Frank, R; Levine, A.; Dijk, O.
Prevailing economic models of consumer behavior completely ignore the well-documented link between context and evaluation. We propose and test a theory that explicitly incorporates this link. Changes in one group's spending shift the frame of reference that defines consumption standards for others just below them on the income scale, giving rise to expenditure cascades. Our model, a descendant of James Duesenberry's relative income hypothesis, predicts the observed ways in which individual sa...
U.S. Department of Health & Human Services — National Health Expenditure Accounts are comprised of the following, National Health Expenditures - Historical and Projected, Age Estimates, State Health...
Letsch, Suzanne W.; Levit, Katharine R.; Waldo, Daniel R.
The 1987 national health expenditure estimates are examined from different perspectives in the following two articles. In the first article, revised expenditure estimates for 1984-87 are presented. A breakdown of the type of services and products purchased is included, as well as the source of funds used to finance health care. In the second article, health care expenditure estimates are used to explore marginal analysis as a policy tool for understanding health spending in relation to our Na...
G. Flores (Gabriela); O.A. O'Donnell (Owen)
textabstractMedical expenditure risk can pose a major threat to living standards. We derive decomposable measures of catastrophic medical expenditure risk from reference-dependent utility with loss aversion. We propose a quantile regression based method of estimating risk exposure from cross-section
Full Text Available ENERGY EXPENDITURE OF ELDERLY PEOPLE.Background: Physical activity is a factor to estimate the energy requirement. The elderly tend to reduce their activities which influence their energy requirement. Now aday the energy need for elderly is extrapolated from the adult. Energy expenditure based on their daily activities Is a method to estimate the energy requirement.Objectives: The purpose of the study was to assess energy expenditure of elderly people based on the daily physical activities.Methods: The study was conducted in 2 sub-sub districts of Bogar Country. A total of 92 elderly (42 men and 50 women were included in this study. The inclusion criteria were BMI 18.5- 25.0, physically and hematologically healthy and agree to participate in this study. Physical activities data were collected 3 days respectively using method record and recall and energy intakes using 3 day food record by weighing.Results: The average age was 67.5 ± 5,1 years for male elderly and 65.4 ± 3.9 years of female elderly. Recreational activities (reading, watching TV, sitting were the most activities done by male elderly (34.9% of the day while female elderly 34.8% of the day were spent for sleeping activity. The highest energy expenditure of male elderly was contributed from reactional activities (570.3 ± 187.8 Kcal/day while female elderly the highest energy expenditure was contributed from household work activities. The average energy expenditure for male elderly was 1870.2 ± 261.2 Kcal/day or 34.4 Kcal/Body weight/day and female elderly was 1840.2 ± 255.7 Kcal/day or 38.2 Kcal/Body weight/day. The energy Intake of male elderly was 1858 ± 471.7 Kcal/day or 34.1 Kcal/Body weight/day and female elderly was 1472 ± 255.7 Kcal/day or 30.8 Kcal/Body weight/day.Conclusions: Conclusion of this research was the energy expenditure of male elderly balance with their energy consumption, while the energy expenditure of female elderly higher than their energy consumption
Hoffman, James M; Shah, Nilay D; Vermeulen, Lee C; Hunkler, Robert J; Hontz, Karrie M
Drug expenditure trends since 2002 and projected drug expenditures for 2004 are discussed. In 2002 there was a moderation in the trend of increasing drug expenditures. Drug expenditures increased by 12.3% between 2001 and 2002. This trend continued in the first half of 2003, with expenditures increasing by only 10% compared with 2002. This moderation in the drug expenditures trend can be attributed to many factors, especially patent expirations and decreases in new drug approvals. Higher cost sharing for consumers and a general economic slowdown in the United States affecting employment and insurance coverage have resulted in a smaller increase in drug utilization. In 2004, there should be a 10-12% increase in drug expenditures for outpatient settings, a 19-21% increase for clinics, and a 6-8% increase for hospitals. Drug expenditure growth should continue to outpace the growth in overall health care expenditures and the growth in the U.S. economy.
Nelson, Gary M.
Examines federal tax expenditures or subsidies directed toward enhancing the retirement income of the elderly. Charges that such expenditures annually target benefits to the wealthiest segment of the elderly population. Examines equity issues and recommends that these tax expenditures be examined on a case-to-case basis. (JAC)
Full Text Available To what extent do frequently cited determinants of military spending allow us to predict and forecast future levels of expenditure? The authors draw on the data and specifications of a recent model on military expenditure and assess the predictive power of its variables using in-sample predictions, out-of-sample forecasts and Bayesian model averaging. To this end, this paper provides guidelines for prediction exercises in general using these three techniques. More substantially, however, the findings emphasize that previous levels of military spending as well as a country’s institutional and economic characteristics particularly improve our ability to predict future levels of investment in the military. Variables pertaining to the international security environment also matter, but seem less important. In addition, the results highlight that the updated model, which drops weak predictors, is not only more parsimonious, but also slightly more accurate than the original specification.
Full Text Available The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE was in the range 225-287 kcal/h for women-men (MET = 4.1, respectively; subjects had an energy intake from food in the range 1000-1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue.
Department of Veterans Affairs — Geographic Distribution of VA Expenditures Report (GDX) located on the Expenditures page in the Expenditure Tables category. This report details VA expenditures at...
Swift, Zhicheng Li; Cavalcanti, Carlos B.
Tax expenditures are concessions that fall outside tax norms or benchmarks. These norms include accounting conventions, the structure of tax rates, the deductibility of compulsory payments, provisions to facilitate tax administration, and norms related to international fiscal obligations. Tax expenditures are deviations from these norms, implemented to encourage behavior deemed desirable b...
Murray, Steven R.; Udermann, Brian E.; Reineke, David M.; Battista, Rebecca A.
Sport stacking is an activity taught in many physical education programs. The activity, although very popular, has been studied minimally, and the energy expenditure for sport stacking is unknown. Therefore, the purposes of this study were to determine the energy expenditure of sport stacking in elementary school children and to compare that value…
Urbinati, Duccio; Rémuzat, Cécile; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher
(−€5,589 million), and, far behind them, Germany (−€831 million), Greece (−€808 million), Portugal (−€243 million), and Hungary (−€84 million). The main source of savings came from the cardiovascular, central nervous system, and respiratory areas and from biosimilar entries. Oncology, immunology, and inflammation, in contrast, lead to additional expenditure. The model was particularly sensitive to the time to market of branded products, generic prices, generic penetration, and the distribution of biosimilars. Conclusions The results of this forecast suggested a decrease in pharmaceutical expenditure in the studied period. The model was sensitive to pharmaceutical policy decisions. PMID:27226837
Ammar Ben Zaed
Full Text Available This article aims to analyze and interpret the phenomenon of increased public expenditures and test explanatory theories as well as to analyze Abstract the relationship between public spending and GDP in the short and long term where you see the Wagner hypothesis that causal heading of GDP to government spending while there is a causal relationship analysis positive trending of government spending to GDP according to the Keynesian hypothesis in this study will be used descriptive analytical method to validate these hypotheses. Results in the short and long term made it clear that there is a difference in the outcome of Applied Studies where we find that each supports a relationship Wagner in the sense that the causal trending of real GDP to government spending and more precisely to increase the economic growth lead to increased aggregate demand which leads in turn increasing the need to increase government spending and to increase the resources available to the government sector to finance the increase in spending by the additional resources resulting from the economic growth while others opines opposes the existence of the relationship.
Full Text Available Tax expenditures are an instrument frequently used when a government wishes to achieve certain economic and social effects. But because of the increasing number and scope of tax expenditures, their proper use, quality of administration and record-keeping have become a major challenge for the tax authorities and the whole of the government. The article considers and explains very diverse forms of tax expenditure such as reliefs, tax deductions, tax allowances, tax exceptions and special rates of taxation and the ways in which they are defined and calculated. The key problems in the analysis are the absence of a single definition and of methodology for the calculations; these ultimately make it impossible to compare tax expenditures between or among countries.
Bogdani, Irena Dh.
This paper looks at public expenditure planning in Albania, presenting and analysing the first two post-communist era Medium-Term Expenditure Plans (METPs) that have been introduced by the Albanian government for the periods 2000-2001 and 2002-2004, respectively. Albania's medium-term macroeconomic perspectives and elements of fiscal decentralisation, as incorporated by the Local Government Law of Albania, are presented, too. It is found that, taking into account the first years of post-commu...
Haller, Stefanie; Murphy, Liam
We examine the determinants of firm's current environmental expenditure and firm's capital investment in equipment for pollution control using a Heckman selection model. As regards current environmental expenditure, we find that larger, exporting firms and firms subject to the Integrated Pollution Prevention and Control directive are more likely to spend resources at all. Once the decision to commit resources has been taken, larger firms, firms that are foreign-owned, and firms that report lo...
Santini, M; Borleri, D; Bresciani, M; Riva, M M; Ielapi, M; Bonelli, G; Mosconi, G
The aim of this study is to show the results obtained from measuring energy expenditure (EE) during work, through portable devices, in a group of male construction workers. After defining cardio-respiratory parameters in laboratory, authors applied to all subjects an heart rate monitor for measuring the heart rate (HR) and, at the same time, a calorimeter for measuring energy expenditure (EE). To analyse data obtained, authors calculate the Relative Aerobic Strain (RAS), both for the measurements of EE and for HR detected. Results confirm that in many of the typical activities of construction industry, in particular in those characterised by an higher component of manual engagement compared to foreman, workloads are exceeding limits of the probable threshold fatigue (33% of RAS), both for energy expenditure than for HR measured.
National Oceanic and Atmospheric Administration, Department of Commerce — A series of expenditure surveys have been done both regionally and nationally. This data pertains to the West coast states . Expenditures on trips by mode (for-hire,...
National Oceanic and Atmospheric Administration, Department of Commerce — A series of expenditure surveys have been done both regionally and nationally. Expenditures on trips by mode (for-hire, private boat, and shore) were collected for...
Corruption, Government Expenditures and Economic Performance: Nigeria's Experience in the New Democratic Era (1999-2012) ... African Journal of Sustainable Development ... It further indicates that capital expenditure component of government expenditure negatively impacted growth in the sample periods. The impact ...
This study examines the effects of social welfare expenditures on infant mortality (deaths younger than age 1 per 1,000 live births) across 19 Organisation for Economic Co-operation and Development (OECD) countries from 1980 to 2010. Data are obtained from various sources including the OECD, World Health Organization, and World Bank. The findings indicate that among three social welfare expenditure measures for families, the expenditures on family cash allowances are predicted to reduce infant mortality. However, the other two measures-the expenditures on parental and maternity leave and expenditures on family services-have no significant effects on infant mortality.
Full Text Available Government spending and the procedures for making them can be examined on the basis of many of public regulations, which are the legal grounds for these expenditure. The procedures of government spending can be studied in the field of personal expenditure of the state budget (including salaries, pensions and social benefits. Appropriate procedures are related to expenditure for purchases of goods and services and for making of public investments (e.g. public roads and buildings. An extensive area of expenditure is in the form of grants. There are special legal ways for transferring the budget grants to different legal organizations and entities. The state expenditure are fixed in the Budget Act. The implementation of the budgetary expenditure needs to take up, by state authorities and agencies, thousands of individual and concrete actions (e.g. the contracts, administrative decisions, other activities. That is, in the Budget Act fixed expenditure have, in principle, normative act features.
Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of
The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The price and expenditure estimates developed in the State Energy Price and Expenditure Data System (SEPEDS) are provided by energy source and economic sector and are published for the years 1970 through 1994. Consumption estimates used to calculate expenditures and the documentation for those estimates are taken from the State Energy Data Report 1994, Consumption Estimates (SEDR), published in October 1996. Expenditures are calculated by multiplying the price estimates by the consumption estimates, which are adjusted to remove process fuel; intermediate petroleum products; and other consumption that has no direct fuel costs, i.e., hydroelectric, geothermal, wind, solar, and photovoltaic energy sources. Documentation is included describing the development of price estimates, data sources, and calculation methods. 316 tabs.
The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The price and expenditure estimates are provided by energy source and economic sector and are published for the years 1970, 1980, and 1985 through 1992. Data for all years, 1970 through 1992, are available on personal computer diskettes.
Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...
Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...
Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...
The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The price and expenditure estimates are provided by energy source and economic sector and are published for the years 1970, 1975, 1980, and 1985 through 1991. Data for all years, 1970 through 1991, are available on personal computer diskettes. Documentation in Appendix A describes how the price estimates are developed, including sources of data, methods of estimation, and conversion factors applied. This report is an update of the State Energy Price and Expenditure Report 1990, published in September 1992.
..., expenditures, independent expenditures, and disbursements by foreign nationals (2 U.S.C. 441e, 36 U.S.C. 510..., independent expenditures, and disbursements by foreign nationals (2 U.S.C. 441e, 36 U.S.C. 510). (a... abroad. (6) Solicit has the same meaning as in 11 CFR 300.2(m). (7) Safe Harbor. For purposes of...
The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates for the 50 States, the District of Columbia, and the United States. The estimates are provided by energy source (e.g., petroleum, natural gas, coal, and electricity) and by major consuming or economic sector. This report is an update of the State Energy Price and Expenditure Report 1988 published in September 1990. Changes from the last report are summarized in a section of the documentation. Energy price and expenditure estimates are published for the years 1970, 1975, 1980, and 1985 through 1989. Documentation follows the tables and describes how the price estimates are developed, including sources of data, methods of estimation, and conversion factors applied. Consumption estimates used to calculate expenditures, and the documentation for those estimates, are from the State Energy Data Report, Consumption Estimates, 1960--1989 (SEDR), published in May 1991. Expenditures are calculated by multiplying the price estimates by the consumption estimates, adjusted to remove process fuel and intermediate product consumption. All expenditures are consumer expenditures, that is, they represent estimates of money directly spent by consumers to purchase energy, generally including taxes. 11 figs., 43 tabs.
The main purpose of the study was to examine the level of household expenditure on dairy products and to identify the principal factors that influence the level of consumption expenditure on dairy products across households in Accra and Kumasi. Structured questionnaire was used to elicit primary information from a total of ...
Expenditure on cassava and other staple foods was determined for each household of the preschool children and classified into two groups and the average determined. Significance of difference between the mean Z – scores of the children for above and below average expenditure households was determined by Student ...
The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the US. The estimates developed in the State Energy Price and Expenditure Data System (SEPEDS) are provided by energy source and economic sector and are published for the years 1970 through 1995. Data for all years are available on a CD-ROM and via Internet. Consumption estimates used to calculate expenditures and the documentation for those estimates are taken from the State Energy Data Report 1995, Consumption Estimates (SEDR), published in December 1997. Expenditures are calculated by multiplying the price estimates by the consumption estimates, which are adjusted to remove process fuel; intermediate petroleum products; and other consumption that has no direct fuel costs, i.e., hydroelectric, geothermal, wind, solar, and photovoltaic energy sources.
Full Text Available Abstract Objective To measure energy expenditure of acutely ill elderly patients in hospital and following discharge in the community. Design Sixty-three consecutive hospitalised acutely ill elderly patients were recruited. Eight patients were studied to assess the reliability of the Delta Tract Machine as a measure of energy expenditure; 35 patients had their energy expenditure studied in hospital on two occasions and 20 patients had their energy expenditure measured in hospital and at 6 weeks in the community Results Men had higher basal energy expenditure (BMR values compared to women however the difference was not statistically significant [Men, mean (SD 1405 (321 Kcal, women 1238 (322 kcal; mean difference (95% CI 166 kcal (-17 to 531, p = 0.075]. After adjusting for age, gender and body mass index both medication and C-reactive protein (CRP, concentrations showed significant correlation with measured energy expenditure in hospital, (r = -0.36, "p Conclusion Tissue inflammation and medications were associated with change in measured energy expenditure in acutely ill patients.
Gerdtham, U G; Jönsson, B
International comparisons of health care expenditure are associated with many different kinds of problems. One type of problem is due to heterogenous definitions and to difficulties with conversion to common prices. Such problems are present also if one selects homogeneous countries as, for example, the Nordic countries, which have a similar GDP per capita and social system. In this paper we compare the health care expenditure in the Nordic countries to illustrate the significance of these problems in international comparisons. We also correct the latest available OECD statistics for local nursing homes, which are not included in health care expenditure for Denmark but are included for the other Nordic countries, and also for the care of the mentally retarded, which is not included in health care expenditure for Denmark or, after 1985, for Sweden. In addition, comparisons of health care expenditure are presented with different currency conversion factors. The comparisons show, for example, that Sweden has a higher expenditure share of gross domestic product (GDP) than Denmark, even after corrections have been made, but that the difference between the countries becomes considerably smaller, from 37% higher expenditure for Sweden without correction to 12-15% after correction.
National Oceanic and Atmospheric Administration, Department of Commerce — A series of expenditure surveys have been done both regionally and nationally. This data pertains to the Northeast U.S. states that was collected in 1998....
National Oceanic and Atmospheric Administration, Department of Commerce — Angler expenditures for their most recent trip in 2006, by fishing mode - for-hire, private boat, shore. Includes categories such as bait, ice, fuel, lodging, meals,...
U.S. Department of Health & Human Services — Modeling Per Capita State Health Expenditure Variation State-Level Characteristics Matter, published in Volume 3, Issue 4, of the Medicare and Medicaid Research...
poverty and government expenditure on growth strategies that have been implemented in Tanzania since the mid 2000s. The paper shows that despite impressive economic growth of about 6 percent per annum that the country has enjoyed in ...
U.S. Department of Health & Human Services — Reconciling Medical Expenditure Estimates from the MEPS and NHEA, 2007, published in Volume 2, Issue 4 of the Medicare and Medicaid Research Review, provides a...
Bender, Alex C; Austin, Andrea M; Grodstein, Francine; Bynum, Julie P W
We examined the relationship between health care expenditures and cognition, focusing on differences across cognitive systems defined by global cognition, executive function, or episodic memory. We used linear regression models to compare annual health expenditures by cognitive status in 8125 Nurses' Health Study participants who completed a cognitive battery and were enrolled in Medicare parts A and B. Adjusting for demographics and comorbidity, executive impairment was associated with higher total annual expenditures of $1488 per person (P memory impairment was found. Expenditures exhibited a linear relationship with executive function, but not episodic memory ($584 higher for every 1 standard deviation decrement in executive function; P losses in executive function may be effective in reducing costly services. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Mzoughi, Olfa; Toumi, Mondher
Background and objective: The value appreciation of new drugs across countries today features a disruption that is making the historical data that are used for forecasting pharmaceutical expenditure poorly reliable. Forecasting methods rarely addressed uncertainty. The objective of this project was to propose a methodology to perform pharmaceutical expenditure forecasting that integrates expected policy changes and uncertainty (developed for the European Commission as the ‘EU Pharmaceutical e...
The latest data on public expenditures show that since 1973 world expenditures on education have exceeded military expenditures in developed nations, but that the opposite situation prevails in developing nations. Beginning with 1965, this article summarizes these expenditures for the world as a whole, including developed and developing nations.…
The most serious health problem in Uganda is AIDS, and prevalence rates range from 2% in remote areas to 30% in cities. AIDS is often seen in infants who were infected by their mothers and who generally die by age 5. The disease is rare in children between age 5 and 14 years, at which time sexual activity begins and infection occurs. By 1993, approximately 115,000 children in Uganda had been orphaned by AIDS. Because of widespread poverty, orphans are at jeopardy for malnutrition and reduced educational opportunities. The health infrastructure, hampered by low spending and an emphasis on curative rather than preventative measures, has been seriously overburdened by the AIDS crisis. The economy has also been affected, since AIDS has taken a particularly heavy toll on those 15-40 years old upon whom economic activities, such as labor intensive farming and growing cash crops, depends. Investments in other areas are in jeopardy also as highly trained professionals leave work to care for the sick or become sick themselves. Declines in domestic income and savings have repercussions throughout the national economy. Widespread poverty also exacerbates the AIDS crisis, especially since poverty drives individuals into adopting risk-taking behavior such as prostitution. Domestic violence has also increased as wives have refused to have sexual intercourse with husbands whom they believe have HIV infections. In order to deal with this crisis, the entire Ugandan society must be mobilized. Alternative sources of income must be sought for the poor, income-generating activities must be available to AIDS patients and their families, health care expenditures must increase, and home-based health care should be promoted. It is absolutely urgent for Ugandans to translate their knowledge about the causes of AIDS into changes in their sexual behavior which will protect them from the disease.
Cascaes, Andreia Morales; de Camargo, Maria Beatriz Junqueira; de Castilhos, Eduardo Dickie; Silva, lexandre Emídio Ribeiro; Barros, Aluísio J D
ABSTRACT OBJECTIVE To quantify the household expenditure per capita and to estimate the percentage of Brazilian households that have spent with dental insurance. METHODS We analyzed data from 55,970 households that participated in the research Pesquisa de Orçamentos Familiares in 2008–2009. We have analyzed the annual household expenditure per capita with dental insurance (business and private) according to the Brazilian states and the socioeconomic and demographic characteristics of the households (sex, age, race, and educational level of the head of the household, family income, and presence of an older adult in the household). RESULTS Only 2.5% of Brazilian households have reported spending on dental insurance. The amount spent per capita amounted to R$5.10 on average, most of which consisted of private dental insurance (R$4.70). Among the characteristics of the household, higher educational level and income were associated with higher spending. São Paulo was the state with the highest household expenditure per capita (R$10.90) and with the highest prevalence of households with expenditures (4.6%), while Amazonas and Tocantins had the lowest values, in which both spent less than R$1.00 and had a prevalence of less than 0.1% of households, respectively. CONCLUSIONS Only a small portion of the Brazilian households has dental insurance expenditure. The market for supplementary dentistry in oral health care covers a restricted portion of the Brazilian population.
Full Text Available This paper entitled "Public expenditure on health in local budgets" aims analysing and deepening major spending categories that public authorities finance at local level, namely health expenditure. In the first part of the article we have specified the content and role of this category of expenditure in local budgets and also made some feedback on decentralization in health. In the second part of the work, based on data available in Statistical Yearbook of Romania, we have carried out an analysis of the dynamics of health spending from local budgets to emphasize their place and role in the health care expenses. The research carried out follows that the evolution and structure of health expenditure financed from local budgets is determined, along with the legislative framework in the field, by several variables that differ from one territorial administrative unit to another: the existence of sanitary units, their type, the involving of local public authorities in their development and modernization, the number and the social structure of the population. The research shows that over the period 1993-2015, the dynamics of the share of health spending in total expenditures of local budgets is sinusoidal, with a minimum threshold in 2000 of only 0.3%.
This presents information about household end-use consumption of energy and expenditures for that energy. These data were collected in the 1993 Residential Energy Consumption Survey; more than 7,000 households were surveyed for information on their housing units, energy consumption and expenditures, stock of energy-consuming appliances, and energy-related behavior. The information represents all households nationwide (97 million). Key findings: National residential energy consumption was 10.0 quadrillion Btu in 1993, a 9% increase over 1990. Weather has a significant effect on energy consumption. Consumption of electricity for appliances is increasing. Houses that use electricity for space heating have lower overall energy expenditures than households that heat with other fuels. RECS collected data for the 4 most populous states: CA, FL, NY, TX.
Full Text Available The objective of this paper is to analyze the evolution of Romania’s public expenditure during the period 1995-2009. Expenditure analysis involves tracking their evolution in absolute and relative size, determining the share of public expenditure within the GDP, as well as determining the level of total public expenditure and of each category of expenditure per capita. At the same time there are several econometric models used in optimizing public expenditure for the various economic sectors by means of econometric modelling software Eviews.
Adriano Eduardo Lima-Silva; Flávio de Oliveira Pires; Fernando Roberto De Oliveira; Maria Augusta Peduti Dal Molin Kiss
http://dx.doi.org/10.5007/1980-0037.2008v10n3p308 The goal of this study was to present a new perspective on the relationship between lipid metabolism and the intensity/duration of exercise and energy expenditure. The idea was to use the second lactate threshold as a marker of the best ratio between energy expenditure and duration of exercise. From the literature review and analyses of experimental data, it was demonstrated that the second lactate threshold mark is the point at which the ...
Herrell, J H
Health-related expenditures in the United States have represented an increasing share of the national output since World War II, driven primarily by rapidly advancing frontiers of knowledge and exploding demand generated by expansion of third-part payment mechanisms and governmental tax incentives. In the decades ahead, the demands of an aging population will add a new dimension to the forces already driving total expenditures upward. The demographics of the 1990's and beyond pose a challenge to our society which must be faced today.
Fleming, E; Ma, C A; McGuire, T G
The authors present a study on expenditures by state mental health, substance abuse, and developmental disability agencies in the United States for the period between 1981 and 1993. The relationship between agency spending and organizational structure of state bureaucracy was examined. Results indicate that organizational structure is a determinant of agency spending. The more independent an agency, the higher its spending; conversely, the more independent its competitor, the lower the agency's spending. The number of levels between an agency and the governor's office was not significant in explaining agency expenditures.
This paper explores the relationship between the reduction in income-poverty and government expenditure on growth strategies that have been implemented in Tanzania since the mid 2000s. The paper shows that despite impressive economic growth of about 6 percent per annum that the country has enjoyed in the course ...
Adequate sleep is crucial during childhood for metabolic health, and physical and cognitive development. Inadequate sleep can disrupt metabolic homeostasis and alter sleeping energy expenditure (SEE). Functional data analysis methods were applied to SEE data to elucidate the population structure of ...
Sherman, Sally A; Rogers, Renee J; Davis, Kelliann K; Minster, Ryan L; Creasy, Seth A; Mullarkey, Nicole C; O'Dell, Matthew; Donahue, Patrick; Jakicic, John M
Whether the energy cost of vinyasa yoga meets the criteria for moderate-to-vigorous physical activity has not been established. To compare energy expenditure during acute bouts of vinyasa yoga and 2 walking protocols. Participants (20 males, 18 females) performed 60-minute sessions of vinyasa yoga (YOGA), treadmill walking at a self-selected brisk pace (SELF), and treadmill walking at a pace that matched the heart rate of the YOGA session (HR-Match). Energy expenditure was assessed via indirect calorimetry. Energy expenditure was significantly lower in YOGA compared with HR-Match (difference = 79.5 ± 44.3 kcal; P YOGA = 3.6 ± 0.6; P YOGA, showed energy expenditure was significantly lower in YOGA compared with HR-Match (difference = 68.0 ± 40.1 kcal; P YOGA meets the criteria for moderate-intensity physical activity. Thus, YOGA may be a viable form of physical activity to achieve public health guidelines and to elicit health benefits.
C. Horváth (Csilla); R. Paap (Richard)
textabstractThis article examines the influence of the business cycle on expenditures of three major types of legalized gambling activities: Casino gambling, lottery, and pari-mutuel wagering. Empirical results are obtained using monthly aggregated US per capita consumption time series for the
Government Expenditure Management and Control within the Framework of Ethiopian Economy. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about how to print, save, and ...
Jingjing Liang; Dave E. Calkin; Krista M. Gebert; Tyron J. Venn; Robin P. Silverstein
There is an urgent and immediate need to address the excessive cost of large fires. Here, we studied large wildland fire suppression expenditures by the US Department of Agriculture Forest Service. Among 16 potential nonmanagerial factors, which represented fire size and shape, private properties, public land attributes, forest and fuel conditions, and geographic...
economy. Benoit (1973, 1978) argued that with increase in military expenditure, economic growth can be promoted by increasing human capital capabilities of the workforce through provisions of education ... spending is financed by taxation, taxation will not only reduce the amount of resources available to the private sector ...
This paper examined the pattern, growth, impact, management and control of government expenditure within the framework of the Ethiopian Economy. This was done with the view that policy options towards effective and efficient management of the government lean resources will be proffered as. This will help in ensuring ...
Nicaragua has had decent economic growth in the past decade, which has contributed to substantial poverty reduction (the largest in Central America), as well as improvements in human development indicators. Fiscal accounts have deteriorated recently, which may pose some challenges to the sustainability of current levels of financing for social sector expenditures. Better planning and monit...
Angelopoulos et al. 2008). Based on this contention it is logical to conclude that government expenditure and government efficiency are complementary if countries aspire to achieve better economic growth by using government expenditure.
Nordsborg, Nikolai Baastrup; Espinosa, Hugo G.; Van Thiel, David H
The determination of energy expenditure is of major interest in training load and performance assessment. Small, wireless accelerometer units have the potential to characterise energy expenditure during swimming. The correlation between absorbed oxygen versus flume swimming speed and absorbed oxy...
Department of Veterans Affairs — This report contains FY2000 through FY2013 data on disability compensation expenditures and recipients and on VA healthcare system patients and patient expenditures.
Full Text Available Abstract Obesity shows an increasing prevalence worldwide and a decrease in energy expenditure has been suggested to be one of the risk factors for developing obesity. An increase in resting energy expenditure would have a great impact on total energy expenditure. This study shows that classical music do not influence resting energy expenditure compared to complete silence. Further studies should be performed including other genres of music and other types of stress-inductors than music.
Qazi Muhammad Adnan HYE
Full Text Available This study determines the causal relationship between the expenditure and revenue of government in the case of Romania by using the autoregressive distributive lag approach to cointegration, variance decomposition and rolling regression method. The results indicate that bidirectional long run relationship exist between expenditure and revenue of government. The variance decomposition method suggests government revenue shock has more sharply impact on the government expenditure as compared to the shock in government expenditure and response of government revenue collection.
Kenayathulla, Husaina Banu
Private tutoring has been a burgeoning phenomenon in Malaysia for decades. This study examines the determinants of private tutoring expenditures in Malaysia using the 2004/2005 Household Expenditures Survey and applies hurdle regression models to the data. The results indicate that total household expenditures, household head's level of education,…
This paper examines whether initial asset distribution affects the composition of government expenditure on education. Using a cross-section of developing countries, it is found that a country's initial asset inequality is positively and significantly associated with the ratio of tertiary education expenditure to government education expenditure,…
... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false RD&D expenditures. 154....401 RD&D expenditures. (a) Requirements. Upon approval by the Commission, a natural gas company may file to recover research, development, and demonstration (RD&D) expenditures in its rates under this...
... Insurance Program expenditures. 457.618 Section 457.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... Children's Health Insurance Program expenditures. (a) Expenditures. (1) Primary expenditures are...
... expenditures to influence legislation; introduction. 1.501(h)-1 Section 1.501(h)-1 Internal Revenue INTERNAL...) Exempt Organizations § 1.501(h)-1 Application of the expenditure test to expenditures to influence..., (except as otherwise provided in subsection (h)).” This requirement is called the substantial part test...
Usman A.; Mobolaji H. I; Kilishi A.A; Yaru M. A; Yakubu, T. A
The debate on the use of fiscal policy for economic stabilization and inducement of economic growth is an old one. Key issue in this debate relates to the efficacy of public expenditure on stimulating economic growth. The neo-classical school held on extreme position by refuting the usage of fiscal policy to regulate the economy even in the time of economic crisis. At the other extreme are those who emphasize the efficiency of fiscal policy in stabilizing economic fluctuations and stimulating...
Glenn Jenkins; Chun-Yan Kuo
This paper takes a broad approach in the sense that only the fundamental structure elements of each tax system are considered as part of the benchmark tax system. Moreover, this paper will go beyond the traditional tax expenditure reporting by taking into account an ideal tax system with minor distortions as part of the benchmark. Because of having an ideal tax system as a norm, the report makes some judgments about the appropriateness of the ideal tax structure in the Dominican Republic and ...
environmental , and smoke plume behavior for each trial. 3. To compare and evaluate smoke munition expenditure calculations of the KWIK model from...Equipment Center ATTN: Technical Information Center Dr. Eugene W. Bierly Orlando, FL 32813 Director, Division of Atmos Sciences National Scinece Foundation...Meteorology Division Fort Monmouth, NJ 07703 AFGL/LY Hanscom AFB, MA 01731 Commander US Army Satellite Comm Agency The Environmental Research ATTN
Illingworth, P J; Jung, R. T.; Howie, P W; P; Leslie; Isles, T E
Energy expenditure at rest and in response to a meal and to an infusion of noradrenaline was measured in 12 lactating women and compared with that in seven bottle feeding women and seven non-pregnant, non-lactating controls. The energy response of the lactating women was remeasured after lactation stopped. During lactation the resting metabolic rate was unaltered but there was a reduced response to infusion of noradrenaline and to a meal, which increased to normal control values after lactati...
Horváth, Csilla; Paap, Richard
textabstractThis article examines the influence of the business cycle on expenditures of three major types of legalized gambling activities: Casino gambling, lottery, and pari-mutuel wagering. Empirical results are obtained using monthly aggregated US per capita consumption time series for the period 1959. 01-2010. 08. Among the three gambling activities only lottery consumption appears to be recession-proof. This series is characterized by a vast and solid growth that exceeds the growth in i...
Ana Corbacho; Hamid R Davoodi
This paper analyzes Central America's track record on inequality, poverty, and quality of fiscal adjustment in relation to economic growth; health and education outcomes; adequacy of social safety nets; and governance. It then assesses the degree to which the track record can be traced to reforms in public expenditure and governance. Despite the considerable heterogeneity among the countries in the region, there are some policies that all countries need to pursue. Sustained growth and a bette...
Full Text Available Natural disasters have increased in their frequency, and the intensity of their destruction over the last ten years in Indonesia. Households usually respond to these difficulties by cutting their consump-tion, especially for non-essential goods. Arguably natural disasters are exogenous events, so this paper uses the exogenous variation from natural disasters as a natural experiment design to estimate the effect of disasters on household expenditure. When a certain group is exposed to the causal variable of interest, such as a disaster, and other groups are not, the Difference In Difference model (DID can be used for estimation. Using a micro level survey data set from the Indonesian Family Life Survey (IFLS which covers approximately 83 percent of the Indonesian population within the survey area, this paper examines the effects of natural disasters on household expenditure. This paper also examines whether there are any different impacts from different types of disasters. The finding is there are no significant effects of disasters on total household expenditure for households living in disaster regions, whether they are affected directly or not by the disaster.
Full Text Available It’s quite a long time that the need is felt for an integrated approach to the territory-mobility system; an approach allowing to plan, programme and carry out interventions affecting urban and territorial development. An approach targeted to point out strategies being more effective and consistent with the goals of competitive growth. In order to assess the effects that a more integrated territory-mobility approach could produce in relation to the functional reorganization of urban systems both on national and local scale, the paper suggests an analysis that quantifies the “financial mass” invested in transport infrastructure and urban equipments as well as its weight modification in the course of time. The above said assessment was worked out by analysing the trend of public expenditure in Italy during the five-year period 2000-2005, appraising the “value” of the interventions in transport infrastructure in comparison to the interventions for realizing and managing urban equipments. The worked out analysis stresses how much the strategies of territorial development, both on central and local level, mainly rely on the interventions for realizing and managing transport infrastructures. Therefore, a new approach could better address the great deal of resources (58% of expenditure for public works amounting to over €150.000 that regards the sector of transport infrastructures, although the trend context shows a great reduction of public financial resources destined to expenditure policies.
Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Mzoughi, Olfa; Toumi, Mondher
The value appreciation of new drugs across countries today features a disruption that is making the historical data that are used for forecasting pharmaceutical expenditure poorly reliable. Forecasting methods rarely addressed uncertainty. The objective of this project was to propose a methodology to perform pharmaceutical expenditure forecasting that integrates expected policy changes and uncertainty (developed for the European Commission as the 'EU Pharmaceutical expenditure forecast'; see http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). 1) Identification of all pharmaceuticals going off-patent and new branded medicinal products over a 5-year forecasting period in seven European Union (EU) Member States. 2) Development of a model to estimate direct and indirect impacts (based on health policies and clinical experts) on savings of generics and biosimilars. Inputs were originator sales value, patent expiry date, time to launch after marketing authorization, price discount, penetration rate, time to peak sales, and impact on brand price. 3) Development of a model for new drugs, which estimated sales progression in a competitive environment. Clinical expected benefits as well as commercial potential were assessed for each product by clinical experts. Inputs were development phase, marketing authorization dates, orphan condition, market size, and competitors. 4) Separate analysis of the budget impact of products going off-patent and new drugs according to several perspectives, distribution chains, and outcomes. 5) Addressing uncertainty surrounding estimations via deterministic and probabilistic sensitivity analysis. This methodology has proven to be effective by 1) identifying the main parameters impacting the variations in pharmaceutical expenditure forecasting across countries: generics discounts and penetration, brand price after patent loss, reimbursement rate, the penetration of biosimilars and discount price, distribution chains, and the time
Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Mzoughi, Olfa; Toumi, Mondher
Background and objective The value appreciation of new drugs across countries today features a disruption that is making the historical data that are used for forecasting pharmaceutical expenditure poorly reliable. Forecasting methods rarely addressed uncertainty. The objective of this project was to propose a methodology to perform pharmaceutical expenditure forecasting that integrates expected policy changes and uncertainty (developed for the European Commission as the ‘EU Pharmaceutical expenditure forecast’; see http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). Methods 1) Identification of all pharmaceuticals going off-patent and new branded medicinal products over a 5-year forecasting period in seven European Union (EU) Member States. 2) Development of a model to estimate direct and indirect impacts (based on health policies and clinical experts) on savings of generics and biosimilars. Inputs were originator sales value, patent expiry date, time to launch after marketing authorization, price discount, penetration rate, time to peak sales, and impact on brand price. 3) Development of a model for new drugs, which estimated sales progression in a competitive environment. Clinical expected benefits as well as commercial potential were assessed for each product by clinical experts. Inputs were development phase, marketing authorization dates, orphan condition, market size, and competitors. 4) Separate analysis of the budget impact of products going off-patent and new drugs according to several perspectives, distribution chains, and outcomes. 5) Addressing uncertainty surrounding estimations via deterministic and probabilistic sensitivity analysis. Results This methodology has proven to be effective by 1) identifying the main parameters impacting the variations in pharmaceutical expenditure forecasting across countries: generics discounts and penetration, brand price after patent loss, reimbursement rate, the penetration of biosimilars and
Moreno-Ramírez, David; Ferrándiz, Lara; Ramírez-Soto, Gabriel; Muñoyerro, M Dolores
Variability in adjusted drug expenditures among clinical departments raises the possibility of difficult access to certain therapies at the time that avoidable expenditures may also exist. Nevertheless, drug expenditures are not usually applied to clinical practice variability analysis. To identify and quantify variability in drug expenditures in comparable dermatology department of the Servicio Andaluz de Salud. Comparative economic analysis regarding the drug expenditures adjusted to population and health care production in 18 dermatology departments of the Servicio Andaluz de Salud. The 2012 cost and production data (homogeneous production units -HPU-)were provided by Inforcoan, the cost accounting information system of the Servicio Andaluz de Salud. The observed drug expenditure ratio ranged from 0.97?/inh to 8.90?/inh and from 208.45?/HPU to 1,471.95?/ HPU. The Pearson correlation between drug expenditure and population was 0.25 and 0.35 for the correlation between expenditure and homogeneous production (p=0.32 and p=0,15, respectively), both Pearson coefficients confirming the lack of correlation and arelevant degree of variability in drug expenditures. The quantitative analysis of variability performed through Pearson correlation has confirmed the existence of drug expenditure variability among comparable dermatology departments. Copyright © 2013 SEFH. Published by AULA MEDICA. All rights reserved.
Roos, Lilian; Taube, Wolfgang; Beeler, Nadja; Wyss, Thomas
The aim of this study was to assess the accuracy of three different sport watches in estimating energy expenditure during aerobic and anaerobic running. Twenty trained subjects ran at different intensities while wearing three commercial sport watches (Suunto Ambit2, Garmin Forerunner920XT, and Polar V800). Indirect calorimetry was used as the criterion measure for assessing energy expenditure. Different formulas were applied to compute energy expenditure from the gas exchange values for aerobic and anaerobic running. The accuracy of the energy expenditure estimations was intensity-dependent for all tested watches. During aerobic running (4-11 km/h), mean absolute percentage error values of -25.16% to +38.09% were observed, with the Polar V800 performing most accurately (stage 1: -12.20%, stage 2: -3.61%, and stage 3: -4.29%). The Garmin Forerunner920XT significantly underestimated energy expenditure during the slowest stage (stage 1: -25.16%), whereas, the Suunto Ambit2 significantly overestimated energy expenditure during the two slowest stages (stage 1: 38.09%, stage 2: 36.29%). During anaerobic running (14-17 km/h), all three watches significantly underestimated energy expenditure by -21.62% to -49.30%. Therefore, the error in estimating energy expenditure systematically increased as the anaerobic running speed increased. To estimate energy expenditure during aerobic running, the Polar V800 is recommended. By contrast, the other two watches either significantly overestimated or underestimated energy expenditure during most running intensities. The energy expenditure estimations generated during anaerobic exercises revealed large measurement errors in all tested sport watches. Therefore, the algorithms for estimating energy expenditure during intense activities must be improved before they can be used to monitor energy expenditure during high-intensity physical activities.
Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Oliveira, Maria Auxiliadora; Arrais, Paulo Sergio Dourado; Ramos, Luiz Roberto; Pizzol, Tatiane da Silva Dal; Mengue, Sotero Serrate; Farias, Mareni Rocha; Bertoldi, Andréa Dâmaso
To describe the magnitude of the expenditure on medicines in Brazil according to region, household size and composition in terms of residents in a situation of dependency. Population-based data from the national household survey were used, with probabilistic sample, applied between September 2013 and February 2014 in urban households. The expenditure on medicines was the main outcome of interest. The prevalence and confidence intervals (95%CI) of the outcomes were stratified according to socioeconomic classification and calculated according to the region, the number of residents dependent on income, the presence of children under five years and residents in a situation of dependency by age. In about one of every 17 households (5.3%) catastrophic health expenditure was reported and, in 3.2%, the medicines were reported as one of the items responsible for this situation. The presence of three or more residents (3.6%) and resident in a situation of dependency (3.6%) were the ones that most reported expenditure on medicines. Southeast was the region with the lowest prevalence of expenditure on medicines. The prevalence of households with catastrophic health expenditure and on medicines in relation to the total of households showed a regressive tendency for economic classes. Catastrophic health expenditure was present in 5.3%, and catastrophic expenditure on medicines in 3.2% of the households. Multi-person households, presence of residents in a situation of economic dependency and belonging to the class D or E had the highest proportion of catastrophic expenditure on medicines. Although the problem is important, permeated by aspects of iniquity, Brazilian policies seem to be protecting families from catastrophic expenditure on health and on medicine. Descrever a magnitude do gasto catastrófico em medicamentos no Brasil segundo região, tamanho das famílias e composição familiar em termos de moradores em situação de dependência. Utilizados dados de inqu
Full Text Available In the 1960s, a ânewâ marketing concept known as "four Ps marketing mix" appeared and shifted the focus from the product to the customer. The objective of the new concept was not only profit, and the means of achieving the objective expanded to include the entire âmarketing mixâ: product, price, promotion, and place (channels and distribution. Expenditures of marketing in a company should be explored from these mixes, because each mix would have an impact on the total marketing expenditures. These four mixes are the main aspects of marketing and thus, should represent almost all expenditures in marketing in a company. From this research it is discovered that the responding contractors have only average efforts to improve or innovate their service, mostly using the latest construction methods and management approach. Correlated to their policy in the fourth mix (Place, they are still national oriented and not international oriented in marketing their services, this may lead to the big question of their survival; their motivation to innovate is only average while their target market is only national market. Their attitude to use more intensive âfeesâ policy rather than both product innovation and promotion is also interesting. Big percentage of the responding contractors assumes these âfeesâ are regular marketing practices. This attitude may better be stopped to make the construction industry practices healthier. Attitude to use more product innovation and true promotion approach in marketing in construction must be encouraged systematically in the future, to improve competitiveness in the long term.
This paper explores the role of physician gender in the expenditures for ambulatory care as a potential source of practice style variation. We exploit a large doctor-patient panel dataset based on insurance-claims data from Switzerland to estimate the effect of physician gender on health care expenditures. We find considerable heterogeneity across specialties. In primary care, female doctors are found to produce similar overall expenditures per visit as their male colleagues, but significantly smaller prescribing costs and significantly higher laboratory costs. In secondary-care specialties, we find that women generate lower overall expenditures, which is mainly driven by consultation costs. These findings provide evidence for the existence of sex-specific practice styles that translate into different overall expenditures as well as different compositions of these expenditures.
Fernando Roberto De-Oliveira
Full Text Available The goal of this study was to present a new perspective on the relationship between lipid metabolism and the intensity/duration of exercise and energy expenditure. The idea was to use the second lactate threshold as a marker of the best ratio between energy expenditure and duration of exercise. From the literature review and analyses of experimental data, it was demonstrated that the second lactate threshold mark is the point at which the best ratio occurs between substrate oxidation rate and duration of effort. This means that any low intensity exercise performed below the second lactate threshold will require more time to achieve the same energy expenditure as exercise performed at the second lactate threshold. On the other hand, exercise performed above the second lactate threshold has a higher substrate oxidation rate, but, due to the shorter time for which the effort can be sustained, the total energy expenditure is less. These considerations have important practical applications in training schedules for reducing body fat. ResumoO foco desse trabalho é apresentar um ponto de vista diferenciado, referente ao inter relacionamento de metabolismo lipídico, intensidade/duração de exercício e gasto energético. A idéia central foi utilizar o segundo limiar de lactato como indicador da melhor relação entre gasto energético e tempo de exercício. A partir de dados levantados na literatura e das análises realizadas com estudos experimentais, foi demonstrado que o segundo limiar de lactato corresponde ao ponto de melhor relação entre a taxa de gasto energético e o tempo de esforço. Isso signifi ca que qualquer exercício de baixa intensidade, realizado abaixo do segundo limiar de lactato, precisaria de mais tempo para obter o mesmo gasto energético do que o realizado na intensidade do segundo limiar. Por outro lado, exercícios acima do segundo limiar de lactato apresentam maior taxa de gasto energético, mas devido ao menor tempo de
Troiano Richard P; Subar Amy F; Zhang Zhumin; Johnson Lindsey A; Bradley David P; Schatzkin Arthur; Schoeller Dale A
Abstract Individuals who smoke generally have a lower body mass index (BMI) than nonsmokers. The relative roles of energy expenditure and energy intake in maintaining the lower BMI, however, remain controversial. We tested the hypothesis that current smokers have higher total energy expenditure than never smokers in 308 adults aged 40-69 years old of which 47 were current smokers. Energy expenditure was measured by doubly labeled water during a two week period in which the subjects lived at h...
The consumption of storable goods does not necessarily equal purchases during a period because of changes in stock. In many cases, we have information about expenditures only, not consumption. A method is developed to obtain an estimate of consumption and changes in stock when only expenditure data are available. In addition to expenditure data, the method requires discrete information about the utilization of available equipment complementary to the storable good in consumption. Household en...
Sikder, S M A
The efficient government finance will increase economic growth and thereby income distribution. This research has been formulated an efficiency theory of production and finance. This research compared the government expenditure patterns into two situations. One, when a government borrows and accordingly allocates resources for productive expenditures for private and public finance. Another situation is that when a government borrows and fixed the resources for productive expenditure for only ...
This paper examines people's attitudes toward public spending on education in Japan. It is well known that Japan has the smallest public education expenditure relative to GDP among the OECD countries, and this may yield unequal opportunities in education. The tax burden in Japan is small compared to those in OECD countries, and there may be no…
... expenses and provide guidance on how to elect to deduct the expenses in accordance with the new rules... make an election to capitalize start-up and organizational costs must ``affirmatively elect to... general. Under section 195(b), a taxpayer may elect to amortize start-up expenditures as defined in...
Echevarria, C A
"In this paper I build a simple model to analyze the consequences that population growth imposes on the relative needs of expenditure of governments in a fiscal federalism setup. I assume, first, that some government expenditure items can be classified according to the age of their recipient individuals and, second, that different levels of government are usually assigned different expenditure programs. The implication is that, for an initially given level of effective public good provision, changes in the size of population as well as in its age structure will influence the composition of public expenditure for different layers of administration in a different manner." excerpt
In order to assess the combined presence of zero expenditures and a heavily skewed distribution of positive expenditures, the Box-Cox transformation with location parameter is used to define a set of models generalising the standard Tobit, Heckman selection and double-hurdle models. Extended flexibility with respect to previous specifications is introduced, notably regarding negative transformation parameters, which may prove necessary for medical expenditures, and corner-solution outcomes. An illustration is provided by the analysis of household health expenditure in Switzerland. Copyright (c) 2005 John Wiley & Sons, Ltd.
Zuconi, Carolina Pereira; Ceolin Alves, Ana Lígia; Toulson Davisson Correia, Maria Isabel
To assess the energy expenditure of women with breast cancer and the effectiveness of available predictive equations (PEs) for the estimation of energy requirements in these subjects. Women with breast cancer and healthy women controls underwent indirect calorimetry and nutritional assessment. The estimation of energy requirements included PEs (Harris-Benedict [HB], corrected by injury and activity factors), the Mifflin St. Jeor, and the quick formula of 25 kcal/kg of body weight (BW). Statistical analyses, including Student's t test, a paired t test, Bland-Altman analysis, and backward multivariate linear regression, were performed using the SPSS 17.0 software. Statistical significance was set at P cancer and 19 healthy women were evaluated. Analysis of nutritional status revealed 64.7% of the patients were overweight/obese, and 88.2% had an excess of body fat mass. The resting energy expenditure (REE) of the breast cancer patients was similar to that of the healthy women, even after adjustment for fat free mass (FFM) (P requirements estimated by the predictive equations widely varied, and the quick formula was the most accurate at determining total energy needs. The REE of women with breast cancer was similar to that of healthy women. The energy requirements of these patients may be calculated based on the quick formula of 25 kcal/kg of BW. Nonetheless, this estimation should be used cautiously as it results in wide variations when used alone. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Tourism activities affect the environment of different destinations, which is influenced by different tourists’ consumption. The objective of this study is to examine the relationship between inbound tourist expenditures and three main environmental dimensions, which are carbon dioxide emission from transport, energy demand, and water usage, in Thailand. This paper employs Vector Autoregressive (VAR models to determine the relationship of variables. Data from Ministry of Energy, Bank of Thailand, Metropolitan Electricity Authority, Provincial Waterworks Authority, National Statistical Office, Department of Tourism, and Tourism Authority of Thailand between 1988 and 2012 have been applied in the model. Note that, energy demand is represented by total electricity consumption of hotel and accommodation sector in Thailand, while water usage is represented by the total water consumption of tourists. This study found the relationships among tourists’ expenditures, carbon dioxide emission from transport, energy demand, and water usage. Therefore, the policies recommendations may be essential to prepare the optimal schemes and budgets for encountering the environmental impacts from tourism business expansion.
Karl J Kaiyala
Full Text Available Despite the suggestion that reduced energy expenditure may be a key contributor to the obesity pandemic, few studies have tested whether acutely reduced energy expenditure is associated with a compensatory reduction in food intake. The homeostatic mechanisms that control food intake and energy expenditure remain controversial and are thought to act over days to weeks. We evaluated food intake in mice using two models of acutely decreased energy expenditure: 1 increasing ambient temperature to thermoneutrality in mice acclimated to standard laboratory temperature or 2 exercise cessation in mice accustomed to wheel running. Increasing ambient temperature (from 21 °C to 28 °C rapidly decreased energy expenditure, demonstrating that thermoregulatory energy expenditure contributes to both light cycle (40 ± 1% and dark cycle energy expenditure (15 ± 3% at normal ambient temperature (21 °C. Reducing thermoregulatory energy expenditure acutely decreased food intake primarily during the light cycle (65 ± 7%, thus conflicting with the delayed compensation model, but did not alter spontaneous activity. Acute exercise cessation decreased energy expenditure only during the dark cycle (14 ± 2% at 21 °C; 21 ± 4% at 28 °C, while food intake was reduced during the dark cycle (0.9 ± 0.1 g in mice housed at 28 °C, but during the light cycle (0.3 ± 0.1 g in mice housed at 21 °C. Cumulatively, there was a strong correlation between the change in daily energy expenditure and the change in daily food intake (R(2 = 0.51, p<0.01. We conclude that acutely decreased energy expenditure decreases food intake suggesting that energy intake is regulated by metabolic signals that respond rapidly and accurately to reduced energy expenditure.
Linnemann, L.; Schabert, A.
This paper assesses the transmission of fiscal policy shocks in a New Keynesian framework where government expenditures contribute to aggregate production. It is shown that even if the impact of government expenditures on production is small, this assumption helps to reconcile the models'
% of total consumer expenditure from 1929 to 1952 (Winakor, 1989). Since 1976 clothing expenditure made up only 6% to 7% of total ... than the overall inflation rate (Laughlin, 1996). Contributing factors are the growth of low-priced apparel ...
Conclusions: It is concluded that depending on the severity of energy expenditure female boxing comes under heavy category and as it is a pioneer attempt in India, further studies in this aspect of sport are required which will guide the coaches regarding the energy expenditure pattern in women boxing. Keywords: Female ...
Kilsztajn, Samuel; Camara, Marcelo Bozzini Da; Carmo, Manuela Santos Nunes Do
This paper analyses the share of the family private health expenditures in the Brazilian GDP and in personal income; and the distribution of the family private health expenditures among social groups. The research utilized the 1998 Brazilian Home Sample Survey (Pesquisa Nacional por Amostra de Domicilios) with the division of the population into four social groups according to the family income per capita; and the distribution of the family private health expenditures among health insurance, physicians, other health professionals, medical tests, drugs, orthopedic and other medical durables, vision products, dental services, hospital care, nursing home care and other health spending. In 1998, only 7.2% of the population with family income per capita up to 1 minimum wage had health insurance and the health expenditures of this group, that represented 52.5% of the population, was US$ 4.62 per capita. For the people with 9 and more minimum wages per capita the health insurance coverage was 83.2% and the health expenditures was US$ 114.66 per capita. The implementation of the Brazilian public universal health care system in 1988 denominated "Sistema Unico de Saude" was followed by an expressive expansion of private insurance coverage in the 1990's. Even if all public health expenditures had been exclusively directed to the population without any private insurance, these people's health expenditures would only reach 43% of the health expenditures of those with private insurance.
In this paper, the dynamic relationship between health expenditure and economic growth from 1980-2010 in Nigeria is examined – using the newly developed ARDL Bounds testing procedure and Granger causality test. The results suggest that there is a long-run relationship between health expenditure and economic ...
Full Text Available A view prominently expounded is that the interaction between the composition and the volume of public expenditures is directly affected by political, institutional, psephological and ideological indicators. A crucial component of public expenditures, social expenditures play an important role in the economy as they directly and indirectly affect the distribution of income and wealth. Social expenditures aim at reallocating income and wealth unequal distribution. These expenditures comprise cash benefits, direct in-kind provision of goods and services, and tax breaks with social purposes.The aim of this study is to determine the relationship between political structure, i.e. government fragmentation, ideological composition, elections and so on, and the social expenditures in Greece. Employing data from the Comparative Political Dataset (CPDS and the OECD Social Expenditure Database (SOCX, a time series analysis was conducted for Greece for the 1980-2014 period. The findings of the study indicate that voter turnout, spending on the elderly population and the number of government changes have positive and statistically significant effects on social expenditures in Greece while debt stock and cabinet composition have negative effects.
... 34 Education 1 2010-07-01 2010-07-01 false Expenditures for professional development. 200.60... Paraprofessionals § 200.60 Expenditures for professional development. (a)(1) Except as provided in paragraph (a)(2... professional development activities to ensure that teachers and paraprofessionals meet the requirements of...
Erik Thibaut; Steven Vos; Jeroen Scheerder
The purpose of this article is to explore the determining factors of household expenditures on sports participation. Due to a relatively large amount of zero-expenditures, simple regression methods are not suited. Because of methodological reasons, the two-step Heckman approach is used over the
... 26 Internal Revenue 17 2010-04-01 2010-04-01 false Tax on political expenditures. 53.4955-1...) MISCELLANEOUS EXCISE TAXES (CONTINUED) FOUNDATION AND SIMILAR EXCISE TAXES Second Tier Excise Taxes § 53.4955-1 Tax on political expenditures. (a) Relationship between section 4955 excise taxes and substantive...
Gade, Rikke; Larsen, Ryan Godsk; Moeslund, Thomas B.
Estimation of human energy expenditure in sports and exercise contributes to performance analyses and tracking of physical activity levels. The focus of this work is to develop a video-based method for estimation of energy expenditure in athletes. We propose a method using thermal video analysis ...
The study assessed expenditure on food among urban households in Benue State of Nigeria. This was done with the view to assess household food expenditure and its implications for food security status of the households; identify and assess determinants that influence household food demand; and analyze the ...
... expenditures on a swimming pool are qualifying expenditures despite the fact that fees from guests of members...; (4) Security personnel; (5) Legal fees; (6) Upkeep of tennis courts; (7) Swimming pools; (8) Recreation rooms and halls; (9) Replacement of common buildings, facilities, air conditioning, etc; (10...
... 42 Public Health 4 2010-10-01 2010-10-01 false Expenditures for enrollment broker services. 438... Participation § 438.810 Expenditures for enrollment broker services. (a) Terminology. As used in this section... phone or in person; Enrollment broker means an individual or entity that performs choice counseling or...
Kaiyala, Karl J; Morton, Gregory J; Thaler, Joshua P; Meek, Thomas H; Tylee, Tracy; Ogimoto, Kayoko; Wisse, Brent E
Despite the suggestion that reduced energy expenditure may be a key contributor to the obesity pandemic, few studies have tested whether acutely reduced energy expenditure is associated with a compensatory reduction in food intake. The homeostatic mechanisms that control food intake and energy expenditure remain controversial and are thought to act over days to weeks. We evaluated food intake in mice using two models of acutely decreased energy expenditure: 1) increasing ambient temperature to thermoneutrality in mice acclimated to standard laboratory temperature or 2) exercise cessation in mice accustomed to wheel running. Increasing ambient temperature (from 21 °C to 28 °C) rapidly decreased energy expenditure, demonstrating that thermoregulatory energy expenditure contributes to both light cycle (40 ± 1%) and dark cycle energy expenditure (15 ± 3%) at normal ambient temperature (21 °C). Reducing thermoregulatory energy expenditure acutely decreased food intake primarily during the light cycle (65 ± 7%), thus conflicting with the delayed compensation model, but did not alter spontaneous activity. Acute exercise cessation decreased energy expenditure only during the dark cycle (14 ± 2% at 21 °C; 21 ± 4% at 28 °C), while food intake was reduced during the dark cycle (0.9 ± 0.1 g) in mice housed at 28 °C, but during the light cycle (0.3 ± 0.1 g) in mice housed at 21 °C. Cumulatively, there was a strong correlation between the change in daily energy expenditure and the change in daily food intake (R(2) = 0.51, psignals that respond rapidly and accurately to reduced energy expenditure.
Trogdon, Justin G; Finkelstein, Eric A; Hoerger, Thomas J
To investigate the use of regression models to calculate disease-specific shares of medical expenditures. Medical Expenditure Panel Survey (MEPS), 2000-2003. Theoretical investigation and secondary data analysis. Condition files used to define the presence of 10 medical conditions. Incremental effects of conditions on expenditures, expressed as a fraction of total expenditures, cannot generally be interpreted as shares. When the presence of one condition increases treatment costs for another condition, summing condition-specific shares leads to double-counting of expenditures. Condition-specific shares generated from multiplicative models should not be summed. We provide an algorithm that allows estimates based on these models to be interpreted as shares and summed across conditions.
Full Text Available The purpose of this paper is to assess the impact of earmarking on central government environment protection expenditure. Since central government spending for the environment relies on earmarked revenues, which is not the case of the local government, it is expected that central government expenditure is to a lesser degree affected by macroeconomic developments. The analysis indicates that this is the case because correlation between GDP change and the change in central government expenditure for environment protection is smaller than that of the local government. It is also found that increasing revenues from earmarked environmental charges have contributed to growing expenditure. However, the analysis also suggests that the main driver of this growth is the expansion is EU funds. Reliance on EU expenditure was further reinforced by changes in earmarking rules in 2008-2009
Full Text Available The paper deals with development and changes in consumption expenditures of population. It uses secondary data to analyze consumption expenditures of EU-25 and the Czech Republic and concetrates on changes in the expenditure groups over the period of past years. Other part of this paper is devoted to primary data analysis. Primary data were obtained in a questionnaire survey. Primary data analysis is based on statistical methods and it investigates changes in the structure of consumption expenditures of households in relation to changes in household income. By using dependency analysis the paper verifies dependency of surveyed groups of consumption expenditures and groups of households sorted by identification characteristics. Additionally, also based on the primary research, the paper tries to find out the way households allocate money surplus remaining after covering all the adequate expenses.
Full Text Available Equity isone of the basic principles of health systems and features explicitly in theNigerian health financing policy. Despite acclaimed commitment to theimplementation of this policy through various pro-poor health programmes andinterventions, the level of inequity in health status and access to basichealth care interventions remain high. This paper examines the equity of healthcare expenditure by individuals in Nigeria. The paper evaluated equity in out-of-pocketspending( OOP for the country and separately for the six geopolitical zones ofthe country.The methodological framework rests onKakwani Progressivity Indices (KPIs, ReynoldSmolensky indices andconcentration indices (CIs using data from the 2004 Nigerian National LivingStandard Survey( NLSS collected by the National Bureau of Statistics. .The results reveal that health financing isregressive with the incidence disproportionately rest on poor households withabout 70% of the total expenditure on health is through out-of-pocket paymentsby households. Poor households are prone to bear most of the expenses in theevent of any health shock. The catastrophic consequences thus push some intopoverty, and aggravate the poverty of others.The paper therefore suggests that thecountry’s health financingsystems must be designed not only to allow people to access services when theyare needed, but must also protect household, from financial catastrophe, byreducing OOP spending through risk pooling and prepayment schemes within thehealth system.Keywords: Equity, Health careexpenditure, Kakwani progressivity index, Nigeria.
Kerkhof, Annemarie C.; Nonhebel, Sanderine; Moll, Henri C.
In this paper we evaluate the relationships between household expenditures and the environmental impact categories climate change, acidification, eutrophication and smog formation, by combining household expenditures with environmentally extended input–output analysis. Expenditure elasticities are
Patients with Parkinson's disease (PD) commonly exhibit weight loss (WL) which investigators attribute to various factors, including elevated energy expenditure. We tested the hypothesis that daily energy expenditure (DEE) and its components, resting energy expenditure (REE) and physical activity (P...
Patients with Parkinson's disease (PD) commonly exhibit weight loss, which investigators attribute to various factors, including elevated resting energy expenditure. We tested the hypothesis that daily energy expenditure (DEE) and its components, resting energy expenditure (REF) and physical activit...
Hunter, Gary R; Fisher, Gordon; Neumeier, William H; Carter, Stephen J; Plaisance, Eric P
This study aims to determine the effects of aerobic or resistance training on activity-related energy expenditure (AEE; kcal·d(-1)) and physical activity index (activity-related time equivalent (ARTE)) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by decreases in AEE, ARTE, and nontraining physical activity energy expenditure (nonexercise activity thermogenesis (NEAT)) and that exercise training would prevent decreases in free-living energy expenditure. One hundred forty premenopausal women had an average weight loss of 25 lb during a diet (800 kcal·d(-1)) of furnished food. One group aerobically trained 3 times per week (40 min·d(-1)), another group resistance-trained 3 times per week (10 exercises/2 sets × 10 repetitions), and the third group did not exercise. Dual-energy x-ray absorptiometry was used to measure body composition, indirect calorimetry was used to measure resting energy expenditure (REE) and walking energy expenditure, and doubly labeled water was used to measure total energy expenditure (TEE). AEE, ARTE, and nontraining physical activity energy expenditure (NEAT) were calculated. TEE, REE, and NEAT all decreased following weight loss for the no-exercise group, but not for aerobic and resistance trainers. Only REE decreased in the two exercise groups. Resistance trainers increased ARTE. HR and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Exercise training prevents a decrease in energy expenditure, including free-living energy expenditure separate from exercise training, following weight loss. Resistance training increases physical activity, whereas economy/ease of walking is associated with increased TEE, AEE, NEAT, and ARTE.
Fang, Kuangnan; Ma, Chi; Jiang, Yefei; Ye, Linglong; Shia, Benchang; Ma, Shuangge
Illness conditions lead to medical expenditure. Even with various types of medical insurance, there can still be considerable out-of-pocket costs. Medical expenditure can affect other categories of household consumptions. The goal of this study is to provide an updated empirical description of the distributions of illness conditions and medical expenditure and their associations with other categories of household consumptions. A phone-call survey was conducted in June and July of 2012. The study was approved by ethics review committees at Xiamen University and FuJen Catholic University. Data was collected using a Computer-Assisted Telephone Survey System (CATSS). "Household" was the unit for data collection and analysis. Univariate and multivariate analyses were conducted, examining the distributions of illness conditions and the associations of illness and medical expenditure with other household consumptions. The presence of chronic disease and inpatient treatment was not significantly associated with household characteristics. The level of per capita medical expenditure was significantly associated with household size, income, and household head occupation. The presence of chronic disease was significantly associated with levels of education, insurance and durable goods consumption. After adjusting for confounders, the associations with education and durable goods consumption remained significant. The presence of inpatient treatment was not associated with consumption levels. In the univariate analysis, medical expenditure was significantly associated with all other consumption categories. After adjusting for confounding effects, the associations between medical expenditure and the actual amount of entertainment expenses and percentages of basic consumption, savings, and insurance (as of total consumption) remained significant. This study provided an updated description of the distributions of illness conditions and medical expenditure in Taiwan. The findings
Full Text Available The aim of this paper is to discuss the Romanian public expenditures policy promoted in the context of the economic and financial crisis. Firstly, we present a brief introduction on the effects of public expenditures policy to economic growth and the role of automatic stabilizers in times of economic recessions. Secondly, the paper analyzes the evolution of current and capital public expenditures before and during the economic and financial crisis, according to which unproductive spending prevailed, in detriment of productive investments which can stimulate the economic recovery.
Fehime Korkmaz Bingöl
Full Text Available Increasing tourist expenditure is a means to increase tourism income, which is extremely important for local economies. The purpose of this study is to understand the expending pattern of tourists coming to Mugla Region and provide empirical background for the policies to increase per tourist expenditure. The survey conducted at Dalaman International Airport and the data has been analyzed using OLS method. Nationality, age, accommodation type, pension type, credit card usage, availability of shopping facilities, standard of night life and entertainment, quality of food and beverage, length of holiday and group size has been found as significant factors affecting tourist expenditure
Hyun, Kyung-Rae; Kang, Sungwook; Lee, Sunmi
Korea's rapid population aging has been considered as a major factor in increase of healthcare expenditure (HCE). However, there were no clear empirical evidences in Korea that show if population aging has a significant impact on HCE. To examine the 'red herring' argument, this study used Heckman, two-part, and augmented model with Korean National Health Insurance claim data for the deceased and survivors of aged 20 years and over verified by Korean National Health Insurance Service between January 1 and December 31, 2010. Our results suggest that when time to death is controlled for as explanatory variable, HCE decreases as a function of age, and HCE during the terminal year increases as a function of time to death, and HCE in the last quarter of life decreases with age. Therefore, this study affirms that there is no age effect in Korea experiencing the most rapid population aging among Asian countries. An increase in the number of elderly, due to the aging of baby boomers, may not increase a share of HCE out of gross domestic product (GDP) in Korea. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Westerterp, K R; Speakman, J R
Obesity results from protracted energy imbalance. Whether this comprises excessive energy intake, lowered physical activity or both, remains disputed. Physical activity energy expenditure, evaluated in three different ways from daily energy expenditure (DEE) measured using doubly labelled water, was examined for trends over time. Data included subjects in Europe (Maastricht, the Netherlands) and North America extending back to the 1980s. These data were compared with measures from the third world, and measures made on wild terrestrial mammals. Physical activity expenditure in Europe (residual of the regression of DEE on basal energy expenditure (BEE)) has slightly but significantly increased since the 1980s. There was no trend over time in physical activity level (PAL=DEE/BEE), or in the residual variance in DEE once mass, sex and age were accounted for. This latter index of physical activity expenditure also significantly increased over time in North America. DEE of individuals in Europe and North America was not significantly different from individuals measured in the third world. In wild terrestrial mammals, DEE mostly depended on body mass and ambient temperature. Predicted DEE for a 78 kg mammal living at 20 degrees C was 9.2 MJ per day (95% CI: 7.9-12.9 MJ per day), not significantly different from the measured DEE of modern humans (around 10.2-12.6 MJ per day). As physical activity expenditure has not declined over the same period that obesity rates have increased dramatically, and daily energy expenditure of modern man is in line with energy expenditure in wild mammals, it is unlikely that decreased expenditure has fuelled the obesity epidemic.
National Oceanic and Atmospheric Administration, Department of Commerce — This is a time-series dataset of trip expenditure data for the Hawaii-based longline fleet for the period August 2004 to present. The data collection includes 10...
Davie, Bruce F.
Presents an overview of the current role of excise taxation in the federal tax system. Breaks down excise taxes into nine distinct types, and identifies problems related to determining tax expenditures and revenue losses.
National Oceanic and Atmospheric Administration, Department of Commerce — This is a time-series dataset for trip expenditure data for the American Samoa-based longline fleet from August 2006 to present. The dataset includes 10 variable...
Marthen Anthon Pentury
Full Text Available In fiscal decentralization, local governments should be able to provide public service facilities for all communities. This study aims to determine the existence of flypaper effect in the total capital public expenditure and capital expenditure on education, health and infrastructure in districts in West Papua, 2003-2006. Tools of analysis used is panel data regression. The General Allocation Fund (DAU, the Special Allocation Fund (DAK and the Special Autonomy Fund (DOK partially and simultaneously have positive impact on total capital spending and capital expenditure in education, health, and infrastructure. It is also indicated the anomaly of flypaper effect in DAU, DAK, and DOK.Keywords: Flypaper effect, anomaly, fiscal decentralization, capital expendituresJEL classification numbers: H50, H75
The research measured the impact of Georgia Department of Transportations highway : expenditures on economic activity in the State. The analysis covered awards made between January 2009 : and April 2013. The research is unique in that it not only ...
Philip Chimobi Omoke
Full Text Available This study uses disaggregated expenditure components of total national income todetermine the behaviour of imports demand in Nigeria using annual time series data and by applyingthe Johansen-Juselius multivariate cointegration technique tests to find out if the relevant economicvariables are cointegrated in the long run. Variables used in the study are volume of imports of goodsand services, consumption expenditure, expenditureon investment goods, relative prices and adummy variable for trade liberalisation policy in Nigeria. The empirical evidence suggests thatcointegrating relationship exists among the variables. The error correction estimate reveals thatalmost all the coefficients of the variables testedcame out with a statistically positive signs.Consumption expenditure, export and investment coefficient relates positively with import implyingthat increase in expenditure on these leads to a significant increase in import. Generally, the resultshowed that import demand function and expenditurecomponent in Nigeria has a statisticallysignificant relationship.
Juyani, Yaser; Hamedi, Dorsa; Hosseini Jebeli, Seyede Sedighe; Qasham, Maryam
There are many disabling medical conditions which can result in catastrophic health expenditure. Multiple Sclerosis is one of the most costly medical conditions through the world which encounter families to the catastrophic health expenditures. This study aims to investigate on what extent Multiple sclerosis patients face catastrophic costs. This study was carried out in Ahvaz, Iran (2014). The study population included households that at least one of their members suffers from MS. To analyze data, Logit regression model was employed by using the default software STATA12. 3.37% of families were encountered with catastrophic costs. Important variables including brand of drug, housing, income and health insurance were significantly correlated with catastrophic expenditure. This study suggests that although a small proportion of MS patients met the catastrophic health expenditure, mechanisms that pool risk and cost (e.g. health insurance) are required to protect them and improve financial and access equity in health care.
... to any particular expenditure applies only to the agreement of those foundation managers who are... action would in all probability not result in the satisfaction of execution on a judgment. (2) Correction...
Ahmad Danu Prasetyo
Full Text Available In this paper, we investigate the efficiency level of government expenditure in 82 countries towards the human development and peace index of the respective countries by using Data Envelopment Analysis (DEA approach during 2007-2011. We found that only few countries that always being positioned in the efficient frontier during the sample period, namely: Japan, Nigeria, and Norway. By using Malmquist index approach, we also found that Cyprus has the largest government expenditure efficiency improvement.Keywords: Government Expenditure Efficiencies, Human Development Index, Global Peace Indexdoi:10.12695/ajtm.2013.6.2.3 How to cite this article:Prasetyo, A.D., and Pudjono, A.N.S. (2013. Measuring Government Expenditure Efficiencies Towards Peace and Human Development. The Asian Journal of Technology Management 6 (2: 82-91. Print ISSN: 1978-6956; Online ISSN: 2089-791X. doi:10.12695/ajtm.2013.6.2.3
Wirtz, Veronika J; Serván-Mori, Edson; Heredia-Pi, Ileana; Dreser, Anahí; Ávila-Burgos, Leticia
To analyze medicine utilization and expenditure and associated factors in Mexico, as well as to discuss their implications for pharmaceutical policy. Analysis of a sample of 193,228 individuals from the Mexican National Health and Nutrition Survey 2012. Probability and amount of expenditure were estimated using logit, probit and quantile regression models, evaluating three dimensions of access to medicines: (1) likelihood of utilization of medicines in the event of a health problem, (2) probability of incurring expenses and (3) amount spent on medicines. Individuals affiliated to IMSS were more likely to use medicines (OR=1.2, pISSSTE or SP reduced the likelihood of spending compared to those without health insurance (about RM 0.7, p<0.01). Median expenditures varied between 195.3 and 274.2 pesos. Factors associated with the use and expenditure on medicines indicate that inequities in the access to medicines persist.
Jurlina-Alibegović, Dubravka; Slijepčević, Sunčana
.... Consequently, the importance of evaluating public drug policy is growing. Public expenditures on combating drug problems are recognised as a very useful indicator of government efforts in this regard...
Nghiem, Son Hong; Connelly, Luke Brian
This study examines the trend and determinants of health expenditures in OECD countries over the 1975-2004 period. Based on recent developments in the economic growth literature we propose and test the hypothesis that health care expenditures in countries of similar economic development level may converge. We hypothesise that the main drivers for growth in health care costs include: aging population, technological progress and health insurance. The results reveal no evidence that health expenditures among OECD countries converge. Nevertheless, there is evidence of convergence among three sub-groups of countries. We found that the main driver of health expenditure is technological progress. Our results also suggest that health care is a (national) necessity, not a luxury good as some other studies in this field have found.
Marthen Anthon Pentury
In fiscal decentralization, local governments should be able to provide public service facilities for all communities. This study aims to determine the existence of flypaper effect in the total capital public expenditure and capital expenditure on education, health and infrastructure in districts in West Papua, 2003-2006. Tools of analysis used is panel data regression. The General Allocation Fund (DAU), the Special Allocation Fund (DAK) and the Special Autonomy Fund (DOK) partially and simul...
Cohen, Eyal; Hall, Matt; Lopert, Ruth; Bruen, Brian; Chamberlain, Lisa J; Bardach, Naomi; Gedney, Jennifer; Zima, Bonnie T; Berry, Jay G
Medication use may be a target for quality improvement, cost containment, and research. We aimed to identify medication classes associated with the highest expenditures among pediatric Medicaid enrollees and to characterize the demographic, clinical, and health service use of children prescribed these medications. Retrospective, cross-sectional study of 3 271 081 Medicaid-enrolled children. Outpatient medication spending among high-expenditure medication classes, defined as the 10 most expensive among 261 mutually exclusive medication classes, was determined by using transaction prices paid to pharmacies by Medicaid agencies and managed care plans among prescriptions filled and dispensed in 2013. Outpatient medications accounted for 16.6% of all Medicaid expenditures. The 10 most expensive medication classes accounted for 63.9% of all medication expenditures. Stimulants (amphetamine-type) accounted for both the highest proportion of expenditures (20.6%) and days of medication use (14.0%) among medication classes. Users of medications in the 10 highest-expenditure classes were more likely to have a chronic condition of any complexity (77.9% vs 41.6%), a mental health condition (35.7% vs 11.9%), or a complex chronic condition (9.8% vs 4.3%) than other Medicaid enrollees (all P < .001). The 4 medications with the highest spending were all psychotropic medications. Polypharmacy was common across all high-expenditure classes. Medicaid expenditure on pediatric medicines is concentrated among a relatively small number of medication classes most commonly used in children with chronic conditions. Interventions to improve medication safety and effectiveness and contain costs may benefit from better delineation of the appropriate prescription of these medications. Copyright © 2017 by the American Academy of Pediatrics.
Hunter, Gary R.; Fisher, Gordon; Neumeier, William H.; Carter, Stephen J.; Plaisance, Eric P.
Purpose Determine the effects of aerobic or resistance training on activity related energy expenditure (AEE, kcal/d) and physical activity index (ARTE) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by a decrease in AEE, ARTE, and non-training physical activity energy expenditure (NEAT) and that exercise training would prevent decreases in free living energy expenditure. Methods 140 pre-menopausal women underwent an average of 25 pound weight loss during an 800 kcal/day diet of furnished food. One group aerobically trained 3 times/wk (40 min/d), another resistance trained 3 times/wk (10 exercises/2 sets x10 repetitions) and the third group did not exercise. DXA was used to measure body composition, indirect calorimetry to measure resting (REE) and walking energy expenditure, and doubly labeled water to measure total energy expenditure (TEE). AEE, ARTE, and non-training physical activity energy expenditure (NEAT) were calculated. Results TEE, REE, and NEAT all decreased following weight loss for the no exercise group, but not for the aerobic and resistance trainers. Only REE decreased in the two exercise groups. The resistance trainers increased ARTE. Heart rate and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Conclusion Exercise training prevents a decrease in energy expenditure, including free living energy expenditure separate from the exercise training, following weight loss. Resistance training increased physical activity, while ease and economy in walking associates with increased TEE, AEE, NEAT, and ARTE. PMID:25606816
Schjerning, Bertel; Sørensen, Anders
This paper studies conversion factors based on the expenditure approach and evaluates the appropriateness for international comparisons of output levels in manufacturing. We apply a consistency check based on the insight that relative productivity levels should be invariant to the choice of base....... The conclusion is insensitive to the applied method for developing conversion factors. The implication is that we cannot measure relative productivity levels in manufacturing across countries using the expenditure approach....
This public expenditure review (PER) examines the budget performance for FY00- and the first eight months of FY01, when domestic revenue remained at the same low level as in the previous year (1.15 percent of GDP), while expenditures increased in FY00 by one percentage point, i.e., 15.9 percent of GDP. Some progress has been made in enhancing funding for priority activities in the areas or...
Burgess, Philip; Pirkis, Jane; Buckingham, Bill; Burns, Jane; Eagar, Kathy; Eckstein, Gary
Relatively little international work has examined whether mental health resource allocation matches need. This study aimed to determine whether adult mental health resources in Australia are being distributed equitably. Individual measures of need were extrapolated to Australian Areas, and Area-based proxies of need were considered. Particular attention was paid to the prevalence of mental health problems, since this is arguably the most objective measure of need. The extent to which these measures predicted public sector, private sector and total adult mental health expenditure at an Area level was examined. In the public sector, 41.6% of expenditure variation was explained by the prevalence of affective disorders, personality disorders, cognitive impairment and psychosis, as well as the Area's level of economic resources and State/Territory effects. In the private sector, 72.4% of expenditure variation was explained by service use and State/Territory effects (with an alternative model incorporating service use and State/Territory supply of private psychiatrists explaining 69.4% of expenditure variation). A relatively high proportion (58.7%) of total expenditure variation could be explained by service utilisation and State/Territory effects. For services to be delivered equitably, the majority of variation in expenditure would have to be accounted for by appropriate measures of need. The best model for public sector expenditure included an appropriate measure of need but had relatively poor explanatory power. The models for private sector and total expenditure had greater explanatory power, but relied on less appropriate measures of need. It is concluded that mental health services in Australia are not yet being delivered equitably.
... 26 Internal Revenue 17 2010-04-01 2010-04-01 false Excess lobbying expenditures of affiliated... (CONTINUED) MISCELLANEOUS EXCISE TAXES (CONTINUED) PUBLIC CHARITY EXCISE TAXES § 56.4911-8 Excess lobbying... expenditures, lobbying expenditures, and grass roots expenditures of an affiliated group of organizations, and...
Moe, R.J.; Kee, J.R.; Lackey, K.C.; Cronin, F.J.
Objective of this report is to analyze recent trends in industrial research and development (R and D) spending. Emphasis is on energy and energy conservation R and D expenditures. This objective was achieved by performing two tasks. The first task was to collect and assemble data on industrial R and D expenditures in the US from the National Science Foundation (NSF), Office of Industrial Studies. The second task was to graphically and numerically analyze recent trends in total, energy-related, and energy conservation R and D expenditures. Total R and D and energy R and D expenditures for the period 1975 to 1982 were analyzed for each of nine industries: chemicals, petroleum, primary metals, machinery, electrical equipment, aircraft and missiles, professional and scientific instruments, other manufacturing, nonmanufacturing. Energy conservation R and D expenditures for this period were analyzed for each of six industries: chemicals, primary metals, machinery, electrical equipment, other manufacturing, and nonmanufacturing. In addition, for all three types of R and D, trends in expenditures for all industries combined were analyzed.
Stec, Michael J; Rawson, Eric S
Recently, it was demonstrated that a uniaxial accelerometer worn at the hip could estimate resistance exercise energy expenditure. As resistance exercise takes place in more than 1 plane, the use of a triaxial accelerometer may be more effective in estimating resistance exercise energy expenditure. The aims of this study were to estimate the energy cost of resistance exercise using triaxial accelerometry and to determine the optimal location for wearing triaxial accelerometers during resistance exercise. Thirty subjects (15 men and 15 women; age = 21.7 ± 1.0 years) performed a resistance exercise protocol consisting of 2 sets of 8 exercises (10RM loads). During the resistance exercise protocol, subjects wore triaxial accelerometers on the wrist, waist, and ankle; a heart rate monitor; and a portable metabolic system. Net energy expenditure was significantly correlated with vertical (r = 0.67, p resistance exercise energy expenditure. A triaxial accelerometer worn at the waist can be used to estimate resistance exercise energy expenditure but appears to offer no benefit over uniaxial accelerometry. The use of accelerometers in estimating resistance exercise energy expenditure may prove useful for individuals and athletes who participate in resistance training and are focused on maintaining a tightly regulated energy balance.
Full Text Available Cruise tourism generates different types of cruise consumption and related indirect, direct and induced expenditure effects, in homeports as well as in ports of call. Cruise passengers’ expenditures produce positive economic effects for destinations, from increasing the incomes and employment, to tax incomes, duties, etc. Therefore, it is no doubt that cruise stakeholders and local economies can benefit from increased cruise passenger consumption. To stimulate higher consumption and passengers’ satisfaction, it is necessary to design the supportive policy framework and build appropriate quality of products and services. Identifying influential variables of cruise passengers’ expenditures in this sense enables the design of appropriate policies and measures. In the current research, based on a survey of 357 cruise passengers, several variables included in a new theoretical model of the expenditures determinants, such as gender, nationality, frequency of cruising and frequency of visits, were found to be statistically significantly associated with cruise passengers’ expenditures. Several conclusions and suggestions to stimulate cruise passenger expenditures based on research findings are provided.
García-Cornejo, Beatriz; Pérez-Méndez, José A
To analyze the relationship between the degree of development of hospital cost systems (CS) implemented by the regional health services (RHS) and the variation in unit cost of hospitals in Spanish National Health Service (NHS) between 2010 and 2013 and to identify other explanatory factors of this variation. A database of NHS hospitals was constructed from exclusively public sources. Using a multilevel regression model, explaining factors of the variation in unit cost (cost per weighted unit of activity [WAU]) of a sample of 170 hospitals were analyzed. The variables representative of the degree of development of CS are associated in a negative and significant way with the variation of the cost per WAU. It is observed that if a high-level development CS is used the cost variation per WAU would be reduced by close to 3.2%. There is also a negative and significant relationship between the variation in the cost per WAU and the variations in the percentage of high technology and the hospital occupancy rate. On the other hand, the variations in the average cost of personnel and in the number of workers per 100 beds are associated in a positive and significant way with the variation of the cost per WAU. In the period analysed, during which the main health expenditure adjustment was made, the control in hospital unit cost is associated not only with spending cuts but also with aspects related to their management, such as the implementation of more developed CS. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Gilgen-Ammann, Rahel; Koller, Marcel; Huber, Céline; Ahola, Riikka; Korhonen, Topi; Wyss, Thomas
The aim of this study was to develop and cross-validate two models to estimate total energy expenditure (TEE) based on respiration variables in healthy subjects during daily physical activities. Ninety-nine male and female subjects systematically varying in age (18-60 years) and body mass index (BMI; 17-36 kg*m-2) completed eleven aerobic activities with a portable spirometer as the criterion measure. Two models were developed using linear regression analyses with the data from 67 randomly selected subjects (50.0% female, 39.9 ± 11.8 years, 25.1 ± 5.2 kg*m-2). The models were cross-validated with the other 32 subjects (49% female, 40.4 ± 10.7 years, 24.7 ± 4.6 kg*m-2) by applying equivalence testing and Bland-and-Altman analyses. Model 1, estimating TEE based solely on respiratory volume, respiratory rate, and age, was significantly equivalent to the measured TEE with a systematic bias of 0.06 kJ*min-1 (0.22%) and limits of agreement of ±6.83 kJ*min-1. Model 1 was as accurate in estimating TEE as Model 2, which incorporated further information on activity categories, heart rate, sex, and BMI. The results demonstrated that respiration variables and age can be used to accurately determine daily TEE for different types of aerobic activities in healthy adults across a broad range of ages and body sizes.
Jong Soo Lee
Full Text Available Adequate sleep is crucial during childhood for metabolic health, and physical and cognitive development. Inadequate sleep can disrupt metabolic homeostasis and alter sleeping energy expenditure (SEE. Functional data analysis methods were applied to SEE data to elucidate the population structure of SEE and to discriminate SEE between obese and non-obese children. Minute-by-minute SEE in 109 children, ages 5-18, was measured in room respiration calorimeters. A smoothing spline method was applied to the calorimetric data to extract the true smoothing function for each subject. Functional principal component analysis was used to capture the important modes of variation of the functional data and to identify differences in SEE patterns. Combinations of functional principal component analysis and classifier algorithm were used to classify SEE. Smoothing effectively removed instrumentation noise inherent in the room calorimeter data, providing more accurate data for analysis of the dynamics of SEE. SEE exhibited declining but subtly undulating patterns throughout the night. Mean SEE was markedly higher in obese than non-obese children, as expected due to their greater body mass. SEE was higher among the obese than non-obese children (p0.1, after post hoc testing. Functional principal component scores for the first two components explained 77.8% of the variance in SEE and also differed between groups (p = 0.037. Logistic regression, support vector machine or random forest classification methods were able to distinguish weight-adjusted SEE between obese and non-obese participants with good classification rates (62-64%. Our results implicate other factors, yet to be uncovered, that affect the weight-adjusted SEE of obese and non-obese children. Functional data analysis revealed differences in the structure of SEE between obese and non-obese children that may contribute to disruption of metabolic homeostasis.
... AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL TEMPORARY ASSISTANCE FOR NEEDY FAMILIES... definition of expenditure at § 260.30, we would only consider the refundable portion of a State or local tax...
Full Text Available OBJECTIVE: To determine energy expenditure in kilocalories (kcal during sexual activity in young healthy couples in their natural environment and compare it to a session of endurance exercise. METHODS: The study population consisted of twenty one heterosexual couples (age: 22.6 ± 2.8 years old from the Montreal region. Free living energy expenditure during sexual activity and the endurance exercise was measured using the portable mini SenseWear armband. Perceived energy expenditure, perception of effort, fatigue and pleasure were also assessed after sexual activity. All participants completed a 30 min endurance exercise session on a treadmill at a moderate intensity. RESULTS: Mean energy expenditure during sexual activity was 101 kCal or 4.2 kCal/min in men and 69.1 kCal or 3.1 kCal/min in women. In addition, mean intensity was 6.0 METS in men and 5.6 METS in women, which represents a moderate intensity. Moreover, the energy expenditure and intensity during the 30 min exercise session in men was 276 kCal or 9.2 kCal/min and 8.5 METS, respectively and in women 213 kCal or 7.1 kCal/min and 8.4 METS, respectively. Interestingly, the highest range value achieved by men for absolute energy expenditure can potentially be higher than that of the mean energy expenditure of the 30 min exercise session (i.e. 306.1 vs. 276 kCal, respectively whereas this was not observed in women. Finally, perceived energy expenditure during sexual activity was similar in men (100 kCal and in women (76.2 kCal when compared to measured energy expenditure. CONCLUSION: The present study indicates that energy expenditure during sexual activity appears to be approximately 85 kCal or 3.6 kCal/min and seems to be performed at a moderate intensity (5.8 METS in young healthy men and women. These results suggest that sexual activity may potentially be considered, at times, as a significant exercise.
Full Text Available Background: Shortcomings in healthcare delivery has led people to spend a substantial proportion of their incomes on medical treatment. World Health Organization (2005 estimates reveal that every year 25 million households are forced into poverty by illness and the struggle to pay for healthcare. Thus we planned to calculate the health care expenditure of rural households and to assess the households incurring catastrophic health expenditure. Methods: A cross-sectional study was conducted in the service area of Sri Manakula Vinayagar Medical College and Hospital from May to August 2011. A total of 100 households from the 4 adjoining villages of our Institute were selected for operational and logistic feasibility. The household’s capacity to pay, out of pocket expenditure and catastrophic health expenditure were calculated. Data collection was done using a pretested questionnaire by the principal investigator and the analysis was done using SPSS (version 16. Results: The average income in the highest income quintile was Rs 51,885 but the quintile ratio was 14.98. The median subsistence expenditure was Rs 4,520. About 18% of households got impoverished paying for health care. About 81% of households were incurring out of pocket expenditure and 66% were facing catastrophic health expenses of 40%.Conclusion There was very high out of pocket spending and a high prevalence of catastrophic expenditure noted. Providing quality care at affordable cost and appropriate risk pooling mechanism are warranted to protect households from such economic threats.
Smith, Alden; Handorf, Elizabeth; Arjmand, Ellis; Lango, Miriam N
To describe geographic variation in spending and evaluate regional Medicare expenditures for otolaryngologist services with population- and beneficiary-related factors, physician supply, and hospital system factors. Cross-sectional study. The average regional expenditures for otolaryngology physician services were defined as the total work relative value units (wRVUs) collected by otolaryngologists in a hospital referral region (HRR) per thousand Medicare beneficiaries in the HRR. A multivariable linear regression model tested associations with regional sociodemographics (age, sex, race, income, education), the physician and hospital bed supply, and the presence of an otolaryngology residency program. In 2012, the mean Medicare expenditure for otolaryngology provider services across HRRs was 224 wRVUs per thousand Medicare beneficiaries (standard deviation [SD] 104), ranging from 31 to 604 wRVUs per thousand Medicare beneficiaries. In 2013, the average Medicare expenditures for each HRR was highly correlated with expenditures collected in 2012 (Pearson correlation coefficient .997, P = .0001). Regional Medicare expenditures were independently and positively associated with otolaryngology, medical specialist, and hospital bed supply in the region, and were negatively associated with the supply of primary care physicians and presence of an otolaryngology residency program after adjusting for other factors. The magnitude of associations with physician supply and hospital factors was stronger than any population or Medicare beneficiary factor. Wide variations in regional Medicare expenditures for otolaryngology physician services, highly stable over 2 years, were strongly associated with regional health system factors. Changes in health policy for otolaryngology care may require coordination with other physician specialties and integrated hospital systems. NA. Laryngoscope, 127:1312-1317, 2017. © 2016 The American Laryngological, Rhinological and Otological Society
Leibel, R L; Rosenbaum, M; Hirsch, J
No current treatment for obesity reliably sustains weight loss, perhaps because compensatory metabolic processes resist the maintenance of the altered body weight. We examined the effects of experimental perturbations of body weight on energy expenditure to determine whether they lead to metabolic changes and whether obese subjects and those who have never been obese respond similarly. We repeatedly measured 24-hour total energy expenditure, resting and nonresting energy expenditure, and the thermic effect of feeding in 18 obese subjects and 23 subjects who had never been obese. The subjects were studied at their usual body weight and after losing 10 to 20 percent of their body weight by underfeeding or gaining 10 percent by overfeeding. Maintenance of a body weight at a level 10 percent or more below the initial weight was associated with a mean (+/- SD) reduction in total energy expenditure of 6 +/- 3 kcal per kilogram of fat-free mass per day in the subjects who had never been obese (P weight at a level 10 percent above the usual weight was associated with an increase in total energy expenditure of 9 +/- 7 kcal per kilogram of fat-free mass per day in the subjects who had never been obese (P weight gain. These changes in energy expenditure were not related to the degree of adiposity or the sex of the subjects. Maintenance of a reduced or elevated body weight is associated with compensatory changes in energy expenditure, which oppose the maintenance of a body weight that is different from the usual weight. These compensatory changes may account for the poor long-term efficacy of treatments for obesity.
Boing, Alexandra Crispim; Bertoldi, Andréa Dâmaso; Barros, Aluísio Jardim Dornellas de; Posenato, Leila Garcia; Peres, Karen Glazer
To analyze the evolution of catastrophic health expenditure and the inequalities in such expenses, according to the socioeconomic characteristics of Brazilian families. Data from the National Household Budget 2002-2003 (48,470 households) and 2008-2009 (55,970 households) were analyzed. Catastrophic health expenditure was defined as excess expenditure, considering different methods of calculation: 10.0% and 20.0% of total consumption and 40.0% of the family's capacity to pay. The National Economic Indicator and schooling were considered as socioeconomic characteristics. Inequality measures utilized were the relative difference between rates, the rates ratio, and concentration index. The catastrophic health expenditure varied between 0.7% and 21.0%, depending on the calculation method. The lowest prevalences were noted in relation to the capacity to pay, while the highest, in relation to total consumption. The prevalence of catastrophic health expenditure increased by 25.0% from 2002-2003 to 2008-2009 when the cutoff point of 20.0% relating to the total consumption was considered and by 100% when 40.0% or more of the capacity to pay was applied as the cut-off point. Socioeconomic inequalities in the catastrophic health expenditure in Brazil between 2002-2003 and 2008-2009 increased significantly, becoming 5.20 times higher among the poorest and 4.17 times higher among the least educated. There was an increase in catastrophic health expenditure among Brazilian families, principally among the poorest and those headed by the least-educated individuals, contributing to an increase in social inequality.
Taghadomi Masoumi, Zahra; Eshraghian, Mohammad Reza; Hedayati, Mahdi; Pishva, Hamideh
Obesity is recognized as the most prevalent metabolic disease worldwide. Decreases in energy expenditure may increase risk of obesity. One of the key regulators of energy balance is uncoupling protein2 (UCP2), a transporter protein presents in mitochondrial inner membrane. Moreover, adiponectin is the most abundant adipocytokine, it may play a role in energy metabolism and gene expression of UCP2. The aim of this study was to investigate potential associations between the level of uncoupling protein 2 and adiponectin and their relationship with REE (Resting Energy Expenditure) in obese women with normal and low resting energy expenditure. A total of 49 subjects (women, 25-50 years old), were included in current study, 16 subjects with BMI > 30 and low resting energy expenditure, 17 subjects with BMI > 30 and normal resting energy expenditure and 16 non-obese subjects as a control group. Anthropometric, body composition parameters and resting energy expenditure were measured. Plasma adiponectin, UCP2 protein and total protein in PBMC were determined. Measured resting energy expenditure in obese subjects with low REE was significantly lower than other groups. Plasma adiponectin in the obese subjects with low REE was significantly lower compared to normal weight group. There was a significant relationship between 'UCP2 protein/Total protein' ratio and plasma adiponectin in obese group with low REE and in three groups when we pooled. There was a significant association between REE and plasma adiponectin in three groups when we pooled. There was a significant association between plasma adiponectin and REE. Moreover, there was a significant relationship between UCP2 and REE.
Scott, Christopher B; Leary, Michael P; Tenbraak, Andrew J
We investigated the work performed and energy expenditure characteristics within and among 2 sets of the bench press at 70%, 80%, and 90% of 1 repetition maximum (1RM). For both sets fatigue was the end point. We asked: do multiple sets affect subsequent work output along with aerobic, anaerobic, and excess postexercise oxygen consumption (EPOC) contributions? Ten males participated. Work was significantly less for the 2nd set within the 70% and 80% protocols, but not the 90% protocol. Anaerobic (glycolytic) energy expenditure was less for the 2nd set within all protocols. However, within all protocols, the work / energy expenditure ratio was not different between sets. Overall work was significantly different among protocols, becoming less as the weight lifted was increased: 70%, 637.1 ± 122.4 J; 80%, 512.4 ± 93.4 J; 90%, 324.7 ± 92.6 J (p EPOC was not different among protocols after the 1st set, 2nd set, or combined overall. Moreover, the overall EPOC did not correlate with overall work performed (r = 0.31, p = 0.11). EPOC overall did correlate with aerobic (r = 0.68, p EPOC that is similar for all. As more work is completed (i.e., lower weight, more repetitions), aerobic and anaerobic exercise energy expenditures appear to increase accordingly, yet absolute EPOC remains essentially unchanged, contributing less to the overall energy expenditure.
Full Text Available This study analyzes the satisfaction of the Nevadans with respect to their highway transportation system and the corresponding expenditures of Nevada Department of Transportation (NDOT. A survey questionnaire was designed to capture the opinions of the Nevadans (customers about a number of characteristics of their transportation system. Data from the financial data warehouse of the NDOT was used to evaluate expenditures. Multinomial probit models were estimated to study the correlations between customers’ opinion and the government expenditures in transportation. The results indicate the customer satisfaction is decreasing with respect to traffic safety throughout Northwestern and Southern Nevada highways. In addition, users of Northwestern highways are more likely to be satisfied, compared to their counterparts, with increasing construction spending to reduce the time taken to complete construction projects. In Southern Nevada highways, customers’ satisfaction increases with the expenditures associated with reduction of congestion. These insights are examples of the conclusions that were obtained as a consequence of simultaneously considering customer satisfaction and the corresponding expenditures in transportation.
Chor Foon TANG
Full Text Available A major macroeconomic policy in generating economic growth is to encourage investments on human capital such as health and education. This is because both health and education make significant contribution to increasing productivity of the labour force which ultimately exerts a positive effect on raising output levels. A question that arises is whether investments on health and education have a causal relationship and if so, what is the directional causality? The objective of this study is to examine the causal relationship between health and education expenditures in Malaysia. This study covered annual data from 1970 to 2007. Using Granger causality as well as Toda and Yamamoto MWALD causality approaches, this study suggests that education Granger-causes health expenditure in both the short run and long run. The findings of this study implied that the Malaysian society places preference on education expenditure rather than health. This preference is not unexpected as generally, an educated and knowledgeable society precedes a healthy one. Before a society has attained a relatively higher level of education, it is less aware of the importance of health. Thus, expenditure on education should lead expenditure on health.
Sharma, Hari; Konetzka, R Tamara; Smieliauskas, Fabrice
Dramatic improvements in reported nursing home quality, including staffing ratios, have come under increased scrutiny in recent years because they are based on data self-reported by nursing homes. In contrast to other domains, the key mechanism for real improvement in the staffing ratios domain is clearer: to improve scores, nursing homes should increase staffing expenditures. We analyze the relationship between changes in expenditures and reported staffing quality pre- versus post the 5-star rating system. Our results show that the relationship between expenditures and licensed practical nurse staffing is weaker in the post-5-star period, overall, and across subgroups; furthermore, there is a weaker relationship between expenditures and registered nurse staffing among for-profit facilities with a high share of Medicaid residents in the post-5-star period. The weaker relationship between staffing expenditures and staffing scores in the post-5-star era underscores the potential for gaming of the self-reported staffing scores and the need for more reliable sources.
Benedict, Christian; Hallschmid, Manfred; Lassen, Arne; Mahnke, Christin; Schultes, Bernd; Schiöth, Helgi Birgir; Born, Jan; Lange, Tanja
Epidemiologic evidence indicates that chronic sleep curtailment increases risk of developing obesity, but the mechanisms behind this relation are largely unknown. We examined the influence of a single night of total sleep deprivation on morning energy expenditures and food intakes in healthy humans. According to a balanced crossover design, we examined 14 normal-weight male subjects on 2 occasions during a regular 24-h sleep-wake cycle (including 8 h of nocturnal sleep) and a 24-h period of continuous wakefulness. On the morning after regular sleep and total sleep deprivation, resting and postprandial energy expenditures were assessed by indirect calorimetry, and the free-choice food intake from an opulent buffet was tested in the late afternoon at the end of the experiment. Circulating concentrations of ghrelin, leptin, norepinephrine, cortisol, thyreotropin, glucose, and insulin were repeatedly measured over the entire 24-h session. In comparison with normal sleep, resting and postprandial energy expenditures assessed on the subsequent morning were significantly reduced after sleep deprivation by ≈5% and 20%, respectively (P ghrelin concentrations (P sleep conditions were detected. Our findings show that one night of sleep deprivation acutely reduces energy expenditure in healthy men, which suggests that sleep contributes to the acute regulation of daytime energy expenditure in humans.
A. N. Shmakov
Full Text Available Purpose. With the aid of indirect calorimetry, to evaluate whether the nosological factors affect energy exchange in severely ill newborns.Materials and methods. Indirect calorimetry was employed to determine the true energy expenditure in new borns under the mechanical ventilation because of intranatal postanoxia encephalopathy (n=19, severe sepsis (n=18, and urgent surgery (n=19. Energy expenditure at rest was estimated at the beginning of intensive therapy and in in 48 hours. Sedation in groups was similar.Results. At the first stage, the energy exchange in all newborns was characterized by hypometabolism. In cases of damage of the central nervous system the anaerobic metabolism was increased, and the principal used substrate was glucose; the most prolonged hypometabolism was revealed in newborns with sepsis, in which the utilization of lactate was decreased, and the main energetic substrate were lipids; in early postoperative period, the decrease in energy expenditure was not associated with preferential oxidation of glucose or lipids, and disappeared due to elimination of anesthetics.Conclusion. Energetic hypometabolism can be considered as a main reaction of the newborn organism to previous invasion. Acute posthypoxic brain damage in newborns is characterized by high activity of peroxidation associated with hypometabolism. For newborns with severe sepsis a slow recovery of aerobic metabolism and intensity of energy expenditure were evident. Early postoperative period in newborns was characterized by profound iatrogenic hypometabolism with fast normalization of energy expenditure.
Full Text Available Measurement of energy balance represents a basic theoretical concept in the determination of nutritional and fluid requirements in humans in health and disease. Infants have special nutrient requirements, more limited reserves and relative immaturity of organ function. Energy requirements of infants have been based either retrospectively on intakes required to achieve normal growth or on equations derived from energy expenditure studies performed early this century. Recently, improved techniques for studying resting energy expenditure (REE, total energy expenditure (TEE and metabolically active body compartments in infants have facilitated more accurate estimates of energy requirements. Such studies indicated that current reference values for energy requirements are overestimates, and that compared with measured values, predicted values vary markedly between the various predictive equations with wide co-efficients of variation. In disease states with altered body composition, such as cystic fibrosis and end-stage liver disease, predictive equations markedly underestimate both energy and fluid requirements. In cystic fibrosis, both TEE and REE are 25% higher than values in healthy infants. In extrahepatic biliary atresia, energy expenditure per unit body cell mass is markedly elevated, suggesting that this is a catabolic condition in infants. Current estimates of energy and fluid requirements in both health and disease in infants need reappraisal. Bedside and free living energy expenditure methodology should be used to define accurately components of energy requirement in individual infants.
Duddy Roesmara Donna
Full Text Available The aim of this study is to estimate and analize the characteristics of Indonesian household expenditure on goods and services, for example food, clothes, household utensils, housing, medical care, education, oil and transportation, gas, electricity and communication. Linear Expenditure System (LES model and seemingly uncorrelated regression (SUR estimation method were applied. This study has some conclusions. First, if ones have more incomes, they will proportionally allocate them for housing, oil and transportation, education, food, and medical care. Second, medical care, education and communication are categorized as superior or deluxe commodities. Third, the approximation of minimum living expenditure to survive is Rp 147.236 for a household per week.
Moreno-Macías, Lidia; Palma-Solís, Marco; Zapata-Vázquez, Rita E
The status of undernourishment in children under the age of five in Mexico is open to debate. Linked to poverty, underweight and stunting, the rates of undernourishment are reported to be diminishing, although poverty remains an incessant problem. This study was done to determine whether there is an association between public expenditure and underweight and stunting distribution in Mexico based on data from the 2006 health and population census and from macroeconomic, social, and demographic variables. We used principal component analysis to reduce the number of variables and analyze their behavior. Multiple regressions showed that underweight and stunting are significantly associated with the marginalization index, support from the Sistema Nacional para el Desarrollo Integral de la Familia (DIF) supplies and breakfast program, the gross domestic product per capita, and expenditure from the Opportunities program. Further, public expenditure aimed to combat undernourishment is inadequately oriented to address the needs of the poor.
Mohanty, Sanjay K; Srivastava, Akanksha
Though promotion of institutional delivery is used as a strategy to reduce maternal and neonatal mortality, about half of the deliveries in India are conducted at home without any medical care. Among women who deliver at home, one in four cites cost as barrier to facility-based care. The relative share of deliveries in private health centres has increased over time and the associated costs are often catastrophic for poor households. Though research has identified socio-economic, demographic and geographic barriers to the utilization of maternal care, little is known on the cost differentials in delivery care in India. The objective of this paper is to understand the regional pattern and socio-economic differentials in out-of-pocket (OOP) expenditure on institutional delivery by source of provider in India. The study utilizes unit data from the District Level Household and Facility Survey (DLHS-3), conducted in India during 2007-08. Descriptive statistics, principal component analyses and a two-part model are used in the analyses. During 2004-08, the mean OOP expenditure for a delivery in a public health centre in India was US$39 compared with US$139 in a private health centre. The predicted expenditure for a caesarean delivery was six times higher than for a normal delivery. With an increase in the economic status and educational attainment of mothers, the propensity and rate of OOP expenditure increases, linking higher OOP expenditure to quality of care. The OOP expenditure in public health centres, adjusting for inflation, has declined over time, possibly due to increased spending under the National Rural Health Mission. Based on these findings, we recommend that facilities in public health centres of poorly performing states are improved and that public-private partnership models are developed to reduce the economic burden for households of maternal care in India.
Gomes, B B; Mourão, L; Massart, A; Figueiredo, P; Vilas-Boas, J P; Santos, A M C; Fernandes, R J
We purposed to study energy expenditure, power output and gross efficiency during kayak ergometer exercise in 12 elite sprint kayakers. 6 males (age 24.2±4.8 years, height 180.4±4.8 cm, body mass 79.7±8.5 kg) and 6 females (age 24.3±4.5 years, height 164.5±3.9 cm, body mass 65.4±3.5 kg), performed an incremental intermittent protocol on kayak ergometer with VO2 and blood lactate concentration assessment, a non-linear increase between power output and energy expenditure being observed. Paddling power output, energy expenditure and gross efficiency corresponding to VO2max averaged 199.92±50.41 W, 75.27±6.30 ml.kg - 1.min - 1, and 10.10±1.08%. Male kayakers presented higher VO2max, power output and gross efficiency at the VO2max, and lower heart rate and maximal lactate concentration than females, but no differences were found between genders regarding energy expenditure at VO2max. Aerobic and anaerobic components of energy expenditure evidenced a significant contribution of anaerobic energy sources in sprint kayak performance. Results also suggested the dependence of the gross efficiency on the changes in the amount of the aerobic and anaerobic contributions, at heavy and severe intensities. The inter-individual variance of the relationship between energy expenditure and the corresponding paddling power output revealed a relevant tracking for females (FDγ=0.73±0.06), conversely to the male group (FDγ=0.27±0.08), supporting that some male kayakers are more skilled in some paddling intensities than others. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Budget deficits and the debate on the sources of deficit finance have been on the agenda of public economics ever since the 1980s. However recently in the post-communist countries fiscal imbalances appear to be an important problem due to prolonged periods of growing poverty resulting from the transition process. Poverty alleviation policies considerably affect the revenue and expenditure decisions of governments, which are subject to hard budget constraints in an open transitional economy and do not have room for departing from sound fiscal policies. The public finance literature provides a vast number of studies analyzing the relationship between public revenues and expenditures. These studies are mostly characterized by efforts to reveal the attitude of the fiscal authority towards maintaining the budget balance. In this respect, budgetary dynamics in which past government revenues have predictive power on the current level of government expenditures are accepted as evidence of the so-called tax-and-spend hypothesis. On the other hand, the revenue-expenditure nexus running from expenditures to revenues is known in the literature as the spend-and-tax hypothesis. The objective of this study is to analyze empirically the relationship between government revenues and expenditures in four of the transitional economies, i.e. Belarus, Kazakhstan, the Kyrgyz Republic and the Russian Federation. The empirical findings of this study, which are based on Granger causality tests, indicate evidence supporting the tax-and-spend hypothesis in Belarus and the Russian Federation and fiscal synchronization in Kazakhstan and the Kyrgyz Republic. The empirical support for the tax-and-spend hypothesis in these economies implies that increasing government revenues may not end up with lower budget deficits due to their stimulating effect on the demand for public goods and services.
This bulletin presents 1960-81 data on per capita food consumption, prices, nutrient availability, food expenditures and marketing costs, and U.S. income and population. Retail food prices rose 7.9 percent, aggregate food consumption fell 1.0 percent, and personal consumption expenditures for food rose 9.7 percent. Per capita meat consumption was down 2.5 pounds in 1981, hut poultry usage rose 1.8 pounds. Dairy consumption per person was lower. Fresh fruit consumption rose 1.6 pounds per pers...
This bulletin ,presents 1962-82 data on per capita food consumption, prices, nutrient availability,food expenditures and marketing costs, and U.S. income and population. Retail food prices in 1982 rose 4.0 percent, aggregate food consumption fell 0.4 percent, and personal food, consumption expenditures rose 6.3 percent from 1981. Per, capita red meat consumption was down 5.8 pounds, but poultry use rose 1.3 pounds. Dairy product consumption per person decreased. Fresh fruit consumption fell 3...
Wahyu Yun Santoso
Full Text Available Great potential of Indonesian biodiversity provides benefits and challenges as well in its protection and preservation. One critical issue arise along the rapid development of biotechnology is on genetic resources commersialization. Precautionary approach as mandated by Convention on Biological Diversity alternatively can be used as an opportunity for performing sustainable use of genetic resources. However, the lack of economic valuation of national natural resources is became an obstacle. Preventive expenditures is a common expenditures spent to avoid or prevent externalities. This normative research aims to find the significance of this method, on the basis of precautionary approach, to valuate the genetic resources within bioprospecting applications.
Foster, Richard S
In this article, the author reviews expenditure growth trends over Medicare's 35-year history and comments on how the program's long-range financial outlook has changed over time. The author focuses on the various legislative, economic, and demographic factors that have affected expenditure growth and financial status. In addition, Medicare's share of total U.S. health costs is briefly reviewed. In an appended comment, the author considers whether the impact of the Balanced Budget Act of 1997 (BBA) was greater than intended by Congress and the Administration. The author concludes with a plea for greater attention to correcting the projected long-range deficits for the Hospital Insurance (HI) Trust Fund.
Bonke, Jens; Browning, Martin
We report on a new data initiative that is designed to address the question of “who gets what” within the household. The data consists of supplements to the Danish Expenditure Survey (DES) which is a traditional nationally representative, diary based survey of expenditures. We collect supplementary...... concerning household management, autonomy and family background. These types of information for the same respondents may facilitate research bridging the divergent views of economist and sociologists concerning the allocation of resources within the household. The paper focuses on the survey design and gives...
Maksimović, Goran; Jović, Srđan; Jovanović, Radomir; Aničić, Obrad
In this study was managed the health care expenditure by soft computing methodology. The main goal was to predict the gross domestic product (GDP) according to several factors of health care expenditure. Soft computing methodologies were applied since GDP prediction is very complex task. The performances of the proposed predictors were confirmed with the simulation results. According to the results, support vector regression (SVR) has better prediction accuracy compared to other soft computing methodologies. The soft computing methods benefit from the soft computing capabilities of global optimization in order to avoid local minimum issues.
Riedstra, Bernd; Dijkstra, Cornelis; Daan, Serge
We used the doubly labeled water (DLW) method to measure daily energy expenditure (DEE) in eight brother-sister pairs of free-living Marsh Harrier (Circus aeruginosus) nestlings. We calculated metabolizable energy intake (ME) from DEE and body-mass change. In each pair, males had lower body mass,
The results imply that, future trends in per capita public health spending would mainly depend on the development of the economy such as real per capita gross domestic product. The result suggests the rapid growth in real per capita public health expenditure is likely to continue in future when the country economy ...
Jakobsen, Tor Georg
This article examines the link between regime types, social expenditure, and welfare attitudes. By employing data on 19 countries taken from the World Values Survey, the main aim is to see to what degree the institutions of a country affect the attitudes of its citizens. According to Esping-Andersen ("The three worlds of welfare…
Objective. To measure the daily energy expenditure in employees previously identified as having ≥2 risk factors for chronic disease, and to identify potential risk-reducing interventions for implementation within or outside the workplace. Design. A total of 122 employees with ≥2 risk factors for chronic disease identified in ...
C. Fillat; J.F. François (Joseph)
textabstractWe examine linkages between aggregate household income, distribution of that income, and aggregate cross-country expenditure patterns. We are able to decompose income effects into international income dispersion effects (from variations in average income) and national income dispersion
.... (a) Expenditures must be for activities described in the statement of work mutually agreed to by FEMA... projects contracted for by the State. (3) Travel costs and per diem costs of State employees not to exceed... supplies for workshops; exhibits. (5) A maximum of $8,000 or 10 percent of the total project allocation...
Discusses the factors that influence long-term aged care demand and provides projections of future expenditure. Long-term aged care in this context comprises mainly residential care (nursing homes and hostels) and community care services for the infirm aged.
Yuliana, Nancy Dewi; Korthout, Henrie; Wijaya, Christofora Hanny; Kim, Hye Kyong; Verpoorte, Robert
The development of obesity is related to the regulation of energy intake, energy expenditure, and energy storage in the body. Increasing energy expenditure by inducing lipolysis followed by fat oxidation is one of the alternatives which could help to reverse this increasingly widespread condition. Currently, there is no approved drug targeting on stimulation of energy expenditure available. The use of herbal medicines has become a preferred alternative, supported by the classical consensus on the innocuity of herbal medicine vs synthetic drugs, something that often lacks a scientific basis (ban on Ephedra, for example). The inclusion of functional food in the daily diet has also been promoted although its efficacy requires further investigation. This review summarizes the results of recent work focused on the investigation of edible plant materials targeted at various important pathways related to stimulation of energy expenditure. The aim is to evaluate a number of plants that may be of interest for further studies because of their potential to provide novel lead compounds or functional foods which may be used to combat obesity, but require further studies to evaluate their antiobesity activity in humans.
Rimmer, James H; Schiller, William; Chen, Ming-De
People with neuromuscular disabilities have high rates of sedentary behavior predisposing them to severe deconditioning and significant health risk. We describe this as disability-associated low energy expenditure deconditioning syndrome and propose new approaches for promoting light-to-moderate intensity physical activity in people with disabilities.
Aug 4, 1990 ... government, from data compiled by the Central Statistical. Services.s-9 An attempt was made to include all expenditure relating to the provision of health services in the public sector. Certain 'hidden costs' that were not taken into account in previous studies,\\0,1 1 such as central government's contributions.
This paper analyzes the implications of government spending on the growth of Nigeria economy over the period 1980 – 2009. Using Johansen Cointegration, unit root test and error correction model, it was discovered that total capital expenditure, inflation rate, degree of openness and current government revenue are ...
This study investigates the validity of Wagner's law and Keynesian hypothesis of the long-run relationship between government expenditure and economic growth in Tanzania using annual time series data from 1978 to 2014. The data series were tested for stationarity using Phillips-Perron unit root test and the results ...
This paper analyzes the impact of government expenditure and efficiency on economic growth of Sub Saharan African low income countries. The paper uses a panel data of 25 Sub-Saharan African low income countries spanning from 2002 – 2015 which are obtained from World Development Indicators (WDI) database.
Sep 4, 2013 ... Measurement of basal metabolic rate (BMR) provides an important baseline for the determination of an individual's total energy requirement. The study sought to establish human energy expenditure of rural farmers in Magubike village in Tanzania, through determination of BMR, physical activity level (PAL) ...
Efforts to promote physical activity in pregnant women in this environment are desirable. Afr J Reprod Health 2014; 18: 117-126). Keywords: Physical activity, Energy expenditure, Pregnancy, Maternal health promotion. Sfil n'y a pas de mises en garde medicales, l'activite physique est benefique pour toutes les personnes ...
van Klaveren, Chris; Ghysels, Joris
In this study we examine the collective labor supply choices of dual-earner parents and take into account child care expenditures. For this purpose we use data of the Flemish Families and Care Survey (FFCS, 2004-2005). The main findings are, firstly, that the supply of paid labor is hardly affected
van Klaveren, C.; Ghysels, J.
In this study we examine the collective labor supply choices of dual-earner parents and take into account child care expenditures. We find that the individual labor supplies are hardly affected by changes in the prices of child care services. In addition, the child care price effects on the
Christenson, James A.; Taylor, Gregory S.
Citizen perception of public service quality was examined to determine its relationship to demographic and socioeconomic characteristics of the community, variations in service expenditures, and quantitative service performance measures. The Bureau of the Census, state agencies, and a mail survey of residents in all 100 North Carolina counties…
Chen, Xian-Bao; Gao, Feng
Robots driven by batteries are clean, quiet, and can work indoors or in space. However, the battery endurance is a great problem. A new gait parameter design energy saving strategy to extend the working hours of the quadruped robot is proposed. A dynamic model of the robot is established to estimate and analyze the energy expenditures during trotting. Given a trotting speed, optimal stride frequency and stride length can minimize the energy expenditure. However, the relationship between the speed and the optimal gait parameters is nonlinear, which is difficult for practical application. Therefore, a simplified gait parameter design method for energy saving is proposed. A critical trotting speed of the quadruped robot is found and can be used to decide the gait parameters. When the robot is travelling lower than this speed, it is better to keep a constant stride length and change the cycle period. When the robot is travelling higher than this speed, it is better to keep a constant cycle period and change the stride length. Simulations and experiments on the quadruped robot show that by using the proposed gait parameter design approach, the energy expenditure can be reduced by about 54% compared with the 100 mm stride length under 500 mm/s speed. In general, an energy expenditure model based on the gait parameter of the quadruped robot is built and the trotting gait parameters design approach for energy saving is proposed.
Hay, Dean Charles; Wakayama, Akinobu; Sakamura, Ken; Fukashiro, Senshi
Estimation of energy expenditure in daily living conditions can be a tool for clinical assessment of health status, as well as a self-measure of lifestyle and general activity levels. Criterion measures are either prohibitively expensive or restricted to laboratory settings. Portable devices (heart rate monitors, pedometers) have gained recent popularity, but accuracy of the prediction equations remains questionable. This study applied an artificial neural network modeling approach to the problem of estimating energy expenditure with different dynamic inputs (accelerometry, heart rate above resting (HRar), and electromyography (EMG)). Nine feed-forward back-propagation models were trained, with the goal of minimizing the mean squared error (MSE) of the training datasets. Model 1 (accelerometry only) and model 2 (HRar only) performed poorly and had significantly greater MSE than all other models (p energy expenditure for models 3 to 9 ranged from 0.745 to 0.817. Analysis of mean error within specific movement categories indicates that EMG models may be better at predicting higher-intensity energy expenditure, but combined accelerometry and HRar provides an economical solution, with sufficient accuracy.
immunology, virology, mycology, medical ethics, forensic medicine, biomechanics and radiology. Of health research, 29% was classified as 'basic research', 58,8% as 'applied .... in Table III is in some cases too highly aggregated to be of much use. Expenditure on comprehensive medicine (which includes community ...
Gallagher, Daniel G.
For all three school district wealth groups examined, the results suggest that collective bargaining activity is exerting pressure on school administrators to expand the level of the total operating budgets by increasing district taxation. Collective bargaining is significantly related to higher expenditure within the teacher salary area.…
Full Text Available Governments of OECD countries are under pressure to improve public sector performance and at the same time to reduce the government expenditure. In the process of improvement of public sector performance it is necessary ensure the efficiency in the provision of education, at the same time, the countries are required to provide their educational services by minimizing the amount of public money directed to them. This prompted us to implement the comparative study to assess the efficiency of government expenditure on secondary education in European countries in 2015. First we analyze the government expenditure based on the data published by International Monetary Fund (IMF. Second, we analyze the quality of education through the PISA indicators published by OECD. Then we apply the Data Envelopment Analysis (DEA to assess the relative efficiency of government expenditure on secondary education using output-oriented model under the assumption of variable return to scale. Based on the results could it be said that average efficiency was 0.955 which suggests that the efficiency in evaluated countries was relatively high.
using their spending to accelerate economic growth. Key words: Government expenditure, efficiency, economic growth, Sub Saharan Africa. 5. Corresponding Author, Department of Economics, Faculty of Business and Finance, UTAR, Malaysia. Email: firstname.lastname@example.org. 6 Professor of Economics, Department of ...
... 42 Public Health 1 2010-10-01 2010-10-01 false Expenditure of cash contributions. 35.66 Section 35.66 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND..., guardians, or friends of patients to enable such persons to be available for the patient's comfort and...
Lindsey, Phoebe A.; Newhouse, Joseph P.
The following summary is of a conference to review national health expenditures accounting. Attendees focused on the annual article published by the Health Care Financing Administration (HCFA) in the Health Care Financing Review that reports how much the United States spends on medical care.
Powers, David M.
The purpose of this paper is to provide student affairs professionals with an overview of the law regarding the constitutionality of expenditure limits in student government elections. Unlike campaigns for federal and state office, it is clear that the limited case law on this topic does allow universities to limit the amount of money that student…
Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Gallagher, Jennifer Elizabeth; Zheng, Shuguo
This study explored catastrophic health expenditure in China, due to out-of-pocket payments for dental care, and its associated individual- and contextual-level factors. We pooled data from 31,566 adults who participated in the third National Oral Health Survey with province-level data from different sources. We defined catastrophic dental health expenditure (CDHE) as payments for dental services and/or medication for dental problems during the last year that exceeded the 10% and 20% of the household income. The association of individual and contextual factors with catastrophic dental health expenditure was evaluated using two-level logistic regression models with individuals nested within provinces. Socioeconomic position (education and household income), household size and dental status (pain in teeth or mouth and number of teeth) were the individual-level factors associated with CDHE among the full sample of participants; and, also, among those who used dental services in the past year. Greater gross domestic product per capita was the only contextual factor associated with CDHE, and only at the lower income threshold. This study shows that out-of-pocket expenses for dental services may put a considerable, and unnecessary, burden on households' finances. Our findings also help characterise those households more likely to face catastrophic expenditure on health if they have to pay for dental services.
Bouwmeester, Maaike; Scholtens, Lambertus
We investigate the implications of an integrated vis-a-vis a national perspective regarding investment in natural gas infrastructure. In particular, we analyze cross-border spillovers related to the investment expenditure of five Western European countries. We develop a practical approach to
Graves, Lee; Stratton, Gareth; Ridgers, N D; Cable, N T
To compare the energy expenditure of adolescents when playing sedentary and new generation active computer games. Cross sectional comparison of four computer games. Setting Research laboratories. Six boys and five girls aged 13-15 years. Participants were fitted with a monitoring device validated to predict energy expenditure. They played four computer games for 15 minutes each. One of the games was sedentary (XBOX 360) and the other three were active (Wii Sports). Predicted energy expenditure, compared using repeated measures analysis of variance. Mean (standard deviation) predicted energy expenditure when playing Wii Sports bowling (190.6 (22.2) kl/kg/min), tennis (202.5 (31.5) kl/kg/min), and boxing (198.1 (33.9) kl/kg/min) was significantly greater than when playing sedentary games (125.5 (13.7) kl/kg/min) (Pgames. Playing new generation active computer games uses significantly more energy than playing sedentary computer games but not as much energy as playing the sport itself. The energy used when playing active Wii Sports games was not of high enough intensity to contribute towards the recommended daily amount of exercise in children.
On the other hand, public and private health expenditure are found to follow different paths, with the ability of the citizens to finance their healthcare needs reducing the government's pressure to offer more health services. External aid programmes also seem to have impacted positively on Lesotho's public health spending ...
Lyons, Elizabeth J; Tate, Deborah F; Ward, Dianne S; Ribisl, Kurt M; Bowling, J Michael; Kalyanaraman, Sriram
Playing active video games can produce moderate levels of physical activity, but little is known about how these games motivate players to be active. Several psychological predictors, such as perceptions of competence, control, and engagement, may be associated with enjoyment of a game, which has in turn been hypothesized to predict energy expended during play. However, these relationships have yet to be tested in active video games. Young adults aged 18-35 (N = 97, 50 female) played a Dance Dance Revolution game for 13 minutes while energy expenditure was measured using indirect calorimetry. Self-reported measures of engagement, perceived competence, perceived control, and enjoyment were taken immediately afterward. Mediation was analyzed using path analysis. A path model in which enjoyment mediated the effects of engagement, perceived competence, and perceived control on energy expenditure and BMI directly affected energy expenditure was an adequate fit to the data, χ(2)(1, N = 97) = .199, p = .655; CFI = 1.00; RMSEA relationship between engagement and energy expenditure (indirect effect = .138, p = .028), but other mediated effects were not significant. Engagement, enjoyment, and BMI affect energy expended during active video game play. Games that are more enjoyable and engaging may produce greater intensity activity. Developers, practitioners, and researchers should consider characteristics that influence these predictors when creating or recommending active video games. PsycINFO Database Record (c) 2014 APA, all rights reserved.
In a convenience store chain, a tail of the cumulative density function of the expenditure of a person during a single shopping trip follows a power law with an exponent of -2.5. The exponent is independent of the location of the store, the shopper's age, the day of week, and the time of day.
Blinman, Thane; Cook, Robin
Predicting energy needs in children is complicated by the wide range of patient sizes, confusing traditional estimation equations, nonobjective stress-activity factors, and so on. These complications promote errors in bedside estimates of nutritional needs by rendering the estimation methods functionally unavailable to bedside clinicians. Here, the authors develop a simple heuristic energy prediction equation that requires only body mass (not height, age, or sex) as input. Expert estimation of energy expenditure suggested a power-law relationship between mass and energy. A similar mass-energy expenditure relationship was derived from published pediatric echocardiographic data using a Monte Carlo model of energy expenditure based on oxygen delivery and consumption. A simplified form of the equation was compared with energy required for normal growth in a cohort of historical patients weighing 2 to 70 kg. All 3 methods demonstrate that variation in energy expenditure in children is dominated by mass and can be estimated by the following equation: Power(kcal/kg/d) = 200 × [Mass(kg)((-0.4))]. This relationship explains 85% of the variability in energy required to maintain expected growth over a broad range of surgical clinical contexts. A simplified power-law equation predicts real-world energy needs for growth in patients over a wide range of body sizes and clinical contexts, providing a more useful bedside tool than traditional estimators.
Measurement of basal metabolic rate (BMR) provides an important baseline for the determination of an individual's total energy requirement. The study sought to establish human energy expenditure of rural farmers in Magubike village in Tanzania, through determination of BMR, physical activity level (PAL) and total energy ...
... Section 9004.7 Federal Elections FEDERAL ELECTION COMMISSION PRESIDENTIAL ELECTION CAMPAIGN FUND: GENERAL... provisions of 11 CFR 106.3, expenditures for travel relating to a Presidential or Vice Presidential candidate... setting, timing and statements or expressions of the purpose of an event, and the substance of the remarks...
... Section 9034.7 Federal Elections FEDERAL ELECTION COMMISSION PRESIDENTIAL ELECTION CAMPAIGN FUND: PRESIDENTIAL PRIMARY MATCHING FUND ENTITLEMENTS § 9034.7 Allocation of travel expenditures. Link to an... setting, timing and statements or expressions of the purpose of an event and the substance of the remarks...
... used when playing active Wii Sports games was not of high enough intensity to contribute towards the recommended daily amount of exercise in children, but contributes a percentage of time to the daily recommended activity levels. Keywords: Wii sports, Body Media Sensewear, energy expenditure, childhood obesity.
In January 1989 the Department of Energy contracted with Universities Research Association, Inc. to design, construct, manage, operate, and maintain the Superconducting Super Collider Laboratory. Through Fiscal Year 1992, costs for subcontractor goods and services accounted for about 75 percent of the Superconducting Super Collider Laboratory expenditures. The Office of Inspector General evaluated the adequacy of controls in place to ensure that subcontractor costs were reasonable, as required by the contract. The following conclusions were drawn from the audit. The Superconducting Super Collider Laboratory did not consistently exercise prudent business judgment in making subcontractor expenditures. As a result, $60 million in expenditures already made and $128 million planned with commercial subcontractors were, in the authors opinion, unnecessary, excessive, or represented uncontrolled growth. The audit also found inadequate justifications, accountability, and cost controls over $143 million in expenditures made and $47 million planned with other Department of Energy laboratories. Improvements were needed in subcontract administration and internal controls, including appropriate audit coverage of the subcontracts. In addition, Department of Energy guidance concerning procurement actions between the laboratories needed to be established.
Energy utilisation at work in the labour-intensive building industry is of prime importance to contractors who match people to jobs. This paper provides an insight into modelling energy expenditure in a specific task, namely brick laying in various postures. It therefore takes previous “generic” biomechanical-energy prediction ...
Tataranni, P A; Harper, I T; Snitker, S
Obesity results from a chronic imbalance between energy intake and energy expenditure. However, experimental evidence of the relative contribution of interindividual differences in energy intake and expenditure (resting or due to physical activity) to weight gain is limited....
Department of Veterans Affairs — The Geographic Distribution of VA Expenditures (GDX) is an annual report that shows estimated VA expenditures for major programmatic areas by geographic area (state,...
Department of Veterans Affairs — The Geographic Distribution of VA Expenditures (GDX) is an annual report that shows estimated VA expenditures for major programmatic areas by geographic area (state,...
Department of Veterans Affairs — The Geographic Distribution of VA Expenditures (GDX) is an annual report that shows estimated VA expenditures for major programmatic areas by geographic area (state,...
U.S. Department of Health & Human Services — 2005-2009. SAMMEC - Smoking-Attributable Mortality, Morbidity, and Economic Costs. Smoking-attributable expenditures (SAEs) are excess health care expenditures...
Rasu, Rafia S; Bawa, Walter Agbor; Suminski, Richard; Snella, Kathleen; Warady, Bradley
Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL) on healthcare utilization and healthcare expenditure. Database analysis used Medical Expenditure Panel Survey (MEPS) from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs) were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL). HLS ranged from 0-500. Health literacy level (HLL) and categorized in 2 groups: Below basic or basic (HLS Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER) visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI). A P value of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA® 11.0 statistical software. The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from 2005-2008. The cohort had an average age of 49 years and included more females (57%). Caucasian were the predominant racial ethnic group (83%) and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P healthcare utilization and expenditure. Individuals with below basic or basic HLL have greater healthcare
Full Text Available Background Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL on healthcare utilization and healthcare expenditure. Methods Database analysis used Medical Expenditure Panel Survey (MEPS from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL. HLS ranged from 0-500. Health literacy level (HLL and categorized in 2 groups: Below basic or basic (HLS <226 and above basic (HLS ≥226. Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI. A Pvalue of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA®11.0 statistical software. Results The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from 2005-2008. The cohort had an average age of 49 years and included more females (57%. Caucasian were the predominant racial ethnic group (83% and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P < .05. The extrapolated national
Wang, Fuhmei; Wang, Jung-Der; Huang, Yu-Xiu
Countries with limited resources in economic downturns often reduce government expenditures, of which spending on preventive healthcare with no apparent immediate health impact might be cut down first. This research aims to find the optimum share of preventive health expenditure to gross domestic product (GDP) and investigate the implications of preventive health services on economic performance and the population's wellbeing. We develop the economic growth model to undertake health-economic analyses and parameterize for Taiwan setting. Based on the US experiences over the period from 1975 to 2013, this research further examines the model's predictions on the relationship between preventive health expenditure and economic performance. Theoretical analysis and numerical simulations show that an inverse U-shaped relationship exists between the proportion of GDP spent on prevention and social welfare, as well as between the proportion spent on prevention and economic growth. Empirical analysis shows an under-investment in prevention in Taiwan. The spending of preventive healthcare in Taiwan government was 0.0027 GDP in 2014, while the optimization levels for economic development and social welfare would be 0 · 0119 and 0 · 0203, respectively. There is a statistically significant nonlinear relationship between health expenditure on prevention and the estimated real impact of economic performance from US experiences. The welfare-maximizing proportion of preventive expenditure is usually greater than the proportion maximizing economic growth, indicating a conflict between economic growth and welfare after a marginal share. Our findings indicate that it is worthwhile increasing investment on prevention up until an optimization level for economic development and social welfare. Such levels could also be estimated in other economies.
Troiano Richard P
Full Text Available Abstract Individuals who smoke generally have a lower body mass index (BMI than nonsmokers. The relative roles of energy expenditure and energy intake in maintaining the lower BMI, however, remain controversial. We tested the hypothesis that current smokers have higher total energy expenditure than never smokers in 308 adults aged 40-69 years old of which 47 were current smokers. Energy expenditure was measured by doubly labeled water during a two week period in which the subjects lived at home and performed their normal activities. Smoking status was determined by questionnaire. There were no significant differences in mean BMI (mean ± SD between smokers and never smokers for either males (27.8+5.1 kg/m2 vs. 27.5+4.0 kg/m2 or females (26.5+5.3 kg/m2 vs. 28.1+6.6 kg/m2, although the difference in females was of similar magnitude to previous reports. Similarly, total energy expenditure of male smokers (3069+764 kcal/d was not significantly different from that of never smokers (2854+468 kcal/d, and that of female smokers (2266+387 kcal/d was not different from that of never smokers (2330+415 kcal/d. These findings did not change after adjustment for age, fat-free mass and self-reported physical activity. Using doubly labeled water, we found no evidence of increased energy expenditure among smokers, however, it should be noted that BMI differences in this cohort also did not differ by smoking status.
Palma-Solis, Marco; Vives-Cases, Carmen; Alvarez-Dardet, Carlos
We sought to explore the effect of economic/political factors and gender progress on femicide. An ecological and retrospective study was undertaken that focused on 61 countries and analyzed the relationships of femicide with the following statistics from the period 1990 to 1999: economic indicators (domestic consumption, gross capital formation, imports and exports per capita, unemployment rate and percentage of urban population), political indicators (government final consumption expenditure, GINI coefficient--a summary measure of the extent to which the actual distribution of income or consumption expenditure or a related variable differs from a hypothetical distribution in which each person receives an identical share--civil liberties and political rights index), and gender progress indicators (female and male unemployment rates, percentage of girls in primary education, gender ratio for primary and secondary education, and percentage of parliamentary seats occupied by women). Bivariate and multivariate logistic regression analyses (likelihood ratio) were performed to explore the relationships between these variables. The bivariate analysis revealed strong links between reductions in government final consumption expenditure per capita (odds ratio [OR] 20.83;95% confidence interval [95% CI] 5.622-77.205), domestic consumption and gross capital formation (both with OR 16.67, 95% CI 4.715-58.911), and the civil liberties and political rights index (OR 7.91, 95% CI 2.526-24.747). In the multivariate stage, statistically significant associations were only observed between government expenditure per capita (OR 61.75;95% CI 7.064-539.81) and occupation of parliamentary seats by women (OR 10.95;95% CI 1.26-95.06). The reduction in government final consumption expenditure and democratic backwardness in terms of gender equality appear to be relevant factors in deaths caused by gender-based violence. To fight femicide effectively, gender-related structural, political, and
Nawi, N M; Yahya, A; Chen, G; Bockari-Gevao, S M; Maraseni, T N
A study was undertaken to evaluate the human energy consumption of various field operations involved in lowland rice cultivation in Malaysia. Based on recorded average heart rates, fertilizing was found to be the most strenuous operation, with an average heart rate of 138 beats min(-1). There were no significant differences in the average heart rates of the subjects among the individual tasks within the first plowing, second plowing, and harvesting operations, with the average heart rates for these three tasks being 116, 106, and 106 beats min(-1), respectively. The corresponding energy expenditures were 3.90, 3.43, and 3.35 kcal min(-1). Loading the seed into the blower tank and broadcasting the seed were the most critical tasks for the seed broadcasting operation, with average heart rates of 124 and 136 beats min(-1), respectively. The highest energy expenditure of 418.38 kcal ha(-1) was observed for seed broadcasting, and the lowest energy expenditure of 127.96 kcal ha(-1) was for second plowing. The total seasonal human energy expenditure for rice cultivation was estimated to be 5810.71 kcal ha(-1), 55.7% of which was spent on pesticide spraying. Although the sample size in this study was relatively small, the results indicated that human energy expenditure per unit area (kcal ha(-1)) was positively linked to the average heart rate of the subjects and negatively linked to the field capacity. Thus, mechanization of certain tasks could decrease worker physical effort and fatigue and increase production.
Floh, Alejandro A; Nakada, Masayuki; La Rotta, Gustavo; Mah, Kandice; Herridge, Joann E; Van Arsdell, Glen; Schwartz, Steven M
To examine the association between cardiopulmonary bypass-related systemic inflammation and resting energy expenditure in pediatric subjects following cardiac surgery. Single-center, prospective cohort study. Pediatric cardiac critical care unit in Toronto, Canada. Children with congenital heart disease undergoing cardiopulmonary bypass surgery. Resting energy expenditure was determined by indirect calorimetry and the modified Weir equation, using VO2 and VCO2 measured by in-line respiratory mass spectrometry. Measurements were taken at baseline and 6-hour intervals from separation from cardiopulmonary bypass for a maximum of 72 hours. Plasma interleukin-6, glucose delivery, feeding status, and cardiac output (calculated by Fick equation) were monitored at each resting energy expenditure measurement. We studied 111 subjects at a median (interquartile range) age of 5.3 months (0.8-10.5 mo), weighing 5.7 kg (3.9-8.1 kg), of whom 88% underwent biventricular repair. Resting energy expenditure decreased from 51 kcal/kg/d to 45 kcal/kg/d during the study period. Resting energy expenditure was positively associated with increased plasma interleukin-6 (estimate variable, 1.76; p = 0.001) and inversely associated with preoperative methylprednisolone use (estimate variable, -6.7; p = 0.003) even after accounting for other predictors. Increase in cardiac output was also associated (estimate variable, 13.7; p cardiopulmonary bypass surgery. It is directly associated with increased inflammation and higher cardiac output and inversely associated with anti-inflammatory strategies. Further studies are required to predict the appropriate caloric delivery in this cohort.
Ezebuilo Romanus Ukwueze
Full Text Available Analysis of public expenditure constitutes a central issue in public sector economics and public finance literature. Understanding the reasons for government spending growth has been a central concern of public sector economists. This is due to the fact that most economies of the world have consistently had increased government expenditures. Nigeria is not an exception. There is need to ascertain the determinants of size of government expenditure in Nigeria. Short-Run Error Correction Model and long-run static equation were used for comparing the influence of those variables on the size of government spending. The long-run static equation served as a test to compare short-run dynamics with the long-run relationships. Ordinary least squares (OLS estimation technique was used. The stationarity tests showed that none of the variables was stationary at level form, but only after their first difference. The results of this study show that the size of revenue and growth rate of national income (output and private investment significantly influence the size of public expenditure both in the short run and long run. External and domestic debts significantly influence the size of government expenditure only in the short run. It is recommended that the revenue base should be expanded; conducive environment should be created for private investment to thrive, and debt accumulation should be reduced and used for stabilization only in the short run. The conclusion to draw from this study is that revenue, private investment, and income boost public spending while public debts might be counterproductive.
Conclusions: OOP health expenditure of patients with UEBMI was significantly more than that of patients without medical insurance. However, for any other medical insurance, there was no difference between OOP health expenditure of the insured patients and patients without insurance. The current reimbursement policies have increased the equity of health expenditure, but are biased toward high-income people.
... 11 Federal Elections 1 2010-01-01 2010-01-01 false Campaign expenditure limitation; compliance and... ELECTION CAMPAIGN FUND: PRESIDENTIAL PRIMARY MATCHING FUND EXPENDITURE LIMITATIONS § 9035.1 Campaign... campaign for nomination, which expenditures, in the aggregate, exceed $10,000,000 (as adjusted under 2 U.S...
... expenditure groups. OPM subdivides each MEG into primary expenditure groups (PEGs). There are approximately 40 PEGs. (c) Detailed expenditure categories. OPM further subdivides each PEG into other categories down... level of tabulated CES categories. OPM classifies each DEC into one of the PEGs to aggregate DECs with...
... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Soil and water conservation expenditures; in... (continued) § 1.175-1 Soil and water conservation expenditures; in general. Under section 175, a farmer may deduct his soil or water conservation expenditures which do not give rise to a deduction for depreciation...
Yussof, Salwa Hana
Tax expenditures are government indirect spending, hidden in the tax system, often used to support government’s social and economic objectives. Instead of directly allocating money for a particular objective, the government forgoes tax revenues from those who undertake activities that could achieve the objective. Therefore, tax expenditures should be analysed as government spending programs. Tax expenditure reporting and analysis has been a regular practice among many countries in the worl...
Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher
With constant incentives for healthcare payers to contain their pharmaceutical budgets, modelling policy decision impact became critical. The objective of this project was to test the impact of various policy decisions on pharmaceutical budget (developed for the European Commission for the project 'European Union (EU) Pharmaceutical expenditure forecast' - http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). A model was built to assess policy scenarios' impact on the pharmaceutical budgets of seven member states of the EU, namely France, Germany, Greece, Hungary, Poland, Portugal, and the United Kingdom. The following scenarios were tested: expanding the UK policies to EU, changing time to market access, modifying generic price and penetration, shifting the distribution chain of biosimilars (retail/hospital). Applying the UK policy resulted in dramatic savings for Germany (10 times the base case forecast) and substantial additional savings for France and Portugal (2 and 4 times the base case forecast, respectively). Delaying time to market was found be to a very powerful tool to reduce pharmaceutical expenditure. Applying the EU transparency directive (6-month process for pricing and reimbursement) increased pharmaceutical expenditure for all countries (from 1.1 to 4 times the base case forecast), except in Germany (additional savings). Decreasing the price of generics and boosting the penetration rate, as well as shifting distribution of biosimilars through hospital chain were also key methods to reduce pharmaceutical expenditure. Change in the level of reimbursement rate to 100% in all countries led to an important increase in the pharmaceutical budget. Forecasting pharmaceutical expenditure is a critical exercise to inform policy decision makers. The most important leverages identified by the model on pharmaceutical budget were driven by generic and biosimilar prices, penetration rate, and distribution. Reducing, even slightly, the prices of
Full Text Available Abstract Background New pharmacological therapies are challenging the healthcare systems, and there is an increasing need to assess their therapeutic value in relation to existing alternatives as well as their potential budget impact. Consequently, new models to introduce drugs in healthcare are urgently needed. In the metropolitan health region of Stockholm, Sweden, a model has been developed including early warning (horizon scanning, forecasting of drug utilization and expenditure, critical drug evaluation as well as structured programs for the introduction and follow-up of new drugs. The aim of this paper is to present the forecasting model and the predicted growth in all therapeutic areas in 2010 and 2011. Methods Linear regression analysis was applied to aggregate sales data on hospital sales and dispensed drugs in ambulatory care, including both reimbursed expenditure and patient co-payment. The linear regression was applied on each pharmacological group based on four observations 2006-2009, and the crude predictions estimated for the coming two years 2010-2011. The crude predictions were then adjusted for factors likely to increase or decrease future utilization and expenditure, such as patent expiries, new drugs to be launched or new guidelines from national bodies or the regional Drug and Therapeutics Committee. The assessment included a close collaboration with clinical, clinical pharmacological and pharmaceutical experts from the regional Drug and Therapeutics Committee. Results The annual increase in total expenditure for prescription and hospital drugs was predicted to be 2.0% in 2010 and 4.0% in 2011. Expenditures will increase in most therapeutic areas, but most predominantly for antineoplastic and immune modulating agents as well as drugs for the nervous system, infectious diseases, and blood and blood-forming organs. Conclusions The utilisation and expenditure of drugs is difficult to forecast due to uncertainties about the rate
An important reason for public intervention in health in developing countries is to address the issue of accessibility. However, numerous studies have found inconclusive evidence of the effect of public expenditure on health outcomes. Here, I revisit the debate by examining the effect of public expenditure on the use of health services, which is an important link between expenditure and outcomes. I use data from two recent waves of the National Family Health Survey of India to study the role of public expenditure on the use of healthcare services during pregnancy and childbirth. India has high state-level variations in the use of prenatal care and delivery by skilled personnel as well as levels of public expenditure. I exploit the variation in public expenditure to identify its effect on the use of healthcare services, controlling for other confounding factors. The results show a significant effect of public expenditure at the state level on the use of both prenatal and delivery care at the individual level. Also, there is no evidence of public expenditure crowding out private expenditure. Further, there is strong evidence that public expenditure reaches the desired targets. The results highlight the positive implications of raising public expenditure for healthcare use of pregnancy and childbirth services in the Indian context.
Lawson, Stuart; Meghreblian, Ben
The academic libraries of higher education institutions (HEIs) pay significant amounts of money each year for access to academic journals. The amounts paid are often not transparent especially when it comes to knowing how much is paid to specific publishers. Therefore data on journal subscription expenditure were obtained for UK HEIs using a series of Freedom of Information requests. Data were obtained for 153 HEIs' expenditure with ten publishers over a five-year period. The majority of institutions have provided figures but some are still outstanding. The data will be of interest to those who wish to understand the economics of scholarly communication and see the scale of payments flowing within the system. Further research could replicate the data collection in other jurisdictions.
Türközü, Duygu; Tek, Nilüfer Acar
In recent years, individuals have begun to tend more frequently to some natural and herbal products to be used alone or as a combination with diet and exercise for ensuring the weight loss. Green tea is the leading one of these products. In some studies, it is reported that the green tea causes an increase in thermogenesis and substrate with fat oxidation by affecting on the sympathetic nervous system. It is reported that green tea has two main components that are associated with energy expenditure. One of them is caffeine and the other is catechin content. Each of these two components has an impact on energy mechanism separately. In this minireview article, mechanisms of action and effects of caffeine and catechin, which are found in green tea composition, on energy expenditure are assessed.
Full Text Available National (macroeconomic competitiveness is one of words in vogue that is mostly used by politicians, economists among others in today’s globalized world. However, the concept of competitiveness is also a very controversial issue. There are lots of concepts and approaches to a country’s overall competitiveness. In this paper, the author applies a comprehensive and established indicator used by The United Nations – The Human development index, to measure competitiveness at the national level. The main goal of this paper is to find whether higher expenditure on education, research and development leads to higher competitiveness. In evaluating the relationship, countries such as the United States, Japan and European Union countries (27 - the Triad countries were used. The panel data analysis was used to investigate the relationship and it was found that, expenditure on education and R & D positively leads to national competitiveness.
Pakozdi, Tamara; Leiva, Laura; Bunout, Daniel; Barrera, Gladys; de la Maza, María Pía; Henriquez, Sandra; Hirsch, Sandra
to asses Total Energy Expenditure (TEE) in healthy Chilean institutionalized or independently older people Methods: twenty seven young (27-30 years), 27 institutionalized (> 65 years old) and 27 free-living older (> 65 years old) participants were studied. Body composition was estimated by dual energy X-ray absorptiometry. Physical activity energy expenditure (AEE) and TEE were assessed using Actiheart accelerometers. The Mini Nutritional Assessment (MNA) was applied and Timed Up and Go (TUG) was measured. AEE was 171, 320 and 497 kcal/day in institutionalized, free living older and young participants, respectively (p young and older participants). Both absolute TEE and TEE/RMR was higher in young people. Multiple regression analysis accepted age, MNA and TUG as significant predictors of AEE (r2 = 0.24 p people, with no differences by institutionalization. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Full Text Available This study tests the relevance of the Wagner’s theory in explaining the health expenditure in Botswana. There is no consensus yet when it comes to the causality relationship between health expenditure and economy. At the moment, there are four dominant schools of thought explaining the causality relationship between health expenditure and economy. The first school of thought is that health expenditure spurs the economy whilst the second school of thought says that the economy drives health expenditure. The third school of thought maintains that there is a feedback effect between health expenditure and the economy whilst the fourth mentions that there is no causality at all between the two variables. However, this study found out that there is no causality relationship between health expenditure and GDP in Botswana thereby dismissing the relevance of the Wagner’s theory.
Midori Tsuneishi; Tatsuo Yamamoto; Takuo Ishii
Although national dental care expenditure has not changed, the number of dental clinics has increased. Mass media has been reporting on the financial difficulties of dental clinics. To address this issue, we reviewed articles that showed the distribution and changes in net income, that is, total expenses subtracted from total income, of private dental clinics in Japan using data from a survey conducted by the Japan Dental Association. We also reviewed articles analyzing the factors relating t...
Allen roy; B. KAMAIAH; M.Govinda Rao
Utilizing the pooled data for 15 large Indian states spanning over six years from 1992-93 to 1997-98, this study employs panel data modes to estimate the normative (average) levels of expenditure on primary, secondary and higher education for providing the average standards of educational services. The findings of the study revel that the actual spending on educational services in low-income states is found to be lower than their 'needs'. This finding implies that the existing fiscal equaliza...
Willi, Semmlero; Alfred, Greiner; Bobo, Diallo; Anand, Rajaram; Armon, Rezai
This paper responds to the development policy debate involving the World Bank and the IMF on the use of fiscal policy not only for economic stabilization but also to promote economic growth and increase per capita income. A key issue in this debate relates to the effect of the composition of public expenditure on economic growth. Policy makers and some researchers have argued that expendit...
Tappy, L; Binnert, C; Schneiter, Ph
Regular physical exercise and endurance training are associated with low body weight and low body fat mass. The relationship between exercise and body-weight control is complex and incompletely understood. Regular exercise may decrease energy balance through an increase in energy expenditure or an increase in fat oxidation. It may also contribute to weight loss by modulating nutrient intake. An intriguing question that remains unresolved is whether changes in nutrient intake or body compositi...
Vyas, Nisarg; Farringdon, Jonathan; Andre, David; Stivoric, John Ivo
In this article we provide insight into the BodyMedia FIT armband system — a wearable multi-sensor technology that continuously monitors physiological events related to energy expenditure for weight management using machine learning and data modeling methods. Since becoming commercially available in 2001, more than half a million users have used the system to track their physiological parameters and to achieve their individual health goals including weight-loss. We describe several challenges...
Wilkins, Tricia Lee; Rust, George S.; Sambamoorthi, Usha
To examine the association between changes in BMI categories and health-care expenditures among elderly Medicare beneficiaries using longitudinal data of the Medicare Current Beneficiary Survey (MCBS) 2000–2005. Changes in BMI were (i) Stayed Normal: individuals with a normal BMI at baseline and follow-up; (ii) Stayed Overweight individuals with overweight BMI at baseline and follow-up; (iii) Stayed Obese individuals with obese BMI at baseline and follow-up; (iv) Normal-Overweight: individual...
Full Text Available The huge regional disparity in government health expenditures (GHE is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.
Pan, Jay; Wang, Peng; Qin, Xuezheng; Zhang, Shufang
The huge regional disparity in government health expenditures (GHE) is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed. PMID:23977049
Gale, H. Frederick, Jr.
"High-income" households in China had per-capita disposable incomes of just $2,637 during 2003, but their ownership of consumer durable goods suggests a standard of living putting them in the "middle class." Their expenditures on food away from home were sharply higher than those of other urban households. Quantities of beverages, dairy products, and poultry products purchased for at-home consumption were also significantly higher, but purchases of most other food products were only marginall...
Scott Christopher B
Full Text Available Abstract Heat production serves as the standard measurement for the determination of energy expenditure and efficiency in animals. Estimations of metabolic heat production have traditionally focused on gas exchange (oxygen uptake and carbon dioxide production although direct heat measurements may include an anaerobic component particularly when carbohydrate is oxidized. Stoichiometric interpretations of the ratio of carbon dioxide production to oxygen uptake suggest that both anaerobic and aerobic heat production and, by inference, all energy expenditure – can be accounted for with a measurement of oxygen uptake as 21.1 kJ per liter of oxygen. This manuscript incorporates contemporary bioenergetic interpretations of anaerobic and aerobic ATP turnover to promote the independence of these disparate types of metabolic energy transfer: each has different reactants and products, uses dissimilar enzymes, involves different types of biochemical reactions, takes place in separate cellular compartments, exploits different types of gradients and ultimately each operates with distinct efficiency. The 21.1 kJ per liter of oxygen for carbohydrate oxidation includes a small anaerobic heat component as part of anaerobic energy transfer. Faster rates of ATP turnover that exceed mitochondrial respiration and that are supported by rapid glycolytic phosphorylation with lactate production result in heat production that is independent of oxygen uptake. Simultaneous direct and indirect calorimetry has revealed that this anaerobic heat does not disappear when lactate is later oxidized and so oxygen uptake does not adequately measure anaerobic efficiency or energy expenditure (as was suggested by the "oxygen debt" hypothesis. An estimate of anaerobic energy transfer supplements the measurement of oxygen uptake and may improve the interpretation of whole-body energy expenditure.
Yang, Yunwen; Adolph, Anne L; Puyau, Maurice R.; Vohra, Firoz A.; Butte, Nancy F.; Zakeri, Issa F.
Advanced mathematical models have the potential to capture the complex metabolic and physiological processes that result in energy expenditure (EE). Study objective is to apply quantile regression (QR) to predict EE and determine quantile-dependent variation in covariate effects in nonobese and obese children. First, QR models will be developed to predict minute-by-minute awake EE at different quantile levels based on heart rate (HR) and physical activity (PA) accelerometry counts, and child ...
Haddock, Bryan L.; Brandt, Andrea M.; Siegel, Shannon R.; Wilkin, Linda D.; Han, Joung-Kyue
The prevalence of overweight in children has increased significantly in recent years. Frequent television viewing and the playing of video games have often been linked to the high prevalence of overweight. The purpose of this study was to determine if overweight children, given access to active video games, will play them at an intensity that will significantly increase energy expenditure. Twenty-three children, classified as “at risk for overweight” or “overweight,” participated in this study. After a 10-minute baseline period in which the children watched a cartoon, the participants played the Jackie Chan Fitness Studio® (Xavix, Hong Kong) games for 30 minutes while rotating through the games as desired and resting whenever needed. Energy expenditure significantly increased from a mean at baseline of 1.15 ± 0.32 kcal/min to 4.08±1.18 kcal/min during the 30-minutes that the participants were given access to the games (p value of 75.00 kcal to a high of 205.86 kcal. Although a modest level of energy expenditure, this level of exertion could contribute to an overall weight control program in children. PMID:24683297
Alberto Inácio da Silva
Full Text Available The aim of this work was to estimate the energetic expenditure of the soccer referee and the assistant soccer referee during a soccer game. Fourteen soccer referees from Curitiba city were observed, 9 acting as referees (mean age of 36.3 years and body mass of 82 kg and 5 as assistant referees (mean age of 30 years and body mass of 77 kg. They were filmed during official state and national games. The time spent by the referees in each motor action was chronometered by watching the tapes. The energetic expenditure was estimated determining oxygen consumption through the equation suggested by the ACSM (1980 for running and sprinting and the equation suggested by Bubb, Martin and Howley apud Vivacqua e Hespanha (1992 for walking and jogging. The oxygen consumption is a function that depends on the intensity of the realized work and on the dislocated mass. The value of consumed O2 was transformed in kcal multiplying it by 5 (constant kcal per liter of O2. A mean energetic expenditure of 740.42 kcal and 494.64 kcal were observed as results for the referees and assistants, respectively. In conclusion, their physical activity is of moderate intensity, as the performance of the referee and the assistant represented an oxygen consumption equal or less than 16.17 ml/kg/min in 73.98% and 89.97% of the total game time, respectively.
You, Xiaohui; Okunade, Albert A
The roles of income and technology as the major determinants of aggregate healthcare expenditure (HEXP) continue to interest economists and health policy researchers. Concepts and measures of medical technologies remain complex; however, income (on the demand side) and technology (on the supply side) are important drivers of HEXP. This paper presents analysis of Australia's HEXP, using time-series econometrics modeling techniques applied to 1971-2011 annual aggregate data. Our work fills two important gaps in the literature. First, we model the determinants of Australia's HEXP using the latest and longest available data series. Second, this novel study investigates several alternative technology proxies (input and output measures), including economy-wide research and development expenditures, hospital research expenditures, mortality rate, and two technology indexes based on medical devices. We then apply the residual component method and the technology proxy approach to quantify the technology effects on HEXP. Our empirical results suggest that Australian aggregate healthcare is a normal good and a technical necessity with the income elasticity estimates ranging from 0.51 to 0.97, depending on the model. The estimated technology effects on HEXP falling in the 0.30-0.35 range and mimicking those in the literature using the US data, reinforce the global spread of healthcare technology. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Pandit, R; Beerens, S; Adan, R A H
The adipocyte-derived hormone leptin is a peripheral signal that informs the brain about the metabolic status of an organism. Although traditionally viewed as an appetite-suppressing hormone, studies in the past decade have highlighted the role of leptin in energy expenditure. Leptin has been shown to increase energy expenditure in particular through its effects on the cardiovascular system and brown adipose tissue (BAT) thermogenesis via the hypothalamus. The current review summarizes the role of leptin signaling in various hypothalamic nuclei and its effects on the sympathetic nervous system to influence blood pressure, heart rate, and BAT thermogenesis. Specifically, the role of leptin signaling on three different hypothalamic nuclei, the dorsomedial hypothalamus, the ventromedial hypothalamus, and the arcuate nucleus, is reviewed. It is known that all of these brain regions influence the sympathetic nervous system activity and thereby regulate BAT thermogenesis and the cardiovascular system. Thus the current work focuses on how leptin signaling in specific neuronal populations within these hypothalamic nuclei influences certain aspects of energy expenditure. Copyright © 2017 the American Physiological Society.
Miller, N E; Merritt, J L; Merkel, K D; Westbrook, P R
Long-leg braces are often used by persons with paraplegia to negotiate architectural barriers, and thereby increase their wheelchair mobility. Such barriers include ramps, stairways, and narrow corridors requiring multiple turns. This study was designed to measure the energy expenditure during such activities for two long-leg orthoses: standard braces without a dorsiflexion stop and Scott-Craig braces. Energy expenditure was measured in eight subjects by indirect spirometry using Douglas bag collection and Haldane analysis. Data obtained were used to calculate oxygen consumption per minute, volume of oxygen per turn, step, or meter, and calories per minute during each activity. Using Scott-Craig braces on one day and standard braces on another day, each subject negotiated five 90 degrees turns and two 180 degree turns, ten 15.24 cm steps, both up and down, and an 11.9 m ramp inclined 12 degrees, both up and down. Milliliters of oxygen consumed per kilogram of body weight per turn, step, or meter were recorded for Scott-Craig braces, standard braces, and normal walking. All of these activities required a high expenditure of energy. No significant difference was apparent between the standard and the Scott-Craig braces for any activity.
Araújo, Carmem Emmanuely Leitão; Gonçalves, Guilherme Quaresma; Machado, José Angelo
In a context that combines decentralization and underfunding of public health policy, Brazilian municipalities expressively extend their spending in this sector, allocating a proportion of their own revenues (direct taxation added to the mandatory intergovernmental transfers from the Union and the states) at levels above the ones that are constitutionally determined. However, there have been incipient studies investigating the expenditure composition on health in these federative units, in order to describe its main characteristics and explanations. In order to contribute to eliminating this gap, this article explores some associations between attributes of the municipalities (population size, region of the country, the proportion of older adults, child mortality, hiring private services and SUS transfer) and health expenditure implemented with the municipalities' own recipes. The study used descriptive statistics and multiple linear regressions in order to investigate such associations with data for 2010. The results point to tax inequities in the sector when comparing municipalities of different population groups and socioeconomic conditions, including the perception of important differences in terms of per capita spending on the analyzed expenditure items.
Milia, Raffaele; Roberto, Silvana; Pinna, Marco; Palazzolo, Girolamo; Sanna, Irene; Omeri, Massimo; Piredda, Simone; Migliaccio, Gianmario; Concu, Alberto; Crisafulli, Antonio
Fencing is an Olympic sport in which athletes fight one against one using bladed weapons. Contests consist of three 3-min bouts, with rest intervals of 1 min between them. No studies investigating oxygen uptake and energetic demand during fencing competitions exist, thus energetic expenditure and demand in this sport remain speculative. The aim of this study was to understand the physiological capacities underlying fencing performance. Aerobic energy expenditure and the recruitment of lactic anaerobic metabolism were determined in 15 athletes (2 females and 13 males) during a simulation of fencing by using a portable gas analyzer (MedGraphics VO2000), which was able to provide data on oxygen uptake, carbon dioxide production and heart rate. Blood lactate was assessed by means of a portable lactate analyzer. Average group energetic expenditure during the simulation was (mean ± SD) 10.24 ± 0.65 kcal·min(-1), corresponding to 8.6 ± 0.54 METs. Oxygen uptakeand heart rate were always below the level of anaerobic threshold previously assessed during the preliminary incremental test, while blood lactate reached its maximum value of 6.9 ± 2.1 mmol·L(-1) during the final recovery minute between rounds. Present data suggest that physical demand in fencing is moderate for skilled fencers and that both aerobic energy metabolism and anaerobic lactic energy sources are moderately recruited. This should be considered by coaches when preparing training programs for athletes.
Full Text Available Abstract Background Previous studies in adults have found that a lower resting metabolic rate is a predictor of future body weight gain. Methods To determine if energy expenditures are reduced in infants born to obese mothers, 21 healthy infants (3.9 ± 1.9 months born to lean (n = 7, BMI 2, overweight (n = 7, BMI between 25–30 and obese (n = 7, BMI>30 mothers, respectively, participated in this study. Measurements of infant weight, length and skin-fold thicknesses, and mother's weight and height were obtained. Infant energy expenditure was measured for 4-hours using the Enhanced Metabolic Testing Activity Chamber. Metabolic data were extrapolated to 24-hours and adjusted for differences in age and body composition using linear regression analysis (SPSS, version 13 and expressed as kcal/day. Differences between the three groups were determined by one way ANOVA with the Bonferroni Post Hoc test procedure (p Results Infants born to obese mothers had a greater BMI (16.7 ± 1.2 than those from both the overweight (15.3 ± 1.4, p Conclusion Lower extrapolated 24-h energy expenditure was present in infants of overweight and obese biological mothers during the first three to six months of life. Furthermore, these infants showed increased BMI and body fat. If these changes are unchecked future childhood obesity may result.
Boeckle, Markus; Chetouani, Yasmine; Schrimpf, Marlene; Liegl, Gregor; Leitner, Anton; Pieh, Christoph
Health costs, which are increasing at a yearly rate of 4 %, represent 11% and thus a large share of Austria's gross domestic product (GDP). High expenditures derive frommental health care costs, including medication. In this article we investigate whether the costs and usage of psychopharmaceutic products in Austria are rising. We did a descriptive analysis of the sales figures and number for packaging units of pharmaceutical products of ATC-classes N05 and N06 in all Austrian hospitals, pharmacies and medicine chests for the years 2006-2013. All data were provided free of charge by IMSHealth. The sales volume and number of prescribed packaging units of pharmaceuticals of ATC-classes N05 and N06 increased over the time period in question. In 2013, about 25% more packaging units were being sold than in 2006. Among the two ATC-classes, however, the indication subgroups developed differently. Expenditures increased a total of about 31%within the period of consideration. The increase in psycho-pharmaceutical sales exceeds the expansion rates of other health expenditures (17.8 %). During the 9 years of observation, 25% more psychopharmaceutical products were sold. This may result from increased prevalence of mental disorders, higher usage or an increment in prescriptions.
Barr, Sadie B; Wright, Jonathan C
Empirical evidence has shown that rising obesity rates closely parallel the increased consumption of processed foods (PF) consumption in USA. Differences in postprandial thermogenic responses to a whole-food (WF) meal vs. a PF meal may be a key factor in explaining obesity trends, but currently there is limited research exploring this potential link. The goal was to determine if a particular PF meal has a greater thermodynamic efficiency than a comparable WF meal, thereby conferring a greater net-energy intake. Subjective satiation scores and postprandial energy expenditure were measured for 5-6 h after isoenergetic meals were ingested. The meals were either 'whole' or 'processed' cheese sandwiches; multi-grain bread and cheddar cheese were deemed whole, while white bread and processed cheese product were considered processed. Meals were comparable in terms of protein (15-20%), carbohydrate (40-50%), and fat (33-39%) composition. Subjects were healthy women (n=12) and men (n=5) studied in a crossover design. There were no significant differences in satiety ratings after the two meals. Average energy expenditure for the WF meal (137+/-14.1 kcal, 19.9% of meal energy) was significantly larger than for the PF meal (73.1+/-10.2 kcal, 10.7% of meal energy). Ingestion of the particular PF meal tested in this study decreases postprandial energy expenditure by nearly 50% compared with the isoenergetic WF meal. This reduction in daily energy expenditure has potential implications for diets comprised heavily of PFs and their associations with obesity.
Sadie B. Barr
Full Text Available Background: Empirical evidence has shown that rising obesity rates closely parallel the increased consumption of processed foods (PF consumption in USA. Differences in postprandial thermogenic responses to a whole-food (WF meal vs. a PF meal may be a key factor in explaining obesity trends, but currently there is limited research exploring this potential link. Objective: The goal was to determine if a particular PF meal has a greater thermodynamic efficiency than a comparable WF meal, thereby conferring a greater net-energy intake. Design: Subjective satiation scores and postprandial energy expenditure were measured for 5–6 h after isoenergetic meals were ingested. The meals were either ‘whole’ or ‘processed’ cheese sandwiches; multi-grain bread and cheddar cheese were deemed whole, while white bread and processed cheese product were considered processed. Meals were comparable in terms of protein (15–20%, carbohydrate (40–50%, and fat (33–39% composition. Subjects were healthy women (n=12 and men (n=5 studied in a crossover design. Results: There were no significant differences in satiety ratings after the two meals. Average energy expenditure for the WF meal (137±14.1 kcal, 19.9% of meal energy was significantly larger than for the PF meal (73.1±10.2 kcal, 10.7% of meal energy. Conclusion: Ingestion of the particular PF meal tested in this study decreases postprandial energy expenditure by nearly 50% compared with the isoenergetic WF meal. This reduction in daily energy expenditure has potential implications for diets comprised heavily of PFs and their associations with obesity.
Williams, Edith M; Walker, Rebekah J; Faith, Trevor; Egede, Leonard E
Joint pain, including back pain, and arthritis are common conditions in the United States, affecting more than 100 million individuals and costing upwards of $200 billion each year. Although activity limitations associated with these disorders impose a substantial economic burden, this relationship has not been explored in a large U.S. cohort. In this study, we used the Medical Expenditures Panel Survey to investigate whether functional limitations explain the difference in medical expenditures between patients with arthritis and joint pain and those without. We used sequential explanatory linear models to investigate this relationship and accounted for various covariates. Unadjusted mean expenditures were $10,587 for those with joint pain or arthritis, compared with $3813 for those without. In a fully adjusted model accounting also for functional limitations, those with joint pain or arthritis paid $1638 more than those without, a statistically significant difference. The growing economic and public health burden of arthritis and joint pain, as well as the corresponding complications of functional, activity, and sensory limitations, calls for an interdisciplinary approach and heightened awareness among providers to identify strategies that meet the needs of high-risk patients in order to prevent and delay disease progression.
Fredrik Alexander Gregersen
Full Text Available The aim of this paper is to contribute to the debate on population aging and growth in health expenditures, by providing precise estimates on how mortality related expenditures are influenced by age. Using a complete register of inpatient hospital admissions to create gender-cohort specific panels for each of the 430 Norwegian municipalities, we are able to identify mortality related hospital expenditures by separating the impact of mortality on current hospital expenditures from the impact of patients’ age and gender. We apply model estimates to quantify the mortality-related hospital expenditures for twenty age groups. The results suggest that mortality-related hospital expenditures are a decreasing function of age. Furthermore, the results clearly suggest that, both age and mortalities should be included when predicting future health care expenditures. The estimation results suggest that 9.2 % of all hospital expenditures is associated with treating individuals in their last year of life. Our results also suggest that the reduction in mortality rates in the period from 1998 to 2009 have, cet. par. contributed to an estimated reduction in total hospital expenditures of 0.6 billion NOK, a difference corresponding to 2 % of the expenditures in 2009. (The appendix can be found under "Supplementary Files" in the menu to the right
Hoang, Van Minh; Oh, Juhwan; Tran, Tuan Anh; Tran, Thi Giang Huong; Ha, Anh Duc; Luu, Ngoc Hoat; Nguyen, Thi Kim Phuong
Health financing has been considered as an important building block of a health system and has a key role in promoting universal health coverage in the Vietnam. This paper aims to describe the pattern of health expenditure, including total health expenditure and composition of health expenditure, over the last two decades in Vietnam. The paper mainly uses the data from Vietnam National Health Account and Vietnam Living Standards Survey. We also included data from other relevant published literature, reports and statistics about health care expenditure in Vietnam. The per capita health expenditure in Vietnam increased from US$ 14 in 1995 to US$ 86 in 2012. The total health expenditure as a share of GDP also rose from 5.2% in 1995 to 6.9% in 2012. Public health expenditure as percentage of government expenditure rose from 7.4% in 1995 to nearly 10% in 2012. The coverage of health insurance went up from 10% in 1995 to 68.5% in 2012. However, health financing in Vietnam was depending on private expenditures (57.4% in 2012). As a result, the proportion of households with catastrophic expenditure in 2012 was 4.2%. The rate of impoverishment in 2012 was 2.5%. To ensure equity and efficient goal of health system, policy actions for containing the health care out-of-pocket payments and their poverty impacts are urgently needed in Vietnam.
Myers, S D; Leamon, S M; Nevola, V R; Llewellyn, M G L
The popularity of sports that expose people to consecutive days of high-intensity physical activity continues to increase. The ability to adequately nourish the human body to sustain the required level of competitive performance may be a key contributor to success in such events. The energy expenditure of a male competitor in a single-handed, transatlantic race (Transat 2004) was assessed using the doubly-labelled water technique. Mean total daily energy expenditure (TDEE) during the race (13 days) was 14.5 MJ/day with a peak expenditure of 18.6 MJ during the most physically demanding 24-hour period. This mean TDEE was approximately 25% lower than that reported in a previous study (14.5 vs. 19.3 MJ/day) for a 13-day leg of a fully crewed offshore race. The difference in results was probably due to the fact that in the previous study, the crew operated in "watches" (work shifts), affording each crew member greater opportunity to eat, rest and sleep. Effective planning and efficient management of resources is essential to the success of the solo sailor. However, the extent to which maintenance of energy balance underpins competitive success remains to be established. To maintain energy balance during the race, a mean daily energy intake of 14.5 MJ/day was necessary for the subject in this study. However, this mean value for energy intake would have been inadequate to match the peak energy expended during the most physically demanding 24 hours of the race.
Middleton, Laura E.; Manini, Todd M.; Simonsick, Eleanor M.; Harris, Tamara B.; Barnes, Deborah E.; Tylavsky, Frances; Brach, Jennifer S.; Everhart, James E.; Yaffe, Kristine
Introduction Studies suggest that physically active people have reduced risk of incident cognitive impairment in late life. However, these studies are limited by reliance on subjective self-reports of physical activity, which only moderately correlate to objective measures and often exclude activity not readily quantifiable by frequency and duration. The objective of this study was to investigate the relationship between activity energy expenditure (AEE), an objective measure of total activity, and incidence of cognitive impairment. Methods We calculated AEE as 90% of total energy expenditure (assessed over two weeks using doubly-labeled water) minus resting metabolic rate (measured using indirect calorimetry) in 197 men and women (mean 74.8 years) who were free of mobility and cognitive impairments at study baseline (1998–2000). Cognitive function was assessed at baseline and 2 or 5 years later using the Modified Mini-Mental State Examination (3MS). Cognitive impairment was defined as a decline of >1.0 SD (9 points) between baseline and follow-up. Results After adjustment for baseline 3MS, demographics, fat free mass, sleep duration, self-reported health, and diabetes, older adults in the highest sex-specific tertile of AEE had lower odds of incident cognitive impairment than those in the lowest tertile (OR, 95% CI 0.09, 0.01–0.79). There was also a significant dose response between AEE and incidence of cognitive impairment (p-for-trend over tertiles=0.05). Conclusions These findings indicate that greater activity energy expenditure may be protective against cognitive impairment in a dose-response manner. The significance of overall activity in contrast to vigorous or light activity should be determined. PMID:21771893
Ogilvie, G K; Walters, L M; Fettman, M J; Hand, M S; Salman, M D; Wheeler, S L
Cancer-caused cachexia has been reported to be caused in part by an increase in energy expenditure, and diets with nutrient profiles containing 30-50% nonprotein calories as fat instead of carbohydrate may exacerbate this state of inefficient energy utilization. Indirect calorimetry was performed on 22 dogs with high-grade lymphoblastic lymphoma that were randomized into a blind study and fed isocaloric amounts of a high-fat diet (Diet A) or a high-carbohydrate diet (Diet B) before and after remission was attained with up to five doses of doxorubicin chemotherapy (30 mg/m2 intravenously). Indirect calorimetry was also performed on 30 normal dogs for comparison. During the initial evaluation period, the resting energy expenditure (REE/kg0.75, P dogs with lymphoma compared with the controls. The RQ determined 6 weeks after the start of the study for the dogs fed Diet A was significantly (P dogs with lymphoma were compared with each other, there was no significant difference in any of the outcomes. The REE/kg0.75 and VO2/kg0.75 values were significantly lower (P Diet A after the third evaluation period compared with the second evaluation. The REE/kg0.75 and VO2/kg0.75 values were significantly lower (P Diet B at the fourth evaluation period compared with the fifth. These data suggest that energy expenditure of dogs with lymphoma decreases transiently in response to chemotherapy and remission, but these values are less than those determined in normal dogs and not altered significantly by diet.
Cabrera de León, Antonio; Rodríguez-Pérez, María del C; Rodríguez-Benjumeda, Luis M; Anía-Lafuente, Basilio; Brito-Díaz, Buenaventura; Muros de Fuentes, Mercedes; Almeida-González, Delia; Batista-Medina, Marta; Aguirre-Jaime, Armando
To compare different definitions of a sedentary lifestyle and to determine which is the most appropriate for demonstrating its relationship with the metabolic syndrome and other cardiovascular risk factors. A cross-sectional study of 5814 individuals was carried out. Comparisons were made between two definitions of a sedentary lifestyle: one based on active energy expenditure being less than 10% of total energy expenditure, and the other, on performing less than 25-30 minutes of physical activity per day. Reported levels of physical activity, anthropometric measurements, and biochemical markers of cardiovascular risk were recorded. The associations between a sedentary lifestyle and metabolic syndrome and other risk factors were adjusted for gender, age and tobacco use. The prevalence of a sedentary lifestyle was higher in women (70%) than in men (45-60%, according to the definition used). The definitions based on physical activity duration and on energy expenditure were equally useful: there were direct associations between a sedentary lifestyle and metabolic syndrome, body mass index, abdominal and pelvic circumferences, systolic blood pressure, heart rate, apolipoprotein B, and triglycerides, and inverse associations with high-density lipoprotein cholesterol and paraoxonase activity, which demonstrated the greatest percentage difference between sedentary and active individuals. An incidental finding was that both definitions of a sedentary lifestyle were more strongly associated with the metabolic syndrome as defined by International Diabetes Federation criteria than by Adult Treatment Panel III criteria. Given that it is relatively easy to determine whether a patient performs less than 25 minutes of physical activity per day, use of this definition of a sedentary lifestyle is recommended for clinical practice. The serum paraoxonase activity level could provide a useful marker for studying sedentary lifestyles.
Full Text Available Tax expenditure analyses have been an important element in the supervision of reform processes linked to implementing different kinds of tax incentive and the management of a correct tax policy. The paper provides an evaluation of tax expenditure in Slovenia relating to personal income tax and corporate income tax. Four consecutive tax years were selected for the calculation of the tax expenditure on personal income tax (2006-09, while three consecutive years were selected for the corporate income tax calculation (2008-10. The tax expenditure calculated for personal income tax was highest in 2006 and reached 5.2% of GDP. After several changes in personal income tax, expenditures decreased to around 3% of GDP in the following three years. The tax expenditure calculated for corporate income tax was much lower as compared to GDP than for personal income tax, reaching around 0.2% of GDP.
Full Text Available The relationship between household income and expenditure is important for understanding how the shape of the economic dynamics of the households. In this study, the relationship between household consumption expenditure and household disposable income were analyzed by Locally Weighted Scatterplot Smoothing Regression which is a nonparametric method using R programming. This study aimed to determine relationship between variables directly, unlike making any assumptions are commonly used as in the conventional parametric regression. According to the findings, effect on expenditure with increasing of income and household size together increased rapidly at first, and then speed of increase decreased. This increase can be explained by having greater compulsory consumption expenditure relatively in small households. Besides, expenditure is relatively higher in middle and high income levels according to low income level. However, the change in expenditure is limited in middle and is the most limited in high income levels when household size changes.
Pérez-Rico, Raymundo; Sesma-Vázquez, Sergio; Puentes-Rosas, Esteban
To describe the differences in catastrophic health expenditures in five Mexican states. This study included five states selected by convenience according to their social exclusion level. Household catastrophic health expenditures attributable to the three components of out of pocket health expenditures (ambulatory care, medication, and inpatient care) were calculated. The risk of impoverishment at the national level was greater in the most vulnerable households, namely, in the 20% poorest, rural, and uninsured households. Nevertheless, in states like Aguascalientes, Guerrero, Sinaloa, and Morelos the results were different. Over 70% of catastrophic health expenditures were attributable to medication and outpatient care expenditures in the poorest states. The differences found among states show that the implementation of local health policies to reduce catastrophic health expenditures should be based on evidence generated from analyses at the state level.
Braendle, Thomas; Colombier, Carsten
A better understanding of the determinants of public health care expenditures is key to designing effective health policies. We integrate demand and supply-side determinants and factors from political economy into an empirical analysis of the highly decentralized Swiss health care system and control for major health care finance reforms. We compile a novel data set of the cantonal health care expenditure in Switzerland, which currently amounts to about one fifth of total health care expenditure. We analyze the period 1970-2012 and use dynamic panel estimation methods. We find that per capita income, the unemployment rate and the share of foreigners are positively related to public health care expenditure growth. With regard to political economy aspects, public health care expenditures increase with the share of women elected to parliament. However, institutional restrictions for politicians, such as fiscal rules, do not appear to limit public health care expenditure growth. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
The bivariate probit model is frequently used for estimating the effect of an endogenous binary regressor (the 'treatment') on a binary health outcome variable. This paper discusses simple modifications that maintain the probit assumption for the marginal distributions while introducing non-normal dependence using copulas. In an application of the copula bivariate probit model to the effect of insurance status on the absence of ambulatory health care expenditure, a model based on the Frank copula outperforms the standard bivariate probit model. Copyright © 2011 John Wiley & Sons, Ltd.
Cvetkovic, Bozidara; Milic, Radoje; Lustrek, Mitja
This paper presents an approach to designing a method for the estimation of human energy expenditure (EE). The approach first evaluates different sensors and their combinations. After that, multiple regression models are trained utilizing data from different sensors. The EE estimation method designed in this way was evaluated on a dataset containing a wide range of activities. It was compared against three competing state-of-the-art approaches, including the BodyMedia Fit armband, the leading consumer EE estimation device. The results show that the proposed method outperforms the competition by up to 10.2 percentage points.
Full Text Available High – tech products are gradually adopted by consumers, who become to consider them indispensable. Their acquisition requires each time a pretty significant financial investment and a serious decision with a high perceived risk. In this paper we intend to analyse some financial issues related to high-tech products purchased by consumers from Brasov city in 2009, such as: the amount of money spent on high tech products, the financial sources used, the connections between expenditures and consumer’s characteristics.
Pontzer, Herman; Durazo-Arvizu, Ramon; Dugas, Lara R.; Plange-Rhule, Jacob; Bovet, Pascal; Forrester, Terrence E.; Lambert, Estelle V.; Cooper, Richard S.; Schoeller, Dale A.; Luke, Amy
Current obesity prevention strategies recommend increasing daily physical activity, assuming that increased activity will lead to corresponding increases in total energy expenditure and prevent or reverse energy imbalance and weight gain [1-3]. Such Additive total energy expenditure models are supported by exercise intervention and accelerometry studies reporting positive correlations between physical activity and total energy expenditure , but challenged by ecological studies in humans an...
Pontzer, Herman; Durazo-Arvizu, Ramon; Dugas, Lara R; Plange-Rhule, Jacob; Bovet, Pascal; Forrester, Terrence E; Lambert, Estelle V; Cooper, Richard S; Schoeller, Dale A; Luke, Amy
Current obesity prevention strategies recommend increasing daily physical activity, assuming that increased activity will lead to corresponding increases in total energy expenditure and prevent or reverse energy imbalance and weight gain [1-3]. Such Additive total energy expenditure models are supported by exercise intervention and accelerometry studies reporting positive correlations between physical activity and total energy expenditure  but are challenged by ecological studies in humans and other species showing that more active populations do not have higher total energy expenditure [5-8]. Here we tested a Constrained total energy expenditure model, in which total energy expenditure increases with physical activity at low activity levels but plateaus at higher activity levels as the body adapts to maintain total energy expenditure within a narrow range. We compared total energy expenditure, measured using doubly labeled water, against physical activity, measured using accelerometry, for a large (n = 332) sample of adults living in five populations . After adjusting for body size and composition, total energy expenditure was positively correlated with physical activity, but the relationship was markedly stronger over the lower range of physical activity. For subjects in the upper range of physical activity, total energy expenditure plateaued, supporting a Constrained total energy expenditure model. Body fat percentage and activity intensity appear to modulate the metabolic response to physical activity. Models of energy balance employed in public health [1-3] should be revised to better reflect the constrained nature of total energy expenditure and the complex effects of physical activity on metabolic physiology. Copyright © 2016 Elsevier Ltd. All rights reserved.
DeSalvo, Karen B; Jones, Tiffany M; Peabody, John; McDonald, Jay; Fihn, Stephan; Fan, Vincent; He, Jiang; Muntner, Paul
Prediction models that identify populations at risk for high health expenditures can guide the management and allocation of financial resources. To compare the ability for identifying individuals at risk for high health expenditures between the single-item assessment of general self-rated health (GSRH), "In general, would you say your health is Excellent, Very Good, Good, Fair, or Poor?," and 3 more complex measures. We used data from a prospective cohort, representative of the US civilian noninstitutionalized population, to compare the predictive ability of GSRH to: (1) the Short Form-12, (2) the Seattle Index of Comorbidity, and (3) the Diagnostic Cost-Related Groups/Hierarchal Condition Categories Relative-Risk Score. The outcomes were total, pharmacy, and office-based annualized expenditures in the top quintile, decile, and fifth percentile and any inpatient expenditures. Medical Expenditure Panel Survey panels 8 (2003-2004, n = 7948) and 9 (2004-2005, n = 7921). The GSRH model predicted the top quintile of expenditures, as well as the SF-12, Seattle Index of Comorbidity, though not as well as the Diagnostic Cost-Related Groups/Hierarchal Condition Categories Relative-Risk Score: total expenditures [area under the curve (AUC): 0.79, 0.80, 0.74, and 0.84, respectively], pharmacy expenditures (AUC: 0.83, 0.83, 0.76, and 0.87, respectively), and office-based expenditures (AUC: 0.73, 0.74, 0.68, and 0.78, respectively), as well as any hospital inpatient expenditures (AUC: 0.74, 0.76, 0.72, and 0.78, respectively). Results were similar for the decile and fifth percentile expenditure cut-points. A simple model of GSRH and age robustly stratifies populations and predicts future health expenditures generally as well as more complex models.
De Wit, Barbera; Meyer, Rosan; Desai, Ajay; Macrae, Duncan; Pathan, Nazima
To determine pre- and postoperative predictors of energy expenditure in children with congenital heart disease requiring open heart surgery; and to compare measured resting energy expenditure with current predictive equations. Prospective resting energy expenditure data were collected, using indirect calorimetry, for ventilated children admitted consecutively to the pediatric intensive care unit after surgery for congenital heart disease. A 30-min steady-state measurement was performed in suitable patients. Resting energy expenditure was compared to pre- and postoperative clinical variables, and to predicted energy expenditure, using currently used predictive equations. Pediatric intensive care unit at the Royal Brompton Hospital, London. Children ventilated in the pediatric intensive care unit post surgery for congenital heart disease. Measurement of energy expenditure by indirect calorimetry. Twenty-one mechanically ventilated children (n = 17 boys, 4 girls) were enrolled in the study. Mean +/- sd measured resting energy expenditure was 67.8 +/- 15.4 kcal/kg/day. Most children had inadequate delivery of nutrients compared with actual requirements. Cardiopulmonary bypass had a significant influence on energy expenditure after surgery; in patients who underwent cardiopulmonary bypass during surgery, mean resting energy expenditure was 73.6 +/- 14.45 kcal/kg/day vs. 58.3 +/- 10.29 kcal/kg/day in patients undergoing nonbypass surgery. Children who were malnourished preoperatively had greater resting energy expenditure postoperatively. There was also a significant difference between measured energy expenditure and the Schofield (p = .006), World Health Organization (p = .002), and pediatric intensive care unit-specific formula (p nutritional status preoperatively and cardiopulmonary bypass were associated with a greater energy expenditure post cardiac surgery. None of the current predictive equations predicted energy requirements within acceptable clinical accuracy.
The development of Israel's government social expenditures during the economic stabilization period of the mid-1980s is analyzed, with specific reference to the changing needs for such expenditure arising from demographic changes. The results reveal a real cut in direct services. The implicit strategy relied, for some two to three years, on restraint of total expenditures on direct services in real terms, with real erosion in services arising from growth in the size of beneficiary groups.
Frank Chirowa; Stephen Atwood; Marc Van Der Putten
Background: This article provided an analysis of gender inequality, health expenditure and its relationship to maternal mortality.Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA). A unique analysis was used to correlate the Gender Inequality Index (GII), Health Expenditure and Maternal Mortality Ratio (MMR). The GII captured inequalities across three dimensions – Reproducti...
Markwald, Rachel R.; Melanson, Edward L.; Mark R Smith; Higgins, Janine; Perreault, Leigh; Eckel, Robert H.; Wright, Kenneth P.
Insufficient sleep is associated with obesity, yet little is known about how repeated nights of insufficient sleep influence energy expenditure and balance. We studied 16 adults in a 14- to 15-d-long inpatient study and quantified effects of 5 d of insufficient sleep, equivalent to a work week, on energy expenditure and energy intake compared with adequate sleep. We found that insufficient sleep increased total daily energy expenditure by ∼5%; however, energy intake—especially at night after ...
Davis, Carlton George; Moussie, M.; Dinning, J.S.; Christakis, G.J.
This paper examines the impact of selected socioeconomic characteristics on aggregate and group food expenditure patterns of racially different low-income households. A double logarithmic functional form was used to explain responses in household food expenditures to socioeconomic factors. Household income, family size, and Food Stamp Program participation were found to exert a strong positive impact on food expenditures. The general educational level of the homemaker registered no significan...
Codogno, Jamile S. [UNESP; Turi,Bruna C.; Sarti,Flávia M.; Fernandes, Rômulo A; Monteiro, Henrique L.
The purpose of this study was to analyze the association between the clustering of physical inactivity with abdominal obesity and public health care expenditure in Brazilian adults. The sample was composed of 963 patients of both genders, randomly selected in the Brazilian Public Health care System during 2010. Entire health care expenditures during the last year were computed and stratified into: medical consultations, medication dispensing, laboratory tests and overall expenditure. Waist ci...
Andrew P Hills
Full Text Available The ability to assess energy expenditure and estimate physical activity in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity and diabetes. It is also important to appreciate that physical activity and energy expenditure are different constructs with physical activity defined as any bodily movement that results in energy expenditure and accordingly, energy is expended as a result of physical activity. However, total energy expenditure, best assessed using the criterion doubly labelled water technique, includes components in addition to physical activity energy expenditure, namely resting energy expenditure and the thermic effect of food. Given the large number of assessment techniques currently used to estimate physical activity in humans, it is imperative to understand the relative merits of each. The goal of this review is to provide information on the utility and limitations of a range of objective measures of physical activity and their relationship with energy expenditure. The measures discussed include those based on energy expenditure or oxygen uptake including doubly labelled water, activity energy expenditure, physical activity level, and metabolic equivalent; those based on heart rate monitoring and motion sensors; and because of their widespread use, selected subjective measures.
Full Text Available Introduction and problem: Non-Communicable Diseases (NCDs have become one of the leading causes of morbidity and mortality in Kenya. Their claim on financial and time resources adversely affects household welfare. Health care cost for NCDs in Kenya is predominantly paid by households as OOP. Health expenditure on NCD stands at 6.2% of Total Health Expenditure which is 0.4 % of the total gross domestic product of the country. This expenditure scenario could have implications on household welfare through catastrophic expenditure in Kenya. Most studies done on catastrophic expenditure in Kenya have not looked at the effect of NCD on poverty. Methodology: The paper has investigated the determinants of catastrophic health spending in a household with special focus on the NCDs. It has also investigated the effect of catastrophic expenditure on household welfare.A National household level survey data on expenditure and utilization is used. Controlling for endogeneity, the results revealed that NCDs and communicable diseases contribute significantly to the likelihood of a household incurring catastrophic expenditure. Results: Although all types of sicknesses have negative effects on household welfare, NCDs have more severe impacts on impoverishment. Policy wise, government and development partners should put in place a health financing plan entailing health insurance and resource pooling as a mean towards social protection. Key words: Non-Communicable Diseases (NCD, Catastrophic Health Expenditure, endogeneity Impoverishment
Full Text Available ODA and Military Expenditure by DAC Members (in Million USD, 2008APD et dépenses militaires des pays membres du CAD (en millions USD, 2008Sources: OECD, DAC; SIPRI Military Expenditure Database.Net ODA Receipts and Military Expenditure in Selected Countries (in Million USD, 2008Recettes nettes d’APD et dépenses militaires d’une sélection de pays (en millions USD, 2008Sources: OECD, Development Co-operation Report 2010, Statistical Annex, Table 25; SIPRI Military Expenditure Database.
Full Text Available This paper empirically examines the effect of corruption on the allocation of government expenditures by function. Equations using pooled panel dataset for 21 OECD countries between 1998 and 2011 were tested, and the findings show that government expenditure on defense and general public services increase, while government expenditures on education, health, recreation, culture and religion decline with higher levels of corruption. This paper presents new results and new evidence on the link between corruption and allocation of government expenditures in OECD countries.
Hughes, David M; Yates, Mark J; Morton, Emma E; Smillie, Luke D
An extensive literature shows that greater left, relative to right, frontal cortical activity (LFA) is involved in approach-motivated affective states and reflects stable individual differences in approach motivation. However, relatively few studies have linked LFA to behavioral indices of approach motivation. In this study, we examine the relation between LFA and effort expenditure for reward, a behavioral index of approach motivation. LFA was calculated for 51 right-handed participants (55% female) using power spectral analysis of electroencephalogram recorded at rest. Participants also completed the effort expenditure for rewards task (EEfRT), which presents a series of trials requiring a choice between a low-reward low-effort task and a high-reward high-effort task. We found that individuals with greater resting LFA were more willing to expend greater effort in the pursuit of larger rewards, particularly when reward delivery was less likely. Our findings offer a more nuanced understanding of the motivational significance of LFA, in terms of processes that mitigate the effort- and uncertainty-related costs of pursuing rewarding goals. © The Author (2014). Published by Oxford University Press. For Permissions, please email: email@example.com.
Elliott, Lewis R; White, Mathew P; Taylor, Adrian H; Herbert, Stephen
Physical inactivity poses a significant challenge to physical and mental health. Environmental approaches to tackle physical inactivity have identified natural environments as potentially important public health resources. Despite this, little is known about characteristics of the activity involved when individuals visit different types of natural environment. Using Natural England's Monitor of Engagement with the Natural Environment Survey, we examined 71,603 English respondents' recreational visits to natural environments in the past week. Specifically, we examined the intensity of the activities they undertook on the visits (METs), the duration of their visit, and the associated total energy expenditure (MET minutes). Visits to countryside and urban greenspace environments were associated with more intense activities than visits to coastal environments. However, visits to coastal environments were associated with the most energy expenditure overall due to their relatively long duration. Results differed by the urbanity or rurality of the respondent's residence and also how far respondents travelled to their destination. Knowledge of what types of natural environment afford the highest volumes and intensities of physical activity could inform landscape architecture and exercise prescriptions. Isolating activity-supporting characteristics of natural environments that can be translated into urban design is important in providing physical activity opportunities for those less able to access expansive environments. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Mermier, C M; Robergs, R A; McMinn, S M; Heyward, V H
OBJECTIVES: To report the physiological responses of indoor rock climbing. METHODS: Fourteen experienced climbers (nine men, five women) performed three climbing trials on an indoor climbing wall. Subjects performed three trials of increasing difficulty: (a) an easy 90 degrees vertical wall, (b) a moderately difficult negatively angled wall (106 degrees), and (c) a difficult horizontal overhang (151 degrees). At least 15 minutes separated each trial. Expired air was collected in a Douglas bag after four minutes of climbing and heart rate (HR) was recorded continuously using a telemetry unit. Arterialised blood samples were obtained from a hyperaemised ear lobe at rest and one or two minutes after each trial for measurement of blood lactate. RESULTS: Significant differences were found between trials for HR, lactate, oxygen consumption (VO2), and energy expenditure, but not for respiratory exchange ratio. Analysis of the HR and VO2 responses indicated that rock climbing does not elicit the traditional linear HR-VO2 relationship characteristic of treadmill and cycle ergometry exercise. During the three trials, HR increased to 74-85% of predicted maximal values and energy expenditure was similar to that reported for running at a moderate pace (8-11 minutes per mile). CONCLUSIONS: These data indicate that indoor rock climbing is a good activity to increase cardiorespiratory fitness and muscular endurance. In addition, the traditional HR-VO2 relationship should not be used in the analysis of this sport, or for prescribing exercise intensity for climbing. PMID:9298558
Mermier, C M; Robergs, R A; McMinn, S M; Heyward, V H
To report the physiological responses of indoor rock climbing. Fourteen experienced climbers (nine men, five women) performed three climbing trials on an indoor climbing wall. Subjects performed three trials of increasing difficulty: (a) an easy 90 degrees vertical wall, (b) a moderately difficult negatively angled wall (106 degrees), and (c) a difficult horizontal overhang (151 degrees). At least 15 minutes separated each trial. Expired air was collected in a Douglas bag after four minutes of climbing and heart rate (HR) was recorded continuously using a telemetry unit. Arterialised blood samples were obtained from a hyperaemised ear lobe at rest and one or two minutes after each trial for measurement of blood lactate. Significant differences were found between trials for HR, lactate, oxygen consumption (VO2), and energy expenditure, but not for respiratory exchange ratio. Analysis of the HR and VO2 responses indicated that rock climbing does not elicit the traditional linear HR-VO2 relationship characteristic of treadmill and cycle ergometry exercise. During the three trials, HR increased to 74-85% of predicted maximal values and energy expenditure was similar to that reported for running at a moderate pace (8-11 minutes per mile). These data indicate that indoor rock climbing is a good activity to increase cardiorespiratory fitness and muscular endurance. In addition, the traditional HR-VO2 relationship should not be used in the analysis of this sport, or for prescribing exercise intensity for climbing.
Full Text Available The purpose of this paper is to highlight the link between economic growth, environmental quality and health of the population and their implications on health expenditure growth.Health is influenced by multiple factors knows as the determinants of health, whose action can not always be kept under control. One of the determinants of health is the quality of the environment, which, together with the quality of the people (genetic heritage, lifestyle, standards of living, health system characteristics, has a bearing both on health and on health expenditure.Most of the determinants of population health have a mutual connection with the degree of economic development of a country and its level of education. In this respect, the high level of the health-related human capital has a positive effect on labor productivity and economic growth rate.Economic growth induces both an increase in standards of living, with positive effects on health, and a deterioration of the environmental conditions, which triggers changes in the degree of incidence of the disease, consequently favoring an increased financial burden on the health system.
Full Text Available The main aim of this paper is to provide a systematic overview of value added taxation in Croatia along with main changes in relevant legislation and to estimate total amount of tax expenditures. Results show that the proportion of tax expenditures in GDP in Croatia in 2010 amounted to less than 4%, a proportion lower than in any of the EU new member states, as well as almost twice as low as the EU-27 average. It can be concluded that the Croatian value added taxation system is efficient in this way, as was additionally shown by an analysis according to which Croatia in 2010 had better efficiency indicators than all the observed EU member states. The Croatian VAT system is mainly harmonized with EU directives, but abolition of the zero rate is still expected; this will increase government revenue by approximately 0.4-0.8% of GDP, depending on a chosen scenario. It has been suggested that a detailed analysis of the overall value added taxation system should be initiated, with the aim of optimizing cost-benefits. The main focus should be placed on the determination of the optimal VAT registration threshold, the costs and benefits of the introduced reliefs and exemptions in the tax system and the potential effects of the repeal of the zero rate.
Pontzer, Herman; Raichlen, David A; Wood, Brian M; Emery Thompson, Melissa; Racette, Susan B; Mabulla, Audax Z P; Marlowe, Frank W
Studies of total energy expenditure, (TEE; kcal/day) among traditional populations have challenged current models relating habitual physical activity to daily energy requirements. Here, we examine the relationship between physical activity and TEE among traditional Hadza hunter-gatherers living in northern Tanzania. Hadza adults were studied at two camps, with minimal intervention so as to monitor energy expenditure and activity during normal daily life. We measured daily walking distance and walking speed using wearable GPS units for 41 adults. For a subset of 30 adults, we measured TEE using doubly labeled water, three indices of work load (foraging return rate, maternal status, and number of dependent children), and urinary biomarkers of metabolic activity and stress (8-hydroxydeoxyguanosine, cortisol, and testosterone). Fat-free mass was the single strongest predictor of TEE among Hadza adults (r(2) = 0.66, P hunter-gatherer populations like the Hadza. Instead, adults with high levels of habitual physical activity may adapt by reducing energy allocation to other physiological activity. © 2015 Wiley Periodicals, Inc.
Rising, Russell; Lifshitz, Fima
Previous studies in adults have found that a lower resting metabolic rate is a predictor of future body weight gain. To determine if energy expenditures are reduced in infants born to obese mothers, 21 healthy infants (3.9 +/- 1.9 months) born to lean (n = 7, BMI obese (n = 7, BMI>30) mothers, respectively, participated in this study. Measurements of infant weight, length and skin-fold thicknesses, and mother's weight and height were obtained. Infant energy expenditure was measured for 4-hours using the Enhanced Metabolic Testing Activity Chamber. Metabolic data were extrapolated to 24-hours and adjusted for differences in age and body composition using linear regression analysis (SPSS, version 13) and expressed as kcal/day. Differences between the three groups were determined by one way ANOVA with the Bonferroni Post Hoc test procedure (p obese mothers had a greater BMI (16.7 +/- 1.2) than those from both the overweight (15.3 +/- 1.4, p obese mothers had greater body fat (26.8 +/- 2.1) than those from the overweight group (22.4 +/- 5.0, p obese (472.1 +/- 30.7 kcal/d; p obese biological mothers during the first three to six months of life. Furthermore, these infants showed increased BMI and body fat. If these changes are unchecked future childhood obesity may result.
Humphries, Debbie L; Behrman, Jere R; Crookston, Benjamin T; Dearden, Kirk A; Schott, Whitney; Penny, Mary E
Relative to plant-based foods, animal source foods (ASFs) are richer in accessible protein, iron, zinc, calcium, vitamin B-12 and other nutrients. Because of their nutritional value, particularly for childhood growth and nutrition, it is important to identify factors influencing ASF consumption, especially for poorer households that generally consume less ASFs. To estimate differential responsiveness of ASF consumption to changes in total household expenditures for households with different expenditures in a middle-income country with substantial recent income increases. The Peruvian Young Lives household panel (n = 1750) from 2002, 2006 and 2009 was used to characterize patterns of ASF expenditures. Multivariate models with controls for unobserved household fixed effects and common secular trends were used to examine nonlinear relationships between changes in household expenditures and in ASF expenditures. Households with lower total expenditures dedicated greater percentages of expenditures to food (58.4% vs.17.9% in 2002 and 24.2% vs. 21.5% in 2009 for lowest and highest quintiles respectively) and lower percentages of food expenditures to ASF (22.8% vs. 33.9% in 2002 and 30.3% vs. 37.6% in 2009 for lowest and highest quintiles respectively). Average percentages of overall expenditures spent on food dropped from 47% to 23.2% between 2002 and 2009. Households in the lowest quintiles of expenditures showed greater increases in ASF expenditures relative to total consumption than households in the highest quintiles. Among ASF components, meat and poultry expenditures increased more than proportionately for households in the lowest quintiles, and eggs and fish expenditures increased less than proportionately for all households. Increases in household expenditures were associated with substantial increases in consumption of ASFs for households, particularly households with lower total expenditures. Increases in ASF expenditures for all but the top quintile of
Debbie L Humphries
Full Text Available Relative to plant-based foods, animal source foods (ASFs are richer in accessible protein, iron, zinc, calcium, vitamin B-12 and other nutrients. Because of their nutritional value, particularly for childhood growth and nutrition, it is important to identify factors influencing ASF consumption, especially for poorer households that generally consume less ASFs.To estimate differential responsiveness of ASF consumption to changes in total household expenditures for households with different expenditures in a middle-income country with substantial recent income increases.The Peruvian Young Lives household panel (n = 1750 from 2002, 2006 and 2009 was used to characterize patterns of ASF expenditures. Multivariate models with controls for unobserved household fixed effects and common secular trends were used to examine nonlinear relationships between changes in household expenditures and in ASF expenditures.Households with lower total expenditures dedicated greater percentages of expenditures to food (58.4% vs.17.9% in 2002 and 24.2% vs. 21.5% in 2009 for lowest and highest quintiles respectively and lower percentages of food expenditures to ASF (22.8% vs. 33.9% in 2002 and 30.3% vs. 37.6% in 2009 for lowest and highest quintiles respectively. Average percentages of overall expenditures spent on food dropped from 47% to 23.2% between 2002 and 2009. Households in the lowest quintiles of expenditures showed greater increases in ASF expenditures relative to total consumption than households in the highest quintiles. Among ASF components, meat and poultry expenditures increased more than proportionately for households in the lowest quintiles, and eggs and fish expenditures increased less than proportionately for all households.Increases in household expenditures were associated with substantial increases in consumption of ASFs for households, particularly households with lower total expenditures. Increases in ASF expenditures for all but the top quintile
Full Text Available Abstract Background The computerisation of primary health care (PHC records offers the opportunity to focus on pharmacy expenditure from the perspective of the morbidity of individuals. The objective of the present study was to analyse the behaviour of pharmacy expenditure within different morbidity groups. We paid special attention to the identification of individuals who had higher values of pharmacy expenditure than their morbidity would otherwise suggest (i.e. outliers. Methods Observational study consisting of 75,574 patients seen at PHC centres in Zaragoza, Spain, at least once in 2005. Demographic and disease variables were analysed (ACG® 8.1, together with a response variable that we termed 'total pharmacy expenditure per patient'. Outlier patients were identified based on boxplot methods, adjusted boxplot for asymmetric distributions, and by analysing standardised residuals of tobit regression models. Results The pharmacy expenditure of up to 7% of attendees in the studied PHC centres during one year exceeded expectations given their morbidity burden. This group of patients was responsible for up to 24% of the total annual pharmacy expenditure. There was a significantly higher number of outlier patients within the low-morbidity band which matched up with the higher variation coefficient observed in this group (3.2 vs. 2.0 and 1.3 in the moderate- and high-morbidity bands, respectively. Conclusions With appropriate validation, the methodologies of the present study could be incorporated in the routine monitoring of the prescribing profile of general practitioners. This could not only enable evaluation of their performance, but also target groups of outlier patients and foster analyses of the causes of unusually high pharmacy expenditures among them. This interpretation of pharmacy expenditure gives new clues for the efficiency in utilisation of healthcare resources, and could be complementary to management interventions focused on
Viviane O Leal
Full Text Available Resting energy expenditure (REE is the predominant component of total daily energy expenditure (TEE. Metabolic disorders and comorbities, such as inflammation and diabetes, can affect the REE in hemodialysis (HD patients. The objective of this study was to evaluate the relationship between inflammation and REE estimated by TEE in HD patients. Twenty-five HD patients (54.5±11.7 years, 15 men, BMI, 24.4±4.7 kg/m2, urea clearance (Kt/Vsp of 1.43±0.26 and 58.2±42.7 months on HD were studied. TEE was measured during two days (one dialysis and one fx1 nondialysis day by SWA (SenseWear Pro2 Armband, BodyMedia Inc, Pittsburgh, PA, USA. This monitor provides directly the TEE and the physical active energy expenditure (PAEE; the REE measurement was obtained by the subtraction of PAEE and thermic effect of food (approximately 10% of TEE from TEE. C-reactive protein (CRP was measured by immunoturbidimetric method. The REE was 1677.7±273.5 kcal/d for men and 1267.0±221.6 kcal/d for women (p〈0.0001. The CRP levels values were 0.27 ± 0.26 mg/dL and nine patients (36% had CRP 〉0.3 mg/dL, compatible with chronic inflammation. A trend for high REE was observed in patients with inflammation (1865±216 kcal/d for men with CRP≥0.3 mg/dL and 1584±257kcal/d with CRP〈0.3 mg/dL (p= 0.05; 1361.4±181.5 kcal/d for women with CRP≥0.3 mg/dL and 1204.1±238.2kcal/d with CRP〈0.3 mg/dL (p = 0.27. CRP was positively correlated with REE (r=0.41; p=0.04. In conclusion, chronic mild inflammation can increase the REE in HD patients.
Noble, Emily E.; Billington, Charles J.; Kotz, Catherine M.
Central oxytocin reduces food intake and increases energy expenditure. The ventromedial hypothalamic nucleus (VMN) is associated with energy balance and contains a high density of oxytocin receptors. We hypothesized that oxytocin in the VMN is a negative regulator of energy balance acting to reduce feeding and increase energy expenditure. To test this idea, oxytocin or vehicle was injected directly into the VMN of Sprague-Dawley rats during fasted and nonfasted conditions. Energy expenditure (via indirect calorimetry) and spontaneous physical activity (SPA) were recorded simultaneously. Animals were also exposed to a conditioned taste aversion test, to determine whether oxytocin's effects on food intake were associated with malaise. When food was available during testing, oxytocin-induced elevations in energy expenditure lasted for 1 h, after which overall energy expenditure was reduced. In the absence of food during the testing period, oxytocin similarly increased energy expenditure during the first hour, but differences in 12-h energy expenditure were eliminated, implying that the differences may have been due to the thermic effects of feeding (digestion, absorption, and metabolic processing). Oxytocin acutely elevated SPA and reduced feeding at doses that did not cause a conditioned taste aversion during both the fed and fasted states. Together, these data suggest that oxytocin in the VMN promotes satiety and acutely elevates energy expenditure and SPA and implicates the VMN as a relevant site for the antiobesity effects of oxytocin. PMID:24990860
Sell, Katie; Lillie, Tia; Taylor, Julie
Objective: Researchers have yet to explore the effect of physically interactive video game playing on energy expenditure, despite its potential for meeting current minimal daily activity and energy expenditure recommendations. Participants and Methods: Nineteen male college students-12 experienced "Dance Dance Revolution" (DDR) players and 7…
Background: Household expenditure on health is increasingly becoming a major source of health care financing in Nigeria. Recognizing the limitations of this pattern of financing health ... Majority of respondents, 41.7% sought treatment from patent medicine vendors. The median out of pocket expenditure on treatment per ...
Robert S. Bristow; Heather Cantillon
The purpose of this paper is to prepare a visitor economic expenditure study for the 1999 Eastern States Exposition, better known as the Big E. The study was executed as part of a class project in Recreation Geography offered the Fall 1999 semester at Westfield State College. The students undertook an economic expenditure study at the Big E by studying tourism...
... GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Expenditures § 100.155 Uncompensated Internet... income from its Internet activities. (e) This section does not exempt from the definition of expenditure... 11 Federal Elections 1 2010-01-01 2010-01-01 false Uncompensated Internet activity by individuals...
de Meijer, C.; Wouterse, B.; Polder, J.J.; Koopmanschap, M.
Although the consequences of population aging for growth in health expenditures have been widely investigated, research on this topic is rather fragmented. Therefore, these consequences are not fully understood. This paper reviews the consequences of population aging for health expenditure growth in
Full Text Available It has been demonstrated that a vegetarian diet may be effective in reducing body weight, however, the underlying mechanisms are not entirely clear. We investigated whether there is a difference in resting energy expenditure between 26 vegetarians and 26 non-vegetarians and the correlation between some nutritional factors and inflammatory markers with resting energy expenditure. In this cross-sectional study, vegetarians and non-vegetarians were matched by age, body mass index and gender. All underwent instrumental examinations to assess the difference in body composition, nutrient intake and resting energy expenditure. Biochemical analyses and 12 different cytokines and growth factors were measured as an index of inflammatory state. A higher resting energy expenditure was found in vegetarians than in non-vegetarians (p = 0.008. Furthermore, a higher energy from diet, fibre, vegetable fats intake and interleukin-β (IL-1β was found between the groups. In the univariate and multivariable analysis, resting energy expenditure was associated with vegetarian diet, free-fat mass and vegetable fats (p < 0.001; Slope in statistic (B = 4.8; β = 0.42. After adjustment for cytokines, log10 interleukin-10 (IL-10 still correlated with resting energy expenditure (p = 0.02. Resting energy expenditure was positively correlated with a specific component of the vegetarian’s diet, i.e., vegetable fats. Furthermore, we showed that IL-10 was positively associated with resting energy expenditure in this population.
Smallwood, Stephen R; Morris, Michael M; Fallows, Stephen J; Buckley, John P
To evaluate the physiologic responses and energy expenditure of active video gaming using Kinect for the Xbox 360. Comparison study. Kirkby Sports College Centre for Learning, Liverpool, England. Eighteen schoolchildren (10 boys and 8 girls) aged 11 to 15 years. A comparison of a traditional sedentary video game and 2 Kinect activity-promoting video games, Dance Central and Kinect Sports Boxing, each played for 15 minutes. Physiologic responses and energy expenditure were measured using a metabolic analyzer. Heart rate, oxygen uptake, and energy expenditure. Heart rate, oxygen uptake, and energy expenditure were considerably higher (P video game play compared with rest and sedentary video game play. The mean (SD) corresponding oxygen uptake values for the sedentary, dance, and boxing video games were 6.1 (1.3), 12.8 (3.3), and 17.7 (5.1) mL · min-1 · kg-1, respectively. Energy expenditures were 1.5 (0.3), 3.0 (1.0), and 4.4 (1.6) kcal · min-1, respectively. Dance Central and Kinect Sports Boxing increased energy expenditure by 150% and 263%, respectively, above resting values and were 103% and 194% higher than traditional video gaming. This equates to an increased energy expenditure of up to 172 kcal · h-1 compared with traditional sedentary video game play. Played regularly, active gaming using Kinect for the Xbox 360 could prove to be an effective means for increasing physical activity and energy expenditure in children.
Heuvel, van den Wim; Olaroiu, Marinela
Objectives: The relationship between health care expenditures and health care outcomes, such as life expectancy and mortality, is complex. Research outcomes show different and contradictory results on this relationship. How and why health care expenditures affect health outcomes is not clear. A
... 26 Internal Revenue 17 2010-04-01 2010-04-01 false Tax on excess lobbying expenditures. 56.4911-1...) MISCELLANEOUS EXCISE TAXES (CONTINUED) PUBLIC CHARITY EXCISE TAXES § 56.4911-1 Tax on excess lobbying expenditures. (a) In general. Section 4911(a) imposes an excise tax of 25 percent on the excess lobbying...
D. Clark Dickin
Conclusion: Compliant surfaces resulted in higher levels of muscular activation in the lower extremities facilitating increased caloric expenditure. Given the increasing trends in sedentary careers and the increases in obesity, this is an important finding to validate the merits of active sitting facilitating increased caloric expenditure and muscle activation.
Luis J. Suau; Myron F. Floyd; John O. Spengler; Jay E. Maddock; Paul H. Gobster
Context: Availability of public neighborhood parks is associated with physical activity. Little is known about how parks contribute to population energy balance. Purpose: This study estimated energy expenditure associated with the use of neighborhood parks and compared energy expenditure by activity areas within parks and by neighborhood race/ethnicity and income....
Lin, Jin-Ding; Lin, Lan-Ping
The purposes of the present study were to describe the welfare expenditure for people with disabilities and examine its relation to national economic growth from 1991 to 2006 in Taiwan. We analyzed data mainly from the information of population with disabilities, disability welfare expenditure and national economic growth and gross national…
Agiovlasitis, Stamatis; Motl, Robert W.; Foley, John T.; Fernhall, Bo
This study examined the relationship between energy expenditure and wrist accelerometer output during walking in persons with and without Down syndrome (DS). Energy expenditure in metabolic equivalent units (METs) and activity-count rate were respectively measured with portable spirometry and a uniaxial wrist accelerometer in 17 persons with DS…
Hollander, Francis M.; Kok, Annemieke; Roos, de Nicole M.; Belle-Van Meerkerk, Gerdien; Graaf, van de Ed A.
Background: Resting energy expenditure (REE) is increased in patients with cystic fibrosis (CF) with end-stage lung disease due to chronic inflammation and pulmonary infections. After lung transplantation (LTx), energy expenditure is expected to be lower because inflammation will decrease. We
Hollander-Kraaijeveld, Francis; Kok, Annemieke; de Roos, Nicole M.; Belle-Van Meerkerk, Gerdien; Van De Graaf, Ed A.
Background: Resting energy expenditure (REE) is increased in patients with cystic fibrosis (CF) with end-stage lung disease due to chronic inflammation and pulmonary infections. After lung transplantation (LTx), energy expenditure is expected to be lower because inflammation will decrease. We
Odhiambo, Nicholas M.; Ntenga, Lydia
The trends and the trajectory of higher education research expenditure in South Africa since the introduction of the New Funding Formula in 2004 have been analysed. The paper also compares the level of South Africa's total gross expenditure on research and development with those of other selected economies. The findings show that following…
This paper analyzes the government expenditures as the percentage of gross domestic product across countries of the European Union. There is a statistical model based on Z-score, whose aim is to calculate how much each EU country deviates from the average value. The model shows that government expenditures on education vary significantly between…
Ministry of Devolution and Planning
This public expenditure review (PER) provides an assessment of the extent to which expenditure addresses national priorities in an effort to strengthen the link between government policies, planning, and budgeting. This report is prepared to provide a critical assessment of public spending, challenges, weaknesses, and successes in the past three years (2009 to 2012). The report subsequently ...
Michael S. Hand; Matthew P. Thompson; Dave Calkin
Increasing costs of wildfire management have highlighted the need to better understand suppression expenditures and potential tradeoffs of land management activities that may affect fire risks. Spatially and temporally descriptive data is used to develop a model of wildfire suppression expenditures, providing new insights into the role of spatial and temporal...
Campbell, Noel D.
Examines whether Georgia K-12 educational spending increased following the Georgia Lottery for Education. Finds a positive and significant relationship between lottery revenues and local education expenditures. However, lottery expenditures did not lead to a meaningful increase in educational spending during the sample time period. Discusses…
... solely to bring light or air into the center of a building which are completely surrounded by external... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Qualified rehabilitated building; expenditures... Depreciable Property § 1.48-11 Qualified rehabilitated building; expenditures incurred before January 1, 1982...
... agents, or a political party committee or its agents. A communication is “made in cooperation... independent expenditure means an expenditure by a person for a communication expressly advocating the election... committee, or their agents, or a political party committee or its agents” if it is a coordinated...
The purposes of this study were to compare the responsiveness of educational expenditures per pupil in Ontario, first, to changes in instructional expenditures per pupil during 1971-77, and, second, to changes in proxy measures of educational quality and price levels of teacher services for 1974-77. Variables used to represent quality and price…
Fazaeli, Ali Akbar; Ghaderi, Hossein; Abbas Fazaeli, Amir; Lotfi, Farhad; Salehi, Masoud; Mehrara, Mohsen
During recent decades, increase in both health care expenditures and improvement of the awareness as well as health expectations have created some problems with regard to finance healthcare expenditures so that the issue of health financing by households has been determined as a major challenge in health sector. According to the definition by the World Health Organization, catastrophic health expenditure is considered if financial contribution for health service is more than 40% of income remaining after subsistence needs have been met. The purpose of our study was determination of Main factors on catastrophic health expenditures in Iranian households. In this study, using an econometrics Bayesian logit model, determinants of the appearance of catastrophic health expenditure based on household budget data collected in 2010 were evaluated. Among Iranian households, the following groups were more likely to encounter with unsustainable health expenditures: rural households, households with the numbers of the elderly more than 65 years, illiterate householders, unemployed householders, households with some unemployed persons, households in upper rank and households with larger equivalent household size were higher than the average of community could significantly predict catastrophic health expenditures. About 2.1% of households were faced with catastrophic health expenditures in 2010. Thus, the implemented policies could not make considerable and significant change in improving justice in financing in health systems.
... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Expenditures by farmers for fertilizer, etc. 1....180-1 Expenditures by farmers for fertilizer, etc. (a) In general. A taxpayer engaged in the business... during the taxable year for the purchase or acquisition of fertilizer, lime, ground limestone, marl, or...
Cook, Benjamin Lê; Manning, Willard G
To assess whether black-white and Hispanic-white disparities increase or abate in the upper quantiles of total health care expenditure, conditional on covariates. Nationally representative adult population of non-Hispanic whites, African Americans, and Hispanics from the 2001-2005 Medical Expenditure Panel Surveys. We examine unadjusted racial/ethnic differences across the distribution of expenditures. We apply quantile regression to measure disparities at the median, 75th, 90th, and 95th quantiles, testing for differences over the distribution of health care expenditures and across income and education categories. We test the sensitivity of the results to comparisons based only on health status and estimate a two-part model to ensure that results are not driven by an extremely skewed distribution of expenditures with a large zero mass. Black-white and Hispanic-white disparities diminish in the upper quantiles of expenditure, but expenditures for blacks and Hispanics remain significantly lower than for whites throughout the distribution. For most education and income categories, disparities exist at the median and decline, but remain significant even with increased education and income. Blacks and Hispanics receive significantly disparate care at high expenditure levels, suggesting prioritization of improved access to quality care among minorities with critical health issues.
... 34 Education 1 2010-07-01 2010-07-01 false Level of expenditures for students enrolled in private... Enrolled in Private Schools § 76.655 Level of expenditures for students enrolled in private schools. (a... funds on: (1) A student enrolled in a private school who receives benefits under the program; and (2) A...
Pugh, G.; Mangan, J.; Blackburn, V.; Radicic, D.
This article estimates the effects of school expenditure on school performance in government secondary schools in New South Wales, Australia over the period 2006-2010. It uses dynamic panel analysis to exploit time series data on individual schools that only recently has become available. We find a significant but small effect of expenditure on…
Noble, Emily E; Billington, Charles J; Kotz, Catherine M; Wang, ChuanFeng
Central oxytocin reduces food intake and increases energy expenditure. The ventromedial hypothalamic nucleus (VMN) is associated with energy balance and contains a high density of oxytocin receptors. We hypothesized that oxytocin in the VMN is a negative regulator of energy balance acting to reduce feeding and increase energy expenditure. To test this idea, oxytocin or vehicle was injected directly into the VMN of Sprague-Dawley rats during fasted and nonfasted conditions. Energy expenditure (via indirect calorimetry) and spontaneous physical activity (SPA) were recorded simultaneously. Animals were also exposed to a conditioned taste aversion test, to determine whether oxytocin's effects on food intake were associated with malaise. When food was available during testing, oxytocin-induced elevations in energy expenditure lasted for 1 h, after which overall energy expenditure was reduced. In the absence of food during the testing period, oxytocin similarly increased energy expenditure during the first hour, but differences in 12-h energy expenditure were eliminated, implying that the differences may have been due to the thermic effects of feeding (digestion, absorption, and metabolic processing). Oxytocin acutely elevated SPA and reduced feeding at doses that did not cause a conditioned taste aversion during both the fed and fasted states. Together, these data suggest that oxytocin in the VMN promotes satiety and acutely elevates energy expenditure and SPA and implicates the VMN as a relevant site for the antiobesity effects of oxytocin.
Kiani, Alishir; Chwalibog, André; Nielsen, Mette O
Late gestation energy expenditure (EE(gest)) originates from energy expenditure (EE) of development of conceptus (EE(conceptus)) and EE of homeorhetic adaptation of metabolism (EE(homeorhetic)). Even though EE(gest) is relatively easy to quantify, its partitioning is problematic. In the present...
Vegas, Emiliana; Coffin, Chelsea
We analyze the diminishing correlations between education expenditure and learning outcomes to address two fundamental questions: Do education systems with different levels of education spending have different student achievement levels? If so, at what amount of education spending does the relationship between increased expenditure and student…
... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Definition of soil and water conservation... (continued) § 1.175-2 Definition of soil and water conservation expenditures. (a) Expenditures treated as a... of soil or water conservation in respect of land used in farming, or for the prevention of erosion of...
Doneva, Nikolinka; Despodov, Zoran; Hadzi-Nikolova, Marija; Mijalkovski, Stojance
This paper presents the structural characteristics of rock material and their influence on the expenditures for construction on horizontal mining facilities. Analyzed the construction of horizontal mining facilities in the same rock type, but with different structural characteristics and determined the expenditures of their construction.
Homaie Rad, Enayatollah; Rashidian, Arash; Arab, Mohamad; Souri, Ali
Several factors can force retirees to go to paid work. Catastrophic health-care expenditure (CHCE) is one of the driving forces for retirees to go to paid work. This cross-sectional study was based on 6,307 Iran retirees' data. Xu method was used to calculate CHCE, and a logit model was estimated to show the association between CHCE and bridge employment. Other control variables were added to the model. The findings showed that there was positive relationship between CHCE and bridge employment. Retirement pension had negative relationship with work after retirement. Prevalence of work after retirement was higher in people who lived in rural region and increased due to increase in household size. The financial constraint was the main pushing factor for the retiree to go to paid work. Thus, covering retirees with health insurances and identifying and listing diseases that may face the retirees with CHCE are some possible efforts to decrease CHCE.
Sørensen, Eva Moll
in a new ‘budget law’ which entails that expenditure limits for the whole public sector are now set by Parliament. In this paper, the ambition is to describe how the institutionalization of economic governance has changed over recent years and to develop a theoretical understanding of the changes based......, historical institutionalism is supplemented with rationalist and sociological variants. Methodologically, the paper is based on a case study of central-local government relations in Denmark with variation on the time dimension. The empirical data consist of policy documents, legal documents and qualitative...... on historical institutionalism. It will be discussed a) whether the recent changes have significantly altered the principles of central-local relations - possibly in line with the development from NPM to post-NPM, b) whether the chances have taken place as a sudden ‘earthquake’ or ‘paradigm change...
Ouyang, Wenjing; Hilsenrath, Peter E
Investment, especially through merger and acquisition (M&A), is a leading topic of concern among health care managers. In addition, the implications of this activity for organization and market concentration are of great interest to policy makers. Using a sample of 2256 firm-year observations in the health care industry during the period from 1985 to 2011, this article provides novel evidence that managers learn from financial markets in making capital expenditure (CAPEX) and M&A investment decisions. Within the industry, managers in the Drugs subsector are most likely to do so, whereas managers in the Medical Equipment and Supplies are least likely to do so. We find informative stock prices improve firm financial performance. This article highlights the importance of financial markets for real economic activity in the health care industry.
Chwalibog, André; Tauson, Anne-Helene; Ali, Abdalla
to evaluate amount of oxidized fat during embryonic development and to compare daily fat oxidation with changes in the fat content of eggs. The experiment comprised 48 embryos from a modern, fast growing line, Ross 308 (RO) and 48 from a slow growing line, Labresse (LA) of White Plymouth Rock. The O2...... fat contributing with nearly 100 % to the total EE. Since oxidised fat was the main energy fuel the content of fat in eggs decreased with 2.0 (RO) and 1.6 g (LA) during the incubation period. It can be concluded that the pattern of gas exchange and thereby the pattern of energy expenditure...... is independent of genetic origin of embryos. However, the embryos from the slow growing broiler line had a lower metabolic rate and oxidised less fat than the modern, fast growing line. The reduced utilization of yolk fat might be a tool for saving fat reserves for the immediate post-hatching period...
Schmidt, Julie Berg; Pedersen, Susie Dawn; Gregersen, Nikolaj Ture
Objectives: Increased energy expenditure (EE) has been proposed an important mechanism for weight loss following Roux-en-Y gastric bypass (RYGB). However, this has never been investigated in a controlled setting independent of changes in energy balance. Likewise, only few studies have investigated...... the effect of RYGB on glycaemic control per se. Here, we investigated the effect of RYGB on EE, appetite, glycaemic control, and specific signalling molecules compared to a control group in comparable negative energy balance. Subjects/Methods:Obese normal glucose tolerant participants were randomized...... to receive RYGB after 8 (n=14) or 12 weeks (n=14). The protocol included a visit at week 0 and three visits (week 7, 11 and 78) where 24 h EE, appetite and blood parameters were assessed. Participants followed a low-calorie diet from week 0-11, with those operated at week 12 serving as a control group...
Konan, Denise Eby, E-mail: firstname.lastname@example.org [Department of Economics, Economic Research Organization, University of Hawaii at Manoa, Saunders Hall 542, Honolulu, HI 96822 (United States); Chan, H.L., E-mail: email@example.com [OmniTrak Group Inc., 1250 Davies Pacific Center, 841 Bishop Street, Honolulu, HI 96813 (United States)
This paper focuses on petroleum use and greenhouse gas emissions associated with economic activities in Hawaii. Data on economic activity, petroleum consumption by type (gasoline, diesel, aviation fuel, residual, propane), and emissions factors are compiled and analyzed. In the baseline year 1997, emissions are estimated to total approximately 23.2 million metric tons of carbon, 181 thousand metric tons of nitrous oxide, and 31 thousand metric tons of methane in terms of carbon-equivalent global warming potential over a 100-year horizon. Air transportation, electricity, and other transportation are the key economic activity responsible for GHG emissions associated with fossil fuel use. More than 22% of total emissions are attributed to visitor expenditures. On a per person per annum basis, emission rates generated by visitor demand are estimated to be higher than that of residents by a factor of 4.3 for carbon, 3.2 for methane, and 4.8 for nitrous oxide.
Konan, Denise Eby [Department of Economics, Economic Research Organization, University of Hawai' i at Manoa, Saunders Hall 542, Honolulu, HI 96822 (United States); Chan, Hing Ling [OmniTrak Group Inc., 1250 Davies Pacific Center, 841 Bishop Street, Honolulu, HI 96813 (United States)
This paper focuses on petroleum use and greenhouse gas emissions associated with economic activities in Hawaii. Data on economic activity, petroleum consumption by type (gasoline, diesel, aviation fuel, residual, propane), and emissions factors are compiled and analyzed. In the baseline year 1997, emissions are estimated to total approximately 23.2 million metric tons of carbon, 181 thousand metric tons of nitrous oxide, and 31 thousand metric tons of methane in terms of carbon-equivalent global warming potential over a 100-year horizon. Air transportation, electricity, and other transportation are the key economic activity responsible for GHG emissions associated with fossil fuel use. More than 22% of total emissions are attributed to visitor expenditures. On a per person per annum basis, emission rates generated by visitor demand are estimated to be higher than that of residents by a factor of 4.3 for carbon, 3.2 for methane, and 4.8 for nitrous oxide. (author)
Răbonţu Cecilia Irina
Full Text Available In Romania, scale sports tourism gets well deserved lately. Tourism and sport has a close relationship since the beginning of their existence, and today we are witnessing a strengthening of it, because we talk about quality of life and greatly enhanced awareness of the beneficial effects of tourism and sport, both contributing to the restoration of working capacity, to increase the health of the population and spending free time pleasant and useful. We have proposed in this paper to analyze consumer behavior of sports tourism in Romania but also places where the cost of sports activities in total expenditures grouped according to several criteria. We conducted a preliminary conceptualization of the notion of tourism and tourist sports, controversial and difficult concept to define. We used for this purpose an extensive bibliographic material and statistical data provided by the National Institute of Statistics of Romania.
BÂLDAN FLORENTINA CRISTINA
Full Text Available The paper „Analysis of consumption expenditure in Romania, period 2009-2015” is highlighting a very important phenomenon for the Romanian economy, consumption. The financial and economic crisis determined a change in the income repartition for the basic products and services. The most influent stimulus at which the Romanian consumers are deciding a product acquisition is the price, therefore they were migrating to product segments with low prices, the quality of life being on a decreasing trend. The level of alimentary products consumption depends in a big extent on the macroeconomic policies, that through numerous leverages is influencing the population consumption behavior. From these leverages we may document the income policy, loan policy, monetary and exchange rate policies, social assistance policy, etc.
Jamile S. Codogno
Full Text Available The purpose of this study was to analyze the association between the clustering of physical inactivity with abdominal obesity and public health care expenditure in Brazilian adults. The sample was composed of 963 patients of both genders, randomly selected in the Brazilian Public Health care System during 2010. Entire health care expenditures during the last year were computed and stratified into: medical consultations, medication dispensing, laboratory tests and overall expenditure. Waist circumference was used to diagnose abdominal obesity and physical activity was assessed by previously validated questionnaire. Sedentary and abdominally obese patients (OR= 3.01 [OR95%CI= 1.81-4.99] had higher likelihood be inserted in the group of higher expenditures than only abdominally obese patients (OR= 1.66 [OR95%CI= 1.07-2.59]. There is a synergic effect between abdominal obesity and physical inactivity on overall health care expenditures.
Simmen, Bruno; Darlu, Pierre; Hladik, Claude Marcel; Pasquet, Patrick
Studies of how a mammal's daily energy expenditure scales with its body mass suggest that humans, whether Westerners, agro-pastoralists, or hunter-gatherers, all have much lower energy expenditures for their body mass than other mammals. However, non-human primates also differ from other mammals in several life history traits suggestive of low energy use. Judging by field metabolic rates of free-ranging strepsirhine and haplorhine primates with different lifestyle and body mass, estimated using doubly labeled water, primates have lower energy expenditure than other similar-sized eutherian mammals. Daily energy expenditure in humans fell along the regression line of non-human primates. The results suggest that thrifty energy use could be an ancient strategy of primates. Although physical activity is a major component of energy balance, our results suggest a need to revise the basis for establishing norms of energy expenditure in modern humans. Copyright © 2014 Elsevier Inc. All rights reserved.
Gosmann, Natan Pereira; Salum, Giovanni Abrahão; Schuch, Felipe; Silveira, Patrícia Pelufo; Bosa, Vera Lucia; Goldani, Marcelo Zubaran; Manfro, Gisele Gus
The objective of this study is to compare energetic expenditure in day-to-day activities among subjects with internalizing disorders (depression and anxiety), externalizing disorders (attention deficit/hyperactivity disorder and oppositional defiant disorder) and healthy children and adolescents without any psychiatric diagnosis. One hundred and five (n = 105) students from a community sample were evaluated throughout a structured psychiatric interview and categorized into three groups: internalizing (n = 54), externalizing (n = 12) and typically developing controls (TDC, n = 39). Energetic expenditure was evaluated using 3-day physical activity record. Subjects with internalizing disorders performed activities with lower energetic expenditure as compared to those with externalizing disorders and TDC. Participants with externalizing disorders had more energetic expenditure variability. Our study suggests that internalizing disorders are associated with activities of low energetic expenditure in day-to-day activities, extending previous findings with physical exercise. These findings may further contribute to the understanding of the associated morbidity previously described in patients with internalizing disorders.
Mafra, Denise; Deleaval, Patrick; Teta, Daniel; Cleaud, Christine; Perrot, Marie-Jo; Rognon, Severine; Thevenet, Muriel; Arkouche, Walid; Jolivot, Anne; Fouque, Denise
The accurate estimation of total daily energy expenditure (TEE) in chronic kidney patients is essential to allow the provision of nutritional requirements; however, it remains a challenge to collect actual physical activity and resting energy expenditure in maintenance dialysis patients. The direct measurement of TEE by direct calorimetry or doubly labeled water cannot be used easily so that, in clinical practice, TEE is usually estimated from resting energy expenditure and physical activity. Prediction equations may also be used to estimate resting energy expenditure; however, their use has been poorly documented in dialysis patients. Recently, a new system called SenseWear Armband (BodyMedia, Pittsburgh, PA) was developed to assess TEE, but so far no data have been published in chronic kidney disease patients. The aim of this review is to describe new measurements of energy expenditure and physical activity in chronic kidney disease patients.
Cope, James R; Doocy, Shannon; Frattaroli, Shannon; McGready, John
Various measures are used to represent socioeconomic status (SES) in health research, including income. However, reliability of income data can be low. Household expenditures are an accepted proxy for income as a more reliable measure but have been studied little in refugee populations. Health and SES measures from cross-sectional surveys of Iraqi refugees in Jordan and Syria were analyzed using logistic regression to assess the interchangeability of household income and expenditures. In Jordan, odds ratios in the regression models including income quartiles were frequently similar to odds ratios found in the models including expenditure quartiles, indicating interchangeability. In Syria, fewer similarities were observed. This study provides some evidence that household expenditures may be used interchangeably with household income for some populations, allowing for the potential collection and use of data related to expenditures as a measure of SES, similar in importance to that of income.
Waldfogel, Jane; Zhai, Fuhua
This study examines the effects of public preschool expenditures on the math and science scores of 4(th) graders, holding constant child, family, and school characteristics, other relevant social expenditures, and country and year effects, in seven Organization for Economic Co-operation and Development (OECD) countries -- Australia, Japan, Netherlands, New Zealand, Norway, U.K., and U.S -- using data from the 1995 and 2003 Trends in International Mathematics and Science Study (TIMSS). Our results indicate that there are small but significant positive effects of public preschool expenditures on the math and science scores of 4(th) graders and preschool expenditures reduce the risk of children scoring at the low level of proficiency. We also find some evidence that children from low-resource homes and homes where the test language is not always spoken may tend to gain more from increased public preschool expenditures than other children,.
Waldfogel, Jane; Zhai, Fuhua
This study examines the effects of public preschool expenditures on the math and science scores of 4th graders, holding constant child, family, and school characteristics, other relevant social expenditures, and country and year effects, in seven Organization for Economic Co-operation and Development (OECD) countries -- Australia, Japan, Netherlands, New Zealand, Norway, U.K., and U.S -- using data from the 1995 and 2003 Trends in International Mathematics and Science Study (TIMSS). Our results indicate that there are small but significant positive effects of public preschool expenditures on the math and science scores of 4th graders and preschool expenditures reduce the risk of children scoring at the low level of proficiency. We also find some evidence that children from low-resource homes and homes where the test language is not always spoken may tend to gain more from increased public preschool expenditures than other children,. PMID:21442008
Full Text Available Local authorities need simple economic tools and methodology how to evaluate public expenditure efficiency. There are a lot of ways for measuring efficiency of public expenditure however methods or economic tools which get actual information about efficiency of current public spending are rare. The paper presents new methodology for evaluating current municipal environmental protection expenditures based on a weighted assessment of multiple economic, social and environmental criteria. This methodology has issued from OECD methodology however it is a more complex tool and addresses the three pillars of sustainable development and following interdisciplinary approaches of Environmental Mainstreaming. The paper presents also case study, where is investigated environmental protection expenditure evaluation in the city of Brno, the second largest city in the Czech Republic. The results of this case study show the correct state of expenditure efficiency in the city of Brno and indicate possible improvements applicable for new investment to environmental protection and sustainable development.
Melbye, Molly L R; Chi, Donald L; Milgrom, Peter; Huebner, Colleen E; Grembowski, David
To identify factors associated with dental utilization and expenditures for children enrolled in Washington State (WA) foster care (FC). This cross-sectional study used 2008 Medicaid enrollment and claims files for children ages Foster Home Care, Kinship Care, Group Care, Other), and urbanicity. Only 43 percent of the children utilized any dental care; the adjusted mean expenditure was $198.35 [95% confidence interval (CI) $181.35, $215.36]. Fewer utilized diagnostic (41 percent), preventive (39 percent), restorative (11 percent), or complex (5 percent) services. Associated with utilization (P ≤ 0.01) were: female [ARR = 1.05, 95% CI(1.01, 1.10)]; 0-2 years [ARR = 0.18, 95% CI(0.15, 0.21)], [3-5 years ARR = 0.78, 95% CI(0.74, 0.83)]; Native American [ARR = 0.85, 95% CI(0.80, 0.91)]; SSI [ARR = 1.10, 95% CI(1.04, 1.17)]; Kinship Care [ARR = 0.94, 95% CI(0.90, 0.98)]; Group Care [ARR = 1.25 95% CI(1.15, 1.37)]; and urban/rural urbanicity with population Care [$28.57 95% CI($14.00, $43.15)]. Most children enrolled in WA FC for ≥11 months during 2008 did not receive dental care. Research is needed to determine the level of unmet need among children in FC and interventions to improve access to oral health of the children. Enforcement of existing federal legislation is needed. © 2013 American Association of Public Health Dentistry.
Egro, Francesco M; Manders, Ernest C; Manders, Ernest K
Historically, estimated energy expenditure (EEE) has been related to the percent of body surface area burned. Subsequent evaluations of these estimates have indicated that the earlier formulas may overestimate the amount of caloric support necessary for burn-injured patients. Ireton-Jones et al derived 2 equations for determining the EEE required to support burn patients, 1 for ventilator-dependent patients and 1 for spontaneously breathing patients. Evidence has proved their reliability, but they remain challenging to apply in a clinical setting given the difficult and cumbersome mathematics involved. This study aims to introduce a graphical calculation of EEE in burn patients that can be easily used in the clinical setting. The multivariant linear regression analysis from Ireton-Jones et al yielded equations that were rearranged into the form of a simple linear equation of the type y = mx + b. By choosing an energy expenditure and the age of the subject, the weight was calculated. The endpoints were then calculated, and a graph was mapped by means of Adobe FrameMaker. A graphical representation of Ireton-Jones et al's equations was obtained by plotting the weight (kg) on the y axis, the age (years) on the x axis, and a series of parallel lines representing the EEE in burn patients. The EEE has been displayed graphically on a grid to allow rapid determination of the EEE needed for a given patient of a designated weight and age. Two graphs were plotted: 1 for ventilator-dependent patients and 1 for spontaneously breathing patients. Correction factors for sex, the presence of additional trauma, and obesity are indicated on the graphical calculators. We propose a graphical tool to calculate caloric requirements in a fast, easy, and portable manner.
Full Text Available This study aimed to assess total energy expenditure (TEE and specific habitual physical activities in adolescent sprint athletes. Two methods used to estimate TEE, an activity diary (AD and SenseWear armband (SWA, were compared. Sixteen athletes (6 girls, 10 boys, mean age 16.5 ± 1.6 yr simultaneously wore a SWA and completed an AD and food diary during one week. Basal energy expenditure as given by the SWA when taken off was corrected for the appropriate MET value using the AD. TEE as estimated by the AD and SWA was comparable (3196 ± 590 kcal and 3012 ± 518 kcal, p = 0.113 without day-to-day variations in TEE and energy expended in activities of high intensity. Daily energy intake (2569 ± 508 kcal did not match TEE according to both the AD and SWA (respectively p < 0.001 and p = 0.007. Athletes were in a supine position for a longer time on weekend days than on week days and slept longer on Sundays. Athletes reported a longer time of high-intensive physical activities in the AD than registered by the SWA on 4 out of 7 days. In addition to specific sprint activities on 3 to 7 days per week, 11 out of 16 athletes actively commuted to school where they participated in sports once or twice per week. The AD and the SWA are comparable in the estimation of TEE, which appears realistic and sustainable. The SWA offers an appropriate and objective method in the assessment of TEE, sleeping and resting in adolescent athletes on the condition that detailed information is given for the times the armband is not worn. The AD offers activity specific information but relies on the motivation, compliance and subjectivity of the individual, especially considering high-intensive intermittent training
Hoyt, Reed W; Buller, Mark J; Santee, William R; Yokota, Miyo; Weyand, Peter G; Delany, James P
Routine walking and running, by increasing daily total energy expenditure (TEE), can play a significant role in reducing the likelihood of obesity. The objective of this field study was to compare TEE estimated using foot-ground contact time (Tc)-pedometry (TEE(PEDO)) with that measured by the criterion doubly labeled water (DLW) method. Eight male U.S. Marine test volunteers [27 +/- 4 years of age (mean +/- SD); weight = 83.2 +/- 10.7 kg; height = 182.2 +/- 4.5 cm; body fat = 17.0 +/- 2.9%] engaged in a field training exercise were studied over 2 days. TEE(PEDO) was defined as (calculated resting energy expenditure + estimated thermic effect of food + metabolic cost of physical activity), where physical activity was estimated by Tc-pedometry. Tc-pedometry was used to differentiate inactivity, activity other than exercise (i.e., non-exercise activity thermogenesis, or NEAT), and the metabolic cost of locomotion (M(LOCO)), where M(LOCO) was derived from total weight (body weight + load weight) and accelerometric measurements of Tc. TEE(PEDO) data were compared with TEEs measured by the DLW (2H2(18)O) method (TEE(DLW)): TEE(DLW) = 15.27 +/- 1.65 MJ/day and TEE(PEDO) = 15.29 +/- 0.83 MJ/day. Mean bias (i.e., TEE(PEDO) - TEE(DLW)) was 0.02 MJ, and mean error (SD of individual differences between TEE(PEDO) and TEE(DLW)) was 1.83 MJ. The Tc-pedometry method provided a valid estimate of the average TEE of a small group of physically active subjects where walking was the dominant activity.
Magarinos-Torres, Rachel; Lynd, Larry David; Luz, Tatiana Chama Borges; Marques, Paulo Eduardo Potyguara Coutinho; Osorio-de-Castro, Claudia Garcia Serpa
The aim was to analyse the implementation dynamics of the essential medicines list (EML). We used the government expenditures on medicines and Brazil as a case study. Drug purchases were considered as a proxy for utilization. The essential medicines (EMs) expenditures were followed over time by Brazilian National EMLs life-time and defined by broad therapeutic categories and by specific medicines. Brazil increased the number of the medicines during the last four editions of Brazilian National EMLs and the federal government expenditures on them. The EML implementation dynamics changed the distribution of expenditures on EMs. We identified a common set of 404 EMs present in all four editions of the Brazilian National EMLs. There was a proportional decrease in expenditures on anti-infectives for systemic use, blood and blood-forming organs and alimentary tract and metabolism, and increase in expenditures on antineoplastic and immunomodulating agents. The expenditures distribution per specific medicines revealed that a small set of EMs was responsible for 50% or more of expenditures considering Brazilian National EML life-time for all four periods. The increase in expenditures on EMs in Brazil was a consequence of the newer medicines incorporated over time in the Brazilian National EMLs. The use of the medicines expenditures as a source of data and the definition of an EML life-time permitted follow-up of the implementation dynamics of different versions of the Brazilian National EMLs. Our results have implications for policymakers and stakeholders to gain a better understanding of the role EMLs play in health system sustainability and in the provision of the most beneficial heath care. © 2017 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).
Full Text Available Single-minded 1 (Sim1 is a transcription factor necessary for development of the paraventricular nucleus of the hypothalamus (PVH. This nucleus is a critical regulator of appetite, energy expenditure and body weight. Previously we showed that Sim1(+/- mice and conditional postnatal Sim1(-/- mice exhibit hyperphagia, obesity, increased linear growth and susceptibility to diet-induced obesity, but no decrease in energy expenditure. Bilateral ablation of the PVH causes obesity due to hyperphagia and reduced energy expenditure. It remains unknown whether Sim1 neurons regulate energy expenditure. In this study, Sim1cre mice were bred to homozygous inducible diphtheria toxin receptor (iDTR mice to generate mice expressing the simian DTR in Sim1 cells. In these mice, Sim1 neuron ablation was performed by intracerebroventricular (ICV injection of diphtheria toxin. Compared to controls, mice with Sim1 neuron ablation became obese (with increased fat mass on a chow diet due to increased food intake and reduced energy expenditure. In post-injection mice, we observed a strong inverse correlation between the degree of obesity and hypothalamic Sim1 expression. The reduction in baseline energy expenditure observed in these mice was accompanied by a reduction in activity. This reduction in activity did not fully account for the reduced energy expenditure as these mice exhibited decreased resting energy expenditure, decreased body temperature, decreased brown adipose tissue temperature, and decreased UCP1 expression suggesting an impairment of thermogenesis. In injected mice, hypothalamic gene expression of Sim1, oxytocin (OXT and thyrotropin releasing hormone (TRH was reduced by about 50%. These results demonstrate that Sim1 neurons in adult mice regulate both food intake and energy expenditure. Based on the body of work in the field, feeding regulation by Sim1 neurons likely occurs in both the PVH and medial amygdala, in contrast to energy expenditure
Giang, Kim Bao; Van Minh, Hoang; Allebeck, Peter
Alcohol use and alcohol-related problems are on the rise in low- and middle-income countries. Expenditure on alcohol is an important problem for families and communities and needs to be assessed. This study examines level of alcohol consumption and expenditure on alcohol in a district in Vietnam. A cross-sectional survey was conducted in a rural district in northern Vietnam. Multi-stage sampling was employed to randomly select participants from 20 communities and a town in the same district. One thousand five hundred and sixty-four adults (765 males and 799 females) aged 18-60 years were interviewed. Information about alcohol use as well as expenditure on alcohol consumption four weeks prior to the interview was gathered. Non-parametric tests and log-linear regression were employed to compare expenditure on alcohol consumption across socioeconomic groups. The prevalence of alcohol use one month prior to interview was 35% (66% among men and 5% among women). The median alcohol consumption among those who reported use of alcohol in the week prior to the interview was 7.9 standard drinks. Excessive drinking (more than 14 standard drinks per week for men and more than seven standard drinks per week for women) occurred among 35% of those who used alcohol. Median expenditure for alcohol consumption during one month by those who drank alcohol was USD 3.5, accounting for 4.6% of household food expenditure, 2.7% of total household expenditure, and 1.8% of household income. The differences in alcohol consumption and expenditure between sexes and between socioeconomic groups are also presented. Our study confirms that alcohol consumption and alcohol-related problems are common among men in Vietnam. The share of alcohol expenditure in total household expenditure is substantial, especially among poor households. This should be considered an important public health issue, which needs to be taken into account in the alcohol policy debate.
Raghavan, Ramesh; Brown, Derek S; Thompson, Hope; Ettner, Susan L; Clements, Lisa M; Key, Whitney
Children in the child welfare system are the most expensive child population to insure for their mental health needs. The objective of this article is to estimate the amount of Medicaid expenditures incurred from the purchase of psychotropic drugs - the primary drivers of mental health expenditures - for these children. We linked a subsample of children interviewed in the first nationally representative survey of children coming into contact with U.S. child welfare agencies, the National Survey of Child and Adolescent Well-Being (NSCAW), to their Medicaid claims files obtained from the Medicaid Analytic Extract. Our data consist of children living in 14 states, and Medicaid claims for 4 years, adjusted to 2010 dollars. We compared expenditures on psychotropic medications in the NSCAW sample to a propensity score-matched comparison sample obtained from Medicaid files. Children surveyed in NSCAW had over thrice the odds of any psychotropic drug use than the comparison sample. Each maltreated child increased Medicaid expenditures by between $237 and $840 per year, relative to comparison children also receiving medications. Increased expenditures on antidepressants and amphetamine-like stimulants were the primary drivers of these increased expenditures. On average, an African American child in NSCAW received $399 less expenditure than a white child, controlling for behavioral problems and other child and regional characteristics. Children scoring in the clinical range of the Child Behavior Checklist received, on average, $853 increased expenditure on psychotropic drugs. Each child with child welfare involvement is likely to incur upwards of $1482 in psychotropic medication expenditures throughout his or her enrollment in Medicaid. Medicaid agencies should focus their cost-containment strategies on antidepressants and amphetamine-type stimulants, and expand use of instruments such as the Child Behavior Checklist to identify high-cost children. Both of these strategies
Pressley, Joyce C; Trieu, Lisa; Kendig, Tiffany; Barlow, Barbara
Examination of expenditures in areas where more universal application of effective injury prevention approaches is indicated could identify specific mechanisms and age groups where effective intervention may impact public injury-related expenditures. The Healthcare Cost and Utilization Project 2003 (KID-HCUP) contains acute care hospitalization data for U.S. children and adolescents residing in 36 states. The study population includes 240,248 unweighted (397,943 weighted) injury-related hospital discharges for ages 0 to 19 years. Injury severity was assessed using ICDMAP-90 and International Classification of Injury Severity Scores (ICISS). SUDAAN was employed to adjust variances for stratified sampling. Expenditures were weighted to represent the U.S. population. Injury-related hospitalizations (mean $28,137 +/- 64,420, median $10,808) were more costly than non-injury discharges, accounting for approximately 10% of all persons hospitalized (unweighted), but more than one-fifth of expenditures. Public sources were the primary payor for 37.7% of injured persons. Incidence and cost per case variations across specific injury mechanisms heavily influenced total mechanism specific expenditures. Motor vehicle crashes were the largest expenditures for private and public payors with two thirds of expenditures in teenagers - more than 40% for drivers. Medicaid covered 45.6% ($192 million) of burn expenditures and 59.2% in 0-4 year olds. Expenditures per case (mean +/- SD, median) were: firearm ($36,196 +/- 58,052, $19,020), motor vehicle driver ($33,731 +/- 50,583, $18,431), pedestrian ($31,414 +/- 57,103, $16,552); burns ($29,242 +/- 64,271, $10,739); falls ($13,069 +/- 20,225, $8,610); and poisoning ($8,290 +/- $15,462, $5,208). More universal application of proven injury prevention has the potential to decrease both the public and private health expenditure burden among several modifiable injury mechanisms.
Kildemoes, Helle Wallach; Andersen, Morten; Støvring, Henrik
To develop a method for projecting the impact of ageing and changing drug utilization patterns on future drug expenditure.......To develop a method for projecting the impact of ageing and changing drug utilization patterns on future drug expenditure....
... TECHNOLOGY INVESTMENT AGREEMENTS Requirements for Expenditure-Based and Fixed-Support Technology Investment... requirements in this subpart. The fundamental difference between an expenditure-based and a fixed-support TIA...
... SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Expenditure-Based and Fixed-Support Technology Investment Agreements § 37.300 What is the difference between an expenditure-based and fixed-support TIA? The fundamental difference between an expenditure-based and fixed...
Alcalde-Unzu, Jorge; Ezcurra, Roberto; Pascual, Pedro
This note investigates the sources of international differences in the levels of per capita health-care expenditure, using data on the OECD countries between 1975 and 2003. To that end, we use Theil's second measure of inequality for decomposing cross-country disparities in per capita health-care expenditure into the contributions of various factors: health-care expenditure expressed as a share of GDP, labour productivity, employment rate, activity rate and the ratio of working-age population to total population. Our results show that cross-country differences in the share of GDP devoted to health-care expenditure and labour productivity are the main determinants of the level of dispersion in per capita health-care expenditure. On the contrary, existing disparities in the remaining explanatory factors considered play a less relevant role in this context. In any event, the analysis performed reveals that the overall inequality in per capita health-care expenditure decreased throughout the study period. This was due to the process of international convergence observed in most of the factors used to break down the level of per capita health-care expenditure. (c) 2008 John Wiley & Sons, Ltd.
Full Text Available This study estimated excess home healthcare use and expenditures among elderly Medicare beneficiaries (age ≥ 65 years with Parkinson’s disease (PD compared to those without PD and analyzed the extent to which predisposing, enabling, need factors, personal health choice, and external environment contribute to the excess home healthcare use and expenditures among individuals with PD. A retrospective, observational, cohort study design using Medicare 5% sample claims for years 2006-2007 was used for this study. Logistic regressions and Ordinary Least Squares regressions were used to assess the association of PD with home health use and expenditures, respectively. Postregression nonlinear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. Elderly Medicare beneficiaries with PD had higher home health use and expenditures compared to those without PD. 27.5% and 18% of the gap in home health use and expenditures, respectively, were explained by differences in characteristics between the PD and no PD groups. A large portion of the differences in home healthcare use and expenditures remained unexplained.
Full Text Available Weight loss/weight control is a major concern in prevention of cardiovascular disease and the realm of health promotion. The primary aim of this study was to investigate the effect of neuromuscular electrical stimulation (NMES at different intensities on energy expenditure (oxygen and calories in healthy adults. The secondary aim was to develop a generalized linear regression (GEE model to predict the increase of energy expenditure facilitated by NMES and identify factors (NMES stimulation intensity level, age, body mass index, weight, body fat percentage, waist/hip ratio, and gender associated with this NMES-induced increase of energy expenditure. Forty sedentary healthy adults (18 males and 22 females participated. NMES was given at the following stimulation intensities for 10 minutes each: sensory level (E1, motor threshold (E2, and maximal intensity comfortably tolerated (E3. Cardiopulmonary gas exchange was evaluated during rest, NMES, and recovery stage. The results revealed that NMES at E2 and E3 significantly increased energy expenditure and the energy expenditure at recovery stage was still significantly higher than baseline. The GEE model demonstrated that a linear dose-response relationship existed between the stimulation intensity and the increase of energy expenditure. No subject’s demographic or anthropometric characteristics tested were significantly associated with the increase of energy expenditure. This study suggested NMES may be used to serve as an additional intervention for weight loss programs. Future studies to develop electrical stimulators or stimulation electrodes to maximize the comfort of NMES are recommended.
Perera, K Manuja N; Guruge, G N Duminda; Jayawardana, Pushpa L
Tobacco is a determinant of poverty and a barrier for development. Monaragala, a rural, agricultural district, reports the highest poverty-related indicators in southern Sri Lanka. A cross-sectional study was used to describe the household expenditure on tobacco and its association with food- and education-related expenditures at household level. This study used a 4-stage cluster sampling method to recruit a representative sample of 1160 households. Response rate was 98.6%. Median monthly household income was LKR 20 000 (interquartile range [IQR] = LKR 12 000-30 000). The median monthly expenditure on tobacco was LKR 1000 (IQR = LKR 400-2000) with the highest spending tertile reporting a median of LKR 2700 (IQR = LKR 2000-3600).The proportionate expenditure from the monthly income ranged from 0.0% to 50% with a median of 5.0% (IQR = 2.0-10.0) and a mean of 7.4% (7.6). The poorest reported the highest mean proportionate expenditure (9.8%, SD = 10) from the household income. Household expenditure on tobacco negatively associated with expenditure on education.
Sato, Misuzu; Iwasaki, Masanori; Yoshihara, Akihiro; Miyazaki, Hideo
Along with rapid aging, medical expenditure for older adults has been increasing in Japan. Research has shown that periodontitis is a useful predictor for excess medical expenditure; however, limited information is available on the elderly population after adequately considering confounding factors. The aim of the present study was to evaluate the association between periodontitis and long-term medical expenditure in elderly Japanese. Baseline health and periodontal examinations were carried out in June 2008. Japanese adults (n = 245) aged 80 years were classified into quartiles based on periodontal inflamed surface area (PISA), which quantifies the degree of periodontal inflammation. Medical care use and costs were monitored by assessment of the National Health Insurance claim files from the baseline survey through the end of February 2011. Multivariable analysis of the differences in medical expenditure among PISA quartiles was carried out using linear regression with robust standard errors. The participants in the fourth (with the largest PISA) and third quartiles had significantly higher inpatient medical expenditure compared with those of the first quartile (P periodontitis and future increase in medical expenditure, suggesting that periodontitis might be a modifiable factor for the reduction of excess medical expenditure among elderly Japanese. Geriatr Gerontol Int 2016; 16: 856-864. © 2015 Japan Geriatrics Society.
Burns, Jill; Forde, Cuisle; Dockrell, Sara
Objectives This study aimed to investigate the energy expenditure of common office-based tasks. The objectives were to: (a) test the classification of tasks as sedentary or light-intensity physical activity and (b) compare the energy expenditure of tasks under two postural conditions (sitting and standing). Background The sedentary nature of office work has been highlighted as a health risk, and strategies to reduce sedentary behavior at work have been developed. However, there is limited evidence to guide the utilization of sit-stand workstations in the workplace for metabolic health benefits. Method A repeated measures laboratory-based study compared the energy expenditure of common office tasks in sitting and standing using indirect calorimetry ( n = 22). Four standardized tasks (sitting/standing quietly, reading, typing, sorting paper) under two postural conditions (sitting, standing) were performed in a randomized order. Results The mean energy expenditure for all tasks in sitting and standing was energy expenditure of doing the same task in sitting compared to standing. In a repeated measures ANOVA, task ( p energy expenditure of tasks carried out in sitting compared to standing is negligible. Application The ubiquitous use and utility of sit-stand workstations in the workplace needs to be reviewed. Notwithstanding the potential benefits of movement that may occur naturally, this study confirmed that standing as opposed to sitting does not produce a clinically important increase in energy expenditure.
Khan Suhaila H
Full Text Available Abstract Objective This study investigated a the amount and types of out-of-pocket expenditures by patients for nominally free services in a large public hospital in Bangladesh, b the factors influencing these expenses, and c the impact of these expenses on household income. Methods Eighty-one maternity patients were interviewed during their hospitalization in the Dhaka Medical College Hospital. Patients were selected by quota sample to match the distribution of maternity patient categories in the hospital. Patients were interviewed with a semi-structured, in-depth questionnaire. Results All interviewees incurred substantial out-of-pocket expenditures for travel, hospital admission fees, medicine, tests, food, and tips. Only two of the expenditures, travel expenses and admission fees, were not supposed to be provided free of charge by the hospital. The median total per-patient expenditure was $65 (range $2–$350, equivalent to 7% (range 0.04%–225% of annual household income. Half of all patients reported that their families had to borrow to pay for care at interest rates of 5%–30% per month. A third of these families reported selling jewelry, land or household items to moneylenders. The rural patients reported more difficulty in paying for care than the urban patients. Factors increasing the expenditures were duration of hospitalization, rural residence, and necessary (e.g. C-section, hysterectomy and unnecessary (e.g. episiotomy medical procedures. Conclusion Free maternity services in Bangladesh impose large out-of-pocket expenditures on patients. Authorities could reduce the burden by reducing the duration of hospital stays, limiting use of medical procedures, eliminating tips, and moving routine services closer to potential users. Fee for service could reduce unofficial expenditures if the fee were lower than and replaced typical unofficial expenditures, otherwise adding service fees without reform of current hospital practices would
Sen, Bisakha; Blackburn, Justin; Morrisey, Michael; Becker, David; Kilgore, Meredith; Caldwell, Cathy; Menachemi, Nir
The primary aim is to explore whether prescription drug expenditures by enrollees changed in Alabama's CHIP program, ALL Kids, after copayment increases in fiscal year 2004. The subsidiary aim is to explore whether non-pharmaceutical expenditures also changed. Data on ALL Kids enrollees between 1999-2007, obtained from claims files and the state's administrative database. We used data on children who were enrolled between one and three years both before and after the changes to the copayment schedule, and estimate regression models with individual-level fixed effects to control for time-invariant heterogeneity at the child level. This allows an accurate estimate of how program expenditures change for the same individual following copayment changes. Primary outcomes of interest are expenditures for prescription drugs by class and brand-name and generic versions. We estimate models for the likelihood of any use of prescription drugs and expenditure level conditional on use. Following the copayment increase, the probability of any expenditure decline by 5.8%, brand name drugs by 6.9%, generic drugs by 7.4%. Conditional on any use, program expenditures decline by 7.9% for all drugs, by 9.6% for brand name drugs, and 6.2% for generic drugs. The largest declines are for antihistamine drugs; the least declines are for Central Nervous System agents. Declines are smaller and statistically weaker for children with chronic health conditions. Concurrent declines are also seen for non-pharmaceutical medical expenditures. Copayment increases appear to reduce program expenditures on prescription drugs per enrollee and may be a useful tool for controlling program costs.
Pechey, Rachel; Monsivais, Pablo
Investigations of the contribution of food costs to socioeconomic inequalities in diet quality may have been limited by the use of estimated (vs. actual) food expenditures, not accounting for where individuals shop, and possible reverse mediation between food expenditures and healthiness of food choices. This study aimed to explore the extent to which food expenditure mediates socioeconomic inequalities in the healthiness of household food choices. Observational panel data on take-home food and beverage purchases, including expenditure, throughout 2010 were obtained for 24,879 UK households stratified by occupational social class. Purchases of (1) fruit and vegetables and (2) less-healthy foods/beverages indicated healthiness of choices. Supermarket choice was determined by whether households ever visited market-defined high-price and/or low-price supermarkets. Results showed that higher occupational social class was significantly associated with greater food expenditure, which was in turn associated with healthier purchasing. In mediation analyses, 63% of the socioeconomic differences in choices of less-healthy foods/beverages were mediated by expenditure, and 36% for fruit and vegetables, but these figures were reduced to 53% and 31% respectively when controlling for supermarket choice. However, reverse mediation analyses were also significant, suggesting that 10% of socioeconomic inequalities in expenditure were mediated by healthiness of choices. Findings suggest that lower food expenditure is likely to be a key contributor to less-healthy food choices among lower socioeconomic groups. However, the potential influence of cost may have been overestimated previously if studies did not account for supermarket choice or explore possible reverse mediation between expenditure and healthiness of choices. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Powell, Lisa M; Harris, Jennifer L; Fox, Tracy
In response to concerns about childhood obesity, the Federal Trade Commission (FTC) released two reports documenting food and beverage marketing expenditures to children and adolescents. The recently released 2012 report found an inflation-adjusted 19.5% reduction in marketing expenditures targeted to youth from $2.1 billion in 2006 to $1.8 billion in 2009. The current article highlights features of the FTC's analysis, examines how expenditures relate to youth exposure to food marketing, and assesses changes in the nutritional content of marketed products. Of the $304.0 million decline in expenditures, $117.8 million (38.7%) was from a decline in premium (i.e., restaurant children's meal toys) expenditures rather than direct marketing. Although inflation-adjusted TV expenditures fell by 19.4%, children and teens still see 12-16 TV advertisements (ads)/day for products generally high in saturated fat, sugar, or sodium. In addition, newer digital forms of unhealthy food and beverage marketing to youths are increasing; the FTC reported an inflation-adjusted 50.7% increase in new media marketing expenditures. The self-regulatory Children's Food and Beverage Advertising Initiative (CFBAI) is limited in scope and effectiveness: expenditures increased for many noncovered marketing techniques (i.e., product placement, movie/video, cross-promotion licenses, athletic sponsorship, celebrity fees, events, philanthropy, and other); only two restaurants are members of CFBAI, and nonpremium restaurant marketing expenditures were up by $86.0 million (22.5% inflation-adjusted increase); industry pledges do not protect children aged >11 years, and some marketing appears to have shifted to older children; and, nutritional content remains poor. Continued monitoring of and improvements to food marketing to youth are needed. © 2013 American Journal of Preventive Medicine.
Powell, Lisa M.; Harris, Jennifer L.; Fox, Tracy
In response to concerns about childhood obesity, the Federal Trade Commission (FTC) released two reports documenting food and beverage marketing expenditures to children and adolescents. The recently released 2012 report found an inflation-adjusted 19.5% reduction in marketing expenditures targeted to youth from $2.1 billion in 2006 to $1.8 billion in 2009. The current article highlights features of the FTC’s analysis, examines how expenditures relate to youth exposure to food marketing, and assesses changes in the nutritional content of marketed products. Of the $304.0 million decline in expenditures, $117.8 million (38.7%) was from a decline in premium (i.e., restaurant children’s meal toys) expenditures rather than direct marketing. Although inflation-adjusted TV expenditures fell by 19.4%, children and teens still see 12–16 TV advertisements (ads)/day for products generally high in saturated fat, sugar or sodium. In addition, newer digital forms of unhealthy food and beverage marketing to youths are increasing; the FTC reported an inflation-adjusted 50.7% increase in new media marketing expenditures. The self-regulatory Children’s Food and Beverage Advertising Initiative (CFBAI) is limited in scope and effectiveness: expenditures increased for many noncovered marketing techniques (i.e., product placement, movie/video, cross-promotion licenses, athletic sponsorship, celebrity fees, events, philanthropy, and other); only two restaurants are members of CFBAI, and nonpremium restaurant marketing expenditures were up by $86.0 million (22.5% inflation-adjusted increase); industry pledges do not protect children aged >11 years, and some marketing appears to have shifted to older children; and, nutritional content remains poor. Continued monitoring of and improvements to food marketing to youth are needed. PMID:24050422
Reynolds, Megan M; Avendano, Mauricio
The U.S. spends more than any other country on health care, yet Americans have lower life expectancy than people in most industrialized countries. Recent studies suggest that lower expenditures on social policies in the U.S. may contribute to less-favorable trends in life expectancy. This study tests the hypothesis that greater social spending will be positively associated with life expectancy across the countries of the Organisation of Economic Co-operation and Development and that the magnitude of these associations will outweigh those between government healthcare spending and life expectancy. In 2016, longitudinal data on six domains of social expenditures for the U.S. and 19 other wealthy nations between 1980 and 2010 were used to estimate the associations between prior year expenditures on education, family, unemployment, incapacity, old age, and active labor market programs, and period life expectancy using fixed effects models. Controlling for a wide set of confounders and government healthcare expenditures, a 1% increase in prior year education expenditures was associated with 0.160 (95% CI=0.033, 0.286) of a year gain in life expectancy, whereas a 1% increase in prior year incapacity benefit expenditures was associated with 0.168 (95% CI=0.003, 0.333) of a year gain in life expectancy. Counterfactual models suggest that if the U.S. were to increase expenditures on education and incapacity to the levels of the country with the maximum expenditures, life expectancy would increase to 80.12 years. The U.S. life expectancy lag could be considerably smaller if U.S. expenditures on education and incapacity programs were comparable with those in other high-income countries. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Crovetto, Mirta; Uauy, Ricardo
During recent decades household incomes have increased steadily, leading to changes in dietary habits and food expenditure. To report changes in household food expenditure focusing on trends in processed food across income quintiles in Metropolitan Santiago. Information obtained from the Fourth (1986-1987), Fifth (1996-1997) and Sixth National Institute of Statistics (INE) Surveys (2006-2007) were used. Food expenditure data over the study periods was extracted from household expenditure surveys (HES) after verifying and adjusting food prices registered by the INE to current 2007 prices. Absolute food expenditure over the study period increased for all groups; the largest increase was found in lowest income quintiles; however, the proportion of total family budget spent on food decreased in all groups. The largest increases in food expenditure corresponded to sweetened beverages, processed fruit juices, alcoholic drinks, ready meals and "eating out". Expenditure on fish rose slightly whereas the absolute spending on legumes, eggs and oils decreased. Expenditure in processed food as percentage of total food expenditure increased from 42% to 57% of total for mean household. For the 2nd quintile it rose from 31% to 48% and for the lowest quintile increased from 53% to 68% over the three decades (1987-2007). Changes were greatest in energy rich processed foods such as bread, pastries, confectioneries and granulated sugar. These particular foods are of high energy density and contain high amounts of saturated fat, sodium and added sugars. These results confirm that food consumption patterns over the past decades have progressively departed from the recommended dietary guidelines given by national and international health organizations.
Thivel, D; Aucouturier, J; Metz, L; Morio, B; Duché, P
Physical activity is mainly used in weight control strategies to favour energy expenditure. Some evidence suggests that exercise might not have the expected impact on energy balance, and may actually cause a decrease in the subsequent physical activity energy expenditure. To question the impact of an acute exercise session of varying intensities on daily energy expenditure in lean and obese adolescents. Data from three separate studies conducted in lean and obese 12-15 years old adolescents (study 1: 12 obese; study 2: 10 obese and nine lean; study 3: 15 obese) have been used. Daily energy expenditure (DEE) was assessed in studies 1 and 2 during an exercise condition with an exercise bout at 70%VO(2max) (EX) and a rest day (REST) (using Actiheart and Armbands, respectively). In study 3, DEE was assessed in calorimetric chambers during (i) a high intensity exercise condition (HIE - 75%VO(2max)) and (ji) a condition with a low intensity exercise (LIE - 40%VO(2max)) and (iii) a rest condition (REST). Morning energy expenditure was significantly higher during the exercise conditions whatever the intensity compared with rest. Afternoon energy expenditure was significantly lower following HIE compared to the rest condition in studies 2 and 3. Afternoon energy expenditure was not significantly different between LIE and REST in study 2. Total DEE was not significantly different between conditions in the three studies. Obese adolescents seem to show a compensatory response to an acute session of HIE (>70%VO(2max)) by decreasing their following physical activity energy expenditure. Although HIE favours body composition, physical fitness and metabolic profile improvements, this induced compensatory energy expenditure response has to be considered to optimize its effect on weight loss. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.
Walker, Emily J; McAinch, Andrew J; Sweeting, Alice; Aughey, Robert J
To quantify the energy expenditure of Australian Football training and matches and the total daily energy expenditure of Australian Football players using tri-axial accelerometers. Cross sectional observation study. An algorithm was developed for the MiniMax 4.0 (Catapult Innovations, Scoresby Australia) using measured oxygen uptake and accelerometer data to estimate energy expenditure of 18 Australian Football players during training and matches. The algorithm was used to validate a metabolic power calculation used by Catapult Innovations (Scoresby Australia) in their proprietary GPS software. The SenseWear™ (Model MF-SW, Bodymedia, Pittsburgh, PA) armband was used to determine non-exercise activity thermogenesis and was worn for 7 days leading into a match. Training, match and non-exercise activity thermogenesis data was summed for total daily energy expenditure. Energy expenditure for field training was estimated to be 2719±666kJ and for matches to be 5745±1468kJ. The estimated energy expenditure in the current study showed a large correlation (r=0.57, 90% CI 0.06-0.84) with the metabolic power calculation. The mean total daily energy expenditure for an in-season main training day was approximately 18,504kJ and match day approximately 19,160kJ with non-exercise activity thermogenesis contributing approximately 85% and 69% on training and match days, respectively. The MiniMax 4.0 and SenseWear™ armband accelerometers provide a practical, non-invasive and an effective method to successfully measure training and match energy expenditure, and non-exercise activity thermogenesis in field sport athletes. Taking methodological limitations into consideration, measuring energy expenditure allows for individualised nutrition programming to enhance performance and achieve body composition goals. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Barbosa, T M; Fernandes, R; Keskinen, K L; Colaço, P; Cardoso, C; Silva, J; Vilas-Boas, J P
The purpose of this study was to measure and compare the total energy expenditure of the four competitive swimming strokes. Twenty-six swimmers of international level were submitted to an incremental set of 200-m swims (5 swimmers at Breaststroke, 5 swimmers at Backstroke, 4 swimmers at Butterfly and 12 swimmers at Front Crawl). The starting velocity was approximately 0.3 m x s (-1) less than a swimmer's best performance and thereafter increased by 0.05 m x s (-1) after each swim until exhaustion. Cardio-pulmonary and gas exchange parameters were measured breath-by-breath (BxB) for each swim to analyze oxygen consumption (VO2) and other energetic parameters by portable metabolic cart (K4b(2), Cosmed, Rome, Italy). A respiratory snorkel and valve system with low hydrodynamic resistance was used to measure pulmonary ventilation and to collect breathing air samples. Blood samples from the ear lobe were collected before and after each swim to analyze blood lactate concentration (YSI 1500 L, Yellow Springs, Ohio, USA). Total energy expenditure (E(tot)), was calculated for each 200-m stage. E (tot) differed significantly between the strokes at all selected velocities. At the velocity of 1.0 m x s (-1) and of 1.2 m x s (-1) the E(tot) was significantly higher in Breaststroke than in Backstroke, in Breaststroke than in Freestyle and in Butterfly than in Freestyle. At the velocity of 1.4 m x s (-1), the E(tot) was significantly higher in Breaststroke than in Backstroke, in Backstroke than in Freestyle, in Breaststroke than in Freestyle and in Butterfly than in Freestyle. At the velocity of 1.6 m x s (-1), the E(tot) was significantly higher in Breaststroke and in Butterfly than in Freestyle. As a conclusion, E(tot) of well-trained competitive swimmers was measured over a large range of velocities utilising a new BxB technique. Freestyle was shown to be the most economic among the competitive swimming strokes, followed by the Backstroke, the Butterfly and the Breaststroke.
Blanksby, B A; Reidy, P W
Ten competitive ballroom dance couples performed simulated competitive sequences of Modern and Latin American dance. Heart rate was telemetered during the dance sequences and related to direct measures of oxygen uptake and heart rate obtained while walking on a treadmill. Linear regression was employed to estimate gross and net energy expenditures of the dance sequences. A multivariate analysis of variance with repeated measures on the dance factor was applied to the data to test for interaction and main effects on the sex and dance factors. Overall mean heart rate values for the Modern dance sequence were 170 beats.min-1 and 173 beats.min-1 for males and females respectively. During the Latin American sequence mean overall heart rate for males was 168 beats.min-1 and 177 beats.min-1 for females. Predicted mean gross values of oxygen consumption for the males were 42.8 +/- 5.7 ml.kg-1 min-1 and 42.8 +/- 6.9 ml.kg-1 min-1 for the Modern and Latin American sequences respectively. Corresponding gross estimates of oxygen consumption for the females were 34.7 +/- 3.8 ml.kg-1 min-1 and 36.1 +/- 4.1 ml.kg-1 min-1. Males were estimated to expand 54.1 +/- 8.1 kJ.min-1 of energy during the Modern sequence and 54.0 +/- 9.6 kJ.min-1 during the Latin American sequence, while predicted energy expenditure for females was 34.7 +/- 3.8 kJ.min-1 and 36.1 +/- 4.1 kJ.min-1 for Modern and Latin American dance respectively. The results suggested that both males and females were dancing at greater than 80% of their maximum oxygen consumption. A significant difference between males and females was observed for predicted gross and net values of oxygen consumption (in L.min-1 and ml.kg-1 min-1). PMID:3167503
Full Text Available There are reasons to think that key elements of a performance-based budgeting methodology have already become a part of the mechanism for public expenditure management in Ukraine. At the same time, there still remains the issue of linking budget expenditures to the specifi c results achieved by specific budget programs. This defines the necessity of applying modern approaches to managing monitoring and evaluation (M&E. This study presents an analysis of the current state of M&E in Ukrainian public expenditure program management and offers some solutions which could improve its utilization.
Getzen, T E; Poullier, J P
Data from 17 countries across 28 years are used to estimate an international health expenditure function based on real per capita GNP. Actual and expected spending levels are compared for 24 countries. Between 1960 and 1987, it has been rare for health expenditure in any country to be more than +/- 20 per cent from the projected value. The norm is for spending to rise at 1.5 times the growth rate of GDP. Two countries appear to display significant anomalies. Spending in the United Kingdom is consistently 15-25 per cent below normal for all years, and Danish expenditure has declined from 7 to 6 per cent of GDP since 1975.
Michael Adebayo Ajayi
Full Text Available The relationship between government expenditure and economic growth has been an issue of debate over the years. This study investigates the causality between government expenditure and economic growth in Nigeria between 1985 and 2014. Following the Toda-Yamamoto non-Granger causality testing approach, it finds that government expenditure and economic growth have no causal effect on each other. This offers evidence to invalidate Wagner’s law and the Keynesian proposition in Nigeria. This study recommends that government should strengthen its efforts to curtail corruption as well as introduce stricter checks and controls to reduce or eliminate the profligacy of public funds.
Full Text Available Although national dental care expenditure has not changed, the number of dental clinics has increased. Mass media has been reporting on the financial difficulties of dental clinics. To address this issue, we reviewed articles that showed the distribution and changes in net income, that is, total expenses subtracted from total income, of private dental clinics in Japan using data from a survey conducted by the Japan Dental Association. We also reviewed articles analyzing the factors relating to the net income. The results of the articles showed that distribution of net income has become positively skewed, with the mean dragged to the right by a few high scores. This means that the median is more appropriate than the mean as a measure of central tendency of net income. Factors relating to net income of private dental clinics have changed: private dental clinics that were opened after 1989 (new and had dental hygienists, who may conduct dental maintenance, had high net income, suggesting that they are well-managed or having a different type of patient mix in recent years. These analyses provide important and useful information for not only better management of private dental clinics but also policy-making in dental health care.
Geaney, Joachim T.; Treadway, Michael T.; Smillie, Luke D.
Research in motivation and emotion has been increasingly influenced by the perspective that processes underpinning the motivated approach of rewarding goals are distinct from those underpinning enjoyment during reward consummation. This distinction recently inspired the construction of the Temporal Experience of Pleasure Scale (TEPS), a self-report measure that distinguishes trait anticipatory pleasure (pre-reward feelings of desire) from consummatory pleasure (feelings of enjoyment and gratification upon reward attainment). In a university community sample (N = 97), we examined the TEPS subscales as predictors of (1) the willingness to expend effort for monetary rewards, and (2) affective responses to a pleasant mood induction procedure. Results showed that both anticipatory pleasure and a well-known trait measure of reward motivation predicted effort-expenditure for rewards when the probability of being rewarded was relatively low. Against expectations, consummatory pleasure was unrelated to induced pleasant affect. Taken together, our findings provide support for the validity of the TEPS anticipatory pleasure scale, but not the consummatory pleasure scale. PMID:26115223
Joachim T Geaney
Full Text Available Research in motivation and emotion has been increasingly influenced by the perspective that processes underpinning the motivated approach of rewarding goals are distinct from those underpinning enjoyment during reward consummation. This distinction recently inspired the construction of the Temporal Experience of Pleasure Scale (TEPS, a self-report measure that distinguishes trait anticipatory pleasure (pre-reward feelings of desire from consummatory pleasure (feelings of enjoyment and gratification upon reward attainment. In a university community sample (N = 97, we examined the TEPS subscales as predictors of (1 the willingness to expend effort for monetary rewards, and (2 affective responses to a pleasant mood induction procedure. Results showed that both anticipatory pleasure and a well-known trait measure of reward motivation predicted effort-expenditure for rewards when the probability of being rewarded was relatively low. Against expectations, consummatory pleasure was unrelated to induced pleasant affect. Taken together, our findings provide support for the validity of the TEPS anticipatory pleasure scale, but not the consummatory pleasure scale.
Fagour, C; Gonzalez, C; Suberville, C; Higueret, P; Rabemanantsoa, C; Beauvieux, M-C; Gin, H; Rigalleau, V
In type 2 diabetes (T2D), insulin-induced weight gain may stem from a reduction in resting energy expenditure (REE). We sought to determine the early effects of insulin introduction on REE in 20 poorly controlled T2D patients. After improving the glycaemia, REE was measured on Day 0 and Day 4 during two treatment regimens: bedtime insulin (n=10, group 1); and one off (3-day) intravenous insulin infusion (n=10, group 2). Both groups were similar in age, gender, BMI, C-peptide, HbA(1c) and initial REE. By Day 4, fasting glycaemia had similarly improved in both groups: group 1: -5.3+/-2.7mmol/L vs group 2: -5.8+/-4.2 mmol/L. In group 2, the second REE was measured 12h after stopping the intravenous insulin infusion, whereas subcutaneous insulin was maintained in group 1. REE did not change in group 2 (-1.3+/-6.5%), whereas it decreased significantly in group 1 (-8.0+/-7.0%; PBedtime insulin led to an early and specific reduction in REE.
Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew
In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Geaney, Joachim T; Treadway, Michael T; Smillie, Luke D
Research in motivation and emotion has been increasingly influenced by the perspective that processes underpinning the motivated approach of rewarding goals are distinct from those underpinning enjoyment during reward consummation. This distinction recently inspired the construction of the Temporal Experience of Pleasure Scale (TEPS), a self-report measure that distinguishes trait anticipatory pleasure (pre-reward feelings of desire) from consummatory pleasure (feelings of enjoyment and gratification upon reward attainment). In a university community sample (N = 97), we examined the TEPS subscales as predictors of (1) the willingness to expend effort for monetary rewards, and (2) affective responses to a pleasant mood induction procedure. Results showed that both anticipatory pleasure and a well-known trait measure of reward motivation predicted effort-expenditure for rewards when the probability of being rewarded was relatively low. Against expectations, consummatory pleasure was unrelated to induced pleasant affect. Taken together, our findings provide support for the validity of the TEPS anticipatory pleasure scale, but not the consummatory pleasure scale.
Massidda, Myosotis; Cugusi, Lucia; Ibba, Maurizio; Tradori, Iosto; Calò, Carla Maria
The aims of this study were to estimate the energy expenditure (EE) and the intensity of physical activity (PA) during a competitive simulation of Latin American dancing and to evaluate the differences in PA and EE values between the sexes, between different dance types, and between the various phases of the competition. Ten Italian dancers (five couples, 5 males and 5 females) competing in Latin American dancing at the international level were examined in this study. The EE (kcal) was measured during the semifinal and final phases of the competition using the SenseWear Pro Armband (SWA). Paired-sample t-tests were used to determine differences in the metabolic equivalent (MET) and EE values between the semifinal and final phases and between each dance. One-way analysis of variance was used to analyze the differences in the MET and EE values between the sexes. The intensity of PA during the dance sequence ranged from moderate (3 to 6 METs) to vigorous (6 to 9 METs). The male dancers had higher EE values than the female dancers during all phases of the simulation. Similar MET values were observed in both sexes. The PA intensity during the finals phase was vigorous for 56% of the time of dance. Of all the dance styles, the rumba had the lowest MET and EE values. Our results demonstrate that competitive Latin American dancing is a heavy exercise and suggest that monitoring variables during normal training can improve training protocols and the dancers' fitness levels.
Berger, Irit; Weintraub, Valentin; Dollberg, Shaul; Kopolovitz, Rozalia; Mandel, Dror
We hypothesized that resting energy expenditure (REE) would be higher after breastfeeding than after bottle-feeding. Nineteen preterm infants (gestational age: 32 weeks) in stable condition who were nourished entirely with their mothers' breast milk were assigned randomly to feeding either by bottle or at the breast. Each infant served as his or her own control subject. REE was measured for 20 minutes after feeding. Breast milk quantity was evaluated with prefeeding and postfeeding weighing. REE values for bottle-feeding and breastfeeding were compared with paired t tests. Contrary to our null hypothesis, the group's mean REE values after bottle-feeding and breastfeeding were very similar (284.7 +/- 26.8 kJ/kg per day [68.3 +/- 6.4 kcal/kg per day] vs 282.6 +/- 28.5 kJ/kg per day [67.5 +/- 6.8 kcal/kg per day]; not significant). The duration of feeding was significantly longer for breastfeeding than for bottle-feeding (20.1 +/- 7.9 vs 7.8 +/- 2.9 minutes; P bottle-fed. Longer feeding times at the breast did not increase REE. We speculate that it is safe to recommend feeding at the breast for infants born at >32 weeks when they can tolerate oral feeding.
Swistak, Piotr; Błońska-Fajfrowska, Barbara
The general purpose of the study, carried out in the group of pensioners was to determine the relation between drug prices, household income and amounts of money spent on drugs in the years 1997-2000. The study was based on representative data gathered from annual household budgets review by Polish Statistical Office and data from pharmaceutical market published in 'Vitamina C++' magazine. The used method combined descriptive, comparative, table-descriptive analysis with graphical analysis. During studied period the real value of expenses on drugs in pensioners' households rose by 39.3% and available income decreased by 5.8%. Increased expenses on drugs caused the rise of the proportion of on spending on drugs in total household expenditure. It rose from 3.9% in 1997 to 5.2% in 2000. Throughout this time period the drug prices increased in real terms: the highest growth (approx. 49%) was noticed in patients' co-payment to reimbursed drugs. Despite rise in spending on drugs, due to the increase in drug retail prices and increasing patients co-payment, pensioners in comparison with 1997, could buy only approx. 93% units of reimbursed drugs in 2000. The possibility of buying drugs within OTC group increased by 18%.
Hongu, Nobuko; Orr, Barron J; Roe, Denise J; Reed, Rebecca G; Going, Scott B
Global positioning system (GPS) watches have been introduced commercially, converting frequent measurements of time, location, speed (pace), and elevation into energy expenditure (EE) estimates. The purpose of this study was to compare EE estimates of 4 different GPS watches (Forerunner, Suunto, Polar, Adeo), at various walking speeds, with EE estimate from a triaxial accelerometer (RT3), which was used as a reference measure in this study. Sixteen healthy young adults completed the study. Participants wore 4 different GPS watches and an RT3 accelerometer and walked at 6-minute intervals on an outdoor track at 3 speeds (3, 5, and 7 km/hr). The statistical significance of differences in EE between the 3 watches was assessed using linear contrasts of the coefficients from the overall model. Reliability across trials for a given device was assessed using intraclass correlation coefficients as estimated in the mixed model. The GPS watches demonstrated lower reliability (intraclass correlation coefficient) across trials when compared with the RT3, particularly at the higher speed, 7 km/hr. Three GPS watches (Forerunner, Polar, and Suunto) significantly and consistently underestimated EE compared with the reference EE given by the RT3 accelerometer (average mean difference: Garmin, -50.5%; Polar, -41.7%; and Suunto, -41.7%; all p < 0.001). Results suggested that caution should be exercised when using commercial GPS watches to estimate EE in athletes during field-based testing and training.
Chen, Danhong; Jaenicke, Edward C; Volpe, Richard J
To examine the associations between obesity and multiple aspects of the food environments, at home and in the neighborhood. Our study included 38,650 individuals nested in 18,381 households located in 2104 US counties. Our novel home food environment measure, USDAScore, evaluated the adherence of a household's monthly expenditure shares of 24 aggregated food categories to the recommended values based on US Department of Agriculture food plans. The US Census Bureau's County Business Patterns (2008), the detailed food purchase information in the IRi Consumer Panel scanner data (2008-2012), and its associated MedProfiler data set (2012) constituted the main sources for neighborhood-, household-, and individual-level data, respectively. After we controlled for a number of confounders at the individual, household, and neighborhood levels, USDAScore was negatively linked with obesity status, and a census tract-level indicator of food desert status was positively associated with obesity status. Neighborhood food environment factors, such as food desert status, were associated with obesity status even after we controlled for home food environment factors.
Souliotis, Kyriakos; Papageorgiou, Manto; Politi, Anastasia; Frangos, Nikolaos; Tountas, Yiannis
... branch to the country's economy. In the second part, we perform a quantitative analysis for the estimation of multiplier effects of public pharmaceutical expenditure reduction on main revenue sources, such as taxes...
Smith, Lee; Ekelund, Ulf; Hamer, Mark
Previous work has shown prospective associations between total daily physical activity energy expenditure and various health outcomes including metabolic risk. Limited evidence is available on the health benefits of standing and light-intensity activity. Therefore, these behaviours are not supported in contemporary physical activity guidelines. Moreover, people may be more willing to replace sedentary activities with standing or light activities that can be incorporated into their daily lives, rather than activities of moderate intensity, as there are fewer potential barriers. With the rapid advancement of objective physical activity monitoring there is now potential to explore total daily physical activity energy expenditure in more depth. This article highlights the need for further research into all areas of total daily physical activity energy expenditure, in particular standing and light-intensity activities. Future physical activity guidelines may benefit from the inclusion of recommendations on physical activity energy expenditure rather than solely focusing on activities of a moderate or vigorous intensity.
Rieken, Rob; van Goudoever, Johannes B.; Schierbeek, Henk; Willemsen, Sten P.; Calis, Elsbeth A. C.; Tibboel, Dick; Evenhuis, Heleen M.; Penning, Corine
Accurate prediction equations for estimating body composition and total energy expenditure (TEE) in children with severe neurologic impairment and intellectual disability are currently lacking. The objective was to develop group-specific equations to predict body composition by using
National Oceanic and Atmospheric Administration, Department of Commerce — This is a time-series dataset of trip expenditure data including actual fishing trip expenses, input usage, and input prices, for boat-based reef fish, bottomfish,...
Full Text Available The welfare state that had become stronger gradually in the post-2nd World War has been in the process of restructuring after the 1980 period as a result of globalisation and neo-liberal policies. Social welfare state has had responsibilities in different fields ranging from health to education and from social security to poverty reduction. In Turkey, the education expenditures may be accepted as social expenditures contributing to general social welfare of the society. The goal of this study is to explain the social welfare state briefly, to review the methodological approaches to social expenditures in the context of the social welfare state, and to examine and compare the level of education expenditures in Turkey and some other countries.
van den Putte, B.
Three main factors determine the effect of advertising campaigns: message content strategy, advertising expenditure and previous consumer behaviour. This study investigates the relative strength of each of these influences. Four possible campaign targets are taken into account: campaign recall,
van der Windt, D A; Pieterson, I; van der Eijken, J W; Hollander, A P; Dahmen, R; de Jong, B A
The surgical treatment of osteosarcoma with a tibial rotationplasty seems to offer functional advantages in comparison with an above-knee amputation. It has not been established whether the functional advantages are accompanied by a lower rate of energy expenditure during walking. In children with a tibial rotationplasty (n = 15), an above-knee amputation (n = 6), or a hip disarticulation (n = 5), energy expenditure was measured during treadmill walking at various walking velocities. The subjects with a tibial rotationplasty were able to walk faster, but there were no differences between the groups in energy expenditure per unit time or per unit distance. Correction for confounding variables including age, sex, height, time since operation, level of activity, and support during walking in a multiple linear regression model did not reveal any significant differences in energy expenditure during walking between groups. 1992 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.
Raval, Amit D; Shah, Anal
Migraine is a common neurological disorder with significant economic burden in the United States. However, changes in the economic burden of migraine in the past decade have not been examined considering therapeutic advances at the national level. Therefore, we estimated cross-sectional trends in the incremental total and types of direct health care expenditures among individuals with migraine using nationally representative data, the Medical Expenditures Panel Survey. The analytic sample was comprised of an annually weighted population of 228,010,000 adults aged 18 years and older from 2004 to 2013. Two-part models were used to estimate the incremental total and types of annual direct health care expenditures (adjusted to 2013 US dollars) among individuals with migraine after adjusting for predisposing, enabling, need, personal health practice, and external environment factors selected on the basis of the Anderson Healthcare Behavior Model. The unadjusted average annual total health care expenditure for individuals with migraine was $8,033 (standard error [SE] = $292) which comprised major proportions of outpatient ($2,952, SE = $128), prescription drugs ($2,207, SE = $91), and inpatient ($1,784, SE = $178) expenditures. Individuals with migraine had $866 (SE = $298) and $1,519 (SE = $400) greater adjusted annual total direct health care expenditures in 2004/2005 and 2012/2013 compared with those without migraine. However, those with migraine in 2012/2013 did not have significant changes in the total direct health care expenditures compared with those having migraine in 2004/2005 (changes: -$330, SE = $480). The estimated adjusted incremental total direct health care expenditures for individuals with migraine was approximately $9.20 billion per year compared with those without migraine. Although annual incremental total direct health care expenditures among individuals with migraine did not change significantly from 2004 to 2013, expenditures
Full Text Available The article is devoted to expenditure rules related to government budget, specified in Public Finance Act. The object of analysis is the legal con-struction and functioning of expenditure rules. The article tries to respond on a question of effectiveness of these restrictions of conduct of budgetary policy. The analysis covers the rules in articles 112a–112d and 86 of Public Finance Act.
Eto, Eriko; Maki, Jota; Tamada, Shoko; Mitsui, Takashi; Hayata, Kei; Hiramatsu, Yuji; Masuyama, Hisashi
To measure longitudinal changes in resting energy expenditure and body composition of Japanese pregnant women with or without diabetes. The study population consisted of women who had delivered a live singleton neonate after 22 weeks' gestation at Okayama University Hospital from July 2013 to June 2017. Resting energy expenditure and body composition were measured in the first trimester, second trimester, third trimester and postpartum. A total of 144 women participated in this study: 103 with normal glucose tolerance and 41 with diabetes. The resting energy expenditure (kcal/day) of pregnant women with normal glucose tolerance was significantly higher in the third trimester (1,644 ± 234) than in the first (1,461 ± 215) and second trimesters (1,491 ± 219), and postpartum (1,419 ± 254), whereas that of pregnant women with diabetes did not significantly change during all periods (1,568 ± 404, 1,710 ± 332, 1,716 ± 251, 1,567 ± 249). The resting energy expenditure of women with good glycemic control was lower than that of women with poor control. Fat-free mass was closely correlated with resting energy expenditure. The resting energy expenditure of Japanese pregnant women with normal glucose tolerance was significantly increased in the third trimester. The resting energy expenditure of women with good glycemic control was lower than that of women with poor control. Resting energy expenditure and fat-free mass are potential indexes for medical nutrition therapy in pregnant women with diabetes. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Canabrava, Karina L. R.; Faria, Fernanda R.; de Lima, Jorge R. P.; Guedes, Dartagnan P.; Amorim, Paulo R. S.
Purpose: This study aimed to compare the energy expenditure and intensity of active video games to that of treadmill walking in children and adolescents. Method: Seventy-two boys and girls (aged 8-13 years) were recruited from local public schools. Energy expenditure and heart rate were measured during rest, during 3-km/hr, 4-km/hr, and 5-km/hr…
The key to deciphering China’s military strategy and intent is to analyze the patterns and trends in military expenditures. It is important to fathom whether the Chinese plan is to develop a military that is personnel centric or whether they will build a military that is technology centric and expect to see significant reductions or reduced accelerations in the number of personnel that are employed. Understanding changes in personnel expenditures is one element in understanding th...
Da, Wa; Xiao, Hong; Zhuo, Ma
We use the regression analysis method of multivariate statistical analysis to establish a multiple linear regression model about the net income and consumption expenditure of Chinese rural households during the year 2007. This paper analyzes the internal relation between the net income and consumption expenditure of Chinese rural households according to the regression result. Some reasonable suggestions are put forward for raising the income of rural households and stimulating consumption.
Bruna Camilo Turi
Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. DESIGN AND SETTING: Cross-sectional study conducted in five primary care units in Bauru (SP, Brazil. METHODS: Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. RESULTS: The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests. Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01, hypertension (OR = 3.04; 95% CI: 1.91-4.82 and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81. Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47 and female sex (OR = 1.70; 95% CI: 1.14-2.55. CONCLUSIONS: Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.
Current Research on Peace and Violence, vol. XIII, no. 1, 1990. Refereed Journal Article The question of Middle East military expenditures is probably most frequently raised in an international context, relative to such problems or potential problems as the Arab-Israeli dispute pr territorial sovereignty in the Horn of Africa When and if any attention is given to the domestic significance of military expenditures, it tends to focus on the general concerns for the un...
Ardanaz, Martin; Maldonado, Stanislao
We study the role of natural resource windfalls in explaining the efficiency of public expenditures. Using a rich dataset of expenditures and public good provision for 1,836 municipalities in Peru for period 2001-2010, we estimate a non-monotonic relationship between the efficiency of public good provision and the level of natural resource transfers. Local governments that were extremely favored by the boom of mineral prices were more efficient in using fiscal windfalls whereas those benefite...
Shmueli, Amir; Israeli, Avi
Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted). We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.
van den Heuvel, Wim J A; Olaroiu, Marinela
The relationship between health care expenditures and health care outcomes, such as life expectancy and mortality, is complex. Research outcomes show different and contradictory results on this relationship. How and why health care expenditures affect health outcomes is not clear. A causal link between the two is not proven. Without such knowledge, effects of increase/decrease in health care expenses on health outcomes may be overestimated/underestimated. This study analyzes the relationship between life expectancy at birth and expenditures on health care, taking into account expenditures of social production and education, as well as the quantity and quality of health care provisions and lifestyles. This is a cross-sectional study, analyzing national data of 31 European countries. First, the bivariate correlation between the dependent variable and independent variables are calculated and described. Next a forward linear regression analysis is applied. The data are derived from standardized, comparative data bases as available in the Organisation for Economic Co-operation and Development and Eurostat. Health care expenditures are assessed as a percentage of the Gross Domestic Product (GDP). Health care expenditures are not the main determinant of life expectancy at birth, but social protection expenditures are. The regression analysis shows that in countries that spend a high percentage of their GDP on social protection, that have fewer curative beds and low infant mortality, whose citizens report fewer unmet health care needs and drink less alcohol, citizens have a significant longer life expectancy. To realize high life expectancy of citizens, policy measures have to be directed on investment in social protection expenditures, on improving quality of care, and on promoting a healthy life style. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Elliott, Kyle H.; Le Vaillant, Maryline; Kato, Akiko; Speakman, John R; Ropert-Coudert, Yan
Animal ecology is shaped by energy costs, yet it is difficult to measure fine-scale energy expenditure in the wild. Because metabolism is often closely correlated with mechanical work, accelerometers have the potential to provide detailed information on energy expenditure of wild animals over fine temporal scales. Nonetheless, accelerometry needs to be validated on wild animals, especially across different locomotory modes. We merged data collected on 20 thick-billed murres (Uria lomvia) from...
Jo, Jeong-Sook; Kim, Young-Man; Paek, Kyung Won; Bea, Min Hee; Chun, Kihong; Lee, Soojin
Purpose Rapid growth of prescription drug expenditures is a problem in South Korea. The objective of this study was to assess the contributions of four variables (therapeutic choice, drug-mix, original use, and price changes) to increases in drug expenditures paid by the National Health Insurance (NHI) in Korea. Materials and Methods A retrospective cohort study was conducted between January 1, 2008 and June 30, 2012 utilizing data from the NHI Claims Database of the Health Insurance Review a...
Zhang, Donglan; Wang, Guijing; Zhang, Ping; Fang, Jing; Ayala, Carma
Trends of prevalence, treatment, and control of hypertension have been documented in the U.S., but changes in medical expenditures associated with hypertension over time have not been evaluated. This study analyzed these expenditures during 2000-2013 among U.S. adults. Data from the Medical Expenditure Panel Survey were analyzed in 2016. The study population was non-institutionalized men and non-pregnant women aged ≥18 years. Hypertension was defined as ever been diagnosed with hypertension or currently taking antihypertensive medications. Medical expenditures included all payments to medical care providers. Expenditures associated with hypertension were estimated by two-part regression models and adjusted into 2015 U.S. dollars. Controlling variables included sociodemographic characteristics, marital status, insurance, region, smoking status, weight status, health status, and comorbidities. Trends were analyzed using joinpoint method. Total per-person annual expenditures associated with hypertension in 2000-2001 ($1,399) were not significantly different from those in 2012-2013 ($1,494) (average annual percent change [AAPC]= -0.6%, p=0.794), but annual national spending increased significantly from $58.7 billion to $109.1 billion (AAPC=8.3%, p=0.015), mainly because of the increase in the number of people treated for hypertension. Per-person outpatient payments were 22.7% higher in 2012-2013 than in 2000-2001 ($416 vs $322, p<0.05; AAPC=0.8%, p-trend=0.826). Payments for prescription medications took up a larger proportion of the medical expenditures associated with hypertension, compared to payments for outpatient or other services (33%-46%). During 2000-2013, annual national medical expenditures associated with hypertension increased significantly. Preventing hypertension could alleviate hypertension-associated economic burden. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.
Full Text Available Abstract Background Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. Objectives To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. Methods We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted. We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. Results While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Conclusions Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.
Stockhammer,Engelbert; Wildauer, Rafael
The past decades have witnessed a strong increase in household debt and high growth of private consumption expenditures in many countries. This paper empirically investigates four explanations: First, the expenditure cascades hypothesis argues that an increase in inequality induced lower income groups to copy the spending behaviour of richer peer groups and thereby drove them into debt (‘keeping up with the Joneses’). Second, the housing boom hypothesis argues that increasing property prices ...
Kim, Annice E; Arnold, Kristin Y; Makarenko, Olga
Electronic cigarettes (e-cigarettes) are growing in popularity, but little is known about the extent to which these products are advertised to consumers. To estimate expenditures for e-cigarette advertising in magazines, TV, the Internet, newspapers, and radio in the U.S. from 2011 to 2012. E-cigarette advertising data were obtained from leading media intelligence companies, Kantar Media and Nielsen. Estimated e-cigarette advertising expenditures were summarized across media channels for 2011 and 2012. Additional information on brands advertised and market-level buys (i.e., local versus national) also was examined. Overall, e-cigarette advertising expenditures across media channels tripled from $6.4 million in 2011 to $18.3 million in 2012. Expenditures were highest in magazines and TV and lowest in newspapers and on the Internet. More than 80 unique brands were advertised, but blu eCigs dominated ad spending, comprising 76.7% of all e-cigarette advertising expenditures in 2012. National markets were increasingly targeted from 54.9% of ad buys in 2011 to 87.0% of ad buys in 2012. E-cigarette advertising expenditures are increasing, with a greater focus on national markets and TV ads, which will likely increase consumer awareness and use of e-cigarettes in the future. Federal-level efforts are needed to mandate that e-cigarette companies report their advertising expenditures. Future studies should examine how e-cigarette advertising expenditures and message content influence consumer awareness of, interest in, and use of e-cigarettes. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.
Lorenz, Christian; Khalid, Muhammad
Since May 2009 the first National Health Accounts (NHA) for Pakistan have been finalised and published by Federal Bureau of Statistics (FBS) in cooperation with German Technical Cooperation (GTZ). This paper goes one step ahead of the report and analyses in more detail the regional differences in health expenditure structures in Pakistan. The further analyses can be divided into four parts: health expenditures in provinces (Provincial Health Accounts, PHA), Punjab provincial and district governments health expenditures and its comparison with ADB figures, all districts of Pakistan and comparison between total district government and provincial government expenditure for each province; the latter calculation is applied as indication for the degree of fiscal autonomy of the districts in each province. Consequently, first the provincial health expenditures by Financial Agents is analysed and compared between the provinces which leads to very heterogeneous results (section 2); the per capita health expenditures differ from 16 to 23 USD. Secondly, NHA results on Punjab district government are compared with available ADB results and differences in methods as possible reasons for different results are presented (section 3). Third, district data of all district governments in all four Pakistani provinces are analysed on the level of detailed function codes in section 4; the aim is to discover regional differences between districts of the same as well as of different provinces. Fourth, in section 5 the degree of fiscal autonomy on health of the districts in each province is analysed; therefore the ordinance description is reviewed and total district government with total provincial government expenditures are compared per province. Finally recommendations for future rounds of NHA in Pakistan are given regarding formats and necessities of detailed health expenditure data collection to ensure evidence based decision making not only on federal, but also on provincial and
Full Text Available Background: Expenditure on healthcare has become a persistent issue of policymaking at both national and international levels. The aim of this study was to investigate the main factors affecting household healthcare expenditures in Kermanshah province by Econometric ARDL model over 20 years (1991-2011. Methods: This retrospective-analytical study investigated the impact of such variables as per capita income, proportion of population aged >65 years, number of physicians and urbanization rate on healthcare expenditures. These data were obtained from the yearbook of Kermanshah province and Iranian Statistical center (ISC. The data analysis was done by Stata 12 and Microfit 4.1 software. Results: The results showed a positively significant relationships both in short- and long-run, between healthcare expenditures and per capita income, number of physicians and urbanization rate. Also, no significant correlation was observed between the proportion of the population aged 65 years and above and healthcare expenditures both in short-term and long-term. Conclusion: The findings showed the elasticity of income was less than 1 and healthcare was an essential goods in Kermanshah province during the study period. Because the impact of variables could be different in different areas and during the time, the healthcare expenditures and its determinants are suggested to be evaluated over time.
Montalcini, Tiziana; De Bonis, Daniele; Ferro, Yvelise; Carè, Ilaria; Mazza, Elisa; Accattato, Francesca; Greco, Marta; Foti, Daniela; Romeo, Stefano; Gulletta, Elio; Pujia, Arturo
It has been demonstrated that a vegetarian diet may be effective in reducing body weight, however, the underlying mechanisms are not entirely clear. We investigated whether there is a difference in resting energy expenditure between 26 vegetarians and 26 non-vegetarians and the correlation between some nutritional factors and inflammatory markers with resting energy expenditure. In this cross-sectional study, vegetarians and non-vegetarians were matched by age, body mass index and gender. All underwent instrumental examinations to assess the difference in body composition, nutrient intake and resting energy expenditure. Biochemical analyses and 12 different cytokines and growth factors were measured as an index of inflammatory state. A higher resting energy expenditure was found in vegetarians than in non-vegetarians (p = 0.008). Furthermore, a higher energy from diet, fibre, vegetable fats intake and interleukin-β (IL-1β) was found between the groups. In the univariate and multivariable analysis, resting energy expenditure was associated with vegetarian diet, free-fat mass and vegetable fats (p vegetarian's diet, i.e., vegetable fats. Furthermore, we showed that IL-10 was positively associated with resting energy expenditure in this population.
James M Lightwood
Full Text Available Large state tobacco control programs have been shown to reduce smoking and would be expected to affect health care costs. We investigate the effect of California's large-scale tobacco control program on aggregate personal health care expenditures in the state.Cointegrating regressions were used to predict (1 the difference in per capita cigarette consumption between California and 38 control states as a function of the difference in cumulative expenditures of the California and control state tobacco control programs, and (2 the relationship between the difference in cigarette consumption and the difference in per capita personal health expenditures between the control states and California between 1980 and 2004. Between 1989 (when it started and 2004, the California program was associated with $86 billion (2004 US dollars (95% confidence interval [CI] $28 billion to $151 billion lower health care expenditures than would have been expected without the program. This reduction grew over time, reaching 7.3% (95% CI 2.7%-12.1% of total health care expenditures in 2004.A strong tobacco control program is not only associated with reduced smoking, but also with reductions in health care expenditures.
Sanguanrungsirikul, S; Somboonwong, J; Nakhnahup, C; Pruksananonda, C
The objective of this study was to assess the energy expenditure and physical activity in obese (n=21) and non-obese (n=21) children (aged 9-12 years) in Bangkok. Anthropometric measurements were performed. Energy expenditure and physical activity were determined by indirect calorimetry (based on oxygen consumption) and the heart rate monitoring method. Physical activity index was calculated by the ratio of total energy expenditure (TEE) to sedentary energy expenditure (SEE). The results showed that obese children had significantly greater (penergy expenditure (AEE) were higher (penergy production. Both obese and non-obese children were similar in the physical activity index level of 1.48+/-0.17 and 1.51+/-0.22, respectively, which was lower than that recommended by the World Health Organization (1.7). In conclusion, energy expenditure of obese children was higher than non-obese children because of greater body weight. Furthermore, the physical activity of both groups was lower than that recommended by WHO. To prevent obesity in children, programmimg of exercise and activities as well as nutritional education should be emphasized for school children and parents.
Hatam, Nahid; Tourani, Sogand; Homaie Rad, Enayatollah; Bastani, Peivand
Increasing knowledge of people about health leads to raising the share of health expenditures in government budget continuously; although governors do not like this rise because of budget limitations. This study aimed to find the association between health expenditures and economic growth in ECO countries. We added health capital in Solow model and used the panel cointegration approach to show the importance of health expenditures in economic growth. For estimating the model, first we used Pesaran cross-sectional dependency test, after that we used Pesaran CADF unit root test, and then we used Westerlund panel cointegration test to show if there is a long-term association between variables or not. After that, we used chaw test, Breusch-Pagan test and Hausman test to find the form of the model. Finally, we used OLS estimator for panel data. Findings showed that there is a positive, strong association between health expenditures and economic growth in ECO countries. If governments increase investing in health, the total production of the country will be increased, so health expenditures are considered as an investing good. The effects of health expenditures in developing countries must be higher than those in developed countries. Such studies can help policy makers to make long-term decisions.
How to manage energy expenditure for cyclist is very crucial part to achieve a good performance. As the tropical situation, the differences of temperature level might be contributed in energy expenditure and durability. The aim of the paper is to estimate and to analysis the configuration of energy expenditure for static cycling activity based on heart rate value in room with air conditioning (AC)/no AC treatment. The research is started with study literatures of climate factors, temperature impact on human body, and definition of energy expenditure. The next step is design the experiment for 5 participants in 2 difference models for 26.80C - 74% relative humidity (room no AC) and 23,80C - 54.8% relative humidity (room with AC). The participants’ heart rate and blood pressure are measured in rest condition and in cycling condition to know the impact of difference temperature in energy expenditure profile. According to the experiment results, the reducing of the temperature has significantly impact on the decreasing of energy expenditure at average 0.3 Kcal/minute for all 5 performers. Finally, the research shows that climate condition (temperature and relative humidity) are very important factors to manage and to reach a higher performance of cycling sport.
Elliott, Kyle H; Le Vaillant, Maryline; Kato, Akiko; Speakman, John R; Ropert-Coudert, Yan
Animal ecology is shaped by energy costs, yet it is difficult to measure fine-scale energy expenditure in the wild. Because metabolism is often closely correlated with mechanical work, accelerometers have the potential to provide detailed information on energy expenditure of wild animals over fine temporal scales. Nonetheless, accelerometry needs to be validated on wild animals, especially across different locomotory modes. We merged data collected on 20 thick-billed murres (Uria lomvia) from miniature accelerometers with measurements of daily energy expenditure over 24 h using doubly labelled water. Across three different locomotory modes (swimming, flying and movement on land), dynamic body acceleration was a good predictor of daily energy expenditure as measured independently by doubly labelled water (R(2) = 0.73). The most parsimonious model suggested that different equations were needed to predict energy expenditure from accelerometry for flying than for surface swimming or activity on land (R(2) = 0.81). Our results demonstrate that accelerometers can provide an accurate integrated measure of energy expenditure in wild animals using many different locomotory modes.
Divino, Victoria; DeKoven, Mitch; Kleinrock, Michael; Wade, Rolin L; Kaura, Satyin
The Orphan Drug Act of 1983 established incentives for the development of drugs that treat rare, or orphan, diseases. We used the IMS Health MIDAS database of audited biopharmaceutical sales to measure US annual spending on orphan drugs in the period 2007-13, and we estimated spending on the drugs for the period 2014-18. We identified 356 brand-name orphan drugs that were approved by the Food and Drug Administration in the period 1983-2013. While we included orphan drugs with both orphan and other indications, we adjusted spending to include only spending for orphan indications. In 2014 dollars, expenditures on orphan drugs totaled $15 billion in 2007 and $30 billion in 2013-representing 4.8 percent and 8.9 percent of total pharmaceutical expenditures, respectively. Our future trend analysis for the period 2014-18 suggests a slowing in the growth of orphan drug expenditures. The overall impact of orphan drugs on payers' drug budgets is relatively small, and spending on orphan drugs as a percentage of total pharmaceutical expenditures has remained fairly stable. Concerns that growth in orphan drug expenditures may lead to unsustainable drug expenditures do not appear to be justified. Project HOPE—The People-to-People Health Foundation, Inc.
Masood, Mohd; Sheiham, Aubrey; Bernabé, Eduardo
This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries) who participated in the WHO World Health Survey (WHS) were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE) in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries. PMID:25923691
Full Text Available This paper examines the determinants of ICT expenditures in 17 OECD countries, including the Czech Republic, looking at Household Expenditures Surveys data. Previous OECD work has shown that average ICT expenditures vary with the gender and the educational attainments of the family head and with the lifecycle and the income of the household. Average data, however, hide the interactions among these factors that occur at the level of households. In order to control for these interactions, this paper analyses the determinants ofICT expenditures based on the household-level data (micro data.Using a double-hurdle model (a probit model to estimate whether a consumer will spend on a certain good or service or not, followed by a truncated regression model that estimates how much to spend on that good or service applied on micro data collected by households budget surveys from 16 OECD countries, the paper analyses the effects of determinants on ICT expenditures. The paper shows that the effects of various determinants between communication services and information technology goods are markedly different. Some determinants,in particular income and presence of children, have significant and relatively similar effects, at the level of more elementary expenditures components (IT goods, IT services, communication goods and communication services. It also shows that the effects of other determinants (such as education level, geographical area, age, or lifecycle stage are less similar across countries or between ICT goods and services.
Botton, Florent; Hautier, Christophe; Eclache, Jean-Paul
The aim of this study was to estimate, using video analysis, what proportion of the total energy expenditure during a tennis match is accounted for by aerobic and anaerobic metabolism, respectively. The method proposed involved estimating the metabolic power (MP) of 5 activities, which are inherent to tennis: walking, running, hitting the ball, serving, and sitting down to rest. The energy expenditure concerned was calculated by sequencing the activity by video analysis. A bioenergetic model calculated the aerobic energy expenditure (EEO2mod) in terms of MP, and the anaerobic energy expenditure was calculated by subtracting this (MP - EEO2mod). Eight tennis players took part in the experiment as subjects (mean ± SD: age 25.2 ± 1.9 years, weight 79.3 ± 10.8 kg, VO2max 54.4 ± 5.1 ml·kg(-1)·min(-1)). The players started off by participating in 2 games while wearing the K4b2, with their activity profile measured by the video analysis system, and then by playing a set without equipment but with video analysis. There was no significant difference between calculated and measured oxygen consumptions over the 16 games (p = 0.763), and these data were strongly related (r = 0.93, p method provided a good estimation of aerobic energy expenditure and made it possible to calculate the anaerobic energy expenditure. This could make it possible to estimate the metabolic intensity of training sessions and matches using video analysis.
Lau, Josephine S.; Adams, Sally H.; Boscardin, W. John; Irwin, Charles E.
Purpose Examine young adults' health care utilization and expenditures prior to the ACA. Methods We used 2009 Medical Expenditure Panel Survey (MEPS) to 1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and 2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other socio-demographic factors, including race/ethnicity and income. Results Young adults had: 1) significantly lower rates of overall utilization (72%) than other age groups (83-88%, Padults had high out-of-pocket expenses. Compared to the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/ person, Padults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language and sex. Conclusions Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of ER visits. The ACA provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address non-insurance barriers and ensure equal access to health services. PMID:24702839
Lee, Sungkyu; Rothbard, Aileen; Choi, Sunha
Little is known about the incremental cost burden associated with treating comorbid health conditions among people with severe mental illness (SMI). This study compares the extent to which each individual medical condition increases healthcare expenditures between people with SMI and people without mental illness. Data were obtained from the 2011 Medical Expenditure Panel Survey (MEPS; N = 17 764). Mental illness and physical health conditions were identified through ICD-9 codes. Guided by the Andersen's behavioral model of health services utilization, generalized linear models were conducted. Total healthcare expenditures among individuals with SMI were approximately 3.3 times greater than expenditures by individuals without mental illness ($11 399 vs. $3449, respectively). Each additional physical health condition increased the total healthcare expenditure by 17.4% for individuals with SMI compared to the 44.8% increase for individuals without mental illness. The cost effect of having additional health conditions on the total healthcare expenditures among individuals with SMI is smaller than those individuals without mental illness. Whether this is due to limited access to healthcare for the medical problems or better coordination between medical and mental health providers, which reduces duplicated medical procedures or visits, requires future investigation.
Tseng, Chung-Kang; Hsu, Hua-Shui; Ho, Chih-Te; Huang, Hui-Ying; Liu, Chiu-Shong; Lin, Cheng-Chieh; Lin, Wen-Yuan
To examine the accuracy of present resting energy expenditure (REE) predictive equations among obese adult Taiwanese, and obtain new predictive equations for this population. A total of 80 participants (men = 42, women = 38) aged 18-64 years (mean 41.5 ± 13.1 years) with body mass index (BMI) ≥30 kg/m(2) were recruited from obesity clinic of a tertiary hospital. Anthropometric data including weight, height, waist circumference (WC), hip circumference (HipC) were collected. Body fat and fat free mass (FFM) were measured using bioelectric impedance analysis. Indirect calorimeter (Vmax 29n) was used for measurement of REE. The commonly used predictive equations (Harris-Benedict equation, Bernstein equation, Mifflin equation, Owen equation, Schofield equation, Cunningham equation, Wang equation, and Liu equation) were tested for group means and individual prediction accuracy for our target population. New predictive equations were formulated using multiple linear regression analyses. The mean BMI was 34.3 ± 4.6 kg/m(2). All of the commonly used predictive equations showed statistically significant differences with the measured REE values. As for individual prediction accuracy, these predictive equations showed poor performance and only Mifflin equation provided an individual accuracy over 40%. The new predictive equation recommended for obese adult Taiwanese is below: REE (kcal/d) = 11.6 × weight (kg) - 204.84 × gender - 4.8 × height (cm) + 1594.6 (gender: men = 1; women = 2). The previous commonly used predictive equations were less accurate in obese Taiwanese. For this specific population, the newly developed equation should be applied for better prediction of REE. Â© 2011 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.
Ellis, Amy C; Rosenfeld, Jeffrey
The purpose of this study was to compare measured resting energy expenditure (REE) with estimates from three common prediction equations with the goal of determining which equation best estimates REE in amyotrophic lateral sclerosis (ALS). Cross-sectional measurements of REE from indirect calorimetry were compared to calculations from the Harris Benedict, Mifflin-St Jeor, and Ireton-Jones equations. Additional measurements to identify predictors of REE included pulmonary function tests, fat-free mass by bioelectrical impedance, and anthropometrics. Participants were 56 men and women with ALS. For comparison, subjects were categorized by disease progression into three groups. Pearson correlations and paired t tests were used to compare measured REE with predicted REE from each equation, and the accuracy of each equation was quantified by the root mean squared prediction error and the percentage of REE estimates within 10% of measured values. Bias for each equation was calculated as the mean percentage difference between calculated and measured REE. Multiple linear regression was used to determine the best predictor variables for REE. Across the disease spectrum, the Harris Benedict and Mifflin-St Jeor equations provided clinically acceptable estimates of REE, whereas the Ireton-Jones equations consistently overestimated REE. The best predictors of REE among this cohort were fat-free mass, sex, and age. When estimating energy requirements for patients with ALS, clinicians should choose prediction equations that incorporate sex and age as predictor variables, such as the Harris Benedict and Mifflin-St Jeor equations. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
Da Silva, Rodrigo Lavinas; Brentano, Michel Arias; Kruel, Luiz Fernando Martins
Although many studies have demonstrated the efficacy of strength training in increasing energetic expenditure (EE) both during and after training sessions, there are no studies available that analyze the influence on EE of the order in which exercises are performed. Accordingly, the objective of this study was to verify whether the order in which exercises are performed, represented by 2 different methods of strength training (circuit [CT] and pre-exhaustion [PE]), influences the magnitude of the excess postexercise oxygen consumption (EPOC) as well as the EE. Eight nonstrength-trained women participated in the study. Two strength training sessions, with different orders of execution, were held with 7 exercises performed with loads of between 50% and 55% of 1 repetition maximum (1RM). The oxygen uptake was measured before the training sessions, and the difference between the values found was taken as the EPOC of each training session and used in later analysis. No significant differences were found in either the EPOC (CT: 7.19 L +/- 6.17 an. PE: 7.22 +/- 5.84 L) or the postexercise EE (CT: 34.67 +/- 29.76 Kcal, PE: 34.77 +/- 28.15 Kcal) of the 2 training methodologies. Our results indicate that, in strength training, the magnitude of the EPOC is not linked to the order in which the exercises are performed. However, the absence of recovery periods between the sets and the exercises promotes an increase in the magnitude of the EPOC to the levels found in training sessions with higher percentages of 1RM.
Voleno, Matteo; Redmond, Stephen J; Cerutti, Sergio; Lovell, Nigel H
Energy expenditure (EE) is a parameter of great relevance in studies involving the assessment of physical activity. However, most reliable techniques for EE estimation are impractical for use in free-living environments, and those which are practically useful often poorly track EE when the subject is working to change their altitude, for example when ascending or descending stairs or slopes. The aim of this study is to evaluate the utility of adding barometric pressure related features, as a surrogate measure for altitude, to existing accelerometry related features to estimate the subject's EE. The EE estimation system described is based on a triaxial accelerometer (triax) and a barometric pressure sensor. The device is wireless, with Bluetooth connectivity for data retrieval, and is mounted at the subject's waist. Using a number of features extracted from the triax and barometric pressure signals, a linear model is trained for EE estimation. This EE estimation model is compared to its counterpart, which solely utilizes accelerometry signals. A protocol (comprising lying, sitting, standing, walking phases) was performed by 13 healthy volunteers (8 male and 5 female; age: 23.8 ± 3.7 years; weight: 70.5 ± 14.9 kg), whose instantaneous oxygen uptake was measured by means of an indirect calorimetry system. The model incorporating barometric pressure information estimated the oxygen uptake with the lowest mean square error of 4.5 ± 1.7 (mlO(2).min(-1).kg(-1))(2), in comparison to 7.1 ± 2.3 (mlO(2).min(-1).kg(-1))(2) using only accelerometry-based features.
Barnett, Paul G; Hamlett-Berry, Kim; Sung, Hai-Yen; Max, Wendy
The health effects of cigarette smoking have been estimated to account for between 6%-8% of U.S. health care expenditures. We estimated Veterans Health Administration (VHA) health care costs attributable to cigarette smoking. VHA survey and administrative data provided the number of Veteran enrollees, current and former smoking prevalence, and the cost of 4 types of care for groups defined by age, gender, and region. Cost and smoking status could not be linked at the enrollee level, so we used smoking attributable fractions estimated in sample of U.S. residents where the linkage could be made. The 7.7 million Veterans enrolled in VHA received $40.2 billion in VHA provided health services in 2010. We estimated that $2.7 billion in VHA costs were attributable to the health effects of smoking. This was 7.6% of the $35.3 billion spent on the types of care for which smoking-attributable fractions could be determined. The fraction of inpatient costs that was attributable to smoking (11.4%) was greater than the fraction of ambulatory care cost attributable to smoking (5.3%). More cost was attributable to current smokers ($1.7 billion) than to former smokers ($983 million). The fraction of VHA costs attributable to smoking is similar to that of other health care systems. Smoking among Veterans is slowly decreasing, but prevalence remains high in Veterans with psychiatric and substance use disorders, and in younger and female Veterans. VHA has adopted a number of smoking cessation programs that have the potential for reducing future smoking-attributable costs. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Kahan, David; McKenzie, Thomas L
Schools are salient locations for addressing the high prevalence of overweight and obesity. Most US states require some physical education (PE) and the energy expended during PE has potential to positively affect energy balance. We previously used 2012 data to examine state policies for PE to calculate estimated student energy expenditure (EEE) under potential (i.e., recommendations followed) and existing conditions. Since then, data have been updated on both state policies and the conduct of PE. Based on updated data, we used PE frequency, duration, and intensity, student mass, and class size to calculate EEE for the delivery of PE under (a) national professional recommendations, (b) 2016 state policies, and (c) school-reported conditions. Although increased from four years ago, only 22 states currently have policies mandating specific PE minutes. EEE over 10years shows the enormous impact PE could have on energy balance. For the average recommended-size PE class, resultant annual EEE based on professional recommendations for min/week far exceeded those based on average state (n=22) policy for min/week by 44.5% for elementary, 62.7% for middle, and 59.5% for high schools. Since 2012 more states adopted policies for PE minutes than dropped them, however, EEE over 10years showed a net loss of 1200kcal/student. With no overall recent improvements in state PE policy and professional recommendations currently not being met, PE remains an underutilized public health resource for EEE. Strong policies, coupled with enhanced accountability of PE teachers and administrators, are needed to ensure PE exists in schools. Copyright © 2016 Elsevier Inc. All rights reserved.
Böhm, Birgit; Hartmann, Michael; Böhm, Harald
Energy expenditure (EE) in active videogames (AVGs) is a component for assessing its benefit for cardiovascular health. Existing evidence suggests that AVGs are able to increase EE above rest and when compared with playing passive videogames. However, the association between body movement and EE remains unclear. Furthermore, for goal-directed game design, it is important to know the contribution of body segments to EE. This knowledge will help to acquire a certain level of exercise intensity during active gaming. Therefore, the purpose of this study was to determine the best predictors of EE from body segment energies, acceleration, and heart rate during different game situations. EE and body segment movement of 17 subjects, aged 22.1 ± 2.5 years, were measured in two different AVGs. In randomized order, the subjects played a handheld-controlled Nintendo(®) Wii™ tennis (NWT) game and a whole body-controlled Sony EyeToy(®) waterfall (ETW) game. Body segment movement was analyzed using a three-dimensional motion capture system. From the video data, mean values of mechanical energy change and acceleration of 10 body segments were analyzed. Measured EE was significantly higher in ETW (7.8 ± 1.4 metabolic equivalents [METs]) than in NWT (3.4 ± 1.0 METs). The best prediction parameter for the more intense ETW game was the energy change of the right thigh and for the less intense hand-controlled NWT game was the energy change of the upper torso. Segment acceleration was less accurate in predicting EE. The best predictors of metabolic EE were the thighs and the upper torso in whole body and handheld-controlled games, respectively. Increasing movement of these body segments would lead to higher physical activity intensity during gaming, reducing sedentary behavior.
Yang, Yunwen; Adolph, Anne L; Puyau, Maurice R; Vohra, Firoz A; Butte, Nancy F; Zakeri, Issa F
Advanced mathematical models have the potential to capture the complex metabolic and physiological processes that result in energy expenditure (EE). Study objective is to apply quantile regression (QR) to predict EE and determine quantile-dependent variation in covariate effects in nonobese and obese children. First, QR models will be developed to predict minute-by-minute awake EE at different quantile levels based on heart rate (HR) and physical activity (PA) accelerometry counts, and child characteristics of age, sex, weight, and height. Second, the QR models will be used to evaluate the covariate effects of weight, PA, and HR across the conditional EE distribution. QR and ordinary least squares (OLS) regressions are estimated in 109 children, aged 5-18 yr. QR modeling of EE outperformed OLS regression for both nonobese and obese populations. Average prediction errors for QR compared with OLS were not only smaller at the median τ = 0.5 (18.6 vs. 21.4%), but also substantially smaller at the tails of the distribution (10.2 vs. 39.2% at τ = 0.1 and 8.7 vs. 19.8% at τ = 0.9). Covariate effects of weight, PA, and HR on EE for the nonobese and obese children differed across quantiles (P PA and HR with EE were stronger for the obese than nonobese population (P EE compared with conventional OLS regression, especially at the tails of the distribution, and revealed substantially different covariate effects of weight, PA, and HR on EE in nonobese and obese children.
Mielgo-Ayuso, Juan; Maroto-Sánchez, Beatriz; Luzardo-Socorro, Raquel; Palacios, Gonzalo; Palacios Gil-Antuñano, Nieves; González-Gross, Marcela
Continuous physical exercise leads the athlete to maintain an unstable balance between dietary intake, energy expenditure and the additional demands of a high amount of physical activity. Thus, an accurate assessment of nutritional status is essential to optimize the performance, since it affects health, body composition, and the recovery of the athlete. Specific aspects like the type of sport, specialty or playing position, training schedule and competition calendar, category, specific objectives, which differ from the general population, must be considered. A biochemical assessment can give us a general idea of the nutritional status, lipid profile, liver or kidney function, if diet is too high in proteins or fats, as well as possible nutritional deficiencies and the need for supplementation. Sport kinanthropometry has great utility that enables the assessment of body mass, height, length, diameter, perimeter and skinfolds, where information is processed by applying different equations, obtaining information on somatotype, body composition, and the proportionality of different parts of the body. To give proper nutritional counselling, energy needs of the athlete must be known. If objective measurement is not possible, there are tables including theoretically established energy requirements of different sports. Dietary assessment should include information about food consumption and nutrient intake to establish the relationship between diet, health status and athlete's performance. On the other hand, an adequate hydration status in athletes is essential to maintain adequate performance. Hence, the knowledge of fluid intake by the athlete is a matter of the utmost importance. Dehydration can cause harmful effects on athletes' health. As there is no gold standard, urine gravidity and urine colour are the most extended methods for analyzing hydration status. There is consensus that due to complexity, the combination of different methods assures an effective data
Ravena Santos Raulino
Full Text Available INTRODUCTION AND OBJECTIVE: the aim of this study was to investigate whether the addition of vibration during interval training would raise oxygen consumption VO2 to the extent necessary for weight management and to evaluate the influence of the intensity of the vibratory stimulus for prescribing the exercise program in question. METHODS: VO2, measured breath by breath, was evaluated at rest and during the four experimental conditions to determine energy expenditure, metabolic equivalent MET, respiratory exchange ratio RER, % Kcal from fat, and rate of fat oxidation. Eight young sedentary females age 22±1 years, height 163.88± 7.62 cm, body mass 58.35±10.96 kg, and VO2 max 32.75±3.55 mLO2.Kg-1.min-1 performed interval training duration = 13.3 min to the upper and lower limbs both with vibration 35 Hz and 2 mm, 40 Hz and 2 mm, 45 Hz and 2 mm and without vibration. The experimental conditions were randomized and balanced at an interval of 48 hours. RESULTS: the addition of vibration to exercise at 45 Hz and 2 mm resulted in an additional increase of 17.77±12.38% of VO2 compared with exercise without vibration. However, this increase did not change the fat oxidation rate p=0.42 because intensity of exercise 29.1±3.3 %VO2max, 2.7 MET was classified as mild to young subjects. CONCLUSION: despite the influence of vibration on VO2 during exercise, the increase was insufficient to reduce body weight and did not reach the minimum recommendation of exercise prescription for weight management for the studied population.
Loftin, Mark; Sothern, Melinda; Koss, Cathie; Tuuri, Georgianna; Vanvrancken, Connie; Kontos, Anthony; Bonis, Marc
This study examined energy expenditure and physiologic determinants for marathon performance in recreational runners. Twenty recreational marathon runners participated (10 males aged 41 +/- 11.3 years, 10 females aged 42.7 +/- 11.7 years). Each subject completed a V(.-)O2max and a 1-hour treadmill run at recent marathon pace, and body composition was indirectly determined via dual energy X-ray absorptiometry. The male runners exhibited higher V(.-)O2max (ml x kg(-1) x min(-1)) values (52.6 +/- 5.5) than their female counterparts (41.9 +/- 6.6), although ventilatory threshold (T-vent) values were similar between groups (males: 76.2 +/- 6.1 % of V(.-)O2max, females: 75.1 +/- 5.1%). The male runners expended more energy (2,792 +/- 235 kcal) for their most recent marathon as calculated from the 1-hour treadmill run at marathon pace than the female runners (2,436 +/- 297 kcal). Body composition parameters correlated moderately to highly (r ranging from 0.50 to 0.87) with marathon run time. Also, V(.-)O2max (r = -0.73) and ventilatory threshold (r = -0.73) moderately correlated with marathon run time. As a group, the participants ran near their ventilatory threshold for their most recent marathon (r = 0.74). These results indicate the influence of body size on marathon run performance. In general, the larger male and female runners ran slower and expended more kilocalories than smaller runners. Regardless of marathon finishing time, the runners maintained a pace near their T-vent, and as T-vent or V(.-)O2max increased, marathon performance time decreased.
Bellinger, Adam S; Elliott, Sean P; Yang, Liu; Wei, John T; Saigal, Christopher S; Smith, Alexandria; Wilt, Timothy J; Strope, Seth A
Benign prostatic hyperplasia creates significant expenses for the Medicare program. We determined expenditure trends for benign prostatic hyperplasia evaluative testing after urologist consultation and placed these trends in the context of overall Medicare expenditures. Using a 5% national sample of Medicare beneficiaries from 2000 to 2007 we developed a cohort of 40,253 with claims for new visits to urologists for diagnoses consistent with symptomatic benign prostatic hyperplasia. We assessed trends in initial inflation and geography adjusted expenditures within 12 months of diagnosis by evaluative test categories derived from the 2003 American Urological Association guideline on the management of benign prostatic hyperplasia. Using governmental reports on Medicare expenditure trends for benign prostatic hyperplasia we compared expenditures to overall and imaging specific Medicare expenditures. Comparisons were assessed by the Z-test and regression analysis for linear trends, as appropriate. Between 2000 and 2007 inflation adjusted total Medicare expenditures per patient for the initial evaluation of patients with benign prostatic hyperplasia seen by urologists increased from $255.44 to $343.98 (p inflation adjusted expenditures increased for benign prostatic hyperplasia related evaluations. This growth was slower than the overall growth in Medicare expenditures. The increase in BPH related imaging expenditures was restrained compared to that of the Medicare program as a whole. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Yang, Caijun; Shen, Qian; Cai, Wenfang; Zhu, Wenwen; Li, Zongjie; Wu, Lina; Fang, Yu
To assess the long-term effects of the introduction of China's zero-markup drug policy on hospitalisation expenditure and hospitalisation expenditures after reimbursement. An interrupted time series was used to evaluate the impact of the zero-markup drug policy on hospitalisation expenditure and hospitalisation expenditure after reimbursement at primary health institutions in Fufeng County of Shaanxi Province, western China. Two regression models were developed. Monthly average hospitalisation expenditure and monthly average hospitalisation expenditure after reimbursement in primary health institutions were analysed covering the period 2009 through to 2013. For the monthly average hospitalisation expenditure, the increasing trend was slowed down after the introduction of the zero-markup drug policy (coefficient = -16.49, P = 0.009). For the monthly average hospitalisation expenditure after reimbursement, the increasing trend was slowed down after the introduction of the zero-markup drug policy (coefficient = -10.84, P = 0.064), and a significant decrease in the intercept was noted after the second intervention of changes in reimbursement schemes of the new rural cooperative medical insurance (coefficient = -220.64, P China. However, hospitalisation expenditure and hospitalisation expenditure after reimbursement were still increasing. More effective policies are needed to prevent these costs from continuing to rise. © 2016 John Wiley & Sons Ltd.
Cisternas, Miriam G; Murphy, Louise B; Yelin, Edward H; Foreman, Aimee J; Pasta, David J; Helmick, Charles G
To examine trends in annual medical expenditures from 1997 to 2005 among adults with arthritis and other rheumatic conditions (denoted Arthritis group). We analyzed annual medical expenditures (2005 US dollars) among adults with Arthritis using the Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the US civilian, noninstitutionalized population. Expenditures were stratified by Arthritis and comorbidity status. The Arthritis population increased by 22% (36.8 to 44.9 million) during this period, attributable entirely to the subpopulation with at least one comorbid condition (31.8 to 40.3 million). The overall, inflation-adjusted annual mean medical expenditures for adults with Arthritis increased from $6,848 in 1997 to $7,854 in 2005. In 1997, inpatient care was the most expensive component of overall expenditures (mean $2,702), but beginning in 2001, mean inpatient and ambulatory expenditures were almost identical. Mean prescription expenditures increased nearly every year, almost doubling from $970 in 1997 to $1,811 in 2005. Aggregate total expenditures for the Arthritis population increased markedly during this period, from $252.0 to $353.0 billion (+40%). Most of this increase was attributable to the population increase in the Arthritis and comorbid condition subgroup. Mean annual ambulatory and prescription expenditures for adults with Arthritis increased far above the rate of medical inflation, offsetting a relative decline in inpatient expenditures. Increases in overall mean and aggregate total expenditures are attributable to the increasing number of adults with Arthritis and at least one comorbid chronic condition. Projected increases in this population suggest that these expenditures will continue to rise.
Zhai, Tiemin; Goss, John; Li, Jinjing
In past two decades, health expenditure in China grew at a rate of 11.6% per year, which is much faster than the growth of the country's economy (9.9% per year). As cost containment is a key aspect of China's new health system reform agenda, this study aims to identify the main drivers of past growth so that cost containment policies are focussed in the right areas. The analysis covered the period 1993-2012. To understand the drivers of past growth during this period, Das Gupta's decomposition method was used to decompose the changes in health expenditure by disease into five main components that include population growth, population ageing, disease prevalence rate, expenditure per case of disease, and excess health price inflation. Demographic data on population size and age-composition were obtained from the Department of Economic and Social Affairs of the United Nations. Age- and disease- specific expenditure and prevalence rates by age and disease were extracted from China's National Health Accounts studies and Global Burden of Disease 2013 studies of the Institute for Health Metrics and Evaluation, respectively. Growth in health expenditure in China was mainly driven by a rapid increase in real expenditure per prevalent case, which contributed 8.4 percentage points of the 11.6% annual average growth. Excess health price inflation and population growth contributed 1.3 and 1.3% respectively. The effect of population ageing was relatively small, contributing 0.8% per year. However, reductions in disease prevalence rates reduced the growth rate by 0.3 percentage points. Future policy in optimising growth in health expenditure in China should address growth in expenditure per prevalent case. This is especially so for neoplasms, and for circulatory and respiratory disease. And a focus on effective interventions to reduce the prevalence of disease in the country will ensure that changing disease rates do not lead to a higher growth in future health expenditure
Teusner, Dana; Smith, Valerie; Gnanamanickam, Emmanuel; Brennan, David
There are few studies of dental service expenditure in Australia. Although dental insurance status is strongly associated with a higher probability of dental visiting, some studies indicate that there is little variation in expenditure by insurance status among those who attend for care. Our objective was to assess the overall impact of insurance on expenditures by modelling the association between insurance and expenditure accounting for variation in the probability of incurring expenses, that is dental visiting. A sample of 3000 adults (aged 30-61 years) was randomly selected from the Australian electoral roll. Dental service expenditures were collected prospectively over 2 years by client-held log books. Questionnaires collecting participant characteristics were administered at baseline, 12 months and 24 months. Unadjusted and adjusted ratios of expenditure were estimated using marginalized two-part log-skew-normal models. Such models accommodate highly skewed data and estimate effects of covariates on the overall marginal mean while accounting for the probability of incurring expenses. Baseline response was 39%; of these, 40% (n = 438) were retained over the 2-year period. Only participants providing complete data were included in the analysis (n = 378). Of these, 68.5% were insured, and 70.9% accessed dental services of which nearly all (97.7%) incurred individual dental expenses. The mean dental service expenditure for the total sample (those who did and did not attend) for dental care was AUS$788. Model-adjusted ratios of mean expenditures were higher for the insured (1.61; 95% CI 1.18, 2.20), females (1.38; 95% CI 1.06, 1.81), major city residents (1.43; 95% CI 1.10, 1.84) and those who brushed their teeth twice or more a day (1.50; 95% CI 1.15, 1.96) than their respective counterparts. Accounting for the probability of incurring dental expenses, and other explanatory factors, insured working-aged adults had (on average) approximately 60% higher individual
Mukherjee, Subrata; Haddad, Slim; Narayana, Delampady
In the Indian context, a household's caste characteristics are most relevant for identifying its poverty and vulnerability status. Inadequate provision of public health care, the near-absence of health insurance and increasing dependence on the private health sector have impoverished the poor and the marginalised, especially the scheduled tribe population. This study examines caste-based inequalities in households' out-of-pocket health expenditure in the south Indian state of Kerala and provides evidence on the consequent financial burden inflicted upon households in different caste groups. Using data from a 2003-2004 panel survey in Kottathara Panchayat that collected detailed information on health care consumption from 543 households, we analysed inequality in per capita out-of-pocket health expenditure across castes by considering households' health care needs and types of care utilised. We used multivariate regression to measure the caste-based inequality in health expenditure. To assess health expenditure burden, we analysed households incurring high health expenses and their sources of finance for meeting health expenses. The per capita health expenditures reported by four caste groups accord with their status in the caste hierarchy. This was confirmed by multivariate analysis after controlling for health care needs and influential confounders. Households with high health care needs are more disadvantaged in terms of spending on health care. Households with high health care needs are generally at higher risk of spending heavily on health care. Hospitalisation expenditure was found to have the most impoverishing impacts, especially on backward caste households. Caste-based inequality in household health expenditure reflects unequal access to quality health care by different caste groups. Households with high health care needs and chronic health care needs are most affected by this inequality. Households in the most marginalised castes and with high health care
Full Text Available Abstract Background In the Indian context, a household's caste characteristics are most relevant for identifying its poverty and vulnerability status. Inadequate provision of public health care, the near-absence of health insurance and increasing dependence on the private health sector have impoverished the poor and the marginalised, especially the scheduled tribe population. This study examines caste-based inequalities in households' out-of-pocket health expenditure in the south Indian state of Kerala and provides evidence on the consequent financial burden inflicted upon households in different caste groups. Methods Using data from a 2003-2004 panel survey in Kottathara Panchayat that collected detailed information on health care consumption from 543 households, we analysed inequality in per capita out-of-pocket health expenditure across castes by considering households' health care needs and types of care utilised. We used multivariate regression to measure the caste-based inequality in health expenditure. To assess health expenditure burden, we analysed households incurring high health expenses and their sources of finance for meeting health expenses. Results The per capita health expenditures reported by four caste groups accord with their status in the caste hierarchy. This was confirmed by multivariate analysis after controlling for health care needs and influential confounders. Households with high health care needs are more disadvantaged in terms of spending on health care. Households with high health care needs are generally at higher risk of spending heavily on health care. Hospitalisation expenditure was found to have the most impoverishing impacts, especially on backward caste households. Conclusion Caste-based inequality in household health expenditure reflects unequal access to quality health care by different caste groups. Households with high health care needs and chronic health care needs are most affected by this inequality
This paper differs in two ways from previous comparative health system research. First, it focuses on the impact of pharmaceutical expenditures on total health expenditures as trends in pharmaceutical expenditures have been blamed of being a major driver of national health expenditures. In addition to pharmaceutical expenditures, other variables of interest are income, public financing, public delivery, ageing and urbanization. Second, the analysis includes a thorough sensitivity analysis on ...
Berggren, E K; O'Tierney-Ginn, P; Lewis, S; Presley, L; De-Mouzon, S Hauguel; Catalano, P M
There are significant variations in gestational weight gain, with many women gaining in excess of the Institute of Medicine guidelines. Unfortunately, efforts to improve appropriate gestational weight gain have had only limited success. To date, interventions have focused primarily on decreasing energy intake and/or increasing physical activity. Maternal resting energy expenditure, which comprises ∼60% of total energy expenditure compared with the ∼20% that comes from physical activity, may be an important consideration in understanding variations in gestational weight gain. Our objective was to quantify the changes in resting energy expenditure during pregnancy and their relationship to gestational weight gain and body composition changes among healthy women. We hypothesized that greater gestational weight gain, and fat mass accrual in particular, are inversely related to variations in resting energy expenditure. We conducted a secondary analysis of a prospective cohort studied before conception and late pregnancy (34-36 weeks). Body composition (estimated using hydrodensitometry) and resting energy expenditure (estimated using indirect calorimetry) were measured. The relationship between the changes in resting energy expenditure and gestational weight gain and the change in fat mass and fat-free mass were quantified. Resting energy expenditure was expressed as kilocalories per kilogram of fat-free mass per day (kilocalories per kilogram of fat-free mass-1/day-1) and kilocalories per day. Correlations are reported as r. Among 51 women, preconception body mass index was 23.0 (4.7) kg/m2; gestational weight gain was 12.8 (4.7) kg. Preconception and late pregnancy resting energy expenditure (kilocalories per day) correlated positively with the change in fat-free mass (r = 0.37, P = .008; r = 0.51, P = .001). Late-pregnancy resting energy expenditure (kilocalories per kilogram of fat-free mass-1/day-1) was inversely associated with the change in fat mass (r
Ankrah Odame, Emmanuel; Akweongo, Patricia; Yankah, Ben; Asenso-Boadi, Francis; Agyepong, Irene
Sustainability of public social welfare programmes has long been of concern in development circles. An important aspect of sustainability is the ability to sustain the recurrent financial costs of programmes. A free maternal care programme (FMCP) was launched under the Ghana National Health Insurance Scheme (NHIS) in 2008 with a start-up grant from the British Government. This article examines claims expenditure under the programme and the implications for the financial sustainability of the programme, and the lessons for donor and public financing of social welfare programmes. Records of reimbursement claims for services and medicines by women benefitting from the policy in participating facilities in one sub-metropolis in Ghana were analysed to gain an understanding of the expenditure on this programme at facility level. National level financial inflow and outflow (expenditure) data of the NHIS, related to implementation of this policy for 2008 and 2009, were reviewed to put the facility-based data in the national perspective. A total of US$936 450.94 was spent in 2009 by the scheme on FMCP in the sub-metropolis. The NHIS expenditure on the programme for the entire country in 2009 was US$49.25 million, exceeding the British grant of US$10.00 million given for that year. Subsequently, the programme has been entirely financed by the National Health Insurance Fund. The rapidly increasing, recurrent demands on this fund from the maternal delivery exemption programme-without a commensurate growth on the amounts generated annually-is an increasing threat to the sustainability of the fund. Provision of donor start-up funding for programmes with high recurrent expenditures, under the expectation that government will take over and sustain the programme, must be accompanied by clear long-term analysis and planning as to how government will sustain the programme.
Dolot, Janet; Viola, Deborah; Shi, Qiuhu; Hyland, Matthew
Physical therapy decreases low back pain, improves function, and may lead to decreased use of medical services. However, factors predicting physical therapy utilization for patients with low back pain are not well understood. The purpose of this study was to identify the impact of out-of-pocket expenditure on physical therapy utilization for US adults with nonspecific low back pain. This study was a secondary analysis of retrospective Medical Expenditure Panel Survey data. The participants were US adults with nonspecific low back pain. The outcome variable was the number of visits per episode of care. The research variable was out-of-pocket expenditure. Covariate variables were Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) component scores. Descriptive statistics and multiple linear regression analyses were performed. Three hundred fourteen adults met the inclusion criteria and submitted SF-12 scores, representing nearly 4 million adults. Out-of-pocket expenditure, physical component score, and the age-insurance category "18-64 years with public coverage only for all of the year or uninsured all of the year" negatively predicted visits per episode of care in the final regression model. Limitations of the study included use of a nonexperimental design, lack of information about symptom severity and content of physical therapy, and SF-12 scores were not taken coincidental with the episode of care. Out-of-pocket expenditure negatively predicts physical therapy utilization. More research is needed to identify all factors influencing physical therapy utilization so that effective health policies may be developed. © 2016 American Physical Therapy Association.
Full Text Available This econometric study contributes to the ongoing debate about the costs and benefits of urban form by employing interdisciplinary means—urban planning, econometrics and public administration—to explore the relationship between urban form and urban public services expenditure. In China, particularly, rapid urbanization is accompanied by an increase of urban public services expenditure and a difference in efficiency, which undermines the promotion of urban public service development. The Chinese government has paid great attention to urban sustainable development and promoting urban public services performance; however, until recently there has been a lack of empirical studies exploring the relationship between urban public services expenditure and urban form. Thus, the present research aims to analyze this issue by using relevant indicators based on an econometric model. The results provide a promising basis for improving urban public services expenditure efficiency. Based on the urban area interpreted by remote sensing data and geographic information system, two urban form metrics, the compactness ratio and the elongation ratio, are selected and quantified to describe urban compactness and urban sprawl accurately. Panel data analyses are performed using a cross-sectional dataset of the 30 cities for the years 2007, 2010 and 2013 to assess the likelihood of association between indicators of urban form and urban public services expenditure, while controlling for other determinants, such as educational level, income per capita, degree of industrialization, and unemployment rate. The results indicate that urban elongation is positively correlated to per capita urban public services expenditure and urban compactness is insignificantly correlated to it. Thus, it is recommended that policymakers consider the relationship between urban form and public services expenditure as part of urban planning and on-going strategies to promote public service
Mahumud, Rashidul Alam; Sarker, Abdur Razzaque; Sultana, Marufa; Islam, Ziaul; Khan, Jahangir; Morton, Alec
As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.
Robst, John; Constantine, Robert; Andel, Ross; Boaz, Timothy; Howe, Andrew
Criminal careers have been extensively studied in general population sample, but less is known about such patterns among people with major mental illness, and where so, criminal justice expenditure has not been taken into account. Our aim was to examine criminal justice system expenditure over time in one Florida county. Our main research question was whether treatment for mental disorders was related to a change in criminal offending and expenditure trajectory. We used the Pinellas County (Florida) Criminal Justice Information System to identify individuals under age 65 arrested between July 2003 and June 2004. Archival medical service, social and homeless services data were used to identify individuals with a serious mental illness. A two-step analysis was used to examine the data: first, we identified groups of people with similar patterns of criminal justice expenditures over 4 years (July 2002 to June 2006); second, we evaluated their demographic characteristics, diagnosis and treatment as potential predictors of group membership. Three thousand seven hundred sixty-nine people with serious mental illness were identified in the Pinellas County jail population. Their average length of stay in jail was 151 days and in prison was 48 days. The trajectory analysis identified three groups of individuals with distinct trajectories of criminal justice expenditures: those with low stable, those with initially high but decreasing and those with initially high and sustained or increasing. Mental health treatment, whether acute or sustained, voluntary or mandatory, was associated with membership of the low stable group. Review of criminal justice expenditure over time on individuals with major mental disorder may provide important indicators of unmet need for mental health services. Furthermore, it seems probable that improved provision of such services for them could reduce recidivism as well as improving health. Interventions may also be better focused if criminal
Full Text Available Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator’s note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.
Hotchkiss, D R; Rous, J J; Karmacharya, K; Sangraula, P
His Majesty's Government of Nepal has embarked on an ambitious social welfare programme of increasing the accessibility of primary education and health care services in rural communities. The implications on the financing of health care services are substantial, as the number of health posts has increased twelve-fold from 1992 to 1996, from 200 to 2597. To strengthen health care financing, government policy-makers are considering a number of financing strategies that are likely to have a substantial impact on household health care expenditures. However, more needs to be known about the role of households in the current structure of the health economy before the government designs and implements policies that affect household welfare. This paper uses the Nepal Living Standards Survey, a rich, nationally-representative sample of households from 1996, to investigate level and distribution of household out-of-pocket health expenditures. Utilization and expenditures for different types of providers are presented by urban/rural status and by socioeconomic status. In addition, the sources of health sector funds are analyzed by contrasting household out-of-pocket expenditures with expenditures by the government and donors. The results indicate that households spend about 5.5% of total household expenditures on health care and that households account for 74% of the total level of funds used to finance the health economy. In addition, rural households are found to spend more on health care than urban households, after controlling for income status. Distributing health care expenditures by type of care utilized indicates that the wealthy, as well as the poor, rely heavily on services provided by the public sector. The results of this analysis are used to discuss the feasibility of implementing alternative health care financing policies.
Physical inactivity is a major public health problem in developed countries, and the fourth leading mortality risk factor globally. Recently, it was suggested that the total energy expenditure of sedentary Western population is similar to the total energy expenditure of Hadza hunter-gatherers known for their traditional foraging lifestyle in the savannah-woodland environment. However, this claim was based on the similarity of metabolic rates of walking and resting, and completely ignored the effects of different total energy expenditure normalized to the fat free body mass in individuals of different height and weight. The above claim stemmed from mixing the effects of tissues with low metabolic rate (bone) and those with high metabolic rate (muscle, liver, brain, etc.). Thus, the total energy expenditure is not similar among the sedentary Westerners and the Hadza hunter-gatherers. While the total energy expenditure recorded for basic human activities is similar across a broad range of cultures and lifestyles when adjusted to the weight, the unadjusted values differ. Thus, increase in body mass, and particularly the obesity, serves as compensatory total energy expenditure increasing mechanism resulting from the combination of low physical activity levels and high long-term total energy intake. Thus if two individuals at iso-energetic conditions match their energy demand with different substrates' contribution, it may be caused, e.g., by their reliance on a different contribution of fatty acids oxidation to cope with energy demand. Differences in substrate partitioning need to be addressed when assessing the energy expenditure across multiple human populations.
Adriano Provezano Gomes
Full Text Available This study aimed to identify whether 23 sectors of Brazilian manufacturing industry spent efficiently in innovation activities in the years 2003 and 2005, through data envelopment analysis, especially by the model of variable returns to scale. It was found that the level of efficiency has reduced considerably over the years, with the average score from 0.82 in 2003 to 0.68 in 2005, and in the past year, have been a shift from the efficient unities. The only efficient industries in the two years were linked to the production of oil, non-ferrous metals and automobiles in general. The conclusion is, after all, that maintaining the levels of profitability in terms of innovation expenditure of the sectors of processing industry depends on a more efficient use of resources in order to achieve or, if possible, overcome the technological standards international.O presente estudo buscou identificar se 23 setores da indústria de transformação que investiram em atividades de inovação foram eficientes em 2003 e 2005, por meio da análise envoltória de dados, principalmente pelo modelo de retornos variáveis à escala. Verificou-se que o nível de eficiência reduziu-se consideravelmente ao longo dos anos, com o escore médio passando de 0,82 para 0,68 entre 2003 e 2005, além de, neste último ano, ter ocorrido uma mudança em relação às unidades eficientes. Os únicos setores eficientes nos dois anos foram os ligados à produção de derivados do petróleo, de metais não ferrosos e de automóveis em geral. Conclui-se, afinal, que a manutenção dos níveis de lucratividade em função dos gastos com inovação dos setores da indústria de transformação nacional depende de uma maior eficiência no uso destes recursos, com o intuito de alcançar ou, se possível, ultrapassar os padrões tecnológicos internacionais.
Butte, Nancy F; Wong, William W; Lee, Jong Soo; Adolph, Anne L; Puyau, Maurice R; Zakeri, Issa F
Accurate, nonintrusive, and feasible methods are needed to predict energy expenditure (EE) and physical activity (PA) levels in preschoolers. Herein, we validated cross-sectional time series (CSTS) and multivariate adaptive regression splines (MARS) models based on accelerometry and heart rate (HR) for the prediction of EE using room calorimetry and doubly labeled water (DLW) and established accelerometry cut points for PA levels. Fifty preschoolers, mean ± SD age of 4.5 ± 0.8 yr, participated in room calorimetry for minute-by-minute measurements of EE, accelerometer counts (AC) (Actiheart and ActiGraph GT3X+), and HR (Actiheart). Free-living 105 children, ages 4.6 ± 0.9 yr, completed the 7-d DLW procedure while wearing the devices. AC cut points for PA levels were established using smoothing splines and receiver operating characteristic curves. On the basis of calorimetry, mean percent errors for EE were -2.9% ± 10.8% and -1.1% ± 7.4% for CSTS models and -1.9% ± 9.6% and 1.3% ± 8.1% for MARS models using the Actiheart and ActiGraph+HR devices, respectively. On the basis of DLW, mean percent errors were -0.5% ± 9.7% and 4.1% ± 8.5% for CSTS models and 3.2% ± 10.1% and 7.5% ± 10.0% for MARS models using the Actiheart and ActiGraph+HR devices, respectively. Applying activity EE thresholds, final accelerometer cut points were determined: 41, 449, and 1297 cpm for Actiheart x-axis; 820, 3908, and 6112 cpm for ActiGraph vector magnitude; and 240, 2120, and 4450 cpm for ActiGraph x-axis for sedentary/light, light/moderate, and moderate/vigorous PA (MVPA), respectively. On the basis of confusion matrices, correctly classified rates were 81%-83% for sedentary PA, 58%-64% for light PA, and 62%-73% for MVPA. The lack of bias and acceptable limits of agreement affirms the validity of the CSTS and MARS models for the prediction of EE in preschool-aged children. Accelerometer cut points are satisfactory for the classification of sedentary, light, and moderate
Full Text Available Abstract Background Sub-optimally nourished rats show reduced growth, biochemical and physiological changes. However, no one has assessed metabolic rate adaptations in rats subjected to chronic suboptimal nutrition (CSN. In this study energy expenditure (EE; kcal/100 g body weight and physical activity (PA; oscillations in weight/min/kg body weight were assessed in rats subjected to three levels of CSN. Results Body weight gain was diminished (76.7 ± 12.0 and 61.6 ± 11.0 g in rats fed 70 and 60% of the ad-libitum fed controls which gained more weight (148.5 ± 32.3 g. The rats fed 80% gained weight similarly to controls (136.3 ± 10.5 g. Percent Fat-free body mass was reduced (143.8 ± 8.7 and 142.0 ± 7.6 g in rats fed 70 and 60% of ad-libitum, but not in those fed 80% (200.8 ± 17.5 g as compared with controls (201.6 ± 33.4 g. Body fat (g decreased in rats fed 80% (19.7 ± 5.3, 70% (15.3 ± 3.5 and 60% (9.6 ± 2.7 of ad-libitum in comparison to controls (26.0 ± 6.7. EE and PA were also altered by CSN. The control rats increased their EE and PA during the dark periods by 1.4 ± 0.8 and 1.7 ± 1.1 respectively, as compared with light the period; whereas CSN rats fed 80 and 70% of ad-libitum energy intake had reduced EE and PA during the dark periods as compared with the light period EE(7.5 ± 1.4 and 7.8 ± 0.6 vs. 9.0 ± 1.2 and 9.7 ± 0.8; p Conclusion CSN rats adapt to mild energy restriction by reducing body fat, EE and PA mainly during the dark period while growth proceeds and lean body mass is preserved. At higher levels of energy restrictions there is decreased growth, body fat and lean mass. Moreover EE and PA are also reduced during both light and dark periods.
Menon, J; Mishra, P
We determined incremental health care resource utilization, incremental health care expenditures, incremental absenteeism, and incremental absenteeism costs associated with osteoarthritis. Medical Expenditure Panel Survey (MEPS) for 2011 was used as data source. Individuals 18 years or older and employed during 2011 were eligible for inclusion in the sample for analyses. Individuals with osteoarthritis were identified based on ICD-9-CM codes. Incremental health care resource utilization included annual hospitalization, hospital days, emergency room visits and outpatient visits. Incremental health expenditures included annual inpatient, outpatient, emergency room, medications, miscellaneous and annual total expenditures. Of the total sample, 1354 were diagnosed with osteoarthritis, and compared to non osteoarthritis individuals. Incremental resource utilization, expenditures, absenteeism and absenteeism costs were estimated using regression models, adjusting for age, gender, sex, region, marital status, insurance coverage, comorbidities, anxiety, asthma, hypertension and hyperlipidemia. Regression models revealed incremental mean annual resource use associated with osteoarthritis of 0.07 hospitalizations, equal to 70 additional hospitalizations per 100 osteoarthritic patients annually, and 3.63 outpatient visits, equal to 363 additional visits per 100 osteoarthritic patients annually. Mean annual incremental total expenditures associated with osteoarthritis were $2046. Annually, mean incremental expenditures were largest for inpatient expenditures at $826, followed by mean incremental outpatient expenditures of $659, and mean incremental medication expenditures of $325. Mean annual incremental absenteeism was 2.2 days and mean annual incremental absenteeism costs were $715.74. Total direct expenditures were estimated at $41.7 billion. Osteoarthritis was associated with significant incremental health care resource utilization, expenditures, absenteeism and
Nayga, Rodolfo M., Jr.
This study examines the effects of a wife's participation in the labor force and other socioeconomic factors on family expenditures for prepared food, food prepared at home, and food away from home using the Bureau of Labor Statistics 1992 consumer expenditure survey. On the one hand, results indicate that the number of children, home ownership with mortgage, seasonality, region, wife's age, and income are important determinants of expenditures on food prepared at home. A wife's education and...
Ulf Elbelt; Tatjana Schuetz; Nina Knoll; Silke Burkert
Reduced physical activity and almost unlimited availability of food are major contributors to the development of obesity. With the decline of strenuous work, energy expenditure due to spontaneous physical activity has attracted increasing attention. Our aim was to assess changes in energy expenditure, physical activity patterns and nutritional habits in obese subjects aiming at self-directed weight loss. Methods: Energy expenditure and physical activity patterns were measured with a portable ...
Lagerros, Ylva Trolle; Mucci, Lorelei A; Bellocco, Rino; Nyrén, Olof; Bälter, Olle; Bälter, Katarina A
Improved methods for quantitative self-reports of total physical activity in epidemiological studies are needed. We evaluated randomly selected individuals' ability to integrate their perception of physical activity over time to produce an estimate of the "usual" level, using a novel instrument for self-quantification of energy expenditure. A population-based sample of 418 Swedish men and women, age 20-59, completed a questionnaire containing the new instrument. For validation, three 24 hour recalls by phone served as gold standard. Reproducibility was assessed through administering the instrument another three times. The validation involved 133 subjects and another 160 completed the reproducibility evaluation. Pearson correlation between usual daily energy expenditure measured by the instrument and the mean of the 24 hour recalls was 0.73. After subdividing the self-reported daily energy expenditure and the mean of the 24 hour recalls into quintiles, 83.5% of the participants remained in the same quintile, or one quintile apart. There was a tendency towards overestimation of usual daily physical activity. This was significantly associated with low education. Reproducibility showed an intraclass correlation of 0.55. Although integrated reports of usual daily energy expenditure over longer periods seem to be afflicted with a tendency of overestimation, total energy expenditure can be estimated with reasonable validity and reproducibility using our instrument.
Rumpler William V
Full Text Available Abstract Background Ghrelin, a peptide secreted by endocrine cells in the gastrointestinal tract, is a hormone purported to have a significant effect on food intake and energy balance in humans. The influence of factors related to energy balance on ghrelin, such as daily energy expenditure, energy intake, and macronutrient intake, have not been reported. Secondly, the effect of ghrelin on food intake has not been quantified under free-living conditions over a prolonged period of time. To investigate these effects, 12 men were provided with an ad libitum cafeteria-style diet for 16 weeks. The macronutrient composition of the diets were covertly modified with drinks containing 2.1 MJ of predominantly carbohydrate (Hi-CHO, protein (Hi-PRO, or fat (Hi-FAT. Total energy expenditure was measured for seven days on two separate occasions (doubly labeled water and physical activity logs. Results Preprandial ghrelin concentrations were not affected by macronutrient intake, energy expenditure or energy intake (all P > 0.05. In turn, daily energy intake was significantly influenced by energy expenditure, but not ghrelin. Conclusion Preprandial ghrelin does not appear to be influenced by macronutrient composition, energy intake, or energy expenditure. Similarly, ghrelin does not appear to affect acute or chronic energy intake under free-living conditions.
Full Text Available Related party transactions (RPTs are transactions made among affiliated companies in a conglomerate group. Heavy RPT ratio means high level of dependence of a firm on the captive market within a conglomerate group. This may depress the firm’s incentive to invest in R&D and the high level of R&D expenditure of a firm with heavy RPT ratio may not be efficiently led to high level of firm performances. Relating these RPTs with firm’s R&D expenditures together, we investigate the impact of RPTs on firm’s R&D expenditures and the effectiveness of R&D with heavy RPT ratio on firm performances, subject to such transactions made by Korean conglomerate groups for the period 2000 to 2010. Results show that higher RPT ratio is negatively associated with R&D expenditures; and the positive relationship between R&D and firm values are negatively moderated by increase in RPTs. Classifying the types of R&D expenditures into research expenses and development expenses, the results are differentiated between them. Evidencing the impact of RPTs on R&D spending and the subsequent effectiveness on firm values, this study helps the related parties to understand the nature of RPTs and conglomerate groups, related to R&D and firm performances, and to make relevant decisions.
Foster, E Michael; Xuan, Fengjuan
To illustrate an episode-based framework for analyzing health care expenditures based on reward renewal models, a stochastic process used in engineering for describing processes that cycle on and off with "rewards" (or costs) occurring at the end of each cycle. Data used in the illustration were collected as part of an evaluation of a national initiative to improve mental health services for children and youth. Participants were enrolled in a longitudinal study at a demonstration site and in a comparison community between 1997 and 1999. The illustration involves analyses of mental health expenditures at the two sites and of the dynamics of service use behind those expenditures. Services data were derived from management information systems as well as patient records at inpatient facilities in the two communities. These data cover services received between 1997 and 2003. The analysis focuses on the year following study entry. Between-site differences in expenditures reflect complex between-site differences in the timing of service use. In particular, children at the demonstration stayed in treatment longer but were less likely to return for treatment later. In contrast, children at the comparison site experienced substantially less continuity of care. Costs per day of treatment within an episode were comparable at the two sites. Reward renewal models offer a promising means for integrating research on service episodes and the dynamics of service use with that on health care expenditures.
Barf, R P; Van Dijk, G; Scheurink, A J W; Hoffmann, K; Novati, A; Hulshof, H J; Fuchs, E; Meerlo, P
Epidemiological studies have shown an association between short or disrupted sleep and an increased risk to develop obesity. In animal studies, however, sleep restriction leads to an attenuation of weight gain that cannot be explained by changes in energy intake. In the present study, we assessed whether the attenuated weight gain under conditions of restricted sleep is a consequence of an overall increase in energy expenditure. Adult male rats were subjected to a schedule of chronic sleep restriction (SR) for 8 days with a 4h window of unrestricted rest per day. Electroencephalogram and electromyogram recordings were performed to quantify the effect of the sleep restriction schedule on sleep-wake patterns. In a separate experiment, we measured sleep restriction-induced changes in body weight, food intake, and regulatory hormones such as glucose, insulin, leptin and corticosterone. To investigate whether a change in energy expenditure underlies the attenuation of weight gain, energy expenditure was measured by the doubly labeled water method from day 5 until day 8 of the SR protocol. Results show a clear attenuation of weight gain during sleep restriction but no change in food intake. Baseline plasma glucose, insulin and leptin levels are decreased after sleep restriction which presumably reflects the nutritional status of the rats. The daily energy expenditure during SR was significantly increased compared to control rats. Together, we conclude that the attenuation of body weight gain in sleep restricted rats is explained by an overall increase in energy expenditure together with an unaltered energy intake. Published by Elsevier Inc.
McGuire, A; Parkin, D; Hughes, D; Gerard, K
The size of national health care expenditure is an important research and policy issue. This paper reviews theoretical and empirical analyses of an implied optimal size for a health sector. Various economic theories are explicitly or implicitly invoked, but none is fully satisfactory. Theory provides, at best, a loose justification for empirical specifications of health sector behaviour. Nevertheless, this has a large and growing empirical research industry. The complexity of the issues provides an excuse for reliance on empirical analyses using ad hoc models. The paper analyses aggregate time-series data, using the cointegration approach, on health, health care expenditures and national income. Only one national model met both statistical criteria and showed a significant relationship: between potential life years lost and health care expenditure in the UK. The case for any general relationships remains unproven. There is no objective scientific method to determine optimal health expenditure, nor should we expect one. However, positive analyses can help with normative questions. A better understanding of health expenditure determination would arise from better specification of the relationships, perhaps by analysis at a lower level of aggregation.
Full Text Available After the peace bonus era, global military expenditures have escalated sharply despite some worldwide declines in military personnel. Theories on the economic impacts of the military institution and escalated military spending greatly differ and include arguments that they either improve domestic economic performance or crowd out growth-inducing processes. Empirical findings on this matter are inconclusive, in part due to a failure to disentangle the various dimensions of military expenditures. We further suggest that modern sociology's relative inattention to such issues has contributed to these shortcomings. We explore a new dimension of military spending that clarifies this issuemilitary expenditures per soldier which captures the capital intensiveness of a countrys military organization. Our cross-national panel regression and causal analyses of developed and less developed countries from 1990 to 2003 show that military expenditures per soldier inhibit the growth of per capita GDP, net of control variables, with the most pronounced effects in least developed countries. These expenditures inhibit national development in part by slowing the expansion of the labor force. Labor-intensive militaries may provide a pathway for upward mobility, but comparatively capital-intensive military organizations limit entry opportunities for unskilled and under- or unemployed people. Deep investments in military hardware also reduce the investment capital available for more economically productive opportunities. We also find that arms imports have a positive effect on economic growth, but only in less developed countries.
Pourat, Nadereh; Choi, Moonkyung Kate; Chen, Xiao
Preventive dental health services are intended to reduce the likelihood of development of tooth decay and the need for more intensive treatment overtime. The evidence on the effectiveness of preventive dental care in reducing treatment services and expenditures is lagging for adults, particularly those with lower incomes and chronic conditions. We assessed the impact of preventive dental services on dental treatment service use and expenditures overall and by category of service. We calculated the annual numbers of preventive (periodic diagnostic and prophylactic procedures) and treatment (restorative, surgery, prosthodontic, endodontic, and periodontic) services per beneficiary using Medicaid enrollment and claims data for beneficiaries with three categories of conditions (diabetes, heart disease, and respiratory disease) from 10 largest California counties. We used Cragg hurdle exponential regression models controlling for past service use, demographics, length of enrollment, and county. We found that using preventive services in 2005-2007 was associated with higher likelihood and number of treatment dental services used, but associated with lower treatment expenditures in 2008. The reduction in expenditures was noted only in restorative, prosthodontics, and periodontic services. The findings provide much needed evidence of the contribution of preventive dental care in maintaining oral health of low-income adults with chronic conditions and potential for savings to the Medicaid program. Providing lower cost preventive dental care to the individuals with chronic conditions would achieve better oral health and lower treatment expenditures. © 2018 American Association of Public Health Dentistry.
South Korea has been undergoing significant change in its population structure over the past three decades. Within 10 years, South Korean baby-boomers will reach the age of 65 years and accelerate this change. This trend in population structure is crucial, because an aging population may increase medical demand, especially that for long-term care (LTC) services, which would create a financial burden on society. This study estimates total LTC expenditure in South Korea from 2015 to 2050 by modifying the method proposed by the UK Personal Social Science Research Unit, the seminal study on projecting costs of LTC services. Using population data from the projections of the Korean Statistical Information Service, I stratify the projected population by gender and age, using the groups 65-69, 70-74, 75-79 and 80 or over and divide LTC services into two categories, namely facility and home care. South Korea's total LTC expenditure is predicted to continuously increase and then reach 4.2% of GDP in 2050. Expenditure on LTC services for women is higher than that for men. Moreover, the increase in total expenditure is dramatic after 2040 for home-based services but is constant for facility services. This study shows that the presence of baby-boomers heavily influences LTC expenditure in South Korea. Copyright © 2013 John Wiley & Sons, Ltd.
Jo, Jeong Sook; Kim, Young Man; Paek, Kyung Won; Bea, Min Hee; Chun, Kihong; Lee, Soojin
Rapid growth of prescription drug expenditures is a problem in South Korea. The objective of this study was to assess the contributions of four variables (therapeutic choice, drug-mix, original use, and price changes) to increases in drug expenditures paid by the National Health Insurance (NHI) in Korea. A retrospective cohort study was conducted between January 1, 2008 and June 30, 2012 utilizing data from the NHI Claims Database of the Health Insurance Review and Assessment Service. The number of target drug types for final analysis was 13959. To analyze the growth rates of drug expenditures, this study used Fisher ideal index and the Laspeyres and Paasche indexes. With the exception of 2012, therapeutic choice contributed to about 40-60% of the increase in drug expenditures every year, while drug-mix contributed to another 30-40%. The rapid growth in prescription drug expenditure was found to be largely due to drug-mix and therapeutic choice over time. Original use had little impact on drug spending.
Wang, Chi-Chih; Tsai, Ming-Chang; Peng, Cheng-Ming; Lee, Hsiang-Lin; Chen, Hsuan-Yi; Yang, Tzu-Wei; Sung, Wen-Wei; Lin, Chun-Che
Health expenditure is a marker associated with an advanced healthcare system, which contributes toward the good prognosis of patients. Mortality-to-incidence ratios (MIRs) are one of the predictors that reflect the prognosis of cancer patients. There remains some uncertainty on the correlation of MIRs of liver cancer with the health expenditure of countries. We therefore analyzed the correlation of MIRs from the GLOBOCAN 2012 database with the WHO rankings and the total expenditures on health/gross domestic product from WHO by linear regression analyses. A total of 29 countries were selected in this study according to the data quality and the incidence number. The results showed high rates of incidence/mortality and MIRs in less developed regions (0.92 vs. 0.96 for more vs. less developed regions). Among the continents, Asia has the highest incidence/mortality in case number, crude rate, and age-standardized rate. In terms of the MIR, Northern America has the lowest MIR and Latin America and the Caribbean have the highest MIRs (0.82 and 1.04, respectively). Finally, favorable MIRs are associated significantly with good WHO ranking and high expenditures on gross domestic product (P=0.048 and 0.025, respectively). The MIR variation for liver cancer is thus found to be associated with the health expenditure and WHO ranking.
Svobodová, J; Haluzík, M; Rosická, M; Nedvídková, J; Kotrlíková, E; Kábrt, J
Leptin is a protein hormone produced by adipocytes. Its serum concentrations in the most of cases positively correlate with total body fat content and body mass index (BMI). Leptin plays a role in the food intake regulation. It also increases resting energy expenditure in hypoleptinaemic ob/ob mice. Its relationship to resting energy expenditure in human is less clear. The aim of our study was to follow the serum leptin levels in healthy females (n = 12) and males (n = 14) and their relationship to resting energy expenditure, body fat content, other antropometric and nutritional biochemical parameters. It was found that serum leptin levels were significantly higher in females comparing to males (6.8 +/- 3 ng.ml-1 vs. 2.6 +/- 1 ng.ml-1, p body fat content and body mass index in both groups. In females the positive correlation between body weight and serum leptin levels was found. No statistically significant relationship between serum leptin levels and resting energy expenditure, serum total protein, albumin or prealbumin concentration was found in any of studied groups. The results of our study do not testify to direct relationship between serum leptin levels and resting energy expenditure in young healthy individuals.
Hills, Andrew P; Mokhtar, Najat; Byrne, Nuala M
The ability to assess energy expenditure (EE) and estimate physical activity (PA) in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity), and diabetes. It is also important to appreciate that PA and EE are different constructs with PA defined as any bodily movement that results in EE and accordingly, energy is expended as a result of PA. However, total energy expenditure, best assessed using the criterion doubly labeled water (DLW) technique, includes components in addition to physical activity energy expenditure, namely resting energy expenditure and the thermic effect of food. Given the large number of assessment techniques currently used to estimate PA in humans, it is imperative to understand the relative merits of each. The goal of this review is to provide information on the utility and limitations of a range of objective measures of PA and their relationship with EE. The measures discussed include those based on EE or oxygen uptake including DLW, activity energy expenditure, physical activity level, and metabolic equivalent; those based on heart rate monitoring and motion sensors; and because of their widespread use, selected subjective measures.
Thivel, David; Aucouturier, Julien; Doucet, Éric; Saunders, Travis J; Chaput, Jean-Philippe
Both physical and sedentary activities primarily impact energy balance through energy expenditure, but they also have important implications in term of ingestive behavior. The literature provides scarce evidence on the relationship between daily activities and subsequent nutritional adaptations in children and adolescents. Sedentary activities and physical exercise are generally considered distinctly despite the fact that they represent the whole continuum of daily activity-induced energy expenditure. This brief review paper examines the impact of daily activities (from vigorous physical activity to imposed sedentary behaviors) on acute energy intake control of lean and obese children and adolescents, and whether energy expenditure is the main predictor of subsequent energy intake in this population. After an overview of the available literature, we conclude that both acute physical activity and sedentary behaviors induce food consumption modifications in children and adolescents but also that the important discrepancy between the methodologies used does not allow any clear conclusion so far. When considering energy intake responses according to the level of energy expenditure generated by those activities, it is clear that energy expenditure is not the main predictor of food consumption in both lean and obese children and adolescents. This suggests that other characteristics of those activities may have a greater impact on calorie intake (such as intensity, duration or induced mental stress) and that energy intake may be mainly determined by non-homeostatic pathways that could override the energetic and hormonal signals. Copyright © 2012 Elsevier Ltd. All rights reserved.