0 Got a health-care spending account? Today may be your last chance to spend those dollars.

Still got some money stashed away in a health-care flexible spending account? If so, you might want to put a trip to the pharmacy on your day's to-do list, or at least check your plan's paperwork to see if you can take advantage of the IRS's optional grace period, to March 15, to spend those funds. Otherwise, after today you'll lose those savings for good.

If you don't need a new pair of glasses and don't know how else to spend that money, here are some qualifying over-the-counter items listed on the Aetna Website that can be purchased without a prescription:

• Bandages
• Eye-care products (contact lens solution, lubricant drops, patches)
• Family-planning supplies (condoms, contraceptive creams, pregnancy tests, and ovulation kits)
• Hearing aid batteries
• Home diagnostic tests or kits, such as blood pressure monitors, blood glucose meters, and thermometers
• Hot/cold packs when used for medical purposes (not for cooling food, for instance).
• Incontinence products for adults
• Joint-support bandages and hosiery
• Vaporizers and humidifiers

Aetna notes that your employers' qualifying expenses may not be identical to its list, so if you're unsure whether a cost will be covered, check with your human resources department. Also refer to IRS Publication 502, Medical and Dental Expenses, for other qualifying expenses.

Check out our recommendations and Ratings if you're ready to buy a blood pressure monitor blood glucose meter, or thermometer.

Whether you spend your FSA funds tomorrow or by March 15, your employer's flexible-spending account administrator is likely to require that you submit your receipts by March 31.

Read more about flexible spending accounts.

0 Top sparkling wines for ringing in the New Year

Looking to purchase a bottle of bubbly for the night? You might not think of Consumer Reports when it comes to buying wine, but our industry experts have reviewed many of your favorite varietals, including Cabernet, Chardonnay, Sauvignon Blanc, Shiraz, Zinfandel, and many more.

Our recent tests of sparkling wine include a recommended GH Mumm Cordon Rouge NV, and a very reasonably priced Gruet Blanc de Noirs NV. The first is a classic Champagne style bubbly that is intense and complex with ripe apple and yeasty/toasty notes, while the second has an attractive array of fruit that mixes nicely with slight yeasty flavors to make for a tasty blanc de noir. For more, read our report on the best sparkling wines in our tests.

If you want to celebrate with a bottle that is fun and a little more daring than most, consider a sparkling ros, such as De Bortoli Emeri Pink Moscato or Korbel Brut Rose, both sell for around $12 and are recommended by our expert wine testers. Check out our Ratings (available to subscribers) of pink sparkling wines for more options. Or if you'd rather, a nice bottle of red or white instead, you can find lots of helpful information in our wine buying guide. Note that if you can't find the vintage we tested, choose another recent one, which we've found should be fairly similar.

Also read our buying advice to learn about pairing wine with food, serving, storing, and much more. As we often find in our wine testing, a high price doesn't guarantee high quality, and you'll find several recommended wines that won't break the bank.

And remember, you don't want to ruin a celebration by blasting the cork off a bottle of champagne and hitting someone in the eye. As it leaves the bottle, the cork can fly up to 50 miles per hourgenerating a force powerful enough to shatter glass. So be mindful and hold that bottle at a safe angle when popping the bubbly.

0 Hospitals still order too many CT scans

Radiation exposure from a CT scan is about 350 times higher than from an ordinary chest X-ray. Yet some hospitals, including several large, well-known ones, continue to order too many of them, exposing patients to needless risk and expense, according our updated hospital Ratings.

We focused on "double scans," or two scans ordered for the same patient, one with a contrast agent (which can make the image clearer), and another without. Such double scans are rarely necessary, and expose patients to 700 times as much radiation as from a standard chest X-ray. Such scans might increase the risk of cancer. Contrast agents add other risks, including possible harm to the kidneys and allergic reactions. And, of course, any unnecessary test is a waste of money, too.

We looked at the number of such double scans at hospitals across the U.S. and found that the percentage of hospitals earning our best score for limiting unnecessary scans did increase, from 19 percent for 2008 to 27 percent for 2010, the most recent year for which data are available. To get a top score, a hospital must do double scans of at most 5 percent of patients who get an abdominal or chest scan. The data come from the Centers for Medicare & Medicaid Services.

The bad news is that far too many hospitals still do double scans: In 250 hospitals that were poor performers in our first analysis, with double-scan rates of 15 percent or more, rates for abdominal scans, chest scans, or both stayed the same or rose.

That group includes mainly small community hospitals but also some large, well-known ones. Among them: Cleveland Clinic Hospital in Weston, Fla.; John Stroger Jr. Hospital in Chicago; Memorial Health University Medical Center in Savannah, Ga.; University of California Irvine Medical Center in Orange, Calif.; and University of Medicine and Dentistry of New Jersey in Newark.

Bottom line: Avoiding unnecessary tests once you're in the hospital is challenging, because you or someone who cares for you must ask difficult questions of the staff. So even before checking into a hospital, consider checking our hospital Ratings. If a doctor orders a CT scan, ask whether an imaging test that doesn't emit radiation, such as an MRI or an ultrasound, could be used instead. And if you're told you need a second CT scan of your chest or abdomen, ask whether it's really necessary.

And see our article How Safe Is Your Hospital and our tips for staying safe in the hospital.

0 Use those gift cards now

If you received gift cards this holiday season, you should get out and use them up now, before they get buried in a drawer, lose value, or expire.

Federal rules for merchant and bank issued gift cards mean they can't expire within five years after they're issued, or in the case of reloadable gift cards, within five years after money was last added. But the rules don't apply to reloadable cards that aren't labeled or marketed as gift cards, including those awarded through loyalty, rebate, or promotional programs. Nor do the federal regulations apply to discount vouchers from such sites as Groupon or Living Social.

Consumers Union, the advocacy arm of Consumer Reports, supports a bill in Congress that prohibits expiration dates and non-use fees and prevents companies that have filed for bankruptcy from selling gift cards or refusing to honor those they've sold.

But in the meantime, here's what else to keep in mind about your gift cards:
You might lose or forget about them: Using them now means you won't have to worry about losing them later.

You may be charged inactivity fees: Bank-issued cards are convenient because you can use them almost anywhere, but they come with fees. For example, you could be charged a monthly fee after 12 months of inactivity. Charity gift cards can also come with fees for transactions, or to transfer funds. Retail store cards usually have few or no fees.

The retailer could go bankrupt: When Sharper Image filed for bankruptcy reorganization several years ago, an estimated $20 million in gift cards and certificates were unredeemed. Consumers with Sharper Image gift cards were first told that the retailer was no longer accepting its cards, then that it would accept the cards if customers spent twice the cards value, and finally that it was closing its stores altogether. Even if a retailer continues honoring its gift cards during bankruptcy reorganization or liquidation, there could be fewer places to redeem them or less time to do so.

0 Ditch the fat-free salad dressing, and other tips for cooking healthier in 2013

New Year's Day is notable for resolutions. If a healthier diet is on your list, just choosing the right foods isn't enough; how you prepare your meals can be just as important as what you put in your shopping cart, according to Bonnie Taub-Dix, a nutrition expert and author of "Read It Before You Eat It" (Plume, 2010).

For example, cooking certain foods makes their nutrients more available, like the lycopene in tomatoes and the carotene in carrots. In other cases, common cooking practices can diminish the nutritional quality of your food or add unnecessary fat and sodium. That's true even for some habits you might think are good ones.

Here are six tips for getting the most nutrients from your meals, adapted from an article in the January issue of Consumer Reports on Health, our monthly health newsletter.

1. Keep nutrients in your veggies. Boiling and overcooking certain fresh vegetables robs them of vitamins, minerals, and antioxidants. Instead, steam them. Studies show that this cooking method preserves more nutrients in vegetables than boiling, stir-frying, or even blanching them. Spinach and other fast-cooking greens can be steamed in as little as 5 minutes; denser vegetables, such as whole carrots or potatoes, will probably need at least 20 minutes. You can also steam vegetables in the microwave, using just 1 to 3 tablespoons of water to preserve nutrients.

2. Don't oversalt. Just one teaspoon of table salt has about 2,300 milligrams of sodium, the generally recommended daily limit. Older people, African-Americans, and people with certain health conditions should get no more than 1,500 mg. To cut down on sodium, remove the salt shaker from your table and try to train yourself to be satisfied with less. Cut back on ready-to-eat processed foods and high-sodium condiments, such as barbecue sauce, ketchup, and soy sauce. Reach instead for healthier flavor enhancersa squirt of lemon or lime juice, a splash of balsamic vinegar, or a sprinkling of oregano or cumin, for example. Reduce the sodium in canned veggies by rinsing them in water before preparation, or, even easier, choose no- or low-sodium canned foods. You can test your sodium smarts with our quiz.

3. Remove the fat from ground beef. If you pan-fry burgers, be sure to pour off the fat. Or make burger patties in a broiling pan, which has slits or holes to let the excess fat drain away from the meat. If you're going to use cooked meat in a casserole or for pasta sauce, consider first blotting it with paper towels, or rinsing it under hot tap water in a colander and then draining for 5 minutes. It might sound gross, but an Iowa State University study found that this technique removed half the fat left after cooking without substantially reducing protein, iron, zinc, or B vitamin levels.

4. Switch to oven-frying. Compared with pan-frying, this method uses a lot less oil but still delivers a "fried" crunch. To do it, coat the food in something crispy that also adds nutrients and contains fewer calories, such as whole wheat panko crumbs or a mix of crushed bran flakes and corn flakes. Then spritz the food with cooking spray or a drizzle of oil, and bake. Learn which fats are healthiest to cook with.

5. Put some oil on that salad. Using fat-free dressing or a squeeze of lemon juice on a salad saves calories but also might prevent your body from absorbing all of the nutrients in the vegetables. That's because some nutrients are fat-soluble, and our bodies don't absorb them as well without a bit of fat. Researchers at Purdue University found that adding 1 tablespoons of canola oil to a salad can boost the body's absorption of carotenoids, antioxidants in carrots that the body converts to vitamin A. Without any accompanying fat, carotenoids go mostly unabsorbed and unused. Another healthful choice is olive oil. See our buying advice on olive oil and (for subscribers) Ratings of 23 extra-virgin varieties.

6. Add variety. Preparing the same type of meal over and over, even if it's a healthful one, limits your nutrient intake. Research has linked a varied diet to better overall health and a reduced risk of cancer and heart disease. You can find ideas for a wide range of breakfast, lunch, and dinner menus tailored to your gender, age, body size, and activity level at ChooseMyPlate.gov.

0 5 tips for easy returns of unwanted holiday gifts

The holidays were wonderful, but now that the wrapping paper has been discarded and the good dishes put away, it's time to take stockshould you keep, return, or re-gift some of the presents you got?

If you choose to return any unwanted gifts, you can prep before making a trip to the store, and follow our tips to steer clear of typical gift-return hassles.

1. Be sure before you open that box: Merchants can impose a restocking fee (often 15 percent of the product's cost), and many do for electronics items. Products such as computer software, CDs, and DVDs aren't generally returnable once they're opened. It might also be hard to return products with damaged packaging or missing tags.

2. Keep all gift receipts: These days, more merchants will turn you away if you don't have a receipt. If you didn't get a gift receipt with a product you want to return, you may be out of luck, unless you're prepared to ask the giver for the receipt.

3. Check store return procedures online and note any time limits: Big merchants usually allow 90 days for returns of most items but might have far shorter periods for electronics, software, and CDs and DVDs. During the holidays, however, some retailers will extend their deadlines.

4. Bring your ID: Some companies require a government-issued ID with a receipt. That way, they can track serial returners even if the transaction is in cash.

5. Know your options: If an item was purchased online and the merchant has walk-in store locations, check the merchant's website to see if you can return it at a store and avoid repacking and a trip to the post office, as well as shipping fees.

For more helpful advice read Hassle-free gift returns, which includes a rundown of both good and bad return policies from various retailers.

0 Gift cards are great last-minute gifts, but purchase with care

Buying a gift card is easy, and while legislation has eliminated a number of the gotchas associated with these presents, some drawbacks remain. So do your homework before you spend any money on gift cards.

Consumers will spend $28.8 billion on gift cards during the holiday season, according to an estimate by the National Retail Federation. But shoppers don't get all they paid forcertain store policies can erode the value.

If you plan on giving a reloadable gift card or one that's not marketed as a gift card specifically, pay close attention to the card's terms and conditions to make sure the person you're giving it to doesn't get hit with fees that lower the overall amount they get to use toward a purchase. Bank-issued cards are convenient (you can use them almost anywhere), but they come with fees. For example, you could be charged a monthly fee after 12 months of inactivity.

Bottom line, if you're set on giving gift cards this holiday season, retail store cards are the way to go because they usually have little or no fees attached to them. And it's always a good idea to make sure the person you're giving one to actually likes to shop at the store the gift card is for.

0 17 million expect to shop on Christmas Eve

With the days until Christmas dwindling, two-thirds of celebrants132 million Americansstill hadn't finished shopping, and 14 percent said they had yet to start, according to Consumer Reports' latest Holiday Poll, fielded Dec. 10-17.

Still others push the limits of procrastination: Nine percent of shoppersan estimated 17 million peoplesaid they plan to shop in stores on Christmas Eve. Last-minute shoppers, in no position to be picky, are most likely to grab a gift card (the go-to present for 62 percent), give cash (27 percent), or a bottle of wine or liquor (15 percent). Other items likely to be bought in a pinch: lottery tickets and candy. Four percent of respondents said they would hand out an IOU for a present.

Most shoppers seem to be into the spirit of the season: 55 percent of respondents continue to be upbeat or ecstatic about the shopping experience, describing it as "pleasant," "fun," or "wonderful." Half as many characterized holiday shopping as "rushed," "nerve-wracking," or "annoying." To date, shoppers have spent an average of $340.

Some other poll findings:

• In order to guarantee that last-minute gifts arrive on time, 38 percent of respondents said they would be very or somewhat likely to pay an online retailer a premium for expedited shipping. But you better act fast--Dec. 22 is the FedEx deadline for overnight shipping for delivery by Christmas; it's a day earlier for UPS.

• If either the clock runs out or shoppers run out of money, service providers (mail carriers and building superintendents, for instance) will be the first crossed off our respondents' gift list, followed by coworkers, the family pet, an extended family member, and the boss. Children, grandchildren, girlfriends, and boyfriends are among the least likely to go without a gift.

• When it comes to who gives the worst holiday gifts, those surveyed said by a landslide that it was an extended family member. Coworkers, in-laws, and friends were also fingered as lousy gifters.

• For many, the holidays are as much about emotional riches as those that come wrapped in a box. When asked how much they looked forward to spending time with certain people during the holidays, 88 percent of married respondents' said they very much looked forward to spending time with their spouse or partner. Eighty-six percent of parents said the same about their children, as did 79 percent of grandparents with regard to grandchildren. Holiday quality time was also eagerly anticipated by most of those planning to enjoy the company of the family pet (68 percent), a girlfriend/boyfriend (also 68 percent), and their mother, father, or grandparent (64, 59, and 55 percent, respectively).

Who in their family would those surveyed prefer to avoid during the holidays? Extended family members such as an aunt, uncle, or cousin topped the list. And one in five said they weren't looking forward to spending time with a sibling or in-law at all.

Previously:
Crowds, packing on the pounds, aggressive parking lot drivers top list of holiday dreads
Despite Black Friday shopping spree, most consumers concerned about holiday spending

Tod Marks

0 Inexpensive, last-minute gifts for food lovers

Got someone on your list who loves good food? Consider one of these products, all of which did well in our recent tests. Even better, they're inexpensive, ranging from $6 to $60.

Trader Joe's California Estate olive oil. Just $6 for a 16.9-ounce bottle. It was excellent in our tests: strong, complex, and very fresh-tasting. It pairs especially well with bread and salad, our testers say.

Columbia Crest Grand Estates cabernet sauvignon and Bogle chardonnay. Both scored Very Good in our tests by expert tasters and were just $10 per bottle. We assessed 2008 and 2009 vintages, respectively, though more recent vintages shouldn't differ very much.

Norman Love Confections Signature Gift Box. At $49, it offers 25 excellent candies that include unusual fillings such as peanut butter and jelly, as well as truffles, creams, nut bits, and fruit pures. Shipping is extra and pricey ($36).

Ninja Master Prep Professional QB1004 blender and food chopper. Excellent at making smooth icy drinks, chopping foods, and pureing soup, the $60, has interchangeable containers and blades that make the combo blender and food chopper easy to use.

0 Got too much milk?

Can kids drink too much milk? Maybe, according to a new study from the American Academy of Pediatrics. It found that while getting enough is key for strong bones, excessive amounts might reduce the amount of iron in the blood, which is important for brain and psychomotor development.

Toronto researchers asked the parents of 1,311 healthy children between the ages of two and five how much milk the kids drank daily. Those who drank more milk had higher levels of vitamin D but lower levels of iron.

Two 8-ounce glasses a day seems to be the "just right" amount. The American Academy of Pediatrics recommends approximately two cups of nonfat or low-fat milk per day.

More: test your milk IQ.

Source: The Relationship Between Cow's Milk and Stores of Vitamin D and Iron in
Early Childhood. [Pediatrics]

0 Make sure your holiday gifts arrive on time this year

Holiday shipping deadlines are fast approaching if you want your gifts to reach their destinations on time. If you're sending gifts and want them to arrive by Christmas, note the various dates below for shipping within the United States.

U.S. Postal Service:
(Check usps.com for shipping deadlines to other countries and military addresses.)

• Parcel Post, Dec. 14
  
• First-Class Mail, Dec. 20
  
• Priority Mail, Dec. 21
  
• Most Express Mail, Dec. 22

FedEx:

• FedEx Ground and FedEx Home Delivery, Dec. 17 (Can vary depending on Zip Code)
  
• FedEx 2 Day, Dec. 20
  
• FedEx Overnight, Dec. 22

UPS:

• UPS Ground, Dec. 21
  
• UPS 2nd Day Air, Dec. 21
  
• UPS Next Day Air, Dec. 22

For a list of holiday shipping deadlines for online merchants visit freeshippingday.com, which also has details on this year's Free Shipping Day, Dec. 17, the last day to get free shipping with delivery by Christmas Eve from more than 1,400 merchants, including Barnes & Noble, Best Buy, Godiva, REI, Lego, Levis, Zales, and many many more.

If you're planning to do some of your holiday shopping online from some of the big-name retailers out there, you might want to check their specific deadlines for ordering if you want your packages to arrive on time.

Sources:
USPS
FedEx
UPS
FreeShippingDay.com

0 Buy an iPad for grandma and grandpa this year?

Got a relative with an age-related eye problem? If so, an iPad or other tablet with a backlit display might make a great gift. The contrast between background and text on those devices makes reading easier for people with macular degeneration and certain other vision problems, according to a new study.

Researchers found that people with the worst vision liked reading on the iPad 2, which was the tablet used in the test, more than reading a regular book or using a standard e-book reader, like the Amazon Kindle, which doesn't have the same backlit display. Even people with normal vision read faster on the iPad 2, the study found. Increasing the font size to 18 helped even more with reading speed. The research was recently presented at the American Academy of Ophthalmology's annual meeting.

Our newest tests found that the latest iPad, the iPad with Retina display, has even sharper text than the iPad 2. The new device tops Consumer Reports tablet ratings with its 9.7 inch, high-resolution display and battery life of 11.6 hours. But at $500, it is pricier than the iPad 2 or the Samsung Galaxy Tab 2 (10.1), which both cost around $400. Some other even cheaper, but great options include the Kindle Fire HD 8.9 with Wi-Fi and the iPad Mini with Wi-Fi. They're smaller than the regular iPads, but you can increase the font size, which might help someone with vision troubles. E-book readers are cheaper still, but most of our top-rated models are not backlit.

So if you're still looking for a gift for an older relative, you might want to consider a backlit tablet, like the iPad. Just don't say we didn't warn you when grandma asks for help downloading Fifty Shades of Grey!

Source
Digital Tablets Improve Speed and Ease of Reading for People with Moderate Vision Loss [American Academy of Ophthalmology]

0 5 tips: Be a return-friendly shopper this holiday season

You may think you've bought the perfect gift for everyone on your list, but at least some of your recipients are likely to disagree.

To help make the return process easier on your gift recipients, consider the following:

1. Check store return policies: It helps to know whether your gift recipient can return something purchased at a store's website to the store's nearest location, instead of having to box it up and ship it off. Big-box stores usually specify on their websites whether you can return something purchased online in a local store.

2. Look for restocking fees: Many retailers impose restocking fees, usually 15 percent of the product's cost, but these fees apply mostly to electronics. In general, retailers can be quick to impose restocking fees on returned electronics.

3. Know what can and can't be returned: Opened softwareincluding video games, audio CDs and moviesusually are not returnable, though your gift recipient should be able to exchange it if the electronics gift is defective.

4. How many days after purchase are returns allowed: Many big-box stores and other merchants have regular return policies of about 60 to 90 days, but usually have shorter periods for electronics, software, CDs and DVDs. Using a certain credit card can also potentially extend the return window as well. During the holidays, retailers sometimes extend deadlines.

5. Get a gift receipt: Many merchants used to offer at least store credit to shoppers without one. These days, more turn those people away.
   

For details on return policies and gotchas to be wary of as well as several apps that can help make returns easier read Hassle-free gift returns, which includes a list of retailers with crazy-good return policies, plus others that offer fast refunds.

0 Diabetic eye problems on the rise

One likely effect of the growing number of young people with type 2 diabetes is that more and more people in their 20s and 30s are developing serious eye problems not correctable with glasses.

"We've all been aware that obesity and type 2 diabetes go hand in hand, but now there is added evidence of an increase in eye diseases," says Marvin M. Lipman, M.D., Consumer Reports chief medical adviser. "Unless we can stem the tide of obesity and defer the onset of diabetes, the younger population may be facing other diabetes complications as well."

Researchers from Johns Hopkins University School of Medicine in Baltimore and elsewhere analyzed data from the National Health and Nutrition Examination Survey, an ongoing, nationally representative study of the nation's health. The Hopkins team compared the results of questionnaires, laboratory tests, and physical examinations taken by 9,471 men and women age 20 or older from 1999 to 2002, with results from 10,480 subjects from 2005 to 2008.

They found an increase in both diabetes diagnosed for 10 or more years, and worsening vision among non-Hispanic whites ages 20 to 39. "If the current finding becomes a persisting trend, it could result in increasing rates of disability in the U.S. population, including greater numbers of patients with end-organ diabetic damage who would require ophthalmic care," the researchers concluded. The article was published this week in the Journal of the American Medical Association.

The findings should spur new efforts to prevent the underlying causes that lead to diabetes and its complications such as obesity-prevention programs aimed at children and adolescents, wrote David C. Musch, Ph.D., M.P.H., and Thomas W. Gardner, M.D., M.S., of the University of Michigan, Ann Arbor, in an accompanying editorial.

Bottom line: If left unchecked, the combination of an increasing incidence of type 2 diabetes in younger individuals and the longer duration of the condition will lead to many more young people living with serious vision loss, among other related problems. See our diabetes toolkit for advice on steps you or a family member can take to prevent and manage the disease, based on survey data from more than 5,000 people with diabetes.

Sources
Prevalence of Nonrefractive Visual Impairment in US Adults and Associated
Risk Factors, 1999-2002 and 2005-2008 [JAMA]
Diabetes and Nonrefractive Visual Impairment [JAMA editorial]

0 Crowds, packing on the pounds, aggressive parking lot drivers top list of holiday dreads

'Tis the season to be jolly, but for many Americans this time of year isn't all eggnog and mistletoe. In fact, for some, the holidays can be downright Grinch-worthy.

In our latest Holiday Poll, a nationally representative survey of more than 1,100 adults, holiday shoppers shared what they dread most about the Yuletide season.

Topping the list by a wide margin were crowds and long lines, cited by 58 percent of respondents, followed by weight gain (41 percent), and aggressive drivers thoughtlessly tooling around parking lots (40 percent). Other angst inducers included getting into debt, gift shopping, seasonal music, lousy presents, and face-to-face get-togethers with certain relatives. The entire list appears below.

Women, in particular, said they dreaded holiday weight gain (47 percent vs. 34 percent of men). Desserts, pastries, and cookies singled out by all respondents as the treats all they overindulge in at this time of year.

Another holiday staple that many people said they'd rather not deal with are gift cards. Sixty percent of those surveyed said they'd prefer to receive cash instead.

For all the dreads, most Americans remain bitten by the holiday spirit. Sixty-four percent of those surveyed said they are enjoying or really enjoying the season, and many expressed a desire to slow down and take pleasure in the holidays even more by traveling less, simply being with family and friends, setting aside a bit more "me time" to relax, and attending fewer parties. (Twice as many men as women were bummed out about the holiday parties or events they had to attend.)

What do you dread most about the holiday season?

• Crowds, long lines: 58*
  
• Weight gain: 41
  
• Aggressive, thoughtless driving in parking lots: 40
  
• Getting into debt: 30
  
• Gift shopping: 20
  
• Seasonal music: 14
  
• Disappointing gifts: 13
  
• Seeing certain relatives: 12
  
• Traveling: 10
  
• Having to attend holiday parties, gatherings or events: 9
  
• Having to be nice: 4
  
• Holiday tipping: 3
  *Multiple responses allowed
  

Tod Marks

0 When you're out of the hospital, are you out of the woods?

If you think leaving the hospital means you're home for good, think again. About twenty percent of heart attack and pneumonia patients, and a quarter of heart failure patients, find themselves back in the hospital within 30 days, according to our updated hospital Ratings. And our new analysis shows that those rates aren't getting better.

The most recent data cover patients discharged between July 2008 and June 2011, which we compared against data from two years earlier, between July 2006 and June 2009. The information is from the Federal Centers for Medicare and Medicaid Services, and shows an estimate of the likelihood that a heart attack, heart failure, or pneumonia patient will be readmitted to any hospital, for any condition, within 30 days of his or her initial discharge.

Readmission rates give important insights to hospital safety for several reasons. First, hospitals are inherently risky places, so being readmitted exposes you to additional risk. Having to be readmitted can also indicate that something went awry during your initial discharge, like poor planning for your home care. Or maybe that something went wrong during your hospital stay, like you developed a hospital-acquired infection that only became apparent when you got home.

To make your discharge as smooth as possible:

• See a discharge planner well in advance of your departure to arrange for services or supplies you'll need at home.
• Get a written summary of what to do when you get home, including drugs you need, how to care for wounds, how active you can be, and when you can shower, drive, return to work, and eat normally.
• Get results of tests done while in the hospital and ask what tests you'll need after you leave and when you'll need them.
• See your primary-care doctor within 10 days of going home.

For more advice, see our tips for staying safe in the hospital. And check out our hospital Ratings to see how your hospital fares on readmissions on other measures of hospital quality.

Abbe Herzig

0 Ultrasonic bug zappers don't help ward off bedbugs

It sure is tempting: Just plug in a device and let sound waves keep bedbugs and other creepy-crawlies away, without pesticides or expensive exterminator bills. Unfortunately, those ultrasonic bug repellent devices marketed on late-night TV and sold online don't work, according to a new study.

Researchers at Northern Arizona University bought four pest repellent devices from Amazon.com. They then let a bunch of bedbugs loose and let them choose between one area filled with sound from the devices and the other silent. Turns out there was no real difference in the number of bedbugs that chose the noisy or quiet areas. The researchers weren't too surprised by this bedbug behavior, since other research has shown these devices aren't effective against ants, mosquitoes, or roaches, either.

The study was published this week in the Journal of Economic Entomology.

Read other bedbug news.

Source
Efficacy of Commercially Available Ultrasonic Pest Repellent Devices to Affect Behavior of Bed Bugs (Hemiptera: Cimicidae) [Journal of Economic Entomology]

0 Consumer Reports Index: Sentiment among wealthier Americans drops sharply

A weak employment picture hit lower-income households the hardest this month, and the budget impasse in Washington created a drag on consumer outlook among the more affluent, according to the Consumer Reports Index, an overall measure of Americans' personal financial health.

"Poor employment levels for the lower-income households and fears of fiscal uncertainty for more affluent households were the perfect storm to sink the significant gains seen last month," says Ed Farrell, director of consumer insight at the Consumer Reports National Research Center.

More Americans are losing rather than starting jobs. The employment measure dropped to 49.7 this month from its high last month of 51.5, and job starts fell to 5.4 percent from 5.7 percent a month earlier, while job losses jumped to 5.9 percent from 2.7 percent. The decline in employment most severely affected those in households earning less than $50,000, where the index dropped to 47.8 from 51.8 last month.

Although consumer sentiment was unchanged overall from last month, it did drop among Americans earning $100,000 or more: For the first time, their strongly positive sentiment fell in line with other income groups, all hovering around the 50 markhalf feel their financial condition is better, and half worse compared to a year ago.

The Trouble Tracker, a measure of the financial difficulties faced by Americans, rose this month to 45.5, up from its record low last month of 38.7. Mounting financial difficulties were not broad based but instead centered on those earning $100,000 or more. However, the level of financial difficulties among this segment of Americans is still far lower than those earning less than $50,000. The level of difficulties reported by other income groups was stable compared to last month.

The past 30-day retail measure was up to 11.1 from 9.6 last month, reflecting the expected holiday jump, but lagged last year's performance of 13.9. Anticipated spending over the next 30 days was also down vs. last year. The next 30-day retail measure stands at 10.1, down from 12.7 last year at this time.

The level of stress that consumers feel was up slightly from last month (59.1 vs. 57.8). The most stressed Americans were those in households earning $50,000 to $99,999 (63.6) and 35- to 64-year-olds (61.1).

The Consumer Reports Index, a monthly telephone poll of a nationally representative sample of American adults, is conducted by the Consumer Reports National Research Center. It comprises five measures: Employment, Retail, Sentiment, Stress, and the Trouble Tracker. A total of 1,007 telephone interviews were completed between November 29 and December 2, 2012. The margin of error is +/-3.2 percentage points at a 95 percent confidence level.

Previously: Consumer Reports Index: Americans see major decline in financial difficulties

0 Despite Black Friday shopping spree, most consumers concerned about holiday spending

Although two-thirds of adults shopped over Black Friday weekend, the latest Consumer Reports Holiday Poll reveals that 81 percent of shoppers remain at least somewhat concerned about racking up big bills.

Fifty-eight percent of those surveyed in our nationally representative poll plan to splurge less on gifts than they did last year (by comparison, only 5 percent said they intend to splurge more than they did in 2011), while 31 will be eying more practical presents this season (vs. 9 percent who say they'll go the opposite way). Charities are taking a hit, too. Nineteen percent say they'll donate less to the needy compared to 13 percent who expect to give more this year.

With roughly three weeks until Christmas, 36 percent of gift givers51.7 million Americanshadn't begun shopping. In fact, most people most people weren't halfway done. By the time they're finished, the median amount spent on gifts will be $483. To date, 28 percent of shoppers say they've found the best deals online, 26 cited mass merchants such as Walmart and Target as the source of the best bargains, while 14 percent identified department stores for superior savings. Ironically, only 9 and 7 percent, respectively, said they found the best deals at warehouse clubs (Costco and Sam's), and outlet stores, which have a reputation for low prices.

Most shoppers rely on newspaper ads to sniff out deals; 38 percent look at promotional flyers and circulars, 36 percent listen to TV and radio ads; and 29 percent keep an eye open for e-mail promotions. Though they receive plenty of publicity, relatively few people get alerted to holiday bargains via coupon sites such as Groupon (15 percent) and Facebook (11 percent).

When asked "how concerned are you about limiting expenses this holiday season," 51 percent answered "somewhat," 30 percent said "very." To keep from going overboard, those surveyed offered a range of responses: Fifty-five percent said they will give cheaper gifts; 46 percent said they'll be more aggressive at seeking out sales and discount coupons; 38 percent said they will chop names off their gift list entirely. Other tactics: Agreeing to more limited gift-giving options with family or friends (29 percent), purchasing exclusively from websites that offer free shipping (23 percent), replace store-bought gifts with homemade ones (21 percent), cut back on holiday travel (19 percent), and send fewer holiday greeting cards (16 percent).

Despite the concerns, most Americans are reveling in the season. Sixty-four percent of respondents are enjoying or "really" enjoying the holidays. And compared to last year, most people indicated they'd like to take things a little easier. For example, a larger percentage of people said they'd prefer to travel less to holiday destinations, go to fewer parties, spend more time with family and friends, and set aside a little more "me" time to relax.

For your own holiday shopping needs, check out our list of 25 recommended products that anyone would love, plus our full holiday gift guide for 2012.

Previously:
One-third of shoppers to hit the malls or keyboard on Black Friday

Tod Marks

0 Has my generic Lipitor been recalled?

Check your prescription container to see if a manufacturer is listed on the label. If your bottle says "Ranbaxy," call or take it back to the pharmacy where you filled the prescription to find out if it's been recalled. The pharmaceutical company Ranbaxy announced recently that it was recalling 41 lots of generic Lipitor (atorvastatin) due to concerns that they might contain small glass particles.

The Food and Drug Administration says the glass particles are so small they are unlikely to cause safety concerns, but the possibility of harm cannot be ruled out. Our medical advisers recommend that if your medication is included in the recall, return it to the pharmacy where you filled the prescription for an exchange. The recall affects 10 mg, 20 mg and 40 mg strengths of the drug, but not the 80 mg dose.

Pharmacy spokespeople at CVS and Costco told us they will work with customers to replace the recalled medication. Costco confirmed that there will be no charge to the patient. Walgreens and Target told us their pharmacy customers should not be affected, since they don't stock the Ranbaxy product that was recalled. Walmart and Kmart didn't return our requests for information.

Versions of generic Lipitor made by other manufacturers, including Apotex, Dr. Reddy's Lab, Mylan, Pfizer, and Watson, aren't affected by the recall. If there is not a manufacturer listed on your prescription bottle and you are unsure if your medication is part of the recall, contact your pharmacy.

Ranbaxy's generic Lipitor represents about 40 percent of the market for all medications, according to our Consumer Reports Best Buy Drugs internal analysis of prescription sales data. Some reports have expressed concern for a short-term shortage of atorvastatin while Ranbaxy works to remedy its manufacturing problems. But retailers we spoke with have made other arrangements.

"I don't anticipate a shortage and pharmacies can normally get another brand in stock within 24 hours," says Nate Eilers, RPh, of Costco.

The FDA has also said is does not expect a shortage will occur.

[Sources]
FDA Statement on the Ranbaxy Atorvastatin Recall [FDA]

Ranbaxy atorvastatin recall announcement [Ranbaxy]

Editor's note: Additional reporting and editing by Steve Mitchell.

0 CDC warns about bedbug pesticides

If you've got a bedbug infestation, you probably want to do whatever necessary to get rid of them, including spraying your home with pesticides. But earlier this week the Centers for Disease Control and Prevention warned about a steep rise in injuries from misuse of pesticides to control the bugs.

Health effects ranged from mild to serious, including one death. Using pesticides that are designed for outdoor use indoors or using too much pesticide were often the cause.

• If you have to use pesticides to kill bedbugs, consider this advice from the CDC:


• Follow all label instructions to the letter. Don't use outdoor pesticides inside your home and don't use more than recommended. This won't kill more bedbugs, but it might make you and your family seriously ill.


• Be careful who you hire. Treating bedbugs is not easy so you want someone who is experienced. Also be sure than any professional you use is licensed and certified to apply pesticides. You should get instructions on what's being used in your home. Ask to read label instructions. This applies to anyone your landlord hires as well.


• Signs of pesticide poisoning include headache, nausea, vomiting, diarrhea, dizziness, and muscle tremors. Children are particularly at risk because they are smaller and may put things in their mouths that have been covered in pesticide. If anyone in your home displays symptoms, seek advice and treatment from health professionals right away. Call your doctor or poison control center at 1-800-222-1222.


• Pet can also be harmed, and because of their smaller body size, may display symptoms before any humans do. So if your dog or cat seems sick after a pesticide application, that may be the first red flag that something is wrong. Call your veterinarian or the National Animal Poison Control Center at 1-888-426-4435.

Read more about how to keep bedbugs at bay.

Source
Health Concerns about Misuse of Pesticides for Bed Bug Control [CDC]

0 Medicare open enrollment: Did Obamacare secretly increase Part B premiums?

Q. I heard that the Medicare Part B premium was going to go up to $120 in 2013 and $247 in 2014 as part of Obamacare, and that this was kept under wraps so as not to influence the outcome of the 2012 election. True or false?

A. I've been sitting on this question for awhile awaiting the announcement of the 2013 Medicare Part B premium. Now it's time to answer. And the answer is that everything you heard was a fiction.

Per a law that has been in effect now for 15 years and has nothing whatsoever to do with the Affordable Care Act, every fall Medicare sets the Part B premium for the coming calendar year at a level that will cover exactly 25 percent of Part B's projected costs. So right off you can see that there is no way that the health reform law, enacted in 2010, could have set premiums three and four years in advance, which, once again, it did not.

Medicare recently announced what the 2013 Part B premium will be. It's $104.90 (not $120). This represents about a five percent increase over 2012's premium of $99.90.

You didn't ask, but should also be aware that higher-income Medicare beneficiaries must pay more than this standard Part B premium, thanks to the same 2003 law that established Medicare Advantage and the Part D prescription drug benefit. These higher premiums in 2013, by income level and filing status, will be:

• $146.90 for incomes between $85,001 and $107,000 (single) and between $170,001 and $214,000 (joint)
• $209.80 for incomes between $107,001 and $160,000 (single) and between $214,001 and $320,000 (joint)
• $272.70 for incomes between $160,001 and $214,000 (single) and $320,001 and $428,000 (joint)
• $335.80 for incomes above $214,000 (single) and $428,000 (joint)

Right now, about five percent of Medicare beneficiaries are paying these higher premiums. But in the next few years, that percentage is going to increase steadily, because of a provision that was put in the Affordable Care Act (but, needless to say, never a secret kept under wraps).

Here's what's happening. The 2003 law that set up these high-income premium surcharges also stated that the income thresholds were to increase every year to account for general inflation. But the Affordable Care Act freezes the thresholds at their current level through 2019, which will over the next six years snare more and more beneficiaries as incomes in general rise (or at least we hope they do). The Kaiser Family Foundation estimates that by 2019, about 14 percent of Medicare beneficiaries will be paying these higher premiums.

A silver lining in this scenario is that as of 2020, the freeze disappears and at that point, the income thresholds will be re-indexed to where they would have been if the freeze had never happened in the first place.

For more information, see our Health Insurance Buying Guide as well as rankings of health insurance plans.
Got a question for me? Ask it here.

0 FDA looking into safety of energy drinks

There's been a lot of buzz lately about the safety of energy drinks and shots. Following reports of harmful reactions and even deaths possibly associated with the products, two U.S. senators recently released a letter from the FDA stating that the agency is conducting a safety review of energy drinks and is considering requiring that labels disclose the amount of caffeine the products pack, limitations on use, and warnings about possible adverse effects. That makes sense, since our recent investigation found that the products sometimes have more caffeine than they claim.

"We support the FDA's investigation into the health effects of these products especially for vulnerable populations, including children, adolescents, those with heart problems and seniors," says Urvashi Rangan, Ph.D., director of consumer safety and sustainability at Consumer Reports. "We also believe that labeling is an important way to warn consumers of any potential dangers but that further action may be warranted based on FDA's findings."

Here's more news from the FDA's letter to U.S. Sens. Richard Blumenthal and Dick Durbin outlining the agency's actions and findings so far:

• FDA is probing whether energy drinks may pose significant risks arising from direct toxic effects when consumed in excess or by vulnerable groups, including young people and those with pre-existing cardiac or other conditions. The FDA said its review would likely include consultation with the Institute of Medicine, an advisory committee or other public meeting.
• FDA has yet to identify any safety studies that call into question the safety of combinations of various ingredients in energy drinks. However, it said that additive or synergistic effects of certain ingredients could be of concern. If stimulants, for instance, raise a significant safety question, FDA could require safety reviews.
• FDA disclosed that an in-depth analysis of caffeine consumption in the U.S. completed in August 2010 found that on average about 300 mg of caffeine, per person, per day is consumed. That's within the 400 mg per day limit that FDA has said is not associated with adverse effects in healthy adults. The report found that teens and young adults, age 14 to 21, consume only about 100 mg of caffeine per person per day, mainly from soft drinks, coffee, or tea. However, it said the data may not reveal possible extremes of consumption which alone or in addition to other factors could pose health risks, and that some smaller individuals may be more sensitive to caffeine's effects.
• FDA will consult with health profession groups about whether it is advisable for children and pregnant women to limit their caffeine consumption. It noted that the American Academy of Pediatrics recommends no more than 100 mg of caffeine per day for adolescents, but that the Institute of Medicine has said that stimulant-containing drinks and products have no place in the diets of children and adolescents because of the risk of physical dependence and withdrawal symptoms, such as sleepiness and irritability. The FDA noted that the United Kingdom's Food Standards Agency recommends that pregnant women consume no more than 200 mg of caffeine per day.

Bottom line: Reports of adverse effects and deaths possibly associated with some products by themselves don't prove the products caused the problems, the companies that responded to our requests for comment said, as did the FDA in a Nov. 16 press release. It's up to FDA investigators to assess the relationship, if any, between the products or ingredients and the reports, the agency said. But the FDA urged consumers thinking about taking energy drinks or shots to first consult a health care provider to ensure that they don't have an underlying or undiagnosed medical condition that could worsen as a result of their use. Consumers and health care providers should report adverse events they believe may be related to energy drinks and shots (or other FDA-regulated products) to the agency's MedWatch Adverse Event Reporting Program. Read our report in Consumer Reports.

Source
Blumenthal, Durbin: FDA Reviewing Safety Of Caffeinated Energy Drinks And Their Additives [Press release]

0 FDA shuts down Sunland peanut butter plant with new enforcement authority

The U.S. Food and Drug Administration has shuttered Sunland Inc.'s New Mexico plant after peanut butter made by the company was linked to an outbreak of Salmonella that sickened 41 people in 20 states.

The FDA suspended Sunland's food facility registration, prohibiting the company from distributing any products. This was the FDA's first use of its registration suspension authority under the Food Safety Modernization Act, which was enacted in January of last year. Without the enforcement authority, the FDA would have had to take Sunland to court in order to halt production and distribution at the plant.

In addition, according to the FDA, Sunland also has a history of violations that contributed to the federal agency's decision to suspend the company's registration.

"This is good news for consumers. FDA was able to act effectively and promptly to deal with a situation of a hazard in the marketplace," says Jean Halloran, director of Food Policy Initiatives for Consumer Reports. "This FDA action sends a powerful message to food processors that if you're producing in substandard conditions and putting out food that is hazardous to consumers, FDA will shut you down."

During plant inspections in September and October, the FDA found Salmonella in 28 samples from surfaces at the plant, in 13 product samples, and one sample of raw peanuts. Sunland's records showed that 11 product lots of nut butter showed the presence of Salmonella between June 2009 and September 2012. And between March 2010 and September 2012, at least a portion of eight product lots of nut butter that Sunland's testing program identified as containing Salmonella was distributed to consumers.

Last month, Sunland expanded a September recall of peanut products due to the Salmonella contamination.

The FDA will reinstate Sunland's registration when it determines that the company has implemented procedures to produce safe products.

Salmonella can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weak immune systems. Healthy people infected with Salmonella can experience fever, diarrhea, nausea, vomiting, and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses.

If you want an alternative for your kids' lunches read Make healthy school lunches your kids will love. For information about how to get involved with food safety, check out our website NotInMyFood.org.

Previously:
Peanut product recall expands due to Salmonella contamination
Trader Joe's peanut butter recall shows the need for tougher food safety regulations

Sources:
FDA Investigates Multistate Outbreak of Salmonella Bredeney Infections Linked to Peanut Butter made by Sunland Inc. [FDA]
The New FDA Food Safety Modernization Act (FSMA) [FDA]
Consumers Union praises FDA shutdown of Sunland plant, presses for further implementation of federal food-safety rules [Consumers Union]

0 Time for a whooping cough booster?

Pertussis, also known as whooping cough, is rising sharply and a new study suggests that a contributing cause may be that the vaccine now used loses effectiveness over time. Which means it may be time for you to get a booster.

The old vaccine, introduced in the late 1940s, dramatically reduced pertussis infections but was often associated with redness, swelling, pain at the injection site, and, in a few cases, serious complications. The current vaccine, which is called DTaP and also vaccinates against diphtheria and tetanus, was introduced in 1992 to reduce those risks.

Infants are most likely to be hospitalized and die from pertussis, but there's also been a sharp increase among school-aged children and even adults, according to the new study, which was published this week in the Journal of the American Medical Association. According to the study, California had its largest pertussis epidemic in 60 years in 2010, with more than 9,000 reported cases and 10 infant deaths. Researchers studied the vaccine records of children ages 4 to 10 and found that the longer the time since the final dose of the vaccine, the greater the risk of infection. That suggests that the vaccine loses effectiveness over time.

Despite whooping cough's recent resurgence, cases are still far below what they were in the pre-vaccine era. Another finding from the JAMA study: unvaccinated children were nine times more likely to contract pertussis than were their immunized peers.

Bottom line: Researchers may eventually recommend a different vaccination schedule or develop a longer lasting vaccine. But for now, the DTaP vaccine offers substantial protection against whooping cough. The vaccine is actually a series of five shots, all of which must be completed in order for it to be most protective. Children should receive doses one through three before their first birthday, dose four between by 18 months old, and dose five between ages 4 and 6 . An adolescent booster, Tdap, should be administered at age 11. Pregnant women should also get a shot, as should people 65 and older who are in contact with infants. For details, see our advice on vaccines for children and adults. And see the CDC's pertussis website.

Source
Association of childhood pertussis with receipt of 5 doses of pertussis vaccine by time since last vaccine dose, California, 2010 [JAMA]

0 Stay safe online on Cyber Monday

Don't want to brave the lines, crowds, and general pandemonium of Black Friday? You could always stay home and shop online on Cyber Monday instead. Many online retailers will be offering substantial discounts, free shipping, and other attractive perqs to Web shoppers on the Monday after Black Fridaythat's November 26 this year.

Here are some tips for safe online shopping:

• Never use the same password for multiple sites. Minimize the chance that a hacker who broke into one account can gain access to your other online accounts.


• Create and use separate e-mail addresses. Specific e-mail accounts for specific shopping sitessay, "MyAmazonAccount@gmail.com"will limit your data exposure when a particular online retailer gets hacked.


• Never use any part of your name or any other easily guessed word in your password.


• Use a strong password, including a mixture of letters, numbers, and special characters. Substituting numbers for letters might help you remember your login--"pa55w0rd" instead of "password," for example. And some websites allow the use of symbols such as ! and . For more password advice, see "How to create a strong password (and remember it!)."


• Verify that the site you're doing business with is a known and trusted retailer.

Make sure to check out any electronics devices you're thinking of buying in our Ratings at ConsumerReports.org. And for more ways on how to protect your money and information online, see our guide to online security.

Related:
Fake online product reviews draw regulator attention
Electronics store buying guide
Computer store buying guide
Naughty or Nice? See which companies made our list this year and why
Consumer Reports' Holiday Gift Guide 2012

0 Meningitis cases from tainted steroids continue to rise

The outbreak of fungal meningitis due to a contaminated steroid has affected 490 people and caused 34 deaths, according to updated figures released earlier this week from the Centers for Disease Control and Prevention. Our medical advisers say the ongoing rise in cases means people who received a tainted injection and who feel fine should continue to watch for any signs of infection. It also underscores our advice to avoid using medication from compounding pharmacies if possible, and to turn to steroid injections for back pain only after trying other treatments.

The fungal meningitis cases stem from three contaminated batches of the steroid methylprednisolone acetate (MPA) made by New England Compounding Center in Framingham, Mass. Thousands of people across 23 states received epidural shots of the contaminated batches of steroids to treat pain. Most of the 490 cases consisted of meningitis (an infection of the brain or spinal cord) following treatment for back pain, but there have also been cases of infections following injections in the elbow, hip, knee, and shoulder.

Doctors have been instructed to contact people who received contaminated shots, but if you think you may have received a tainted injection and you haven't been contacted, check the CDC list of facilities to see if it includes the clinic you visited. If it does, double-check with your doctor whether your injection came from one of the recalled batches. The CDC has also an online map that shows the states affected.

If you received an epidural steroid injection from one of the listed clinics since May 21, 2012, be alert for any symptoms that could signal a fungal infection. Those include:

• fever


• increased pain, redness or swelling at your injection site


• new or worsening headache


• sensitivity to light


• slurred speech


• stiff neck


• weakness or numbness in any part of your body

If you experience any of those, talk to your doctor as soon as possible. The CDC has additional advice on what to do if you think you received a tainted injection.

To reduce your risk in the future, our medical advisers recommend that you only use a medication from a compounding pharmacy if no other FDA-approved product is available. Also, in most cases of back pain, you should start with simpler measures, such as over-the-counter pain relievers, physical therapy, and exercise, before turning to steroid shots.

[Sources]
Multistate Fungal Meningitis Outbreak Investigation [Centers for Disease Control and Prevention]

Is it OK to use a compounding pharmacy? (And what is one anyway?) [Consumer Reports]

Should you avoid all steroid injections for your back pain? [Consumer Reports]

0 One-third of shoppers to hit the malls or keyboard on Black Friday

With just over a month until Christmas, 57 percent of consumers (and 65 percent of men) have yet to begin shopping, mostly because they think they have plenty of time, according to the latest Consumer Reports Holiday poll. However, in yet another reminder of ongoing tough times, 17 percent said they've delayed shopping because they just don't have enough money.

Despite the economic upheaval of the past four years, most Americans are anxiously awaiting the holidays. Thirty-seven percent of those surveyed said they're looking forward to them; another 26 percent are really looking forward to celebrating the holidays. Nevertheless, there are always a few Scrooges among us. Six percent of respondents said they're not looking forward to the holidays at all.

Neither the state of the economy nor the recent presidential election is affecting cheerfulness one way or the other. Sixty-seven percent of respondents expect to be just as happy this year as in 2011.

The poll, a nationally representative telephone survey of 1,557 adults 18 and older, reveals that since the recession many Americans have changed their behavior - spending more conservatively, and giving fewer and less-lavish gifts. Indeed, the gifts people are considering this year skew to the practical: clothing, cited by 52 percent of respondents, gift cards (46 percent), toys (39 percent) cash or check (37 percent), and books (31 percent).

With shopping as much a part of the season as eggnog and holiday music, expect millions to be out in force on Black Friday weekend. Thirty-two percent of respondents say they'll hit the stores; 34 percent intend to shop online, the same percentage that plan to order online from the office on Nov. 26 to participate in the phenomenon known as "Cyber Monday."

Since the economy tanked in 2008, half of those surveyed said they're spending less than they did before the recession. Forty-seven percent have economized by buying cheaper gifts; 36 are purchasing fewer presents. Six percent have replaced store-bought items with handmade ones to save money. For the upcoming season, 37 percent of respondents said they intend to spend less than they did in 2011 (only 12 percent indicated they'll spend more).

Budgeting will play a big role this year, too. Fifty-two percent plan to make a holiday spending budget. Hopefully, they'll do a better job living within it. In 2011, one-third of the 41 percent who set a budget exceeded their spending limit; four percent went way over budget.

One problem that hasn't disappeared is holiday debt. Half of shoppers charged gift purchases last year and 13 percent are still paying off credit card debt from those purchases.

While gift cards continue to be desirable, 15 percent of people still have at least one unused card from 2011.When asked why the cards haven't been spent, 29 percent said they haven't had time to use the card; 24 percent indicated they couldn't find anything they wanted to buy; and 23 percent (30 percent of men) simply forgot about the card. Seven percent cited the fact that the card came from a store they didn't like.

Wondering what some of the hot electronics gifts will be? High on the list of those surveyed include: the Amazon Kindle Fire, Apple iPod, iPad mini, and iPhone 5, LeapFrog LeapPad2 Explorer, Nintendo Wii U, Samsung Galaxy S III, and Apple MacBook Air. Among toys: Hasbro's Furby, Barbie Photo Fashion Doll, and Lego Ninjago Epic Dragon Battle.

We recently named the Kindle Fire, iPhone 5, and Galaxy S III standout performers. Find out which other devices are included in our 10 top electronics products review.

Tod Marks

0 Hot cocoa makers recalled due to possible lead risk

Focus Products Group International, which owns the West Bend brand name, is recalling several hot cocoa drink makers today. According to the Food and Drug Administration, the small appliances have internal parts that may leach heavy metal lead while making hot cocoa.

Although there have been no reported illnesses or deaths tied to the recall, safety experts warn that the lead-leaching can be dangerousespecially to young children. Exposure to heavy metals, such as lead and cadmium, may bring irreversible health effects such as anemia, kidney damage, and brain damage.

In May, the Centers for Disease Control and Prevention had lowered the allowable blood lead-levels for children, due to concerns that their developing bodies can more-readily absorb and retain toxic heavy metals.

Read "CDC advisers call for less allowable lead" and our buying advice for lead testing kits for more information on how to reduce your child's lead exposure and prevent lead poisoning.

Today's recall involves the following Cocoa Latte Hot Drink Maker models, sold nationwide at retailers such as Bed, Bath & Beyond and Amazon.com from 2004 through October 12, 2012:

Make	Model Number
West Bend	65032
Back to Basics	CM300BK CM300BKL CM300BLSS CM300BR CM300BRBRL CM300BRL CM300W

Consumers are urged to immediately stop using the recalled Cocoa Latte Hot Drink Maker and contact Focus Products' Call Center (toll-free: 888-943-5202) for instructions to obtain a free replacement hot cocoa maker.

Sources:
Focus Products Group International, LLC Announces a Nationwide Recall of Cocoa Latte Hot Drink Maker [FDA]
Nationwide Recall of Cocoa Latte Hot Drink Makers Due to Possible Lead Risk [Focus Products Group International]
Product recall information [West Bend]

0 Is it OK to use a compounding pharmacy? (And what is one anyway?)

A: Until other much-needed changes occur, you should only use a medication from a compounding pharmacy if no other FDA-approved product is available, say our medical advisers. Compounding pharmacies create individual, customized drugs. They can, for example, omit ingredients such as lactose or gluten for people with allergies, flavor drugs to make them easier to take, create lower doses for children, or prepare a liquid, dissolvable lozenge, or suppository for those who can't swallow a capsule.

The national meningitis outbreak, which has sickened at least 451 people and claimed the lives of 32, has heightened concern about the safety of compounding pharmacies. There are 7,500 in the U.S., plus about 8,200 associated with hospitals and other health institutions. They are mostly regulated by state pharmacy boards, whose rules vary. The Food and Drug Administration cooperates in investigations and follow-up actions, but it has limited oversight of the pharmacies, according to a recent Congressional Research Service report.

"Regulation of compounding pharmacies by state boards of pharmacy is not uniform throughout this country and it should be," says Marvin M. Lipman, M.D., chief medical adviser for Consumer Reports. "In addition, all large-scale compounding pharmacies should be under the purview of the FDA before another tragedy occurs."

The drugs implicated in the current crisis came from a single pharmacy, the New England Compounding Pharmacy, which compounded more than 17,000 doses of the potentially tainted steroids and shipped it to 76 healthcare facilities--where an estimated 14,000 patients received the injections to treat pain. By compounding so much medication, the "pharmacy was behaving more like a drug manufacturer. Instead, compounding is meant to respond to individual patient needs on a small scale," says Cynthia Reilly, B.S. Pharm, director of the practice development division of the American Society of Health-System Pharmacists.

Clinics and hospitals might purchase compounded medications when there is a shortage of a certain drug and it becomes difficult to obtain a standard version from a distributor or manufacturer. In other cases, compounders may create a less expensive version of an FDA-approved drug without having to meet the agency's strict manufacturing standards.

The major risk from compounding lies with drugs that are injected, delivered through an intravenous (IV) line, used in the eyes, or inhaled through a nebulizer. Such medications must be completely germ-free in order to prevent infection, and the meningitis tragedy demonstrates the harm that can occur if they're not.

If you are scheduled to receive an intravenous, joint or spinal injection, ask if the material was compounded and whether the compounding pharmacy is accredited by the Pharmacy Compounding Accreditation Board (PCAB). That advice also applies if you receive injectable eye medication or eye drops in connection with an eye operation or procedure. "In light of the current situation, health-care providers will be expecting to hear these questions much more frequently," says Reilly.

For all other medications, if your doctor prescribes a drug compounded especially for you, ask if a standard FDA-approved formulation is available and appropriate for your treatment instead. But if not, "consumers shouldn't be afraid to use a compounding pharmacy if they need a product that's not available, such as an ointment instead of a pill, and they have a prescription from their physician for it," says Allen Vaida, PharmD, executive vice-president of the Institute for Safe Medication Practices.

[Additional links]
Steroid injections for back pain: Worth a shot? (Consumer Reports)

Relief for your aching back: What worked for our readers (Consumer Reports)

Death toll from contaminated shots rises (Consumer Reports)

0 Open enrollment: My income is really low. Can I get help paying for health care?

Q. I am 68 and have only Medicare Part A. My sole source of income is $1,062 a month from Social Security. I'm in good health but concerned about future medical needs. Are there any plans for lower-income people?

A.Yes, and it's a shame more Medicare beneficiaries don't know about them. It's understandable why they don't, as these programs are complex, vary from state to state, and seem to have been designed so everything about them is as baffling as possible.

But let's give it a shot anyway.

We'll start with a program that helps lower-income Medicare beneficiaries pay premiums and out-of-pocket costs for Medicare Parts A and B. Its overall name is the Medicare Savings Program (MSP), and it has several different benefit levels for people with different financial resources. At its most generous the program will pay your Part B premium and pretty much all your Medicare deductibles and coinsurance. At its least generous the program will pay just your Part B premium. (In situations like yours, where you didn't sign up for Part B when first eligible, the program will also pay the 10 percent premium penalty you'll be assessed for every year you could have enrolled, but did not.)

How poor, exactly, do you have to be to qualify for a MSP? The minimum standard, set by Medicare, is an income under 135 percent of the federal poverty level, which at the moment works out to $1,277 a month for individuals. "Everything counts towards income, including payouts from 401(k) plans, pensions, Social Security, and help from family members," says Brandy Bauer, communications manager at the National Council on Aging. Medicare also allows states to impose an asset test, which can be as little as $6,940 per individual (not counting your house or car but counting retirement savings and bank accounts).

But some states have made their MSP programs a lot more generous, with much higher income limits and in some cases no asset tests at all. And the program may be called something else in your state.

"In most states, nobody will automatically let you know you qualify," says Mitchell Clark, a media spokesperson for the Medicare Rights Center. "You have to actively apply." The place to apply is your state's Medicaid office, which you can find a link to at Medicaid.gov.

There is another completely separate program that helps with prescription drugs. Continuing with the theme of maximum confusingness, it has two names, Low-Income Subsidy and Extra Help, for no apparent reason. And to get it, you apply through your local Social Security office, not your Medicaid office.

Depending on exactly how low your income is, the program will pay all or part of your Part D prescription drug plan premium and deductible, a hefty chunk of your copay, and totally eliminate the infamous doughnut hole. In 2013, individuals with an income of up to $1,398 a month can qualify for Extra Help. There are also asset limitations.

If you manage to get yourself into a Medicare Savings Program, you will automatically qualify for Extra Help. But because the requirements are slightly different, even if you don't qualify for a Medicare Savings Program for Part B you might be able to get Extra Help for Part D.

Right now you're probably about to give up because you have no idea whether you might qualify for any of this. Happily, the National Council on Aging has created an invaluable online interactive tool, BenefitsCheckUp, to do the work for you. If you answer all the questions, it will in the end not only tell you which programs you may qualify for, but provide downloadable application forms and, in the case of Extra Help, allow you to complete your entire application online. The program even knows the specific MSP eligibility rules in your state.

Or, if you'd prefer interacting with an actual human being, you can start by contacting your State Health Insurance Assistance Program, a free personal counseling service for Medicare beneficiaries. Here's a list of programs by state.

For more information, see our Health Insurance Buying Guide as well as rankings of health insurance plans.
Got a question for me? Ask it here.

0 Medicare open enrollment: Sandy victims get an extension

Medicare beneficiaries whose lives have been upended by Hurricane Sandy will be allowed to sign up for Medicare health and drug plans after the open enrollment deadline of Dec. 7, the Centers for Medicare and Medicaid Services has announced.

If you don't plan to change your Medicare Advantage or Medicare Part D drug plan for 2013, you don't have to worry about the deadline at all as you will be automatically re-enrolled in you current plan.

If you do want to make a change, CMS would still like you to hit the December 7 deadline if you possibly can. But if you can't because of the big storm, you can enroll as soon as you're able by calling 1-800-MEDICARE (1-800-633-4227). Your new coverage will start Jan. 1, 2013 if you sign up before the end of December. If it's later than that, coverage in most cases will start at the beginning of the next month.

CMS said it is taking people's word for whether they were affected by Hurricane Sandy, including individuals "who don't live in the affected area but rely on help making healthcare decisions from friends or family members who do."

For more information, see our Health Insurance Buying Guide as well as rankings of health insurance plans.
Got a question for me? Ask it here.

0 iPhone, Droid smarter picks than BlackBerry for people with allergies

In case BlackBerry users needed another reason to upgrade to a newer smart phone, research released today suggests there could be a health benefit to doing so, at least for people with skin allergies.

In a small study presented at the annual scientific meeting of the American College of Allergy, Asthma and Immunology, researchers measured the levels of cobalt and nickeltwo metals that can cause itchy allergic reactions in susceptible peoplein 72 cell phones, including 25 iPhones, 17 Motorola Droids, 9 BlackBerries, and 21 older-style flip phones. None of the iPhones or Droids tested positive for either cobalt or nickel, compared with 29 percent of BlackBerries that tested positive for nickel (none of them had detectable levels of cobalt). The presence of potentially allergenic metals was even higher among flip phones: 91 percent of them tested positive for nickel and 52 percent contained cobalt.

The researchers note that hypersensitivity to metals is on the rise, though more research is needed to determine whether metals in cell phones contribute to the development of such allergies, especially facial dermatitis (marked by itchy, dry skin in the area that's come into contact with an allergen).

In the meantime, although the study was small and not yet published, it probably makes sense for people with known allergies to use a non-BlackBerry smart phone, especially if they've noticed facial symptoms after using one of the phones found to contain metal.

If you're thinking of upgrading, check our smart phone Ratings to see how current models fared in our tests.

Source
Blackberry vs. iPhone. There is a Winner, for your Health. [American College of Allergy, Asthma, and Immunology]

0 Hurricane and nor'easter dramatize role of flood insurance

The one-two punch of last week's Superstorm Sandy and yesterday's nameless nor'easter is likely to put flood insurance on many East Coast consumers' shopping lists, joining generators, bottled water, batteries, and plane tickets the heck outta here.

Unfortunately, unlike those other items, flood coverage is generally subject to a 30-day waiting period, so a policy bought today typically won't provide protection until a month from now. (FloodSmart.gov, the website of the National Flood Insurance Program, describes the few exceptions to the 30-day rule, along with other details.) Still, if your home is in danger of flooding, a peril typically excluded from traditional homeowners insurance policies, flood coverage could be money very well spent.

Some basics:

• Flood insurance is a federal program, though policies are sold through private insurance companies and agents.


• Coverage is capped at $250,000 per residential dwelling and $100,000 for contents.


• Costs vary by risk of flooding. You can get an estimate for where you live, as well as a list of local agents, by typing your address into the NFIP's One-Step Flood Risk Profile.

Our short video Should you buy flood insurance? also answers many of the basic questions.

Related:
Homeowners insurance buying guide
Generator buying guide

0 Popping a daily multivitamin doesn't prevent heart attacks, study finds

Do you think of taking a daily multivitamin as a form of "health insurance"? More evidence suggests that you may be wasting your money.

Researchers at Brigham and Women's Hospital and the Harvard Medical School gave either a multivitamin or a placebo to about 15,000 male physicians, from 1997 to 2011. Over that time, the men who took the vitamin had the same rate of heart attacks, strokes, and other forms of cardiovascular disease as those who took a placebo. The study was published this week in the Journal of the American Medical Association.

The study's authors worried that people who take daily multis may think that the vitamins provide enough protection to offset healthy behaviors. They also cited concerns about how much money Americans spend on the vitamins. Sales of multivitamins are in the billions each year.

Our medical experts share those concerns. "How much evidence is really needed to convince the millions of Americans who, with military exactitude, pop a daily multivitamin?" says Marvin M. Lipman, M.D., Consumer Reports' Chief Medical Adviser. "Multiple well-controlled studies involving large populations showing the uselessness of supplemental single vitamins and multivitamins have more than countered the advertising and wishful label claims of those products. We should wake up and realize that, genetics aside, lifestyle changes in our diet and exercise patterns are the prime determinants of good health."

Last month the same study suggested that multis might help protect against cancer. But as we pointed out then, the benefit was modest at best, and man other studies had failed to find similar results. For details, see our recent report 10 Surprising Dangers of Vitamins.

So we continue to recommend that when possible you get your nutrients from foods. If you do need more of certain nutrients, like calcium and vitamin D, we think it's usually better to get that from specific supplements rather than from a multi.

People who might need a multivitamin include women who are pregnant, breast-feeding, or trying to conceive; dieters consuming fewer than 1,200 calories a day or cutting out an entire food group (carbs, for example); strict vegetarians; and those with medical conditions that affect digestion and food absorption. For more detailed advice, see our Ratings of multivitamins.

Note that our Ratings found that most of the multis we tested contained what they claimed, so we advise that if you do opt for the pills you choose by price, not brand. Centrum Silver, the brand used in this study, was near the middle of the pack in price. Kirkland Signature Daily Multi (Costco) and Equate Complete Multivitamin (Walmart) were the least expensive.

Source
Multivitamins in the Prevention of Cardiovascular Disease in Men: The Physicians' Health Study II Randomized Controlled Trial

0 Bypass surgery beats angioplasty for people with diabetes

For almost two decades research has suggested that people with diabetes and multiple clogged arteries live longer and have fewer heart attacks if they undergo bypass surgery instead of angioplasty. Yet many of those people continue to be treated by angioplasty, since many doctors remain unaware of the evidence, or unconvinced by it. Now a major new study, out this week in the New England Journal of Medicine should finally settle the matter in bypass's favor.

In the new study, researchers divided 1,900 people with diabetes plus multiple clogged arteries into two groups. About half underwent coronary artery bypass graft surgery (CABG), in which heart surgeons cut out the blocked section of artery and replace it with a length of healthy artery taken from elsewhere in the body. The other half underwent angioplasty (also called percutaneous coronary intervention, or PCI), in which an interventional cardiologist snakes a balloon up into the clogged section of the coronary artery, inflates it to push the blockage aside, and then leaves a cylindrical, drug-coated metal stent behind to keep the artery propped open. It was the largest such study to date, using the most up-to-date and accepted practices for each.

After five years, 18.7 percent of the bypass patients had died or had a heart attack or stroke, compared with 26.6 percent of those who underwent angioplasty. That represents an impressive 30 percent reduced risk for bypass surgery over angioplasty. The finding jibes with many earlier, smaller prior studies.

An editorial accompanying the study concluded that it "provides compelling evidence of the comparative effectiveness of CABG versus PCI in patients with diabetes multivessel coronary artery disease." And it also points out that one reason angioplasty rates continue to be so high is that doctors often rush patients into the procedure without fully explaining it's limitations.

That is a problem we have long warned heart patients about. For details, see our story, Too Much Angioplasty. If you do need bypass surgery, use our heart surgeon Ratings to find a practice in your community with low complication and high success rates.

Sources
Strategies for Multivessel Revascularization in Patients with Diabetes [New England Journal of Medicine]

Compelling Evidence for Coronary-Bypass Surgery in Patients with Diabetes [New England Journal of Medicine]

0 Tips for a smooth transition on Bank Transfer Day

Today is Bank Transfer Day, which encourages you to switch your money to a credit union or smaller bank if you are unhappy with your current bank.

According to a Consumer Reports survey this past summer, nearly one-fifth of all consumers with checking accounts considered switching to a new financial institution over the previous 12 months.

"Consumer frustration has only grown over the past year as bank fees have continued to rise," says Suzanne Martindale, staff attorney for Consumer Union, the advocacy arm of Consumer Reports. "But many frustrated consumers end up staying with their bank because switching to a new financial institution can turn into a big hassle."

Consumers Union renewed its call for Congress and the Consumer Financial Protection Bureau to enact reforms that would make it easier for consumers to move their money to a new financial institution. "It's time to make it easier for consumers to move their money so they have a real choice when it comes to where to bank," says Martindale.

You're more likely to find lower fees and better rates at community banks, larger credit unions, and online institutions.

Tips to help guide you to a new bank:

1. Open your new bank account with a small deposit, leaving the bulk of your funds with your old bank. Deposit just enough to avoid any fees you may be charged for maintaining a low balance.
   
2. Next, make a list of all the automatic payments and deposits scheduled to go in and out of your old account each month. If you have direct deposit, ask your employer to reroute your paychecks to your new account. Find out what date the first deposit will occur, then reschedule each automatic payment or debit to come out of your new account and make sure to ask the company what date the change will apply.
   
3. Leave some cash in your old account for at least one month.
   
4. Once you are sure that all automatic payments and all direct deposits are coming and going from your new account, electronically transfer the final funds from your old account.
   
5. Once the transfer clears, follow the procedure laid out by your old bank to close your account. If you don't close it, you might get hit with a monthly account maintenance fee even after you stop using it. Get written confirmation that the account is closed.

For more read our report on how to fight back or flee when facing more fees and what to do if you're being nickeled-and-dimed by your bank.

0 Hurricane Sandy proves cash is still king in emergencies

The widespread and ongoing power outages caused by Hurricane Sandy not only left millions of people in the dark but reminded many of us of how useful it can be to have some good, old-fashioned cash on hand for an emergency.

Many ATMs in Sandy's path were rendered useless by the storm. Those that remained in operation often had long lines, and some reportedly ran out of cash. Credit and debit cards weren't of much use either, dependent as they are on electronic store terminals.

So, before the next big storm, it may make sense to round up a little extra cash. Some advice from our money experts:

• If you want to conceal cash in a safe place at home, it's easy enough to make one. For example, put a roll of bills into an empty food can and stow it deep in your pantry or hollow out that copy of "Moby Dick" you know you'll never read anyhow. Burglars have seen it all, of course, but they're usually in too big a hurry to check every book or canned good you own. If you're not the do-it-yourself type, you can buy similar items, such as wall clocks with secret compartments and Pringles tubes with fake bottoms.
• Consider a home safe. Safes are designed to protect their contents from fire, burglary, water, or some combination of those perils. So your first step is to decide what risks you're most concerned about. You can find safes at retailers such as Costco, Home Depot, Lowe's, Sears, and Target, as well at specialty stores and online. Expect to pay $50 for a small chest suitable for stowing cash or $100 and up for a safe large enough to accommodate other valuables and important documents. Consumer Reports doesn't test them, but our Money Adviser newsletter has published a guide to choosing and using a home safe.
• Finally, and obvious as it seems, if you hide money around the house, try not to forget where you put it.