Study finds link between contraceptive and periodontitis

An injectable contraceptive administered every three months may be putting women who opt for this method at increased risk for periodontal disease, according to a new study in the Journal of Peridontology.

Depot medroxyprogesterone acetate (DMPA) is a progestin-only, injectable contraceptive that is most often seen under the brand name Depo-Provera, marketed by Pfizer.
It has been suggested that progestins may have an inflammatory component and/or stimulate the synthesis of prostaglandins, which is why the extended use of DMPA may be associated with a higher risk of periodontal diseases, according to the study authors.

"There are many hormonal contraceptive options out there for women to prevent or delay pregnancy, yet we have little information on how they may affect women's oral health," lead author Susan Taichman, RDH, MPH, PhD, assistant professor at the University of Michigan School of Dentistry, said in an interview with DrBicuspid.com.  Information regarding the pill and gingival inflammation is mixed, she added, with some studies showing an association and others not.

"There remains some controversy over the impact of new, low-dose oral contraceptives and periodontal diseases," she said. "We previously reported in an analysis of National Health and Nutrition Examination Survey (NHANES) data that low-dose oral contraceptives had no significant association with decreased periodontal health."

Economic status plays a role

In the current JOP study, Taichman and her co-authors found that although women of all socioeconomic backgrounds and ages use DMPA, roughly twice as many blacks and one-third Hispanics and Latinas use it as compared with whites. In addition, the majority of DMPA users are women of low socioeconomic status who are already at risk for increased levels of gingival disease, they noted.

“Women ... who use this method of birth control may be at a higher risk for gingivitis” says Susan Taichman, RDH, MPH, PhD.  "Given that DMPA use is common among high-risk women, it is important to learn more about potential deleterious effects on periodontal tissues," the researchers wrote.

The study authors collected the data from the 1999-2004 NHANES, a set of cross-sectional studies designed to obtain information on the health and nutritional status of the non-institutionalized population of the U.S.

They looked at 4,460 U.S. women between 15 and 44 who were asked about their use of DMPA. In the final sample, 4% were current DMPA users while 12 % indicated a past history of DMPA use.  In addition, they included data on the women's periodontal health, which was assessed using randomly assigned half-mouths (one upper and one lower quadrant) for each individual using a periodontal probe.

The authors also took into account sociodemographic and behavioral factors, which have been shown to be associated with DMPA use, they noted.  They found significant differences in pocket depths, gingival bleeding, and CA loss between DMPA users and non users. The prevalence of gingivitis was 53.9% for women who reported having used DMPA, compared to 46.1% for never having used DMPA.

DMPA use was associated with an increased risk of gingivitis and periodontitis after adjusting for age, race, education, poverty income ratio, dental care utilization, and smoking status, the researchers noted.

More research needed

The study findings suggest that DMPA use may be associated with periodontal disease, they concluded.  "Although many women of child-bearing age use DMPA, a large portion of DMPA users are young, non-white women of low socioeconomic status with a history of smoking, and thus may be at an already increased risk for periodontal diseases," explained Taichman.

"Women and adolescents who use this method of birth control may be at a higher risk for gingivitis and periodontitis," she said. "Dentists should encourage women who use DMPA contraceptives to maintain good oral health habits and seek regular dental examinations."
Future clinical studies that also look at oral health behaviors and duration of DMPA use are required to further understand the relationship between DMPA use and the incidence of periodontal health, she and her co-authors concluded.

Excerpt of article by Rabia Mughal, Contributing Editor of drbicuspid.com.  See original article here.

Franchise lending shortfall robbing the nation of jobs, economic output

For information about a franchise that can be purchased with IRA funds rather than a small business loan, see the notes at the bottom of this post.  

Lenders continue to fall shy of the overall loan volume sought by franchise business owners, a shortfall that’s holding back the recovery by choking job creation and economic production.

New lending to franchises will total $9.5 billion this year, according to new data released by the International Franchise Association. While that’s up slightly from 2011, it falls well short of the $11.72 billion those franchise owners will seek in loans over the course of 2012.

“As a result of demand for more business units, there has been an increase in demand for new loans,” IFA Educational Foundation President John Reynolds said at the 2nd Small Business Lending Summit in Washington on Tuesday. “But unfortunately, lending hasn’t kept pace with the demand from franchise businesses.”

During a time when the economic recovery is still struggling to gather momentum, that 18.6 percent gap in loan demand and loan supply will rob the economy of an estimated 94,000 new jobs and $12.9 billion in gross domestic output in 2012, experts said. Contributing to the shortfall are factors like tighter credit standards, heightened regulatory scrutiny and uncertainty surrounding the tax code, according to the report, which was conducted by the the IFA in partnership with FRANdata.

The gap draws a distinction between the credit challenges facing franchises and those facing small businesses as a whole. Recently, an overwhelming majority (92 percent) of small firm owners reported either no problems securing loans or no need for a loan in response to a study published by the National Federation of Independent Business. Those findings were backed up in a recent Wells Fargo/Gallup survey, which showed that the number of small employers who believe credit will be hard to come by this year is on the decline.

“In the competition for limited credit, franchise businesses must prove credit worthiness by showing strong unit economics and system performance,” IFA President Steve Caldeira said in a statement. “With a still slow, uneven and sluggish economic recovery, coupled with a stricter regulatory environment as a result of Dodd-Frank, the pressure to maintain and create jobs has never been greater for franchisees, franchisors and the overall small business community.”

When they do manage to get their hands on the capital they need, franchise owners have proven themselves effective job creators. SBA Administrator Karen Mills, who also spoke at the summit on Tuesday, pointed to research that showed franchises create roughly 34 new jobs for every $1 million they receive in new loans. 

“Two thousand franchises, 825,000 franchise units and 18 million people that you employ,” Mills said. “This is a real constant job creator, and it’s a great business model, an American business model. It’s really one of our competitive assets around the world.”

On the bright side, the overall health of the franchise industry appears to be improving and the gap between loans sought and loans acquired is growing smaller rather than larger. A year ago, lenders fell 19.6 percent short of franchise loan demand, and the year before, they missed the mark by 22.8 percent. Moreover, the IFA estimates nearly 36,000 new franchise units will be financed this year.

Hoping to accelerate that growth, the IFA on Tuesday announced an expanded partnership with the Financial Services Roundtable and the Consumer Bankers Association. The consortium has asked members of the administration and lawmakers in Congress to sit down with their respective members to address the current regulatory and lending hurdles facing franchises, small businesses and lending institutions.

Article by J.D. Harrison, posted April 18, 2012 on www.washingpost.com.  See original article here.

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Treating Gum Disease May Help Diabetics Avoid Complications

Good periodontal care helped reduce hospitalizations, medical costs over time, study found

 Treating gum disease in people with diabetes reduces their medical costs and hospitalizations, new research shows.

The three-year study included diabetes patients with gum (periodontal) disease who were randomly selected either to receive periodontal therapy or no treatment (control group).

Those in the treatment group underwent periodontal therapy in the first year and their gum health was maintained for the following two years. The patients in the control group had incomplete periodontal therapy before the study and did not receive regular periodontal maintenance during the study.

The total annual per-patient cost of hospital admissions, doctor visits and overall medical care was an average of more than $1,800 lower in the treatment group than in the control group. The patients in the treatment group had 33 percent fewer hospital admissions.

The study was presented March 26, 2012 at the annual meeting of the American Association for Dental Research, in Tampa, Fla.

"There have been emerging links between oral infections and systemic diseases such as diabetes, which is increasingly prevalent in our population," lead researcher Marjorie Jeffcoat, professor and dean emeritus of the University of Pennsylvania School of Dental Medicine in Philadelphia, said in an association news release.

"My research team and I had looked at other data sets and we knew that health care costs could be reduced, but we wanted to look at the hospitalizations and see how those could be reduced," Jeffcoat said. "This study provided direct insight as to how lower hospitalizations could be achieved through periodontal therapy, and we will further this study by analyzing other chronic diseases and conditions such as heart attacks, strokes and pregnancy with pre-term birth."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

It's also important to note that although the study showed an association between better gum care and lowered health costs for diabetics, it didn't prove that healthier gums directly resulted in fewer hospitalizations or lowered costs.

SOURCE: American Association for Dental Research, news release, March 23, 2012

See story here.

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New Bill Offers Steep Tax Breaks for Veterans to Open a Franchise

Tax rebate would make franchise ownership possible for a larger number of returning veterans

Veterans looking to start their own business may get a big assist from the United States Senate, which is considering a bipartisan bill that would provide tax rebates to veterans who become franchisees.

The American Growth, Recovery, Empowerment and Entrepreneurship Act is cosponsored by Senators Marco Rubio (R-FL) and Chris Coons (D-DE), who introduced the legislation in November. The bill proposes to give veterans a 25 percent tax rebate on the cost of franchise fees, up to $100,000.

“The AGREE Act is a meaningful step to find common ground and create a better environment for job creators to start businesses or expand existing ones,” Rubio said in announcing the legislation.

A report by the International Franchise Association shows that for every $1 million of lending obtained by a franchised business, more than 34 jobs are created. The IFA and other organizations are lobbying Congress to help entrepreneurs create jobs for themselves and others by making it easier to borrow the money they need to start and operate a franchise.

The help would come at the same time that federal agencies are aggressively trying to send more of contracting dollars to veteran-owned small businesses. Executive Order 13360, signed by President George W. Bush, directed all federal agencies to send at least 3 percent of their contracting dollars to businesses owned by service-disabled veterans.

“Now is an excellent time for veterans to use the skills they’ve acquired and open new franchised businesses,” said Jania Bailey, COO of FranNet, a national franchise consulting firm. “These incentives make a franchise purchase much easier for veterans.”

With government contracting adding up to more than $425 billion a year, that means there is $12.5 billion that the government is eager to send to veteran-owned businesses.

The U.S. General Services Administration notes, though, that agencies have fallen far short of the 3 percent goal — largely due to the lack of identified veteran-owned small businesses in the marketplace.

The tax rebate on franchise fees would give service members an ideal way to start businesses that already have a proven business model — many of which are well-suited for government contracting work. 

The AGREE Act also reflects a growing realization in Congress that if the economy is going to regain its strength, something needs to be done to free up money to start franchises and other small businesses. Small businesses have accounted for 65 percent of new jobs over the past 17 years, according to the Small Business Administration.

View original post here. 

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Economic Health of the Franchise Industry is Stronger Compared to a Year Ago

A new economic index that provides a current reading of the economic health of the franchise sector -The Franchise Business Index (FBI) - increased 0.3 percent in February to 107.7 (Jan 2000=100) - the sixth consecutive monthly gain, the International Franchise Association announced today. The index was up 1.4 percent compared with February 2011.

Designed to provide more consistent and timely tracking of the growing role of franchise businesses in the U.S. economy, the index was developed by IHS Global Insight on behalf of the IFA. The FBI combines indicators of growth in the industries where franchising is most prevalent and measures of the general economic environment for franchising.

"The franchise industry is a unique business sector and a vitally important contributor to the U.S. economy spanning some 300 lines of business, supporting nearly 18 million jobs, 825,000 establishments and providing for over $2.1 trillion in economic output," said IFA President & CEO Steve Caldeira. "Measuring the strength of the franchise industry through the Franchise Business Index provides another indicator of the health of the economy as a whole. While the index shows we are moving in the right direction, more certainty in the tax and regulatory environments would help franchise businesses grow faster, creating more jobs and economic output at the local, state and national levels."

Following a period of flat to declining values in mid-2011, the FBI turned up in September and has shown increases of 0.3 percent in three of the last five months.

Increases among the components of the index tied to the labor market and small business optimism contributed most to the February gain in the FBI. An improvement in consumer demand, which had been flat at the end of last year, gave a small boost to the index. Credit conditions showed no change in February.
IFA also released an update to its 2012 economic outlook prepared by IHS Global Insight in December 2011. The updated forecast shows little change from the initial forecast.

"Since our December 2011 forecast report was prepared, there have been a number of positive economic releases," said James Gillula, managing director at IHS Global Insight. "However, negative factors that could restrain an economic rebound remain."

The revised forecast indicates that the number of franchise establishments in the United States will increase by 1.6 percent in 2012, down slightly from the original forecast of 1.9 percent. Employment and economic output growth forecasts are unchanged at 2.1 percent and 5 percent respectively.
IFA plans to update the Franchise Business Economic Outlook on a quarterly basis beginning in 2012 instead of just an annual outlook.

Index, Jan 2000 = 100

Source: IHS Global Insight, March 2012

About The IFA Franchise Business Index
The Franchise Business Index is a measure of the economic environment for franchise business activity constructed with timely economic indicators that provide a current reading of the industry's health. It combines indicators of the growth or decline of industries where franchise activity has historically been concentrated with measures of the demand for franchise business services and the general business environment.

The components of the IFA Franchise Business Index for the U.S. include:

• Employment in Franchise-intensive Industries* (BLS) 
• Number of Self Employed* (BLS) 
• Unemployment Rate* (BLS) 
• Consumer Demand in Franchise-Intensive Services* (BEA) 
• Small Business Optimism Index* (NFIB) 
• Small Business Credit Conditions Index* (NFIB) 

Research for the IFA Franchise Business Index and the quarterly forecast reports is underwritten by a generous grant from Jani-King International to the IFA Educational Foundation.

*For more information about the components and the methodology, click here.

March 22, 2012 – International Franchise Organization, www.franchise.org  

See original article here:  

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Will the JOBS Act help small business?

JOBS Act clears Senate, back to House for final passage

A bipartisan effort to make it easier for smaller businesses to access investment cash was back on track after clearing the Senate, but not without grave warnings from opponents who insisted it would open the door to a new era of fraud.

Senators added a provision that would bolster investor protections on the emerging practice of crowd-funding – soliciting pools of investors online and from social media. The bill passed overwhelmingly, 73-26, but broader efforts to amend it had been turned back by GOP-led opposition.

President Obama has given the measure qualified support, and it now returns to the House where GOP leaders expect swift passage, sending it to the White House next week as a rare bipartisan victory.

“We are heartened by the important investor protections added to the crowdfunding provision and will be vigilant in monitoring this and other elements to ensure the overall bill achieves its goal of helping entrepreneurs while maintaining protections for investors,” said Jay Carney, the White House Press Secretary, in urging Congress to quickly finish the bill.

Both Republicans and Democrats want to show voters they are working to improve the nation’s unemployment rate, with the GOP particularly characterizing the Jumpstart Our Business Start-ups, or JOBS Act, as legislation that would help smaller companies expand and create jobs.

“The bipartisan JOBS Act will cut through Washington red tape and help these small businesses and startups grow, expand and create jobs right away,” said the bill’s champion, Majority Leader Eric Cantor (R-Va.), who had dismissed as “phantom investor protection issues” the Senate’s efforts to change the bill to address concerns from AARP, federal regulators and others that weakening regulations could lead to fraud.

Passage in the Senate came after a tumultuous week that splintered Democrats, whose leaders were reluctant to halt a bill that had broad political support, including from powerful investment banking interests. Only 23 lawmakers had voted against the earlier version of the bill this month in the House.

The JOBS Act aims to help smaller businesses attract investment capital by loosening federal regulations, some stemming from the Sarbanes-Oxley Act of 2002, that supporters of the bill say can be onerous and costly.

One provision in the legislation would make it easier for businesses launch initial public offerings by phasing financial reporting requirements with the Securities and Exchange Commission over five years or until the company achieves more than $1 billion in annual revenues. The SEC chief said this exemption was too broad, and would allow even large firms to bypass federal regulation.

“We will rue the day we rammed this through the House and Senate,” said Sen. Richard Durbin of Illinois, the No. 2 Democrat, who broke with party leadership in voting against the bill.

Senators did, however, find bipartisan support attach an amendment that would require crowd-funding websites, which can pool up to $1 million in investments by selling stock online, to use register with the SEC.

The change would also require disclosure by investment promoters as a way to prevent anonymous “pump-and-dump” operations, and it would cap the annual amount individuals can invest.

That amendment was a bipartisan effort from Sen. Jeff Merkley (D-Ore.), Michael Bennet (D-Colo.) of Colorado and Sen. Scott Brown (R-Ma.), is expected to remain when the House considers the bill next week.

But even Merkley voted against the final product, calling it a “paved highway to predatory scams.”

March 2, 2012

By Lisa Mascaro, L.A. Times

See original online story here. 

 

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4 Questions to Ask Before Venturing Into a Self-Directed IRA

Prospective investors must understand the risks, as well as the specific rules, governing these accounts.

The stock market has posted tremendous gains during the past three years, with the S&P 500 gaining nearly 30% on an annualized basis and many more aggressive funds posting even gaudier returns than that. 

But because the financial crisis was so bruising--and because stocks have exhibited plenty of volatility since they bottomed out--many investors are still feeling lukewarm on stocks. New flows into bond funds have been robust, and investors have also been gravitating toward commodities and alternatives investments. Equity funds, by contrast, continue to see redemptions, even when you factor in relatively strong inflows into equity exchange-traded funds.

Against that backdrop, the notion of a self-directed IRA might seem promising. Such vehicles enable investors to buy into asset classes that are often outside of the purview of fund companies and brokerage firms--including non publicly traded real estate, private equity, precious metals, and partnerships and joint ventures. These investments might exhibit radically different performance patterns than stocks and bonds, a quality that bear-market-battered investors could be craving.

In some respects, all IRAs are self-directed, in that as the account owner, you're entirely in control of what you put inside of your account. And on the surface, self-directed IRAs have features that are comfortably similar to conventional IRAs that hold stocks, bonds, or mutual funds. The contribution limits are the same, rollovers from other IRAs are permitted, and you can opt for a traditional or Roth version.

Some articles about self-directed IRAs make it sound like the big brokerage firms and mutual fund companies are in an evil cabal designed to keep you out of the best-performing investments. However, investing in a self-directed IRA isn't as simple as sending a check to Fidelity or Vanguard and tuning out; instead, it's far from it. In addition to analyzing the investment merits of a prospective self-directed IRA investment, it's also important to consider how the inclusion of a single, possibly large, and undiversified investment interacts with your other holdings. You also need to be aware of the different rules governing these accounts because you could run into serious trouble if you run afoul of them.

  

Here are some of the key questions to consider before taking the plunge into the world of self-directed IRAs.

What will it cost?

If you hold stocks or mutual funds in an IRA, your costs will be pretty transparent: mutual fund management fees and any commissions you might pay to buy and sell. Self-directed IRAs charge another layer of fees because you must go through a custodian, who in turn will invest in the assets on your behalf. As a result, there's typically a setup fee for a self-directed IRA as well as ongoing administrative costs; these costs can vary widely by custodian, so you really need to do your homework. And if you choose to set up a limited liability company that your IRA invests in, thereby giving you more control over your investments, your start-up costs are apt to be even higher. Your ongoing administrative costs might be lower, however. Of course, investing in mutual funds or individual stocks isn't free, but taken together, the extra costs associated with self-directed IRAs mean that your investments will need to perform that much better than traditional stocks and funds just to pull ahead.

How does it fit with the rest of your portfolio?

 
Even if you're sold on the merits of an investment you'd like to put inside of a self-directed IRA--such as a rental property or gold bars--it's still important to consider how it fits within the context of your overall portfolio. Are you sinking a disproportionate sum of your money into a single asset? Property holdings are among the most common investments held inside self-directed brokerage accounts, and real estate guru Ilyce Glink points out that a reasonable rule of thumb is that real estate holdings--including a primary residence--should compose no more than 25% of a person's net worth.

Do you thoroughly understand the rules?

Self-directed IRAs come with a whole separate set of rules, the majority of which are designed to prohibit self-dealing, which is, essentially, obtaining use from an asset even though you're receiving a tax deferral on it. Say, for example, you buy an apartment building in a self-directed IRA, but your son is living in one of the units. You're receiving tax-deferred income on your rentals, but you're also receiving a benefit at the same time. If the Internal Revenue Service gets wind of this self-dealing, the entire sum in that IRA could be considered taxable and subject to the 10% early withdrawal penalty because you've effectively distributed your IRA holdings prematurely. Consult with a qualified legal or financial advisor to ensure that your self-directed IRA investment is on the up and up and that you're hewing to the rules on an ongoing basis.

Could an ETF accomplish the job with fewer complications?

True, self-directed IRAs allow you to invest in assets that mutual funds don't invest in, such as individual plots of farmland and residential properties on which your IRA can, in turn, earn income. However, it's worth noting that many of the asset classes that had historically been the domain of self-directed IRAs are now available in some fashion via exchange-traded funds and conventional mutual funds. Investors can now buy ETFs that invest in private equity firms, gold, and farmland, for example. Of course, such funds might not be a pure play on a given asset; for example, private equity ETFs and funds invest in publicly traded private equity firms. But the fund format provides more diversification potential than you'd be able to obtain by sinking a large sum into a single property or company as well as fewer administrative obligations and costs.  

Article by Christine Benz, posted March 12, 2012 on www.news.morningstar.com. See original article here.

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Christine Benz is Morningstar's director of personal finance and author of 30-Minute Money Solutions: A Step-by-Step Guide to Managing Your Finances and the Morningstar Guide to Mutual Funds: 5-Star Strategies for Success.