blamed the need for liquidation on a strike by the Bakery, Confectionery, Tobacco and Grain Millers (BCTGM) union, which started on 9 November.

Hostess Brands had sought protection from its creditors through Chapter 11 bankruptcy in January, but said it could not afford to continue operating through a strike.

The BCTGM blamed the company’s problems on years of mismanagement and being saddled with debt by private equity owners.

But Hostess said: “The wind-down was necessitated by an inflated cost structure that put the company at a profound competitive disadvantage”, adding that the main problem was its collective bargaining agreements with its staff.

‘Iconic brands’

One of the firm’s lawyers said there had been a “flood of enquiries” about buying some of the brands.

Advisers to Hostess Brands said they had been showing a potential buyer for the Drake’s cakes brand around the factory in New Jersey on Tuesday.

“These are iconic brands that people love,” said Joshua Scherer from Perella Weinberg Partners.

Hostess expects to keep on about 3,200 staff to help shut down its properties, but only about 200 of them are likely to still be employed at the firm by the end of March.

Hostess said the liquidation would mean the closure of 33 bakeries, 565 distribution centres, approximately 5,500 delivery routes and 570 bakery outlet stores.

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Ivory Coast: New prime minister named

ABIDJAN, Ivory Coast (AP) — President Alassane Ouattara has tapped Foreign Minister Daniel Kablan Duncan to serve as prime minister in a new government one week after the surprise dissolution of cabinet.

The appointment of Duncan, a member of the PDCI party of former President Henri Konan Bedie, was announced at a press conference Wednesday by Amadou Gon Coulibaly, general secretary of the presidency.

Ouattara dissolved the cabinet last week over a feud between his political party and the PDCI over proposed changes to the country’s marriage law.

The PDCI supported Ouattara in the November 2010 runoff election in exchange for the prime minister’s post, helping him defeat incumbent President Laurent Gbagbo. Gbagbo’s refusal to cede office led to five months of violence that claimed at least 3,000 lives before Ouattara’s forces won.

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Tablets, discounters top U.S. holiday shopping lists: Reuters/Ipsos

(Reuters) – Move over computers, your sleek siblings are the prized gift of the holidays.

One-third of U.S. consumers are thinking about buying an electronic tablet this holiday season, according to a new Ipsos poll conducted for Thomson Reuters. And 22 percent of those who want one of the hot devices said they plan to cut back on other holiday purchases in order to afford them.

But the new, smaller tablet from industry leader Apple Inc – the iPad mini – is not taking the world by storm. Only 8 percent named the iPad mini as their first choice, the same percentage that said they would like to buy a Microsoft Corp Surface tablet.

“There has been a lot of controversy about the fact that the iPad mini is $ 329, that the price might not be right,” said Jharonne Martis, director of consumer research for Thomson Reuters.

Still, Apple’s full-size iPad remains the leader, with 25 percent picking it as the tablet of choice while 15 percent want to buy Amazon.com Inc’s Kindle Fire, and another 15 percent want a Samsung Galaxy device.

Apple sold about 11 million iPads during the 2011 holiday quarter, and this year analysts expect it to sell about 16 million iPads and 8 million iPad mini tablets, Martis said.

Retailers have prepared for a big tablet season. Walmart, for example, doubled its orders for iPads and other tablets and will offer an iPad 2 with a $ 75 gift card for $ 399 as one of its specials on Thanksgiving night.

Laptops are still on the wish lists for 32 percent of respondents, while 18 percent would like to buy desktop computers and only 13 percent are looking for ultrabooks.

SPENDING LESS OR STILL UNSURE

Meanwhile, retailers may want shoppers to believe the holiday shopping season begins sometime in September. But the poll shows that most consumers still are waiting until around Thanksgiving to start their holiday shopping.

Walmart, Toys R Us and others started promoting their layaway plans in September as a way to reserve hot items.

While 11 percent said they were using layaway more this year than last year, 71 percent said they were not.

Seventy-two percent have done no shopping yet or less than a quarter of it, the poll found.

“The fact that 72 percent haven’t really started yet reinforces why Black Friday is coined the official beginning of the holiday season because that’s truly when shoppers start to open their wallets,” Martis said.

Most of that shopping will still take place in stores, despite the rise of online shopping and fears of shoppers using physical stores as showrooms for products they will buy online using their mobile devices.

“It is still growing, but it is still a very small portion of retail sales,” Martis said of mobile shopping.

Going to a mix of different types of stores is the plan for 42 percent of the respondents planning to go to stores, while 31 percent plan to do most of their holiday shopping at a discount chain such as Walmart, Target or Kmart, which will all be open for at least some of Thanksgiving Day to court shoppers.

The U.S. economy and possible tax hikes continue to be a concern for some, with 28 percent saying that they are spending less this year because of the fiscal cliff, though 58 percent said the fiscal cliff was not affecting their holiday spending plans.

Two-thirds of shoppers said they were planning to spend the same amount as last year or were unsure about their spending plans, while 21 percent plan to spend less and 11 percent plan to spend more. Also, 60 percent said are choosing to shop closer to home to save on gas.

Contrary to the cry of some traditional retailers, “show rooming” is not the norm for most people.

When asked how, if at all, they use a mobile device while in stores, 63 percent said they do not even pull out their smartphones while shopping. Fifteen percent compare prices online and 14 percent said they research products.

Amazon is the top online retailer shoppers plan to visit more than they did last year, with 42 percent picking it, 38 percent choosing Walmart, 23 percent selecting Target and 14 percent picking EBay.

Physical stores remain the top destination, with 26 percent planning to shop primarily at stores and only 14 percent planning to shop primarily online.

The poll is the first in a series that Ipsos will conduct during the holiday season.

The findings are from an Ipsos poll conducted for Thomson Reuters from November 15-19, 2012, with 1,169 American adults interviewed online. Results are within the poll’s credibility intervals, a tool used to account for statistical variation in Internet-based polling. The credibility interval was plus or minus 3.3 percentage points.

(Additional reporting by Brad Dorfman; Editing by Edward Tobin and Leslie Gevirtz)

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OB/GYNs back over-the-counter birth control pills

WASHINGTON (AP) — No prescription or doctor’s exam needed: The nation’s largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.

Tuesday’s surprise opinion from these gatekeepers of contraception could boost longtime efforts by women’s advocates to make the pill more accessible.

But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it’s not clear if any are considering it. Plus there are big questions about what such a move would mean for many women’s wallets if it were no longer covered by insurance.

Still, momentum may be building.

Already, anyone 17 or older doesn’t need to see a doctor before buying the morning-after pill — a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex. Earlier this year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.

Now the influential American College of Obstetricians and Gynecologists is declaring it’s safe to sell the pill that way.

Wait, why would doctors who make money from women’s yearly visits for a birth-control prescription advocate giving that up?

Half of the nation’s pregnancies every year are unintended, a rate that hasn’t changed in 20 years — and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.

“It’s unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem,” said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.

Many women have trouble affording a doctor’s visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.

If the pill didn’t require a prescription, women could “pick it up in the middle of the night if they run out,” she said. “It removes those types of barriers.”

Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.

Then there’s the price question. The Obama administration’s new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.

If the pill were sold without a prescription, it wouldn’t be covered under that provision, just as condoms aren’t, said Health and Human Services spokesman Tait Sye.

ACOG’s opinion, published in the journal Obstetrics & Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $ 16 per month’s supply.

The doctors group made clear that:

—Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.

—Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.

—Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.

—And there’s no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they’d like to discuss other forms of birth control such as implantable contraceptives that do require a physician’s involvement.

The group didn’t address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers’ ages. Presumably regular birth control pills would be treated the same way.

Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe, Australia and a few other places, but many countries don’t require a prescription.

Switching isn’t a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor’s involvement. The question was how to pay for it.

Some pharmacies in parts of London have a similar project under way, and a recent report from that country’s health officials concluded the program is working well enough that it should be expanded.

And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexico to buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.

“Being able to easily get the pill when you need it makes a difference,” he said.

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Online:

OB/GYN group: http://www.acog.org

Medications/Drugs News Headlines – Yahoo! News

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