WorldWideScience

Sample records for relative cost weights

  1. Comparison of alternative weight recalibration methods for diagnosis-related groups

    Science.gov (United States)

    Rogowski, Jeannette Roskamp; Byrne, Daniel J.

    1990-01-01

    In this article, alternative methodologies for recalibration of the diagnosis-related group (DRG) weights are examined. Based on 1984 data, cost and charge-based weights are less congruent than those calculated with 1981 data. Previous studies using 1981 data demonstrated that cost- and charge-based weights were not very different. Charge weights result in higher payments to surgical DRGs and lower payments to medical DRGs, relative to cost weights. At the provider level, charge weights result in higher payments to large urban hospitals and teaching hospitals, relative to cost weights. PMID:10113568

  2. Investigating DRG cost weights for hospitals in middle income countries.

    Science.gov (United States)

    Ghaffari, Shahram; Doran, Christopher; Wilson, Andrew; Aisbett, Chris; Jackson, Terri

    2009-01-01

    Identifying the cost of hospital outputs, particularly acute inpatients measured by Diagnosis Related Groups (DRGs), is an important component of casemix implementation. Measuring the relative costliness of specific DRGs is useful for a wide range of policy and planning applications. Estimating the relative use of resources per DRG can be done through different costing approaches depending on availability of information and time and budget. This study aims to guide costing efforts in Iran and other countries in the region that are pursuing casemix funding, through identifying the main issues facing cost finding approaches and introducing the costing models compatible with their hospitals accounting and management structures. The results show that inadequate financial and utilisation information at the patient's level, poorly computerized 'feeder systems'; and low quality data make it impossible to estimate reliable DRGs costs through clinical costing. A cost modelling approach estimates the average cost of 2.723 million Rials (Iranian Currency) per DRG. Using standard linear regression, a coefficient of 0.14 (CI = 0.12-0.16) suggests that the average cost weight increases by 14% for every one-day increase in average length of stay (LOS).We concluded that calculation of DRG cost weights (CWs) using Australian service weights provides a sensible starting place for DRG-based hospital management; but restructuring hospital accounting systems, designing computerized feeder systems, using appropriate software, and development of national service weights that reflect local practice patterns will enhance the accuracy of DRG CWs.

  3. Low-cost, low-weight CNG cylinder development. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Richards, Mark E.; Melford, K.; Wong, J.; Gambone, L.

    1999-09-01

    This program was established to develop and commercialize new high-strength steel-lined, composite hoop-wrapped compressed natural gas (CNG) cylinders for vehicular applications. As much as 70% of the cost of natural gas vehicles can be related to on-board natural gas storage costs. The cost and weight targets for this program represent significant savings in each characteristic when compared to comparable containers available at the initiation of the program. The program objectives were to optimize specific weight and cost goals, yielding CNG cylinders with dimensions that should, allowing for minor modifications, satisfy several vehicle market segments. The optimization process encompassed material, design, and process improvement. In optimizing the CNG cylinder design, due consideration was given to safety aspects relative to national, international, and vehicle manufacturer cylinder standards and requirements. The report details the design and development effort, encompassing plant modifications, material selection, design issues, tooling development, prototype development, and prototype testing. Extenuating circumstances prevented the immediate commercialization of the cylinder designs, though significant progress was made towards improving the cost and performance of CNG cylinders. A new low-cost fiber was successfully employed while the weight target was met and the cost target was missed by less than seven percent.

  4. Cost-effectiveness of sibutramine in the LOSE Weight Study: evaluating the role of pharmacologic weight-loss therapy within a weight management program.

    Science.gov (United States)

    Malone, Daniel C; Raebel, Marsha A; Porter, Julie A; Lanty, Frances A; Conner, Douglas A; Gay, Elizabeth C; Merenich, John A; Vogel, Erin A

    2005-01-01

    the cost-effectiveness of drug therapy when used in conjunction with a weight management program (WMP) for treatment of obesity. The objective was to compare the cost-effectiveness of sibutramine (Meridia) plus a structured WMP versus only a structured WMP in both overweight and obese individuals. The core WMP was a physician-supervised, multidisciplinary program for which each enrollee paid $100 out of pocket. A cost-effectiveness analysis was performed based upon the results of a previously published randomized controlled trial conducted within a managed care organization. The target population for this study was obese or overweight persons. The perspective of the study was that of a managed care organization. The intervention consisted of subjects receiving a WMP with or without sibutramine. The primary outcomes of this study were (a) absolute change in body weight and percentage change in body weight over 12 months, (b) change in obesity-related and total medical costs from 12 months prior to enrollment through 12 months after enrollment, and (c) cost-effectiveness in terms of cost per pound of weight loss. All costs were adjusted to 2004 dollars using the respective components of the consumer price index for each medical service or medication. A total of 501 evaluable subjects were enrolled in the study, with 281 receiving sibutramine plus a structured WMP and 220 receiving only the structured WMP. The meanSD weight loss was significantly greater in the sibutramine (13.715.5 pounds, 4.8%) group than in the nondrug group (513.2 pounds, 2.2%) (P cost was a median increase of $408 for the sibutramine group compared with $31 for the nondrug group (P cost was a median $1,279 increase in the sibutramine group compared with $271 for the nondrug group (P cost by $44 per additional pound of weight loss (95% confidence interval, 42-46). Sensitivity analyses found that the results were sensitive to the price of sibutramine, whereas varying the cost of clinic visits did

  5. Weight and cost forecasting for advanced manned space vehicles

    Science.gov (United States)

    Williams, Raymond

    1989-01-01

    A mass and cost estimating computerized methology for predicting advanced manned space vehicle weights and costs was developed. The user friendly methology designated MERCER (Mass Estimating Relationship/Cost Estimating Relationship) organizes the predictive process according to major vehicle subsystem levels. Design, development, test, evaluation, and flight hardware cost forecasting is treated by the study. This methodology consists of a complete set of mass estimating relationships (MERs) which serve as the control components for the model and cost estimating relationships (CERs) which use MER output as input. To develop this model, numerous MER and CER studies were surveyed and modified where required. Additionally, relationships were regressed from raw data to accommodate the methology. The models and formulations which estimated the cost of historical vehicles to within 20 percent of the actual cost were selected. The result of the research, along with components of the MERCER Program, are reported. On the basis of the analysis, the following conclusions were established: (1) The cost of a spacecraft is best estimated by summing the cost of individual subsystems; (2) No one cost equation can be used for forecasting the cost of all spacecraft; (3) Spacecraft cost is highly correlated with its mass; (4) No study surveyed contained sufficient formulations to autonomously forecast the cost and weight of the entire advanced manned vehicle spacecraft program; (5) No user friendly program was found that linked MERs with CERs to produce spacecraft cost; and (6) The group accumulation weight estimation method (summing the estimated weights of the various subsystems) proved to be a useful method for finding total weight and cost of a spacecraft.

  6. Intensive treatment for adults with anorexia nervosa: The cost of weight restoration.

    Science.gov (United States)

    Guarda, Angela S; Schreyer, Colleen C; Fischer, Laura K; Hansen, Jennifer L; Coughlin, Janelle W; Kaminsky, Michael J; Attia, Evelyn; Redgrave, Graham W

    2017-03-01

    Weight restoration in anorexia nervosa (AN) is associated with lower relapse risk; however rate of weight gain and percent of patients achieving weight restoration (BMI ≥ 19 at discharge) vary among treatment programs. We compared both cost/pound of weight gained and cost of weight restoration in a hospital-based inpatient (IP)-partial hospitalization (PH) eating disorders program to estimates of these costs for residential treatment. All adult first admissions to the IP-PH program with AN (N = 314) from 2003 to 2015 were included. Cost of care was based on hospital charges, rates of weight gain, and weight restoration data. Results were compared with residential treatment costs extracted from a national insurance claims database and published weight gain data. Average charge/day in the IP-PH program was $2295 for IP and $1567 for PH, yielding an average cost/pound gained of $4089 and $7050, respectively, with 70% of patients achieving weight restoration. Based on published mean weight gain data and conservative cost/day estimates, residential treatment is associated with higher cost/pound, and both higher cost and lower likelihood of weight restoration for most patients. The key metrics used in this study are recommended for comparing the cost-effectiveness of intensive treatment programs for patients with AN. © 2017 Wiley Periodicals, Inc.

  7. A within-trial cost-effectiveness analysis of primary care referral to a commercial provider for weight loss treatment, relative to standard care—an international randomised controlled trial

    Science.gov (United States)

    Fuller, N R; Colagiuri, S; Schofield, D; Olson, A D; Shrestha, R; Holzapfel, C; Wolfenstetter, S B; Holle, R; Ahern, A L; Hauner, H; Jebb, S A; Caterson, I D

    2013-01-01

    Background: Due to the high prevalence of overweight and obesity there is a need to identify cost-effective approaches for weight loss in primary care and community settings. Objective: We evaluated the cost effectiveness of two weight loss programmes of 1-year duration, either standard care (SC) as defined by national guidelines, or a commercial provider (Weight Watchers) (CP). Design: This analysis was based on a randomised controlled trial of 772 adults (87% female; age 47.4±12.9 years; body mass index 31.4±2.6 kg m−2) recruited by health professionals in primary care in Australia, United Kingdom and Germany. Both a health sector and societal perspective were adopted to calculate the cost per kilogram of weight loss and the ICER, expressed as the cost per quality adjusted life year (QALY). Results: The cost per kilogram of weight loss was USD122, 90 and 180 for the CP in Australia, the United Kingdom and Germany, respectively. For SC the cost was USD138, 151 and 133, respectively. From a health-sector perspective, the ICER for the CP relative to SC was USD18 266, 12 100 and 40 933 for Australia, the United Kingdom and Germany, respectively. Corresponding societal ICER figures were USD31 663, 24 996 and 51 571. Conclusion: The CP was a cost-effective approach from a health funder and societal perspective. Despite participants in the CP group attending two to three times more meetings than the SC group, the CP was still cost effective even including these added patient travel costs. This study indicates that it is cost effective for general practitioners (GPs) to refer overweight and obese patients to a CP, which may be better value than expending public funds on GP visits to manage this problem. PMID:22929209

  8. Sequential Optimization of Paths in Directed Graphs Relative to Different Cost Functions

    KAUST Repository

    Mahayni, Malek A.

    2011-07-01

    Finding optimal paths in directed graphs is a wide area of research that has received much of attention in theoretical computer science due to its importance in many applications (e.g., computer networks and road maps). Many algorithms have been developed to solve the optimal paths problem with different kinds of graphs. An algorithm that solves the problem of paths’ optimization in directed graphs relative to different cost functions is described in [1]. It follows an approach extended from the dynamic programming approach as it solves the problem sequentially and works on directed graphs with positive weights and no loop edges. The aim of this thesis is to implement and evaluate that algorithm to find the optimal paths in directed graphs relative to two different cost functions ( , ). A possible interpretation of a directed graph is a network of roads so the weights for the function represent the length of roads, whereas the weights for the function represent a constraint of the width or weight of a vehicle. The optimization aim for those two functions is to minimize the cost relative to the function and maximize the constraint value associated with the function. This thesis also includes finding and proving the relation between the two different cost functions ( , ). When given a value of one function, we can find the best possible value for the other function. This relation is proven theoretically and also implemented and experimented using Matlab®[2].

  9. Designing for psychological change: individuals' reward and cost valuations in weight management.

    Science.gov (United States)

    Hsu, Anne; Blandford, Ann

    2014-06-26

    Knowledge of the psychological constructs that underlie behavior offers valuable design opportunities for persuasive systems. We use the decision theory, which describes how behavior is underpinned by reward-cost valuations, as a framework for investigating such psychological constructs to deliver design objectives for weight management technologies. We applied a decision theory-based analysis in the domain of weight management to understand the rewards and costs that surround individuals' weight management behaviors, with the aim of uncovering design opportunities for weight management technologies. We conducted qualitative interviews with 15 participants who were or had been trying to lose weight. Thematic analysis was used to extract themes that covered the rewards and costs surrounding weight management behaviors. We supplemented our qualitative study with a quantitative survey of 100 respondents investigating the extent to which they agreed with statements reflecting themes from the qualitative study. The primary obstacles to weight management were the rewards associated with unhealthy choices, such as the pleasures of unhealthy foods and unrestricted consumption in social situations, and the significant efforts required to change habits, plan, and exercise. Psychological constructs that supported positive weight management included feeling good after making healthy choices, being good to oneself, experiencing healthy yet still delicious foods, and receiving social support and encouraging messages (although opinions about encouraging messages was mixed). A rewards-costs driven enquiry revealed a wide range of psychological constructs that contribute to discouraging and supporting weight management. The constructs extracted from our qualitative study were verified by our quantitative survey, in which the majority of respondents also reported similar thoughts and feelings. This understanding of the rewards and costs surrounding weight management offers a range

  10. Equity weighting and the marginal damage costs of climate change

    Energy Technology Data Exchange (ETDEWEB)

    Anthoff, David [The Economic and Social Research Institute, Dublin (Ireland)]|[International Max Planck Research School on Earth System Modelling, Hamburg (Germany)]|[Research Unit Sustainability and Global Change, Hamburg University and Centre for Marine and Atmospheric Science, Hamburg (Germany); Hepburn, Cameron [Smith School of Enterprise and the Environment, and James Martin Institute, Said Business School, University of Oxford, and New College, Oxford (United Kingdom); Tol, Richard S.J. [The Economic and Social Research Institute, Dublin (Ireland)]|[Research Unit Sustainability and Global Change, Hamburg University and Centre for Marine and Atmospheric Science, Hamburg (Germany)]|[Institute for Environmental Studies, Vrije Universiteit, Amsterdam (Netherlands)]|[Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA (United States)

    2009-01-15

    Climate change will give rise to different impacts in different countries, and different countries have different levels of development. Equity-weighted estimates of the (marginal) impact of greenhouse gas emissions reflect these differences. This paper analyses the impact of equity weighting on the marginal damage cost of carbon dioxide emissions, and reaches four main conclusions. First, equity-weighted estimates are substantially higher than estimates without equity-weights; equity-weights may even change the sign of the social cost estimates. Second, estimates differ by two orders of magnitude depending on the region to which the equity weights are normalised. Third, equity-weighted estimates are sensitive to the resolution of the impact estimates. Depending on the assumed intra-regional income distribution, estimates may be more than twice as high if national rather than regional impacts are aggregated. Fourth, variations in the assumed inequality aversion have different impacts in different scenarios, not only because different scenarios have different emissions and hence warming, but also because different scenarios have different income differences, different growth rates, and different vulnerabilities. (author)

  11. Equity weighting and the marginal damage costs of climate change

    International Nuclear Information System (INIS)

    Anthoff, David; Hepburn, Cameron; Tol, Richard S.J.

    2009-01-01

    Climate change will give rise to different impacts in different countries, and different countries have different levels of development. Equity-weighted estimates of the (marginal) impact of greenhouse gas emissions reflect these differences. This paper analyses the impact of equity weighting on the marginal damage cost of carbon dioxide emissions, and reaches four main conclusions. First, equity-weighted estimates are substantially higher than estimates without equity-weights; equity-weights may even change the sign of the social cost estimates. Second, estimates differ by two orders of magnitude depending on the region to which the equity weights are normalised. Third, equity-weighted estimates are sensitive to the resolution of the impact estimates. Depending on the assumed intra-regional income distribution, estimates may be more than twice as high if national rather than regional impacts are aggregated. Fourth, variations in the assumed inequality aversion have different impacts in different scenarios, not only because different scenarios have different emissions and hence warming, but also because different scenarios have different income differences, different growth rates, and different vulnerabilities. (author)

  12. Discount rates, equity weights and the social cost of carbon

    International Nuclear Information System (INIS)

    Hope, Chris

    2008-01-01

    Equity weighting has been proposed as a way of allowing welfare equivalents to be included in the social cost of carbon since a dollar to a poor person is worth more than a dollar to a rich one. Here we use the PAGE2002 integrated assessment model to show that the social cost of carbon is higher without equity weights (an elasticity of marginal utility with respect to income of 0) than with them. This might seem counter-intuitive, but it comes about because of the logical link between equity weights and discount rates; as the elasticity goes from 0 to - 0.5 to - 1.0, the social rate of time preference rises, and the drop in present values that results far outweighs the small increase in impacts that equity weights bring. (author)

  13. Associations of recent weight loss with health care costs and utilization among older women.

    Directory of Open Access Journals (Sweden)

    John T Schousboe

    Full Text Available The association of weight loss with health care costs among older women is uncertain. Our study aim was to examine the association of objectively measured weight change with subsequent total health care (THC costs and other health care utilization among older women. Our study population included 2,083 women (mean age 80.2 years enrolled in the Study of Osteoporotic Fractures and U.S. Medicare Fee for Service. Weight loss and gain were defined, respectively, as ≥5% decrease and ≥5% increase in body weight, and weight maintenance as <5% change in body weight over a period of 4.5 years. THC costs, outpatient costs, hospitalizations, and skilled nursing facility [SNF] utilization were estimated from Medicare claims for 1 year after the period during which weight change was measured. The associations of weight change with THC and outpatient costs were estimated using generalized linear models with gamma variance and log link functions, and with hospitalizations and SNF utilization using logistic models. Adjusted for age and current body mass index (BMI, weight loss compared with weight maintenance was associated with a 35% increase in THC costs ($2148 [95% CI, 745 to 3552], 2014 U.S. dollars, a 15% increase in outpatient costs ($329 [95% C.I. -1 to 660], and odds ratios of 1.42 (95% CI, 1.14 to 1.76 for ≥1 hospital stay and 1.45 (95% CI, 1.03 to 2.03 for ≥1 SNF stay. These associations did not vary by BMI category. After additional adjustment for multi-morbidity and functional status, associations of weight loss with all four outcomes were no longer significant. In conclusion, ≥5% weight loss among older women is not associated with increased THC and outpatient costs, hospitalization, and SNF utilization, irrespective of BMI category after accounting for multi-morbidity and impaired functional status that accompany weight loss.

  14. Predictive Engineering Tools for Injection-Molded Long-Carbon-Thermoplastic Composites: Weight and Cost Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Ba Nghiep [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fifield, Leonard S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Gandhi, Umesh N. [Toyota Research Inst. North America, Ann Arbor, MI (United States); Mori, Steven [MAGNA Exteriors and Interiors Corporation, Aurora, ON (Canada); Wollan, Eric J. [PlastiComp, Inc., Winona, MN (United States)

    2016-08-01

    This project proposed to integrate, optimize and validate the fiber orientation and length distribution models previously developed and implemented in the Autodesk Simulation Moldflow Insight (ASMI) package for injection-molded long-carbon-fiber thermoplastic composites into a cohesive prediction capability. The current effort focused on rendering the developed models more robust and efficient for automotive industry part design to enable weight savings and cost reduction. The project goal has been achieved by optimizing the developed models, improving and integrating their implementations in ASMI, and validating them for a complex 3D LCF thermoplastic automotive part (Figure 1). Both PP and PA66 were used as resin matrices. After validating ASMI predictions for fiber orientation and fiber length for this complex part against the corresponding measured data, in collaborations with Toyota and Magna PNNL developed a method using the predictive engineering tool to assess LCF/PA66 complex part design in terms of stiffness performance. Structural three-point bending analyses of the complex part and similar parts in steel were then performed for this purpose, and the team has then demonstrated the use of stiffness-based complex part design assessment to evaluate weight savings relative to the body system target (≥ 35%) set in Table 2 of DE-FOA-0000648 (AOI #1). In addition, starting from the part-to-part analysis, the PE tools enabled an estimated weight reduction for the vehicle body system using 50 wt% LCF/PA66 parts relative to the current steel system. Also, from this analysis an estimate of the manufacturing cost including the material cost for making the equivalent part in steel has been determined and compared to the costs for making the LCF/PA66 part to determine the cost per “saved” pound.

  15. Food-related parenting practices and child and adolescent weight and weight-related behaviors.

    Science.gov (United States)

    Loth, K; Fulkerson, J A; Neumark-Sztainer, D

    2014-03-01

    The prevalence of overweight and obesity in children has reached a concerning plateau in the past three decades, with overweight or obesity impacting approximately one-third of youth. Unhealthy weight-related behaviors, including dieting, unhealthy weight control practices and binge eating, are also a great public health concern for young people given both their high prevalence and harmful consequences. Food-related parenting practices, including food restriction and pressure-to-eat, have been associated with higher weight status, as well as the use of unhealthy weight-related behaviors, in children and adolescents. Physicians and other health care providers who work with families should discourage parents from using food restriction and pressure-to-eat parenting practices with their child or adolescent. Alternatively, parents should be empowered to promote healthy eating by focusing on making nutritious food items readily available within their home and modeling healthy food choices for their child or adolescent.

  16. Effects of independently altering body weight and body mass on the metabolic cost of running.

    Science.gov (United States)

    Teunissen, Lennart P J; Grabowski, Alena; Kram, Rodger

    2007-12-01

    The metabolic cost of running is substantial, despite the savings from elastic energy storage and return. Previous studies suggest that generating vertical force to support body weight and horizontal forces to brake and propel body mass are the major determinants of the metabolic cost of running. In the present study, we investigated how independently altering body weight and body mass affects the metabolic cost of running. Based on previous studies, we hypothesized that reducing body weight would decrease metabolic rate proportionally, and adding mass and weight would increase metabolic rate proportionally. Further, because previous studies show that adding mass alone does not affect the forces generated on the ground, we hypothesized that adding mass alone would have no substantial effect on metabolic rate. We manipulated the body weight and body mass of 10 recreational human runners and measured their metabolic rates while they ran at 3 m s(-1). We reduced weight using a harness system, increased mass and weight using lead worn about the waist, and increased mass alone using a combination of weight support and added load. We found that net metabolic rate decreased in less than direct proportion to reduced body weight, increased in slightly more than direct proportion to added load (added mass and weight), and was not substantially different from normal running with added mass alone. Adding mass alone was not an effective method for determining the metabolic cost attributable to braking/propelling body mass. Runners loaded with mass alone did not generate greater vertical or horizontal impulses and their metabolic costs did not substantially differ from those of normal running. Our results show that generating force to support body weight is the primary determinant of the metabolic cost of running. Extrapolating our reduced weight data to zero weight suggests that supporting body weight comprises at most 74% of the net cost of running. However, 74% is probably an

  17. The effect of simulating weight gain on the energy cost of walking in unimpaired children and children with cerebral palsy.

    Science.gov (United States)

    Plasschaert, Frank; Jones, Kim; Forward, Malcolm

    2008-12-01

    To examine the effect of simulating weight gain on the energy cost of walking in children with cerebral palsy (CP) compared with unimpaired children. Repeated measures, matched subjects, controlled. University hospital clinical gait and movement analysis laboratory. Children (n=42) with CP and unimpaired children (n=42). Addition of 10% of body mass in weight belt. Energy cost of walking parameters consisting of walking speed, Physiological Cost Index, Total Heart Beat Index, oxygen uptake (VO2), gross oxygen cost, nondimensional net oxygen cost, and net oxygen cost with speed normalized to height were measured by using a breath-by-breath gas analysis system (K4b2) and a light beam timing gate system arranged around a figure 8 track. Two walking trials were performed in random order, with and the other without wearing a weighted belt. Children with CP and their unimpaired counterparts responded in fundamentally different ways to weight gain. The unimpaired population maintained speed and VO2 but the children with CP trended toward a drop in their speed and an increase in their VO2. The oxygen consumption of children with CP showed a greater dependence on mass than the unimpaired group (P=.043). An increase of a relatively small percentage in body mass began to significantly impact the energy cost of walking in children with CP. This result highlights the need for weight control to sustain the level of functional walking in these children.

  18. Cost Effectiveness of a Weight Management Program Implemented in the Worksite: Translation of Fuel Your Life.

    Science.gov (United States)

    Corso, Phaedra S; Ingels, Justin B; Padilla, Heather M; Zuercher, Heather; DeJoy, David M; Vandenberg, Robert J; Wilson, Mark G

    2018-04-18

    Conduct a cost-effectiveness analysis of the Fuel Your Life (FYL) program dissemination. Employees were recruited from three workplaces randomly assigned to one of the conditions: telephone coaching, small group coaching, and self-study. Costs were collected prospectively during the efficacy trial. The main outcome measures of interest were weight loss and quality-adjusted life years (QALYs). The phone condition was most costly ($601-$589/employee) and the self-study condition was least costly ($145-$143/employee). For weight loss, delivering FYL through the small group condition was no more effective, yet more expensive, than the self-study delivery. For QALYs, the group delivery of FYL was in an acceptable cost-effectiveness range ($22,400/QALY) relative to self-study (95% CI: $10,600/QALY - dominated). Prevention programs require adaptation at the local level and significantly affect the cost, effectiveness, and cost effectiveness of the program.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

  19. A randomized controlled trial testing an Internet delivered cost-benefit approach to weight loss maintenance.

    Science.gov (United States)

    Leahey, Tricia M; Fava, Joseph L; Seiden, Andrew; Fernandes, Denise; Doyle, Caroline; Kent, Kimberly; La Rue, Molly; Mitchell, Marc; Wing, Rena R

    2016-11-01

    Weight loss maintenance is a significant challenge in obesity treatment. During maintenance the "costs" of adhering to weight management behaviors may outweigh the "benefits." This study examined the efficacy of a novel approach to weight loss maintenance based on modifying the cost-benefit ratio. Individuals who achieved a 5% weight loss (N=75) were randomized to one of three, 10-month maintenance interventions. All interventions were delivered primarily via the Internet. The Standard arm received traditional weight maintenance strategies. To increase benefits, or rewards, for maintenance behaviors, the two cost-benefit intervention conditions received weekly monetary rewards for self-monitoring and social reinforcement via e-coaching. To decrease behavioral costs (boredom) and increase novelty, participants in the cost-benefit conditions also monitored different evidence-based behaviors every two weeks (e.g., Weeks 1 & 2: steps; Week 3 & 4: red foods). The primary difference between the cost-benefit interventions was type of e-coach providing social reinforcement: Professional (CB Pro) or Peer (CB Peer). Study procedures took place in Providence, RI from 2013 to 2014. Retention was 99%. There were significant group differences in weight regain (p=.01). The Standard arm gained 3.5±5.7kg. In contrast, participants in CB Pro and CB Peer lost an additional 1.8±7.0kg and 0.5±6.4kg, respectively. These results suggest that an Internet delivered cost-benefit approach to weight loss maintenance may be effective for long-term weight control. In addition, using peer coaches to provide reinforcement may be a particularly economic alternative to professionals. These data are promising and provide support for a larger, longer trial. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Cost reduction in abdominal CT by weight-adjusted dose.

    Science.gov (United States)

    Arana, Estanislao; Martí-Bonmatí, Luis; Tobarra, Eva; Sierra, Consuelo

    2009-06-01

    To analyze the influence of contrast dose adjusted by weight vs. fixed contrast dose in the attenuation and cost of abdominal computed tomography (CT). A randomised, consecutive, parallel group study was conducted in 151 patients (74 men and 77 women, age range 22-67 years), studied with the same CT helical protocol. A dose at 1.75 ml/kg was administered in 101 patients while 50 patients had a fixed dose of 120 ml of same non-ionic contrast material (320 mg/ml). Mean enhancements were measured at right hepatic lobe, superior abdominal aorta and inferior cava vein. Statistical analysis was weight-stratified (81 kg). Aortic attenuation was significantly superior (p61 kg in dose-adjusted group, presented higher hepatic attenuation, being statistically significant in those >81 kg (p80 kg, there was an over cost of euro 10.7 per patient. An injection volume of 1.75 ml/kg offers an optimal diagnostic quality with a global savings of euro 1.34 per patient.

  1. Environmental costs and resource planning consequences: New England electric's rating and weighting approach

    International Nuclear Information System (INIS)

    Destribats, A.F.; Hutchinson, M.A.; Stout, T.M.; White, D.S.

    1990-01-01

    In mid 1989, the New England Electric System (NEES or Company) began an effort to reflect the potential environmental externalities of new resources in its long range planning process. Having examined several methods for incorporating externalities, including cost of control, the Company adopted a rating and weighting approach. Not strictly quantitative nor qualitative, the rating and weighting approach provided a means to apply an environmental score to all new resources considered for the Company's long range resource plan, NEESPLAN 1990. A maximum environmental cost penalty of fifteen percent was applied to the resource considered for inclusion in the plan that posed the highest amount of potential environmental degradation. All other resources received a smaller penalty that was based on the ratio of their environmental score to the highest score. Application of this penalty tended to improve the cost-effectiveness of demand-side programs and worsen some supply-side options' cost-effectiveness. Both the rating and weighting approach employed by NEES and its application in the long range planning process have been the subject of several critical reviews. Having stated that the advantages of the rating and weighting approach include its easy reviewability and flexibility to be modified as better information becomes available, the Company has subsequently revised the approach to address the comments made by reviewers. The purpose of this paper is to describe the rating and weighting approach, its recent revisions, and the effect of the revised methodology on the Company's long range resource plan

  2. Weight status and weight-related behaviors of children commencing school.

    Science.gov (United States)

    Hardy, Louise L; King, Lesley; Hector, Debra; Lloyd, Beverley

    2012-11-01

    To describe the weight status and weight-related behaviors of children commencing school. This study is a representative cross-sectional survey of Australian children in their first year of schooling (n=1141) in 2010. Height and weight were measured, and parents reported their child's diet, physical activity and screen-time. 18.7% of children were overweight/obese. Compared with non-overweight/obese peers, overweight/obese boys were 1.73 times (95% CI 1.08, 2.79) as likely to exceed recommended screen time and 2.07 times (95% CI 1.11, 3.87) as likely to eat dinner three or more times/week in front of the TV. Overweight/obese girls were twice as likely to have a TV in their bedroom (OR 2.00, 95% CI 1.12, 3.59) and usually be rewarded with sweets for good behavior (OR 1.96, 95% CI 1.09, 3.51) and were 1.65 times as likely to be inactive (95% CI 1.08, 2.55). We showed that many children begin school with established weight-related behaviors that occur in the home environment. The inclusion of parents and the home environment in intervention strategies will be important to support changes to reduce childhood obesity. The weight status and weight-related behaviors of children entering school may potentially be a general indicator of the overall effectiveness of obesity prevention interventions among preschool-aged children. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  3. A low cost, light weight cenosphere–aluminium composite for brake ...

    Indian Academy of Sciences (India)

    . Home; Journals; Bulletin of Materials Science; Volume 39; Issue 1. A low cost, light weight cenosphere–aluminium composite for brake disc application. V Saravanan P R Thyla S R Balakrishnan. Volume 39 Issue 1 February 2016 pp 299-305 ...

  4. Cost reduction in abdominal CT by weight-adjusted dose

    International Nuclear Information System (INIS)

    Arana, Estanislao; Marti-Bonmati, Luis; Tobarra, Eva; Sierra, Consuelo

    2009-01-01

    Aim: To analyze the influence of contrast dose adjusted by weight vs. fixed contrast dose in the attenuation and cost of abdominal computed tomography (CT). Materials and methods: A randomised, consecutive, parallel group study was conducted in 151 patients (74 men and 77 women, age range 22-67 years), studied with the same CT helical protocol. A dose at 1.75 ml/kg was administered in 101 patients while 50 patients had a fixed dose of 120 ml of same non-ionic contrast material (320 mg/ml). Mean enhancements were measured at right hepatic lobe, superior abdominal aorta and inferior cava vein. Statistical analysis was weight-stratified ( 81 kg). Results: Aortic attenuation was significantly superior (p 61 kg in dose-adjusted group, presented higher hepatic attenuation, being statistically significant in those >81 kg (p 80 kg, there was an over cost of Euro 10.7 per patient. Conclusions: An injection volume of 1.75 ml/kg offers an optimal diagnostic quality with a global savings of Euro 1.34 per patient.

  5. Configuration space analysis of common cost functions in radiotherapy beam-weight optimization algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Rowbottom, Carl Graham [Joint Department of Physics, Institute of Cancer Research and the Royal Marsden NHS Trust, Sutton, Surrey (United Kingdom); Webb, Steve [Joint Department of Physics, Institute of Cancer Research and the Royal Marsden NHS Trust, Sutton, Surrey (United Kingdom)

    2002-01-07

    The successful implementation of downhill search engines in radiotherapy optimization algorithms depends on the absence of local minima in the search space. Such techniques are much faster than stochastic optimization methods but may become trapped in local minima if they exist. A technique known as 'configuration space analysis' was applied to examine the search space of cost functions used in radiotherapy beam-weight optimization algorithms. A downhill-simplex beam-weight optimization algorithm was run repeatedly to produce a frequency distribution of final cost values. By plotting the frequency distribution as a function of final cost, the existence of local minima can be determined. Common cost functions such as the quadratic deviation of dose to the planning target volume (PTV), integral dose to organs-at-risk (OARs), dose-threshold and dose-volume constraints for OARs were studied. Combinations of the cost functions were also considered. The simple cost function terms such as the quadratic PTV dose and integral dose to OAR cost function terms are not susceptible to local minima. In contrast, dose-threshold and dose-volume OAR constraint cost function terms are able to produce local minima in the example case studied. (author)

  6. Association of increased monetary cost of dietary intake, diet quality and weight management in Spanish adults.

    Science.gov (United States)

    Schröder, Helmut; Serra-Majem, Luis; Subirana, Isaac; Izquierdo-Pulido, Maria; Fitó, Montserrat; Elosua, Roberto

    2016-03-14

    Higher monetary diet cost is associated with healthier food choices and better weight management. How changes in diet cost affect changes in diet quality and weight remains unknown. The aim of this study was to assess the impact of changes in individual monetary diet cost on changes in diet quality, measured by the modified Mediterranean diet score recommendations (MDS-rec) and by energy density (ED), as well as changes in weight and BMI. We conducted a prospective, population-based study of 2181 male and female Spaniards aged between 25 and 74 years, who were followed up to the 2009-2010 academic year. We measured weight and height and recorded dietary data using a validated FFQ. Average food cost was calculated from official Spanish government data. We fitted multivariate linear and logistic regression models. The average daily diet cost increased from 3·68(SD0.0·89)€/8·36 MJ to 4·97(SD1·16)€/8·36 MJ during the study period. This increase was significantly associated with improvement in diet quality (Δ ED and Δ MDS-rec; Pcost per 8·36 MJ was associated with a decrease of 0·3 kg in body weight (P=0·02) and 0·1 kg/m(2) in BMI (P=0·04). These associations were attenuated after adjusting for changes in diet quality indicators. An improvement in diet quality and better weight management were both associated with an increase in diet cost; this could be considered in food policy decisions.

  7. Estimation of Relative Economic Weights of Hanwoo Carcass Traits Based on Carcass Market Price

    Science.gov (United States)

    Choy, Yun Ho; Park, Byoung Ho; Choi, Tae Jung; Choi, Jae Gwan; Cho, Kwang Hyun; Lee, Seung Soo; Choi, You Lim; Koh, Kyung Chul; Kim, Hyo Sun

    2012-01-01

    The objective of this study was to estimate economic weights of Hanwoo carcass traits that can be used to build economic selection indexes for selection of seedstocks. Data from carcass measures for determining beef yield and quality grades were collected and provided by the Korean Institute for Animal Products Quality Evaluation (KAPE). Out of 1,556,971 records, 476,430 records collected from 13 abattoirs from 2008 to 2010 after deletion of outlying observations were used to estimate relative economic weights of bid price per kg carcass weight on cold carcass weight (CW), eye muscle area (EMA), backfat thickness (BF) and marbling score (MS) and the phenotypic relationships among component traits. Price of carcass tended to increase linearly as yield grades or quality grades, in marginal or in combination, increased. Partial regression coefficients for MS, EMA, BF, and for CW in original scales were +948.5 won/score, +27.3 won/cm2, −95.2 won/mm and +7.3 won/kg when all three sex categories were taken into account. Among four grade determining traits, relative economic weight of MS was the greatest. Variations in partial regression coefficients by sex categories were great but the trends in relative weights for each carcass measures were similar. Relative economic weights of four traits in integer values when standardized measures were fit into covariance model were +4:+1:−1:+1 for MS:EMA:BF:CW. Further research is required to account for the cost of production per unit carcass weight or per unit production under different economic situations. PMID:25049531

  8. Lifting the weight of a diagnosis-related groups family change: a comparison between refined and non-refined DRG systems for top-down cost accounting and efficiency indicators.

    Science.gov (United States)

    Zlotnik, Alexander; Cuchi, Miguel Alfaro; Pérez Pérez, Maria Carmen

    Public healthcare providers in all Spanish Regions - Autonomous Communities (ACs) use All Patients Diagnosis-Related Groups (AP-DRGs) for billing non-insured patients, cost accounting and inpatient efficiency indicators. A national migration to All Patients Refined Diagnosis-Related Groups (APR-DRGs) has been scheduled for 2016. The analysis was performed on 202,912 inpatient care episodes ranging from 2005 to 2010. All episodes were grouped using AP-DRG v25.0 and APR-DRG v24.0. Normalised DRG weight variations for an AP-DRG to APR-DRG migration scenario were calculated and compared. Major differences exist between normalised weights for inpatient episodes depending on the DRGs family used. The usage of the APR-DRG system in Spain without any adjustments, as it was developed in the United States, should be approached with care. In order to avoid reverse incentives and provider financial risks, coding practices should be reviewed and structural differences between DRG families taken into account.

  9. Weight Discrimination and Unhealthy Eating-related Behaviors

    Science.gov (United States)

    Sutin, Angelina; Robinson, Eric; Daly, Michael; Terracciano, Antonio

    2016-01-01

    Individuals with obesity often experience unfair treatment because of their body weight. Such experiences are associated with binge eating, but less is known about its association with other eating-related behaviors and whether these relations are specific to discrimination based on weight or extend to other attributions for discrimination. The present research uses a large national sample (N=5,129) to examine whether weight discrimination is associated with diet and meal rhythmicity, in addition to overeating, and whether these associations generalize to nine other attributions for discrimination. We found that in addition to overeating, weight discrimination was associated with more frequent consumption of convenience foods and less regular meal timing. These associations were generally similar across sex, age, and race. Discrimination based on ancestry, gender, age, religion, and physical disability were also associated with overeating, which suggests that overeating may be a general coping response to discrimination. Unfair treatment because of body weight is associated with unhealthy eating-related behaviors, which may be one pathway through which weight discrimination increases risk for weight gain and obesity. PMID:26877216

  10. Body checking is associated with weight- and body-related shame and weight- and body-related guilt among men and women.

    Science.gov (United States)

    Solomon-Krakus, Shauna; Sabiston, Catherine M

    2017-12-01

    This study examined whether body checking was a correlate of weight- and body-related shame and guilt for men and women. Participants were 537 adults (386 women) between the ages of 17 and 74 (M age =28.29, SD=14.63). Preliminary analyses showed women reported significantly more body-checking (pbody-related shame (pbody-related guilt (pbody checking was significantly and positively associated with weight- and body-related shame (R 2 =.29 and .43, pbody-related guilt (R 2 =.34 and .45, pbody checking is associated with negative weight- and body-related self-conscious emotions. Intervention and prevention efforts aimed at reducing negative weight- and body-related self-conscious emotions should consider focusing on body checking for adult men and women. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Weight discrimination and unhealthy eating-related behaviors.

    Science.gov (United States)

    Sutin, Angelina; Robinson, Eric; Daly, Michael; Terracciano, Antonio

    2016-07-01

    Individuals with obesity often experience unfair treatment because of their body weight. Such experiences are associated with binge eating, but less is known about its association with other eating-related behaviors and whether these relations are specific to discrimination based on weight or extend to other attributions for discrimination. The present research uses a large national sample (N = 5129) to examine whether weight discrimination is associated with diet and meal rhythmicity, in addition to overeating, and whether these associations generalize to nine other attributions for discrimination. We found that in addition to overeating, weight discrimination was associated with more frequent consumption of convenience foods and less regular meal timing. These associations were generally similar across sex, age, and race. Discrimination based on ancestry, gender, age, religion, and physical disability were also associated with overeating, which suggests that overeating may be a general coping response to discrimination. Unfair treatment because of body weight is associated with unhealthy eating-related behaviors, which may be one pathway through which weight discrimination increases risk for weight gain and obesity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Standing economy: does the heterogeneity in the energy cost of posture maintenance reside in differential patterns of spontaneous weight-shifting?

    Science.gov (United States)

    Miles-Chan, Jennifer L; Fares, Elie-Jacques; Berkachy, Redina; Jacquet, Philippe; Isacco, Laurie; Schutz, Yves; Montani, Jean-Pierre; Dulloo, Abdul G

    2017-04-01

    Due to sedentarity-associated disease risks, there is much interest in methods to increase low-intensity physical activity. In this context, it is widely assumed that altering posture allocation can modify energy expenditure (EE) to impact body-weight regulation and health. However, we have recently shown the existence of two distinct phenotypes pertaining to the energy cost of standing-with most individuals having no sustained increase in EE during steady-state standing relative to sitting comfortably. Here, we investigated whether these distinct phenotypes are related to the presence/absence of spontaneous "weight-shifting", i.e. the redistribution of body-weight from one foot to the other. Using indirect calorimetry to measure EE in young adults during sitting and 10 min of steady-state standing, we examined: (i) heterogeneity in EE during standing (n = 36); (ii) EE and spontaneous weight-shifting patterns (n = 18); (iii) EE during spontaneous weight-shifting versus experimentally induced weight-shifting (n = 7), and; (iv) EE during spontaneous weight-shifting versus intermittent leg/body displacement (n = 6). Despite heterogeneity in EE response to steady-state standing, no differences were found in the amount or pattern of spontaneous weight-shifting between the two phenotypes. Whilst experimentally induced weight-shifting resulted in a mean EE increase of only 11% (range: 0-25%), intermittent leg/body displacement increased EE to >1.5 METs in all participants. Although the variability in spontaneous weight-shifting signatures between individuals does not appear to underlie heterogeneity in the energy cost of standing posture maintenance, these studies underscore the fact that leg/body displacement, rather than standing posture alone, is needed to increase EE above the currently defined sedentary threshold.

  13. Costs and expected gain in lifetime health from intensive care versus general ward care of 30,712 individual patients: a distribution-weighted cost-effectiveness analysis.

    Science.gov (United States)

    Lindemark, Frode; Haaland, Øystein A; Kvåle, Reidar; Flaatten, Hans; Norheim, Ole F; Johansson, Kjell A

    2017-08-21

    Clinicians, hospital managers, policy makers, and researchers are concerned about high costs, increased demand, and variation in priorities in the intensive care unit (ICU). The objectives of this modelling study are to describe the extra costs and expected health gains associated with admission to the ICU versus the general ward for 30,712 patients and the variation in cost-effectiveness estimates among subgroups and individuals, and to perform a distribution-weighted economic evaluation incorporating extra weighting to patients with high severity of disease. We used a decision-analytic model that estimates the incremental cost per quality-adjusted life year (QALY) gained (ICER) from ICU admission compared with general ward care using Norwegian registry data from 2008 to 2010. We assigned increasing weights to health gains for those with higher severity of disease, defined as less expected lifetime health if not admitted. The study has inherent uncertainty of findings because a randomized clinical trial comparing patients admitted or rejected to the ICU has never been performed. Uncertainty is explored in probabilistic sensitivity analysis. The mean cost-effectiveness of ICU admission versus ward care was €11,600/QALY, with 1.6 QALYs gained and an incremental cost of €18,700 per patient. The probability (p) of cost-effectiveness was 95% at a threshold of €22,000/QALY. The mean ICER for medical admissions was €10,700/QALY (p = 97%), €12,300/QALY (p = 93%) for admissions after acute surgery, and €14,700/QALY (p = 84%) after planned surgery. For individualized ICERs, there was a 50% probability that ICU admission was cost-effective for 85% of the patients at a threshold of €64,000/QALY, leaving 15% of the admissions not cost-effective. In the distributional evaluation, 8% of all patients had distribution-weighted ICERs (higher weights to gains for more severe conditions) above €64,000/QALY. High-severity admissions gained the most, and were more

  14. Weight-Loss Expectancies, Relative Weight, and Symptoms of Bulimia in Young Women.

    Science.gov (United States)

    Thombs, Dennis L.; And Others

    1996-01-01

    A canonical correlation analysis of various weight concerns in a sample of college women revealed that strong expectations of weight loss benefits and a high relative body weight were positively correlated with the four major symptoms of bulimia. Expectations of increased self-worth and social confidence were linked to eating problems. (RJM)

  15. Frequency-Weighted Balancing Related Controller Reduction

    OpenAIRE

    Varga, Andras; Anderson, Brian D.O.

    2002-01-01

    The efficient solution of a class of controller approximation problems by using frequency-weighted balancing related model reduction approaches is considered. It is shown that for certain standard performance and stability enforcing frequency-weights, the computation of the frequency-weighted controllability and observability grammians can be done by solving reduced order Lyapunov equations regardless the controller itself is stable or unstable. The new approach can be used in conjunction wit...

  16. Public Support for Weight-Related Antidiscrimination Laws and Policies.

    Science.gov (United States)

    Hilbert, Anja; Hübner, Claudia; Schmutzer, Gabriele; Danielsdottir, Sigrun; Brähler, Elmar; Puhl, Rebecca

    2017-01-01

    Weight-related discrimination is prevalent and associated with health impairments for those who are targeted, which underscores the need of antidiscrimination legislation. This study is the first to examine public support of weight-related antidiscrimination laws or policies in Germany, compared to the US and Iceland. In a representative German population sample (N = 2,513), public support for general and employment-specific weight-related antidiscrimination policies, weight-based victimization, and weight bias internalization were measured through established self-report questionnaires. Half of the German population sample agreed with antidiscrimination policies. General antidiscrimination laws received lower support than employment-specific laws. Support for policies considering obesity a physical disability was greatest in Germany, whereas support for employment-specific antidiscrimination laws was lower in Germany than in the US and Iceland. Total support for weight-related antidiscrimination policies was significantly predicted by lower age, female gender, obese weight status, residence in West Germany, church membership, and readiness to vote in elections. German support for weight-related antidiscrimination policies is moderate. Increasing awareness about weight-related discrimination and laws prohibiting this behavior may help to promote policy acceptance. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  17. Selecting an Architecture for a Safety-Critical Distributed Computer System with Power, Weight and Cost Considerations

    Science.gov (United States)

    Torres-Pomales, Wilfredo

    2014-01-01

    This report presents an example of the application of multi-criteria decision analysis to the selection of an architecture for a safety-critical distributed computer system. The design problem includes constraints on minimum system availability and integrity, and the decision is based on the optimal balance of power, weight and cost. The analysis process includes the generation of alternative architectures, evaluation of individual decision criteria, and the selection of an alternative based on overall value. In this example presented here, iterative application of the quantitative evaluation process made it possible to deliberately generate an alternative architecture that is superior to all others regardless of the relative importance of cost.

  18. Cessation-related weight concern among homeless male and female smokers.

    Science.gov (United States)

    Pinsker, Erika Ashley; Hennrikus, Deborah Jane; Erickson, Darin J; Call, Kathleen Thiede; Forster, Jean Lois; Okuyemi, Kolawole Stephen

    2017-09-01

    Concern about post-cessation weight gain is a barrier to making attempts to quit smoking; however, its effect on smoking cessation is unclear. In this study we examine cessation-related weight concern among the homeless, which hasn't been studied. Homeless males (n = 320) and females (n = 110) participating in a smoking cessation RCT in the Twin Cities, Minnesota from 2009 to 2011 completed surveys on cessation-related weight concern, smoking status, and components from the Behavioral Model for Vulnerable Populations. Generalized estimating equations were used to examine baseline predictors of cessation-related weight concern at baseline, the end of treatment, and 26-weeks follow-up. Logistic regression models were used to examine the relationship between cessation-related weight concern and smoking status at the end of treatment and follow-up. Females had higher cessation-related weight concern than males. Among males, older age, Black race, higher BMI, depression, and having health insurance were associated with higher cessation-related weight concern. Among females, nicotine dependence, greater cigarette consumption, indicating quitting is more important, older age of smoking initiation, and less support to quit from family were associated with higher cessation-related weight concern. In multivariate analyses, cessation-related weight concern decreased over time among females. Cessation-related weight concern wasn't associated with smoking cessation. Although several types of characteristics predicted cessation-related weight concern among males, only smoking characteristics predicted cessation-related weight concern among females. Given the small proportion of quitters in this study (8% of males and 5% of females), further research on the impact of cessation-related weight concern on smoking cessation among the homeless is warranted.

  19. Derivation of weighting factors for cost and radiological impact for use in comparison of waste management methods

    International Nuclear Information System (INIS)

    Allen, P.T.; Lee, T.R.

    1991-01-01

    Nuclear waste management decisions are complex, and must include considerations of cost and social factors in addition to dose limitation. Decision-aiding techniques, such as multi-attribute analysis, can assist in structuring the problem and can icorporate as many factors, or attributes, as required. However, the relative weights of such attributes need to be established. Methods were devised which could be compared with one another. These were questionnaire-based but, in order to examine the possible influence of the measurement procedures on the results, two of the methods were combined in an experimental design. The two direct methods for obtaining weights (the conventional rating scales and the direct rating task) showed good agreement and yielded different values for separate social groups, such as industrial employees and lay public. The main conclusion is that the elicitation of weighting factors from the public is possible and that the resulting weights are meaningful and could have significant effects on the choice of waste management options

  20. Parenting style as a predictor of adolescent weight and weight-related behaviors.

    Science.gov (United States)

    Berge, Jerica M; Wall, Melanie; Loth, Katie; Neumark-Sztainer, Dianne

    2010-04-01

    Current research indicates that specific parenting styles are associated with adolescent overweight, dietary intake, and physical activity; but most of the research has been cross-sectional, making it difficult to determine the temporal order of these associations. The current study adds to the previous research by examining 5-year longitudinal associations between parenting style and adolescent weight and weight-related behaviors. Data from Project EAT, a population-based study with adolescents from diverse ethnic and socioeconomic backgrounds, were used. Adolescents (N = 2,516) from 31 Minnesota schools completed in-class assessments in 1999 (Time 1) and mailed surveys in 2004 (Time 2). Multiple linear regression models were used to predict mean levels of adolescent outcomes at Time 2 from parenting style at Time 1. Time 1 maternal authoritative parenting style predicted lower body mass index in adolescent sons and daughters at Time 2. Time 1 paternal permissive parenting style predicted more fruits and vegetables intake in daughters at Time 2. Significant associations were not found between parenting style and adolescent physical activity. Findings suggest that authoritative parenting style may play a protective role related to adolescent overweight and that the dimension of warmth and/or caring in the parent-adolescent relationship may be important in relation to female adolescent healthy dietary intake. Further exploration of opposite sex parent-adolescent dyad patterns related to parenting style and adolescent weight and weight-related behaviors is warranted. Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.

  1. Cost-effectiveness of bone densitometry among Caucasian women and men without a prior fracture according to age and body weight.

    Science.gov (United States)

    Schousboe, J T; Gourlay, M; Fink, H A; Taylor, B C; Orwoll, E S; Barrett-Connor, E; Melton, L J; Cummings, S R; Ensrud, K E

    2013-01-01

    We used a microsimulation model to estimate the threshold body weights at which screening bone densitometry is cost-effective. Among women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to identify those for whom bone densitometry is cost-effective. Bone densitometry may be more cost-effective for those with lower body weight since the prevalence of osteoporosis is higher for those with low body weight. Our purpose was to estimate weight thresholds below which bone densitometry is cost-effective for women and men without a prior clinical fracture at ages 55, 60, 65, 75, and 80 years. We used a microsimulation model to estimate the costs and health benefits of bone densitometry and 5 years of fracture prevention therapy for those without prior fracture but with femoral neck osteoporosis (T-score ≤ -2.5) and a 10-year hip fracture risk of ≥3%. Threshold pre-test probabilities of low BMD warranting drug therapy at which bone densitometry is cost-effective were calculated. Corresponding body weight thresholds were estimated using data from the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men (MrOS) study, and the National Health and Nutrition Examination Survey (NHANES) for 2005-2006. Assuming a willingness to pay of $75,000 per quality adjusted life year (QALY) and drug cost of $500/year, body weight thresholds below which bone densitometry is cost-effective for those without a prior fracture were 74, 90, and 100 kg, respectively, for women aged 55, 65, and 80 years; and were 67, 101, and 108 kg, respectively, for men aged 55, 75, and 80 years. For women aged 55-65 years and men aged 55-75 years without a prior fracture, body weight can be used to select those for whom bone densitometry is cost-effective.

  2. A Systematic Review of Electronic Mindfulness-Based Therapeutic Interventions for Weight, Weight-Related Behaviors, and Psychological Stress.

    Science.gov (United States)

    Lyzwinski, Lynnette Nathalie; Caffery, Liam; Bambling, Matthew; Edirippulige, Sisira

    2018-03-01

    Recent research indicates that mindfulness-based interventions are effective for stress, maladaptive weight-related behaviors, and weight loss. Little is presently known about their applicability and effectiveness when delivered electronically, including through Web-based and mobile device media. The primary aims of this review were to identify what types of electronic mindfulness-based interventions have been undertaken for stress, maladaptive weight-related behaviors, and weight loss, and to assess their overall effectiveness. A systematic search of PubMed (MEDLINE), Embase, CINAHL, and Web of Science databases was undertaken in June 2016. A total of 21 studies were identified that met inclusion criteria and were selected in the final review. Of these, 19 were mindfulness-based interventions for stress reduction. Two were Web-based mindful eating/intuitive eating interventions for weight. Only one electronic mindfulness-based study was identified that targeted both stress and maladaptive weight-related behaviors. Most electronic interventions were effective for stress reduction N = 14/19 (74%). There were insufficient electronic mindfulness-based interventions for weight to determine if they were effective or not. Additionally, no mobile mindfulness-based intervention was identified for weight or weight-related behaviors. Electronic mindfulness-based interventions through diverse media appear to be effective for stress reduction. More studies are needed that target weight and weight-related behaviors as well as studies that target both stress and weight. More randomized controlled trials (RCTs) that assess mobile mindfulness-based apps are needed as we only identified four app trials for stress. Mobile mindfulness-based interventions for weight and weight-related behaviors are a future area of research novelty.

  3. Weighted Activity and Costing of Surveillance and Control in Animal Epidemiology

    Directory of Open Access Journals (Sweden)

    Duboz Raphaël

    2013-01-01

    Full Text Available Activity based modeling and simulation is a very promising field. It has recently demonstrated its potential from modeling software development methods [9] to the design of low energy sensors. In this position paper, I would like to initiate a reflexion on the use of the weighted activity in the context of financial costing using the formulation recently proposed by X. Hu and B.P. Zeigler [5]. I propose here to formalize a recent approach of costing, the Time-Driven Activity Based Costing [3], using the theoretical modeling framework initiated by B.P. Zeigler [6]. I argue that this specification can potentially improve the traditional model of Time-Driven Activity Based Costing. I illustrate the approach in the context of surveillance and control in animal epidemiology. The demonstration of its effectiveness is not done in this position paper. Nevertheless, as the existing costing systems are designed to support decision making in business management, the scenario based approach proposed in this paper should be very useful to support decisions in complex management situations.

  4. Demographic, Psychological, and Weight-Related Correlates of Weight Control Behaviors Among Active Duty Military Personnel

    Science.gov (United States)

    2007-03-01

    model of bulimia nervosa: Evidence for restrained-eating and affect-regulation mechanisms. Journal of Social and Clinical Psychology , 15, 340-363...DATE MAR 2007 2. REPORT TYPE 3. DATES COVERED 00-00-2007 to 00-00-2007 4. TITLE AND SUBTITLE Demographic, Psychological , and Weight-Related...weigh-in/physical fitness testing. Both weight-related factors and psychological factors were associated with increased odds of engaging in weight

  5. Effects of independently altering body weight and body mass on the metabolic cost of running

    NARCIS (Netherlands)

    Teunissen, L.P.J.; Grabowski, A.; Kram, R.

    2011-01-01

    The metabolic cost of running is substantial, despite the savings from elastic energy storage and return. Previous studies suggest that generating vertical force to support body weight and horizontal forces to brake and propel body mass are the major determinants of the metabolic cost of running. In

  6. Computerized systems analysis and optimization of aircraft engine performance, weight, and life cycle costs

    Science.gov (United States)

    Fishbach, L. H.

    1979-01-01

    The computational techniques utilized to determine the optimum propulsion systems for future aircraft applications and to identify system tradeoffs and technology requirements are described. The characteristics and use of the following computer codes are discussed: (1) NNEP - a very general cycle analysis code that can assemble an arbitrary matrix fans, turbines, ducts, shafts, etc., into a complete gas turbine engine and compute on- and off-design thermodynamic performance; (2) WATE - a preliminary design procedure for calculating engine weight using the component characteristics determined by NNEP; (3) POD DRG - a table look-up program to calculate wave and friction drag of nacelles; (4) LIFCYC - a computer code developed to calculate life cycle costs of engines based on the output from WATE; and (5) INSTAL - a computer code developed to calculate installation effects, inlet performance and inlet weight. Examples are given to illustrate how these computer techniques can be applied to analyze and optimize propulsion system fuel consumption, weight, and cost for representative types of aircraft and missions.

  7. Optimal dual-fuel propulsion for minimum inert weight or minimum fuel cost

    Science.gov (United States)

    Martin, J. A.

    1973-01-01

    An analytical investigation of single-stage vehicles with multiple propulsion phases has been conducted with the phasing optimized to minimize a general cost function. Some results are presented for linearized sizing relationships which indicate that single-stage-to-orbit, dual-fuel rocket vehicles can have lower inert weight than similar single-fuel rocket vehicles and that the advantage of dual-fuel vehicles can be increased if a dual-fuel engine is developed. The results also indicate that the optimum split can vary considerably with the choice of cost function to be minimized.

  8. Assessment of various failure theories for weight and cost optimized laminated composites using genetic algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, T. [Indian Institute of Technology Kanpur. Dept. of Aerospace Engineering, UP (India); Gupta, R. [Infotech Enterprises Ltd., Hyderabad (India)

    2012-07-01

    In this work, minimum weight-cost design for laminated composites is presented. A genetic algorithm has been developed for the optimization process. Maximum-Stress, Tsai-Wu and Tsai-Hill failure criteria have been used along with buckling analysis parameter for the margin of safety calculations. The design variables include three materials; namely Carbon-Epoxy, Glass-Epoxy, Kevlar-Epoxy; number of plies; ply orientation angles, varying from -75 deg. to 90 deg. in the intervals of 15 deg. and ply thicknesses which depend on the material in use. The total cost is a sum of material cost and layup cost. Layup cost is a function of the ply angle. Validation studies for solution convergence and weight-cost inverse proportionality are carried out. One set of results for shear loading are also validated from literature for a particular case. A Pareto-Optimal solution set is demonstrated for biaxial loading conditions. It is then extended to applied moments. It is found that global optimum for a given loading condition is a function of the failure criteria for shear loading, with Maximum Stress criteria giving the lightest-cheapest and Tsai-Wu criteria giving the heaviest-costliest optimized laminates. Optimized weight results are plotted from the three criteria to do a comparative study. This work gives a global optimized laminated composite and also a set of other local optimum laminates for a given set of loading conditions. The current algorithm also provides with adequate data to supplement the use of different failure criteria for varying loadings. This work can find use in the industry and/or academia considering the increased use of laminated composites in modern wind blades. (Author)

  9. Health technology prioritization: which criteria for prioritizing new technologies and what are their relative weights?

    Science.gov (United States)

    Golan, Ofra; Hansen, Paul; Kaplan, Giora; Tal, Orna

    2011-10-01

    To review the criteria and 'other' considerations used internationally for prioritizing new health technologies, and to demonstrate a conjoint-analysis methodology (also known as discrete choice experiments) for deriving relative weights for the criteria. We searched the literature for criteria and other considerations for prioritizing new technologies. A convenience sample of 74 respondents completed a conjoint-analysis survey involving criteria related to technologies' 'benefits'. Encompassing 11 countries and the US state of Oregon, we were able to distinguish three main groups of criteria: (a) Need, appropriateness and clinical benefits; (b) Efficiency (including cost-effectiveness); and (c) Equality, solidarity and other ethical or social values. For several countries, the quality of the clinical and economic evidence and factors related to strategic issues and procedural justice respectively are also considered. The criteria and their weights from the conjoint-analysis survey are: 'Lives saved'=0.343, 'Life-prolongation benefits'=0.243, 'Quality-of-life gains'=0.217, a criterion representing the availability of alternative treatments=0.107, and 'Other important social/ethical benefits'=0.087. The criteria represent a pluralistic combination of needs-based, maximizing and egalitarian principles, and we demonstrated a methodology for deriving the weights for criteria related to technologies' 'benefits'. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  10. Drought effect on weaning weight and efficiency relative to cow size in semiarid rangeland.

    Science.gov (United States)

    Scasta, J D; Henderson, L; Smith, T

    2015-12-01

    Cow size has been suggested to be an important consideration for selecting cattle to match their production environment. Over the last several decades, the trend in genetic selection for maximum growth has led to gradual increases in beef cow size. An unrelated trend during this same period in the western United States has been an increase in temperature, drought frequency, and drought severity. Due to the potential influence of the increasing cow size trend on nutritional maintenance costs and production, we assessed the effect of cow size on weaning weight and efficiency in relation to drought on a semiarid high-elevation ranch in Wyoming. This study addresses a lack of empirical studies on the interaction between cow size and drought. We measured calf weaning weights of 80 Angus × Gelbvieh cows from 2011 to 2014 and assessed how drought affected weaning weights, efficiency (considered as calf weight relative to cow weight), intake requirements, and potential herd sizes relative to cow size. We stratified cows into 5 weight classes (453, 498, 544, 589, and 634 kg) as a proxy for cow size and adjusted weaning weights to a 210-d calf sex adjusted value. Cow size was a significant factor every year, with different cow sizes having advantages or disadvantages different years relative to weaning weight. However, efficiency for the smallest cows (453 kg) was always greater than efficiency for largest cows (634 kg; cows was greater in the driest year (0.41 ± 0.02) than efficiency of the largest cows in the wettest years (0.37 ± 0.01). The change in efficiency (ΔE) between wet and dry years was 0.18 for the smallest cow size and 0.02 for the largest cow size, and ΔE decreased as cow size increased. This is an indication of the ability of smaller cows to lower maintenance requirements in response to changes in the production environment but with optimal upside potential when conditions are favorable. These results indicate large cows (589 to 634 kg) do not maximize

  11. Weight loss maintenance in relation to locus of control: The MedWeight study.

    Science.gov (United States)

    Anastasiou, Costas A; Fappa, Evaggelia; Karfopoulou, Eleni; Gkza, Anastasia; Yannakoulia, Mary

    2015-08-01

    Locus of control, i.e. the degree of an individual's belief on the control of his/her life, has been related to many health outcomes, including weight loss in overweight/obese individuals. No information is available on the impact of locus of control in maintaining weight loss. We aimed to investigate the effect of locus of control in weight loss maintenance and explore potential associations with lifestyle factors. Study participants included 239 individuals (41% males) who had lost at least 10% of body weight in the past and either maintained the loss (maintainers: weight maintenance of at least 10% of initial weight) or regained it (regainers). Locus of control was defined by a relevant multi-dimensional scale; participants were categorised to internals and externals, based on "internal" and "others" sub-scales. A significant interaction was found between locus of control and weight loss maintenance status (p locus of control. Individualised treatment, according to locus of control, may increase weight loss maintenance rates in former overweight/obese individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Evaluation of activity-based costing versus resource-based relative value costing.

    Science.gov (United States)

    Berlin, Mark F; Smith, Tommy H

    2004-01-01

    Activity-based costing (ABC) and relative value units costing (RVU) are two approaches that a practice manager can use to determine the cost of physician services. Each costing approach has features that provide distinction as well as differentiation in the cost estimates that are estimated. This paper will provide cost estimates under each approach along with cost estimates under a hybrid approach that merges features from each costing approach known as the ABC-RVU costing technique. A comparison of the results will be provided.

  13. 42 CFR 423.6 - Cost-sharing in beneficiary education and enrollment-related costs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Cost-sharing in beneficiary education and enrollment-related costs. 423.6 Section 423.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... BENEFIT General Provisions § 423.6 Cost-sharing in beneficiary education and enrollment-related costs. The...

  14. Direct observation of weight-related communication in primary care: a systematic review.

    Science.gov (United States)

    McHale, Calum T; Laidlaw, Anita H; Cecil, Joanne E

    2016-08-01

    Primary care is ideally placed to play an effective role in patient weight management; however, patient weight is seldom discussed in this context. A synthesis of studies that directly observe weight discussion in primary care is required to more comprehensively understand and improve primary care weight-related communication. To systematically identify and examine primary care observational research that investigates weight-related communication and its relationship to patient weight outcomes. A systematic review of literature published up to August 2015, using seven electronic databases (including MEDLINE, Scopus and PsycINFO), was conducted using search terms such as overweight, obese and/or doctor-patient communication. Twenty papers were included in the final review. Communication analysis focused predominantly on 'practitioner' use of specific patient-centred communication. Practitioner use of motivational interviewing was associated with improved patient weight-related outcomes, including patient weight loss and increased patient readiness to lose weight; however, few studies measured patient weight-related outcomes. Studies directly observing weight-related communication in primary care are scarce and limited by a lack of focus on patient communication and patient weight-related outcomes. Future research should measure practitioner and patient communications during weight discussion and their impact on patient weight-related outcomes. This knowledge may inform the development of a communication intervention to assist practitioners to more effectively discuss weight with their overweight and/or obese patients. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Cross-sectional associations between weight-related health behaviors and weight misperception among U.S. adolescents with overweight/obesity.

    Science.gov (United States)

    Hahn, Samantha L; Borton, Kelley A; Sonneville, Kendrin R

    2018-04-18

    Weight misperception occurs when there is a discrepancy between one's actual and perceived weight status. Among adolescents with overweight/obesity, many believe that correcting weight misperception is imperative to inspire weight-related behavior change. However, past research has shown that adolescents with overweight/obesity who misperceive their weight status gain less weight over time compared to accurate perceivers. Therefore, our objective was to examine possible mechanisms underlying this relationship. Specifically, we examined the association between weight misperception and engagement in weight-related health behaviors among adolescents with overweight/obesity. Self-reported data from the 2015 National Youth Risk Behavior Survey was used in analyses restricted to participants with overweight/obesity (n = 4383). Using multivariate logistic models correcting for sex, race/ethnicity, and grade in school, we examined the cross-sectional associations between weight misperception and engagement in weight-related health behaviors, specifically related to dietary intake, physical activity, and sleep. Adolescents with overweight/obesity who misperceived their weight status were more likely to drink 100% fruit juice two or more times per day (OR = 1.53, 95% CI: 1.20, 1.94), eat vegetables two or more times per day (OR = 1.29, 95% CI: 1.07, 1.57), be physically active for 1 hour or more per day for at least 5 days in the week prior (OR = 1.40, 95% CI: 1.15, 1.72), be on a sports team in the last year (OR = 1.55, 95% CI: 1.21, 1.97), sleep an average of at least 8 hours per school night (OR = 1.40, 95% CI: 1.15, 1.72), and less likely to be trying to lose weight (OR = 0.17, 95% CI: 0.15, 0.20). Misperceivers were more likely to consume breakfast every morning in the week prior and to drink a sports drink at least once per day, though these results were not statistically significant. We observed no difference in fruit intake, soda intake

  16. Weight-related concerns and weight-control behaviors among overweight adolescents in Delhi, India: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Shrivastav Radhika

    2011-02-01

    Full Text Available Abstract Background Obesity is emerging as a public health problem among adolescents in India. The aim of this study was to describe specific weight-related concerns among school-going youth in Delhi, India and to assess the prevalence of weight control behaviors, including healthy and unhealthy ones. Differences by weight status, gender, grade level, and school-type (a proxy for SES in this setting are considered. Methods This study is cross-sectional by design. A sample of eighth and tenth graders (n = 1818 enrolled in Private (middle-high SES and Government (low SES schools (n = 8 in Delhi, India participated. All students' height and weight were measured. Students participated in a survey of weight-related concerns and weight-control behaviors, as well. Mixed-effects regression models were used to test for differences in weight-related concerns and weight-control behaviors across key factors of interest (i.e., weight status, gender, grade level, and SES. Results The combined prevalence of obesity and overweight was 16.6%, overall. Controlling one's weight was important to overweight and non-overweight youth, alike (94.2% v. 84.8%, p p Conclusions Interventions to promote healthy weight control should be pertinent to and well-received by school-going youth in India. Healthy weight control practices need to be explicitly encouraged and unhealthy practices reduced. Future interventions should address issues specific to body image, too, as body dissatisfaction was not uncommon among youth.

  17. Cost-effectiveness of pharmacotherapy to reduce obesity.

    Directory of Open Access Journals (Sweden)

    J Lennert Veerman

    Full Text Available AIMS: Obesity causes a high disease burden in Australia and across the world. We aimed to analyse the cost-effectiveness of weight reduction with pharmacotherapy in Australia, and to assess its potential to reduce the disease burden due to excess body weight. METHODS: We constructed a multi-state life-table based Markov model in Excel in which body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. We use data on effectiveness identified from PubMed searches, on mortality from Australian Bureau of Statistics, on disease costs from the Australian Institute of Health and Welfare, and on drug costs from the Department of Health and Ageing. We evaluate 1-year pharmacological interventions with sibutramine and orlistat targeting obese Australian adults free of obesity-related disease. We use a lifetime horizon for costs and health outcomes and a health sector perspective for costs. Incremental Cost-Effectiveness Ratios (ICERs below A$50 000 per Disability Adjusted Life Year (DALY averted are considered good value for money. RESULTS: The ICERs are A$130 000/DALY (95% uncertainty interval [UI] 93 000-180 000 for sibutramine and A$230 000/DALY (170 000-340 000 for orlistat. The interventions reduce the body weight-related disease burden at the population level by 0.2% and 0.1%, respectively. Modest weight loss during the interventions, rapid post-intervention weight regain and low adherence limit the health benefits. CONCLUSIONS: Treatment with sibutramine or orlistat is not cost-effective from an Australian health sector perspective and has a negligible impact on the total body weight-related disease burden.

  18. Cost analysis of biologic drugs in rheumatoid arthritis first line treatment after methotrexate failure according to patients' body weight.

    Science.gov (United States)

    Román Ivorra, José Andrés; Ivorra, José; Monte-Boquet, Emilio; Canal, Cristina; Oyagüez, Itziar; Gómez-Barrera, Manuel

    2016-01-01

    The objective was to assess the influence of patients' weight in the cost of rheumatoid arthritis treatment with biologic drugs used in first line after non-adequate response to methotrexate. Pharmaceutical and administration costs were calculated in two scenarios: non-optimization and optimization of intravenous (IV) vials. The retrospective analysis of 66 patients from a Spanish 1,000 beds-hospital Rheumatology Clinic Service was used to obtain posology and weight data. The study time horizon was two years. Costs were expressed in 2013 euros. For an average 69kg-weighted patient the lowest cost corresponded to abatacept subcutaneous (SC ABA) (€21,028.09) in the scenario without IV vials optimization and infliximab (IFX) (€20,779.29) with optimization. Considering patients' weight in the scenario without IV vials optimization infliximab (IFX) was the least expensive drug in patients ranged 45-49kg, IV ABA in 50-59kg and SC ABA in patients over 60kg. With IV vials optimization IFX was the least expensive drug in patients under 69kg and SC ABA over 70kg. Assuming comparable effectiveness of biological drugs, patient's weight is a variable to consider, potentials savings could reach €20,000 in two years. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  19. Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial.

    Science.gov (United States)

    Rushing, J; Wing, R; Wadden, T A; Knowler, W C; Lawlor, M; Evans, M; Killean, T; Montez, M; Espeland, M A; Zhang, P

    2017-03-01

    The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10 years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention. The ILI was designed to promote weight loss and increase physical activity. It involved a combination of group plus individual intervention sessions, with decreasing frequency of contact over the 10 years. The intervention incorporated a variety of strategies, including meal replacement products, to improve weight loss outcomes. The costs of intervention delivery were derived from staff surveys of effort and from records of intervention materials from the 16 US academic clinical trial sites. Costs were calculated from the payer perspective and presented in 2012 dollars. During the first year, when intervention delivery was most intensive, the annual cost of intervention delivery, averaged (standard deviation) across clinical sites, was $2,864.6 ($513.3) per ILI participant compared with $202.4 ($76.6) per DSE participant. As intervention intensity declined, costs decreased, such that from years 5 to 9 of the trial, the annual cost of intervention was $1,119.8 ($227.7) per ILI participant and $102.9 ($33.0) per DSE participant. Staffing accounted for the majority of costs throughout the trial, with meal replacements and materials to promote adherence accounting for smaller shares. The sustained weight losses produced by the Look AHEAD intervention were supported by intervention costs that were within the range of other weight loss programmes. Future work will include an evaluation of the cost-effectiveness of the ILI and will contain additional follow-up data.

  20. Brain network analysis: separating cost from topology using cost-integration.

    Directory of Open Access Journals (Sweden)

    Cedric E Ginestet

    Full Text Available A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i differences in weighted costs and (ii differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration.

  1. Brain Network Analysis: Separating Cost from Topology Using Cost-Integration

    Science.gov (United States)

    Ginestet, Cedric E.; Nichols, Thomas E.; Bullmore, Ed T.; Simmons, Andrew

    2011-01-01

    A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i) differences in weighted costs and (ii) differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration. PMID:21829437

  2. Obtaining the mean relative weights of the cost of care in Catalonia (Spain): retrospective application of the adjusted clinical groups case-mix system in primary health care.

    Science.gov (United States)

    Sicras-Mainar, Antoni; Velasco-Velasco, Soledad; Navarro-Artieda, Ruth; Aguado Jodar, Alba; Plana-Ripoll, Oleguer; Hermosilla-Pérez, Eduardo; Bolibar-Ribas, Bonaventura; Prados-Torres, Alejandra; Violan-Fors, Concepción

    2013-04-01

    The study aims to obtain the mean relative weights (MRWs) of the cost of care through the retrospective application of the adjusted clinical groups (ACGs) in several primary health care (PHC) centres in Catalonia (Spain) in routine clinical practice. This is a retrospective study based on computerized medical records. All patients attended by 13 PHC teams in 2008 were included. The principle measurements were: demographic variables (age and sex), dependent variables (number of diagnoses and total costs), and case-mix or co-morbidity variables (International Classification of Primary Care). The costs model for each patient was established by differentiating the fix costs from the variable costs. In the bivariate analysis, the Student's t, analysis of variance, chi-squared, Pearson's linear correlation and Mann-Whitney-Wilcoxon tests were used. In order to compare the MRW of the present study with those of the United States (US), the concordance [intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC)] and the correlation (coefficient of determination: R²) were measured. The total number of patients studied was 227,235, and the frequentation was 5.9 visits/habitant/year) and with a mean diagnoses number of 4.5 (3.2). The distribution of costs was €148.7 million, of which 29.1% were fixed costs. The mean total cost per patient/year was €654.2 (851.7), which was considered to be the reference MRW. Relationship between study-MRW and US-MRW: ICC was 0.40 [confidential interval (CI) 95%: 0.21-0.60] and the CCC was 0.42 (CI 95%: 0.35-0.49). The correlation between the US MRW and the MRW of the present study can be seen; the adjusted R² value is 0.691. The explanatory power of the ACG classification was 36.9% for the total costs. The R² of the total cost without considering outliers was 56.9%. The methodology has been shown appropriate for promoting the calculation of the MRW for each category of the classification. The results provide

  3. Recruitment of young adults into a randomized controlled trial of weight gain prevention: message development, methods, and cost.

    Science.gov (United States)

    Tate, Deborah F; LaRose, Jessica G; Griffin, Leah P; Erickson, Karen E; Robichaud, Erica F; Perdue, Letitia; Espeland, Mark A; Wing, Rena R

    2014-08-16

    Young adulthood (age 18 to 35) is a high-risk period for unhealthy weight gain. Few studies have recruited for prevention of weight gain, particularly in young adults. This paper describes the recruitment protocol used in the Study of Novel Approaches to Prevention (SNAP). We conducted extensive formative work to inform recruitment methods and message development. We worked with a professional marketing firm to synthesize major themes and subsequently develop age-appropriate messages for recruitment. A variety of approaches and channels were used across two clinical centers to recruit young adults who were normal or overweight (body mass index (BMI) 21 to 30 kg/m2) for a 3-year intervention designed to prevent weight gain. We tracked recruitment methods, yields, and costs by method. Logistic regression was used to identify recruitment methods that had the highest relative yield for subgroups of interest with covariate adjustments for clinic. The final sample of 599 participants (27% minority, 22% male) was recruited over a 19-month period of sustained efforts. About 10% of those who initially expressed interest via a screening website were randomized. The most common reason for ineligibility was already being obese (BMI >30 kg/m2). The top two methods for recruitment were mass mailing followed by email; together they were cited by 62% of those recruited. Television, radio, paid print advertising, flyers and community events each yielded fewer than 10% of study participants. Email was the most cost-effective method per study participant recruited. These findings can guide future efforts to recruit young adults and for trials targeting weight gain prevention. ClinicalTrials.gov NCT01183689 (registered 13 August 2010).

  4. Parent-Adolescent Conversations about Eating, Physical Activity and Weight: Prevalence across Sociodemographic Characteristics and Associations with Adolescent Weight and Weight-Related Behaviors

    Science.gov (United States)

    Berge, Jerica M.; MacLehose, Richard F; Loth, Katie A.; Eisenberg, Marla E.; Fulkerson, Jayne A.; Neumark-Sztainer, Dianne

    2015-01-01

    This paper aims to describe the prevalence of parent-adolescent conversations about eating, physical activity and weight across sociodemographic characteristics and to examine associations with adolescent BMI, dietary intake, physical activity and sedentary behaviors. Data from two linked epidemiological studies were used for cross-sectional analysis. Parents (n=3,424; 62% females) and adolescents (n=2,182; 53.2% girls) were socioeconomically and racially/ethnically diverse. Fathers reported more parent-adolescent conversations about healthful eating and physical activity with their sons and mothers reported more weight-focused conversations with their daughters. Parents of Hispanic/Latino and Asian/Hmong youth and parents from lower SES categories engaged in more conversations about weight and size. Adolescents whose mothers or fathers had weight-focused conversations with them had higher BMI percentiles. Adolescents who had two parents engaging in weight-related conversations had higher BMI percentiles. Healthcare providers may want to talk about the types of weight-related conversations parents are having with their adolescents and emphasize avoiding conversations about weight specifically. PMID:24997555

  5. Cost-effectiveness of a Population-based Lifestyle Intervention to Promote Healthy Weight and Physical Activity in Non-attenders of Cardiac Rehabilitation.

    Science.gov (United States)

    Cheng, Qinglu; Church, Jody; Haas, Marion; Goodall, Stephen; Sangster, Janice; Furber, Susan

    2016-03-01

    To evaluate the long-term cost-effectiveness of two home-based cardiac rehabilitation (CR) interventions (Healthy Weight (HW) and Physical Activity (PA)) for patients with cardiovascular disease (CVD), who had been referred to cardiac rehabilitation (CR) but had not attended. The interventions consisted of pedometer-based telephone coaching sessions on weight, nutrition and physical activity (HW group) or physical activity only (PA group) and were compared to a control group who received information brochures about physical activity. A cost-effectiveness analysis was conducted using data from two randomised controlled trials. One trial compared HW to PA (PANACHE study), and the second compared PA to usual care. A Markov model was developed which used one risk factor, body mass index (BMI) to determine the CVD risk level and mortality. Patient-level data from the trials were used to determine the transitions to CVD states and healthcare related costs. The model was run for separate cohorts of males and females. Univariate and probabilistic sensitivity analysis were conducted to test the robustness of the results. Given a willingness-to-pay threshold of $50,000/QALY, in the long run, both the HW and PA interventions are cost-effective compared with usual care. While the HW intervention is more effective, it also costs more than both the PA intervention and the control group due to higher intervention costs. However, the HW intervention is still cost-effective relative to the PA intervention for both men and women. Sensitivity analysis suggests that the results are robust. The results of this paper provide evidence of the long-term cost-effectiveness of home-based CR interventions for patients who are referred to CR but do not attend. Both the HW and PA interventions can be recommended as cost-effective home-based CR programs, especially for people lacking access to hospital services or who are unable to participate in traditional CR programs. Copyright © 2015

  6. Prospect theory and body mass: characterizing psychological parameters for weight-related risk attitudes and weight-gain aversion.

    Science.gov (United States)

    Lim, Seung-Lark; Bruce, Amanda S

    2015-01-01

    We developed a novel decision-making paradigm that allows us to apply prospect theory in behavioral economics to body mass. 67 healthy young adults completed self-report measures and two decision-making tasks for weight-loss, as well as for monetary rewards. We estimated risk-related preference and loss aversion parameters for each individual, separately for weight-loss and monetary rewards choice data. Risk-seeking tendency for weight-loss was positively correlated with body mass index in individuals who desired to lose body weight, whereas the risk-seeking for momentary rewards was not. Risk-seeking for weight-loss was correlated to excessive body shape preoccupations, while aversion to weight-gain was correlated with self-reports of behavioral involvement for successful weight-loss. We demonstrated that prospect theory can be useful in explaining the decision-making process related to body mass. Applying prospect theory is expected to advance our understanding of decision-making mechanisms in obesity, which might prove helpful for improving healthy choices.

  7. Prospect theory and body mass: Characterizing psychological parameters for weight-related risk attitudes and weight-gain aversion

    Directory of Open Access Journals (Sweden)

    Seung-Lark eLim

    2015-03-01

    Full Text Available We developed a novel decision-making paradigm that allows us to apply prospect theory in behavioral economics to body mass. 67 healthy young adults completed self-report measures and two decision-making tasks for weight-loss, as well as for monetary rewards. We estimated risk-related preference and loss aversion parameters for each individual, separately for weight-loss and monetary rewards choice data. Risk-seeking tendency for weight-loss was positively correlated with body mass index in individuals who desired to lose body weight, whereas the risk-seeking for momentary rewards was not. Risk-seeking for weight-loss was correlated to excessive body shape preoccupations, while aversion to weight-gain was correlated with self-reports of behavioral involvement for successful weight-loss. We demonstrated that prospect theory can be useful in explaining the decision-making process related to body mass. Applying prospect theory is expected to advance our understanding of decision-making mechanisms in obesity, which might prove helpful for improving healthy choices.

  8. [Relating costs to activities in hospitals. Use of internal cost accounting].

    Science.gov (United States)

    Stavem, K

    1995-01-10

    During the last few years hospital cost accounting has become widespread in many countries, in parallel with increasing cost pressure, greater competition and new financing schemes. Cost accounting has been used in the manufacturing industry for many years. Costs can be related to activities and production, e.g. by the costing of procedures, episodes of care and other internally defined cost objectives. Norwegian hospitals have lagged behind in the adoption of cost accounting. They ought to act quickly if they want to be prepared for possible changes in health care financing. The benefits can be considerable to a hospital operating in a rapidly changing health care environment.

  9. A cost analysis of implementing a behavioral weight loss intervention in community mental health settings: Results from the ACHIEVE trial.

    Science.gov (United States)

    Janssen, Ellen M; Jerome, Gerald J; Dalcin, Arlene T; Gennusa, Joseph V; Goldsholl, Stacy; Frick, Kevin D; Wang, Nae-Yuh; Appel, Lawrence J; Daumit, Gail L

    2017-06-01

    In the ACHIEVE randomized controlled trial, an 18-month behavioral intervention accomplished weight loss in persons with serious mental illness who attended community psychiatric rehabilitation programs. This analysis estimates costs for delivering the intervention during the study. It also estimates expected costs to implement the intervention more widely in a range of community mental health programs. Using empirical data, costs were calculated from the perspective of a community psychiatric rehabilitation program delivering the intervention. Personnel and travel costs were calculated using time sheet data. Rent and supply costs were calculated using rent per square foot and intervention records. A univariate sensitivity analysis and an expert-informed sensitivity analysis were conducted. With 144 participants receiving the intervention and a mean weight loss of 3.4 kg, costs of $95 per participant per month and $501 per kilogram lost in the trial were calculated. In univariate sensitivity analysis, costs ranged from $402 to $725 per kilogram lost. Through expert-informed sensitivity analysis, it was estimated that rehabilitation programs could implement the intervention for $68 to $85 per client per month. Costs of implementing the ACHIEVE intervention were in the range of other intensive behavioral weight loss interventions. Wider implementation of efficacious lifestyle interventions in community mental health settings will require adequate funding mechanisms. © 2017 The Obesity Society.

  10. Estimation of utility weights for human papilloma virus-related health states according to disease severity.

    Science.gov (United States)

    Ock, Minsu; Park, Jeong-Yeol; Son, Woo-Seung; Lee, Hyeon-Jeong; Kim, Seon-Ha; Jo, Min-Woo

    2016-11-28

    A cost-utility study of a human papilloma virus (HPV) vaccine requires that the utility weights for HPV-related health states (i.e., cervical intraepithelial neoplasia (CIN), cervical cancer, and condyloma) be evaluated. The aim of the present study was to determine the utility weights for HPV-related health states. Hypothetical standardised health states related to HPV were developed based on patient education material and previous publications. To fully reflect disease progression from diagnosis to prognosis, each health state comprised four parts (diagnosis, symptoms, treatment, and progression and prognosis). Nine-hundred members from the Korean general population evaluated the HPV-related health states using a visual analogue scale (VAS) and a standard gamble (SG) approach, which were administered face-to-face via computer-assisted interview. The mean utility values were calculated for each HPV-related health state. According to the VAS, the highest utility (0.73) was HPV-positive status, followed by condyloma (0.66), and CIN grade I (0.61). The lowest utility (0.18) was cervical cancer requiring chemotherapy without surgery, followed by cervical cancer requiring chemoradiation therapy (0.42). SG revealed that the highest utility (0.83) was HPV-positive status, followed by condyloma (0.78), and CIN grade I (0.77). The lowest utility (0.43) was cervical cancer requiring chemotherapy without surgery, followed by cervical cancer requiring chemoradiation therapy (0.60). This study was based on a large sample derived from the general Korean population; therefore, the calculated utility weights might be useful for evaluating the economic benefit of cancer screening and HPV vaccination programs.

  11. FORMALIZING PRODUCT COST DISTORTION: The Impact of Volume-Related Allocation Bases on Cost Information

    Directory of Open Access Journals (Sweden)

    Johnny Jermias

    2003-09-01

    Full Text Available The purpose o f this study is to formally analyze product cost distortions resulting from the process of allocating costs to products based on Activity-Based Costing (ABC and the conventional product costing systems. The model developed in this paper rigorously shows the impact of treating costs that are not volume related as if they are. The model demonstrates that the source of product cost distortion is the difference between the proportion of driver used by each product in ABC and the proportion of the base used by the same product in the conventional costing systems. The difference arises because the conventional costing systems ignore the existence of batch-related and product-related costs. The model predicts a positive association between volume and size diversity with product cost distortions. When interaction between volume and size diversity exists, the distortion is either mitigated or exacerbated. The magnitude of the distortion is jointly determined by the size of the differences and the size of the total indirect costs.

  12. The Exposure Effects of Online Model Pictures and Weight-Related Persuasive Messages on Women's Weight-Loss Planned Behaviors.

    Science.gov (United States)

    Pan, Wenjing; Peña, Jorge

    2017-10-01

    This study examined how exposure to pictures of women with different body sizes (thin, obese), physical attractiveness levels (attractive, unattractive), along with exposure to weight-related messages (pro-anorexia, anti-anorexia) embedded in a fashion website affected female participants' planned behavior toward weight loss. Participants exposed to attractive model pictures showed higher intentions, attitudes, and subjective norms to lose weight compared with unattractive models. Additionally, participants exposed to thin and attractive model pictures indicated the highest attitudes and self-efficacy to lose weight, whereas those exposed to thin and unattractive model pictures indicated the lowest. Furthermore, weight-related messages moderated the effect of model appearance (body size and attractiveness) on controllability of weight-loss activities. However, website pictures' body size differences had no main effects on planned behavior toward weight loss. These effects are discussed in the light of social comparison mechanisms.

  13. Neighbourhood Influences on Children's Weight-related Behaviours and Body Mass Index.

    Science.gov (United States)

    Jenkin, Gabrielle L; Pearson, Amber L; Bentham, Graham; Day, Peter; Kingham, Simon

    2015-01-01

    Neighbourhood contextual factors such as accessibility of food shops and green spaces are associated with adult bodyweight but not necessarily weight-related behaviours. Whether these associations are replicated amongst children is unknown. To understand which aspects of childrens' neighbourhoods are associated with unhealthy weight and weight-related behaviours. Individual-level data for children from the 2006/7 New Zealand Health Survey (of Body Mass Index (BMI), dietary indicators and socioeconomic variables) were linked with geographic level data on neighbourhood deprivation, rural/urban status, percentage of community engaged in active travel, access to green space, food shops and sports/leisure facilities. Logistic regression models were fitted for measures of BMI and weight-related behaviours; sugar sweetened beverage (SSB) consumption; fast-food consumption; and television viewing. Increased community engagement in active transport was, counterintuitively, the only neighbourhood contextual factor associated with unhealthy weight amongst children. After adjustment for socioeconomic and environmental variables, greater access to green space appeared to have a protective effect on SSB consumption and neighbourhood deprivation was associated with all three unhealthy weight-related behaviours (SSB and fast-food consumption and television viewing). Although further research is needed, evidence from the current study suggests that a repertoire of health promotion interventions and policies to change unhealthy weight-related behaviours in high deprivation neighbourhoods may be required to address childhood obesity.

  14. Unpaid ecological costs related to emissions in the air

    International Nuclear Information System (INIS)

    Moreau, Sylvain; Bottin, Anne; Nauroy, Frederic; Boitard, Corinne; Bird, Geoffrey; David, Michel; Greffet, Pierre; Mordant, Guillaume; Moreau, Sylvain; Nirascou, Francoise; Le Moullec, Aurelie; Berthier, Jean-Pierre; Hassan, Marie-Elizabeth; Curri-Lemaitre, Elen; Lagarenne, Christine; Devaux, Jeremy; Nicklaus, Doris; Puydarrieux, Philippe; Vanoli, Andre; Schucht, Simone

    2014-05-01

    This study proposes an analysis of unpaid ecological terms based on the use of new economic indicators related to sustainable development (going beyond the GDP, adjusted accounting aggregates, accounting unpaid ecological costs), an analysis of unpaid ecological costs related to climate change (context, used results and data, definitions of trajectories associated with greenhouse gas emissions, cost to be applied to emissions to get rid of, assessment of unpaid ecological costs), and an analysis of unpaid ecological costs related to air pollution (objectives, standard to be adopted, towards more ambitious emission reduction and re-assessed costs, unpaid ecological costs in 2010)

  15. Relative costs to nuclear plants: international experience

    International Nuclear Information System (INIS)

    Souza, Jair Albo Marques de

    1992-03-01

    This work approaches the relative costs to nuclear plants in the Brazil. It also presents the calculation methods and its hypothesis to determinate the costs, and the nacional experience in costs of investment, operating and maintenance of the nuclear plants

  16. Obesity related eating behaviour patterns in Swedish preschool children and association with age, gender, relative weight and parental weight - factorial validation of the Children's Eating Behaviour Questionnaire

    Directory of Open Access Journals (Sweden)

    Svensson Viktoria

    2011-12-01

    Full Text Available Abstract Background The Children's Eating Behaviour Questionnaire (CEBQ is a multi-dimensional, parent-reported questionnaire measuring children's eating behaviours related to obesity risk, i.e. 'enjoyment of food', 'food responsiveness', 'slowness in eating' and 'satiety responsiveness'. It has not previously been validated in a Swedish population, neither on children under the age of 2 years. In the present study we examined the factor structure and the reliability of the Swedish version of the CEBQ, for use in an obesity intervention programme targeting preschool children 1-6 years. Further, the associations between eating behaviours and children's age, gender and relative weight (BMI SDS and parental weight were investigated. Methods Parents to 174 children aged 1-6 years (50% girls, mean age 3.8 years, recruited from five kindergartens in Stockholm, completed the Swedish version of the CEBQ. Data on children's weight and height, parental weight, height and educational level was collected. Children's relative weight was calculated for a subpopulation (mean BMI SDS -0.4, n = 47. Factorial validation (Principal Component Analysis on all CEBQ items was performed. Differences in eating behaviours by age, gender and parental weight were examined. Correlations between eating behaviours and the child's BMI SDS were analysed controlling for age, gender, parental weight and education in linear regression analyses. Results The factor analysis revealed a seven factor solution with good psychometric properties, similar to the original structure. The behaviour scales 'overeating'/'food responsiveness', 'enjoyment of food' and 'emotional undereating' decreased with age and 'food fussiness' increased with age. Eating behaviours did not differ between girls and boys. The children's relative weight was not related to any of the eating behaviours when controlling for age, gender, parental weight and education, and only associated with parental weight status

  17. Medida de los pesos relativos del coste de la asistencia como efecto de la aplicación retrospectiva de los adjusted clinical groups en atención primaria Measurement of relative cost weights as an effect of the retrospective application of adjusted clinical groups in primary care

    Directory of Open Access Journals (Sweden)

    Antoni Sicras-Mainar

    2006-03-01

    Full Text Available Objetivo: El objeto del estudio es obtener los pesos relativos medios de los costes de la asistencia con la aplicación retrospectiva de los adjusted clinical groups (ACG en población atendida por equipos de atención primaria en situación de práctica clínica habitual. Métodos: Estudio descriptivo de carácter retrospectivo. Fueron incluidos en el estudio todos los pacientes atendidos por 4 equipos de atención primaria durante el año 2003. Las principales mediciones fueron: variables universales (edad y sexo, dependientes (visitas y costes y de casuística o comorbilidad. El modelo de costes para cada paciente se estableció diferenciando los costes fijos y los variables. Se efectuó un análisis de regresión lineal múltiple para la predicción de los modelos. El coste relativo de cada ACG se obtuvo dividiendo el coste medio de cada categoría entre el coste medio de toda la población de referencia. Resultados: El número total de pacientes estudiados fue de 62.311 (intensidad de uso del 76,7%, con una media de 4,8 ± 3,2 episodios y 7,8 ± 7,5 visitas/paciente/año. La distribución de los costes fue de 24.135.236,41 €, el 28,9% fijos. El coste unitario total por visita/año fue de 49,62 ± 24,71 € y el promedio paciente/año de 387,34 ± 145,87 € (pesos relativos de referencia. El poder explicativo de la clasificación ACG fue del 50,1% en las visitas y del 54,9% para los costes totales. Conclusiones: Los ACG se muestran como un aceptable sistema de clasificación de pacientes en situación de práctica clínica habitual. De confirmarse los resultados posibilitarían una mejora en la aplicación práctica de los ACG como una posible herramienta para la gestión clínica en los centros de atención primaria.Objective: The objective of the study is to obtain the cost's relative average weights of the assistance with the retrospective application of the Adjusted Clinical Groups (ACG's in four teams of Primary Care with an attended

  18. Neonatal birth weight and related factors in south of Iran, Jahrom

    Directory of Open Access Journals (Sweden)

    Fatemeh Emamghorashi

    2008-12-01

    Full Text Available Objective: This study aimed to determinate the relationship between neonatal birth weight and related factors in Jahrom, Iran. Materials and methods: All women delivering in two hospitals, in which obstetric services were presented, entered the study. In this cross sectional study, 2311 women were enrolled prospectively in a 12- month period during 2006-7. Data were collected during first three post partum days from the following sources: maternal hospital files and charts, interview with the mothers, measurement of anthropometric indices of fathers and the infants. Percentile distribution of birth weight for classified gestational age was calculated.Results: Results showed significant correlation between neonatal birth weight with neonatal gender, maternal age, weight, education and working status. There was no relation between neonatal weight with paternal weight, maternal education and living in urban or rural areas.Conclusion: Neonatal birth weight is affected by neonatal gender, maternal age and weight; education and job.

  19. Development of lengths of stay and DRG cost weights in dermatology from 2003 to 2006.

    Science.gov (United States)

    Wenke, Andreas; Müller, Marcel L; Babapirali, Judith; Rompel, Rainer; Hensen, Peter

    2009-08-01

    The G-DRG per case payments are calculated annually on the basis of present output and cost data provided from German hospitals. The economic valuation of dermatology-related DRGs depends largely on inpatients' length of stay. At present, longitudinal analyses of dermatologic hospital data considering the development of length of stay under DRG conditions are not available. A multicenter, longitudinal study of clinical data from hospitals with different care levels was performed (n = 23). Frequent and relevant dermatologic diagnoses were grouped and analyzed over a time period of four years (2003-2006). The development of lengths of stay and of G-DRG cost weights were studied in detail. Descriptive statistical methods were applied. After introduction of DRG, the data reveal a) reduction of length of stay in inpatient dermatology and b) after an initial abrupt rise, DRG valuation of dermatologic groups moderately decreased over time. Both trends changed most rapidly in the early years but reached a stable niveau in 2006. The study furthermore points out that not only length of stay, but also other type of costs influence DRG calculations. German dermatology reflects the international trend showing reductions of length of stay after introduction of a DRG-based hospital funding system. The DRG calculation and valuation of inpatient services depend on the duration of hospital stay. However, increasing per diem costs resulting from higher performances of every inpatient bed day are also taken into account. Further reduction of length of stay must not threaten the quality of inpatient care in dermatology.

  20. Self-perception of weight status and its association with weight-related knowledge, attitudes, and behaviors among Chinese children in Guangzhou.

    Science.gov (United States)

    Cai, Li; Zhang, Ting; Ma, Jun; Ma, Lu; Jing, Jin; Chen, Yajun

    2017-07-01

    How weight perception influences weight-related knowledge, attitudes, and behaviors in Chinese children is unknown. We investigated self-perception of body weight and its correlates, and analyzed the relationship between weight perception and weight-related knowledge, attitudes, and behaviors in children in Guangzhou, China. We assessed self-reported weight perception, weight-related knowledge, attitudes, and behaviors in 3752 children aged 7-12 years. Underweight or overweight was defined using the Chinese criteria based on body mass index (BMI). Binary logistic regression analyses were performed to assess correlates of weight underestimation. In total, 27.3% of children underestimated and 6.7% overestimated their weight status. Weight underestimation was common among normal-weight (34.1%) and overweight children (25.3%). Older age, female sex, and child BMI z-score were negatively associated with normal-weight children's underestimation, whereas older age, paternal obesity, maternal obesity, and child BMI z-score were negatively associated with overweight children's underestimation. Correct answers on weight-related knowledge questions ranged from 81.5% to 98.6% and did not differ by weight perception within BMI categories. Although negative perceivers (i.e., those who perceived themselves as underweight or overweight) had a higher intention to change weight, they behaved more unhealthily on fruit intake, breakfast, screen time, and daily moderate-to-vigorous physical activities time than counterparts. Weight underestimation was prevalent in normal-weight and overweight children in Guangzhou. Negative perceivers had stronger willingness to change weight but tended to behave more unhealthily on certain behaviors than positive perceivers. Childhood obesity interventions should incorporate health education and practical support to promote healthy eating and physical activity. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  1. Quantifying cause-related mortality by weighting multiple causes of death

    Science.gov (United States)

    Moreno-Betancur, Margarita; Lamarche-Vadel, Agathe; Rey, Grégoire

    2016-01-01

    Abstract Objective To investigate a new approach to calculating cause-related standardized mortality rates that involves assigning weights to each cause of death reported on death certificates. Methods We derived cause-related standardized mortality rates from death certificate data for France in 2010 using: (i) the classic method, which considered only the underlying cause of death; and (ii) three novel multiple-cause-of-death weighting methods, which assigned weights to multiple causes of death mentioned on death certificates: the first two multiple-cause-of-death methods assigned non-zero weights to all causes mentioned and the third assigned non-zero weights to only the underlying cause and other contributing causes that were not part of the main morbid process. As the sum of the weights for each death certificate was 1, each death had an equal influence on mortality estimates and the total number of deaths was unchanged. Mortality rates derived using the different methods were compared. Findings On average, 3.4 causes per death were listed on each certificate. The standardized mortality rate calculated using the third multiple-cause-of-death weighting method was more than 20% higher than that calculated using the classic method for five disease categories: skin diseases, mental disorders, endocrine and nutritional diseases, blood diseases and genitourinary diseases. Moreover, this method highlighted the mortality burden associated with certain diseases in specific age groups. Conclusion A multiple-cause-of-death weighting approach to calculating cause-related standardized mortality rates from death certificate data identified conditions that contributed more to mortality than indicated by the classic method. This new approach holds promise for identifying underrecognized contributors to mortality. PMID:27994280

  2. Obesity related eating behaviour patterns in Swedish preschool children and association with age, gender, relative weight and parental weight--factorial validation of the Children's Eating Behaviour Questionnaire.

    Science.gov (United States)

    Svensson, Viktoria; Lundborg, Linda; Cao, Yingting; Nowicka, Paulina; Marcus, Claude; Sobko, Tanja

    2011-12-08

    The Children's Eating Behaviour Questionnaire (CEBQ) is a multi-dimensional, parent-reported questionnaire measuring children's eating behaviours related to obesity risk, i.e. 'enjoyment of food', 'food responsiveness', 'slowness in eating' and 'satiety responsiveness'. It has not previously been validated in a Swedish population, neither on children under the age of 2 years. In the present study we examined the factor structure and the reliability of the Swedish version of the CEBQ, for use in an obesity intervention programme targeting preschool children 1-6 years. Further, the associations between eating behaviours and children's age, gender and relative weight (BMI SDS) and parental weight were investigated. Parents to 174 children aged 1-6 years (50% girls, mean age 3.8 years), recruited from five kindergartens in Stockholm, completed the Swedish version of the CEBQ. Data on children's weight and height, parental weight, height and educational level was collected. Children's relative weight was calculated for a subpopulation (mean BMI SDS -0.4, n = 47). Factorial validation (Principal Component Analysis) on all CEBQ items was performed. Differences in eating behaviours by age, gender and parental weight were examined. Correlations between eating behaviours and the child's BMI SDS were analysed controlling for age, gender, parental weight and education in linear regression analyses. The factor analysis revealed a seven factor solution with good psychometric properties, similar to the original structure. The behaviour scales 'overeating'/'food responsiveness', 'enjoyment of food' and 'emotional undereating' decreased with age and 'food fussiness' increased with age. Eating behaviours did not differ between girls and boys. The children's relative weight was not related to any of the eating behaviours when controlling for age, gender, parental weight and education, and only associated with parental weight status. Our results support the use of the CEBQ as a

  3. [Prevention of catheter-related infection: usefulness and cost-effectiveness of antiseptic catheters in children].

    Science.gov (United States)

    Lenz, Ana M; Vassallo, Juan C; Moreno, Guillermo E; Althabe, María; Gómez, Silvia; Magliola, Ricardo; Casimir, Lidia; Bologna, Rosa; Barretta, Jorge; Ruffa, Pablo

    2010-06-01

    To evaluate the cost-effectiveness of the antiseptic-impregnated catheter compared with conventional catheters in preventing catheter- related blood stream infections (CR-BSI). Cost-effectiveness analysis; clinical trial, experimental, randomized, controlled, prospective, open label. Patients and methods. A 172 patient cohort, under 1-year-old or less than 10 kg, postoperative cardiovascular children with central venous catheters (CVC) admitted to Cardiac Intensive Care Unit (UCI 35) at Hospital Nacional de Pediatría "Prof. Dr. Juan P. Garrahan", since September 2005 to December 2007. Demographic and CVC data were retrieved to compare: age, gender, weight, diagnosis, surgery, CVC days, costs and complications. Intervention. CVC Arrow, double-lumen, > 48 h of duration; intervention group: antiseptic-impregnated CVC vs. control group: CVC without antiseptics (conventional). The incidence of CR-IE (CR-Infected Events: colonization, local infection and/or CRBSI; combined end point) was 27% for antiseptic- impregnated CVC vs. 31% for conventional catheters (p= 0.6) with similar accumulated incidence of CR- BSI: 2.8 vs. 3.3 per 1000 dayscatheter. We found no differences between groups, except in weight: median 4.0 kg (r 2-17) vs. 4.7 kg (r 2-9) p= 0.0002 and age, median 2 months (r 1- 48) vs. 5 months (r 1- 24) p= 0.0019 in antiseptic-impregnated CVC group. These differences, though statistically significant were clinically non relevant. Median cost per patient during intensive care stay in the conventional CVC group was $3.417 (359-9.453) and in the antiseptic-impregnated-CVC group was $4.962 (239-24.532), p= 0.10. The use of antiseptic-impregnated CVC compared with conventional CVC did not decrease CR-BSI in this population. The cost per patients was higher in the antiseptic impregnated CVC group. These results do not support the routine use of this type of CVC in our population.

  4. Alcohol- and drug-related absenteeism: a costly problem.

    Science.gov (United States)

    Roche, Ann; Pidd, Ken; Kostadinov, Victoria

    2016-06-01

    Absenteeism related to alcohol and other drug (AOD) use can place a substantial burden on businesses and society. This study estimated the cost of AOD-related absenteeism in Australia using a nationally representative dataset. A secondary analysis of the 2013 National Drug Strategy Household Survey (n=12,196) was undertaken. Two measures of AOD-related absenteeism were used: participants' self-reported absence due to AOD use (M1); and the mean difference in absence due to any illness/injury for AOD users compared to abstainers (M2). Both figures were multiplied by $267.70 (average day's wage in 2013 plus 20% on-costs) to estimate associated costs. M1 resulted in an estimation of 2.5 million days lost annually due to AOD use, at a cost of more than $680 million. M2 resulted in an estimation of almost 11.5 million days lost, at a cost of $3 billion. AOD-related absenteeism represents a significant and preventable impost upon Australian businesses. Workplaces should implement evidence-based interventions to promote healthy employee behaviour and reduce AOD-related absenteeism. © 2015 Public Health Association of Australia.

  5. Relational Climate and Health Care Costs: Evidence From Diabetes Care.

    Science.gov (United States)

    Soley-Bori, Marina; Stefos, Theodore; Burgess, James F; Benzer, Justin K

    2018-01-01

    Quality of care worries and rising costs have resulted in a widespread interest in enhancing the efficiency of health care delivery. One area of increasing interest is in promoting teamwork as a way of coordinating efforts to reduce costs and improve quality, and identifying the characteristics of the work environment that support teamwork. Relational climate is a measure of the work environment that captures shared employee perceptions of teamwork, conflict resolution, and diversity acceptance. Previous research has found a positive association between relational climate and quality of care, yet its relationship with costs remains unexplored. We examined the influence of primary care relational climate on health care costs incurred by diabetic patients at the U.S. Department of Veterans Affairs between 2008 and 2012. We found that better relational climate is significantly related to lower costs. Clinics with the strongest relational climate saved $334 in outpatient costs per patient compared with facilities with the weakest score in 2010. The total outpatient cost saving if all clinics achieved the top 5% relational climate score was $20 million. Relational climate may contribute to lower costs by enhancing diabetic treatment work processes, especially in outpatient settings.

  6. Neighbourhood Influences on Children’s Weight-related Behaviours and Body Mass Index

    Directory of Open Access Journals (Sweden)

    Gabrielle L. Jenkin

    2015-08-01

    Full Text Available Introduction: Neighbourhood contextual factors such as accessibility of food shops and green spaces are associated with adult bodyweight but not necessarily weight-related behaviours. Whether these associations are replicated amongst children is unknown.Aim: To understand which aspects of childrens' neighbourhoods are associated with unhealthy weight and weight-related behaviours.Methods: Individual-level data for children from the 2006/7 New Zealand Health Survey (of Body Mass Index (BMI, dietary indicators and socioeconomic variables were linked with geographic level data on neighbourhood deprivation, rural/urban status, percentage of community engaged in active travel, access to green space, food shops and sports/leisure facilities. Logistic regression models were fitted for measures of BMI and weight-related behaviours; sugar sweetened beverage (SSB consumption; fast-food consumption; and television viewing. Results:Increased Ccommunity engagement in active transport was, counterintuitively, the only neighbourhood contextual factor associated with unhealthy weight amongst children. After adjustment for socioeconomic and environmental variables, greater access to green space appeared to have a protective effect on SSB consumption and neighbourhood deprivation was associated with all three unhealthy weight-related behaviours (SSB and fast-food consumption and television viewing. Conclusions: Although further research is needed, evidence from the current study suggests that a repertoire of health promotion interventions and policies to change unhealthy weight- related behaviours in high deprivation neighbourhoods may be required to address childhood obesity.

  7. Cost-effectiveness of diet and exercise interventions to reduce overweight and obesity.

    Science.gov (United States)

    Forster, M; Veerman, J L; Barendregt, J J; Vos, T

    2011-08-01

    To analyze whether two dietary weight loss interventions--the dietary approaches to stop hypertension (DASH) program and a low-fat diet program--would be cost-effective in Australia, and to assess their potential to reduce the disease burden related to excess body weight. We constructed a multi-state life-table-based Markov model in which the distribution of body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. The target population was the overweight and obese adult population in Australia in 2003. We used a lifetime horizon for health effects and costs, and a health sector perspective for costs. We populated the model with data identified from Medline and Cochrane searches, Australian Bureau of Statistics published catalogues, Australian Institute of Health and Welfare, and Department of Health and Ageing. Disability adjusted life years (DALYs) averted, incremental cost-effectiveness ratios (ICERs) and proportions of disease burden avoided. ICERs under AUS$50,000 per DALY are considered cost-effective. The DASH and low-fat diet programs have ICERs of AUS$12,000 per DALY (95% uncertainty range: Cost-saving- 68,000) and AUS$13,000 per DALY (Cost-saving--130,000), respectively. Neither intervention reduced the body weight-related disease burden at population level by more than 0.1%. The sensitivity analysis showed that when participants' costs for time and travel are included, the ICERs increase to AUS$75,000 per DALY for DASH and AUS$49,000 per DALY for the low-fat diet. Modest weight loss during the interventions, post-intervention weight regain and low participation limit the health benefits. Diet and exercise interventions to reduce obesity are potentially cost-effective but have a negligible impact on the total body weight-related disease burden.

  8. An assessment of greenhouse gas emissions-weighted clean energy standards

    International Nuclear Information System (INIS)

    Coffman, Makena; Griffin, James P.; Bernstein, Paul

    2012-01-01

    This paper quantifies the relative cost-savings of utilizing a greenhouse gas emissions-weighted Clean Energy Standard (CES) in comparison to a Renewable Portfolio Standard (RPS). Using a bottom-up electricity sector model for Hawaii, this paper demonstrates that a policy that gives “clean energy” credit to electricity technologies based on their cardinal ranking of lifecycle GHG emissions, normalizing the highest-emitting unit to zero credit, can reduce the costs of emissions abatement by up to 90% in comparison to a typical RPS. A GHG emissions-weighted CES provides incentive to not only pursue renewable sources of electricity, but also promotes fuel-switching among fossil fuels and improved generation efficiencies at fossil-fired units. CES is found to be particularly cost-effective when projected fossil fuel prices are relatively low. - Highlights: ► Proposes a GHG Emissions-Weighted Clean Energy Standard (CES) mechanism. ► Compares CES to RPS using a case study of Hawaii. ► Finds CES is up to 90% more cost-effective as a GHG abatement tool.

  9. Trends and racial differences in birth weight and related survival.

    Science.gov (United States)

    Alexander, G R; Tompkins, M E; Allen, M C; Hulsey, T C

    1999-06-01

    In the past two decades, infant mortality rates in the United States declined in African-American and White populations. Despite this, racial disparities in infant mortality rates have increased and rates of low birth weight deliveries have shown little change. In this study, we examine temporal changes in birth weight distributions, birth weight specific neonatal mortality, and the birth weight threshold for an adverse risk of survival within both racial groups in order to explore the mechanisms for the disparities in infant mortality rates. Single live births born to South Carolina resident mothers between 1975 and 1994 and considered White or African-American based on the mother's report of maternal race on the birth certificate were selected for investigation. We define the birth weight threshold for adverse survival odds as the birth weight at which 50% or more of infants in the population died within the first month of life. Despite significant increases in very low birth weight percentages, neonatal mortality rates markedly declined. Birth weight specific neonatal mortality decreased for both races, although greater reductions accrued to White low birth weight infants. By the end of the study period, the birth weight at which over 50% of newborns died within the first month of life was 696 g for Whites and 673 g for African-Americans. The ongoing decline in neonatal mortality is mainly due to reductions in birth weight specific neonatal mortality, probably related to high-risk obstetric and neonatal care. Technological developments in these areas may have differentially benefited Whites, resulting in an increasing racial disparity in mortality rates. Moreover, the relatively greater and increasing mortality risk from postmaturity and macrosomia in infants of African-America mothers may further exacerbate the racial gap in infant mortality.

  10. Bridging Weighted Rules and Graph Random Walks for Statistical Relational Models

    Directory of Open Access Journals (Sweden)

    Seyed Mehran Kazemi

    2018-02-01

    Full Text Available The aim of statistical relational learning is to learn statistical models from relational or graph-structured data. Three main statistical relational learning paradigms include weighted rule learning, random walks on graphs, and tensor factorization. These paradigms have been mostly developed and studied in isolation for many years, with few works attempting at understanding the relationship among them or combining them. In this article, we study the relationship between the path ranking algorithm (PRA, one of the most well-known relational learning methods in the graph random walk paradigm, and relational logistic regression (RLR, one of the recent developments in weighted rule learning. We provide a simple way to normalize relations and prove that relational logistic regression using normalized relations generalizes the path ranking algorithm. This result provides a better understanding of relational learning, especially for the weighted rule learning and graph random walk paradigms. It opens up the possibility of using the more flexible RLR rules within PRA models and even generalizing both by including normalized and unnormalized relations in the same model.

  11. Model reduction by weighted Component Cost Analysis

    Science.gov (United States)

    Kim, Jae H.; Skelton, Robert E.

    1990-01-01

    Component Cost Analysis considers any given system driven by a white noise process as an interconnection of different components, and assigns a metric called 'component cost' to each component. These component costs measure the contribution of each component to a predefined quadratic cost function. A reduced-order model of the given system may be obtained by deleting those components that have the smallest component costs. The theory of Component Cost Analysis is extended to include finite-bandwidth colored noises. The results also apply when actuators have dynamics of their own. Closed-form analytical expressions of component costs are also derived for a mechanical system described by its modal data. This is very useful to compute the modal costs of very high order systems. A numerical example for MINIMAST system is presented.

  12. Equivalent weight loss for weight management programs delivered by phone and clinic

    Science.gov (United States)

    Donnelly, Joseph E.; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K.; Lee, Robert; Smith, Bryan K.; Lambourne, Kate; Mayo, Matthew S.; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J.; Washburn, Richard A.

    2013-01-01

    Objective Face-to-face weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by face-to-face (FTF) clinic or group conference calls (phone). Design and Methods Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0–6 months) was achieved by reducing energy intake between 1,200– 1,500 kcal/day and progressing physical activity to 300 minutes/week. Weight maintenance (7–18 months) provided adequate energy to maintain weight and continued 300 minutes/week of physical activity. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during months 7–18. A cost analysis provided a comparison of expenses between groups. Results Weight change from baseline to 6 months was −13.4 ± 6.7% and −12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6 months to 18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more person. Conclusions Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. PMID:23408579

  13. Home food environment in relation to children's diet quality and weight status.

    Science.gov (United States)

    Couch, Sarah C; Glanz, Karen; Zhou, Chuan; Sallis, James F; Saelens, Brian E

    2014-10-01

    The objective of this cohort study was to explore relationships among the home food environment (HFE), child/parent characteristics, diet quality, and measured weight status among 699 child-parent pairs from King County, WA, and San Diego County, CA. HFE variables included parenting style/feeding practices, food rules, frequency of eating out, home food availability, and parents' perceptions of food costs. Child dietary intake was measured by 3-day recall and diet quality indicators included fruits and vegetables, sweet/savory snacks, high-calorie beverages, and Dietary Approaches to Stop Hypertension (DASH) score. Individual linear regression models were run in which child BMI z score and child diet quality indicators were dependent variables and HFE variables and child/parent characteristics were independent variables of interest. Fruit and vegetable consumption was associated with parental encouragement/modeling (β=.68, Ppermissive feeding style (-1.04, Ppermissive feeding style (0.14, Pparent's use of food restriction (0.21, Ppermissive feeding style (0.16, Pparenting around eating and food availability are related to child diet quality and weight status. These factors should be considered when designing interventions for improving child health. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  14. The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial.

    Science.gov (United States)

    John, Leslie K; Troxel, Andrea B; Yancy, William S; Friedman, Joelle; Zhu, Jingsan; Yang, Lin; Galvin, Robert; Miller-Kovach, Karen; Halpern, Scott D; Loewenstein, George; Volpp, Kevin

    2018-01-01

    To test the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally available weight management program. A randomized trial tested the impact of employer subsidy: 100%; 80%, 50%, and a hybrid 50% subsidy that could become a 100% subsidy by attaining attendance targets. NCT01756066. Twenty three thousand twenty-three employees of 2 US companies. The primary outcome was the percentage of employees who enrolled in the weight management program. We also tested whether the subsidies were associated with differential attendance and weight loss over 12 months, as might be predicted by the expectation that they attract employees with differing degrees of motivation. Analysis and Results: Enrollment differed significantly by subsidy level ( P < .0001). The 100% subsidy produced the highest enrollment (7.7%), significantly higher than each of the lower subsidies (vs 80% subsidy: 6.2%, P = .002; vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Enrollment in the 80% subsidy group was significantly higher than both lower subsidy groups (vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Among enrollees, there were no differences among the 4 groups in attendance or weight loss. This pragmatic trial, conducted in a real-world workplace setting, suggests that higher rates of employer subsidization help individuals to enroll in weight loss programs, without a decrement in program effectiveness. Future research could explore the cost-effectiveness of such subsidies or alternative designs.

  15. Cost-benefit analysis for a lead wheel weight phase-out in Canada.

    Science.gov (United States)

    Campbell, P M; Corneau, E; Nishimura, D; Teng, E; Ekoualla, D

    2018-05-06

    Lead wheel weights (LWWs) have been banned in Europe, and some US States, but they continue to dominate the market in Canada. Exposure to lead is associated with numerous health impacts and can result in multiple and irreversible health problems which include cognitive impairment when exposure occurs during early development. Such impacts incur high individual and social costs. The purpose of this study was to assess the costs and public health benefits of a Risk Management Strategy (RMS) that would result from a LWW phase-out in Canada and compare this to a Business-As-Usual (BAU) scenario. The contribution of LWWs to lead concentrations in media including roadway soil/dust, ambient and indoor air, and indoor dust were estimated. The Integrated Exposure Uptake Biokinetic Model for Lead in Children (IEUBK) was used to develop estimates for the blood lead levels (BLLs) in children (μg/dL) associated with the BAU and the RMS. The BLLs estimated via the IEUBK model were then used to assess the IQ decrements associated with the BAU that would be avoided under the RMS. The subsequent overall societal benefits in terms of increased lifetime earning potential and reduced crime rate, were then estimated and compared to industry and government costs. LWWs form 72% of the Canadian wheel weight market and >1500 tonnes of lead as new LWWs attached to vehicles enters Canadian society annually. We estimate that 110-131 tonnes of lead in detached WWs are abraded on roadways in Canada each year. A LWW phase-out was predicted to result in a drop in pre-school BLLs of up to 0.4 μg/dL. The estimated net benefits associated with the RMS based on cognitive decrements avoided and hence increased lifetime earning potential (increased productivity) and reduced crime are expected to be: C$248 million (8% discount rate) to C$1.2 billion (3% discount rate) per year. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Weight concerns in male low birth weight adolescents: relation to body mass index, self-esteem, and depression.

    Science.gov (United States)

    Blond, Anna; Whitaker, Agnes H; Lorenz, John M; Feldman, Judith F; Nieto, Marlon; Pinto-Martin, Jennifer A; Paneth, Nigel

    2008-06-01

    To compare weight concerns and self-reported body mass index (BMI) of low birth weight (LBW) adolescent boys to those of a normative sample and examine relationships among BMI, weight concerns, self-esteem, and depression in the LBW cohort. LBW boys (n = 260; mean age, 16.0) belong to the Neonatal Brain Hemorrhage Study birth cohort. Normative boys (n = 305; mean age, 16.5) belong to the National Health and Nutrition Examination Survey. Both samples were assessed in 2001-2004 with self-report questionnaires. BMI was calculated from self-reported height and weight. Weight perception and weight dissatisfaction were assessed with the Eating Symptoms Inventory. In LBW boys, self-esteem was measured with the Rosenberg Self-Esteem Scale and depression with the Beck Depression Inventory. Based on self-reported height and weight, LBW boys were more likely to be healthy weight or underweight and less likely to be overweight than normative boys. Despite having healthier self-reported BMIs, LBW boys reported more weight concerns than the normative sample. A total of 46.9% of LBW boys perceived their weight as abnormal, and 76.5% desired weight change. Weight concerns in LBW boys mostly reflected a perception of being underweight (31.2% of the cohort) and a desire to gain weight (47.5% of the cohort), although only 6.5% were clinically underweight. Weight concerns, but not BMI, were related to clinical depression and lower self-esteem. LBW adolescent boys are at high risk of experiencing weight concerns. Weight concerns rather than BMI are associated with emotional problems in LBW boys.

  17. Economic weights in rabbit meat production

    Directory of Open Access Journals (Sweden)

    L. Cartuche

    2014-09-01

    Full Text Available A profit function was designed for an industrial commercial rabbitry with the most common management in industrial rabbit production. The incomes, costs, and profit function were calculated and economic weights of the traits were estimated. The variable costs (feeding, artificial insemination, health and replacement represented 62% of the total costs, and the fixed costs (labour, utilities, amortisation and administration represented 38% of the total costs. Major costs were feeding of fattening kits and labour cost, at 26% and 18% of the total cost, respectively. The economic weights were feed conversion rate during fattening (–20.2 €/[g feed/g liveweight], number of kits born alive (15.7 €/kit, pregnancy rate (1.7 €/percentage unit, weaning survival (1.7 €/percentage unit, fattening survival (2.0 €/percentage unit, daily feed intake (–0.50 €/(g feed/d, daily gain during fattening (1.33 €/(g weight/d, and replacement rate (–0.29 €/percentage unit. When varying the prices of kg of fattening feed and kg of liveweight, only the economic weights of feed conversion rate during fattening in the first case and the number of kits born alive in the second case changed considerably. Changes in labour cost produced appreciable changes in the whole production cost. Although economic weights are robust to changes in prices, these weights should be recalculated after some generations of selection, because changes in the mean of the traits due to selection can also change economic weights.

  18. Reference chart for relative weight change to detect hypernatraemic dehydration

    NARCIS (Netherlands)

    Dommelen, P. van; Wouwe, J.P. van; Breuning-Boers, J.M.; Buuren, S. van; Verkerk, P.H.

    2007-01-01

    Objective: The validity of the rule of thumb that infants may have a weight loss of 10% in the first days after birth is unknown. We assessed the validity of this and other rules to detect breast-fed infants with hypernatraemic dehydration. Design: A reference chart for relative weight change was

  19. Comparisons of hypertension-related costs from multinational clinical studies.

    Science.gov (United States)

    Mullins, C Daniel; Sikirica, Mirko; Seneviratne, Viran; Ahn, Jeonghoon; Akhras, Kasem S

    2004-01-01

    This study identifies and compares the individual cost components of hospital and ambulatory services that manage the care of hypertensive patients in eight countries: the US, the UK, France, Spain, Germany, Italy, Canada and Australia. Hypertension-related costs are classified according to four major cardiovascular events: (i) acute myocardial infarction; (ii) congestive heart failure; (iii) stroke; and (iv) renal failure, which was subdivided into renal failure treated by dialysis and renal failure treated by kidney transplantation. To make cross-country costs comparisons, we used the DRG codes used in the US and DRG-like codes from each country. US cost information was obtained from hypertension data available from the literature and health economics researchers. For costs in other countries, we consulted with national health economics experts in each country, used analyses by the Research Triangle Institute, and performed Medline and international literature searches. When available, we obtained information from the countries' public and private nationally representative data sources. For cross-country currency adjustments, all currencies were converted using the Purchasing Power Parities from the Organisation for Economic Cooperation and Development, and then converted into inflation-adjusted year 2000 US dollars. There exists considerable variation in hypertension-related costs from multinational clinical studies. This study documents that costs are generally higher in the US than in other countries; however, this is not always true. In particular, costs of treating heart failure in France and the costs of renal failure without transplantation in Germany and the UK are relatively high. While analysing multinational hypertensive cost data, this study also addresses the impact of cross-country cost variations on cost analyses. During the last decade, drug-development researchers have drawn extensively upon multinational trials to resolve enrollment problems and

  20. Addressing Size Stereotypes: A Weight Bias and Weight-Related Teasing Intervention among Adolescents

    Science.gov (United States)

    Miyairi, Maya; Reel, Justine J.; Próspero, Moisés; Okang, Esther N.

    2015-01-01

    Purpose: The purpose of this study was to evaluate a weight-related teasing prevention program implemented for both female and male students in a school setting. Methods: Junior High School students (N = 143) in seventh grade were invited to participate in the program. One hundred eighteen participants completed pre- and posttest surveys to assess…

  1. Youth WAVE Screener: addressing weight-related behaviors with school-age children.

    Science.gov (United States)

    Isasi, Carmen R; Soroudi, Nafisseh; Wylie-Rosett, Judith

    2006-01-01

    This study evaluated the feasibility of using the youth Weight, Activity, Variety, and Excess (WAVE) screener in a classroom setting for assessing student weight control intentions and the extent to which they used the WAVE strategies to control their weight. The Youth WAVE Screener was administered to fifth-grade students in an inner-city school located in the Bronx, New York. The study was conducted in part to increase student awareness of snack foods and sugary beverages in relation to weight. Of the 169 students who completed the survey, 45.5% (n = 77) were trying to lose weight. Students who were trying to lose weight were more likely to have low-fat dairy products, less likely to have sugary beverages, and less likely to eat junk foods than those who were not trying to lose weight. Students who reported exercising 3 times weekly were more likely to report healthier dietary patterns and less sedentary behaviors than were students who exercise less often. Feedback and dialogue with fifth graders addressed the relationship between TV viewing and eating behavior, advertisement, availability, and preferences of fruits and vegetables. The Youth WAVE Screener can be used to quickly identify children who are concerned about their weight as well as those with dietary and physical activity patterns that may increase the risk of obesity. Diabetes educators can use this screener to start a dialogue with children about their weight-related behaviors.

  2. goGPS: open source software for enhancing the accuracy of low-cost receivers by single-frequency relative kinematic positioning

    International Nuclear Information System (INIS)

    Realini, Eugenio; Reguzzoni, Mirko

    2013-01-01

    goGPS is a free and open source satellite positioning software package aiming to provide a collaborative platform for research and teaching purposes. It was first published in 2009 and since then several related projects are on-going. Its objective is the investigation of strategies for enhancing the accuracy of low-cost single-frequency GPS receivers, mainly by relative positioning with respect to a base station and by a tailored extended Kalman filter working directly on code and phase observations. In this paper, the positioning algorithms implemented in goGPS are presented, emphasizing the modularity of the software design; two specific strategies to support the navigation with low-cost receivers are also proposed and discussed, namely an empirical observation weighting function calibrated on the receiver signal-to-noise ratio and the inclusion of height information from a digital terrain model as an additional observation in the Kalman filter. The former is crucial when working with high-sensitivity receivers, while the latter can significantly improve the positioning in the vertical direction. The overall goGPS positioning accuracy is assessed by comparison with a dual-frequency receiver and with the positioning computed by a standard low-cost receiver. The benefits of the calibrated weighting function and the digital terrain model are investigated by an experiment in a dense urban environment. It comes out that the use of goGPS and low-cost receivers leads to results comparable with those obtained by higher level receivers; goGPS has good performances also in a dense urban environment, where its additional features play an important role. (paper)

  3. Gestational Weight Gain and its Relation with Birth Weight of the Newborn.

    Science.gov (United States)

    Thapa, Meena; Paneru, Rupa

    2017-01-01

    Gestational weight gain is an important predictor of the health of the newborn. It is affected by body mass index of the women. This study was conducted to find out gestational weight gain according to Institute of Medicine 2009 recommendation and relationship of newborn birth weight to body mass index and gestational weight gain of the women. It was cross sectional, hospital based study. The women, who attended at term pregnancy for delivery and having recorded first trimester body weight, were included in the study. Their body mass index was calculated and they were stratified into 4 groups according to body mass index. The gestational weight gain was calculated by subtracting first trimester body weight from body weight at the time of admission for delivery. All the women were followed till delivery. The newborn birth weight was taken immediately after delivery. A total of 227 women were enrolled in the study. More than half of the women had normal body mass index. There were 84 (37%) overweight and obese women. Mean gestational weight gain was 10.21 kg, and mean weight of the newborn was 3.05 kg. There were equal number of women who had adequate weight gain and less weight gain according to recommendation. Excess weight gain was seen in 34 (15%) women. Women of higher body mass index and women who had gain more weight during pregnancy had larger newborns. Body mass index and gestational weight gain of the women were important predictors of birth weight of the newborn. There is a positive correlation between gestational weight gain of the women and birth weight of the newborn.

  4. Genetic Evidence for Causal Relationships Between Maternal Obesity-Related Traits and Birth Weight

    DEFF Research Database (Denmark)

    Tyrrell, Jessica; Richmond, Rebecca C; Palmer, Tom M

    2016-01-01

    IMPORTANCE: Neonates born to overweight or obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. OBJECTIVE: To test for genetic evidence...... of causal associations of maternal body mass index (BMI) and related traits with birth weight. DESIGN, SETTING, AND PARTICIPANTS: Mendelian randomization to test whether maternal BMI and obesity-related traits are potentially causally related to offspring birth weight. Data from 30,487 women in 18 studies...

  5. Can mindfulness influence weight management related eating behaviors? If so, how?

    Science.gov (United States)

    Tapper, Katy

    2017-04-01

    Mindfulness is increasingly being used for weight management. However, the strength of the evidence for such an approach is unclear; although mindfulness-based weight management programs have had some success, it is difficult to conclude that the mindfulness components were responsible. Research in this area is further complicated by the fact that the term 'mindfulness' is used to refer to a range of different practices. Additionally, we have little understanding of the mechanisms by which mindfulness might exert its effects. This review addresses these issues by examining research that has looked at the independent effects of mindfulness and mindfulness-related strategies on weight loss and weight management related eating behaviors. As well as looking at evidence for effects, the review also considers whether effects may vary with different types of strategy, and the kinds of mechanisms that may be responsible for any change. It is concluded that there is some evidence to support the effects of (a) present moment awareness, when applied to the sensory properties of food, and (b) decentering. However, research in these areas has yet to be examined in a controlled manner in relation to weight management. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  6. Bariatric surgery patients’ perceptions of weight-related stigma in healthcare settings impair post-surgery dietary adherence

    Directory of Open Access Journals (Sweden)

    Danielle M. Raves

    2016-10-01

    Full Text Available Background: Weight-related stigma is reported frequently by higher body-weight patients in healthcare settings. Bariatric surgery triggers profound weight loss. This weight loss may therefore alleviate patients’ experiences of weight-related stigma within healthcare settings. In non-clinical settings, weight-related stigma is associated with weight-inducing eating patterns. Dietary adherence is a major challenge after bariatric surgery.Objectives: (1 Evaluate the relationship between weight-related stigma and post-surgical dietary adherence; (2 understand if weight loss reduces weight-related stigma, thereby improving post-surgical dietary adherence; and (3 explore provider and patient perspectives on adherence and stigma in healthcare settings. Design: This mixed methods study contrasts survey responses from 300 postoperative bariatric patients with ethnographic data based on interviews with 35 patients and extensive multi-year participant-observation within a clinic setting. The survey measured experiences of weight-related stigma, including from healthcare professionals, on the Interpersonal Sources of Weight Stigma scale and internalized stigma based on the Weight Bias Internalization Scale. Dietary adherence measures included patient self-reports, non-disordered eating patterns reported on the Disordered Eating after Bariatric Surgery scale, and food frequencies. Regression was used to assess the relationships among post-surgical stigma, dietary adherence, and weight loss. Qualitative analyses consisted of thematic analysis.Results: The quantitative data show that internalized stigma and general experiences of weight-related stigma predict worse dietary adherence, even after weight is lost. The qualitative data show patients did not generally recognize this connection, and health professionals explained it as poor patient compliance.Conclusion: Reducing perceptions of weight-related stigma in healthcare settings and weight bias

  7. Length-weight relationships, condition factors and relative weight of ...

    African Journals Online (AJOL)

    The aim of this study was to record the length-weight relationship parameters and condition factors for some commercially important fish of Bushehr coastal waters of Persian Gulf. The length-weight relationships were calculated for five species caught during fishing surveys using different types of fishing gears (trawls, pots ...

  8. Perceptions relating to body size, weight loss and weight-loss interventions in black South African women: a qualitative study.

    Science.gov (United States)

    Draper, Catherine E; Davidowitz, Kesiah J; Goedecke, Julia H

    2016-02-01

    A higher tolerance for a larger body size has been associated with obesity in black South African (SA) women. The aim of the present study was to explore perceptions regarding body size and weight loss in a sample of black women from a low-income community in Cape Town, SA. Qualitative pilot study including five focus groups. Data were analysed using thematic analysis. Khayelitsha, Cape Town, SA. Twenty-one black SA women. The majority of participants had positive perceptions of overweight/obesity, which were influenced by community and cultural perceptions, but some inconsistencies were observed as overweight/obesity was also associated with ill health. Participants identified many benefits to weight loss, but due to the association with sickness, they were concerned about being stigmatised in their community. Although participants had knowledge about healthy eating, the main barrier to eating healthily included the perceived higher cost of healthier food and food insecurity. All participants saw exercise as a strategy to lose weight and improve health, and were interested in participating in a community-based exercise intervention, but negative community perceptions and conflicting views regarding who should lead the intervention were identified as barriers. These findings highlight the complexities surrounding participants' perceptions regarding body size, weight loss and weight-loss interventions, and emphasise low socio-economic status as a barrier to change. The study also highlights the strong influence of cultural ideals and community perceptions on personal perceptions. These findings underscore the necessity for culturally appropriate weight-loss interventions in low-income, transitioning communities.

  9. Unhealthy weight control behaviors mediate the association between weight status and weight-specific health-related quality of life in treatment-seeking youth who are obese.

    Science.gov (United States)

    Lim, Crystal S; Gowey, Marissa A; Cohen, Megan J; Silverstein, Janet; Janicke, David M

    2017-03-01

    Examine whether unhealthy and extreme weight control behaviors (WCBs) mediate the relationship between youth weight status and disease-specific health-related quality of life (HRQOL) in treatment-seeking youth who are overweight and obese (OV/OB). 82 youth 10-17 years of age who were OV/OB and attending an outpatient obesity-related medical appointment completed measures assessing unhealthy and extreme WCBs and disease-specific HRQOL. Parents completed a demographic questionnaire and medical staff measured youth height and weight. Regression analyses revealed that unhealthy WCBs mediated the associations between youth weight status and emotional and social avoidance disease-specific HRQOL, such that higher body mass index (BMI) predicted unhealthy WCBs, which were ultimately associated with poorer emotional and social HRQOL. Mediation analyses were not significant for total, physical, teasing/marginalization, and positive attributes disease-specific HRQOL. In addition, extreme WCBs did not mediate the association between youth weight status and any subscales of the disease-specific HRQOL measure. Weight status is an important predictor of disease-specific HRQOL in OV/OB youth; however, the association with emotional and social HRQOL is partially accounted for by youth engagement in unhealthy WCBs. Clinicians and researchers should assess WCBs and further research should explore and evaluate appropriate intervention strategies to address unhealthy WCBs in pediatric weight management prevention and treatment efforts.

  10. The Economic Impact of Weight Regain

    Directory of Open Access Journals (Sweden)

    Caroline E. Sheppard

    2013-01-01

    Full Text Available Background. Obesity is well known for being associated with significant economic repercussions. Bariatric surgery is the only evidence-based solution to this problem as well as a cost-effective method of addressing the concern. Numerous authors have calculated the cost effectiveness and cost savings of bariatric surgery; however, to date the economic impact of weight regain as a component of overall cost has not been addressed. Methods. The literature search was conducted to elucidate the direct costs of obesity and primary bariatric surgery, the rate of weight recidivism and surgical revision, and any costs therein. Results. The quoted cost of obesity in Canada was $2.0 billion–$6.7 billion in 2013 CAD. The median percentage of bariatric procedures that fail due to weight gain or insufficient weight loss is 20% (average: 21.1%±10.1%, range: 5.2–39, n=10. Revision of primary surgeries on average ranges from 2.5% to 18.4%, and depending on the procedure accounts for an additional cost between $14,000 and $50,000 USD per patient. Discussion. There was a significant deficit of the literature pertaining to the cost of revision surgery as compared with primary bariatric surgery. As such, the cycle of weight recidivism and bariatric revisions has not as of yet been introduced into any previous cost analysis of bariatric surgery.

  11. [The impact of low birth weight related to gestational depression on federal funding of public health: a study in Pelotas, Rio Grande do Sul State, Brazil].

    Science.gov (United States)

    Menezes, Leticia Oliveira de; Pinheiro, Ricardo Tavares; Quevedo, Luciana de Avila; Oliveira, Sandro Schreiber de; Silva, Ricardo Azevedo da; Pinheiro, Karen Amaral Tavares; Santo, Graciela Coelho Espírito; Jansen, Karen

    2012-10-01

    Low birth weight is related to morbidity and mortality and sequelae during infant development, thereby impacting health system costs. It is thus important to evaluate factors that influence low birth weight and to estimate their impact on the Brazilian Unified National Health System (SUS). This was a nested prospective study in a cohort of pregnant women who received prenatal care and gave birth in the National Health System in hospitals with ICUs in the city of Pelotas, Rio Grande do Sul State, Brazil. Gestational depression was associated with a fourfold risk of low birth weight (PR = 3.94; CI: 1.49-10.36). Based on the population-attributable fraction, in the overall population an estimated 36.17% of low birth weight infants are born to mothers with an episode of depression during pregnancy, with an estimated cost of more than R$76 million (U$38 million) in Brazil. The study recommends the expansion of preventive and therapeutic mental health care measures for pregnant women and the adequate use of resources in the Unified National Health System to improve neonatal outcomes.

  12. Good intentions gone awry? Effects of weight-related social control on health and well-being.

    Science.gov (United States)

    Brunson, Julie A; Overup, Camilla S; Nguyen, Mai-Ly; Novak, Sarah A; Smith, C Veronica

    2014-01-01

    A negative body image has been associated with a variety of negative health and well-being outcomes. Social pressures from others, in the form of weight-related social control, may serve to exacerbate this effect, especially for college-aged women. Undergraduate students (N=399) completed a variety of questionnaires assessing weight-related social control, well-being, and diet and exercise behaviors. The results suggest that weight is associated with a variety of negative health and well-being outcomes and particularly for women, weight-related social control is also associated with these negative effects. In addition, men of higher body mass indexes (BMIs) or higher self-perceived weight did not experience negative health and well-being outcomes to the same degree that overweight women did. Parents in particular seem to instigate weight-related social control to change students' diet and exercise behaviors. These results help clarify the effects of weight-related social control in a college population, where weight may be especially important. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Structural relations of harmonic sums and Mellin transformers at weight w=6

    Energy Technology Data Exchange (ETDEWEB)

    Bluemlein, Johannes

    2009-01-15

    We derive the structural relations between nested harmonic sums and the corresponding Mellin transforms of Nielsen integrals and harmonic polylogarithms at weight w=6. They emerge in the calculations of massless single-scale quantities in QED and QCD, such as anomalous dimensions and Wilson coefficients, to 3- and 4-loop order. We consider the set of the multiple harmonic sums at weight six without index {l_brace}-1{r_brace}. This restriction is sufficient for all known physical cases. The structural relations supplement the algebraic relations, due to the shuffle product between harmonic sums, studied earlier. The original amount of 486 possible harmonic sums contributing at weight w=6 reduces to 99 sums with no index {l_brace}-1{r_brace}. Algebraic and structural relations lead to a further reduction to 20 basic functions. These functions supplement the set of 15 basic functions up to weight w=5 derived formerly. We line out an algorithm to obtain the analytic representation of the basic sums in the complex plane. (orig.)

  14. Genetic Evidence for Causal Relationships Between Maternal Obesity-Related Traits and Birth Weight.

    Science.gov (United States)

    Tyrrell, Jessica; Richmond, Rebecca C; Palmer, Tom M; Feenstra, Bjarke; Rangarajan, Janani; Metrustry, Sarah; Cavadino, Alana; Paternoster, Lavinia; Armstrong, Loren L; De Silva, N Maneka G; Wood, Andrew R; Horikoshi, Momoko; Geller, Frank; Myhre, Ronny; Bradfield, Jonathan P; Kreiner-Møller, Eskil; Huikari, Ville; Painter, Jodie N; Hottenga, Jouke-Jan; Allard, Catherine; Berry, Diane J; Bouchard, Luigi; Das, Shikta; Evans, David M; Hakonarson, Hakon; Hayes, M Geoffrey; Heikkinen, Jani; Hofman, Albert; Knight, Bridget; Lind, Penelope A; McCarthy, Mark I; McMahon, George; Medland, Sarah E; Melbye, Mads; Morris, Andrew P; Nodzenski, Michael; Reichetzeder, Christoph; Ring, Susan M; Sebert, Sylvain; Sengpiel, Verena; Sørensen, Thorkild I A; Willemsen, Gonneke; de Geus, Eco J C; Martin, Nicholas G; Spector, Tim D; Power, Christine; Järvelin, Marjo-Riitta; Bisgaard, Hans; Grant, Struan F A; Nohr, Ellen A; Jaddoe, Vincent W; Jacobsson, Bo; Murray, Jeffrey C; Hocher, Berthold; Hattersley, Andrew T; Scholtens, Denise M; Davey Smith, George; Hivert, Marie-France; Felix, Janine F; Hyppönen, Elina; Lowe, William L; Frayling, Timothy M; Lawlor, Debbie A; Freathy, Rachel M

    2016-03-15

    Neonates born to overweight or obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. To test for genetic evidence of causal associations of maternal body mass index (BMI) and related traits with birth weight. Mendelian randomization to test whether maternal BMI and obesity-related traits are potentially causally related to offspring birth weight. Data from 30,487 women in 18 studies were analyzed. Participants were of European ancestry from population- or community-based studies in Europe, North America, or Australia and were part of the Early Growth Genetics Consortium. Live, term, singleton offspring born between 1929 and 2013 were included. Genetic scores for BMI, fasting glucose level, type 2 diabetes, systolic blood pressure (SBP), triglyceride level, high-density lipoprotein cholesterol (HDL-C) level, vitamin D status, and adiponectin level. Offspring birth weight from 18 studies. Among the 30,487 newborns the mean birth weight in the various cohorts ranged from 3325 g to 3679 g. The maternal genetic score for BMI was associated with a 2-g (95% CI, 0 to 3 g) higher offspring birth weight per maternal BMI-raising allele (P = .008). The maternal genetic scores for fasting glucose and SBP were also associated with birth weight with effect sizes of 8 g (95% CI, 6 to 10 g) per glucose-raising allele (P = 7 × 10(-14)) and -4 g (95% CI, -6 to -2 g) per SBP-raising allele (P = 1×10(-5)), respectively. A 1-SD ( ≈ 4 points) genetically higher maternal BMI was associated with a 55-g higher offspring birth weight (95% CI, 17 to 93 g). A 1-SD ( ≈ 7.2 mg/dL) genetically higher maternal fasting glucose concentration was associated with 114-g higher offspring birth weight (95% CI, 80 to 147 g). However, a 1-SD ( ≈ 10 mm Hg) genetically higher maternal SBP was associated with a 208-g

  15. Designer's unified cost model

    Science.gov (United States)

    Freeman, William T.; Ilcewicz, L. B.; Swanson, G. D.; Gutowski, T.

    1992-01-01

    A conceptual and preliminary designers' cost prediction model has been initiated. The model will provide a technically sound method for evaluating the relative cost of different composite structural designs, fabrication processes, and assembly methods that can be compared to equivalent metallic parts or assemblies. The feasibility of developing cost prediction software in a modular form for interfacing with state of the art preliminary design tools and computer aided design programs is being evaluated. The goal of this task is to establish theoretical cost functions that relate geometric design features to summed material cost and labor content in terms of process mechanics and physics. The output of the designers' present analytical tools will be input for the designers' cost prediction model to provide the designer with a data base and deterministic cost methodology that allows one to trade and synthesize designs with both cost and weight as objective functions for optimization. The approach, goals, plans, and progress is presented for development of COSTADE (Cost Optimization Software for Transport Aircraft Design Evaluation).

  16. Factors Related to Weight Gain/Loss among Emerging Adults with Obesity.

    Science.gov (United States)

    Johnson, Ping H; Annesi, James J

    2018-05-01

    We examined the reasons for weight gain and barriers to weight loss among emerging adults with obesity. Eighty-one female undergraduate students with obesity completed 4-open ended questions in 2015-2016. Qualitative responses were analyzed using NVivo 11 Pro software. Most participants experienced weight gain prior to attending college. The most commonly reported reasons for weight gain include a lack of ability to control one's behaviors or overcome barriers (ie, poor eating habits, lack of physical activity, lack of time, easy access to food), emotional/mental health issues, physical health, and influence of significant others. Nearly half reported having a weight loss goal. Most reported having used one or more weight loss methods. Few reached short-term weight loss but quickly regained the lost weight. Major reported barriers reflect a lack of self-regulation skills, negative mood and stress, and lack of self-efficacy for healthy eating or physical activity. Results suggest that the perceived ability to control one's behaviors and overcome barriers, self-efficacy, and mood are important in weight-related behaviors, weight, and weight loss success among emerging adults, especially those enrolled in college.

  17. The social patterning of relative body weight and obesity in Denmark and Finland

    DEFF Research Database (Denmark)

    Sarlio-Lähteenkorva, Sirpa; Lissau, Inge; Lahelma, Eero

    2006-01-01

    BACKGROUND: Relative body weight is typically inversely associated with social status in affluent societies but studies comparing the social patterning of relative body weight and obesity in different countries have only seldom been conducted. The aim of this study was to analyse and compare....... Relative weight was studied by using body mass index (BMI), and those with BMI > or =30 kg/m(2) were regarded as obese. Logistic regression analysis was used to examine the social patterning of obesity in the pooled dataset. Two-variable interaction effects were tested separately. RESULTS: Compared...

  18. Cost of work-related injuries in insured workplaces in Lebanon.

    OpenAIRE

    Fayad, Rim; Nuwayhid, Iman; Tamim, Hala; Kassak, Kassem; Khogali, Mustafa

    2003-01-01

    OBJECTIVE: To estimate the medical and compensation costs of work-related injuries in insured workplaces in Lebanon and to examine cost distributions by worker and injury characteristics. METHODS: A total of 3748 claims for work injuries processed in 1998 by five major insurance companies in Lebanon were reviewed. Medical costs (related to emergency room fees, physician consultations, tests, and medications) and wage and indemnity compensation costs were identified from the claims. FINDINGS: ...

  19. Compact, Light-weight and Cost-effective Microscope based on Lensless Incoherent Holography for Telemedicine Applications

    Science.gov (United States)

    Mudanyali, Onur; Tseng, Derek; Oh, Chulwoo; Isikman, Serhan O.; Sencan, Ikbal; Bishara, Waheb; Oztoprak, Cetin; Seo, Sungkyu; Khademhosseini, Bahar; Ozcan, Aydogan

    2010-01-01

    Despite the rapid progress in optical imaging, most of the advanced microscopy modalities still require complex and costly set-ups that unfortunately limit their use beyond well equipped laboratories. In the meantime, microscopy in resource-limited settings has requirements significantly different from those encountered in advanced laboratories, and such imaging devices should be cost-effective, compact, light-weight and appropriately accurate and simple to be usable by minimally trained personnel. Furthermore, these portable microscopes should ideally be digitally integrated as part of a telemedicine network that connects various mobile health-care providers to a central laboratory or hospital. Toward this end, here we demonstrate a lensless on-chip microscope weighing ~46 grams with dimensions smaller than 4.2cm × 4.2cm × 5.8cm that achieves sub-cellular resolution over a large field of view of ~24 mm2. This compact and light-weight microscope is based on digital in-line holography and does not need any lenses, bulky optical/mechanical components or coherent sources such as lasers. Instead, it utilizes a simple light-emitting-diode (LED) and a compact opto-electronic sensor-array to record lensless holograms of the objects, which then permits rapid digital reconstruction of regular transmission or differential interference contrast (DIC) images of the objects. Because this lensless incoherent holographic microscope has orders-of-magnitude improved light collection efficiency and is very robust to mechanical misalignments it may offer a cost-effective tool especially for telemedicine applications involving various global health problems in resource limited settings. PMID:20401422

  20. Dietary intake of fruit in relation to body weight management among adults

    DEFF Research Database (Denmark)

    Alinia, Sevil

    and relatively nutrient-dense foods and beverages such as vegetables, fruit juice and processed fruit and an inverse association between fruit intake and relatively nutrient-dilute foods and beverages such as soft drinks and snack foods as well as energy density and E% from fat. The feasibility study showed......The prevalence of overweight and obesity among adults worldwide is high with an increasing trend. Therefore, effective strategies in relation to body weight management, targeting to maintain normal body weight and prevent excessive weight gain, are warranted. Reducing the energy density of the diet...... may aid to achieve these goals. Energy density of the diet can be reduced by substituting energy-dense food items with less energy-dense food items such as fruit and vegetables. Fruit and vegetables are considered as relatively low energy-dense food groups due to their high content of water...

  1. Experiences of weight teasing in adolescence and weight-related outcomes in adulthood: A 15-year longitudinal study.

    Science.gov (United States)

    Puhl, Rebecca M; Wall, Melanie M; Chen, Chen; Bryn Austin, S; Eisenberg, Marla E; Neumark-Sztainer, Dianne

    2017-07-01

    Weight-based teasing is common among youth, but little is known about its long-term impact on health outcomes. We aimed to 1) identify whether weight-based teasing in adolescence predicts adverse eating and weight-related outcomes 15years later; and 2) determine whether teasing source (peers or family) affects these outcomes. Data were collected from Project EAT-IV (Eating and Activity in Teens and Young Adults) (N=1830), a longitudinal cohort study that followed a diverse sample of adolescents from 1999 (baseline) to 2015 (follow-up). Weight-based teasing at baseline was examined as a predictor of weight status, binge eating, dieting, eating as a coping strategy, unhealthy weight control, and body image at 15-year follow-up. After adjusting for demographic covariates and baseline body mass index (BMI), weight-based teasing in adolescence predicted higher BMI and obesity 15years later. For women, these longitudinal associations occurred across peer and family-based teasing sources, but for men, only peer-based teasing predicted higher BMI. The same pattern emerged for adverse eating outcomes; weight-based teasing from peers and family during adolescence predicted binge eating, unhealthy weight control, eating to cope, poor body image, and recent dieting in women 15years later. For men, teasing had fewer longitudinal associations. Taken together, this study shows that weight-based teasing in adolescence predicts obesity and adverse eating behaviors well into adulthood, with differences across gender and teasing source. Findings underscore the importance of addressing weight-based teasing in educational and health initiatives, and including the family environment as a target of anti-bullying intervention, especially for girls. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Resistance Training using Low Cost Elastic Tubing is Equally Effective to Conventional Weight Machines in Middle-Aged to Older Healthy Adults: A Quasi-Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Lima, Fabiano F; Camillo, Carlos A; Gobbo, Luis A; Trevisan, Iara B; Nascimento, Wesley B B M; Silva, Bruna S A; Lima, Manoel C S; Ramos, Dionei; Ramos, Ercy M C

    2018-03-01

    The objectives of the study were to compare the effects of resistance training using either a low cost and portable elastic tubing or conventional weight machines on muscle force, functional exercise capacity, and health-related quality of life (HRQOL) in middle-aged to older healthy adults. In this clinical trial twenty-nine middle-aged to older healthy adults were randomly assigned to one of the three groups a priori defined: resistance training with elastic tubing (ETG; n = 10), conventional resistance training (weight machines) (CTG; n = 9) and control group (CG, n = 10). Both ETG and CTG followed a 12-week resistance training (3x/week - upper and lower limbs). Muscle force, functional exercise capacity and HRQOL were evaluated at baseline, 6 and 12 weeks. CG underwent the three evaluations with no formal intervention or activity counseling provided. ETG and CTG increased similarly and significantly muscle force (Δ16-44% in ETG and Δ25-46% in CTG, p tubing (a low cost and portable tool) and conventional resistance training using weight machines promoted similar positive effects on peripheral muscle force and functional exercise capacity in middle-aged to older healthy adults.

  3. Selection for body weight in dairy cattle

    NARCIS (Netherlands)

    Koenen, E.P.C.

    2001-01-01

    This thesis deals with selection for body weight (BW) in dairy cattle. The economic efficiency of present breeding schemes might increase further when selection decisions also consider information on BW as BW relates to feed costs and revenues from beef production. However, the practical

  4. 48 CFR 231.205-1 - Public relations and advertising costs.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Public relations and... PROCEDURES Contracts With Commercial Organizations 231.205-1 Public relations and advertising costs. (e) See... public relations and advertising costs also include monies paid to the Government associated with the...

  5. Comparing methodologies for the allocation of overhead and capital costs to hospital services.

    Science.gov (United States)

    Tan, Siok Swan; van Ineveld, Bastianus Martinus; Redekop, William Ken; Hakkaart-van Roijen, Leona

    2009-06-01

    Typically, little consideration is given to the allocation of indirect costs (overheads and capital) to hospital services, compared to the allocation of direct costs. Weighted service allocation is believed to provide the most accurate indirect cost estimation, but the method is time consuming. To determine whether hourly rate, inpatient day, and marginal mark-up allocation are reliable alternatives for weighted service allocation. The cost approaches were compared independently for appendectomy, hip replacement, cataract, and stroke in representative general hospitals in The Netherlands for 2005. Hourly rate allocation and inpatient day allocation produce estimates that are not significantly different from weighted service allocation. Hourly rate allocation may be a strong alternative to weighted service allocation for hospital services with a relatively short inpatient stay. The use of inpatient day allocation would likely most closely reflect the indirect cost estimates obtained by the weighted service method.

  6. Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters.

    Science.gov (United States)

    Senekal, Marjanne; Lasker, Gabrielle L; van Velden, Lindsay; Laubscher, Ria; Temple, Norman J

    2016-09-01

    Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Two hundred and fifty female students from South Africa universities, aged 18-25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters) and 88 were non-dieters. Weight and height were measured and BMI (kg/m(2)) computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data). Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m(2)) were identified using regression models. Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students), dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased risk for BMI ≥25 included weight-loss attempt

  7. Absolute and relative densities of fast-food versus other restaurants in relation to weight status: Does restaurant mix matter?

    Science.gov (United States)

    Polsky, Jane Y; Moineddin, Rahim; Dunn, James R; Glazier, Richard H; Booth, Gillian L

    2016-01-01

    Given the continuing epidemic of obesity, policymakers are increasingly looking for levers within the local retail food environment as a means of promoting healthy weights. To examine the independent and joint associations of absolute and relative densities of restaurants near home with weight status in a large, urban, population-based sample of adults. We studied 10,199 adults living in one of four cities in southern Ontario, Canada, who participated in the Canadian Community Health Survey (cycles 2005, 2007/08, 2009/10). Multivariate models assessed the association of weight status (obesity and body mass index) with absolute densities (numbers) of fast-food, full-service and other restaurants, and the relative density (proportion) of fast-food restaurants (FFR) relative to all restaurants within ~10-minute walk of residential areas. Higher numbers of restaurants of any type were inversely related to excess weight, even in models adjusting for a range of individual covariates and area deprivation. However, these associations were no longer significant after accounting for higher walkability of areas with high volumes of restaurants. In contrast, there was a direct relationship between the proportion of FFR relative to all restaurants and excess weight, particularly in areas with high volumes of FFR (e.g., odds ratio for obesity=2.55 in areas with 5+ FFR, 95% confidence interval: 1.55-4.17, across the interquartile range). Policies aiming to promote healthy weights that target the volume of certain retail food outlets in residential settings may be more effective if they also consider the relative share of outlets serving more and less healthful foods. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Development and validation of the Treatment Related Impact Measure of Weight (TRIM-Weight

    Directory of Open Access Journals (Sweden)

    Lessard Suzanne

    2010-02-01

    Full Text Available Abstract Background The use of prescription anti-obesity medication (AOM is becoming increasingly common as treatment options grow and become more accessible. However, AOM may not be without a wide range of potentially negative impacts on patient functioning and well being. The Treatment Related Impact Measure (TRIM-Weight is an obesity treatment-specific patient reported outcomes (PRO measure designed to assess the key impacts of prescription anti-obesity medication. This paper will present the validation findings for the TRIM-Weight. Methods The online validation battery survey was administered in four countries (the U.S., U.K., Australia, and Canada. Eligible subjects were over age eighteen, currently taking a prescription AOM and were currently or had been obese during their life. Validation analyses were conducted according to an a priori statistical analysis plan. Item level psychometric and conceptual criteria were used to refine and reduce the preliminary item pool and factor analysis to identify structural domains was performed. Reliability and validity testing was then performed and the minimally importance difference (MID explored. Results Two hundred and eight subjects completed the survey. Twenty-one of the 43 items were dropped and a five-factor structure was achieved: Daily Life, Weight Management, Treatment Burden, Experience of Side Effects, and Psychological Health. A-priori criteria for internal consistency and test-retest coefficients for the total score and all five subscales were met. All pre-specified hypotheses for convergent and known group validity were also met with the exception of the domain of Daily Life (proven in an ad hoc analysis as well as the 1/2 standard deviation threshold for the MID. Conclusion The development and validation of the TRIM-Weight has been conducted according to well-defined principles for the creation of a PRO measure. Based on the evidence to date, the TRIM-Weight can be considered a brief

  9. Designers' unified cost model

    Science.gov (United States)

    Freeman, W.; Ilcewicz, L.; Swanson, G.; Gutowski, T.

    1992-01-01

    The Structures Technology Program Office (STPO) at NASA LaRC has initiated development of a conceptual and preliminary designers' cost prediction model. The model will provide a technically sound method for evaluating the relative cost of different composite structural designs, fabrication processes, and assembly methods that can be compared to equivalent metallic parts or assemblies. The feasibility of developing cost prediction software in a modular form for interfacing with state-of-the-art preliminary design tools and computer aided design programs is being evaluated. The goal of this task is to establish theoretical cost functions that relate geometric design features to summed material cost and labor content in terms of process mechanics and physics. The output of the designers' present analytical tools will be input for the designers' cost prediction model to provide the designer with a database and deterministic cost methodology that allows one to trade and synthesize designs with both cost and weight as objective functions for optimization. This paper presents the team members, approach, goals, plans, and progress to date for development of COSTADE (Cost Optimization Software for Transport Aircraft Design Evaluation).

  10. How recalibration method, pricing, and coding affect DRG weights

    Science.gov (United States)

    Carter, Grace M.; Rogowski, Jeannette A.

    1992-01-01

    We compared diagnosis-related group (DRG) weights calculated using the hospital-specific relative-value (HSR V) methodology with those calculated using the standard methodology for each year from 1985 through 1989 and analyzed differences between the two methods in detail for 1989. We provide evidence suggesting that classification error and subsidies of higher weighted cases by lower weighted cases caused compression in the weights used for payment as late as the fifth year of the prospective payment system. However, later weights calculated by the standard method are not compressed because a statistical correlation between high markups and high case-mix indexes offsets the cross-subsidization. HSR V weights from the same files are compressed because this methodology is more sensitive to cross-subsidies. However, both sets of weights produce equally good estimates of hospital-level costs net of those expenses that are paid by outlier payments. The greater compression of the HSR V weights is counterbalanced by the fact that more high-weight cases qualify as outliers. PMID:10127456

  11. Does Weight Status Influence Weight-Related Beliefs and the Consumption of Sugar-Sweetened Beverages and Fast Food Purchases in Adolescents?

    Science.gov (United States)

    Hearst, Mary O.; Pasch, Keryn E.; Fulkerson, Jayne A.; Lytle, Leslie A.

    2009-01-01

    Objective: To determine if weight status affects the relationship between weight-related beliefs and consumption of sugar-sweetened beverages (SSB) and fast and convenience store food purchases (FCFP). Design: Observational, cross-sectional. Setting: Twin Cities Metropolitan area, Minnesota, USA. Methods: Body composition and psychosocial survey…

  12. Prevalence of abnormal birth weight and related factors in Northern region, Ghana.

    Science.gov (United States)

    Abubakari, Abdulai; Kynast-Wolf, Gisela; Jahn, Albrecht

    2015-12-15

    Birth weight is a crucial determinant of the development potential of the newborn. Abnormal newborn weights are associated with negative effects on the health and survival of the baby and the mother. Therefore, this study was designed to determine the prevalence of abnormal birth weight and related factors in Northern region, Ghana. The study was a facility-based cross-sectional survey in five hospitals in Northern region, Ghana. These hospitals were selected based on the different socio-economic backgrounds of their clients. The data on birth weight and other factors were derived from hospital records. It was observed that low birth weight is still highly prevalent (29.6%), while macrosomia (10.5%) is also increasingly becoming important. There were marginal differences in low birth weight observed across public hospitals but marked difference in low birth weight was observed in Cienfuegos Suglo Specialist Hospital (Private hospital) as compared to the public hospitals. The private hospital also had the highest prevalence of macrosomia (20.1%). Parity (0-1) (p malnutrition phenomenon, which is currently being experienced by developing and transition counties. Both low birth weight and macrosomia are risk factors, which could contribute considerably to the current and future burden of diseases. This may overstretch the already fragile health system in Ghana. Therefore, it is prudent to recommend that policies aiming at reducing diet related diseases should focus on addressing malnutrition during pregnancy and early life.

  13. 48 CFR 1631.205-70 - FEHBP public relations and advertising costs.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true FEHBP public relations and... COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 1631.205-70 FEHBP public relations and advertising costs. (a) The cost of media messages that are directed at advising current FEHBP...

  14. Costs and compensation of work‐related injuries in British Columbia sawmills

    Science.gov (United States)

    Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

    2007-01-01

    Objective To estimate the costs of work‐related injury in a cohort of sawmill workers in British Columbia from the perspective of the workers' compensation system. Methods Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5786 actively employed sawmill workers. A total of 173 work‐related injury cases were identified from these records using the International classification of diseases—ninth revision (ICD‐9) external cause of injury codes and the responsibility of payment schedule. Workers' compensation records were extracted and matched with hospital records by dates and ICD‐9 diagnosis codes. All costs were converted into 1995 constant Canadian dollars using the Provincial General Consumer Price Index for the non‐healthcare costs and Medical Consumer Price Index for the healthcare costs. A 5% discounting rate was applied to adjust for the time value of money. For the uncompensated cases, costs were imputed from the compensated cases using the median cost for a similar nature of injury. Results 370 hospitalisation events due to injury were captured, and by either of the two indicators (E Codes or payment schedules), 173 (47%) hospitalisation events due to injury, were identified as work related. The median healthcare cost was $4377 and the median non‐healthcare cost was $16 559 for a work‐related injury. The median non‐healthcare and healthcare costs by injury were falls, $19 978 and $5185; struck by falling object, $32 398 and $8625; struck against, $12 667 and $5741; machinery related, $26 480 and $6643; caught in or between, $24 130 and $4389; and overexertion, $7801 and $2710. The total cost was $10 374 115 for non‐healthcare and $1 764 137 for healthcare. The compensation agency did not compensate $874 871 (8.4%) of the non‐healthcare costs and $200 588 (11.4%) of the healthcare costs. Conclusion Eliminating avoidable work‐related injury events can save valuable resources. PMID:17053018

  15. Costs and compensation of work-related injuries in British Columbia sawmills.

    Science.gov (United States)

    Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

    2007-03-01

    To estimate the costs of work-related injury in a cohort of sawmill workers in British Columbia from the perspective of the workers' compensation system. Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5786 actively employed sawmill workers. A total of 173 work-related injury cases were identified from these records using the International classification of diseases-ninth revision (ICD-9) external cause of injury codes and the responsibility of payment schedule. Workers' compensation records were extracted and matched with hospital records by dates and ICD-9 diagnosis codes. All costs were converted into 1995 constant Canadian dollars using the Provincial General Consumer Price Index for the non-healthcare costs and Medical Consumer Price Index for the healthcare costs. A 5% discounting rate was applied to adjust for the time value of money. For the uncompensated cases, costs were imputed from the compensated cases using the median cost for a similar nature of injury. 370 hospitalisation events due to injury were captured, and by either of the two indicators (E Codes or payment schedules), 173 (47%) hospitalisation events due to injury, were identified as work related. The median healthcare cost was 4377 dollars and the median non-healthcare cost was 16,559 dollars for a work-related injury. The median non-healthcare and healthcare costs by injury were falls, 19,978 dollars and 5185 dollars; struck by falling object, 32,398 dollars and 8625 dollars; struck against, 12,667 dollars and 5741 dollars; machinery related, 26,480 dollars and 6643 dollars; caught in or between, 24,130 dollars and 4389 dollars; and overexertion, 7801 dollars and 2710 dollars. The total cost was 10,374,115 dollars for non-healthcare and 1,764,137 dollars for healthcare. The compensation agency did not compensate 874,871 dollars (8.4%) of the non-healthcare costs and 200,588 dollars (11.4%) of the healthcare costs. Eliminating avoidable work-related injury events

  16. Behavioural factors related with successful weight loss 15 months post-enrolment in a commercial web-based weight-loss programme.

    Science.gov (United States)

    Neve, Melinda J; Morgan, Philip J; Collins, Clare E

    2012-07-01

    As further understanding is required of what behavioural factors are associated with long-term weight-loss success, the aim of the present study was to determine the prevalence of successful weight loss 15 months post-enrolment in a commercial web-based weight-loss programme and which behavioural factors were associated with success. An online survey was completed 15 months post-enrolment in a commercial web-based weight-loss programme to assess weight-related behaviours and current weight. Participants were classified as successful if they had lost ≥5 % of their starting weight after 15 months. Commercial users of a web-based weight-loss programme. Participants enrolled in the commercial programme between August 2007 and May 2008. Six hundred and seventy-seven participants completed the survey. The median (interquartile range) weight change was -2·7 (-8·2, 1·6) % of enrolment weight, with 37 % achieving ≥5 % weight loss. Multivariate logistic regression analysis found success was associated with frequency of weight self-monitoring, higher dietary restraint score, lower emotional eating score, not skipping meals, not keeping snack foods in the house and eating takeaway foods less frequently. The findings suggest that individuals trying to achieve or maintain ≥5 % weight loss should be advised to regularly weigh themselves, avoid skipping meals or keeping snack foods in the house, limit the frequency of takeaway food consumption, manage emotional eating and strengthen dietary restraint. Strategies to assist individuals make these changes to behaviour should be incorporated within obesity treatments to improve the likelihood of successful weight loss in the long term.

  17. Overweight and obese adults have low intentions of seeking weight-related care: a cross-sectional survey

    NARCIS (Netherlands)

    Tol, Jacqueline; Swinkels, Ilse C; De Bakker, Dinny H; Veenhof, Cindy; Seidell, Jaap C

    2014-01-01

    BACKGROUND: The prevalence of obesity is growing worldwide. Obesity guidelines recommend increasing the level of weight-related care for persons with elevated levels of weight-related health risk (WRHR). However, there seems to be a discrepancy between need for and use of weight-related care. The

  18. Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters

    Directory of Open Access Journals (Sweden)

    Marjanne Senekal

    2016-09-01

    Full Text Available Abstract Background Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Methods Two hundred and fifty female students from South Africa universities, aged 18–25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters and 88 were non-dieters. Weight and height were measured and BMI (kg/m2 computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data. Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m2 were identified using regression models. Results Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students, dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased

  19. Parental perception of weight an weight-related behaviour in 2-to 4-year-old children in the eastern part of the Netherlands

    NARCIS (Netherlands)

    Bossink-Tuna, H.N.; L'Hoir, M.P.; Beltman, M.; Boere-Boonekamp, Magdalena M.

    2009-01-01

    Parental perception of weight status and weight-related behaviour of their toddler was determined through a questionnaire survey in child health care centres (CHCs). Complete data on weight, length, sex and age were available for 635 of 682 children (93.1%). The median age of the children was 37.0

  20. Effectiveness of Social Media-based Interventions on Weight-related Behaviors and Body Weight Status: Review and Meta-analysis.

    Science.gov (United States)

    An, Ruopeng; Ji, Mengmeng; Zhang, Sheng

    2017-11-01

    We reviewed scientific literature regarding the effectiveness of social media-based interventions about weight-related behaviors and body weight status. A keyword search were performed in May 2017 in the Clinical-Trials.gov, Cochrane Library, PsycINFO, PubMed, and Web of Science databases. We conducted a meta-analysis to estimate the pooled effect size of social media-based interventions on weight-related outcome measures. We identified 22 interventions from the keyword and reference search, including 12 randomized controlled trials, 6 pre-post studies and 3 cohort studies conducted in 9 countries during 2010-2016. The majority (N = 17) used Facebook, followed by Twitter (N = 4) and Instagram (N = 1). Intervention durations averaged 17.8 weeks with a mean sample size of 69. The meta-analysis showed that social media-based interventions were associated with a statistically significant, but clinically modest reduction of body weight by 1.01 kg, body mass index by 0.92 kg/m2, and waist circumstance by 2.65 cm, and an increase of daily number of steps taken by 1530. In the meta-regression there was no doseresponse effect with respect to intervention duration. The boom of social media provides an unprecedented opportunity to implement health promotion programs. Future interventions should make efforts to improve intervention scalability and effectiveness.

  1. The Smoking-Related Weight and Eating Episodes Test (SWEET): development and preliminary validation.

    Science.gov (United States)

    Adams, Claire E; Baillie, Lauren E; Copeland, Amy L

    2011-11-01

    Many smokers believe that smoking helps them to control their weight, and concerns about weight gain can interfere with smoking cessation. As researchers typically assess general weight concerns, a measure specific to smoking-related weight concerns is needed. The Smoking-related Weight and Eating Episodes Test (SWEET) was created by generating items from 4 content domains: Hunger, Craving, Overeating, and Body Image. Female undergraduate smokers (N = 280) rated their postcessation weight gain concern and completed the SWEET, Fagerström Test for Nicotine Dependence, Brief Smoking Consequences Questionnaire-Adult, Eating Attitudes Test (EAT)-26, Bulimia Test-Revised (BULIT-R), and Body Shape Questionnaire. Factor analysis of the initial items suggested a 4-factor solution, suggesting 4 subscales: Smoking to suppress appetite, smoking to prevent overeating, smoking to cope with body dissatisfaction, and withdrawal-related appetite increases. Based on these results, the SWEET subscales were revised and shortened. The resulting 10-item SWEET showed excellent internal consistency (total α = .94; mean α = .86) and evidence of validity by predicting smoking frequency, eating pathology, and body image concerns (ps < .05). Smoking frequency, eating pathology, and body image concerns were significantly predicted by the SWEET while controlling for existing measures of postcessation weight gain concern. The SWEET appears to be a reliable and valid measure of tendencies to smoke in response to body image concern and nicotine withdrawal and as a way to control appetite and overeating.

  2. The Relationship Between Job Satisfaction and Productivity-Related Costs: A Longitudinal Analysis.

    Science.gov (United States)

    Arnold, Amélie E; Coffeng, Jennifer K; Boot, Cécile R L; van der Beek, Allard J; van Tulder, Maurits W; Nieboer, Dagmar; van Dongen, Johanna M

    2016-09-01

    The aim of this study was to examine the longitudinal relationship between job satisfaction and total productivity-related costs, and between job satisfaction and absenteeism and presenteeism costs separately. A secondary aim was to explore whether these relationships differed across job types. Linear generalized estimating equation analyses were used to explore the longitudinal relationships. To explore whether the relationships differed across job types, stratified analyses were performed. A significant relationship was found between job satisfaction and total productivity-related costs [β = &OV0556;-273; 95% confidence interval (95% CI): -407 to -200] and between job satisfaction and presenteeism costs (β = &OV0556;-276; 95% CI: -367 to -235), but not between job satisfaction and absenteeism costs. These relationships differed across job types. Higher levels of job satisfaction were longitudinally related to lower total productivity-related costs and presenteeism costs, but not to lower absenteeism costs. These relationships seem to differ across job types.

  3. The hospital costs of treating work-related sawmill injuries in British Columbia.

    Science.gov (United States)

    Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

    2007-05-01

    This study estimates the hospital costs of treating work-related injury among a cohort of sawmill workers in British Columbia. Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5,876 actively employed sawmill workers. Injury cases were identified as work-related from these records using ICD-9 external cause of injury codes that indicate place of occurrence and the responsibility of payment schedule that identifies workers' compensation as being responsible for payment. The hospitals in British Columbia have a standard ward rate chart prepared annually by the provincial Ministry of Health to bill and collect payment from agency like workers' compensation agency. Costs were calculated from the hospital perspective using this billing chart. All costs were expressed in 1995 Canadian dollars. The workers' compensation claim records for this study population were extracted and matched with the hospitalised work-related injury records. Costs were also calculated for work-related hospitalisations that the hospital did not appear to be reimbursed for by the workers' compensation system. There were 173 injuries requiring hospitalisation during the 10-year followup period. The median stay in hospitals was 3 days and the median hospital costs were $847. The most costly cause of injury categories were fire, flame, natural and environmental and struck against with median costs of $10,575 and $1,206, respectively, while the least costly category was cutting and piercing with median costs of $296. The most costly nature of injury categories were burns and fracture of lower limb with median costs of $10,575 and $1,800, respectively, while the least costly category was dislocation, sprains and strains with median costs of $437. The total hospital costs for all the work-related injuries were $434,990. Out of a total hospital cost of $434,990 for the 173 work-related injuries, the provincial compensation agency apparently did not compensate $50,663 (12

  4. 48 CFR 2131.205-1 - Public relations and advertising costs.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Public relations and... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 2131.205-1 Public relations and advertising costs. The provisions of FAR 31.205-1 shall be modified to include the following...

  5. [The ratio birth-weight, placental weight and the term of delivery. A contribution to the problem of a relative placental insufficiency in late pregnancy (author's transl)].

    Science.gov (United States)

    Warkentin, B

    1976-12-10

    It is suggested, that a relative placental insufficiency in late pregnancy is one of the releasing factors of childbirth. Under this assumption 1027 deliveries in term pregnancy (266th-294th day of pregnancy) were inquired on the interrelationship between the ratio brith-weight: placental-weight and the duration of pregnancy. The average birth-weight increases slighly but significantly with the duration of pregnancy just as the average placental-weight. The average ratio birth-weight: placental-weight decreases significantly: The more unfavorable the ratio birth-weight: placental-weight is, the shorter remains the fetus in utero. This underlines the assumption of a relative placental insufficiency as one of the releasing factors of childbirth.

  6. Body Image, Self-Esteem, and Weight-Related Criticism from Romantic Partners.

    Science.gov (United States)

    Befort, Christie; Kurpius, Sharon E. Robinson; Hull-Blanks, Elva; Nicpon, Megan Foley; Huser, Laura; Sollenberger, Sonja

    2001-01-01

    Examines weight-related criticism from romantic partners and the importance of the romantic relationship in relation to the body image and self esteem for college freshmen women. Results reveal that self esteem and body image were positively related. Partner importance also predicted self esteem, whereas criticism did not. (Contains 55 references…

  7. Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia.

    Science.gov (United States)

    Ali Jadoo, Saad Ahmed; Aljunid, Syed Mohamed; Nur, Amrizal Muhammad; Ahmed, Zafar; Van Dort, Dexter

    2015-02-10

    The service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital. All patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components' cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs). Drugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83. A mixed

  8. Cost-effectiveness of SHINE: A Telephone Translation of the Diabetes Prevention Program

    Directory of Open Access Journals (Sweden)

    Christopher S. Hollenbeak

    2016-01-01

    Full Text Available Background The Support, Health Information, Nutrition, and Exercise (SHINE trial recently showed that a telephone adaptation of the Diabetes Prevention Program (DPP lifestyle intervention was effective in reducing weight among patients with metabolic syndrome. The aim of this study is to determine whether a conference call (CC adaptation was cost effective relative to an individual call (IC adaptation of the DPP lifestyle intervention in the primary care setting. Methods We performed a stochastic cost-effectiveness analysis alongside a clinical trial comparing two telephone adaptations of the DPP lifestyle intervention. The primary outcomes were incremental cost-effectiveness ratios estimated for weight loss, body mass index (BMI, waist circumference, and quality-adjusted life years (QALYs. Costs were estimated from the perspective of society and included direct medical costs, indirect costs, and intervention costs. Results After one year, participants receiving the CC intervention accumulated fewer costs ($2,831 vs. $2,933 than the IC group, lost more weight (6.2 kg vs. 5.1 kg, had greater reduction in BMI (2.1 vs. 1.9, and had greater reduction in waist circumference (6.5 cm vs. 5.9 cm. However, participants in the CC group had fewer QALYs than those in the IC group (0.635 vs. 0.646. The incremental cost-effectiveness ratio for CC vs. IC was $9,250/QALY, with a 48% probability of being cost-effective at a willingness-to-pay of $100,000/QALY. Conclusions CC delivery of the DPP was cost effective relative to IC delivery in the first year in terms of cost per clinical measure (weight lost, BMI, and waist circumference but not in terms of cost per QALY, most likely because of the short time horizon.

  9. Prevalence of abnormal birth weight and related factors in Northern region, Ghana

    OpenAIRE

    Abubakari, Abdulai; Kynast-Wolf, Gisela; Jahn, Albrecht

    2015-01-01

    Background: Birth weight is a crucial determinant of the development potential of the newborn. Abnormal newborn weights are associated with negative effects on the health and survival of the baby and the mother. Therefore, this study was designed to determine the prevalence of abnormal birth weight and related factors in Northern region, Ghana. Methods: The study was a facility-based cross-sectional survey in five hospitals in Northern region, Ghana. These hospitals were selected based on t...

  10. Accuracy and congruence of patient and physician weight-related discussions: from Project CHAT (Communicating Health: Analyzing Talk)

    Science.gov (United States)

    Bodner, Michael E.; Dolor, Rowena J.; Óstbye, Truls; Lyna, Pauline; Alexander, Stewart C.; Tulsky, James A.; Pollak, Kathryn I.

    2014-01-01

    Objective Primary care providers should counsel overweight patients to lose weight. Rates of self-reported weight-related counseling vary, perhaps due to self-report bias. We assessed accuracy and congruence of weight-related discussions among patients, physicians, and audio-recorded encounters. Methods We audio recorded encounters between physicians (n=40) and their overweight/obese patients (n=461) at five community-based practices. We coded weight-related content and surveyed patients and physicians immediately after the visit. Generalized linear mixed models assessed factors associated with accuracy. Results Overall, accuracy was moderate: patient (67%), physician (70%), and congruence (62%). When encounters contained weight-related content were analyzed, patients (98%) and physicians (97%) were highly accurate and congruent (95%) but when weight was not discussed patients and physicians were more inaccurate and incongruent (patient 36%; physician 44%; 28% congruence). Physicians less comfortable discussing weight were more likely to misreport that weight was discussed [OR = 4.5 (95% CI=1.88–10.75, p<0.001)]. White physicians with African-American patients were more likely to report accurately no discussion about weight than White physicians with White patients OR=0.30 (95% CI=0.13–0.69, p<0.01). Conclusion Physician and patient self-report of weight-related discussions were highly accurate and congruent when audio-recordings indicated weight was discussed, but not when recordings indicated no weight discussions. Physician overestimation of weight discussions when weight is not discussed constitutes missed opportunities for health interventions. PMID:24390888

  11. Do body-related shame and guilt mediate the association between weight status and self-esteem?

    Science.gov (United States)

    Pila, Eva; Sabiston, Catherine M; Brunet, Jennifer; Castonguay, Andree L; O'Loughlin, Jennifer

    2015-05-01

    Individuals who are overweight or obese report body image concerns and lower self-esteem. However, little is known about the mechanisms underpinning these associations. The objective of this study was to test body-related shame and guilt as mediators in the association between weight status and self-esteem. Young adult participants (n = 790) completed assessments of self-esteem and body-related guilt and shame, and weight status indicators were measured by trained technicians. Findings from multiple mediation analyses suggest that body-related shame mediates the relationship between weight status and self-esteem. If replicated in longitudinal studies, these findings suggest that reducing body-related emotions may have important implications for improving self-esteem in clinical weight management. © The Author(s) 2015.

  12. Associations of maternal stress with children's weight-related behaviours: a systematic literature review.

    Science.gov (United States)

    O'Connor, S G; Maher, J P; Belcher, B R; Leventhal, A M; Margolin, G; Shonkoff, E T; Dunton, G F

    2017-05-01

    Low adherence to guidelines for weight-related behaviours (e.g. dietary intake and physical activity) among US children underscores the need to better understand how parental factors may influence children's obesity risk. In addition to most often acting as primary caregiver to their children, women are also known to experience greater levels of stress than men. This study systematically reviewed associations between maternal stress and children's weight-related behaviours. Our search returned 14 eligible articles, representing 25 unique associations of maternal stress with a distinct child weight-related behaviour (i.e. healthy diet [n = 3], unhealthy diet [n = 6], physical activity [n = 7] and sedentary behaviour [n = 9]). Overall, findings for the relationship between maternal stress and children's weight-related behaviours were mixed, with no evidence for an association with children's healthy or unhealthy dietary intake, but fairly consistent evidence for the association of maternal stress with children's lower physical activity and higher sedentary behaviour. Recommendations for future research include prioritizing prospective designs, identifying moderators, and use of high-resolution, real-time data collection techniques to elucidate potential mechanisms. © 2017 World Obesity Federation.

  13. Relations of hedonic hunger and behavioral change to weight loss among adults in a behavioral weight loss program utilizing meal-replacement products.

    Science.gov (United States)

    Theim, Kelly R; Brown, Joshua D; Juarascio, Adrienne S; Malcolm, Robert R; O'Neil, Patrick M

    2013-11-01

    Greater self-regulatory behavior usage is associated with greater weight loss within behavioral weight loss treatments. Hedonic hunger (i.e., susceptibility to environmental food cues) may impede successful behavior change and weight loss. Adult men and women (N = 111, body mass index M ± SD = 35.89 ± 6.97 kg/m(2)) were assessed before and after a 15-week lifestyle change weight loss program with a partial meal-replacement diet. From pre- to post-treatment, reported weight control behavior usage improved and hedonic hunger decreased, and these changes were inversely related. Individuals with higher hedonic hunger scores at baseline showed the greatest weight loss. Similarly, participants with lower baseline use of weight control behaviors lost more weight, and increased weight control behavior usage was associated with greater weight loss-particularly among individuals with low baseline hedonic hunger. Further study is warranted regarding the significance of hedonic hunger in weight loss treatments.

  14. Transaction-cost Expenditures and the Relative Performance of Mutual Funds

    OpenAIRE

    John M.R. Chalmers; Roger M. Edelen; Gregory B. Kadlec

    1999-01-01

    We directly estimate annual trading costs for a sample of equity mutual funds and find that these costs are large and exhibit substantial cross sectional variation. Trading costs average 0.78% of fund assets per year and have an inter-quartile range of 0.59%. Trading costs, like expense ratios, are negatively related to fund returns and we find no evidence that on average trading costs are recovered in higher gross fund returns. We find that our direct estimates of trading costs have more exp...

  15. Reliable, Low-Cost, Low-Weight, Non-Hermetic Coating for MCM Applications

    Science.gov (United States)

    Jones, Eric W.; Licari, James J.

    2000-01-01

    Through an Air Force Research Laboratory sponsored STM program, reliable, low-cost, low-weight, non-hermetic coatings for multi-chip-module(MCK applications were developed. Using the combination of Sandia Laboratory ATC-01 test chips, AvanTeco's moisture sensor chips(MSC's), and silicon slices, we have shown that organic and organic/inorganic overcoatings are reliable and practical non-hermetic moisture and oxidation barriers. The use of the MSC and unpassivated ATC-01 test chips provided rapid test results and comparison of moisture barrier quality of the overcoatings. The organic coatings studied were Parylene and Cyclotene. The inorganic coatings were Al2O3 and SiO2. The choice of coating(s) is dependent on the environment that the device(s) will be exposed to. We have defined four(4) classes of environments: Class I(moderate temperature/moderate humidity). Class H(high temperature/moderate humidity). Class III(moderate temperature/high humidity). Class IV(high temperature/high humidity). By subjecting the components to adhesion, FTIR, temperature-humidity(TH), pressure cooker(PCT), and electrical tests, we have determined that it is possible to reduce failures 50-70% for organic/inorganic coated components compared to organic coated components. All materials and equipment used are readily available commercially or are standard in most semiconductor fabrication lines. It is estimated that production cost for the developed technology would range from $1-10/module, compared to $20-200 for hermetically sealed packages.

  16. The energy cost of playing active video games in children with obesity and children of a healthy weight.

    Science.gov (United States)

    O'Donovan, C; Roche, E F; Hussey, J

    2014-08-01

    Increasing physical activity and reducing sedentary behaviour form a large part of the treatment of paediatric obesity. However, many children today spend prolonged periods of time playing sedentary video games. Active video games (AVGs) represent a novel and child friendly form of physical activity. To measure the energy cost of playing two AVGs in children with obesity and healthy age- and gender-matched children. The energy cost of gaming and heart rates achieved during gaming conditions were compared between groups. AVG play can result in light-to-moderate intensity physical activity (2.7-5.4 metabolic equivalents). When corrected for fat-free mass those with obesity expended significantly less energy than healthy weight peers playing Nintendo Wii Fit Free Jogging (P = 0.017). No significant difference was seen between groups in the energy cost of playing Boxing. Certain AVGs, particularly those that require lower limb movement, could be used to increase total energy expenditure, replace more sedentary activities, or achieve moderate intensity physical activity among children with obesity. There seems to be some differences in how children with obesity and children of a healthy weight play AVGs. This could result in those with obesity expending less energy than their lean peers during AVG play. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

  17. A simple idea for reducing the cost and weight of plaster-cast orthoses Uma ideia simples para diminuir custo e peso das talas gessadas

    Directory of Open Access Journals (Sweden)

    André Esmanhotto

    2013-01-01

    Full Text Available OBJECTIVE: To reduce the cost and weight of plaster molded orthosis (increasing patient comfort, keeping the same resistance. METHODS: 22 plaster orthosis were analysed, 11 with conventional shape and 11 with pyramidal shape. It was compared, in theory (mathematcally and practice, the change of weight (and consequently cost and flexion resistance between conventional shape and pyramidal shape. RESULTS: Theorical analysis: weight and cost decrease of 26.7%-38.9%, according to the layers disposition of the cast. Laboratorial analysis: cast´s weight decrease of 34.5% (p = 0.000005 and resistance increase of 26.7% (p = 0.03. CONCLUSION: plaster molded orthosis made in a pyramidal shape, have a statistically significant decrease of weight (and consequently cost and statistically significant increase of resistance if compared with traditional shape. OBJETIVO: Diminuir o custo e o peso (aumentando o conforto para o paciente das talas gessadas, mantendo resistência semelhante. MÉTODOS: Foram analisadas 22 talas de gesso, 11 com formato convencional e 11 com formato piramidal. Foi feita comparação, teórica (matemática e prática, entre as talas convencionais e as piramidais quanto à mudança de peso (e consequentemente de custo e à resistência à flexão. RESULTADOS: Análise matemática – diminuição peso e custo entre 26,7% e 38,9%, variando conforme a disposição das camadas da tala. Análise prática – diminuição do peso em 34,5% (p = 0,000005 e resistência aumentada em 26,7% (p = 0,03. CONCLUSÃO: A tala gessada com formato piramidal apresenta diminuição estatisticamente significativa de peso (e consequentemente de custo, com aumento estatisticamente significativo da resistência, se comparada à tala de formato convencional.

  18. General aviation accidents related to exceedance of airplane weight/center of gravity limits.

    Science.gov (United States)

    Boyd, Douglas D

    2016-06-01

    Obesity, affects a third of the US population and its corollary occupant weight adversely impacts safe flight operations. Increased aircraft weight results in longer takeoff/landing distances, degraded climb gradients and airframe failure may occur in turbulence. In this study, the rate, temporal changes, and lethality of accidents in piston-powered, general aviation aircraft related to exceeding the maximum aircraft weight/center of gravity (CG) limits were determined. Nation-wide person body mass were from the National Health and Nutrition Examination Survey. The NTSB database was used to identify accidents related to operation of aircraft outside of their weight/CG envelope. Statistical analyses employed T-tests, proportion tests and a Poisson distribution. While the average body mass climbed steadily (p<0.001) between 1999 and 2014 the rate of accidents related to exceedance of the weight/CG limits did not change (p=0.072). However, 57% were fatal, higher (p<0.001) than the 21% for mishaps attributed to other causes/factors. The majority (77%) of accidents were due to an overloaded aircraft operating within its CG limits. As to the phase of flight, accidents during takeoff and those occurring enroute carried the lowest (50%) and highest (85%) proportion of fatal accidents respectively. While the rate of general aviation accidents related to operating an aircraft outside of its weight/CG envelope has not increased over the past 15 years, these types of accidents carry a high risk of fatality. Airmen should be educated as to such risks and to dispel the notion held by some that flights may be safely conducted with an overloaded aircraft within its CG limits. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. The weight of racism: Vigilance and racial inequalities in weight-related measures

    Science.gov (United States)

    Hicken, Margaret T.; Lee, Hedwig; Hing, Anna K.

    2017-01-01

    In the United States, racial/ethnic inequalities in obesity are well-documented, particularly among women. Using the Chicago Community Adult Health Study, a probability-based sample in 2001–2003 (N=3,105), we examined the roles of discrimination and vigilance in racial inequalities in two weight-related measures, body mass index (BMI) and waist circumference (WC), viewed through a cultural racism lens. Cultural racism creates a social environment in which Black Americans bear the stigma burden of their racial group while White Americans are allowed to view themselves as individuals. We propose that in this context, interpersonal discrimination holds a different meaning for Blacks and Whites, while vigilance captures the coping style for Blacks who carry the stigma burden of the racial group. By placing discrimination and vigilance within the context of cultural racism, we operationalize existing survey measures and utilize statistical models to clarify the ambiguous associations between discrimination and weight-related inequalities in the extant literature. Multivariate models were estimated for BMI and WC separately and were stratified by gender. Black women had higher mean BMI and WC than any other group, as well as highest levels of vigilance. White women did not show an association between vigilance and WC but did show a strong positive association between discrimination and WC. Conversely, Black women displayed an association between vigilance and WC, but not between discrimination and WC. These results demonstrate that vigilance and discrimination may hold different meanings for obesity by ethnoracial group that are concealed when all women are examined together and viewed without considering a cultural racism lens. PMID:28372829

  20. The weight of racism: Vigilance and racial inequalities in weight-related measures.

    Science.gov (United States)

    Hicken, Margaret T; Lee, Hedwig; Hing, Anna K

    2018-02-01

    In the United States, racial/ethnic inequalities in obesity are well-documented, particularly among women. Using the Chicago Community Adult Health Study, a probability-based sample in 2001-2003 (N = 3105), we examined the roles of discrimination and vigilance in racial inequalities in two weight-related measures, body mass index (BMI) and waist circumference (WC), viewed through a cultural racism lens. Cultural racism creates a social environment in which Black Americans bear the stigma burden of their racial group while White Americans are allowed to view themselves as individuals. We propose that in this context, interpersonal discrimination holds a different meaning for Blacks and Whites, while vigilance captures the coping style for Blacks who carry the stigma burden of the racial group. By placing discrimination and vigilance within the context of cultural racism, we operationalize existing survey measures and utilize statistical models to clarify the ambiguous associations between discrimination and weight-related inequalities in the extant literature. Multivariate models were estimated for BMI and WC separately and were stratified by gender. Black women had higher mean BMI and WC than any other group, as well as highest levels of vigilance. White women did not show an association between vigilance and WC but did show a strong positive association between discrimination and WC. Conversely, Black women displayed an association between vigilance and WC, but not between discrimination and WC. These results demonstrate that vigilance and discrimination may hold different meanings for obesity by ethnoracial group that are concealed when all women are examined together and viewed without considering a cultural racism lens. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Age-related differences in body weight loss in response to altered thyroidal status.

    Science.gov (United States)

    Mooradian, A D

    1990-01-01

    To determine whether age-related differences in body weight loss in hyperthyroidism could be related to caloric intake, the body weight and food consumption of Fischer 344 male rats were monitored every other day for four weeks. Six-month-old (young) rats were compared to 16-month-old rats (intermediate age) and 25-month-old (aged) rats. Hypothyroidism was induced with 0.025% methimazole in the drinking water for four weeks. Hyperthyroidism was induced with triiodothyronine (T3) injections (15 micrograms/100 g body weight i.p.) for the last 10 days of observation. A group of young rats pair fed with aged rats was included as a control group. The body weight changes of aged rats were similar to hypothyroid young rats. An index of T3 catabolic effect was calculated based on the net weight loss and food intake. This index was not different in aged rats compared to young rats. The apparent hypersensitivity of aged rats to T3 as evidenced by excessive weight loss could totally be attributed to decreased caloric intake. It is concluded that aged rats compared to the young are not more sensitive to the overall catabolic effects of thyroid hormones.

  2. Use of the Decision Support System for VA cost-effectiveness research.

    Science.gov (United States)

    Barnett, P G; Rodgers, J H

    1999-04-01

    The Department of Veterans Affairs is adopting the Decision Support System (DSS), computer software and databases which include a cost-accounting system which determines the cost of health care products and patient encounters. A system for providing cost data for cost-effectiveness analysis should be provide valid, detailed, and comprehensive data that can be aggregated. The design of DSS is described and compared with those criteria. Utilization data from DSS was compared with other VA utilization data. Aggregate DSS cost data from 35 medical centers was compared with relative resource weights developed for the Medicare program. Data on hospital stays at 3 facilities found that 3.7% of the stays in DSS were not in the VA discharge database, whereas 7.6% of the stays in the discharge data were not in DSS. DSS reported between 68.8% and 97.1% of the outpatient encounters reported by six facilities in the ambulatory care data base. Relative weights for each Diagnosis Related Group based on DSS data from 35 VA facilities correlated with Medicare weights (correlation coefficient of .853). DSS will be useful for research if certain problems are overcome. It is difficult to distinguish long-term from acute hospital care. VA does not have a complete database of all inpatient procedures, so DSS has not assigned them a specific cost. The authority to access encounter-level DSS data needs to be centralized. Researchers can provide the feedback needed to improve DSS cost estimates. A comprehensive encounter-level extract would facilitate use of DSS for research.

  3. The relation of birth weight and gestational age to biological, occupational and socioeconomic factors.

    Science.gov (United States)

    Velonakis, E G; Maghiorakos, P; Tzonou, A; Barrat, J; Proteau, J; Ladopoulos, I

    1997-01-01

    The data of the 2,040 single births, born during 1987 at the "Saint Antoine" Hospital in Paris, were analysed in order to identify the impact of various biological, occupational, and socioeconomic factors on gestational age and birth weight. Birth weight is associated with the height of the mother and the weight gained during pregnancy. It is lower for mothers with preeclampsia during the current or previous pregnancies or with urogenital infections during the current pregnancy and for mothers with one or more induced abortions. Girls weigh less than boys. Parity has a positive relation to the baby's weight, while manual work seems to have a negative one. APGAR score and duration of the pregnancy are associated with the birth weight. Placenta previa, preeclampsia and urinary infections affect the gestational age. A short pause period in work is related to a shorter gestational age. Weight gain is associated with a prolonged duration of the pregnancy. Gestational age and birth weight are associated with the nationality of the mother, especially in some ethnic groups, and with marital status.

  4. Weight-related stigma is a significant psychosocial stressor in developing countries: Evidence from Guatemala.

    Science.gov (United States)

    Hackman, Joseph; Maupin, Jonathan; Brewis, Alexandra A

    2016-07-01

    Weight-related stigma is established as a major psychosocial stressor and correlate of depression among people living with obesity in high-income countries. Anti-fat beliefs are rapidly globalizing. The goal of the study is to (1) examine how weight-related stigma, enacted as teasing, is evident among women from a lower-income country and (2) test if such weight-related stigma contributes to depressive symptoms. Modeling data for 12,074 reproductive-age women collected in the 2008-2009 Guatemala National Maternal-Infant Health Survey, we demonstrate that weight-related teasing is (1) experienced by those both underweight and overweight, and (2) a significant psychosocial stressor. Effects are comparable to other factors known to influence women's depressive risk in lower-income countries, such as living in poverty, experiencing food insecurity, or suffering sexual/domestic violence. That women's failure to meet local body norms-whether they are overweight or underweight-serves as such a strong source of psychological distress is particularly concerning in settings like Guatemala where high levels of over- and under-nutrition intersect at the household and community level. Current obesity-centric models of weight-related stigma, developed from studies in high-income countries, fail to recognize that being underweight may create similar forms of psychosocial distress in low-income countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Gender orientation and alcohol-related weight control behavior among male and female college students.

    Science.gov (United States)

    Peralta, Robert L; Barr, Peter B

    2017-01-01

    We examine weight control behavior used to (a) compensate for caloric content of heavy alcohol use; and (b) enhance the psychoactive effects of alcohol among college students. We evaluate the role of gender orientation and sex. Participants completed an online survey (N = 651; 59.9% women; 40.1% men). Weight control behavior was assessed via the Compensatory-Eating-and-Behaviors-in Response-to-Alcohol-Consumption-Scale. Control variables included sex, race/ethnicity, age, and depressive symptoms. Gender orientation was measured by the Bem Sex Role Inventory. The prevalence and probability of alcohol-related weight control behavior using ordinal logistic regression are reported. Men and women do not significantly differ in compensatory-weight-control-behavior. However, regression models suggest that recent binge drinking, other substance use, and masculine orientation are positively associated with alcohol-related weight control behavior. Sex was not a robust predictor of weight control behavior. Masculine orientation should be considered a possible risk factor for these behaviors and considered when designing prevention and intervention strategies.

  6. Can community-based, low-cost antenatal care in the third trimester of pregnancy reduce the incidence of low birth weight newborns?

    Science.gov (United States)

    Chaudhary, A K; Chaudhary, Asha; Tiwari, S C; Dwivedi, R

    2012-06-01

    To determine if community-based, low-cost interventions during third trimester of pregnancy can reduce the incidence of low birth weight babies. In a case control study, 290 pregnant women from a slum area were registered in the beginning of third trimester of pregnancy and provided full antenatal care comprising fortnightly check up, one IFA tablet daily, counseling for minimum one-and-a-half hour post-lunch rest in left lateral position, additional diet to ensure minimum 2,200 kcal per day, and management of clinical conditions, if any. An equal number of pregnant women belonging to the same slum area were registered as control who received routine antenatal services from the existing health care facilities. The birth weight of the babies in the two groups were recorded and compared. Test of significance and correlation coefficient were applied to the data. Mean birth weight of the babies of the Subjects was 2.76 kg (SD 0.39) compared to mean birth weight of 2.57 kg (SD 0.36) of the babies in the Control group. Incidence of low birth weight babies among subjects who consumed minimum 2,400 kcal per day, had one-and-a-half hour post-lunch rest in left lateral position and who consumed one tablet of IFA (100 mg iron and 5 mg folic acid) per day during the last trimester of pregnancy was lower (17.6 %) as compared with women in the Control group (36.2 %). The difference in the mean birth weight of newborns of the two groups was statistically significant (t = 2.52, p < 0.01). Incidence of low birth weight babies can be significantly reduced by providing simple, low-cost care to pregnant women during the last trimester of pregnancy in the community setting.

  7. On the relation between cost and service models for general inventory systems

    NARCIS (Netherlands)

    Houtum, van G.J.J.A.N.; Zijm, W.H.M.

    2000-01-01

    In this paper, we present a systematic overview of possible relations between cost and service models for fairly general single- and multi-stage inventory systems. In particular, we relate various types of penalty costs in pure cost models to equivalent types of service measures in service models.

  8. Induction-related cost of patients with acute myeloid leukaemia in France.

    Science.gov (United States)

    Nerich, Virginie; Lioure, Bruno; Rave, Maryline; Recher, Christian; Pigneux, Arnaud; Witz, Brigitte; Escoffre-Barbe, Martine; Moles, Marie-Pierre; Jourdan, Eric; Cahn, Jean Yves; Woronoff-Lemsi, Marie-Christine

    2011-04-01

    The economic profile of acute myeloid leukaemia (AML) is badly known. The few studies published on this disease are now relatively old and include small numbers of patients. The purpose of this retrospective study was to evaluate the induction-related cost of 500 patients included in the AML 2001 trial, and to determine the explanatory factors of cost. "Induction" patient's hospital stay from admission for "induction" to discharge after induction. The study was performed from the French Public Health insurance perspective, restrictive to hospital institution costs. The average management of a hospital stay for "induction" was evaluated according to the analytical accounting of Besançon University Teaching Hospital and the French public Diagnosis-Related Group database. Multiple linear regression was used to search for explanatory factors. Only direct medical costs were included: treatment and hospitalisation. Mean induction-related direct medical cost was estimated at €41,852 ± 6,037, with a mean length of hospital stay estimated at 36.2 ± 10.7 days. After adjustment for age, sex and performance status, only two explanatory factors were found: an additional induction course and salvage course increased induction-related cost by 38% (± 4) and 15% (± 1) respectively, in comparison to one induction. These explanatory factors were associated with a significant increase in the mean length of hospital stay: 45.8 ± 11.6 days for 2 inductions and 38.5 ± 15.5 if the patient had a salvage course, in comparison to 32.9 ± 7.7 for one induction (P cost for patients with AML.

  9. Reducing rotor weight

    Energy Technology Data Exchange (ETDEWEB)

    Cheney, M.C. [PS Enterprises, Inc., Glastonbury, CT (United States)

    1997-12-31

    The cost of energy for renewables has gained greater significance in recent years due to the drop in price in some competing energy sources, particularly natural gas. In pursuit of lower manufacturing costs for wind turbine systems, work was conducted to explore an innovative rotor designed to reduce weight and cost over conventional rotor systems. Trade-off studies were conducted to measure the influence of number of blades, stiffness, and manufacturing method on COE. The study showed that increasing number of blades at constant solidity significantly reduced rotor weight and that manufacturing the blades using pultrusion technology produced the lowest cost per pound. Under contracts with the National Renewable Energy Laboratory and the California Energy Commission, a 400 kW (33m diameter) turbine was designed employing this technology. The project included tests of an 80 kW (15.5m diameter) dynamically scaled rotor which demonstrated the viability of the design.

  10. Nursing dependency, diagnosis-related groups, and length of hospital stay

    OpenAIRE

    Halloran, Edward J.; Kiley, Marylou

    1987-01-01

    Most efforts to modify the diagnosis-related group (DRG) case classification system focus on variables related to medical management. In this study, we investigated the separate but related natures of medicine and nursing by examining 1,288 adult medical and surgical patients in an urban teaching hospital. The complexity of medical treatment was measured by use of the DRG relative cost weight. The nursing indicator was derived from a set of nursing diagnoses. We found that the DRG cost weight...

  11. Costs in Relation to Disability, Disease Activity, and Health-related Quality of Life in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Wallman, Johan K; Eriksson, Jonas K; Nilsson, Jan-Åke

    2016-01-01

    between-patient associations) and by generalized estimating equations (GEE), using all observations to also account for within-patient associations of HAQ/DAS28/EQ-5D to costs. RESULTS: Regardless of the methodology (linear or GEE regression), HAQ was most closely related to both cost types, while work......OBJECTIVE: To compare how costs relate to disability, disease activity, and health-related quality of life (HRQOL) in rheumatoid arthritis (RA). METHODS: Antitumor necrosis factor (anti-TNF)-treated patients with RA in southern Sweden (n = 2341) were monitored 2005-2010. Health Assessment...... Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), and EQ-5D scores were linked to register-derived costs of antirheumatic drugs (excluding anti-TNF agents), patient care, and work loss from 30 days before to 30 days after each visit (n = 13,289). Associations of HAQ/DAS28/EQ-5D to healthcare...

  12. Parent and family associations with weight-related behaviors and cognitions among overweight adolescents

    Science.gov (United States)

    Cromley, Taya R.; Neumark-Sztainer, Dianne; Story, Mary; Boutelle, Kerri

    2013-01-01

    Purpose To examine parent and family variables in relation to adolescent weight control and eating behaviors, body satisfaction, and importance of thinness among overweight adolescents. Methods This study examined parent-reported use of weight control behaviors (i.e., healthy and unhealthy behaviors, behavioral changes, other diet strategies), parent psychosocial functioning (i.e., depression, self-esteem, body satisfaction, importance of thinness), and family functioning (i.e., cohesion and adaptability) in relation to adolescent weight control and eating behaviors, body satisfaction, and importance of thinness. Surveys were completed by 103 overweight (BMI ≥ 85th percentile) adolescents, ages 12 to 20, and their parents. Height and weight were also measured. Linear regression equations were used for continuous outcomes and logistic regression equations for dichotomous outcomes. Results Adolescent report of lower body satisfaction and engagement in more “severe” or less healthy forms of weight control behavior were associated with parent weight control behaviors. Adolescent report of overeating was associated with lower scores of family cohesion and adaptability. Adolescent report of lower body satisfaction was positively associated with parent report of body satisfaction and self-esteem. Adolescent report of greater importance placed on thinness was associated with parent report of lower self-esteem. Conclusions Findings indicate that several parent and family variables are associated with weight control behaviors, episodes of overeating, and body satisfaction and importance of thinness among overweight adolescents. Parent weight control behaviors and adolescent cognitions about body image may be important variables to target within intervention research and treatment programs for overweight youth. PMID:20708565

  13. Birth Weight of Newborns in Relation to Nutritional Status of ...

    African Journals Online (AJOL)

    The desire to achieve the Millennium Development Goals 4 and 5 has stimulated several investiga-tions related to pregnancy and birth outcome. Gestational weight gain and haemoglobin levels of pregnant women attending antenatal clinics in the Nkawie Government Hospital were assessed to ascertain their ...

  14. Cost-Related Medication Nonadherence and Cost-Saving Behaviors Among Patients With Glaucoma Before and After the Implementation of Medicare Part D.

    Science.gov (United States)

    Blumberg, Dana M; Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; De Moraes, C Gustavo

    2015-09-01

    Understanding factors that lead to nonadherence to glaucoma treatment is important to diminish glaucoma-related disability. To determine whether the implementation of the Medicare Part D prescription drug benefit affected rates of cost-related nonadherence and cost-reduction strategies in Medicare beneficiaries with and without glaucoma and to evaluate associated risk factors for such nonadherence. Serial cross-sectional study using 2004 to 2009 Medicare Current Beneficiary Survey data linked with Medicare claims. Coding to extract data started in January 2014 and analyses were performed between September and November of 2014. Participants were all Medicare beneficiaries, including those with a glaucoma-related diagnosis in the year prior to the collection of the survey data, those with a nonglaucomatous ophthalmic diagnosis in the year prior to the collection of the survey data, and those without a recent eye care professional claim. Effect of the implementation of the Medicare Part D drug benefit. The change in cost-related nonadherence and the change in cost-reduction strategies. Between 2004 and 2009, the number of Medicare beneficiaries with glaucoma who reported taking smaller doses and skipping doses owing to cost dropped from 9.4% and 8.2% to 2.7% (P cost did not improve in the same period (3.4% in 2004 and 2.1% in 2009; P = .12). After Part D, patients with glaucoma had a decrease in several cost-reduction strategies, namely price shopping (26.2%-15.2%; P cost-related nonadherence measures were female sex, younger age, lower income (implementation of Part D, there was a decrease in the rate that beneficiaries with glaucoma reported engaging in cost-saving measures. Although there was a decline in the rate of several cost-related nonadherence behaviors, patients reporting failure to fill prescriptions owing to cost remained stable. This suggests that efforts to improve cost-related nonadherence should focus both on financial hardship and medical

  15. How do pregnancy-related weight changes and breastfeeding relate to maternal weight and BMI-adjusted waist circumference 7 y after delivery?

    DEFF Research Database (Denmark)

    Kirkegaard, Helene; Stovring, Henrik; Rasmussen, Kathleen M

    2014-01-01

    of breastfeeding are unknown. OBJECTIVE: The objective was to examine how prepregnancy weight, gestational weight gain, postpartum weight changes, and breastfeeding influence maternal weight and body mass index-adjusted waist circumference (WCBMI) 7 y after delivery. DESIGN: This was a prospective cohort study......; 87% of this effect was mediated through later weight changes. For both outcomes, a small inverse association was observed for breastfeeding duration. This was strongest for WCBMI, for which 97% of the effect was direct, ie, not mediated through postpartum weight. CONCLUSIONS: These findings show...... that postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum contribute equally to adverse maternal anthropometric measures 7 y after delivery. Breastfeeding duration may have a beneficial effect....

  16. Correlates of weight-related quality of life among individuals with binge eating disorder before and after cognitive behavioral therapy.

    Science.gov (United States)

    Mason, Tyler B; Crosby, Ross D; Kolotkin, Ronette L; Grilo, Carlos M; Mitchell, James E; Wonderlich, Stephen A; Crow, Scott J; Peterson, Carol B

    2017-12-01

    Individuals with obesity and binge eating disorder (BED) report poorer weight-related quality of life (WRQOL) compared to individuals with obesity alone. Cognitive behavioral therapy (CBT), the best available treatment for BED, does not consistently produce weight loss or improvements in weight QOL. The purpose of the current study was to examine baseline and longitudinal associations between eating-related and psychosocial variables and dimensions of weight QOL. We examined associations between predictor variables, including body mass index (BMI), eating disorder (ED) psychopathology, and psychosocial factors, in relation to three dimensions of WRQOL among 171 patients whom received CBT for BED. Participants completed interviews and self-report measures at baseline prior to CBT and at end of treatment. At baseline the following associations were significant: BMI, ED psychopathology, and self-esteem were associated with weight-related self-esteem; gender, BMI, and self-esteem were associated with weight-related public distress (i.e., stigma and worry in public because of one's weight); and age, BMI, and ED psychopathology were associated with weight-related physical function. At end of treatment, the following associations were significant: changes in ED psychopathology and coping predicted weight-related self-esteem; changes in coping and self-esteem predicted weight-related public distress; and changes in BMI and subjective binge eating predicted weight-related physical function. Overall, changes in a number of ED and associated symptoms were associated with improvements in WRQOL. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Comparing the relative cost-effectiveness of diagnostic studies: a new model

    International Nuclear Information System (INIS)

    Patton, D.D.; Woolfenden, J.M.; Wellish, K.L.

    1986-01-01

    We have developed a model to compare the relative cost-effectiveness of two or more diagnostic tests. The model defines a cost-effectiveness ratio (CER) for a diagnostic test as the ratio of effective cost to base cost, only dollar costs considered. Effective cost includes base cost, cost of dealing with expected side effects, and wastage due to imperfect test performance. Test performance is measured by diagnostic utility (DU), a measure of test outcomes incorporating the decision-analytic variables sensitivity, specificity, equivocal fraction, disease probability, and outcome utility. Each of these factors affecting DU, and hence CER, is a local, not universal, value; these local values strongly affect CER, which in effect becomes a property of the local medical setting. When DU = +1 and there are no adverse effects, CER = 1 and the patient benefits from the test dollar for dollar. When there are adverse effects effective cost exceeds base cost, and for an imperfect test DU 1. As DU approaches 0 (worthless test), CER approaches infinity (no effectiveness at any cost). If DU is negative, indicating that doing the test at all would be detrimental, CER also becomes negative. We conclude that the CER model is a useful preliminary method for ranking the relative cost-effectiveness of diagnostic tests, and that the comparisons would best be done using local values; different groups might well arrive at different rankings. (Author)

  18. Associations of maternal stress with children’s weight-related behaviors: A systematic literature review

    Science.gov (United States)

    O’Connor, Sydney G.; Maher, Jaclyn P.; Belcher, Britni R.; Leventhal, Adam M.; Margolin, Gayla; Shonkoff, Eleanor T.; Dunton, Genevieve F.

    2017-01-01

    Low adherence to guidelines for weight-related behaviors (e.g., dietary intake and physical activity) among U.S. children underscores the need to better understand how parental factors may influence children’s obesity risk. In addition to most often acting as primary caregiver to their children, women are also known to experience greater levels of stress than men. This study systematically reviewed associations between maternal stress and children’s weight-related behaviors. Our search returned 14 eligible articles, representing 25 unique associations of maternal stress with a distinct child weight-related behavior (i.e., healthy diet (n=3), unhealthy diet (n=6), physical activity (n=7), sedentary behavior (n=9)). Overall, findings for the relationship between maternal stress and children’s weight-related behaviors were mixed, with no evidence for an association with children’s healthy or unhealthy dietary intake, but fairly consistent evidence for the association of maternal stress with children’s lower physical activity and higher sedentary behavior. Recommendations for future research include prioritizing prospective designs, identifying moderators, and use of high resolution, real-time data collection techniques to elucidate potential mechanisms. PMID:28296057

  19. Development and Application of Coating Weight Control Technology

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jin Hyoung [Dongbu Steel, Incheon (Korea, Republic of)

    2010-08-15

    Precise coating weight control is very important issue on quality and minimizing operating costs on continuous galvanizing line. These days, many steel making companies are having a new understanding of cost importance by rise raw material prices and customers requirement for cost reduction. Dongbu steel also meets these situations and decided to develop the technologies. Dongbu Steel developed Integrated coating weight control system jointly with Objective Control Ltd. and installed 2CGL and 4CGL. Several technological functions were developed and realized to achieve true hands-off operation and maximum cost benefit by combining model-based preset and dynamic prediction models. We also installed it on 1 CGL on April, 2008. This paper will present the interface, functions and application result of the integrated coating weight control system including Zn saving and coating weight uniformity.

  20. [The kangaroo mothers' programme: a simple and cost-effective alternative for protecting the premature newborn or low-birth-weight babies].

    Science.gov (United States)

    Lizarazo-Medina, Jenny P; Ospina-Diaz, Juan M; Ariza-Riaño, Nelly E

    2012-06-01

    Describing the efficacy and achievements of the kangaroo mothers' programme (KMP) regarding preterm or low-birth-weight babies' health and development in Hospital San Rafael in Tunja from November 2007 to December 2009. This was a retrospective observational cohort study; 374 infants born prematurely or having low-birth-weight were included to assess household socio-demographic factors, maternal and obstetric history, delivery characteristics and complications and follow-up until 40 weeks post-conception age. There was a high prevalence of teenage pregnancy (17.5 %) and in women older than 35 years (12.6 %), unwanted pregnancy (40.6 %), low quality and poor availability of food in families, complications such as preeclampsia, infection and premature rupture of membranes, 1,969 grams average birth weight, 2,742.9 grams average weight on discharge and 22 grams average weight gain per day. It was found that KMP methodology substantially improved the mothers' psychological aspects and health status and the newborns' prognosis and led to stabilising body temperature and weight gain rate while decreasing risks of complications and nosocomial infection. It also lowered health care costs and shortened hospital stay.

  1. Relational Benefits & Costs in Social Media Brand Pages

    OpenAIRE

    Tsimonis, Georgios; Dimitriadis, Sergios

    2014-01-01

    Attracted by the rapid penetration of social media into society, firms are increasingly using them to offer interactive services to their customers, and to create or enhance their relationships with them. As the number of consumers who join brand pages on social media platforms raises, it brings to the front a new question: What relational benefits and costs arise from customer interactions with brands in social media? Thus, this study is an attempt to identify what benefits and costs users p...

  2. Market value calculation and the solution of circularity between value and the weighted average cost of capital WACC

    Directory of Open Access Journals (Sweden)

    Ignacio Vélez-Pareja

    2009-12-01

    Full Text Available Most finance textbooks present the Weighted Average Cost of Capital (WACC calculation as: WACC = Kd×(1-T×D% + Ke×E%, where Kd is the cost of debt before taxes, T is the tax rate, D% is the percentage of debt on total value, Ke is the cost of equity and E% is the percentage of equity on total value. All of them precise (but not with enough emphasis that the values to calculate D% y E% are market values. Although they devote special space and thought to calculate Kd and Ke, little effort is made to the correct calculation of market values. This means that there are several points that are not sufficiently dealt with: Market values, location in time, occurrence of tax payments, WACC changes in time and the circularity in calculating WACC. The purpose of this note is to clear up these ideas, solve the circularity problem and emphasize in some ideas that usually are looked over. Also, some suggestions are presented on how to calculate, or estimate, the equity cost of capital.

  3. Relationship between weight-related behavioral profiles and health outcomes by sexual orientation and gender.

    Science.gov (United States)

    VanKim, Nicole A; Erickson, Darin J; Eisenberg, Marla E; Lust, Katherine; Rosser, B R Simon; Laska, Melissa N

    2016-07-01

    Examine relationships between weight-related factors and weight status, body dissatisfaction, chronic health conditions, and quality of life across sexual orientation and gender. Two- and four-year college students participated in the College Student Health Survey (n = 28,703; 2009-2013). Risk differences were calculated to estimate relationships between behavioral profiles and weight status, body satisfaction, diagnosis of a chronic condition, and quality of life, stratified by gender and sexual orientation. Four behavioral profiles, characterized as "healthier eating habits, more physically active," "healthier eating habits," "moderate eating habits," and "unhealthy weight control," were utilized based on latent class analyses, estimated from nine weight-related behavioral survey items. Sexual orientation differences in weight and quality of life were identified. For example, sexual minority groups reported significantly poorer quality of life than their heterosexual counterparts (females: 22.5%-38.6% (sexual minority) vs. 19.8% (heterosexual); males: 14.3%-26.7% (sexual minority) vs. 11.8% (heterosexual)). Compared with the "healthier eating habits, more physically active" profile, the "unhealthy weight control" profile was associated with obesity, poor body satisfaction, and poor quality of life in multiple gender/sexual orientation subgroups. Interventions are needed to address obesity, body dissatisfaction, and poor quality of life among sexual minority college students. © 2016 The Obesity Society.

  4. Physical Activity and Smoking Habits in Relation to Weight Status ...

    African Journals Online (AJOL)

    Purpose: Understanding factors that impact overweight or obesity is an essential step towards formulating programs to prevent or control obesity in young adults. Thus, we aim to assess the prevalence of physical activity and smoking habits in relation to weight status among a sample of university students. Methods: A ...

  5. [Motivation for weight loss among weight loss treatment participants].

    Science.gov (United States)

    Czeglédi, Edit

    2017-12-01

    Unrealistic expectations about weight goal and about weight loss-related benefits can hinder the effort for a successful long-term weight control. To explore weight loss-related goals and their background among overweight/obese patients. Study sample consisted of patients who participated in the inpatient weight loss treatment in the Lipidological Department of Szent Imre Hospital (n = 339, 19% men). Mean age: 50.2 years (SD = 13.47 years), mean BMI: 38.6 (SD = 7.58). self-reported anthropometric data, type and number of treated illnesses, Goals and Relative Weights Questionnaire, Motivations for Weight Loss Scale, Body Shape Questionnaire. Participants would feel disappointed with a possible 10% weight loss in a half-year time span. The acceptable weight loss percentage was higher among women, younger participants and among those who had more excess weight. Motivation regarding the increase in social desirability by weight loss is in association with body dissatisfaction, health related motivation is in association with the number of treated illnesses. Our results are contributing to the understanding of motivational factors behind weight reduction efforts, considering these can improve treatment success rates. Orv Hetil. 2017; 158(49): 1960-1967.

  6. Healthcare tariffs for specialist inpatient neurorehabilitation services: rationale and development of a UK casemix and costing methodology.

    Science.gov (United States)

    Turner-Stokes, Lynne; Sutch, Stephen; Dredge, Robert

    2012-03-01

    To describe the rationale and development of a casemix model and costing methodology for tariff development for specialist neurorehabilitation services in the UK. Patients with complex needs incur higher treatment costs. Fair payment should be weighted in proportion to costs of providing treatment, and should allow for variation over time CASEMIX MODEL AND BAND-WEIGHTING: Case complexity is measured by the Rehabilitation Complexity Scale (RCS). Cases are divided into five bands of complexity, based on the total RCS score. The principal determinant of costs in rehabilitation is staff time. Total staff hours/week (estimated from the Northwick Park Nursing and Therapy Dependency Scales) are analysed within each complexity band, through cross-sectional analysis of parallel ratings. A 'band-weighting' factor is derived from the relative proportions of staff time within each of the five bands. Total unit treatment costs are obtained from retrospective analysis of provider hospitals' budget and accounting statements. Mean bed-day costs (total unit cost/occupied bed days) are divided broadly into 'variable' and 'non-variable' components. In the weighted costing model, the band-weighting factor is applied to the variable portion of the bed-day cost to derive a banded cost, and thence a set of cost-multipliers. Preliminary data from one unit are presented to illustrate how this weighted costing model will be applied to derive a multilevel banded payment model, based on serial complexity ratings, to allow for change over time.

  7. Risk Preferences, Probability Weighting, and Strategy Tradeoffs in Wildfire Management.

    Science.gov (United States)

    Hand, Michael S; Wibbenmeyer, Matthew J; Calkin, David E; Thompson, Matthew P

    2015-10-01

    Wildfires present a complex applied risk management environment, but relatively little attention has been paid to behavioral and cognitive responses to risk among public agency wildfire managers. This study investigates responses to risk, including probability weighting and risk aversion, in a wildfire management context using a survey-based experiment administered to federal wildfire managers. Respondents were presented with a multiattribute lottery-choice experiment where each lottery is defined by three outcome attributes: expenditures for fire suppression, damage to private property, and exposure of firefighters to the risk of aviation-related fatalities. Respondents choose one of two strategies, each of which includes "good" (low cost/low damage) and "bad" (high cost/high damage) outcomes that occur with varying probabilities. The choice task also incorporates an information framing experiment to test whether information about fatality risk to firefighters alters managers' responses to risk. Results suggest that managers exhibit risk aversion and nonlinear probability weighting, which can result in choices that do not minimize expected expenditures, property damage, or firefighter exposure. Information framing tends to result in choices that reduce the risk of aviation fatalities, but exacerbates nonlinear probability weighting. © 2015 Society for Risk Analysis.

  8. One-year health-related quality of life outcomes in weight loss trial participants: comparison of three measures

    Directory of Open Access Journals (Sweden)

    Kolotkin Ronette L

    2009-06-01

    Full Text Available Abstract Background The literature on changes in health-related quality of life (HRQOL in weight loss studies is inconsistent, and few studies use more than one type of measure. The purpose of the current study was to compare one-year changes in HRQOL as a function of weight change using three different measures: a weight-related measure (Impact of Weight on Quality of Life-Lite [IWQOL-Lite] and two generic measures (SF-36; EQ-5D. Methods Data were obtained from 926 participants (mean Body Mass Index (BMI (kg/m2 = 35.4; 84% female; mean age = 49.5 years in a placebo-controlled randomized trial for weight loss. At baseline and one-year, participants completed all three HRQOL measures. HRQOL was compared across weight change categories (≥ 5% and 0–4.9% gain, 0–4.9%, 5.0–9.9% and ≥ 10% loss, using effect sizes. Results The weight-related measure of HRQOL exhibited greater improvements with one-year weight loss than either of the generic instruments, with effect sizes ranging from 0.24 to 0.62 for 5–9.9% weight reductions and 0.44 to 0.95 for ≥ 10% reductions. IWQOL-Lite Self-Esteem also showed a small improvement with weight gain. Changes in the two generic measures of HRQOL were inconsistent with each other, and in the case of the SF-36, variable across domains. For participants gaining ≥ 5% of weight, the greatest reductions in HRQOL occurred with respect to SF-36 Mental Health, MCS, and Vitality, with effect sizes of -0.82, -0.70, and -0.63 respectively. Conclusion This study found differences between weight-related and generic measures of health-related quality of life in a one-year weight loss trial, reflecting the potential value of using more than one measure in a trial. Although weight loss was generally associated with improved IWQOL-Lite, physical SF-36 subscale and EQ-5D scores, a small amount of weight gain was associated with a slight improvement on weight-specific HRQOL and almost no change on the EQ-5D, suggesting the

  9. Peer Review of “LDT Weight Reduction Study with Crash Model, Feasibility and Detailed Cost Analyses – Chevrolet Silverado 1500 Pickup”

    Science.gov (United States)

    The contractor will conduct an independent peer review of FEV’s light-duty truck (LDT) mass safety study, “Light-Duty Vehicle Weight Reduction Study with Crash Model, Feasibility and Detailed Cost Analysis – Silverado 1500”, and its corresponding computer-aided engineering (CAE) ...

  10. Structural relations of harmonic sums and Mellin transforms up to weight w=5

    Energy Technology Data Exchange (ETDEWEB)

    Bluemlein, Johannes

    2009-01-15

    We derive the structural relations between the Mellin transforms of weighted Nielsen integrals emerging in the calculation of massless or massive single-scale quantities in QED and QCD, such as anomalous dimensions and Wilson coefficients, and other hard scattering cross sections depending on a single scale. The set of all multiple harmonic sums up to weight five cover the sums needed in the calculation of the 3-loop anomalous dimensions. The relations extend the set resulting from the quasi-shuffle product between harmonic sums studied earlier. Unlike the shuffle relations, they depend on the value of the quantities considered. Up to weight w=5, 242 nested harmonic sums contribute. In the present physical applications it is sufficient to consider the sub-set of harmonic sums not containing an index i=-1, which consists out of 69 sums. The algebraic relations reduce this set to 30 sums. Due to the structural relations a final reduction of the number of harmonic sums to 15 basic functions is obtained. These functions can be represented in terms of factorial series, supplemented by harmonic sums which are algebraically reducible. Complete analytic representations are given for these 15 meromorphic functions in the complex plane deriving their asymptotic- and recursion relations. A general outline is presented on the way nested harmonic sums and multiple zeta values emerge in higher order calculations of zero- and single scale quantities. (orig.)

  11. It's all relative: The role of object weight in toddlers' gravity bias.

    Science.gov (United States)

    Hast, Michael

    2018-02-01

    Work over the past 20 years has demonstrated a gravity bias in toddlers; when an object is dropped into a curved tube, they will frequently search at a point immediately beneath the entry of the tube rather than in the object's actual location. The current study tested 2- to 3½-year-olds' (N = 88) gravity bias under consideration of object weight. They were tested with either a heavy or light ball, and they had information about either one of the balls only or both balls. Evaluating their first search behavior showed that participants generally displayed the same age trends as other studies had demonstrated, with older toddlers passing more advanced task levels by being able to locate objects in the correct location. Object weight appeared to have no particular impact on the direction of these trends. However, where weight was accessible as relative information, toddlers were younger at passing levels and older at failing levels, although significantly so only from around 3 years of age onward. When they failed levels, toddlers made significantly more gravity errors with the heavy ball when they had information about both balls and made more correct choices with the light ball. As a whole, the findings suggest that nonvisual object variables, such as weight, affect young children's search behaviors in the gravity task, but only if these variables are presented in relation to other objects. This relational information has the potential to enhance or diminish the gravity bias. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Fetal growth in relation to gestational weight gain in women with Type 2 diabetes

    DEFF Research Database (Denmark)

    Parellada, C B; Asbjörnsdóttir, Björg; Ringholm, Lene

    2014-01-01

    AIMS: To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes. METHODS: A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre-pregnancy BMI .../week, respectively. In multiple linear regression analysis, gestational weight gain was associated with a higher infant birth weight z-score independent of pre-pregnancy BMI, smoking, HbA1c and insulin dose at last visit, ethnicity and parity [β=0.1 (95% CI 0.06-0.14), P

  13. Chronic Hepatitis C-Related Cirrhosis Hospitalization Cost Analysis in Bulgaria

    Directory of Open Access Journals (Sweden)

    Maria Dimitrova

    2017-08-01

    Full Text Available ObjectiveHCV infection is a leading cause of chronic liver disease with long-term complications—extensive fibrosis, cirrhosis, and hepatocellular carcinoma. The objective of this study is to perform cost analysis of therapy of patients with chronic HCV-related cirrhosis hospitalized in the University Hospital “Queen Joanna-ISUL” for 3-year period (2012–2014.MethodsIt is a prospective, real life observational study of 297 patients with chronic HCV infection and cirrhosis monitored in the University Hospital “Queen Joanna-ISUL” for 3-year period. Data on demographic, clinical characteristics, and health-care resources utilization (hospitalizations, highly specialized interventions, and pharmacotherapy were collected. Micro-costing approach was applied to evaluate the total direct medical costs. The points of view are that of the National Health Insurance Fund (NHIF, hospital and the patients. Collected cost data are from the NHIF and hospitals tariffs, patients, and from the positive dug list for medicines prices. Descriptive statistics, chi-squared test, Kruskal–Wallis, and Friedman tests were used for statistical processing.Results76% of patients were male. 93% were diagnosed in grade Child-Pugh A and B. 97% reported complications, and almost all developed esophageal varices. During the 3 years observational period, patients did not change the critical clinical values for Child-Pugh status and therefore the group was considered as homogenous. 847 hospitalizations were recorded for 3 years period with average length of stay 17 days. The mortality rate of 6.90% was extremely high. The total direct medical costs for the observed cohort of patients for 3-year period accounted for 1,290,533 BGN (€659,839 with an average cost per patient 4,577 BGN (€2,340. Statistically significant correlation was observed between the total cost per patient from the different payers’ perspective and the Child-Pugh cirrhosis score.ConclusionHCV-related

  14. Relationship between weight-related behavioral profiles and health outcomes by sexual orientation and gender

    OpenAIRE

    VanKim, Nicole A.; Erickson, Darin J.; Eisenberg, Marla E.; Lust, Katherine; Rosser, B. R. Simon; Laska, Melissa N.

    2016-01-01

    Objective Examine relationships between weight-related factors and weight status, body dissatisfaction, chronic health conditions, and quality of life across sexual orientation and gender. Methods Two- and four-year college students participated in the College Student Health Survey (n=28,703; 2009-2013). Risk differences were calculated to estimate relationships between behavioral profiles and weight status, body satisfaction, diagnosis of a chronic condition, and quality of life, stratified ...

  15. Position of the American Dietetic Association: weight management.

    Science.gov (United States)

    Seagle, Helen M; Strain, Gladys Witt; Makris, Angela; Reeves, Rebecca S

    2009-02-01

    It is the position of the American Dietetic Association that successful weight management to improve overall health for adults requires a lifelong commitment to healthful lifestyle behaviors emphasizing sustainable and enjoyable eating practices and daily physical activity. Given the increasing incidence of overweight and obesity along with the escalating health care costs associated with weight-related illnesses, health care providers must discover how to effectively treat this complex condition. Food and nutrition professionals should stay current and skilled in weight management to assist clients in preventing weight gain, optimizing individual weight loss interventions, and achieving long-term weight loss maintenance. Using the American Dietetic Association's Evidence Analysis Process and Evidence Analysis Library, this position paper presents the current data and recommendations for weight management. The evidence supporting the value of portion control, eating frequency, meal replacements, and very-low-energy diets are discussed as well as physical activity, behavior therapy, pharmacotherapy, and surgery. Public policy changes to create environments that can assist all populations to achieve and sustain healthful lifestyle behaviors are also reviewed.

  16. [Body weight evolution and classification of body weight in relation to the results of bariatric surgery: roux-en-Y gastric bypass].

    Science.gov (United States)

    Novais, Patrícia Fátima Sousa; Rasera Junior, Irineu; Leite, Celso Vieira de Souza; Oliveira, Maria Rita Marques de

    2010-03-01

    The objective of this study was to assess the evolution and classification of body weight in relation to the results of bariatric surgery in women who underwent the procedure more than two years ago. A total of 141 women underwent banded Roux-en-Y gastric bypass (RYGB). The participants were divided according to the time elapsed since surgery and the percentage of excess weight lost (%EWL): 75. The women in the group with %EWL 75 (36.2%) ranged from normal to pre-obese and presented lower late weight gain than the women in the other groups. Weight evolution two or more years after surgery showed the expected reductions, with some individuals responding better to surgery than others. This shows that it is necessary to monitor, investigate and intervene to obtain the desired results.

  17. The health-related social costs of alcohol in Belgium.

    Science.gov (United States)

    Verhaeghe, Nick; Lievens, Delfine; Annemans, Lieven; Vander Laenen, Freya; Putman, Koen

    2017-12-16

    Alcohol is associated with adverse health effects causing a considerable economic impact to society. A reliable estimate of this economic impact for Belgium is lacking. This is the aim of the study. A prevalence-based approach estimating the direct, indirect and intangible costs for the year 2012 was used. Attributional fractions for a series of health effects were derived from literature. The human capital approach was used to estimate indirect costs, while the concept of disability-adjusted life years was used to estimate intangible costs. Sensitivity and scenario analyses were conducted to assess the uncertainty around cost estimates and to evaluate the impact of alternative modelling assumptions. In 2012, total alcohol-attributable direct costs were estimated at €906.1 million, of which the majority were due to hospitalization (€743.7 million, 82%). The indirect costs amounted to €642.6 million, of which 62% was caused by premature mortality. Alcohol was responsible for 157,500 disability-adjusted life years representing €6.3 billion intangible costs. Despite a number of limitations intrinsic to this kind of research, the study can be considered as the most comprehensive analysis thus far of the health-related social costs of alcohol in Belgium.

  18. Weight-related behaviors among non-overweight adolescents: results from the Korean national survey from 2005 to 2007.

    Science.gov (United States)

    Lee, Kayoung

    2012-01-01

    This study aimed to assess the prevalence of overweight misperception, unhealthy diet practices, and factors associated with these weight-related behaviors among Korean adolescents. The subjects were a nationally representative sample of non-overweight students (52,515 in 2005, 64,084 in 2006, and 67,113 in 2007) in middle and high schools who completed the Korea Youth Risk Behavior Web-Based Survey. The prevalence of weight-related behaviors and factors associated with these behaviors were assessed using a complex sampling design. Of non-overweight students, 14.9% of boys and 22.2% of girls reported their weight as overweight/obese. Dieting within the last year was reported by 19.8% of boys and 41.8% of girls. Of those who attempted dieting, 17.1% of boys and 24.6% of girls indicated practicing at least one unhealthy diet behavior within the last month. Overweight misperceptions were independently associated with diet attempts and unhealthy diets after adjustment for weight status, and demographic, social, and psychological factors. Additionally, these weight-related behaviors were also associated with psychosocial factors such as low school achievement, sadness, suicidal ideation, increased stress perception, and cigarette or alcohol use. In conclusion, the high prevalence of inappropriate weight-related behaviors suggests a need for comprehensive approaches to improve weight-related behaviors in non-overweight Korean adolescents.

  19. "Bending the cost curve" in gastroenterology.

    Science.gov (United States)

    Slattery, E; Harewood, G C; Murray, F; Patchett, S

    2013-12-01

    Increasing attention is being focused on reigning in escalating costs of healthcare, i.e. trying to 'bend the cost curve'. In gastroenterology (GI), inpatient hospital care represents a major component of overall costs. This study aimed to characterize the trend in cost of care for GI-related hospitalizations in recent years and to identify the most costly diagnostic groups. All hospital inpatients admitted between January 2008 and December 2009 with a primary diagnosis of one of the six most common GI-related Diagnosis Related Groups (DRGs) in this hospital system were identified; all DRGs contained at least 40 patients during the study period. Patient Level Costing (PLC) was used to express the total cost of hospital care for each patient; PLC comprised a weighted daily bed cost plus cost of all medical services provided (e.g., radiology, pathology tests) calculated according to an activity-based costing approach; cost of medications were excluded. All costs were discounted to 2009 values. Mean length of stay (LOS) was also calculated for each DRG. Over 2 years, 470 patients were admitted with one of the six most common GI DRGs. Mean cost of care increased from 2008 to 2009 for all six DRGs with the steepest increases seen in 'GI hemorrhage (non-complex)' (31 % increase) and 'Cirrhosis/Alcoholic hepatitis (non-complex)' (45 % increase). No differences in readmission rates were observed over time. There was a strong correlation between year-to-year change in costs and change in mean LOS, r = 0.93. The cost of GI-related inpatient care appears to be increasing in recent years with the steepest increases observed in non-complex GI hemorrhage and non-complex Cirrhosis/Alcoholic hepatitis. Efforts to control the increasing costs should focus on these diagnostic categories.

  20. City-scale analysis of water-related energy identifies more cost-effective solutions.

    Science.gov (United States)

    Lam, Ka Leung; Kenway, Steven J; Lant, Paul A

    2017-02-01

    Energy and greenhouse gas management in urban water systems typically focus on optimising within the direct system boundary of water utilities that covers the centralised water supply and wastewater treatment systems, despite a greater energy influence by the water end use. This work develops a cost curve of water-related energy management options from a city perspective for a hypothetical Australian city. It is compared with that from the water utility perspective. The curves are based on 18 water-related energy management options that have been implemented or evaluated in Australia. In the studied scenario, the cost-effective energy saving potential from a city perspective (292 GWh/year) is far more significant than that from a utility perspective (65 GWh/year). In some cases, for similar capital cost, if regional water planners invested in end use options instead of utility options, a greater energy saving potential at a greater cost-effectiveness could be achieved in urban water systems. For example, upgrading a wastewater treatment plant for biogas recovery at a capital cost of $27.2 million would save 31 GWh/year with a marginal cost saving of $63/MWh, while solar hot water system rebates at a cost of $28.6 million would save 67 GWh/year with a marginal cost saving of $111/MWh. Options related to hot water use such as water-efficient shower heads, water-efficient clothes washers and solar hot water system rebates are among the most cost-effective city-scale opportunities. This study demonstrates the use of cost curves to compare both utility and end use options in a consistent framework. It also illustrates that focusing solely on managing the energy use within the utility would miss substantial non-utility water-related energy saving opportunities. There is a need to broaden the conventional scope of cost curve analysis to include water-related energy and greenhouse gas at the water end use, and to value their management from a city perspective. This

  1. 48 CFR 31.205-1 - Public relations and advertising costs.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Public relations and... Organizations 31.205-1 Public relations and advertising costs. (a) Public relations means all functions and...; or (2) Maintaining or promoting reciprocal understanding and favorable relations with the public at...

  2. Costs and revenues of investment in enterprise-related schooling.

    NARCIS (Netherlands)

    Hartog, J.; Groot, W.J.N.; Oosterbeek, H.

    1994-01-01

    In this paper, a general specification of the wage equation is used to derive a marginal revenue equation for enterprise-related schooling. The optimal amount of investment in enterprise-related schooling is found by equating the marginal revenues and marginal costs. For the empirical analysis, the

  3. Weight-Related Correlates of Psychological Dysregulation in Adolescent and Young Adult (AYA) Females with Severe Obesity

    Science.gov (United States)

    Gowey, Marissa A.; Reiter-Purtill, Jennifer; Becnel, Jennifer; Peugh, James; Mitchell, James E.; Zeller, Meg H.

    2016-01-01

    Objective Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Methods Fifty-four AYA females with severe obesity (MBMI=48.71 kg/m2; Mage=18.29, R=15–21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Results Breakfast was the most frequently skipped meal (consumed 3–4 times/week). Eating out was common (4–5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Conclusions Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may

  4. Children's perceptions of weight, obesity, nutrition, physical activity and related health and socio-behavioural factors.

    Science.gov (United States)

    Economos, Christina D; Bakun, Peter J; Herzog, Julia Bloom; Dolan, Peter R; Lynskey, Vanessa M; Markow, Dana; Sharma, Shanti; Nelson, Miriam E

    2014-01-01

    Approximately one-third of children in the USA are either overweight or obese. Understanding the perceptions of children is an important factor in reversing this trend. An online survey was conducted with children to capture their perceptions of weight, overweight, nutrition, physical activity and related socio-behavioural factors. Within the USA. US children (n 1224) aged 8-18 years. Twenty-seven per cent of children reported being overweight; 47·1% of children overestimated the rate of overweight/obesity among US children. A higher percentage of self-classified overweight children (81·9%) worried about weight than did self-classified under/normal weight children (31·1%). Most children (91·1%) felt that it was important to not be overweight, for both health-related and social-related reasons. The majority of children believed that if someone their age is overweight they will likely be overweight in adulthood (93·1%); get an illness such as diabetes or heart disease in adulthood (90·2%); not be able to play sports well (84·5%); and be teased or made fun of in school (87·8%). Children focused more on food/drink than physical activity as reasons for overweight at their age. Self-classified overweight children were more likely to have spoken with someone about their weight over the last year than self-classified under/normal weight children. Children demonstrated good understanding of issues regarding weight, overweight, nutrition, physical activity and related socio-behavioural factors. Their perceptions are important and can be helpful in crafting solutions that will resonate with children.

  5. Cost-effectiveness of anti-oxidant vitamins plus zinc treatment to prevent the progression of intermediate age-related macular degeneration. A Singapore perspective.

    Science.gov (United States)

    Saxena, Nakul; George, Pradeep Paul; Heng, Bee Hoon; Lim, Tock Han; Yong, Shao Onn

    2015-06-01

    To determine if providing high dose anti-oxidant vitamins and zinc treatment age-related eye disease study (AREDS formulation) to patients with intermediate age-related macular degeneration (AMD) aged 40-79 years from Singapore is cost-effective in preventing progression to wet AMD. A hypothetical cohort of category 3 and 4 AMD patients from Singapore was followed for 5 calendar years to determine the number of patients who would progress to wet AMD given the following treatment scenarios: (a) AREDS formulation or placebo followed by ranibizumab (as needed) for wet AMD. (b) AREDS formulation or placebo followed by bevacizumab (monthly) for wet AMD. (c) AREDS formulation or placebo followed by aflibercept (VIEW I and II trial treatment regimen). Costs were estimated for the above scenarios from the providers' perspective, and cost-effectiveness was measured by cost per disability-adjusted life year (DALY) averted with a disability weight of 0.22 for wet AMD. The costs were discounted at an annual rate of 3%. Over 5400 patients could be prevented from progressing to wet AMD cumulatively if AREDS formulation were prescribed. AREDS formulation followed by ranibizumab was cost-effective compared to placebo-ranibizumab or placebo-aflibercept combinations (cost per DALY averted: SGD$23,662.3 and SGD$21,138.8, respectively). However, bevacizumab (monthly injections) alone was more cost-effective compared to AREDS formulation followed by bevacizumab. Prophylactic treatment with AREDS formulation for intermediate AMD patients followed by ranibizumab or for patients who progressed to wet AMD was found to be cost-effective. These findings have implications for intermediate AMD screening, treatment and healthcare planning in Singapore.

  6. Estimating the relative contributions of maternal genetic, paternal genetic and intrauterine factors to offspring birth weight and head circumference.

    Science.gov (United States)

    Rice, Frances; Thapar, Anita

    2010-07-01

    Genetic factors and the prenatal environment contribute to birth weight. However, very few types of study design can disentangle their relative contribution. To examine maternal genetic and intrauterine contributions to offspring birth weight and head circumference. To compare the contribution of maternal and paternal genetic effects. Mothers and fathers were either genetically related or unrelated to their offspring who had been conceived by in vitro fertilization. 423 singleton full term offspring, of whom 262 were conceived via homologous IVF (both parents related), 66 via sperm donation (mother only related) and 95 via egg donation (father only related). Maternal weight at antenatal booking, current weight and maternal height. Paternal current weight and height were all predictors. Infant birth weight and head circumference were outcomes. Genetic relatedness was the main contributing factor between measures of parental weight and offspring birth weight as correlations were only significant when the parent was related to the child. However, there was a contribution of the intrauterine environment to the association between maternal height and both infant birth weight and infant head circumference as these were significant even when mothers were unrelated to their child. Both maternal and paternal genes made contributions to infant birth weight. Maternal height appeared to index a contribution of the intrauterine environment to infant growth and gestational age. Results suggested a possible biological interaction between the intrauterine environment and maternal inherited characteristics which suppresses the influence of paternal genes. 2010 Elsevier Ltd. All rights reserved.

  7. RELATION OF WEIGHT GAIN INTERDIALYTIC ANDFOOD CONSUMPTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

    Directory of Open Access Journals (Sweden)

    Isis Delfrate Rodrigues

    2017-05-01

    Full Text Available The objective of the papper was to verify the relationship between dietary intake and interdialytic weight gain in patients with chronic kidney disease. Cross-sectional study, in a renal clinic in Irati, Paraná, Brazil. Prehemodialysis weight and weight after hemodialysis were evaluated. Food intake was analyzed according to food frequency and usual food day (DAH. The data were evaluated descriptively and also through the chi-square test, Student's t-test and Mann-Whitney test. Sixty-one patients (54.1% participated in the study, with a mean age of 57.78±14.58 years, 62.3% of males. The mean pre-hemodialysis weight was 68.28±15.14 kg, while hemodialysis was 65.63±15.01 kg (p0.05. The other food groups (meat, cereals, fats and sweets also had no association with weight gain (p> 0.05. When the nutrients were compared, according to the DAH, there was no relation with the interdialytic weight gain (p>0.05. Thus, it was observed that there was a relationship between interdialytic weight gain and macronutrient consumption; The same was not observed for micronutrients.

  8. Cost of tobacco-related diseases, including passive smoking, in Hong Kong.

    Science.gov (United States)

    McGhee, S M; Ho, L M; Lapsley, H M; Chau, J; Cheung, W L; Ho, S Y; Pow, M; Lam, T H; Hedley, A J

    2006-04-01

    Costs of tobacco-related disease can be useful evidence to support tobacco control. In Hong Kong we now have locally derived data on the risks of smoking, including passive smoking. To estimate the health-related costs of tobacco from both active and passive smoking. Using local data, we estimated active and passive smoking-attributable mortality, hospital admissions, outpatient, emergency and general practitioner visits for adults and children, use of nursing homes and domestic help, time lost from work due to illness and premature mortality in the productive years. Morbidity risk data were used where possible but otherwise estimates based on mortality risks were used. Utilisation was valued at unit costs or from survey data. Work time lost was valued at the median wage and an additional costing included a value of USD 1.3 million for a life lost. In the Hong Kong population of 6.5 million in 1998, the annual value of direct medical costs, long term care and productivity loss was USD 532 million for active smoking and USD 156 million for passive smoking; passive smoking accounted for 23% of the total costs. Adding the value of attributable lives lost brought the annual cost to USD 9.4 billion. The health costs of tobacco use are high and represent a net loss to society. Passive smoking increases these costs by at least a quarter. This quantification of the costs of tobacco provides strong motivation for legislative action on smoke-free areas in the Asia Pacific Region and elsewhere.

  9. Overeating with and without loss of control: Associations with weight status, weight-related characteristics, and psychosocial health.

    Science.gov (United States)

    Goldschmidt, Andrea B; Loth, Katie A; MacLehose, Richard F; Pisetsky, Emily M; Berge, Jerica M; Neumark-Sztainer, Dianne

    2015-12-01

    The relative importance of loss of control and overeating in the relationship between binge eating and eating-related and general psychopathology has been debated in the literature. This study assessed the prevalence and correlates of overeating with and without loss of control within a diverse, population-based sample of adolescents. A highly diverse (81.1% non-White) sample of adolescents (n = 2,793) from EAT-2010 (Eating and Activity in Teens) completed self-report questionnaires assessing eating-related psychopathology, substance use, nonsuicidal self-injury, depressive symptoms, and self-esteem. Overeating without loss of control was reported by 6.9% of girls and 5.0% of boys, while 9.6% of girls and 6.3% of boys reported overeating with loss of control (binge eating). Overall, overeating (with or without loss of control) was positively associated with unhealthy or extreme weight control behaviors, dieting, nonsuicidal self-injury, lower body satisfaction, and self-esteem, and higher depressive symptoms relative to no overeating. Among girls, binge eating was associated with unhealthy or extreme weight control behaviors, lower self-esteem, and higher depressive symptoms relative to overeating without loss of control, while in boys, binge eating was associated with greater cigarette usage, lower body satisfaction, and greater depressive symptoms than overeating without loss of control (although cigarette usage was comparable in boys reporting binge eating and no overeating). Any overeating, with or without loss of control, was associated with multiple adverse correlates among adolescents. Loss of control was uniquely associated with multiple health indicators, further highlighting its importance as a marker of severity of overeating. © 2015 Wiley Periodicals, Inc.

  10. Approximate Shortest Homotopic Paths in Weighted Regions

    KAUST Repository

    Cheng, Siu-Wing

    2010-01-01

    Let P be a path between two points s and t in a polygonal subdivision T with obstacles and weighted regions. Given a relative error tolerance ε ∈(0,1), we present the first algorithm to compute a path between s and t that can be deformed to P without passing over any obstacle and the path cost is within a factor 1 + ε of the optimum. The running time is O(h 3/ε2 kn polylog(k, n, 1/ε)), where k is the number of segments in P and h and n are the numbers of obstacles and vertices in T, respectively. The constant in the running time of our algorithm depends on some geometric parameters and the ratio of the maximum region weight to the minimum region weight. © 2010 Springer-Verlag.

  11. Approximate shortest homotopic paths in weighted regions

    KAUST Repository

    Cheng, Siuwing

    2012-02-01

    A path P between two points s and t in a polygonal subdivision T with obstacles and weighted regions defines a class of paths that can be deformed to P without passing over any obstacle. We present the first algorithm that, given P and a relative error tolerance ε (0, 1), computes a path from this class with cost at most 1 + ε times the optimum. The running time is O(h 3/ε 2kn polylog (k,n,1/ε)), where k is the number of segments in P and h and n are the numbers of obstacles and vertices in T, respectively. The constant in the running time of our algorithm depends on some geometric parameters and the ratio of the maximum region weight to the minimum region weight. © 2012 World Scientific Publishing Company.

  12. Succession of the turkey gastrointestinal bacterial microbiome related to weight gain

    Directory of Open Access Journals (Sweden)

    Jessica L. Danzeisen

    2013-12-01

    Full Text Available Because of concerns related to the use of antibiotics in animal agriculture, antibiotic-free alternatives are greatly needed to prevent disease and promote animal growth. One of the current challenges facing commercial turkey production in Minnesota is difficulty obtaining flock average weights typical of the industry standard, and this condition has been coined “Light Turkey Syndrome” or LTS. This condition has been identified in Minnesota turkey flocks for at least five years, and it has been observed that average flock body weights never approach their genetic potential. However, a single causative agent responsible for these weight reductions has not been identified despite numerous efforts to do so. The purpose of this study was to identify the bacterial community composition within the small intestines of heavy and light turkey flocks using 16S rRNA sequencing, and to identify possible correlations between microbiome and average flock weight. This study also sought to define the temporal succession of bacteria occurring in the turkey ileum. Based upon 2.7 million sequences across nine different turkey flocks, dominant operational taxonomic units (OTUs were identified and compared between the flocks studied. OTUs that were associated with heavier weight flocks included those with similarity to Candidatus division Arthromitus and Clostridium bartlettii, while these flocks had decreased counts of several Lactobacillus species compared to lighter weight flocks. The core bacterial microbiome succession in commercial turkeys was also defined. Several defining markers of microbiome succession were identified, including the presence or abundance of Candidatus division Arthromitus, Lactobacillus aviarius, Lactobacillus ingluviei, Lactobacillus salivarius, and Clostridium bartlettii. Overall, the succession of the ileum bacterial microbiome in commercial turkeys proceeds in a predictable manner. Efforts to prevent disease and promote growth in

  13. Length of stay and associated costs of obesity related hospital admissions in Ireland.

    LENUS (Irish Health Repository)

    Vellinga, Akke

    2008-01-01

    BACKGROUND: Obesity is the cause of other chronic diseases, psychological problems, obesity shortens the lifespan and puts strain on health systems. The risk associated with childhood obesity in particular, which will accelerate the development of adult morbidity and mortality, has been identified as an emerging public health problem. METHODS: To estimate the length of stay and associated hospital costs for obesity related illnesses a cost of illness study was set up. All discharges from all acute hospitals in the Republic of Ireland from 1997 to 2004 with a principal or secondary diagnostic code for obesity for all children from 6 to 18 years of age and for adults were collected.A discharge frequency was calculated by dividing obesity related discharges by the total number of diagnoses (principal and secondary) for each year. The hospital costs related to obesity was calculated based on the total number of days care. RESULTS: The discharge frequency of obesity related conditions increased from 1.14 in 1997 to 1.49 in 2004 for adults and from 0.81 to 1.37 for children. The relative length of stay (number of days in care for obesity related conditions per 1000 days of hospital care given) increased from 1.47 in 1997 to 4.16 in 2004 for children and from 3.68 in 1997 to 6.74 in 2004 for adults.Based on the 2001 figures for cost per inpatient bed day, the annual hospital cost was calculated to be 4.4 Euromillion in 1997, increasing to 13.3 Euromillion in 2004. At a 20% variable hospital cost the cost ranges from 0.9 Euromillion in 1997 to 2.7 Euromillion in 2004; a 200% increase. CONCLUSION: The annual increase in the proportion of hospital discharges related to obesity is alarming. This increase is related to a significant increase in economic costs. This paper emphasises the need for action at an early stage of life. Health promotion and primary prevention of obesity should be high on the political agenda.

  14. The cost of making wine: A Tuscan case study based on a full cost approach

    Directory of Open Access Journals (Sweden)

    Enrico Marone

    2017-12-01

    Full Text Available This article׳s aim is to identify and quantify the connection between a winery business typology and its production cost per bottle to create benchmarks for managerial and organisational choices. Accounting data from wineries in representative areas of the Tuscan wine sector were collected with direct, face-to-face interviews. The data were processed using a cost accounting model elaborated by UniCeSV (Centre for the Strategic Development of the Wine Sector, University of Florence to classify costs according to production phases and production factors. The study was completed using a hierarchical cluster analysis (HCA approach to investigate the relation between cost structures and business typologies. The implementation of the cost accounting model and the HCA showed a strong relationship between how wineries are organised and how costs are structured. Moreover, the weight of geographical localisation (i.e., belonging to a specific denomination of origin has proved to be a key determinant in the shape of the cost structures of wineries. Keywords: Wine production, Full cost analysis, Clustering

  15. Three-Year Improvements in Weight Status and Weight-Related Behaviors in Middle School Students: The Healthy Choices Study.

    Directory of Open Access Journals (Sweden)

    Karen E Peterson

    Full Text Available Few dissemination evaluations exist to document the effectiveness of evidence-based childhood obesity interventions outside the research setting.Evaluate Healthy Choices (HC, a multi-component obesity prevention program, by examining school-level changes in weight-related behaviors and weight status and the association of implementation components with odds of overweight/obesity.We compared baseline and Year 3 school-level behavioral and weight status outcomes with paired t-tests adjusted for schools' socio-demographic characteristics. We used generalized estimating equations to examine the odds of overweight/obesity associated with program components.Consecutive sample of 45 of 51 middle schools participating in the HC program with complete baseline and follow-up survey data including a subsample of 35 schools with measured anthropomentry for 5,665 7th grade students.Schools developed a multi-disciplinary team and implemented an obesity prevention curriculum, before and after school activities, environmental and policy changes and health promotions targeting a 5-2-1 theme: eat ≥ 5 servings/day of fruits and vegetables (FV, watch ≤ 2 hours of television (TV and participate in ≥ 1 hours/day of physical activity (PA on most days.1 School-level percent of students achieving targeted behaviors and percent overweight/obese; and 2 individual odds of overweight/obesity.The percent achieving behavioral goals over three years increased significantly for FV: 16.4 to 19.4 (p = 0.001, TV: 53.4 to 58.2 (p = 0.003 and PA: 37.1 to 39.9 (p = 0.02, adjusting for school size, baseline mean age and percent female, non-Hispanic White, and eligible for free and reduced price lunch. In 35 schools with anthropometry, the percent of overweight/obese 7th grade students decreased from 42.1 to 38.4 (p = 0.016. Having a team that met the HC definition was associated with lower odds of overweight/obesity (OR = 0.83, CI: 0.71-0.98.The HC multi-component intervention

  16. Weight loss maintenance: A review on dietary related strategies

    Directory of Open Access Journals (Sweden)

    Fatemeh Azizi Soeliman

    2014-01-01

    Full Text Available Background: Weight regain after weight loss is a common problem for all those obese or overweight who have had a recent weight loss. Different cures such as diet therapy, behavioral therapy, exercise or a mixture of them have been advised as solutions. The purpose of this review is to find the best diet or eating pattern to maintain a recent weight loss. Materials and Methods: We searched in PubMed and SCOPUS by using the following key words: Overweight, obesity, weight maintenance, weight regain, and diet therapy. Finally, we assessed 26 articles in the present article. Results: Meal replacement, low carbohydrate-low glycemic index (GI diet, high protein intake, and moderate fat consumption have shown some positive effects on weight maintenance. However, the results are controversial. A Dietary Approach to Stop Hypertension (DASH-type diet seems helpful for weight maintenance although the need for more study has remained. Some special behaviors were associated with less weight regain, such as, not being awake late at night, drinking lower amount of sugar-sweetened beverages, and following a healthy pattern. Some special foods have been suggested for weight maintenance. However, the roles of specific foods are not confirmed. Conclusion: Healthy diets recommend low carbohydrate, low GI, and moderate fat foods, but it is not clear whether they are useful in preventing weight gain. It seems that consuming fewer calories helps people to keep weight loss. Further research to find strategies in obesity management focusing on successful maintenance of weight loss is needed.

  17. Accuracy of the CT-estimated weight of the right hepatic lobe prior to living related liver donation (LRLD) for predicting the intraoperatively measured weight of the graft

    International Nuclear Information System (INIS)

    Lemke, A.-J.; Brinkmann, M.; Felix, R.; Pascher, A.; Steinmueller, T.; Settmacher, U.; Neuhaus, P.

    2003-01-01

    Purpose: Due to the shortage of cadaver donors, living related liver donation (LRLD) has emerged as an alternative to cadaver donation. The expected graft weight is one of the main determinants for donor selection. This study investigates the accuracy of preoperatively performed CT-volumetry to predict the actual weight of the right liver lobe graft. Materials and methods: In a prospective study the weight of the right hepatic lobe was calculated by volumetric analysis based on CT in 33 patients (21 females, 12 males, mean age 42.1 years, median age 41 years) prior to living related liver donation. Graft weight was calculated as the product of CT-based graft volume and 1.00 g/ml (the approximated density of healthy liver parenchyma). The calculated weight was compared with the intraoperatively measured weight of the harvested right hepatic lobe. The difference was used to determine a correction factor for estimating the actual graft weight. Results: Based on the assumption of a parenchymal density of 1.00 g/ml, the preoperatively estimated graft weight (mean 980 g ± 168 g) deviated + 33% from the intraoperatively measured right hepatic lobe weight (mean 749 g ± 170 g). By reducing the preoperatively predicted weight of the right hepatic lobe with a correction factor of 0.75, the actual graft weight can be calculated [de

  18. Sequential optimization of matrix chain multiplication relative to different cost functions

    KAUST Repository

    Chikalov, Igor; Hussain, Shahid; Moshkov, Mikhail

    2011-01-01

    In this paper, we present a methodology to optimize matrix chain multiplication sequentially relative to different cost functions such as total number of scalar multiplications, communication overhead in a multiprocessor environment, etc. For n matrices our optimization procedure requires O(n 3) arithmetic operations per one cost function. This work is done in the framework of a dynamic programming extension that allows sequential optimization relative to different criteria. © 2011 Springer-Verlag Berlin Heidelberg.

  19. Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity.

    Science.gov (United States)

    Gowey, Marissa A; Reiter-Purtill, Jennifer; Becnel, Jennifer; Peugh, James; Mitchell, James E; Zeller, Meg H

    2016-04-01

    Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Fifty-four AYA females with severe obesity (MBMI = 48.71 kg/m(2); Mage = 18.29, R = 15-21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Breakfast was the most frequently skipped meal (consumed 3-4 times/week). Eating out was common (4-5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional

  20. (Dis-)solving the Weight Problem in Binge-Eating Disorder: Systemic Insights From Three Treatment Contexts With Weight Stability, Weight Loss, and Weight Acceptance.

    Science.gov (United States)

    Meyer, Lene Bomholt; Waaddegaard, Mette; Lau, Marianne Engelbrecht; Tjørnhøj-Thomsen, Tine

    2018-04-01

    Binge-eating disorder (BED) is a severe eating disorder strongly associated with obesity. Treatments struggle to provide safe and effective ways of addressing weight in a BED context. This study explored a two-phased treatment for BED developed at a major out-patient eating disorder service in Denmark. The study used interviews and participant observations to gain insight into experiences and processes related to weight and body issues in three treatment contexts that addressed weight stability, weight acceptance, and weight loss. Using systems theory, the study proposed a relational weight problem that embeds feelings of non-acceptance due to weight, a merge of weight and identity, and an internalized body- and weight-critical gaze of others. Contrary to critical claims that weight acceptance discourages people with obesity from engaging in weight loss efforts, this study suggests that acceptance and a disentanglement of weight and identity are prerequisites for weight loss for this group.

  1. Adiponectin changes in relation to the macronutrient composition of a weight-loss diet.

    Science.gov (United States)

    Summer, Suzanne S; Brehm, Bonnie J; Benoit, Stephen C; D'Alessio, David A

    2011-11-01

    Adiponectin is an adipose-derived protein with beneficial metabolic effects. Low adiponectin is associated with obesity and related diseases. Significant weight loss increases adiponectin, reducing disease risk. This study compared the effects of two weight-loss diets with different macronutrient compositions on adiponectin. Eighty-one obese women in two cohorts were randomized to a low-fat (LF) or a low-carbohydrate (LC) diet. All subjects underwent equivalent weight-loss intervention, with weight and other measures assessed at baseline and after 6 (cohort I) or 4 (cohort II) months. Body fat was measured by dual energy X-ray absorptiometry. Adiponectin was measured by radioimmunoassay. Diet intake was assessed using 24-h recalls and 3-day diet records. Data were analyzed via t-tests and repeated-measures factorial ANOVA using time, diet, and replicate (cohort I vs. cohort II) as factors. Age, weight, body fat, BMI, adiponectin, and diet were similar at baseline. Following intervention, macronutrient composition of the diet was vastly different between the groups, reflecting the assigned diet. Both groups lost weight and body fat (P vs. -4.97 kg weight, P vs. -2.62 kg fat, P < 0.001). Adiponectin increased in the LC (+1.92 mcg/ml, P < 0.01), but not the LF (+0.86 mcg/ml, P = 0.81), group. There was no correlation between weight loss and increase in adiponectin. These results confirm that diet-induced loss of weight and body fat is associated with increased adiponectin concentrations. This effect is evident with weight loss of 10% or more, and may be greater with LC diets.

  2. Trajectories of childhood weight gain: the relative importance of local environment versus individual social and early life factors.

    Directory of Open Access Journals (Sweden)

    Megan A Carter

    Full Text Available To determine the association between local environmental factors with child weight status in a longitudinal study, using a semi-parametric, group-based method, while also considering social and early life factors.Standardized, directly measured BMI from 4-10 y of age, and group-based trajectory modeling (PROC TRAJ were used to estimate developmental trajectories of weight change in a Québec birth cohort (n = 1,566. Associations between the weight trajectories and living location, social cohesion, disorder, and material and social deprivation were estimated after controlling for social and early life factors.FOUR WEIGHT TRAJECTORY GROUPS WERE ESTIMATED: low-increasing (9.7%; low-medium, accelerating (36.2%; medium-high, increasing (43.0%; and high-stable (11.1%. In the low-increasing and medium-high trajectory groups, living in a semi-urban area was inversely related to weight, while living in a rural area was positively related to weight in the high-stable group. Disorder was inversely related to weight in the low-increasing group only. Other important risk factors for high-stable weight included obesity status of the mother, smoking during pregnancy, and overeating behaviors.In this study, associations between local environment factors and weight differed by trajectory group. Early life factors appear to play a more consistent role in weight status. Further work is needed to determine the influence of place on child weight.

  3. A seismic performance and cost comparison of top and bottom supported liquid metal reactor vessels

    International Nuclear Information System (INIS)

    Carlson, T.M.; Kiciman, O.K.; Petrozelli, J.F.

    1989-01-01

    It is the premise of this paper that the revision of a pool LMR from a TSRV configuration to a specific bottom supported reactor vessel (BSRV) configuration can resolve the above TSRV disadvantages related to load path length and diversity, thereby improving seismic performance and simultaneously reducing RV block costs by reducing weights. This paper demonstrates this premise by comparing a reference TSRV block with a specific BSRV block design. Recent capital cost estimates ($/kWe) for U.S. liquid metal reactor (LMR) plant designs reveal that the balance of plant costs could be reduced below that of the balance of plant costs for a comparable light water reactor plant. However, in regions of high seismicity, non-seismically isolated LMR nuclear steam supply system weights are costs per kWe are two to three times the weights and costs of light water reactor nuclear steam supply systems. While all portions of the LMR nuclear steam supply system require examination for potential cost reductions, the focus of this paper is the reactor vessel (RV) block for a large pool plant

  4. Health economic modeling to assess short-term costs of maternal overweight, gestational diabetes, and related macrosomia - a pilot evaluation.

    Science.gov (United States)

    Lenoir-Wijnkoop, Irene; van der Beek, Eline M; Garssen, Johan; Nuijten, Mark J C; Uauy, Ricardo D

    2015-01-01

    Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes mellitus (GDM) and associated with increased morbidity for mother and child in the perinatal period. Poorly controlled diabetes during pregnancy, pre- pregnancy maternal obesity and/or excessive maternal weight gain during pregnancy are associated with intermittent periods of fetal exposure to hyperglycemia and subsequent hyperinsulinemia, leading to increased birth weight (e.g., macrosomia), body adiposity, and glycogen storage in the liver. Macrosomia is associated with an increased risk of developing obesity and type 2 diabetes mellitus later in life. Provide insight in the short-term health-economic impact of maternal overweight, GDM, and related macrosomia. To this end, a health economic framework was designed. This pilot study also aims to encourage further health technology assessments, based on country- and population-specific data. The estimation of the direct health-economic burden of maternal overweight, GDM and related macrosomia indicates that associated healthcare expenditures are substantial. The calculation of a budget impact of GDM, based on a conservative approach of our model, using USA costing data, indicates an annual cost of more than $1,8 billion without taking into account long-term consequences. Although overweight and obesity are a recognized concern worldwide, less attention has been given to the health economic consequences of these conditions in women of child-bearing age and their offspring. The presented outcomes underline the need for preventive management strategies and public health interventions on life style, diet and physical activity. Also, the predisposition in people of Asian ethnicity to develop diabetes emphasizes the urgent need to collect more country

  5. Predicting Production Costs for Advanced Aerospace Vehicles

    Science.gov (United States)

    Bao, Han P.; Samareh, J. A.; Weston, R. P.

    2002-01-01

    For early design concepts, the conventional approach to cost is normally some kind of parametric weight-based cost model. There is now ample evidence that this approach can be misleading and inaccurate. By the nature of its development, a parametric cost model requires historical data and is valid only if the new design is analogous to those for which the model was derived. Advanced aerospace vehicles have no historical production data and are nowhere near the vehicles of the past. Using an existing weight-based cost model would only lead to errors and distortions of the true production cost. This paper outlines the development of a process-based cost model in which the physical elements of the vehicle are soared according to a first-order dynamics model. This theoretical cost model, first advocated by early work at MIT, has been expanded to cover the basic structures of an advanced aerospace vehicle. Elemental costs based on the geometry of the design can be summed up to provide an overall estimation of the total production cost for a design configuration. This capability to directly link any design configuration to realistic cost estimation is a key requirement for high payoff MDO problems. Another important consideration in this paper is the handling of part or product complexity. Here the concept of cost modulus is introduced to take into account variability due to different materials, sizes, shapes, precision of fabrication, and equipment requirements. The most important implication of the development of the proposed process-based cost model is that different design configurations can now be quickly related to their cost estimates in a seamless calculation process easily implemented on any spreadsheet tool.

  6. Economic costs and health-related quality of life for hand, foot and mouth disease (HFMD patients in China.

    Directory of Open Access Journals (Sweden)

    Yaming Zheng

    Full Text Available Hand, foot and mouth disease (HFMD is a common illness in China that mainly affects infants and children. The objective of this study is to assess the economic cost and health-related quality of life associated with HFMD in China.A telephone survey of caregivers were conducted in 31 provinces across China. Caregivers of laboratory-confirmed HFMD patients who were registered in the national HFMD enhanced surveillance database during 2012-2013 were invited to participate in the survey. Total costs included direct medical costs (outpatient care, inpatient care and self-medication, direct non-medical costs (transportation, nutrition, accommodation and nursery, and indirect costs for lost income associated with caregiving. Health utility weights elicited using EuroQol EQ-5D-3L and EQ-Visual Analogue Scale (VAS were used to calculate associated loss in quality adjusted life years (QALYs.The subjects comprised 1136 mild outpatients, 1124 mild inpatients, 1170 severe cases and 61 fatal cases. The mean total costs for mild outpatients, mild inpatients, severe cases and fatal cases were $201 (95%CI $187, $215, $1072 (95%CI $999, $1144, $3051 (95%CI $2905, $3197 and $2819 (95%CI $2068, $3571 respectively. The mean QALY losses per HFMD episode for mild outpatients, mild inpatients and severe cases were 3.6 (95%CI 3.4, 3,9, 6.9 (95%CI 6.4, 7.4 and 13.7 (95%CI 12.9, 14.5 per 1000 persons. Cases who were diagnosed with EV-A71 infection and had longer duration of illness were associated with higher total cost and QALY loss.HFMD poses a high economic and health burden in China. Our results provide economic and health utility data for cost-effectiveness analysis for HFMD vaccination in China.

  7. Economic costs and health-related quality of life for hand, foot and mouth disease (HFMD) patients in China.

    Science.gov (United States)

    Zheng, Yaming; Jit, Mark; Wu, Joseph T; Yang, Juan; Leung, Kathy; Liao, Qiaohong; Yu, Hongjie

    2017-01-01

    Hand, foot and mouth disease (HFMD) is a common illness in China that mainly affects infants and children. The objective of this study is to assess the economic cost and health-related quality of life associated with HFMD in China. A telephone survey of caregivers were conducted in 31 provinces across China. Caregivers of laboratory-confirmed HFMD patients who were registered in the national HFMD enhanced surveillance database during 2012-2013 were invited to participate in the survey. Total costs included direct medical costs (outpatient care, inpatient care and self-medication), direct non-medical costs (transportation, nutrition, accommodation and nursery), and indirect costs for lost income associated with caregiving. Health utility weights elicited using EuroQol EQ-5D-3L and EQ-Visual Analogue Scale (VAS) were used to calculate associated loss in quality adjusted life years (QALYs). The subjects comprised 1136 mild outpatients, 1124 mild inpatients, 1170 severe cases and 61 fatal cases. The mean total costs for mild outpatients, mild inpatients, severe cases and fatal cases were $201 (95%CI $187, $215), $1072 (95%CI $999, $1144), $3051 (95%CI $2905, $3197) and $2819 (95%CI $2068, $3571) respectively. The mean QALY losses per HFMD episode for mild outpatients, mild inpatients and severe cases were 3.6 (95%CI 3.4, 3,9), 6.9 (95%CI 6.4, 7.4) and 13.7 (95%CI 12.9, 14.5) per 1000 persons. Cases who were diagnosed with EV-A71 infection and had longer duration of illness were associated with higher total cost and QALY loss. HFMD poses a high economic and health burden in China. Our results provide economic and health utility data for cost-effectiveness analysis for HFMD vaccination in China.

  8. The indirect costs of cancer-related absenteeism in the workplace in Poland.

    Science.gov (United States)

    Macioch, Tomasz; Hermanowski, Tomasz

    2011-12-01

    The aim of this study was to evaluate cancer-related absenteeism costs in Poland. Data on sickness absences and disability were retrieved from the Department of Statistics of the Social Insurance Institution. The cost of lost productivity owing to premature death was estimated from data retrieved from the Polish National Cancer Registry. Absenteeism costs were estimated on the basis of the measure of gross value added per employee. The costs of lost productivity owing to sick leave, disability, and premature death were estimated to be 1.572 billion EUR, 0.504 billion EUR, and 0.535 billion EUR, respectively, in 2009. The indirect costs of lost productivity owing to cancer-related sick leave, disability, and premature death have a substantial effect on the Polish economy. In 2009, they accounted for more than 0.8% of GDP.

  9. Lamb Production Costs: Analyses of Composition and Elasticities Analysis of Lamb Production Costs

    Directory of Open Access Journals (Sweden)

    C. Raineri

    2015-08-01

    Full Text Available Since lamb is a commodity, producers cannot control the price of the product they sell. Therefore, managing production costs is a necessity. We explored the study of elasticities as a tool for basing decision-making in sheep production, and aimed at investigating the composition and elasticities of lamb production costs, and their influence on the performance of the activity. A representative sheep production farm, designed in a panel meeting, was the base for calculation of lamb production cost. We then performed studies of: i costs composition, and ii cost elasticities for prices of inputs and for zootechnical indicators. Variable costs represented 64.15% of total cost, while 21.66% were represented by operational fixed costs, and 14.19% by the income of the factors. As for elasticities to input prices, the opportunity cost of land was the item to which production cost was more sensitive: a 1% increase in its price would cause a 0.2666% increase in lamb cost. Meanwhile, the impact of increasing any technical indicator was significantly higher than the impact of rising input prices. A 1% increase in weight at slaughter, for example, would reduce total cost in 0.91%. The greatest obstacle to economic viability of sheep production under the observed conditions is low technical efficiency. Increased production costs are more related to deficient zootechnical indexes than to high expenses.

  10. Audit report on GDF Suez's supply costs and non-supply related costs in natural gas regulated sale tariffs - May 2014

    International Nuclear Information System (INIS)

    2014-05-01

    After having recalled the legal context of objectives of this audit performed by the French Commission for Energy Regulation (CRE), this report proposes an analysis of GDF Suez's dissociated accounting which showed that costs are covered by natural gas regulated sale tariffs. In the second part, it comments the current market indexing used in tariff formula, comments current and present negotiations and their consequences for the market indexing share in long term contracts, discusses the issue of tariff volatility related to an increased market indexing share, discusses the possible re-examination of indices at the occasion of formula reviewing, and outlines that the diversified supplier portfolio allows optimisation operations. The third part addresses non-supply related costs: evolution of different infrastructure costs (related to distribution, transport, and storage) to be taken into account in regulated sale tariffs, evolution of commercial costs. Some recommendations are then made regarding the perspective of a tariff formula revision, and the perspectives of evolution of non-supply related costs

  11. Cost analysis of Human Papillomavirus-related cervical diseases and genital warts in Swaziland.

    Directory of Open Access Journals (Sweden)

    Themba G Ginindza

    Full Text Available Human papillomavirus (HPV has proven to be the cause of several severe clinical conditions on the cervix, vulva, vagina, anus, oropharynx and penis. Several studies have assessed the costs of cervical lesions, cervical cancer (CC, and genital warts. However, few have been done in Africa and none in Swaziland. Cost analysis is critical in providing useful information for economic evaluations to guide policymakers concerned with the allocation of resources in order to reduce the disease burden.A prevalence-based cost of illness (COI methodology was used to investigate the economic burden of HPV-related diseases. We used a top-down approach for the cost associated with hospital care and a bottom-up approach to estimate the cost associated with outpatient and primary care. The current study was conducted from a provider perspective since the state bears the majority of the costs of screening and treatment in Swaziland. All identifiable direct medical costs were considered for cervical lesions, cervical cancer and genital warts, which were primary diagnoses during 2015. A mix of bottom up micro-costing ingredients approach and top-down approaches was used to collect data on costs. All costs were computed at the price level of 2015 and converted to dollars ($.The total annual estimated direct medical cost associated with screening, managing and treating cervical lesions, CC and genital warts in Swaziland was $16 million. The largest cost in the analysis was estimated for treatment of high-grade cervical lesions and cervical cancer representing 80% of the total cost ($12.6 million. Costs for screening only represented 5% of the total cost ($0.9 million. Treatment of genital warts represented 6% of the total cost ($1million.According to the cost estimations in this study, the economic burden of HPV-related cervical diseases and genital warts represents a major public health issue in Swaziland. Prevention of HPV infection with a national HPV immunization

  12. Marital status and body weight, weight perception, and weight management among U.S. adults.

    Science.gov (United States)

    Klos, Lori A; Sobal, Jeffery

    2013-12-01

    Married individuals often have higher body weights than unmarried individuals, but it is unclear how marital roles affect body weight-related perceptions, desires, and behaviors. This study analyzed cross-sectional data for 4,089 adult men and 3,989 adult women using multinomial logistic regression to examine associations between marital status, perceived body weight, desired body weight, and weight management approach. Controlling for demographics and current weight, married or cohabiting women and divorced or separated women more often perceived themselves as overweight and desired to weigh less than women who had never married. Marital status was unrelated to men's weight perception and desired weight change. Marital status was also generally unrelated to weight management approach, except that divorced or separated women were more likely to have intentionally lost weight within the past year compared to never married women. Additionally, never married men were more likely to be attempting to prevent weight gain than married or cohabiting men and widowed men. Overall, married and formerly married women more often perceived themselves as overweight and desired a lower weight. Men's marital status was generally unassociated with weight-related perceptions, desires, and behaviors. Women's but not men's marital roles appear to influence their perceived and desired weight, suggesting that weight management interventions should be sensitive to both marital status and gender differences. © 2013 Elsevier Ltd. All rights reserved.

  13. Gender and Socioeconomic Status in Relation to Weight Perception and Weight Control Behavior in Korean Adults

    Directory of Open Access Journals (Sweden)

    Hee-Kyung Joh

    2013-02-01

    Full Text Available Aim: In Korea, obesity is more prevalent among men and lower socioeconomic groups. To explain this obesity disparity, we compared weight perception and weight control behavior across gender and socioeconomic status (SES. Methods: We analyzed data from 16,260 participants aged 20 years or older in a nationally representative cross-sectional survey. SES indicators included education and income levels. Weight under-perception was defined when participants considered themselves lighter than their measured BMI status. Either no active or inappropriate weight control (i.e., trying to gain weight in obese individuals was considered to be unhealthy patterns. Multivariate prevalence ratios were calculated using log-binomial regressions. Results: Men had a higher prevalence of weight under-perception (24.5 vs. 11.9% and unhealthy patterns of weight control behavior (57 vs. 40% than women. Low education level was associated with weight under-perception (ptrend = 0.022 in men, ptrend trend trend = 0.047 in men, ptrend Conclusion: Weight perception and weight control behavior significantly varied by gender and SES. Public actions should be directed toward improving perception and behavior of high-risk populations.

  14. Early weight loss predicts weight loss treatment response regardless of binge-eating disorder status and pretreatment weight change.

    Science.gov (United States)

    Barnes, Rachel D; Ivezaj, Valentina; Pittman, Brian P; Grilo, Carlos M

    2018-04-10

    Individuals seeking weight loss treatment have diverse pretreatment weight trajectories, and once enrolled, individuals' response to weight loss treatments also varies greatly and may be influenced by the presence of binge-eating disorder (BED). Reported average weight losses may obscure these considerable differences. This study examined whether BED status and different weight-related change variables are associated with successful weight loss treatment outcomes in a controlled treatment study. Participants (N = 89) with overweight/obesity, with and without BED, participated in a 3-month weight loss trial in primary care with 3- and 12-month follow-ups. We tested the prognostic significance of four weight-related change variables (the last supper, early weight loss, pretreatment weight trajectory, weight suppression) on outcomes (weight loss-overall, weight loss-"subsequent," weight loss during second half of treatment). Early weight loss was positively associated with weight loss-overall at post-treatment, and at 3-month and 12-month follow-up. Early weight loss was positively associated with weight loss-subsequent at post-treatment only. No other weight-related variables were significantly associated with weight loss. Models including BED status and treatment condition were not significant. Participants with early weight loss were more likely to continue losing weight, regardless of BED status or treatment condition. The results highlight the importance of early dedication to weight loss treatment to increase the likelihood of positive outcomes. © 2018 Wiley Periodicals, Inc.

  15. Weight-related concerns and diet behaviors among urban young females: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Shabnam Omidvar

    2016-01-01

    Full Text Available Background: Females are more likely than males to perceive themselves as too heavy, this has been explained in terms of the equation of “female beauty with extreme thinness.” Therefore, females are in general prone to develop unhealthy behaviors for weight management. Wrong weight control behaviors have significant health consequences. Objectives: To investigate the body weight concerns, body satisfaction, and weight control behaviors among young females and their association with age and socioeconomic status (SES. Materials and Methods: A cross-sectional study conducted in urban areas from a major city in South India. About 650 healthy unmarried females aged 15–25 years formed the study population. Self-reporting questionnaires were used to obtain relevant data. The categorical data were analyzed using Chi-square, correlation, and regression analyses by SPSS version 16. Results: Most overweight and obese subjects perceived themselves as overweight. Adolescents were more likely to report themselves as overweight. The perceived weight, body satisfaction, and weight control behaviors are influenced by weight status and age of the subjects. However, SES of the participants did not exhibit effect of others' opinion about their weight and body satisfaction as well as weight management behaviors. Conclusion: The high prevalence of weight-related concerns suggests that all females should be reached with appropriate information and interventions. Healthy weight control practices need to be explicitly promoted and unhealthy practices discouraged. Young females need special attention toward weight management.

  16. Health economic modelling to assess short-term costs of maternal overweight, gestational diabetes and related macrosomia – a pilot evaluation

    Directory of Open Access Journals (Sweden)

    Irene eLenoir-Wijnkoop

    2015-05-01

    Full Text Available Background: Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes (GDM and associated with increased morbidity for mother and child in the perinatal period. Poorly controlled diabetes during pregnancy, pre- pregnancy maternal obesity and/or excessive maternal weight gain during pregnancy are associated with intermittent periods of fetal exposure to hyperglycemia and subsequent hyperinsulinemia, leading to increased birth weight (e.g. macrosomia, body adiposity and glycogen storage in the liver. Macrosomia is associated with an increased risk of developing obesity and type 2 diabetes mellitus later in life.Objective: Provide insight in the short-term health-economic impact of maternal overweight, gestational diabetes (GDM and related macrosomia. To this end, a health economic framework was designed. This pilot study also aims to encourage further health technology assessments, based on country- and population-specific data. Results: The estimation of the direct health-economic burden of maternal overweight, GDM and related macrosomia indicates that associated healthcare expenditures are substantial. The calculation of a budget impact of GDM, based on a conservative approach of our model, using USA costing data, indicates an annual cost of more than $1,8 billion without taking into account long-term consequences.Conclusion: Although overweight and obesity are a recognized concern worldwide, less attention has been given to the health economic consequences of these conditions in women of child-bearing age and their offspring. The presented outcomes underline the need for preventive management strategies and public health interventions on life style, diet and physical activity. Also, the predisposition in people of Asian ethnicity to develop

  17. Parrotfish grazing ability: interspecific differences in relation to jaw-lever mechanics and relative weight of adductor mandibulae on an Okinawan coral reef

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    Atsushi Nanami

    2016-09-01

    Full Text Available Parrotfishes (family Labridae: Scarini are regarded to have important roles for maintaining the ecosystem balance in coral reefs due to their removal of organic matter and calcic substrates by grazing. The purpose of the present study was to clarify the interspecific differences in grazing ability of five parrotfish species (Chlorurus sordidus, C. bowersi, Scarus rivulatus, S. niger and S. forsteni in relation to interspecific differences in jaw-lever mechanics and the relative weight of the adductor mandibulae (muscles operating jaw closing. The grazing ability was calculated by using stomach contents (CaCO3 weight/organic matter weight defined as the grazing ability index (GAI. There were significant interspecific differences in GAI (C. sordidus = C. bowersi > S. rivulatus > S. niger = S. forsteni. Teeth of C. sordidus and C. bowersi were protrusive-shape whereas teeth of S. rivulatus, S. niger and S. forsteni were flat-shape. C. sordidus and C. bowersihave jaw-lever mechanics producing a greater biting force and have a larger weight of adductor mandibulae. S. rivulatus has jaw-lever mechanics producing a greater biting force but a smaller weight of adductor mandibulae that produce an intermediate biting force. In contrast, S. niger and S. forsteni have jaw-lever mechanics producing a lesser biting force and have a smaller weight of adductor mandibulae. Feeding rates and foray size of S. rivulatus, S. niger and S. forsteni were greater than C. sordidus and C. bowersi. The degree in bioerosion (GAI × feeding rate was the largest for S. rivulatusand the smallest for S. forsteni. The degree in bioerosion for C. sordidus was larger than S. niger whereas relatively equal between C. bowersi and S. niger. These results suggest that interspecific difference in GAI was explained by interspecific differences in teeth shape, jaw-lever mechanics and relative weight of adductor mandibulae. The interspecific difference in the degree of bioerosion suggests

  18. Parrotfish grazing ability: interspecific differences in relation to jaw-lever mechanics and relative weight of adductor mandibulae on an Okinawan coral reef.

    Science.gov (United States)

    Nanami, Atsushi

    2016-01-01

    Parrotfishes (family Labridae: Scarini) are regarded to have important roles for maintaining the ecosystem balance in coral reefs due to their removal of organic matter and calcic substrates by grazing. The purpose of the present study was to clarify the interspecific differences in grazing ability of five parrotfish species (Chlorurus sordidus, C. bowersi, Scarus rivulatus, S. niger and S. forsteni) in relation to interspecific differences in jaw-lever mechanics and the relative weight of the adductor mandibulae (muscles operating jaw closing). The grazing ability was calculated by using stomach contents (CaCO3 weight/organic matter weight) defined as the grazing ability index (GAI). There were significant interspecific differences in GAI (C. sordidus = C. bowersi > S. rivulatus > S. niger = S. forsteni). Teeth of C. sordidus and C. bowersi were protrusive-shape whereas teeth of S. rivulatus, S. niger and S. forsteni were flat-shape. C. sordidus and C. bowersihave jaw-lever mechanics producing a greater biting force and have a larger weight of adductor mandibulae. S. rivulatus has jaw-lever mechanics producing a greater biting force but a smaller weight of adductor mandibulae that produce an intermediate biting force. In contrast, S. niger and S. forsteni have jaw-lever mechanics producing a lesser biting force and have a smaller weight of adductor mandibulae. Feeding rates and foray size of S. rivulatus, S. niger and S. forsteni were greater than C. sordidus and C. bowersi. The degree in bioerosion (GAI × feeding rate) was the largest for S. rivulatusand the smallest for S. forsteni. The degree in bioerosion for C. sordidus was larger than S. niger whereas relatively equal between C. bowersi and S. niger. These results suggest that interspecific difference in GAI was explained by interspecific differences in teeth shape, jaw-lever mechanics and relative weight of adductor mandibulae. The interspecific difference in the degree of bioerosion suggests the

  19. Understanding the Determinants of Weight-Related Quality of Life among Bariatric Surgery Candidates

    Directory of Open Access Journals (Sweden)

    Annie Tessier

    2012-01-01

    Full Text Available Obesity and its relation to quality of life are multifaceted. The purpose of this paper was to contribute evidence to support a framework for understanding the impact of obesity on quality of life in 42 morbidly obese subjects considering a wide number of potential determinants. A model of weight-related quality of life (WRQL was developed based on the Wilson-Cleary model, considering subjects' weight characteristics, arterial oxygen pressure (PaO2, walking capacity (6-minute walk test, 6MWT, health-related quality of life (HRQL; Physical and Mental Component Summaries of the SF-36 PCS/MCS, and WRQL. The model of WRQL was tested with linear regressions and a path analysis, which showed that as PaO2 at rest increased 6MWT increased. 6MWT was positively associated with the PCS, which in turn was positively related to WRQL along with the MCS. The model showed good fit and explained 38% of the variance in WRQL.

  20. comparative cost and strength analysis of cement and aggregate

    African Journals Online (AJOL)

    2012-07-02

    Jul 2, 2012 ... and a mix design of 1:1.5:3 batching by weight was adopted. ... study suggests that; the cost of construction and concrete production can be reduced if cement and ... duction is relatively high due to the manufacture of its.

  1. Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.

    Science.gov (United States)

    Crowley, Matthew J; Edelman, David; Voils, Corrine I; Maciejewski, Matthew L; Coffman, Cynthia J; Jeffreys, Amy S; Turner, Marsha J; Gaillard, Leslie A; Hinton, Teresa A; Strawbridge, Elizabeth; Zervakis, Jennifer; Barton, Anna Beth; Yancy, William S

    2017-07-01

    Rates of glycemic control remain suboptimal nationwide. Medication intensification for diabetes can have undesirable side effects (weight gain, hypoglycemia), which offset the benefits of glycemic control. A Shared Medical Appointment (SMA) intervention for diabetes that emphasizes weight management could improve glycemic outcomes and reduce weight while simultaneously lowering diabetes medication needs, resulting in less hypoglycemia and better quality of life. We describe the rationale and design for a study evaluating a novel SMA intervention for diabetes that primarily emphasizes low-carbohydrate diet-focused weight management. Jump Starting Shared Medical Appointments for Diabetes with Weight Management (Jump Start) is a randomized, controlled trial that is allocating overweight Veterans (body mass index≥27kg/m 2 ) with type 2 diabetes into two arms: 1) a traditional SMA group focusing on medication management and self-management counseling; or 2) an SMA group that combines low-carbohydrate diet-focused weight management (WM/SMA) with medication management. Hemoglobin A1c reduction at 48weeks is the primary outcome. Secondary outcomes include hypoglycemic events, diabetes medication use, weight, medication adherence, diabetes-related quality of life, and cost-effectiveness. We hypothesize that WM/SMA will be non-inferior to standard SMA for glycemic control, and will reduce hypoglycemia, diabetes medication use, and weight relative to standard SMA, while also improving quality of life and costs. Jump Start targets two common problems that are closely related but infrequently managed together: diabetes and obesity. By focusing on diet and weight loss as the primary means to control diabetes, this intervention may improve several meaningful patient-centered outcomes related to diabetes. Copyright © 2017. Published by Elsevier Inc.

  2. Changes in health-related behaviors and their effect on dissatisfaction with body weight in youths

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    Diego Augusto Santos Silva

    2014-05-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2014v16s1p79 The aim of the present study was to establish whether changes in health related behaviors are associated with changes in the satisfaction/dissatisfaction with body weight in youths. It was a prospective study that performed a secondary analysis of data from Project “Saúde na Boa”, which included youths attending night classes in secondary public schools in Recife in the state of Pernambuco and Florianópolis in the state of Santa Catarina. Data on the youths’ body type (thinness or excess weight and degree of satisfaction/dissatisfaction with body weight and lifestyle (level of physical activity, participation in physical education classes, sedentary behavior and snacks, soda and alcohol intake were collected at 10 schools from each town (five in the intervention group and five in the control group. The percentages of youths dissatisfied with their body weight were 50.5% and 48.6% at baseline and after intervention, respectively. The percentage of youths with body dissatisfaction due to thinness decreased (21.4% vs. 16.5%, while the percentage of youths with body dissatisfaction due to excess weight increased (29.1% vs. 32.1%. Approximately 41.2% of the youths with body dissatisfaction due to thinness and 18.3% of those dissatisfied due to excess weight became satisfied with their body weight after intervention. The intervention targeting health-related behaviors induced changes in the youths’ degree of satisfaction with their body weight.

  3. Economic Consequences and Potentially Preventable Costs Related to Osteoporosis in the Netherlands.

    Science.gov (United States)

    Dunnewind, Tom; Dvortsin, Evgeni P; Smeets, Hugo M; Konijn, Rob M; Bos, Jens H J; de Boer, Pieter T; van den Bergh, Joop P; Postma, Maarten J

    2017-06-01

    Osteoporosis often does not involve symptoms, and so the actual number of patients with osteoporosis is higher than the number of diagnosed individuals. This underdiagnosis results in a treatment gap. To estimate the total health care resource use and costs related to osteoporosis in the Netherlands, explicitly including fractures, and to estimate the proportion of fracture costs that are linked to the treatment gap and might therefore be potentially preventable; to also formulate, on the basis of these findings, strategies to optimize osteoporosis care and treatment and reduce its related costs. In this retrospective study, data of the Achmea Health Database representing 4.2 million Dutch inhabitants were used to investigate the economic consequence of osteoporosis in the Netherlands in 2010. Specific cohorts were created to identify osteoporosis-related fractures and their costs. Besides, costs of pharmaceutical treatment regarding osteoporosis were included. Using data from the literature, the treatment gap was estimated. Sensitivity analysis was performed on the base-case results. A total of 108,013 individuals with a history of fractures were included in this study. In this population, 59,193 patients were using anti-osteoporotic medication and 86,776 patients were using preventive supplements. A total number of 3,039 osteoporosis-related fractures occurred. The estimated total costs were €465 million. On the basis of data presented in the literature, the treatment gap in our study population was estimated to vary from 60% to 72%. The estimated total costs corrected for treatment gap were €1.15 to €1.64 billion. These results indicate room for improvement in the health care policy against osteoporosis. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  4. Weight Loss Nutritional Supplements

    Science.gov (United States)

    Eckerson, Joan M.

    Obesity has reached what may be considered epidemic proportions in the United States, not only for adults but for children. Because of the medical implications and health care costs associated with obesity, as well as the negative social and psychological impacts, many individuals turn to nonprescription nutritional weight loss supplements hoping for a quick fix, and the weight loss industry has responded by offering a variety of products that generates billions of dollars each year in sales. Most nutritional weight loss supplements are purported to work by increasing energy expenditure, modulating carbohydrate or fat metabolism, increasing satiety, inducing diuresis, or blocking fat absorption. To review the literally hundreds of nutritional weight loss supplements available on the market today is well beyond the scope of this chapter. Therefore, several of the most commonly used supplements were selected for critical review, and practical recommendations are provided based on the findings of well controlled, randomized clinical trials that examined their efficacy. In most cases, the nutritional supplements reviewed either elicited no meaningful effect or resulted in changes in body weight and composition that are similar to what occurs through a restricted diet and exercise program. Although there is some evidence to suggest that herbal forms of ephedrine, such as ma huang, combined with caffeine or caffeine and aspirin (i.e., ECA stack) is effective for inducing moderate weight loss in overweight adults, because of the recent ban on ephedra manufacturers must now use ephedra-free ingredients, such as bitter orange, which do not appear to be as effective. The dietary fiber, glucomannan, also appears to hold some promise as a possible treatment for weight loss, but other related forms of dietary fiber, including guar gum and psyllium, are ineffective.

  5. Light-weight plastination.

    Science.gov (United States)

    Steinke, Hanno; Rabi, Suganthy; Saito, Toshiyuki; Sawutti, Alimjan; Miyaki, Takayoshi; Itoh, Masahiro; Spanel-Borowski, Katharina

    2008-11-20

    Plastination is an excellent technique which helps to keep the anatomical specimens in a dry, odourless state. Since the invention of plastination technique by von Hagens, research has been done to improve the quality of plastinated specimens. In this paper, we have described a method of producing light-weight plastinated specimens using xylene along with silicone and in the final step, substitute xylene with air. The finished plastinated specimens were light-weight, dry, odourless and robust. This method requires less use of resin thus making the plastination technique more cost-effective. The light-weight specimens are easy to carry and can easily be used for teaching.

  6. Effect of density and weight of load on the energy cost of carrying loads by donkeys and ponies.

    Science.gov (United States)

    Pearson, R A; Dijkman, J T; Krecek, R C; Wright, P

    1998-02-01

    Two experiments were designed to compare the energy used in carrying loads by donkeys and ponies. In the first experiment 3 donkeys and 3 ponies were compared on treadmills in the UK. Density of load (lead shot or straw) had no significant effect on the energy cost of carrying loads; however, the energy cost of carrying a load decreased significantly (p < 0.001) as the weight of the load increased (in donkeys 6.44, 4.35 and 3.03 J/kg load/m, in ponies 5.82, 3.75 and 3.68 J/kg load/m, for loads of 13, 20 and 27 kg/100 kg liveweight (M) respectively). Differences between species were not significant. In the second experiment energy expenditures were determined in 3 donkeys carrying loads equivalent to 40 kg/100 kg M over gently undulating gravel tracks in Tunisia. Energy costs of carrying the load were 2.34 (SE 0.07) J/kg load/m. The results of both experiments showed that provided the load is balanced, density does not significantly affect the energy cost of carrying; however, as the load increased then the unit energy cost of carrying it decreased. This suggest that it is more efficient in terms of energy used to carry loads equivalent to 27 to 40 kg/100 kg M than it is to carry lighter loads to less than 20 kg/100 kg M.

  7. Weight and its relationship to adolescent perceptions of their providers (WRAP): a qualitative and quantitative assessment of teen weight-related preferences and concerns.

    Science.gov (United States)

    Cohen, Marc L; Tanofsky-Kraff, Marian; Young-Hyman, Deborah; Yanovski, Jack A

    2005-08-01

    To examine the relationship of body weight to satisfaction with care in adolescents, and to obtain qualitative data on preferences for general and weight-related medical care in normal weight and overweight adolescents. The Weight and its Relationship to Adolescent Perceptions of their Providers survey, a 4-page questionnaire containing previously validated satisfaction scales and open-ended qualitative questions regarding health care preferences, was administered to 62 severely overweight (body mass index [BMI] 38.9 +/- 8.4 kg/m2) and 29 normal weight (BMI 22.5 +/- 4.0 kg/m2) adolescents (age 13.9 +/- 1.7 years; 57% female; 50% Caucasian, 47% African-American, 3% Hispanic). The affective subscale of the medical satisfaction scale was negatively correlated with BMI standard deviation score (r = -.22, p teens. Seventy-nine percent of overweight adolescents stated their health care provider discussed their weight with them; however, only 41% of overweight adolescents desired to discuss their weight. Compared to normal-weight adolescents, overweight teens were more likely to report that their provider raised topics of weight (p teens expressed concerns regarding the public location of their provider's office scale. Satisfaction with affective aspects of the provider-patient relationship is negatively correlated with BMI standard deviation score. Length of experience with one's provider is also a strong predictor of teen satisfaction with their medical care. Teens prefer the term "overweight" for those with high body weight. Sensitivity to confidentiality, privacy, and embarrassment regarding physical examination and weight are important for teen satisfaction.

  8. Weight and its relationship to adolescent perceptions of their providers (WRAP): A qualitative and quantitative assessment of teen weight-related preferences and concerns

    Science.gov (United States)

    Cohen, Marc L.; Tanofsky-Kraff, Marian; Young-Hyman, Deborah; Yanovski, Jack A.

    2008-01-01

    Purpose To examine the relationship of body weight to satisfaction with care in adolescents, and to obtain qualitative data on preferences for general and weight-related medical care in normal weight and overweight adolescents. Methods The Weight and its Relationship to Adolescent Perceptions of their Providers survey, a 4-page questionnaire containing previously validated satisfaction scales and open-ended qualitative questions regarding health care preferences, was administered to 62 severely overweight (body mass index [BMI] 38.9 ± 8.4 kg/m2) and 29 normal weight (BMI 22.5 ± 4.0 kg/m2) adolescents (age 13.9 ± 1.7 years; 57% female; 50% Caucasian, 47% African-American, 3% Hispanic). Results The affective subscale of the medical satisfaction scale was negatively correlated with BMI standard deviation score (r = −.22, p teens. Seventy-nine percent of overweight adolescents stated their health care provider discussed their weight with them; however, only 41% of overweight adolescents desired to discuss their weight. Compared to normal-weight adolescents, overweight teens were more likely to report that their provider raised topics of weight (p teens expressed concerns regarding the public location of their provider’s office scale. Conclusions Satisfaction with affective aspects of the provider-patient relationship is negatively correlated with BMI standard deviation score. Length of experience with one’s provider is also a strong predictor of teen satisfaction with their medical care. Teens prefer the term “overweight” for those with high body weight. Sensitivity to confidentiality, privacy, and embarrassment regarding physical examination and weight are important for teen satisfaction. PMID:16026727

  9. Assessing Cost-Effectiveness in Obesity (ACE-Obesity: an overview of the ACE approach, economic methods and cost results

    Directory of Open Access Journals (Sweden)

    Swinburn Boyd

    2009-11-01

    Full Text Available Abstract Background The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. Methods The Assessing Cost Effectiveness (ACE approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. Results The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum and when expressed as a 'cost per child' estimate (from Conclusion The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost-effectiveness results and

  10. Billing and insurance-related administrative costs in United States' health care: synthesis of micro-costing evidence.

    Science.gov (United States)

    Jiwani, Aliya; Himmelstein, David; Woolhandler, Steffie; Kahn, James G

    2014-11-13

    The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs. Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012. We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies settings, so extrapolated from known sectors. We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated "added" BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses. BIR costs in the U.S. health care system totaled approximately $471 ($330 - $597) billion in 2012. This includes $70 ($54 - $76) billion in physician practices, $74 ($58 - $94) billion in hospitals, an estimated $94 ($47 - $141) billion in settings providing other health services and supplies, $198 ($154 - $233) billion in private insurers, and $35 ($17 - $52) billion in public insurers. Compared to simplified financing, $375

  11. The node-weighted Steiner tree approach to identify elements of cancer-related signaling pathways.

    Science.gov (United States)

    Sun, Yahui; Ma, Chenkai; Halgamuge, Saman

    2017-12-28

    Cancer constitutes a momentous health burden in our society. Critical information on cancer may be hidden in its signaling pathways. However, even though a large amount of money has been spent on cancer research, some critical information on cancer-related signaling pathways still remains elusive. Hence, new works towards a complete understanding of cancer-related signaling pathways will greatly benefit the prevention, diagnosis, and treatment of cancer. We propose the node-weighted Steiner tree approach to identify important elements of cancer-related signaling pathways at the level of proteins. This new approach has advantages over previous approaches since it is fast in processing large protein-protein interaction networks. We apply this new approach to identify important elements of two well-known cancer-related signaling pathways: PI3K/Akt and MAPK. First, we generate a node-weighted protein-protein interaction network using protein and signaling pathway data. Second, we modify and use two preprocessing techniques and a state-of-the-art Steiner tree algorithm to identify a subnetwork in the generated network. Third, we propose two new metrics to select important elements from this subnetwork. On a commonly used personal computer, this new approach takes less than 2 s to identify the important elements of PI3K/Akt and MAPK signaling pathways in a large node-weighted protein-protein interaction network with 16,843 vertices and 1,736,922 edges. We further analyze and demonstrate the significance of these identified elements to cancer signal transduction by exploring previously reported experimental evidences. Our node-weighted Steiner tree approach is shown to be both fast and effective to identify important elements of cancer-related signaling pathways. Furthermore, it may provide new perspectives into the identification of signaling pathways for other human diseases.

  12. Accuracy of a digital weight scale relative to the nintendo wii in measuring limb load asymmetry.

    Science.gov (United States)

    Kumar, Ns Senthil; Omar, Baharudin; Joseph, Leonard H; Hamdan, Nor; Htwe, Ohnmar; Hamidun, Nursalbiyah

    2014-08-01

    [Purpose] The aim of the present study was to investigate the accuracy of a digital weight scale relative to the Wii in limb loading measurement during static standing. [Methods] This was a cross-sectional study conducted at a public university teaching hospital. The sample consisted of 24 participants (12 with osteoarthritis and 12 healthy) recruited through convenient sampling. Limb loading measurements were obtained using a digital weight scale and the Nintendo Wii in static standing with three trials under an eyes-open condition. The limb load asymmetry was computed as the symmetry index. [Results] The accuracy of measurement with the digital weight scale relative to the Nintendo Wii was analyzed using the receiver operating characteristic (ROC) curve and Kolmogorov-Smirnov test (K-S test). The area under the ROC curve was found to be 0.67. Logistic regression confirmed the validity of digital weight scale relative to the Nintendo Wii. The D statistics value from the K-S test was found to be 0.16, which confirmed that there was no significant difference in measurement between the equipment. [Conclusion] The digital weight scale is an accurate tool for measuring limb load asymmetry. The low price, easy availability, and maneuverability make it a good potential tool in clinical settings for measuring limb load asymmetry.

  13. Relatively high-protein or 'low-carb' energy-restricted diets for body weight loss and body weight maintenance?

    Science.gov (United States)

    Soenen, Stijn; Bonomi, Alberto G; Lemmens, Sofie G T; Scholte, Jolande; Thijssen, Myriam A M A; van Berkum, Frank; Westerterp-Plantenga, Margriet S

    2012-10-10

    'Low-carb' diets have been suggested to be effective in body weight (BW) management. However, these diets are relatively high in protein as well. To unravel whether body-weight loss and weight-maintenance depends on the high-protein or the 'low-carb' component of the diet. Body-weight (BW), fat mass (FM), blood- and urine-parameters of 132 participants (age=50 ± 12 yr; BW=107 ± 20 kg; BMI=37 ± 6 kg/m(2); FM=47.5 ± 11.9 kg) were compared after 3 and 12 months between four energy-restricted diets with 33% of energy requirement for the first 3 months, and 67% for the last 9 months: normal-protein normal-carbohydrate (NPNC), normal-protein low-carbohydrate (NPLC); high-protein normal-carbohydrate (HPNC), high-protein low-carbohydrate (HPLC); 24h N-analyses confirmed daily protein intakes for the normal-protein diets of 0.7 ± 0.1 and for the high-protein diets of 1.1 ± 0.2g/kg BW (pvs. NP (-11.5 ± 4 kg; -9.3 ± 0.7 kg) (pvs. NC (-12.3 ± 3 kg; -10.3 ± 1.1 kg) (ns). Diet × time interaction showed HPLC (-14.7 ± 5 kg; -11.9 ± 1.6 kg) vs. HPNC (-13.8 ± 3 kg; -11.9 ± 1.8 kg) (ns); NPLC (-12.2 ± 4 kg; -10.0 ± 0.8 kg) vs. NPNC (-10.7 ± 4 kg; -8.6 ± 0.7 kg) (ns); HPLC vs. NPLC (pvs. NPNC (pvs. NP (-8.9 ± 3 kg; -7.7 ± 0.6 kg) (pvs. NC (11.1 ± 3 kg; 9.3 ± 0.7 kg) (ns). Diet × time interaction showed HPLC (-11.6 ± 5 kg ; -8.2 ± 0.7 kg) vs. HPNC (-14.1 ± 4 kg; -10.0 ± 0.9 kg) (ns); NPNC (-8.2 ± 3 kg; -6.7 ± 0.6 kg) vs. NPLC (-9.7 ± 3 kg; -8.5 ± 0.7 kg) (ns); HPLC vs. NPLC (pvs. NPNC (pvs. all other diets reduced diastolic blood pressure more. Relationships between changes in BW, FM, FFM or metabolic parameters and energy percentage of fat in the diet were not statistically significant. Metabolic profile and fat-free-mass were improved following weight-loss. Body-weight loss and weight-maintenance depends on the high-protein, but not on the 'low-carb' component of the diet, while it is unrelated to the concomitant fat-content of the diet. Copyright

  14. Direct diabetes-related costs in young patients with early-onset, long-lasting type 1 diabetes.

    Directory of Open Access Journals (Sweden)

    Christina Bächle

    Full Text Available OBJECTIVE: To estimate diabetes-related direct health care costs in pediatric patients with early-onset type 1 diabetes of long duration in Germany. RESEARCH DESIGN AND METHODS: Data of a population-based cohort of 1,473 subjects with type 1 diabetes onset at 0-4 years of age within the years 1993-1999 were included (mean age 13.9 (SD 2.2 years, mean diabetes duration 10.9 (SD 1.9 years, as of 31.12.2007. Diabetes-related health care services utilized in 2007 were derived from a nationwide prospective documentation system (DPV. Health care utilization was valued in monetary terms based on inpatient and outpatient medical fees and retail prices (perspective of statutory health insurance. Multiple regression models were applied to assess associations between direct diabetes-related health care costs per patient-year and demographic and clinical predictors. RESULTS: Mean direct diabetes-related health care costs per patient-year were €3,745 (inter-quartile range: 1,943-4,881. Costs for glucose self-monitoring were the main cost category (28.5%, followed by costs for continuous subcutaneous insulin infusion (25.0%, diabetes-related hospitalizations (22.1% and insulin (18.4%. Female gender, pubertal age and poor glycemic control were associated with higher and migration background with lower total costs. CONCLUSIONS: Main cost categories in patients with on average 11 years of diabetes duration were costs for glucose self-monitoring, insulin pump therapy, hospitalization and insulin. Optimization of glycemic control in particular in pubertal age through intensified care with improved diabetes education and tailored insulin regimen, can contribute to the reduction of direct diabetes-related costs in this patient group.

  15. Secukinumab Significantly Reduces Psoriasis-Related Work Impairment and Indirect Costs Compared With Ustekinumab and Etanercept in the United Kingdom.

    Science.gov (United States)

    Warren, R B; Halliday, A; Graham, C N; Gilloteau, I; Miles, L; McBride, D

    2018-05-30

    Psoriasis causes work productivity impairment that increases with disease severity. Whether differential treatment efficacy translates into differential indirect cost savings is unknown. To assess work hours lost and indirect costs associated with secukinumab versus ustekinumab and etanercept in the United Kingdom (UK). This was a post hoc analysis of work impairment data collected in the CLEAR study (secukinumab vs. ustekinumab) and applied to the FIXTURE study (secukinumab vs. etanercept). Weighted weekly and annual average indirect costs per patient per treatment were calculated from (1) overall work impairment derived from Work Productivity and Activity Impairment data collected in CLEAR at 16 and 52 weeks by Psoriasis Area and Severity Index (PASI) response level; (2) weekly/annual work productivity loss by PASI response level; (3) weekly and annual indirect costs by PASI response level, based on hours of work productivity loss; and (4) weighted average indirect costs for each treatment. In the primary analysis, work impairment data for employed patients in CLEAR at Week 16 were used to compare secukinumab and ustekinumab. Secondary analyses were conducted at different timepoints and with patient cohorts, including FIXTURE. In CLEAR, 452 patients (67%) were employed at baseline. At Week 16, percentages of weekly work impairment/mean hours lost decreased with higher PASI: PASI hours; PASI 50-74: 13.3%/4.45 hours; PASI 75-89: 6.4%/2.14 hours; PASI ≥90: 4.9%/1.65 hours. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than ustekinumab (1.96/102.51 vs. 2.40/125.12; P=0.0006). Results were consistent for secukinumab versus etanercept (2.29/119.67 vs. 3.59/187.17; Ρreduced work impairment and associated indirect costs of psoriasis compared with ustekinumab and etanercept at Week 16 through 52 in the UK. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. [Financial burden of hepatitis B-related diseases and factors influencing the costs in Shenzhen, China].

    Science.gov (United States)

    Liang, Sen; Zhang, Shun-xiang; Ma, Qi-shan; Xiao, He-wei; Lü, Qiu-ying; Xie, Xu; Mei, Shu-jiang; Hu, Dong-sheng; Zhou, Bo-ping; Li, Bing; Chen, Jing-fang; Cui, Fu-qiang; Wang, Fu-zhen; Liang, Xiao-feng

    2010-12-01

    To investigate the direct, indirect and intangible costs due to hepatitis B-related diseases and to explore main factors associated with the costs in Shenzhen. Cluster sampling for cases collected consecutively during the study period was administrated. Subjects were selected from eligible hepatitis B-related patients. By pre-trained professional investigators, health economics-related information was collected, using a structured questionnaire. Hospitalization expenses were obtained through hospital records after the patients were discharged from hospital. Total economic burden of hepatitis B-related patients would involve direct, indirect and intangible costs. Direct costs were further divided into direct medical costs and direct nonmedical costs. Human Capital Approach was employed to measure the indirect costs both on patients and the caregivers in 1-year time span. Willing to pay method was used to estimate the intangible costs. Multiple linear stepwise regression models were conducted to determine the factors linked to the economic burden. On average, the total annual cost of per patient with hepatitis B-related diseases was 81 590.23 RMB Yuan. Among which, direct, indirect and intangible costs were 30 914.79 Yuan (account for 37.9%), 15 258.01 Yuan (18.7%), 35 417.43 Yuan (43.4%), respectively. The total annual costs per patient for hepatocellular carcinoma, severe hepatitis B, decompensated cirrhosis, compensated cirrhosis, chronic hepatitis B and acute hepatitis B were 194 858.40 Yuan, 144 549.20 Yuan, 120 333.60 Yuan, 79 528.81 Yuan, 66 282.46 Yuan and 39 286.81 Yuan, respectively. The ratio of direct to indirect costs based on the base-case estimation foot add to 2.0:1, increased from hepato-cellular carcinoma (0.7:1) to compensated cirrhosis (3.5:1), followed by acute hepatitis B (3.3:1), severe hepatitis B (2.8:1), decompensate cirrhosis (2.3:1) and chronic hepatitis B (2.2:1). Direct medical costs were more than direct nonmedical. Ratio between the

  17. Impact of Weight of the Nation Community Screenings on Obesity-Related Beliefs

    Science.gov (United States)

    Luecking, Courtney T.; Noar, Seth M.; Dooley, Rachel M.; Gizlice, Ziya; Ammerman, Alice S.

    2017-01-01

    Introduction HBO’s Weight of the Nation was a collaborative effort among several national organizations to raise awareness about the complexity of the obesity epidemic and promote action through media and community forums. The primary aim of this study was to assess the short-term effects of Weight of the Nation community screenings on obesity-related beliefs, intentions, and policy support. Methods Five Prevention Research Centers across the U.S. administered surveys at nine Weight of the Nation community screenings between September 2012 and May 2013. Adults aged ≥18 years who completed pre–post surveys were included. The survey assessed demographic information, perceptions of the documentary, efficacy to take action and influence policies that affect obesity, intentions to take actions to support a healthy weight, and positions on policy changes that impact food systems. Data were analyzed in 2015. Results A convenience sample of 442 individuals completed surveys. The sample was mostly health workers, female, college educated, aged 25–44 years, and racially and ethnically diverse. Significant increases (p<0.001) were observed for perceived self- and collective efficacy that individuals and communities can influence policies and environmental factors that affect obesity, intentions to take actions that contribute to a healthy weight, and support for policies that change the food system. Conclusions A broad, nationwide effort, such as Weight of the Nation, that combines media with opportunities to bring community members together for discussion, may play a role in influencing beliefs, intentions, and policy support regarding obesity prevention. PMID:28215388

  18. Nutrition Facts Use in Relation to Eating Behaviors and Healthy and Unhealthy Weight Control Behaviors.

    Science.gov (United States)

    Christoph, Mary J; Loth, Katie A; Eisenberg, Marla E; Haynos, Ann F; Larson, Nicole; Neumark-Sztainer, Dianne

    2018-03-01

    Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors. Cross-sectional survey in 2015-2016. Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults-IV survey, the fourth wave of a longitudinal cohort study. Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating. Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status. In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating. Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  19. Procedures’ costs related to outpatient chemotherapy treatment of women suffering from breast cancer

    Directory of Open Access Journals (Sweden)

    Caroline Rife Nobrega

    2014-08-01

    Full Text Available To identify the direct cost of procedures related to an outpatient chemotherapy treatment for women with breast cancer. Method: This is a quantitative research, using the case study methodology, performed in an outpatient chemotherapy of a private hospital. The total cost was calculated by multiplying the time spent by professionals involved in therapeutic procedures, the unit cost of direct labor, adding to the cost of materials, drugs and solutions. For performing the calculations, we used the Brazilian currency (R$. Results: The average total cost per chemotherapy session corresponded to R$ 1,783.01 (100%, being R$ 1,671.66 (93,75% spent with drugs, R$ 74,98 (4.21% with materials, R$ 28.49 (1.60% with labor and R$ 7.88 (0.44% with solutions. Conclusion: The results may support discussions and decision making for the management of costs related to chemotherapy aimed at reducing expenses and eliminating waste without harm to the care provided.

  20. [Relation between physical activity, weight balance and breast cancer].

    Science.gov (United States)

    Maître, Carole

    2013-05-01

    Many epidemiologic studies, with a good methodology, support the evidence of the positive role of regular physical activity on primary and tertiary prevention of breast cancer on the risk of recurrence and mortality. This relation depends on the level of total energy expenditure by week, which helps balance weight on lifetime, an essential part of benefit. The beneficial effects of physical activity are linked to many interrelated additional mechanisms: in a short-term, contraction of skeletal muscles involves aerobic metabolism which utilizes glucose and amino acids like glutamine, improves insulin sensitivity and lowers plasma insulin; in a long-term, physical activity produces favorable changes in body composition, decreasing body fat and increasing lean mass. That is a key point to reduce the intake of energy substrates stimulating carcinogenesis, to improve insulin sensitivity, to change the ratio of leptin and adiponectin, to enhance cellular immunity and to block cellular pathways of cell proliferation and angiogenesis. Maintaining a healthy weight through regular physical activity well balanced with energy intake is it a goal for prevention of breast cancer. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Cost of osteoporosis-related fracture in Italy. Results of the BLOCK study

    Directory of Open Access Journals (Sweden)

    Luca Degli Esposti

    2011-09-01

    Full Text Available The objectives of the present study were to calculate the cost of illness of osteoporosis and to assess drug utilization patterns in postmenopausal women after a fracture-related hospitalization. The study subjects were enrolled from a large population-based administrative database. Female patients (age ≥ 65 years who were hospitalized for a typical osteoporotic fracture between 1/1/2000 and 31/12/2005 were included. Patients were classified as exposed/unexposed to treatment according to the presence/absence of at least one prescription for an osteoporosis-related medication in the 6 months following the discharge date. Treatment adherence was calculated for patients who were exposed to bisphosphonate therapy and was defined as at least 80% of treatment coverage during the follow-up period of 18 months after the discharge date. Hospitalizations, medications, diagnostic tests, laboratory tests and specialist visits during the 18-month follow-up period were collected and classified as osteoporosis-related or non-related to osteoporosis. A total of 12,376 patients were included in the study (mean age ± SD, 79.1 ± 7.5 years, out of which 97.9% (n = 12,110 were hospitalized due to an osteoporosis-related fracture and only 2.1% (n = 266 had general osteoporosis diagnosis. Among the 12,110 women with a fracture, 15.2% (n = 1,845 had a subsequent fracture-related hospitalization (63.8% of the patients had hip fracture. Only 32.3% (n = 4,001 of all included patients was exposed to osteoporosis-related medications and out of those patients exposed to bisphosphonates (n = 860 only 34.2% (n = 294 was adherent to therapy. The average cost per patient was € 4,481, of which € 1,089 was for osteoporosis-related and € 3,392 for non-osteoporosis-related items. The average cost of a matching cohort of patients without hospitalizations for fracture was € 2,339. Among osteoporosis-related costs, 87.0% was due to hospitalizations for subsequent fractures

  2. Prediction of line failure fault based on weighted fuzzy dynamic clustering and improved relational analysis

    Science.gov (United States)

    Meng, Xiaocheng; Che, Renfei; Gao, Shi; He, Juntao

    2018-04-01

    With the advent of large data age, power system research has entered a new stage. At present, the main application of large data in the power system is the early warning analysis of the power equipment, that is, by collecting the relevant historical fault data information, the system security is improved by predicting the early warning and failure rate of different kinds of equipment under certain relational factors. In this paper, a method of line failure rate warning is proposed. Firstly, fuzzy dynamic clustering is carried out based on the collected historical information. Considering the imbalance between the attributes, the coefficient of variation is given to the corresponding weights. And then use the weighted fuzzy clustering to deal with the data more effectively. Then, by analyzing the basic idea and basic properties of the relational analysis model theory, the gray relational model is improved by combining the slope and the Deng model. And the incremental composition and composition of the two sequences are also considered to the gray relational model to obtain the gray relational degree between the various samples. The failure rate is predicted according to the principle of weighting. Finally, the concrete process is expounded by an example, and the validity and superiority of the proposed method are verified.

  3. Impact of response criteria (tibia ash weight vs. percent) on phytase relative non phytate phosphorus equivalance.

    Science.gov (United States)

    Li, W; Angel, R; Kim, S-W; Jiménez-Moreno, E; Proszkowiec-Weglarz, M; Plumstead, P W

    2015-09-01

    The current study was conducted to evaluate the impacts of using tibia ash percentage or ash weight as the response criteria on estimated phytase relative equivalence. Straight run broilers were fed treatment (Trt) diets from 7 to 21 d age (6 birds/pen, 8 pens/Trt). The corn-soy based Trt were formulated to contain 0.80% Ca and 4 non-phytate phosphorus (nPP) concentrations (0.20, 0.27, 0.34, and 0.40%). Monocalcium phosphate was the inorganic phosphate source added to achieve 4 different dietary nPP concentrations and against which the nPP relative equivalence of phytase was determined. A 6-phytase (Danisco Animal Nutrition, DuPont Industrial Biosciences, Marlborough, UK) was added at 500 or 1,000 phytase unit ( FTU: )/kg to the 0.20% nPP diet resulting 6 total Trts. Tibia ash was determined at 21 d age. Phytase fed at 500 or 1,000 FTU/kg increased tibia ash weight and ash percentage compared to that of birds fed 0.20% nPP diet without phytase (Pphytase nPP relative equivalence. The R2 obtained from pen value regressions were 0.81 and 0.84, for tibia ash weight and percentage, respectively. Ash percentage from birds fed 500 and 1,000 FTU phytase/kg fell within the range obtained with the MCP additions. Ash weight (842 mg/tibia) from birds fed 1,000 FTU phytase/kg exceeded (Pphytase/kg Trt. The nPP relative equivalence in birds fed 500 FTU phytase/kg were 0.117 and 0.168% based on ash percentage and weight, respectively (Pphytase/kg was 0.166% for ash percentage. Results suggested that ash weight better reflects the amount of bone mineralization as compared to ash percentage and using ash percentage may lead to an underestimation of phytase efficacy. © 2015 Poultry Science Association Inc.

  4. Consumer response to healthy eating, physical activity and weight-related recommendations: a systematic review.

    Science.gov (United States)

    Boylan, S; Louie, J C Y; Gill, T P

    2012-07-01

    Strong evidence linking poor diet and lack of physical activity to risk of obesity and related chronic disease has supported the development and promotion of guidelines to improve population health. Still, obesity continues to escalate as a major health concern, and so the impact of weight-related guidelines on behaviour is unclear. The aim of this review was to examine consumer response to weight-related guidelines. A systematic literature search was performed using Medline, PsycInfo, ProQuest Central and additional searches using Google and reference lists. Of the 1,765 articles identified, 46 relevant titles were included. Most studies examined attitudes towards content, source, tailoring and comprehension of dietary guidelines. Many respondents reported that guidelines were confusing, and that simple, clear, specific, realistic, and in some cases, tailored guidelines are required. Recognition of guidelines did not signify understanding nor did perceived credibility of a source guarantee utilization of guidelines. There was a lack of studies assessing: the impact of guidelines on behaviour; responses to physical activity guidelines; responses among males and studies undertaken in developing countries. Further research is needed, in particular regarding responses to physical activity guidelines and guidelines in different populations. Communication professionals should assist health professionals in the development of accurate and effective weight-related guidelines. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

  5. The relation of weight suppression and BMI to bulimic symptoms.

    Science.gov (United States)

    Butryn, Meghan L; Juarascio, Adrienne; Lowe, Michael R

    2011-11-01

    High levels of weight suppression have been associated with greater binge eating and weight gain as well as poorer treatment outcome in bulimia nervosa. This study examined the relationship between weight suppression and bulimia nervosa symptoms and explored how weight suppression might interact with body mass index (BMI) in accounting for level of symptomatology at presentation for treatment. Participants were 64 women with threshold or sub-threshold bulimia nervosa. A clinical interview assessed binge eating and purging. Weight suppression and the interaction between BMI and weight suppression predicted frequency of binge eating such that participants with low BMI and high weight suppression engaged in the most binge eating. High levels of weight suppression also predicted more frequent purging. Additional research is warranted to examine mediators of these relationships. Copyright © 2010 Wiley Periodicals, Inc.

  6. Weight-Related Health Behaviors and Body Mass: Associations between Young Adults and Their Parents, Moderated by Parental Authority

    Science.gov (United States)

    Niemeier, Brandi S.; Hektner, Joel M.

    2012-01-01

    Background: Parents' behaviors could contribute to the development of their children's weight-related health behaviors. Purpose: Relationships of young adults' (N = 151) and their parents' weight-related behaviors were examined along with parental authority styles. Methods: Questionnaires were completed by young adults and their parents.…

  7. The Impact of Kangaroo Care on Premature Infant Weight Gain.

    Science.gov (United States)

    Evereklian, Melvina; Posmontier, Bobbie

    Preterm births occur among 11.4% of all live infant births. Without steady weight gain, premature infants may experience lengthy hospitalizations, neurodevelopmental deficits and hospital readmissions, which can increase the financial burden on the health care system and their families. The total U.S. health-related costs linked to preterm infant deliveries are estimated at $4.33 billion. Kangaroo care is a feasible practice that can improve preterm infant weight gain. However, this intervention is utilized less often throughout the U.S. due to numerous barriers including a lack of consistent protocols, inadequate knowledge, and decreased level of confidence in demonstrating the proper kangarooing technique. An integrative review was conducted to evaluate the impact of kangaroo care on premature infant weight gain in order to educate nurses about its efficacy among preterm infants. A literature search was conducted using CINAHL, PubMed, Cochrane Reviews, ClinicalKey and Google Scholar. Large volume searches were restricted using appropriate filters and limiters. Most of the evaluated studies determined that weight gain was greater among the kangarooing premature infants. Kangaroo care is a low-tech low-cost modality that can facilitate improved preterm infant weight gain even in low-resource settings. Despite its current efficacy, kangaroo care is not widely utilized due to several barriers including an absence of standardized protocols and a lack of knowledge about its benefits. Kangaroo care can become a widespread formalized practice after nurses and parents learn about the technique and its numerous benefits for premature infants, including its association with improved weight gain. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Computerized cost estimation spreadsheet and cost data base for fusion devices

    International Nuclear Information System (INIS)

    Hamilton, W.R.; Rothe, K.E.

    1985-01-01

    Component design parameters (weight, surface area, etc.) and cost factors are input and direct and indirect costs are calculated. The cost data base file derived from actual cost experience within the fusion community and refined to be compatible with the spreadsheet costing approach is a catalog of cost coefficients, algorithms, and component costs arranged into data modules corresponding to specific components and/or subsystems. Each data module contains engineering, equipment, and installation labor cost data for different configurations and types of the specific component or subsystem. This paper describes the assumptions, definitions, methodology, and architecture incorporated in the development of the cost estimation spreadsheet and cost data base, along with the type of input required and the output format

  9. The effects of age, gender, and crash types on drivers' injury-related health care costs.

    Science.gov (United States)

    Shen, Sijun; Neyens, David M

    2015-04-01

    There are many studies that evaluate the effects of age, gender, and crash types on crash related injury severity. However, few studies investigate the effects of those crash factors on the crash related health care costs for drivers that are transported to hospital. The purpose of this study is to examine the relationships between drivers' age, gender, and the crash types, as well as other crash characteristics (e.g., not wearing a seatbelt, weather condition, and fatigued driving), on the crash related health care costs. The South Carolina Crash Outcome Data Evaluation System (SC CODES) from 2005 to 2007 was used to construct six separate hierarchical linear regression models based on drivers' age and gender. The results suggest that older drivers have higher health care costs than younger drivers and male drivers tend to have higher health care costs than female drivers in the same age group. Overall, single vehicle crashes had the highest health care costs for all drivers. For males older than 64-years old sideswipe crashes are as costly as single vehicle crashes. In general, not wearing a seatbelt, airbag deployment, and speeding were found to be associated with higher health care costs. Distraction-related crashes are more likely to be associated with lower health care costs in most cases. Furthermore this study highlights the value of considering drivers in subgroups, as some factors have different effects on health care costs in different driver groups. Developing an understanding of longer term outcomes of crashes and their characteristics can lead to improvements in vehicle technology, educational materials, and interventions to reduce crash-related health care costs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Communicating with children and families about obesity and weight-related topics: a scoping review of best practices.

    Science.gov (United States)

    McPherson, A C; Hamilton, J; Kingsnorth, S; Knibbe, T J; Peters, M; Swift, J A; Krog, K; Chen, L; Steinberg, A; Ball, G D C

    2017-02-01

    Healthcare professionals have called for direction on how best to communicate about weight-related topics with children and families. Established scoping review methodology was used to answer the question: 'How can healthcare professionals best communicate with children and their families about obesity and weight-related topics?' We searched four scientific databases, two grey literature repositories and 14 key journals (2005-2016). Inclusion criteria were (i) children up to and including 18 years of age and/or their parents; (ii) communication about healthy weight, overweight, obesity or healthy/active living; and (iii) healthcare setting. Thirty-two articles were included. Evidence-based best practices were largely absent from the literature, although the following guiding principles were identified: (i) include all stakeholders in discussions; (ii) raise the topic of weight and health early and regularly; (iii) use strengths-based language emphasizing health over weight; (iv) use collaborative goal-setting to engage children and parents and (v) augment discussions with appropriate tools and resources. Guidance on how to implement these principles and how to negotiate relevant contextual factors (e.g. age, culture and disability) is still needed. Despite agreement on a number of guiding principles, evidence-based weight-related communication best practices are lacking. Rigorous, empirical evaluations of communication approaches are urgently required, especially those that include children's perspectives. © 2016 World Obesity Federation.

  11. Objectively measured walkability and active transport and weight-related outcomes in adults: a systematic review.

    Science.gov (United States)

    Grasser, Gerlinde; Van Dyck, Delfien; Titze, Sylvia; Stronegger, Willibald

    2013-08-01

    The aim of this study was to investigate which GIS-based measures of walkability (density, land-use mix, connectivity and walkability indexes) in urban and suburban neighbourhoods are used in research and which of them are consistently associated with walking and cycling for transport, overall active transportation and weight-related measures in adults. A systematic review of English publications using PubMed, Science Direct, Active Living Research Literature Database, the Transportation Research Information Service and reference lists was conducted. The search terms utilised were synonyms for GIS in combination with synonyms for the outcomes. Thirty-four publications based on 19 different studies were eligible. Walkability measures such as gross population density, intersection density and walkability indexes most consistently correlated with measures of physical activity for transport. Results on weight-related measures were inconsistent. More research is needed to determine whether walkability is an appropriate measure for predicting weight-related measures and overall active transportation. As most of the consistent correlates, gross population density, intersection density and the walkability indexes have the potential to be used in planning and monitoring.

  12. Reciprocal longitudinal relations between weight/shape concern and comorbid pathology among women at very high risk for eating disorder onset.

    Science.gov (United States)

    Fitzsimmons-Craft, Ellen E; Eichen, Dawn M; Kass, Andrea E; Trockel, Mickey; Crosby, Ross D; Taylor, C Barr; Wilfley, Denise E

    2017-12-28

    Understanding how known eating disorder (ED) risk factors change in relating to one another over time may inform efficient intervention targets. We examined short-term (i.e., 1 month) reciprocal longitudinal relations between weight/shape concern and comorbid symptoms (i.e., depressed mood, anxiety) and behaviors (i.e., binge drinking) over the course of 24 months using cross-lagged panel models. Participants were 185 women aged 18-25 years at very high risk for ED onset, randomized to an online ED preventive intervention or waitlist control. We also tested whether relations differed based on intervention receipt. Weight/shape concern in 1 month significantly predicted depressed mood the following month; depressed mood in 1 month also predicted weight/shape concern the following month, but the effect size was smaller. Likewise, weight/shape concern in 1 month significantly predicted anxiety the following month, but the reverse was not true. Results showed no temporal relations between weight/shape concern and binge drinking in either direction. Relations between weight/shape concern, and comorbid symptoms and behaviors did not differ based on intervention receipt. Results support focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change. Level I, evidence obtained from a properly designed randomized controlled trial.

  13. Food connections: a qualitative exploratory study of weight- and eating-related distress in families affected by advanced cancer

    OpenAIRE

    Hopkinson, Jane B.

    2016-01-01

    Purpose\\ud \\ud Weight loss and eating problems are common in cancer and have a profound effect on quality of life. They are symptoms of cancer cachexia syndrome.\\ud \\ud This paper examines interdependency between advanced cancer patient and family carer experience of weight- and eating-related problems, leading to proposition of how weight- and eating-related distress might be alleviated in both patients and their family members.\\ud \\ud Methods\\ud \\ud The study was of cross-sectional design. ...

  14. Statement on the conditions of use for health claims related to meal replacements for weight control

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2015-01-01

    ) and maintenance of body weight after weight loss (ID1418) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. Taking into account that the mechanisms by which meal replacements could exert the claimed effects were mostly related to their controlled energy content and the relatively high protein/low fat...... content, the Panel concludes that the differences in the micronutrient composition of meal replacements which would derive from changing the conditions of use from Directive 96/8/EC to Regulation (EU) 1169/2011 do not affect the scientific substantiation of health claims related to meal replacements...

  15. Effects of competing news media frames of weight on antifat stigma, beliefs about weight and support for obesity-related public policies.

    Science.gov (United States)

    Frederick, D A; Saguy, A C; Sandhu, G; Mann, T

    2016-03-01

    In the popular news media, public health officials routinely emphasize the health risks of obesity and portray weight as under personal control. These messages may increase support for policies designed to reduce rates of obesity, but can also increase antifat stigma. Less often, the media cover 'Health at Every Size' or 'Fat Rights' perspectives that may have the opposite effects. We investigated how exposure to different 'fat frames' shifts attitudes about weight and support for obesity policies. Across four experiments (n=2187), people read constructed news articles framing fatness as negative (unhealthy, controllable, acceptable to stigmatize) or positive (healthy, uncontrollable, unacceptable to stigmatize). Compared with people who read fat-positive frames, people who read fat-negative frames expressed more: belief in the health risks of being fat (d=0.95-1.22), belief weight is controllable (d=0.38-0.55), support for charging obese people more for health insurance (d=0.26-0.77), antifat prejudice (in three out of four experiments, d=0.28-0.39), willingness to discriminate against fat people (d=0.39-0.71) and less willingness to celebrate body size diversity (d=0.37-0.64). They were also less willing to say that women at the lower end of the obese range could be healthy at their weights. Effects on support for public policies, however, were generally small and/or nonsignificant. Compared with a control condition, exposure to fat-positive frames generally shifted attitudes more than fat-negative frames. In experiment 4, adding a message about the unacceptability of weight-based discrimination to unhealthy/controllable news articles only reduced antifat stigma on one of three measures compared with articles adding a discrimination-acceptable message. Exposure to different news frames of fat can shift beliefs about weight-related health risks and weight-based stigma. Shifting policy attitudes, however, is more challenging.

  16. Costing in Radiology and Health Care: Rationale, Relativity, Rudiments, and Realities.

    Science.gov (United States)

    Rubin, Geoffrey D

    2017-02-01

    Costs direct decisions that influence the effectiveness of radiology in the care of patients on a daily basis. Yet many radiologists struggle to harness the power of cost measurement and cost management as a critical path toward establishing their value in patient care. When radiologists cannot articulate their value, they risk losing control over how imaging is delivered and supported. In the United States, recent payment trends directing value-based payments for bundles of care advance the imperative for radiology providers to articulate their value. This begins with the development of an understanding of the providers' own costs, as well as the complex interrelationships and imaging-associated costs of other participants across the imaging value chain. Controlling the costs of imaging necessitates understanding them at a procedural level and quantifying the costs of delivering specific imaging services. Effective product-level costing is dependent on a bottom-up approach, which is supported through recent innovations in time-dependent activity-based costing. Once the costs are understood, they can be managed. Within the high fixed cost and high overhead cost environment of health care provider organizations, stakeholders must understand the implications of misaligned top-down cost management approaches that can both paradoxically shift effort from low-cost workers to much costlier professionals and allocate overhead costs counterproductively. Radiology's engagement across a broad spectrum of care provides an excellent opportunity for radiology providers to take a leading role within the health care organizations to enhance value and margin through principled and effective cost management. Following a discussion of the rationale for measuring costs, this review contextualizes costs from the perspectives of a variety of stakeholders (relativity), discusses core concepts in how costs are classified (rudiments), presents common and improved methods for measuring

  17. The Economic Impact of Weight Regain

    OpenAIRE

    Sheppard, Caroline E.; Lester, Erica L. W.; Chuck, Anderson W.; Birch, Daniel W.; Karmali, Shahzeer; de Gara, Christopher J.

    2013-01-01

    Background. Obesity is well known for being associated with significant economic repercussions. Bariatric surgery is the only evidence-based solution to this problem as well as a cost-effective method of addressing the concern. Numerous authors have calculated the cost effectiveness and cost savings of bariatric surgery; however, to date the economic impact of weight regain as a component of overall cost has not been addressed. Methods. The literature search was conducted to elucidate the dir...

  18. INSURANCE AND THE CORPORATE COST OF CAPITAL

    Directory of Open Access Journals (Sweden)

    Monika Wieczorek-Kosmala

    2012-04-01

    Full Text Available The purpose of the paper is to provide some support to the thesis that insurance may reduce the cost of capital in a company by influencing both the cost of capital components and the need for rising capital. The problem is here perceived from two perspectives – the classical concept related to the weighted average cost of capital (WACC and a novel concept related to the risk-based capital structure model with the total average cost of capital (TACC. The paper explains the idea of insurance as a retrospective (post-loss risk financing tool and the risk transfer mechanism upon it. As the risk financing tool insurance reduces the need for the balance-sheet capital in a company and thus the financial distress costs. Also, insurance may reduce the level of operating risk and thus influences the required returns of the capital providers. These observations allow emphasising the impact of insurance on the WACC. However, according to the novel concept of the risk-based capital structure, insurance (as a risk financing tool represents an off-balance sheet capital component. As a consequence, it extends the volume of total capital. The presented conceptual model, based on the TACC concept, indicates that large volume of insurance (the insurance sum and its relatively low cost (the insurance premium gives the possibility to the significant reduction of the cost of capital on average. The concluding remarks discuss some dilemmas over the utility of the TACC concept.

  19. Decidability and Expressiveness of Recursive Weighted Logic

    DEFF Research Database (Denmark)

    Xue, Bingtian; Larsen, Kim Guldstrand; Mardare, Radu Iulian

    2014-01-01

    Labelled weighted transition systems (LWSs) are transition systems labelled with actions and real numbers. The numbers represent the costs of the corresponding actions in terms of resources. RecursiveWeighted Logic (RWL) is a multimodal logic that expresses qualitative and quantitative properties...

  20. Communicating about obesity and weight-related topics with children with a physical disability and their families: spina bifida as an example.

    Science.gov (United States)

    McPherson, Amy C; Swift, Judy A; Peters, Michelle; Lyons, Julia; Joy Knibbe, Tara; Church, Paige; Chen, Lorry; Farrell, Renée M; Willem Gorter, Jan

    2017-04-01

    The purpose of this study was to explore the experiences of children with spina bifida (SB), their families and healthcare professionals (HCPs) when discussing weight-related topics. In-depth qualitative interviews were conducted with HCPs from Canadian outpatient SB clinics (n = 13), children aged 6-18 years with SB (n = 17) and their parents (n = 20). Data were analyzed using a phenomenological approach within an interpretative paradigm. Many HCPs were not confident talking about weight, concerned that they would damage relationships with children and families. Parents wanted routine weight surveillance, but were worried about their children's self-esteem if their weight was discussed. They wanted HCPs to acknowledge the challenges of weight management in children with a physical disability and provide specialized solutions. Children wanted a positively framed and tailored approach to weight discussions, although this had generally not been their experience. Stakeholders describe therapeutic relationships that are currently disconnected around the issue of weight and obesity. However, children, parents and HCPs all believed that discussing this topic was critical. Positively framed, strengths-based and tailored approaches to weight-related discussions are warranted. Implications for Rehabilitation Rates of overweight and obesity in children and youth with physical disabilities are substantially higher than their typically developing peers. Healthcare professionals, children with physical disabilities and families often find weight-related discussions challenging and disconnected. Weight-related discussions should be tailored to the child and family's circumstances and priorities. Positively framed and strengths-based approaches to weight-related discussions are warranted.

  1. Health-related economic costs of the Three-Mile Island accident.

    Science.gov (United States)

    Hu, T W; Slaysman, K S

    1984-01-01

    On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.

  2. Projected reduction in healthcare costs in Belgium after optimization of iodine intake: impact on costs related to thyroid nodular disease.

    Science.gov (United States)

    Vandevijvere, Stefanie; Annemans, Lieven; Van Oyen, Herman; Tafforeau, Jean; Moreno-Reyes, Rodrigo

    2010-11-01

    Several surveys in the last 50 years have repeatedly indicated that Belgium is affected by mild iodine deficiency. Within the framework of the national food and health plan in Belgium, a selective, progressive, and monitored strategy was proposed in 2009 to optimize iodine intake. The objective of the present study was to perform a health economic evaluation of the consequences of inadequate iodine intake in Belgium, focusing on undisputed and measurable health outcomes such as thyroid nodular disease and its associated morbidity (hyperthyroidism). For the estimation of direct, indirect, medical, and nonmedical costs related to thyroid nodular diseases in Belgium, data from the Federal Public Service of Public Health, Food Chain Safety and Environment, the National Institute for Disease and Disability Insurance (RIZIV/INAMI), the Information Network about the prescription of reimbursable medicines (FARMANET), Intercontinental Marketing Services, and expert opinions were used. These costs translate into savings after implementation of the iodization program and are defined as costs due to thyroid nodular disease throughout the article. Costs related to the iodization program are referred to as program costs. Only figures dating from before the start of the intervention were exploited. Only adult and elderly people (≥18 years) were taken into account in this study because thyroid nodular diseases predominantly affect this age group. The yearly costs due to thyroid nodular diseases caused by mild iodine deficiency in the Belgian adult population are ∼€38 million. It is expected that the iodization program will result in additional costs of ∼€54,000 per year and decrease the prevalence of thyroid nodular diseases by 38% after a 4-5-year period. The net savings after establishment of the program are therefore estimated to be at least €14 million a year. Optimization of iodine intake in Belgium should be quite cost effective, if only considering its impact on

  3. Medical care costs incurred by patients with smoking-related non-small cell lung cancer treated at the National Cancer Institute of Mexico.

    Science.gov (United States)

    Arrieta, Oscar; Quintana-Carrillo, Roger Humberto; Ahumada-Curiel, Gabriel; Corona-Cruz, Jose Francisco; Correa-Acevedo, Elma; Zinser-Sierra, Juan; de la Mata-Moya, Dolores; Mohar-Betancourt, Alejandro; Morales-Oyarvide, Vicente; Reynales-Shigematsu, Luz Myriam

    2014-01-01

    Smoking is a public health problem in Mexico and worldwide; its economic impact on developing countries has not been well documented. The aim of this study was to assess the direct medical costs attributable to smoking incurred by lung cancer patients treated at the National Cancer Institute of Mexico (INCan). The study was conducted at INCan in 2009. We carried out a cost of illness (COI) methodology, using data derived from an expert panel consensus and from medical chart review. A panel of experts developed a diagnostic-therapeutic guide that combined the hospital patient pathways and the infrastructure, human resources, technology, and services provided by the medical units at INCan. Cost estimates in Mexican pesos were adjusted by inflation and converted into US Dollars using the 2013 FIX exchange rate for foreign transactions (1 USD = 13.06 Mexican pesos). A 297 incident cases diagnosed with any type of lung cancer were analyzed. According to clinical stage, the costs per patient were 13,456; 35,648; 106,186; and 144,555 USD, for lung cancer stages I, II, III, and IV respectively. The weighted average annual cost/patient was and 139,801 USD and the average annual cost/patient that was attributable to smoking was 92,269 USD. This cost was independent of the clinical stage, with stage IV representing 96% of the annual cost. The total annual cost of smoking-related lung cancer at INCan was 19,969,781 USD. The medical care costs of lung cancer attributable to smoking represent a high cost both for INCan and the Mexican health sector. These costs could be reduced if all provisions established in the Framework Convention of Tobacco Control of the World Health Organization were implemented in Mexico.

  4. Relation between birth weight and blood pressure: longitudinal study of infants and children

    NARCIS (Netherlands)

    L.J. Launer (Lenore); D.E. Grobbee (Diederick); A. Hofman (Albert)

    1993-01-01

    textabstractOBJECTIVE--To study the relation between birth weight and systolic blood pressure in infancy and early childhood. DESIGN--Longitudinal study of infants from birth to 4 years of age. SETTING--A middle class community in the Netherlands. PARTICIPANTS--476

  5. Geometric Least Square Models for Deriving [0,1]-Valued Interval Weights from Interval Fuzzy Preference Relations Based on Multiplicative Transitivity

    Directory of Open Access Journals (Sweden)

    Xuan Yang

    2015-01-01

    Full Text Available This paper presents a geometric least square framework for deriving [0,1]-valued interval weights from interval fuzzy preference relations. By analyzing the relationship among [0,1]-valued interval weights, multiplicatively consistent interval judgments, and planes, a geometric least square model is developed to derive a normalized [0,1]-valued interval weight vector from an interval fuzzy preference relation. Based on the difference ratio between two interval fuzzy preference relations, a geometric average difference ratio between one interval fuzzy preference relation and the others is defined and employed to determine the relative importance weights for individual interval fuzzy preference relations. A geometric least square based approach is further put forward for solving group decision making problems. An individual decision numerical example and a group decision making problem with the selection of enterprise resource planning software products are furnished to illustrate the effectiveness and applicability of the proposed models.

  6. A novel weight determination method for time series data aggregation

    Science.gov (United States)

    Xu, Paiheng; Zhang, Rong; Deng, Yong

    2017-09-01

    Aggregation in time series is of great importance in time series smoothing, predicting and other time series analysis process, which makes it crucial to address the weights in times series correctly and reasonably. In this paper, a novel method to obtain the weights in time series is proposed, in which we adopt induced ordered weighted aggregation (IOWA) operator and visibility graph averaging (VGA) operator and linearly combine the weights separately generated by the two operator. The IOWA operator is introduced to the weight determination of time series, through which the time decay factor is taken into consideration. The VGA operator is able to generate weights with respect to the degree distribution in the visibility graph constructed from the corresponding time series, which reflects the relative importance of vertices in time series. The proposed method is applied to two practical datasets to illustrate its merits. The aggregation of Construction Cost Index (CCI) demonstrates the ability of proposed method to smooth time series, while the aggregation of The Taiwan Stock Exchange Capitalization Weighted Stock Index (TAIEX) illustrate how proposed method maintain the variation tendency of original data.

  7. Effect of plyometric vs. dynamic weight training on the energy cost of running.

    Science.gov (United States)

    Berryman, Nicolas; Maurel, Delphine B; Bosquet, Laurent

    2010-07-01

    The purpose of this study is to compare the effects of 2 strength training methods on the energy cost of running (Cr). Thirty-five moderately to well-trained male endurance runners were randomly assigned to either a control group (C) or 2 intervention groups. All groups performed the same endurance-training program during an 8-week period. Intervention groups added a weekly strength training session designed to improve neuromuscular qualities. Sessions were matched for volume and intensity using either plyometric training (PT) or purely concentric contractions with added weight (dynamic weight training [DWT]). We found an interaction between time and group (p < 0.05) and an effect of time (p < 0.01) for Cr. Plyometric training induced a larger decrease of Cr (218 +/- 16 to 203 +/- 13 ml.kg.km) than DWT (207 +/- 15 to 199 +/- 12 ml.kg.km), whereas it remained unchanged in C. Pre-post changes in Cr were correlated with initial Cr (r = -0.57, p < 0.05). Peak vertical jump height (VJHpeak) increased significantly (p < 0.01) for both experimental groups (DWT = 33.4 +/- 6.2 to 34.9 +/- 6.1 cm, PT = 33.3 +/- 4.0 to 35.3 +/- 3.6 cm) but not for C. All groups showed improvements (p < 0.05) in Perf3000 (C = 711 +/- 107 to 690 +/- 109 seconds, DWT = 755 +/- 87 to 724 +/- 77 seconds, PT = 748 +/- 81 to 712 +/- 76 seconds). Plyometric training were more effective than DWT in improving Cr in moderately to well-trained male endurance runners showing that athletes and coaches should include explosive strength training in their practices with a particular attention on plyometric exercises. Future research is needed to establish the origin of this adaptation.

  8. Relationship between paraspinal muscle cross-sectional area and relative proprioceptive weighting ratio of older persons with lumbar spondylosis.

    Science.gov (United States)

    Ito, Tadashi; Sakai, Yoshihito; Nakamura, Eishi; Yamazaki, Kazunori; Yamada, Ayaka; Sato, Noritaka; Morita, Yoshifumi

    2015-07-01

    [Purpose] The purpose of this study was to examine the relationship between the paraspinal muscle cross-sectional area and the relative proprioceptive weighting ratio during local vibratory stimulation of older persons with lumbar spondylosis in an upright position. [Subjects] In all, 74 older persons hospitalized for lumbar spondylosis were included. [Methods] We measured the relative proprioceptive weighting ratio of postural sway using a Wii board while vibratory stimulations of 30, 60, or 240 Hz were applied to the subjects' paraspinal or gastrocnemius muscles. Back strength, abdominal muscle strength, and erector spinae muscle (L1/L2, L4/L5) and lumbar multifidus (L1/L2, L4/L5) cross-sectional areas were evaluated. [Results] The erector spinae muscle (L1/L2) cross-sectional area was associated with the relative proprioceptive weighting ratio during 60Hz stimulation. [Conclusion] These findings show that the relative proprioceptive weighting ratio compared to the erector spinae muscle (L1/L2) cross-sectional area under 60Hz proprioceptive stimulation might be a good indicator of trunk proprioceptive sensitivity.

  9. Relation between Protein Intrinsic Normal Mode Weights and Pre-Existing Conformer Populations.

    Science.gov (United States)

    Ozgur, Beytullah; Ozdemir, E Sila; Gursoy, Attila; Keskin, Ozlem

    2017-04-20

    Intrinsic fluctuations of a protein enable it to sample a large repertoire of conformers including the open and closed forms. These distinct forms of the protein called conformational substates pre-exist together in equilibrium as an ensemble independent from its ligands. The role of ligand might be simply to alter the equilibrium toward the most appropriate form for binding. Normal mode analysis is proved to be useful in identifying the directions of conformational changes between substates. In this study, we demonstrate that the ratios of normalized weights of a few normal modes driving the protein between its substates can give insights about the ratios of kinetic conversion rates of the substates, although a direct relation between the eigenvalues and kinetic conversion rates or populations of each substate could not be observed. The correlation between the normalized mode weight ratios and the kinetic rate ratios is around 83% on a set of 11 non-enzyme proteins and around 59% on a set of 17 enzymes. The results are suggestive that mode motions carry intrinsic relations with thermodynamics and kinetics of the proteins.

  10. Design windows and cost analysis on helical reactors

    International Nuclear Information System (INIS)

    Kozaki, Y.; Imagawa, S.; Sagara, A.

    2007-01-01

    The LHD type helical reactors are characterized by a large major radius but slender helical coil, which give us different approaches for power plants from tokamak reactors. For searching design windows of helical reactors and discussing their potential as power plants, we have developed a mass-cost estimating model linked with system design code (HeliCos), thorough studying the relationships between major plasma parameters and reactor parameters, and weight of major components. In regard to cost data we have much experience through preparing ITER construction. To compare the weight and cost of magnet systems between tokamak and helical reactors, we broke down magnet systems and cost factors, such as weights of super conducting strands, conduits, support structures, and winding unit costs, through estimating ITER cost data basis. Based on FFHR2m1 deign we considered a typical 3 GWth helical plant (LHD type) with the same magnet size, coil major radius Rc 14 m, magnetic energy 120 GJ, but increasing plasma densities. We evaluated the weight and cost of magnet systems of 3 GWth helical plant, the total magnet weights of 16,000ton and costs of 210 BYen, which are similar values of tokamak reactors (10,200 ton, 110 BYen in ITER 2002 report, and 21,900 ton, 275 BYen in ITER FDR1999). The costs of strands and winding occupy 70% of total magnet costs, and influence entire power plants economics. The design windows analysis and comparative economics studies to optimize the main reactor parameters have been carried out. Economics studies show that it is misunderstanding to consider helical coils are too large and too expensive to achieve power plants. But we should notice that the helical reactor design windows and economics are very sensitive to allowable blanket space (depend on ergodic layer conditions) and diverter configuration for decreasing heat loads. (orig.)

  11. Genetic evidence for causal relationships between maternal obesity-related traits and birth weight

    NARCIS (Netherlands)

    A.W.R. Tyrrell; R.C. Richmond (Rebecca C.); T.M. Palmer (Tom); B. Feenstra (Bjarke); J. Rangarajan (Janani); S. Metrustry (Sarah); A. Cavadino (Alana); L. Paternoster (Lavinia); L.L. Armstrong (Loren L.); N.M.G. De Silva (N. Maneka G.); A.R. Wood (Andrew); M. Horikoshi (Momoko); F. Geller (Frank); R. Myhre (Ronny); J.P. Bradfield (Jonathan); E. Kreiner-Møller (Eskil); I. Huikari (Ille); J.N. Painter (Jodie N.); J.J. Hottenga (Jouke Jan); C. Allard (Catherine); D. Berry (Diane); L. Bouchard (Luigi); S. Das (Shikta); D.M. Evans (David); H. Hakonarson (Hakon); M.G. Hayes (M. Geoffrey); J. Heikkinen (Jani); A. Hofman (Albert); B.A. Knight (Bridget); P.A. Lind (Penelope); M.I. McCarthy (Mark); G. Mcmahon (George); S.E. Medland (Sarah Elizabeth); M. Melbye (Mads); A.P. Morris (Andrew); M. Nodzenski (Michael); C. Reichetzeder (Christoph); S.M. Ring (Susan); S. Sebert (Sylvain); V. Sengpiel (Verena); T.I.A. Sørensen (Thorkild); G.A.H.M. Willemsen (Gonneke); E.J.C. de Geus (Eco); N.G. Martin (Nicholas); T.D. Spector (Timothy); C. Power (Christine); M.-R. Jarvelin (Marjo-Riitta); H. Bisgaard (Hans); S.F.A. Grant (Struan); C. Nohr (Christian); V.W.V. Jaddoe (Vincent); B. Jacobsson (Bo); J.C. Murray (Jeffrey C.); B. Hocher (Berthold); A.T. Hattersley (Andrew); D.M. Scholtens (Denise M.); G.D. Smith; M.-F. Hivert (Marie-France); J.F. Felix (Janine); E. Hypponen (Elina); W.L. Lowe Jr. (William); T.M. Frayling (Timothy); D.A. Lawlor (Debbie); R.M. Freathy (Rachel)

    2016-01-01

    textabstractIMPORTANCE Neonates born to overweight or obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. OBJECTIVE To test for genetic

  12. Relating shape/weight based self-esteem, depression, and anxiety with weight and perceived physical health among young adults.

    Science.gov (United States)

    Kamody, Rebecca C; Thurston, Idia B; Decker, Kristina M; Kaufman, Caroline C; Sonneville, Kendrin R; Richmond, Tracy K

    2018-06-01

    Simultaneous contributions of self-esteem, depression, and anxiety to weight and perceived physical health in young adults is understudied. A diverse sample of 424 young adults completed measures of shape/weight based self-esteem, depression, anxiety, and perceived physical health. Height and weight were measured to calculate body mass index (BMI). Latent profile analysis was conducted to derive patterns of depression, anxiety, and shape/weight based self-esteem. Then, we examined the association of the profiles with weight status and perceived physical health. Three profiles emerged: (1) High Shape/Weight Influence (HSWI); (2) Low Shape/Weight, Depression, & Anxiety Influence (LSWDAI); and (3) High Depression & Anxiety Influence (HDAI). The HSWI profile had significantly higher BMI than the LSWDAI and HDAI profiles, and significantly lower perceived physical health than the LSWDAI profile. Over emphasis on shape/weight, regardless of depression and anxiety, is associated with elevated weight and negative internalized health views. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Parameters of Dismantling Techniques Related to Costs for Decommissioning of Nuclear Facilities

    International Nuclear Information System (INIS)

    Jeong, Kwanseong; Moon, Jeikwon; Choi, Byungseon

    2012-01-01

    Reliable cost estimating is one of the most important elements of decommissioning operation. Reliable cost estimating is one of the most important elements of decommissioning planning. Alternative technologies may be evaluated and compared on their efficiency and effectiveness, and measured against a baseline cost as to the feasibility and benefit derived from the technology. This principle ensures that the cost consideration is economically sound and practical for funding. This paper provides a list with basic review of cutting and dismantling techniques, including some typical characteristics if available, as well as aspects of implementation, parameters of cutting and dismantling techniques in decommissioning costing. This paper gives an overview of the principles of the unit factor approach and its implementation in costing in relation to dismantling activities. In general, proper evaluation of decommissioning costs is important for following issues and relevant measures for achieving the listed aspects are: · Selection of a decommissioning strategy and activities: several decommissioning options should be evaluated: · Support to a cost-benefit analysis to ensure that the principle of optimization and reasonably practicable measures are applied: the extent of evaluated decommissioning options should cover all possible scenarios for dismantling activities; · Estimate of required financial resources for the selected strategy: the selected option should involve the dismantling activities in a structure and extent relevant to real procedure of dismantling activities; · Preparation of the project schedule, workforce requirements and phased funding needs: dismantling activities should be structured according to the tasks of the decommissioning schedule; · Definition of measures for proper management and maintenance of resources for safe and timely decommissioning: the time distribution and safety related parameters of dismantling activities should be known

  14. Stocks and flows of lead-based wheel weights in the United States

    Science.gov (United States)

    Bleiwas, Donald I.

    2006-01-01

    Lead is used in many widely known applications, such as automobile batteries and radiation shielding. Another lesser known, but long-term, use of lead is in automotive vehicle wheel weights. Lead weights have been used to balance wheels since the 1930s because of its high specific gravity, low relative cost, and its malleability. Out-of-balance tires tend to 'cup' and vibrate and as a result cause excessive wear on tires and vehicle suspension components and result in compromised handling, especially at high speeds. The mass, number, and style of weights needed to balance a wheel depend on the tire's size and weight and on the type and condition of the wheels (rims) on the vehicle. This study addresses an accounting of the stocks and flows of lead contained in lead wheel weights from their manufacture, through use, dissipation, and recycling, and environmental issues associated with the use of lead.

  15. Relative Error Model Reduction via Time-Weighted Balanced Stochastic Singular Perturbation

    DEFF Research Database (Denmark)

    Tahavori, Maryamsadat; Shaker, Hamid Reza

    2012-01-01

    A new mixed method for relative error model reduction of linear time invariant (LTI) systems is proposed in this paper. This order reduction technique is mainly based upon time-weighted balanced stochastic model reduction method and singular perturbation model reduction technique. Compared...... by using the concept and properties of the reciprocal systems. The results are further illustrated by two practical numerical examples: a model of CD player and a model of the atmospheric storm track....

  16. Childhood Anorexia Nervosa Compared with Low Weight Food Intake Disorder Without Weight and Shape-Related Psychopathology: A Retrospective Study of 102 Patients.

    Science.gov (United States)

    Wallin, Ulf; Råstam, Maria

    2016-07-01

    To compare the clinical presentation of children with anorexia nervosa (AN group) with that of children with low-weight food intake disorder without weight and shape-related psychopathology (non-AN group). Medical and psychiatric data were obtained from the case records of a consecutive series of 102 children with an eating disorder and a pronounced low weight who were below the age of 13 at the start of treatment. Fifty-eight patients constituted the AN group, and 44 constituted the non-AN group. The non-AN group was younger and had a longer duration of symptoms than the AN group. The non-AN group also had a lower maximum premorbid weight and shorter stature. There were no differences in medical severity, but the AN group had more psychiatric treatment. The non-AN group seems to have a medically equally severe disorder as the AN group, but is less often detected and properly treated. Copyright © 2016 The Authors European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd. Copyright © 2016 The Authors European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.

  17. Low birth weight in relation to maternal age and multiple ...

    African Journals Online (AJOL)

    Vihar

    Objectives: To determine the relationship between Low Birth Weight (LBW), maternal age and multiple ... mothers. Low socio-economic status is the underlying ... rate of low birth weight infants. ... Table 3: Distribution of Age against Birth weight.

  18. Relative Greenhouse Gas Abatement Cost Competitiveness of Biofuels in Germany

    Directory of Open Access Journals (Sweden)

    Markus Millinger

    2018-03-01

    Full Text Available Transport biofuels derived from biogenic material are used for substituting fossil fuels, thereby abating greenhouse gas (GHG emissions. Numerous competing conversion options exist to produce biofuels, with differing GHG emissions and costs. In this paper, the analysis and modeling of the long-term development of GHG abatement and relative GHG abatement cost competitiveness between crop-based biofuels in Germany are carried out. Presently dominant conventional biofuels and advanced liquid biofuels were found not to be competitive compared to the substantially higher yielding options available: sugar beet-based ethanol for the short- to medium-term least-cost option and substitute natural gas (SNG for the medium to long term. The competitiveness of SNG was found to depend highly on the emissions development of the power mix. Silage maize-based biomethane was found competitive on a land area basis, but not on an energetic basis. Due to land limitations, as well as cost and GHG uncertainty, a stronger focus on the land use of crop-based biofuels should be laid out in policy.

  19. Weighted Branching Simulation Distance for Parametric Weighted Kripke Structures

    DEFF Research Database (Denmark)

    Foshammer, Louise; Larsen, Kim Guldstrand; Mariegaard, Anders

    2016-01-01

    This paper concerns branching simulation for weighted Kripke structures with parametric weights. Concretely, we consider a weighted extension of branching simulation where a single transitions can be matched by a sequence of transitions while preserving the branching behavior. We relax this notion...... to allow for a small degree of deviation in the matching of weights, inducing a directed distance on states. The distance between two states can be used directly to relate properties of the states within a sub-fragment of weighted CTL. The problem of relating systems thus changes to minimizing the distance...... which, in the general parametric case, corresponds to finding suitable parameter valuations such that one system can approximately simulate another. Although the distance considers a potentially infinite set of transition sequences we demonstrate that there exists an upper bound on the length...

  20. Weight-related actual and ideal self-states, discrepancies, and shame, guilt, and pride: examining associations within the process model of self-conscious emotions.

    Science.gov (United States)

    Castonguay, Andree L; Brunet, Jennifer; Ferguson, Leah; Sabiston, Catherine M

    2012-09-01

    The aim of this study was to examine the associations between women's actual:ideal weight-related self-discrepancies and experiences of weight-related shame, guilt, and authentic pride using self-discrepancy (Higgins, 1987) and self-conscious emotion (Tracy & Robins, 2004) theories as guiding frameworks. Participants (N=398) completed self-report questionnaires. Main analyses involved polynomial regressions, followed by the computation and evaluation of response surface values. Actual and ideal weight self-states were related to shame (R2 = .35), guilt (R2 = .25), and authentic pride (R2 = .08). When the discrepancy between actual and ideal weights increased, shame and guilt also increased, while authentic pride decreased. Findings provide partial support for self-discrepancy theory and the process model of self-conscious emotions. Experiencing weight-related self-discrepancies may be important cognitive appraisals related to shame, guilt, and authentic pride. Further research is needed exploring the relations between self-discrepancies and a range of weight-related self-conscious emotions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. 78 FR 17300 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

    Science.gov (United States)

    2013-03-21

    ... and II Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and... Relating to Grants and Cooperative Agreements; Cost Principles and Administrative Requirements (Including...

  2. Body weight concerns: Cross-national study and identification of factors related to eating disorders

    Science.gov (United States)

    da Silva, Wanderson Roberto; Santana, Moema de Souza; Maroco, João; Maloa, Benvindo Felismino Samuel

    2017-01-01

    Background Body weight concerns are common among individuals with eating disorders, and this construct can be assessed using psychometric instruments. The Weight Concerns Scale (WCS) is commonly used to assess body weight concerns. Aims To evaluate the psychometric properties of the WCS with Brazilian, Portuguese, and Mozambican female college students; to estimate body weight concerns; and to identify factors related to eating disorders. Methods Confirmatory factor analysis was performed. Factorial, convergent, concurrent, and divergent validity, as well as reliability, were assessed. Cross-national invariance was tested by means of multigroup analysis. Structural models were tested using the WCS as the dependent variable, while demographic and academic variables and body mass index were used as independent variables. Logistic models were tested to estimate the likelihood of eating disorders being developed in specific groups. Results Participants were 2,068 female students. The psychometric properties of the WCS were adequate for the Portuguese sample; however, for the Brazilian and Mozambican samples, it was necessary to correlate the errors of two items to improve model fit. The WCS did not show cross-national invariance. The variables “thoughts about dropping out of college,” “medication use because of studies,” “medication and supplements use for body change,” “body mass index,” “socioeconomic status,” “age,” and “performance in course” were significant predictors of body weight concerns. Overall, 24.4% (95% confidence interval = 22.9–26.7) of the students were likely to develop eating disorders. Students under 21 years old, who use medication and supplements for body change, and who were classified as overweight/obese have increased likelihood of developing eating disorders. Conclusion The WCS showed good psychometric properties with Brazilian, Portuguese, and Mozambican students; however, it did not show cross

  3. Egg weights, egg component weights, and laying gaps in Great Tits (Parus major) in relation to ambient temperature

    NARCIS (Netherlands)

    Lessells, C.M.; Dingemanse, N.J.; Both, C.; Blem, C.

    2002-01-01

    We collected 328 freshly laid Great Tit (Parus major) eggs from 38 clutches in 1999 to determine the relationship of whole egg weight, wet yolk weight, wet albumen weight, dry shell weight, and the occurrence of laying gaps with mean ambient temperature in the three days preceding laying, while

  4. Egg weights, egg component weights, and laying gaps in great tits (Parus major) in relation to ambient temperature.

    NARCIS (Netherlands)

    Lessells, C.M.; Dingemanse, N.J.; Both, C.

    2002-01-01

    We collected 328 freshly laid Great Tit (Parus major) eggs from 38 clutches in 1999 to determine the relationship of whole egg weight, wet yolk weight, wet albumen weight, dry shell weight, and the occurrence of laying gaps with mean ambient temperature in the three days preceding laying, while

  5. ESTIMATION OF YELLOWFIN TUNA PRODUCTION LANDED IN BENOA PORT WITH WEIGHT-WEIGHT, LENGTH-WEIGHT RELATIONSHIPS AND CONDITION FACTOR APPROACHES

    Directory of Open Access Journals (Sweden)

    Irwan Jatmiko

    2017-01-01

    Full Text Available Yellowfin tuna (Thunnus albacares is one of the important catch for the fishing industry in Indonesia. Length-weight relationship study is one of important tools to support fisheries management. However it could not be done to yellowfin tuna landed in Benoa port since they are in the form of gilled-gutted condition. The objectives of this study are to determine the relationship between gilled-gutted weight (GW and whole weight (WW, to calculate length weight relationship between fork length (FL and estimated whole weight (WW and to assess the relative condition factor (Kn of yellowfin tuna in Eastern Indian Ocean. Data were collected from three landing sites i.e. Malang, East Java; Benoa, Bali and Kupang, East Nusa Tenggara from January 2013 to February 2014. Linear regression analysis applied to test the significance baseline between weight-weight relationships and log transformed length weight relationship. Relative condition factor (Kn used to identify fish condition among length groups and months. The results showed a significant positive linear relationships between whole weight (WW and gilled-gutted weight (GW of T. albacares (p<0.001. There was a significant positive linier relationships between log transformed fork length and log transformed whole weight of T. albacares (p<0.001. Relative condition factor (Kn showed declining pattern along with length increase and varied among months. The findings from this study provide data for management of yellowfin tuna stock and population.

  6. The relation of age to low birth weight rates among foreign-born black mothers: a population-based exploratory study.

    Science.gov (United States)

    Deal, Stephanie B; Bennett, Amanda C; Rankin, Kristin M; Collins, James W

    2014-01-01

    In stark contrast to the J or U- shaped relationship between age and low birth weight rates (birth weight rates among US-born Blacks are lowest in their teens and rise with increasing age (ie, weathering). The age-related pattern of low birth weight rates among foreign-born Black mothers is unknown. To determine the relationship between age and low birth weight rates among foreign-born Black mothers. Stratified analyses were performed on the 2003-2004 National Center for Health Statistics vital record datasets of foreign-born Black mothers. Maternal age was categorized into six subgroups. Potential confounding variables examined included marital status, parity, and prenatal care usage. Foreign-born Black mothers (N = 143,235) demonstrated a J/U-shaped age-related pattern of low birth weight rates with the lowest rates observed among those in their twenties and early thirties. The subgroups of 15-19 and 35-39 year old mothers had low birth weight rates of 12.0% and 11.4% compared to 9.1% for 25-29 year old mothers; RR = 1.31 (1.22-1.42) and 1.25 (1.20-1.31), respectively. The J/U-shaped age-related pattern persisted independent of marital status, parity and prenatal care usage. Foreign-born black mothers do not exhibit a weathering pattern of rising low birth weight rates with advancing age regardless of traditional individual-level risk factors. Further research into the age-related pattern of birth outcome among impoverished foreign-born Black mothers is warranted.

  7. The Social Costs of Health-related Early Retirement in Germany

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela; Stolpe, Michael

    2012-01-01

    Using data from the German Socio-economic Panel, we study how stratification in health and income contributes to the social cost of health-related early retirement, the balance of lost labour income and health benefits. On average, early retirees improve their health by almost two thirds...... of the loss suffered during the last four working years. We calibrate counterfactual scenarios and find keeping all workers in very good health, the highest of five categories of self-assessed health, would delay the average retirement age by more than three years and reduce the social costs by more than 20...

  8. An economic evaluation: Simulation of the cost-effectiveness and cost-utility of universal prevention strategies against osteoporosis-related fractures.

    Science.gov (United States)

    Nshimyumukiza, Léon; Durand, Audrey; Gagnon, Mathieu; Douville, Xavier; Morin, Suzanne; Lindsay, Carmen; Duplantie, Julie; Gagné, Christian; Jean, Sonia; Giguère, Yves; Dodin, Sylvie; Rousseau, François; Reinharz, Daniel

    2013-02-01

    A patient-level Markov decision model was used to simulate a virtual cohort of 500,000 women 40 years old and over, in relation to osteoporosis-related hip, clinical vertebral, and wrist bone fractures events. Sixteen different screening options of three main scenario groups were compared: (1) the status quo (no specific national prevention program); (2) a universal primary prevention program; and (3) a universal screening and treatment program based on the 10-year absolute risk of fracture. The outcomes measured were total directs costs from the perspective of the public health care system, number of fractures, and quality-adjusted life-years (QALYs). Results show that an option consisting of a program promoting physical activity and treatment if a fracture occurs is the most cost-effective (CE) (cost/fracture averted) alternative and also the only cost saving one, especially for women 40 to 64 years old. In women who are 65 years and over, bone mineral density (BMD)-based screening and treatment based on the 10-year absolute fracture risk calculated using a Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool is the best next alternative. In terms of cost-utility (CU), results were similar. For women less than 65 years old, a program promoting physical activity emerged as cost-saving but BMD-based screening with pharmacological treatment also emerged as an interesting alternative. In conclusion, a program promoting physical activity is the most CE and CU option for women 40 to 64 years old. BMD screening and pharmacological treatment might be considered a reasonable alternative for women 65 years old and over because at a healthcare capacity of $50,000 Canadian dollars ($CAD) for each additional fracture averted or for one QALY gained its probabilities of cost-effectiveness compared to the program promoting physical activity are 63% and 75%, respectively, which could be considered socially acceptable. Consideration of the indirect costs could

  9. Differences in hospital casemix, and the relationship between casemix and hospital costs.

    Science.gov (United States)

    Söderlund, N; Milne, R; Gray, A; Raftery, J

    1995-03-01

    The aim of the study was to examine the relationship between hospital costs and casemix, and after adjustment for casemix differences, between cost and institutional size, number of specialties, occupancy and teaching status. A retrospective analysis of all admissions to nine acute-care NHS hospitals in the Oxford region during the 1991-1992 financial year was undertaken. All episodes were assigned to a diagnosis-related group (DRG) and a cost weight assigned accordingly. Costs per finished consultant episode, before and after adjustment for casemix differences, were analysed at the hospital and specialty level. Casemix differences were significant, and accounted for approximately 77 per cent of the difference in costs between providers. Costs per casemix-adjusted episode were not significantly associated with differences in hospital size, scope, occupancy levels or teaching status, but sample size was insufficient to investigate these relationships adequately. Specialty costs were poorly correlated with specialty casemix. This was probably due to poor apportionment of specialty costs in hospital accounting returns. Casemix differences need to be taken into account when comparing providers for the purposes of contracting, as unadjusted unit costs may be misleading. Although the methods used may currently be applied to most NHS hospitals, widespread use would be greatly facilitated by the development of indigenous cost weights and better routine hospital data coding and collection.

  10. Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial

    OpenAIRE

    Rushing, J.; Wing, R.; Wadden, T. A.; Knowler, W. C.; Lawlor, M.; Evans, M.; Killean, T.; Montez, M.; Espeland, M. A.; Zhang, P.

    2017-01-01

    Summary Objective The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10?years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention. Methods The ...

  11. Health-related quality of life for extremely low birth weight adolescents in Canada, Germany, and the Netherlands

    NARCIS (Netherlands)

    Verrips, E.; Vogels, T.; Saigal, S.; Wolke, D.; Meyer, R.; Hoult, L.; Verloove-Vanhorick, S.P.

    2008-01-01

    OBJECTIVE.The goal was to compare health-related quality of life of 12- to 16-year-old adolescents born at an extremely low birth weight in regional cohorts from Ontario (Canada), Bavaria (Germany), and the Netherlands. METHODS. Patients were extremely low birth weight survivors from Canada,

  12. Weight-Aware Sensor Deployment in Wireless Sensor Networks for Smart Cities

    Directory of Open Access Journals (Sweden)

    Mingshan Xie

    2018-01-01

    Full Text Available During the construction of wireless sensor networks (WSNs for smart cities, a preliminary survey of the relative criticalness within the monitored area can be performed. It is a challenge for deterministic sensor deployment to balance the tradeoff of sensing reliability and cost. In this paper, based on the sensing accuracy of the sensor, we establish a reliability model of the sensing area which is divided into sensing grids, and different weights are allocated to those grids. We employ a practical evaluation criterion using seesaw mapping for determining the weights of sensing grids. We further formulate and solve an optimization problem for maximizing the trust degree of the WSNs. With our proposed method, the efficient deployment of sensors can be realized. Simulation results show that our proposed deployment strategy can achieve higher trust degree with reduced sensor deployment cost and lower number of sensors at a certain miss probability threshold.

  13. Cost-effectiveness of per oral endoscopic myotomy relative to laparoscopic Heller myotomy for the treatment of achalasia.

    Science.gov (United States)

    Greenleaf, Erin K; Winder, Joshua S; Hollenbeak, Christopher S; Haluck, Randy S; Mathew, Abraham; Pauli, Eric M

    2018-01-01

    Per oral endoscopic myotomy (POEM) has recently emerged as a viable option relative to the classic approach of laparoscopic Heller myotomy (LHM) for the treatment of esophageal achalasia. In this cost-utility analysis of POEM and LHM, we hypothesized that POEM would be cost-effective relative to LHM. A stochastic cost-utility analysis of treatment for achalasia was performed to determine the cost-effectiveness of POEM relative to LHM. Costs were estimated from the provider perspective and obtained from our institution's cost-accounting database. The measure of effectiveness was quality-adjusted life years (QALYs) which were estimated from direct elicitation of utility using a visual analog scale. The primary outcome was the incremental cost-effectiveness ratio (ICER). Uncertainty was assessed by bootstrapping the sample and computing the cost-effectiveness acceptability curve (CEAC). Patients treated within an 11-year period (2004-2016) were recruited for participation (20 POEM, 21 LHM). During the index admission, the mean costs for POEM ($8630 ± $2653) and the mean costs for LHM ($7604 ± $2091) were not significantly different (P = 0.179). Additionally, mean QALYs for POEM (0.413 ± 0.248) were higher than that associated with LHM (0.357 ± 0.338), but this difference was also not statistically significant (P = 0.55). The ICER suggested that it would cost an additional $18,536 for each QALY gained using POEM. There was substantial uncertainty in the ICER; there was a 48.25% probability that POEM was cost-effective at the mean ICER. At a willingness-to-pay threshold of $100,000, there was a 68.31% probability that POEM was cost-effective relative to LHM. In the treatment of achalasia, POEM appears to be cost-effective relative to LHM depending on one's willingness-to-pay for an additional QALY.

  14. The effects of antipsychotics on weight gain, weight-related hormones and homocysteine in children and adolescents: a 1-year follow-up study.

    Science.gov (United States)

    Baeza, Inmaculada; Vigo, Laura; de la Serna, Elena; Calvo-Escalona, Rosa; Merchán-Naranjo, Jessica; Rodríguez-Latorre, Pamela; Arango, Celso; Castro-Fornieles, Josefina

    2017-01-01

    To analyze weight gain, metabolic hormones, and homocysteine (Hcys) levels in children and adolescents on antipsychotics (AP) during a year-long follow-up. 117 patients, AP-naïve or quasi-naïve (less than 30 days on AP), were included. Weight, body mass index (BMI), BMI z-score (z-BMI), and levels of leptin, insulin, insulin resistance (HOMA-IR), adiponectin, ghrelin, thyroid stimulating hormone (TSH), free thyroxine (FT4), and Hcys were measured at baseline, and at 3, 6, and 12 months, while patients remained on the same AP. Patients (mean age: 14.4 ± 3 years; 64.1 % male) were on risperidone (N = 84), olanzapine (N = 20) or quetiapine (N = 13) from baseline up to 1-year follow-up and significantly increased weight (5.8 ± 4.3 kg at 3-month, 8.1 ± 6.1 kg at 6-month, and 11.6 ± 7.0 kg at 1 year), BMI, and z-BMI. Leptin levels significantly increased from baseline to 3 and 6 months, as did TSH levels from baseline to 3 months, while FT4 levels decreased from baseline to 3 and 6 months. Patients with BMI >85th percentile at baseline (N = 16) significantly increased weight, BMI, and z-BMI, more than patients with normal BMI over time. Higher baseline levels of insulin, HOMA-IR, and leptin were associated with increased weight/BMI during follow-up, while higher baseline levels of FT4, adiponectin, and ghrelin were associated with lower weight/BMI during follow-up. All AP were associated with increased weight and BMI/z-BMI in all of the assessments; however, at 1-year assessment, this increase was significantly higher for patients on quetiapine. Both higher baseline levels of insulin, HOMA-IR, and leptin, as well as being overweight/obese at baseline were associated with increased weight/BMI during 1-year follow-up in children and adolescents on AP. Awareness of weight-related parameters in this population may help inform decisions regarding AP prescriptions.

  15. [Costs of temporary disability in Spain related to diabetes mellitus and its complications].

    Science.gov (United States)

    Vicente-Herrero, M Teófila; Terradillos García, M Jesús; Capdevila García, Luisa M; Ramírez Iñiguez de la Torre, M Victoria; López-González, Angel Arturo

    2013-10-01

    To ascertain the socioeconomic impact of diabetes, it is essential to estimate overall costs, including both direct and indirect costs (premature retirements, working hours lost, or sick leaves). This study analyzed indirect costs for temporary disability (TD) due to diabetes and its complications in Spain in 2011 by assessing the related ICD-9 MC codes. For this purpose, the number of TD processes and their mean duration were recorded. The indirect costs associated to loss of working days were also estimated. In 2011, diabetes and its complications were related to 2.567 TD processes, which resulted in the loss of 154.214 days. In terms of costs, this disease represented for Spanish public health administrations an expense of 3,297.095.3 €, with an estimated cost per patient and year of 141 €. These data suggest an urgent need to devise plans for prevention and early diagnosis of diabetes and its complications, as well as programs to optimize the available health care resources by creating multidisciplinary teams where occupational medical services assume an important role. A decrease in absenteeism would result in benefits for diabetic patients, society overall, and companies or public institutions. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  16. [Status and related factors for gestational weight gain of Chinese pregnant women during 2010-2012].

    Science.gov (United States)

    Bi, Y; Duan, Y F; Wang, J; Jiang, S; Pang, X H; Yin, S A; Yang, Z Y; Lai, J Q

    2018-01-06

    Objective: To examine the status and related factors for gestational weight gain of Chinese pregnant women at different trimesters in 2010-2012. Methods: Participants were from Chinese National Nutrition and Health Surveillance in 2010-2012. Using a multi-stage stratified cluster random sampling method, we recruited 2 805 singleton pregnant women with gestational age 13 weeks or more from 31 provinces of China. A standard questionnaire was used to collect general information and pre-pregnancy weight; body weight and height of pregnant women were measured using a unified weighing scale and stadiometer, dietary intake during the previous year was collected using a food frequency questionnaire. A multiple logistic regression was used to analyze potential factors associated with appropriate gestational weight gain. Results: Among 2 805 pregnant women, 1 441 were in the second (13-27 weeks) and 1 364 in the third trimesters (≥28 weeks) . In the 2(nd) trimester, 229 cases (15.9%), 440 cases (30.5%) and 772 cases (53.6%) were insufficient gestational weight gain, appropriate gestational weight gain and excessive gestational weight gain respectively. So were 256 cases (18.8%), 474 cases (34.8%), 634 cases (46.5%) in the 3(rd) trimester respectively. In the multivariate unconditional logistic model, less fruit intake was associated with insufficient weight gain for women in the 2(nd) trimester ( OR (95% CI ): 1.58 (1.06-2.34)). Pregnant women with Han ethnicity who live in the small/medium city had lower risk of insufficient weight gain in the 3(rd) trimester ( OR (95% CI ): 0.58 (0.34-0.98)). Those pregnant women with physical activity gain ( OR (95% CI ): 1.33 (1.02-1.73)). Conclusion: The prevalence of appropriate gestational weight gain was low in China. Our study suggests that pregnant weight gain is associated with fruit intake, types of residential area and physical activity.

  17. Length-weight relation and condition factor of @iPenaeus indicus@@ and @iMetapenaeus dobsoni@@ in the Cochin Backwater

    Digital Repository Service at National Institute of Oceanography (India)

    Devi, C.B.L.; Nair, K.K.C.; Balasubramanian, T.; Gopalakrishnan, T.C.; Aravindakshan, P.N.; Kutty, M.K.

    Length-weight relation and condition factor of @iPenaeus indicus@@ and @iMetapenaeus dobsoni@@ were estimated using samples from Cochin backwater. Statistical tests support the view that the length-weight exponent of these species may be species...

  18. Height, Weight, and Aerobic Fitness Level in Relation to the Risk of Atrial Fibrillation.

    Science.gov (United States)

    Crump, Casey; Sundquist, Jan; Winkleby, Marilyn A; Sundquist, Kristina

    2018-03-01

    Tall stature and obesity have been associated with a higher risk of atrial fibrillation (AF), but there have been conflicting reports of the effects of aerobic fitness. We conducted a national cohort study to examine interactions between height or weight and level of aerobic fitness among 1,547,478 Swedish military conscripts during 1969-1997 (97%-98% of all 18-year-old men) in relation to AF identified from nationwide inpatient and outpatient diagnoses through 2012 (maximal age, 62 years). Increased height, weight, and aerobic fitness level (but not muscular strength) at age 18 years were all associated with a higher AF risk in adulthood. Positive additive and multiplicative interactions were found between height or weight and aerobic fitness level (for the highest tertiles of height and aerobic fitness level vs. the lowest, relative excess risk = 0.51, 95% confidence interval (CI): 0.40, 0.62; ratio of hazard ratios = 1.50, 95% CI: 1.34, 1.65). High aerobic fitness levels were associated with higher risk among men who were at least 186 cm (6 feet, 1 inch) tall but were protective among shorter men. Men with the combination of tall stature and high aerobic fitness level had the highest risk (for the highest tertiles vs. the lowest, adjusted hazard ratio = 1.70, 95% CI: 1.61, 1.80). These findings suggest important interactions between body size and aerobic fitness level in relation to AF and may help identify high-risk subgroups.

  19. Exploring parental factors related to weight management in survivors of childhood central nervous system tumors.

    Science.gov (United States)

    Santa Maria, Diane; Swartz, Maria C; Markham, Christine; Chandra, Joya; McCurdy, Sheryl; Basen-Engquist, Karen

    2014-01-01

    Childhood central nervous system tumor survivors (CCNSTS) are at risk for adverse health issues. Little research has been conducted to explore the role of parental factors in weight management to mitigate adverse health outcomes. We conducted 9 group interviews (n=20) with CCNSTS, their parents, and health care providers to ascertain parental factors that may influence weight management practices in CCNSTS. Three main themes were identified: parenting style, parent-child connectedness, and food and physical activity (PA) environment. Although most parents adopted an authoritative parenting style related to diet and PA practices, some adopted a permissive parenting style. Participants expressed high levels of connection that may hinder the development of peer relationships and described the food and PA environments that promote or hinder weight management through parental modeling of healthy eating and PA and access to healthy food and activities. Weight management interventions for CCNSTS may experience greater benefit from using a family-focused approach, promoting positive food and PA environments, parental modeling of healthy eating and exercise, and partnering with youth to adopt weight management behaviors.

  20. Mission management, planning, and cost: PULSE Attitude And Control Systems (AACS)

    Science.gov (United States)

    1990-01-01

    The Pluto unmanned long-range scientific explorer (PULSE) is a probe that will do a flyby of Pluto. It is a low weight, relatively low costing vehicle which utilizes mostly off-the-shelf hardware, but not materials or techniques that will be available after 1999. A design, fabrication, and cost analysis is presented. PULSE will be launched within the first decade of the twenty-first century. The topics include: (1) scientific instrumentation; (2) mission management, planning, and costing; (3) power and propulsion systems; (4) structural subsystem; (5) command, control, and communication; and (6) attitude and articulation control.

  1. Administrative Costs Associated With Physician Billing and Insurance-Related Activities at an Academic Health Care System.

    Science.gov (United States)

    Tseng, Phillip; Kaplan, Robert S; Richman, Barak D; Shah, Mahek A; Schulman, Kevin A

    2018-02-20

    Administrative costs in the US health care system are an important component of total health care spending, and a substantial proportion of these costs are attributable to billing and insurance-related activities. To examine and estimate the administrative costs associated with physician billing activities in a large academic health care system with a certified electronic health record system. This study used time-driven activity-based costing. Interviews were conducted with 27 health system administrators and 34 physicians in 2016 and 2017 to construct a process map charting the path of an insurance claim through the revenue cycle management process. These data were used to calculate the cost for each major billing and insurance-related activity and were aggregated to estimate the health system's total cost of processing an insurance claim. Estimated time required to perform billing and insurance-related activities, based on interviews with management personnel and physicians. Estimated billing and insurance-related costs for 5 types of patient encounters: primary care visits, discharged emergency department visits, general medicine inpatient stays, ambulatory surgical procedures, and inpatient surgical procedures. Estimated processing time and total costs for billing and insurance-related activities were 13 minutes and $20.49 for a primary care visit, 32 minutes and $61.54 for a discharged emergency department visit, 73 minutes and $124.26 for a general inpatient stay, 75 minutes and $170.40 for an ambulatory surgical procedure, and 100 minutes and $215.10 for an inpatient surgical procedure. Of these totals, time and costs for activities carried out by physicians were estimated at a median of 3 minutes or $6.36 for a primary care visit, 3 minutes or $10.97 for an emergency department visit, 5 minutes or $13.29 for a general inpatient stay, 15 minutes or $51.20 for an ambulatory surgical procedure, and 15 minutes or $51.20 for an inpatient surgical procedure. Of

  2. Health Related Quality of Life and Weight Self-Efficacy of Life Style among Normal-Weight, Overweight and Obese Iranian Adolescents: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Seyedeh Fatemeh Miri

    2017-11-01

    Full Text Available Background: Identifying and investigating the factors influencing self-efficacy and eventually health related quality of life (HRQoL can be an important step toward the prevention and treatment of the obesity. The aim of the study was to compare weight self-efficacy and HRQoL among normal-weight, overweight and obese Iranian adolescents. Materials and Methods In this case-control study, 118 obese and overweight adolescents (case group and 118 adolescents with normal weight (control group were recruited. Adolescent's anthropometric characteristics were measured. The Weight Efficacy Lifestyle Questionnaire (WEL, pediatric quality of life inventory (PedsQLTM 4.0 and self-reported physical activity were completed by the adolescents. Results: Multivariate logistic regression adjusting for various confounders indicated that overweight and obese adolescents were less likely to be physically active (adjusted odds ratio, AOR= 0.66; 95% confidence interval [CI], 0.48 to 0.911, had lower ability to cope with social pressure (AOR= 0.54; 95% CI, 0.32 to 0.93, involved in less positive activities (AOR= 0.53; 95% CI, 0.37 to 0.75, and felt more negative emotions (AOR= 0.23; 95% CI, 0.14 to 0.36 than their normal-weight counterparts. Moreover, obese and overweight adolescents were more likely to report deteriorated quality of life in all PedsQL subscales than those with normal weight P

  3. Relative biological effectiveness and radiation weighting factors in the context of animals and plants

    International Nuclear Information System (INIS)

    Higley, K.A.; Kocher, D.C.; Real, A.G.; Chambers, D.B.

    2012-01-01

    Radiation weighting factors have long been employed to modify absorbed dose as part of the process of evaluating radiological impact to humans. Their use represents an acknowledgement of the fundamental difference in energy deposition patterns of charged and uncharged particles, and how this can translate into varying degrees of biological impact. Weighting factors used in human radiation protection are derived from a variety of endpoints taken from in-vitro experiments that include human and animal cell lines, as well as in-vivo experiments with animals. Nonetheless, the application of radiation weighting factors in the context of dose assessment of animals and plants is not without some controversy. Specifically, radiation protection of biota has largely focused on limiting deterministic effects, such as reduced reproductive fitness. Consequently, the application of conventional stochastic-based radiation weighting factors (when used for human protection) appears inappropriate. While based on research, radiation weighting factors represent the parsing of extensive laboratory studies on relative biological effectiveness. These studies demonstrate that the magnitude of a biological effect depends not just on dose, but also on other factors including the rate at which the dose is delivered, the type and energy of the radiation delivering the dose, and, most importantly, the endpoint under consideration. This article discusses the efforts taken to develop a logical, transparent, and defensible approach to establishing radiation weighting factors for use in assessing impact to non-human biota, and the challenges found in differentiating stochastic from deterministic impacts.

  4. Centrality measures for immunization of weighted networks

    Directory of Open Access Journals (Sweden)

    Mohammad Khansari

    2016-03-01

    Full Text Available Effective immunization of individual communities with minimal cost in vaccination has made great discussion surrounding the realm of complex networks. Meanwhile, proper realization of relationship among people in society and applying it to social networks brings about substantial improvements in immunization. Accordingly, weighted graph in which link weights represent the intensity and intimacy of relationships is an acceptable approach. In this work we employ weighted graphs and a wide variety of weighted centrality measures to distinguish important individuals in contagion of diseases. Furthermore, we propose new centrality measures for weighted networks. Our experimental results show that Radiality-Degree centrality is satisfying for weighted BA networks. Additionally, PageRank-Degree and Radiality-Degree centralities showmoreacceptable performance in targeted immunization of weighted networks.

  5. Family functioning and quality of parent-adolescent relationship: cross-sectional associations with adolescent weight-related behaviors and weight status.

    Science.gov (United States)

    Haines, Jess; Rifas-Shiman, Sheryl L; Horton, Nicholas J; Kleinman, Ken; Bauer, Katherine W; Davison, Kirsten K; Walton, Kathryn; Austin, S Bryn; Field, Alison E; Gillman, Matthew W

    2016-06-14

    Little is known about how factors within the general family environment are associated with weight and related behaviors among adolescents/young adults. We studied 3768 females and 2614 males, 14-24 years old in 2011, participating in the Growing Up Today Study 2. We used generalized mixed models to examine cross-sectional associations of family functioning and quality of mother- and father-adolescent relationship with adolescent/young adult weight status, disordered eating, intake of fast food and sugar-sweetened beverages, screen time, physical activity, and sleep duration. In all models, we included participant's age and family structure. Eighty percent of participants reported high family functioning and 60% and 50% of participants reported high-quality mother and father relationship, respectively. Among both males and females, high family functioning was associated with lower odds of disordered eating (adjusted odds ratio [AOR] females = 0.53; 95% Confidence Interval [CI] = 0.45-0.63; AOR males = 0.48; CI = 0.39-0.60), insufficient physical activity, i.e., less than 1 h/day, (AOR females = 0.74; CI = 0.61-0.89; AOR males = 0.73; CI = 0.58-0.92), and insufficient sleep, i.e., less than 7 h/day, (AOR females = 0.56; CI = 0.45-0.68; AOR males = 0.65; CI 0.5-0.85). High family functioning was also associated with lower odds of being overweight/obese (AOR = 0.73; CI = 0.60-0.88) and eating fast food one or more times/week (AOR = 0.74; CI = 0.61-0.89) among females only. Among females, high-quality mother and father relationship were both associated with lower odds of being overweight/obese and disordered eating, eating fast food, and insufficient sleep and the magnitude of associations were similar for mother and father relationship quality (AOR range 0.61-0.84). Among males, high-quality mother and father relationship were both associated with lower odds of disordered eating, insufficient physical activity

  6. Cardiovascular mortality in relation to birth weight of children and grandchildren in 500,000 Norwegian families.

    Science.gov (United States)

    Naess, Oyvind; Stoltenberg, Camilla; Hoff, Dominic A; Nystad, Wenche; Magnus, Per; Tverdal, Aage; Davey Smith, George

    2013-11-01

    Cardiovascular diseases (CVDs) have been related to low birth weight, suggesting the foetal environment may program future risk. Alternatively, common genetic factors for both low birth weight and CVD could explain such associations. We investigated associations between offspring birth weight and paternal and maternal cardiovascular mortality and offspring birth weight and cardiovascular mortality among all four grandparents, and further assessed the mediating role of maternal smoking during pregnancy. All births from 1967 to 2008 that could be linked to parents and grandparents comprised the population (n = 1,004,255). The mortality follow-up among parents was from 1970 to 2008 and among grandparents from 1960 to 2008. The association of grandparental mortality with maternal smoking during pregnancy was analysed in a subpopulation of those born after 1997 (n = 345,624). Per quintile higher in birth weight was related to 0.82 (0.75-0.89) hazard ratio from coronary heart disease in mothers and 0.94 (0.92-0.97) in fathers. For stroke, these were 0.85 (0.78-0.92) and 0.94 (0.89-1.00), respectively. In grandparents for cardiovascular causes, the effects were 0.95 (0.93-0.96) (maternal grandmother), 0.97 (0.96-0.98) (maternal grandfather), 0.96 (0.94-0.98) (paternal grandmother), and 0.98 (0.98-1.00) (paternal grandfather). Adjusting for maternal smoking in pregnancy in the subpopulation accounted for much of the effect on grandparental cardiovascular mortality in all categories of birth weight. For grandparental diabetes mortality, U-shaped associations were seen with grandchild birth weight for the maternal grandmother and inverse associations for all other grandparents. Associations between CVD mortality in all four grandparents and grandchild birth weight exist, and while genetic and environmental factors may contribute to these, it appears that there is an important role for maternal smoking during pregnancy (and associated paternal smoking) in generating these

  7. Indirect, out-of-pocket and medical costs from influenza-related illness in young children.

    Science.gov (United States)

    Ortega-Sanchez, Ismael R; Molinari, Noelle-Angelique M; Fairbrother, Gerry; Szilagyi, Peter G; Edwards, Kathryn M; Griffin, Marie R; Cassedy, Amy; Poehling, Katherine A; Bridges, Carolyn; Staat, Mary Allen

    2012-06-13

    Studies have documented direct medical costs of influenza-related illness in young children, however little is known about the out-of-pocket and indirect costs (e.g., missed work time) incurred by caregivers of children with medically attended influenza. To determine the indirect, out-of-pocket (OOP), and direct medical costs of laboratory-confirmed medically attended influenza illness among young children. Using a population-based surveillance network, we evaluated a representative group of children aged accounting databases, and follow-up interviews with caregivers. Outcome measures included work time missed, OOP expenses (e.g., over-the-counter medicines, travel expenses), and direct medical costs. Costs were estimated (in 2009 US Dollars) and comparisons were made among children with and without high risk conditions for influenza-related complications. Data were obtained from 67 inpatients, 121 ED patients and 92 outpatients with laboratory-confirmed influenza. Caregivers of hospitalized children missed an average of 73 work hours (estimated cost $1456); caregivers of children seen in the ED and outpatient clinics missed 19 ($383) and 11 work hours ($222), respectively. Average OOP expenses were $178, $125 and $52 for inpatients, ED-patients and outpatients, respectively. OOP and indirect costs were similar between those with and without high risk conditions (p>0.10). Medical costs totaled $3990 for inpatients and $730 for ED-patients. Out-of-pocket and indirect costs of laboratory-confirmed and medically attended influenza in young children are substantial and support the benefits of vaccination. Published by Elsevier Ltd.

  8. Comprehensive Evaluation of Car-Body Light-Weighting Scheme Based on LCC Theory

    Directory of Open Access Journals (Sweden)

    Han Qing-lan

    2016-01-01

    Full Text Available In this paper, a comprehensive evaluation model of light-weighting scheme is established, which is based on three dimensions, including the life cycle costs of the resource consumed by the designed objects (LCC, willingness to pay for the environmental effect of resource consumption (WTP and performance (P. Firstly, cost of each stage is determined. Then, based on the resource classification, which is based on cost elements, determine the material list needed, and apply WTP weight coefficient to monetize life cycle environmental impact and obtain the life cycle comprehensive cost of designed scheme (TCC. In the next step Performance (P index is calculated to measure the value of the life cycle costs by applying AHP and SAW method, integrated (TCC and (P to achieve comprehensive evaluation of light-weighting scheme. Finally, the effectiveness of the evaluation model is verified by the example of car engine hood.

  9. Comparing Diagnostic Accuracy of Cognitive Screening Instruments: A Weighted Comparison Approach

    Directory of Open Access Journals (Sweden)

    A.J. Larner

    2013-03-01

    Full Text Available Background/Aims: There are many cognitive screening instruments available to clinicians when assessing patients' cognitive function, but the best way to compare the diagnostic utility of these tests is uncertain. One method is to undertake a weighted comparison which takes into account the difference in sensitivity and specificity of two tests, the relative clinical misclassification costs of true- and false-positive diagnosis, and also disease prevalence. Methods: Data were examined from four pragmatic diagnostic accuracy studies from one clinic which compared the Mini-Mental State Examination (MMSE with the Addenbrooke's Cognitive Examination-Revised (ACE-R, the Montreal Cognitive Assessment (MoCA, the Test Your Memory (TYM test, and the Mini-Mental Parkinson (MMP, respectively. Results: Weighted comparison calculations suggested a net benefit for ACE-R, MoCA, and MMP compared to MMSE, but a net loss for TYM test compared to MMSE. Conclusion: Routine incorporation of weighted comparison or other similar net benefit measures into diagnostic accuracy studies merits consideration to better inform clinicians of the relative value of cognitive screening instruments.

  10. Relationships of cognitive load on eating and weight-related behaviors of young adults.

    Science.gov (United States)

    Byrd-Bredbenner, Carol; Quick, Virginia; Koenings, Mallory; Martin-Biggers, Jennifer; Kattelmann, Kendra K

    2016-04-01

    Little is known about the relationship between weight-related behaviors and cognitive load (working memory available to complete mental activities like those required for planning meals, selecting foods, and other health-related decisions). Thus, the purpose of this study was to explore associations between cognitive load and eating behaviors, physical activity, body mass index (BMI), and waist circumference of college students. College students (n=1018) from 13 institutions completed an online survey assessing eating behaviors (e.g., routine and compensatory restraint, emotional eating, and fruit/vegetable intake), stress level, and physical activity level. BMI and waist circumference were measured by trained researchers. A cognitive load score was derived from stress level, time pressure/income needs, race and nationality. High cognitive load participants (n=425) were significantly (Pcognitive loads (n=593). Compared to low cognitive load participants, high cognitive load participants were significantly more likely to eat cognitive load scores had a non-significant trend toward higher BMIs, waist circumferences, and drinking more alcohol than low cognitive load counterparts. In conclusion, cognitive load may be an important contributor to health behaviors. Understanding how cognitive load may affect eating and other weight-related behaviors could potentially lead to improvements in the effectiveness of obesity prevention and intervention programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Cost effectiveness of a screen-and-treat program for asymptomatic vaginal infections in pregnancy: towards a significant reduction in the costs of prematurity.

    Science.gov (United States)

    Kiss, H; Pichler, Eva; Petricevic, L; Husslein, P

    2006-08-01

    The purpose of this investigation was to determine the cost-saving potential of a simple screen-and-treat program for vaginal infection, which has previously been shown to lead to a reduction of 50% in the rate of preterm births. To determine the potential cost savings, we compared the direct costs of preterm delivery of infants with a birth weight below 1900g with the costs of the screen-and-treat program. We used a cut-off birth weight of 1900g because, in our population, all infants with a birth weight below 1900g were transferred to the neonatal intensive care unit. The direct costs associated with preterm delivery were defined to include the costs of the initial hospitalization of both mother and infant and the costs of outpatient follow-up throughout the first 6 years of life of the former preterm infant. The costs of the screen-and-treat program were defined to include the costs of the screening examination and the resulting costs of antimicrobial treatment and follow-up. All calculations were based on health-economic data obtained in the metropolitan area of Vienna, Austria. The number of preterm infants with a birth weight below 1900g was 12 (0.5%) in the intervention group (N=2058) and 29 (1.3%) in the control group (N=2097). The direct costs per preterm birth were found to amount to EUR (euro) 60262. Overall, the expected total savings in direct costs achieved by the screen-and-treat program and the ensuing 50% reduction in the number preterm births with a birth weight below 1900g amounted to more than euro 11 million. The costs of screening and treatment were found to amount to merely 7% of the direct costs saved as a result of the screen-and-treat program. A simple preterm prevention program, consisting of screening and antimicrobial treatment and follow-up of women with asymptomatic vaginal infection, leads not only to a significant reduction in the rate of preterm births but also to substantial savings in the direct costs associated with prematurity.

  12. Tweet for health: using an online social network to examine temporal trends in weight loss-related posts.

    Science.gov (United States)

    Turner-McGrievy, Gabrielle M; Beets, Michael W

    2015-06-01

    Few studies have used social networking sites to track temporal trends in health-related posts, particularly around weight loss. To examine the temporal relationship of Twitter messages about weight loss over 1 year (2012). Temporal trends in #weightloss mentions and #fitness, #diet, and #health tweets which also had the word "weight" in them were examined using three a priori time periods: (1) holidays: pre-winter holidays, holidays, and post-holidays; (2) Season: winter and summer; and (3) New Year's: pre-New Year's and post-New Year's. Regarding #weightloss, there were 145 (95 % CI 79, 211) more posts/day during holidays and 143 (95 % CI 76, 209) more posts/day after holidays as compared to 480 pre-holiday posts/day; 232 (95 % CI 178, 286) more posts/day during the winter versus summer (441 posts/day); there was no difference in posts around New Year's. Examining social networks for trends in health-related posts may aid in timing interventions when individuals are more likely to be discussing weight loss.

  13. The Effectiveness and Cost of Lifestyle Interventions Including Nutrition Education for Diabetes Prevention: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Sun, Yu; You, Wen; Almeida, Fabio; Estabrooks, Paul; Davy, Brenda

    2017-03-01

    Type 2 diabetes is a significant public health concern. With the completion of the Diabetes Prevention Program, there has been a proliferation of studies attempting to translate this evidence base into practice. However, the cost, effectiveness, and cost-effectiveness of these adapted interventions is unknown. The purpose of this systematic review was to conduct a comprehensive meta-analysis to synthesize the effectiveness, cost, and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent (dietitian vs non-dietitian) and channel (in-person vs technology-delivered). English and full-text research articles published up to July 2015 were identified using the Cochrane Library, PubMed, Education Resources Information Center, CAB Direct, Science Direct, and Google Scholar. Sixty-nine studies met inclusion criteria. Most employed both dietary and physical activity intervention components (four of 69 were diet-only interventions). Changes in weight, fasting and 2-hour blood glucose concentration, and hemoglobin A1c were extracted from each article. Heterogeneity was measured by the I 2 index, and study-specific effect sizes or mean differences were pooled using a random effects model when heterogeneity was confirmed. Participants receiving intervention with nutrition education experienced a reduction of 2.07 kg (95% CI 1.52 to 2.62; Phemoglobin A1c level changes ranged from small to medium. The meta-regression analysis revealed a larger relative weight loss in dietitian-delivered interventions than in those delivered by nondietitians (full sample: -1.0 kg; US subsample: -2.4 kg), and did not find statistical evidence that the delivery channel was an important predictor of weight loss. The average cost per kilogram weight loss ranged from $34.06 over 6 months to $1,005.36 over 12 months. The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non

  14. Birth Weight, Postnatal Weight Gain, and Childhood Adiposity in Relation to Lipid Profile and Blood Pressure During Early Adolescence.

    Science.gov (United States)

    Hulst, Andraea Van; Barnett, Tracie A; Paradis, Gilles; Roy-Gagnon, Marie-Hélène; Gomez-Lopez, Lilianne; Henderson, Mélanie

    2017-08-04

    Different pathways likely underlie the association between early weight gain and cardiovascular disease risk. We examined whether birth weight for length relationship and weight gain up to 2 years of age are associated with lipid profiles and blood pressure (BP) in early adolescence and determined whether childhood adiposity mediates these associations. Data from QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), a cohort of white children with parental history of obesity, were analyzed (n=395). Sex-specific weight for length z scores from birth to 2 years were computed. Rate of postnatal weight gain was estimated using individual slopes of weight for length z -score measurements. Percentage of body fat was measured at 8 to 10 years. Fasting lipids and BP were measured at 10 to 12 years. Using path analysis, we found indirect effects of postnatal weight gain, through childhood adiposity, on all outcomes: Rate of postnatal weight for length gain was positively associated with childhood adiposity, which in turn was associated with unfavorable lipid and BP levels in early adolescence. In contrast, small beneficial direct effects on diastolic BP z scores, independent of weight at other time points, were found for birth weight for length (β=-0.05, 95% CI, -0.09 to -0.002) and for postnatal weight gain (β=-0.02, 95% CI, -0.03 to -0.002). Among children with at least 1 obese parent, faster postnatal weight gain leads to cardiovascular risk factors in early adolescence through its effect on childhood adiposity. Although heavier newborns may have lower BP in early adolescence, this protective direct effect could be offset by a deleterious indirect effect linking birth weight to later adiposity. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  15. Relating cost-benefit analysis results with transport project decisions in the Netherlands

    NARCIS (Netherlands)

    Annema, Jan Anne; Frenken, Koen|info:eu-repo/dai/nl/207145253; Koopmans, Carl; Kroesen, Maarten

    2017-01-01

    This paper relates the cost-benefit analysis (CBA) results of transportation policy proposals in the Netherlands with the decision to implement or abandon the proposal. The aim of this study is to explore the relation between the CBA results and decision-making. Multinomial logit regression models

  16. Relating cost-benefit analysis results with transport project decisions in the Netherlands

    NARCIS (Netherlands)

    Annema, J.A.; Frenken, Koen; Koopmans, Carl; Kroesen, M.

    2017-01-01

    This paper relates the cost-benefit analysis (CBA) results of transportation policy proposals in the Netherlands with the decision to implement or abandon the proposal. The aim of this study is to explore the relation between the CBA results and decision-making. Multinomial logit regression

  17. Health-related physical fitness and weight status in 13- to 15-year-old Latino adolescents. A pooled analysis.

    Science.gov (United States)

    García-Hermoso, Antonio; Correa-Bautista, Jorge E; Olloquequi, Jordi; Ramírez-Vélez, Robinson

    2018-05-05

    The aim of this study was to investigate the relation between health-related physical fitness and weight status in 13- to 15-year-old Latino adolescents. The final sample consisted of 73,561 adolescents aged 13-15 years (35,175 girls) from Chile (n=48,771) and Colombia (n=24,790). Cardiorespiratory and musculoskeletal fitness were measured using 20-m shuttle run (relative peak oxygen uptake - VO 2peak ) and standing broad jump test (lower body explosive strength), respectively. The International Obesity Task Force definition was used to define weight status (i.e., underweight, normal weight, overweight, and obese). The present study found an inverted J-shape relationship between body mass index, cardiorespiratory fitness, and musculoskeletal fitness in both genders and all age groups (pfitness (based on new international criterion-referenced standards) profile when compared with their normal weight peers, except in girls aged 14 (p=0.268) and 15 years (p=0.280). The present results indicate low cardiorespiratory fitness and musculoskeletal fitness levels in underweight, overweight, and obese adolescents when compared with their normal weight peers. The findings appear to suggest that exercise programs should to decrease fat mass in overweight/obese adolescents and increase muscle mass in underweight adolescents. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  18. Body composition of preschool children and relation to birth weight

    Directory of Open Access Journals (Sweden)

    Thais Costa Machado

    2014-01-01

    Full Text Available Objective: to evaluate the relationship between body composition of preschool children suffering from excess weight and birth weight (BW. Methods: probabilistic sample, by conglomerates, with 17 daycare centers (of a total of 59 composing a final sample of 479 children. We used Z-score of Body Mass Index (zBMI ≥ +1 and ≥ +2, respectively, to identify preschool children with risk of overweight and excess weight (overweight or obesity. The arm muscle area (AMA and the arm fat area (AFA were estimated from measurements of arm circumference, triceps skin fold thickness. Results: the prevalence of risk of overweight was 22.9% (n=110 and excess weight was 9.3% (n=44. The risk of overweight and excess weight in children did not show correlation between BW and AFA, but it did with adjusted arm muscle area (AMAa (rp= 0.21; p= 0.0107. The analysis of the group with excess weight alone also showed a positive correlation between BW and AMAa (rp= 0.42; p= 0.0047. Conclusion: among overweight children, lower BW is associated with a lower arm muscle area in early preschool age, regardless of the fat arm area presented by them.

  19. A new reliability allocation weight for reducing the occurrence of severe failure effects

    International Nuclear Information System (INIS)

    Kim, Kyungmee O.; Yang, Yoonjung; Zuo, Ming J.

    2013-01-01

    A reliability allocation weight is used during the early design stage of a system to apportion the system reliability requirement to its individual subsystems. Since some failures have serious effects on public safety, cost and environmental issues especially in a mission critical system, the failure effect must be considered as one of the important factors in determining the allocation weight. Previously, the risk priority number or the criticality number was used to consider the failure effect in the allocation weight. In this paper, we identify the limitations of the previous approach and propose a new allocation weight based on the subsystem failure severity and its relative frequency. An example is given to illustrate that the proposed method is more effective than the previous method for reducing the occurrence of the unacceptable failure effects in a newly designed system

  20. Addressing weight stigma in physiotherapy: Development of a theory-driven approach to (re)thinking weight-related interactions.

    Science.gov (United States)

    Setchell, J; Gard, M; Jones, L; Watson, B M

    2017-08-01

    In this article, we propose a theory-driven approach to developing interventions for reducing weight stigma in physiotherapy and discuss the design and exploratory trial of such an intervention. Weight stigma has been identified in physiotherapists in empirical investigations. However, there has been little consideration of how this stigma might be addressed. We highlight Goffman's work on stigma that provides social and embodied understandings of stigma. Goffman's approach, however, is notably apolitical, ahistorical and lacks mechanisms for understanding power. We suggest that post-structuralist perspectives can provide insight into these areas. Drawing on these theories, we critically examine the literature on weight stigma reduction, finding that trials have largely been unsuccessful. We argue that this may be due to overly passive and simplistic intervention designs. As context-specific understandings are desirable, we examine the nature of physiotherapy to determine what might be relevant to (re)thinking weight in this profession. We then discuss the development of a multifactorial, active weight stigma intervention we trialed with eight physiotherapists. Supported by theory, the outcomes of the exploratory study suggest that physiotherapy-specific factors such as fostering professional reflexivity and improving understandings of stigma need to be incorporated into an active intervention that considers the complex determinants of weight stigma.

  1. Combined multi-criteria and cost-benefit analysis

    DEFF Research Database (Denmark)

    Moshøj, Claus Rehfeld

    1996-01-01

    The paper is an introduction to both theory and application of combined Cost-Benefit and Multi-Criteria Analysis. The first section is devoted to basic utility theory and its practical application in Cost-Benefit Analysis. Based on some of the problems encountered, arguments in favour...... of the application of utility-based Multi-Criteria Analyses methods as an extension and refinement of the traditional Cost-Benefit Analysis are provided. The theory presented in this paper is closely related the methods used in the WARP software (Leleur & Jensen, 1989). The presentation is however wider in scope.......The second section introduces the stated preference methodology used in WARP to create weight profiles for project pool sensitivity analysis. This section includes a simple example. The third section discusses how decision makers can get a priori aid to make their pair-wise comparisons based on project pool...

  2. Differences in the association between smoking and relative body weight by level of education

    NARCIS (Netherlands)

    Molarius, A.; Seidell, J C

    OBJECTIVE: To investigate differences in the association between smoking and relative body weight by sex, age group and level of education. DESIGN: Cross-sectional study. SUBJECTS: About 36,000 men and women who participated in the Monitoring Project on Cardiovascular Disease Risk Factors in the

  3. Studies on the growth of penaeid prawns: 1. Length-weight relation and condition factor under different levels of feeding

    Digital Repository Service at National Institute of Oceanography (India)

    Nair, S.R.S.; Iyer, H.K.; Devi, C.B.L.; Kutty, M.K.

    Length-weight relation and earthworm feeding conditions under different levels for @iPenaeus indicus@@ and @iMetapenaeus dobsoni@@ were estimated. Length-weight exponent in both species was unaffected by the feeding levels and the consequent...

  4. Weight Loss at a Cost: Implications of High-Protein, Low- Carbohydrate Diets.

    Science.gov (United States)

    Gabel, Kathe A.; Lund, Robin J.

    2002-01-01

    Addresses three claims of high-protein, low-carbohydrate diets: weight loss is attributed to the composition of the diet; insulin promotes the storage of fat, thereby, by limiting carbohydrates, dieters will decrease levels of insulin and body fat; and weight loss is the result of fat loss. The paper examines relevant scientific reports and notes…

  5. Modeling production functions and economic weights in intensive meat production of guinea pigs.

    Science.gov (United States)

    Pascual, Mariam; Cruz, Danny Julio; Blasco, Agustín

    2017-10-01

    A profit function for a typical commercial farm of intensive guinea pig production was designed. The simulated farm contained 86 cages with a ratio of 7:1 females/males, with continuous mating. Kits were weaned at 15 days of age and slaughtered for meat production at 90 days of age. The absolute (EW) and relative economic weights of the main traits were calculated. The highest EW were kits produced per kindling (US$25), kits weaned per kindling (US$22), kits born alive per kindling (US$20), and the number of kindlings per female and year (US$12). Profit, returns, and costs per female and year were US$15, 68, and 53, respectively. Returns came from the production of young guinea pigs and discarded reproductive adults for meat production, 90 and 10% of the total returns. The highest costs were feeding and labor, 44 and 23% of the total cost. The EW and profit did not substantially change when simulating variations of ±20% in the prices of kilograms of fattening feed and kilograms of live weight of guinea pig, showing their robustness to future variations in market prices or to variations in prices between countries. The results obtained highlight the importance of the feeding costs in the guinea pig meat production.

  6. Cost-effectiveness modeling for neuropathic pain treatments: investigating the relative importance of parameters using an open-source model.

    Science.gov (United States)

    Hirst, Matthew; Bending, Matthew W; Baio, Gianluca; Yesufu-Udechuku, Amina; Dunlop, William C N

    2018-06-08

    The study objective was to develop an open-source replicate of a cost-effectiveness model developed by National Institute for Health and Care (NICE) in order to explore uncertainties in health economic modeling of novel pharmacological neuropathic pain treatments. The NICE model, consisting of a decision tree with branches for discrete levels of pain relief and adverse event (AE) severities, was replicated using R and used to compare a hypothetical neuropathic pain drug to pregabalin. Model parameters were sourced from NICE's clinical guidelines and associated with probability distributions to account for underlying uncertainty. A simulation-based scenario analysis was conducted to assess how uncertainty in efficacy and AEs affected the net monetary benefit (NMB) for the hypothetical treatment at a cost-effectiveness threshold of £20,000 per QALY. Relative to pregabalin, an increase in efficacy was associated with greater NMB than an improvement in tolerability. A greater NMB was observed when efficacy was marginally higher than that of pregabalin while maintaining the same level of AEs than when efficacy was equivalent to pregabalin but with a more substantial reduction in AEs. In the latter scenario, the NMB was only positive at a low cost-effectiveness threshold. The replicate model shares the limitations described in the NICE guidelines. There is a lack of support in scientific literature for the assumption that increased efficacy is associated with a greater reduction in tolerability. The replicate model also included a single comparator, unlike the NICE model. Pain relief is a stronger driver of NMB than tolerability at a cost-effectiveness threshold of £20,000 per QALY. Health technology assessment decisions which are influenced by NICE's model may reward efficacy gains even if they are associated with more severe AEs. This contrasts with recommendations from clinical guidelines for neuropathic pain which place more equal weighting on improvements in

  7. Environmental Parametric Cost Model in Oil and Gas EPC Contracts

    Directory of Open Access Journals (Sweden)

    Madjid Abbaspour

    2018-01-01

    Full Text Available This study aims at identifying the parameters that govern the environmental costs in oil and gas projects. An initial conceptual model was proposed. Next, the costs of environmental management work packages were estimated, separately and were applied in project control tools (WBS/CBS. Then, an environmental parametric cost model was designed to determine the environmental costs and relevant weighting factors. The suggested model can be considered as an innovative approach to designate the environmental indicators in oil and gas projects. The validity of variables was investigated based on Delphi method. The results indicated that the project environmental management’s weighting factor is 0.87% of total project’s weighting factor.

  8. Together Achieving More: Primary Care Team Communication and Alcohol-Related Healthcare Utilization and Costs.

    Science.gov (United States)

    Mundt, Marlon P; Zakletskaia, Larissa I; Shoham, David A; Tuan, Wen-Jan; Carayon, Pascale

    2015-10-01

    Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol-related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol-related patient outcomes. Using a sociometric survey of primary care clinic communication, this study evaluated the relation between team communication networks and alcohol-related utilization of care and costs. Between May 2013 and December 2013, a total of 155 healthcare employees at 6 primary care clinics participated in a survey on team communication. Three-level hierarchical modeling evaluated the link between connectedness within the care team and the number of alcohol-related emergency department visits, hospital days, and associated medical care costs in the past 12 months for each team's primary care patient panel. Teams (n = 31) whose registered nurses displayed more strong (at least daily) face-to-face ties and strong (at least daily) electronic communication ties had 10% fewer alcohol-related hospital days (rate ratio [RR] = 0.90; 95% confidence interval [CI]: 0.84, 0.97). Furthermore, in an average team size of 19, each additional team member with strong interaction ties across the whole team was associated with $1,030 (95% CI: -$1,819, -$241) lower alcohol-related patient healthcare costs per 1,000 team patients in the past 12 months. Conversely, teams whose primary care practitioner (PCP) had more strong face-to-face communication ties and more weak (weekly or several times a week) electronic communication ties had 12% more alcohol-related hospital days (RR = 1.12; 95% CI: 1.03, 1.23) and $1,428 (95% CI: $378, $2,478) higher alcohol-related healthcare costs per 1,000 patients in the past 12 months. The analyses controlled for patient age, gender, insurance, and comorbidity diagnoses. Excessive alcohol-using patients may fair better if cared for by teams whose

  9. The impact of a workplace-based weight loss program on work-related outcomes in overweight male shift workers.

    Science.gov (United States)

    Morgan, Philip J; Collins, Clare E; Plotnikoff, Ronald C; Cook, Alyce T; Berthon, Bronwyn; Mitchell, Simon; Callister, Robin

    2012-02-01

    The aim of this study was to evaluate the impact of a workplace-based weight loss program (Workplace POWER [Preventing Obesity Without Eating like a Rabbit]) for male shift workers on a number of work-related outcomes. A total of 110 overweight/obese (body mass index = 25-40) (mean [SD] age = 44.3 [8.6] years; body mass index = 30.5 [3.6]) male employees at Tomago Aluminium (New South Wales, Australia) were randomized to either (i) Workplace POWER program (n = 65) or (ii) a 14-week wait-list control group (n = 45). Men were assessed at baseline and 14-week follow-up for weight, quality of life, sleepiness, productivity at work (presenteeism), absenteeism, and workplace injuries. Retention was 81%. Intention-to-treat analysis using linear mixed models revealed a significant intervention effect for weight, quality of life (mental), presenteeism, absenteeism, and injuries. The Workplace POWER weight loss program improved a number of important work-related outcomes in male shift workers.

  10. Diet in the management of weight loss

    OpenAIRE

    Strychar, Irene

    2006-01-01

    Obesity is an established risk factor for numerous chronic diseases, and successful treatment will have an important impact on medical resources utilization, health care costs, and patient quality of life. With over 60% of our population being overweight, physicians face a major challenge in assisting patients in the process of weight loss and weight-loss maintenance. Low-calorie diets can lower total body weight by an average of 8% in the short term. These diets are well-tolerated and charac...

  11. Mental health, quality of life and social relations in young adults born with low birth weight

    Directory of Open Access Journals (Sweden)

    Lund Line K

    2012-12-01

    Full Text Available Abstract Background Being born with low birth weight may have an impact on different aspects of mental health, psychosocial functioning and well-being; however results from studies in young adulthood have so far yielded mixed findings. The aim of this study was to assess the long-term impact in young adulthood on self-reported mental health, health-related quality of life, self-esteem and social relations by investigating differences between two low birth weight groups and a control group. Methods In a follow-up at 20 years of age, 43 preterm VLBW (birth weight ≤ 1500 g, 55 term SGA (birth weight  Results The VLBW and SGA groups reported significantly more mental health problems than controls. The VLBW group predominantly had internalizing problems, and the non-significant association with ASR Total score was reduced by the Intelligence Quotient (IQ. The SGA group had increased scores on both internalizing and externalizing problems, and the association with ASR Total score remained significant after adjusting for IQ in this group. Both low birth weight groups reported less interaction with friends and lower quality of life related to mental health domains than controls. Self-esteem scores were lower than in the control group for athletic competence (VLBW and social acceptance (SGA. Conclusion Our findings suggest that self-reported mental health and well-being in young adulthood may be adversely affected by low birth weight, irrespective of whether this is the result of premature birth or being born SGA at term.

  12. Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study.

    Science.gov (United States)

    Brown, V; Moodie, M; Cobiac, L; Mantilla Herrera, A M; Carter, R

    2017-05-04

    Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis. Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under "best case" assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2

  13. Relationship between different approaches to derive weighting functions related to atmospheric remote sensing problems

    International Nuclear Information System (INIS)

    Rozanov, Vladimir V.; Rozanov, Alexei V.

    2007-01-01

    The paper is devoted to the investigation of the relationship between different methods used to derive weighting functions required to solve numerous inverse problems related to the remote sensing of the Earth's atmosphere by means of scattered solar light observations. The first method commonly referred to as the forward-adjoint approach is based on a joint solution of the forward and adjoint radiative transfer equations and the second one requires the linearized forward radiative transfer equation to be solved. In the framework of the forward-adjoint method we consider two approaches commonly used to derive the weighting functions. These approaches are referenced as the 'response function' and the 'formal solution' techniques, respectively. We demonstrate here that the weighting functions derived employing the formal solution technique can also be obtained substituting the analytical representations for the direct forward and direct adjoint intensities into corresponding expressions obtained in the framework of the response function technique. The advantages and disadvantages of different techniques are discussed

  14. Am I overweight? A longitudinal study on parental and peers weight-related perceptions on dietary behaviors and weight status among adolescents

    Directory of Open Access Journals (Sweden)

    Karolina eZarychta

    2016-02-01

    Full Text Available Objective: An investigation of the interplay between various types of adolescents’ perceptions of weight status in predicting adolescents’ nutrition behavior and their body weight was conducted. In particular, it was hypothesized that the relationship between parental and peers’ perceptions of their own weight status (reported by adolescents and objectively measured weight status of adolescents would be mediated by three types of adolescents’ weight status perceptions (adolescents’ own weight perceptions, parental perceptions of adolescents’ weight status perceived by participants, and peers’ perceptions of adolescents’ weight status perceived by participants and by adolescents’ nutrition behaviors. Design: Data were collected twice, with a 13-month follow-up. Participants (N = 1096 were aged 14-20, with BMI ranging from 16.20 to 41.21. Multiple mediation analysis with two sequential mediators was applied.Main outcome measures: At the baseline adolescents completed the questionnaire assessing their nutrition behaviors and weight status perceptions. Weight and height were measured objectively at baseline and follow-up.Results: Two types of weight perceptions (adolescents’ own weight status perceptions, peers’ perceptions of adolescents’ weight status reported by participants, and adolescents’ nutrition behaviors mediated the relationship between the others’ own weight perceptions and adolescents’ weight status. No indirect effects of others’ own weight perceptions on adolescents’ weight status through parental perceptions were found.Conclusion: Adolescents’ nutrition behaviors and body weight status depend on what they think about their own weight status and what they think of their peers’ perceptions, but do not depend on what adolescents think of their parents’ perceptions.

  15. Solutions to Address Diabetes-Related Financial Burden and Cost-Related Nonadherence: Results from a Pilot Study

    Science.gov (United States)

    Patel, Minal R.; Resnicow, Kenneth; Lang, Ian; Kraus, Kathleen; Heisler, Michele

    2018-01-01

    Background: Cost-related nonadherence (CRN) to recommended self-management behaviors among adults with chronic conditions such as diabetes is prevalent. Few behavioral interventions to mitigate CRN have been tested and evaluated. Aims: We developed a financial burden resource tool and examined its acceptability and the preliminary effects on…

  16. Uncertainty in relative cost investigation

    International Nuclear Information System (INIS)

    Bunn, D.; Viahos, K.

    1989-01-01

    One of the consequences of the privatization of the Central Electricity Generating Board has been a weakening of the economic case for nuclear generation over coal. Nuclear has higher capital, but lower operating costs than coal and is therefore favoured in capital budgeting by discounting at lower rates of return. In the Sizewell case (in 1987), discounting at the public sector rate of 5 per cent favoured nuclear. However, the private sector will require higher rates of return, thus rendering nuclear less attractive. Hence the imposition by the government of a diversity constraint on the privatized industry to ensure that contracts are made for a minimum fraction of non-fossil (essentially nuclear) energy. An electricity capacity planning model was developed to estimate the costs of imposing various non-fossil energy constraints on the planning decision of a privatized electricity supply industry, as a function of various discount rates. Using a large-scale linear programming technique, the model optimizes over a 50 year horizon the schedule of installation, and mix of generating capacity, both with and without a minimum non-fossil constraint. The conclusion is that the opportunity cost of diversity may be a complex joint substation of more than one type of plant (eg coal and gas) depending on the discount rate. (author)

  17. The effect of dietary garlic supplementation on body weight gain, feed intake, feed conversion efficiency, faecal score, faecal coliform count and feeding cost in crossbred dairy calves.

    Science.gov (United States)

    Ghosh, Sudipta; Mehla, Ram K; Sirohi, S K; Roy, Biswajit

    2010-06-01

    Thirty-six crossbred calves (Holstein cross) of 5 days of age were used to study the effect of garlic extract feeding on their performance up to the age of 2 months (pre-ruminant stage). They were randomly allotted into treatment and control groups (18 numbers in each group). Performance was evaluated by measuring average body weight (BW) gain, feed intake (dry matter (DM), total digestible nutrient (TDN) and crude protein (CP)), feed conversion efficiency (FCE; DM, TDN and CP), faecal score, faecal coliform count and feeding cost. Diets were the same for the both groups. In addition, treatment group received garlic extract supplementation at 250 mg/kg BW per day per calf. Body weight measured weekly, feed intake measured twice daily, proximate analysis of feeds and fodders analysed weekly, faecal scores monitored daily and faecal coliform count done weekly. There was significant increase in average body weight gain, feed intake and FCE and significant decrease in severity of scours as measured by faecal score and faecal coliform count in the treatment group compared to the control group (P Feed cost per kilogramme BW gain was significantly lower in the treatment group compared to control group (P calves for better performance.

  18. Family-related predictors of body weight and weight-related behaviours among children and adolescents: a systematic umbrella review.

    Science.gov (United States)

    Cislak, A; Safron, M; Pratt, M; Gaspar, T; Luszczynska, A

    2012-05-01

    This umbrella review analysed the relationships between family variables and child/adolescent body weight, diet and physical activity. In line with theories of health behaviour change, it was assumed that behaviour-specific family variables (i.e. beliefs, perceptions and practices referring to food intake or physical activity) would have stronger support than more general family variables (i.e. socio-economic status or general parental practices). Data obtained from 18 systematic reviews (examining 375 quantitative studies) were analysed. Reviews of experimental trials generally supported the effectiveness of reward/positive reinforcement parental strategies, parental involvement in treatment or prevention programmes, and cognitive-behavioural treatment in reducing child/adolescent body mass and/or obesity. Results across reviews of correlational studies indicated that healthy nutrition of children/adolescents was related to only one parental practice (parental monitoring), but was associated with several behaviour-specific family variables (e.g. a lack of restrictive control over food choices, high intake of healthy foods and low intake of unhealthy foods by parents and siblings, low pressure to consume foods). With regard to adolescent physical activity, stronger support was also found for behaviour-specific variables (e.g. physical activity of siblings), and for certain socio-economic variables (e.g. parental education). Child and adolescent obesity prevention programmes should account for behaviour-specific family variables. © 2011 Blackwell Publishing Ltd.

  19. Comparative studies on the increase of uterine weight and related mechanisms of cadmium and p-nonylphenol

    International Nuclear Information System (INIS)

    Zhang Wenchang; Yang Jinsong; Wang Jiali; Xia Pincang; Xu Youqiong; Jia Haimei; Chen Yongshan

    2007-01-01

    The research was designed to compare the effect of cadmium and p-nonylphenol on the increase of uterine weight and to study the related mechanisms. It provided basic evidence for us to understand the possible different mechanisms among different EEDs. In this study, both ovaries of 60 Wistar rats (28 days age) were ectomized, and after 21 days recovery, the rats were randomly assigned into six groups and exposed to cadmium (0.12, 1.20 mg/kg), NP (100, 200 mg/kg), control (sterile PBS), and positive control (17β-estradiol) per day for 3 days, respectively, then related indexes were detected. The results showed that the increase of uterine weight induced by cadmium was accompanied by the increase of the thickness of luminal epithelium cell and endometrium but the decrease of nuclear/cytoplasm of luminal epithelium cell and endometrium, while the increase of uterine weight induced by p-nonylphenol was accompanied by the increase of the thickness of luminal epithelium cell, endometrium, and myometrium but the decrease of nuclear/cytoplasm of luminal epithelium cell and endometrium. Cadmium could inhibit the positive expression of PCNA while p-nonylphenol prompted it. Exposure to cadmium and NP both could also stimulate phosphorylation of ERK mitogen-activated protein kinases, implying that this signal pathway had an effect on the increase of the uterine weight induced by cadmium and p-nonylphenol. The results indicate that cadmium may induce the increase of uterine weight, which is accompanied with toxic effect on endometrium, while NP's effect of the increase of uterine weight is due to cell proliferation of endometrium, the mechanisms of which are the same as estrogen, but they may both activate ERK signal pathway

  20. Alcohol-related hand injuries: an unnecessary social and economic cost.

    OpenAIRE

    Marston, R. A.

    1992-01-01

    Severe hand injuries constitute the largest number of acute referrals to this plastic surgery unit, the admission of these patients often displacing routine admissions due to bed shortages, thus increasing waiting list time. This study showed that a high percentage of these injuries were alcohol-related and were therefore preventable. The economic cost to the unit is discussed.

  1. Biochemical, Anthropometric and Lifestyle Factors Related with Weight Maintenance after Weight Loss Secondary to a Hypocaloric Mediterranean Diet.

    Science.gov (United States)

    de Luis, Daniel Antonio; Izaola, Olatz; Primo, David; Ovalle, Hilda F; Lopez, Juan Jose; Gomez, Emilia; Ortola, Ana; Aller, Rocio

    2017-01-01

    The aim of our study was to evaluate the influence of lifestyle factors and molecular biomarkers on the maintenance of the weight lost after a hypocaloric Mediterranean diet. After 3 months on a diet, patients (n = 335) remained with no controlled diet during 3 years and they were revaluated. Using linear regression, in the group of responders, we detected that a positive weight loss at 3 months, serum levels of leptin at 3 months, and each 30 min per week of physical activity were associated with weight loss maintenance. In the model with reduced weight (RW) as dependent variable, a positive weight loss at 3 months was associated with 2.4% RW (95% CI 1.31-8.11; p = 0.015), each unit of serum leptin levels at 3 months with -0.44% RW (95% CI -0.59 to -0.020; p = 0.007), each basal unit homeostasis model assessment for insulin resistance (HOMA-IR) level with -2.32% (95% CI -13.01 to -0.17; p = 0.040), and each 30 min per week of physical activity with 1.58% RW (95% CI 1.08-2.94; p = 0.020). Obese subjects who are on maintenance weight loss after a dietary intervention appear to have a better initial response during the 3 months intervention, more physical activity at 3 years, and lower basal HOMA-IR and leptin after weight loss than those who regain weight. © 2017 S. Karger AG, Basel.

  2. Gestational Weight Gain and Pregnancy Outcomes in Relation to Body Mass Index in Asian Indian Women.

    Science.gov (United States)

    Bhavadharini, Balaji; Anjana, Ranjit Mohan; Deepa, Mohan; Jayashree, Gopal; Nrutya, Subramanyam; Shobana, Mahadevan; Malanda, Belma; Kayal, Arivudainambi; Belton, Anne; Joseph, Kurian; Rekha, Kurian; Uma, Ram; Mohan, Viswanathan

    2017-01-01

    The aim of the study was to compare the weight gain during pregnancy (using Institute of Medicine guidelines) among Asian Indians across different body mass index (BMI) categories (using World Health Organization Asia Pacific BMI cut points) and to compare the pregnancy outcomes in each of the different BMI categories. Retrospective records of 2728 pregnant women attending antenatal clinics and private maternity centers in Chennai, South India, from January 2011 to January 2014 were studied. Pregnancy outcomes were analyzed in relation to BMI and weight gain across different BMI categories. Overweight and obese women who gained more weight during pregnancy were at high risk of delivering macrosomic infants (overweight - odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.1-5.2, P = 0.02 and obese - OR: 1.6, 95% CI: 1.1-2.4, P = 0.01). In addition, obese women who gained more weight were also at high risk of preterm labor (OR: 2.1, 95% CI: 1.1-3.8; P = 0.01), cesarean section (OR: 1.9, 95% CI: 1.4-2.5; P women who gained less weight had a protective effect from cesarean section and macrosomia. Overweight/obese women who gained more weight than recommended are at a high risk of developing adverse pregnancy outcomes. Normal and overweight women who gained weight less than recommended have low risk for cesarean section and macrosomia. However, they have a higher (statistically insignificant) risk for low birth weight and preterm birth. This highlights the need for gaining adequate weight during pregnancy.

  3. Computerized cost estimation spreadsheet and cost data base for fusion devices

    International Nuclear Information System (INIS)

    Hamilton, W.R.; Rothe, K.E.

    1985-01-01

    An automated approach to performing and cataloging cost estimates has been developed at the Fusion Engineering Design Center (FEDC), wherein the cost estimate record is stored in the LOTUS 1-2-3 spreadsheet on an IBM personal computer. The cost estimation spreadsheet is based on the cost coefficient/cost algorithm approach and incorporates a detailed generic code of cost accounts for both tokamak and tandem mirror devices. Component design parameters (weight, surface area, etc.) and cost factors are input, and direct and indirect costs are calculated. The cost data base file derived from actual cost experience within the fusion community and refined to be compatible with the spreadsheet costing approach is a catalog of cost coefficients, algorithms, and component costs arranged into data modules corresponding to specific components and/or subsystems. Each data module contains engineering, equipment, and installation labor cost data for different configurations and types of the specific component or subsystem. This paper describes the assumptions, definitions, methodology, and architecture incorporated in the development of the cost estimation spreadsheet and cost data base, along with the type of input required and the output format

  4. "Fat is really a four-letter word": Exploring weight-related communication best practices in children with and without disabilities and their caregivers.

    Science.gov (United States)

    McPherson, A C; Knibbe, T J; Oake, M; Swift, J A; Browne, N; Ball, G D C; Hamilton, J

    2018-05-15

    Health care professionals play a critical role in preventing and managing childhood obesity, but the American Academy of Pediatrics recently stressed the importance of using sensitive and nonstigmatizing language when discussing weight with children and families. Although barriers to weight-related discussions are well known, there are few evidence-based recommendations around communication best practices. Disability populations in particular have previously been excluded from work in this area. The objectives were to present the findings of a recent scoping review to children with and without disabilities and their caregivers for their reactions; and to explore the experiences and perceptions of the children and their caregivers regarding weight-related communication best practices. Focus group and individual interviews were conducted with 7-18-year olds with and without disabilities and their caregivers. The interview guide was created using findings from a recent scoping review of weight-related communication best practices. Inductive thematic analysis was employed. Eighteen children (9 boys; 7 children with disabilities) and 21 caregivers (17 mothers, 1 step-father, 3 other caregivers) participated in 8 focus group and 7 individual interviews. Preferred communication strategies were similar across those with and without disabilities, although caregivers of children with autism spectrum disorder endorsed more concrete approaches. Discussions emphasizing growth and health were preferred over weight and size. Strengths-based, solution-focused approaches for weight conversations were endorsed, although had not been widely experienced. Perceptions of weight-related communication were similar across stakeholder groups, regardless of children's disability or weight status. Participants generally agreed with the scoping review recommendations, suggesting that they apply broadly across different settings and populations; however, tailoring them to specific circumstances

  5. EFFECT OF ARSENIC ON DRY WEIGHT AND RELATIVE CHLOROPHYLL CONTENT IN GREENINGMAIZE AND SUNFLOWER TISSUES

    Directory of Open Access Journals (Sweden)

    Szilvia Várallyay

    2015-02-01

    Full Text Available Arsenic is one of the most toxic elements that can be found in the environment. Excessive uptake of arsenic may cause physiological changes in plants. The aim of the study was to investigate the effect of different arsenic treatments on relative chlorophyll content and dry weight of shoot and root of maize and sunflower in the early phases of plant development. Seedlings were grown in climatic room in nutrient solution under strictly regulated environmental conditions. The plants were exposed to 3, 10 and 30 mg kg-1arsenic, whereas there was no arsenic treatment on the control plants. We applied arsenic in the form of arsenite (NaAsO2 and arsenate (KH2AsO4, respectively. After 14 days of arsenic treatments, changes in relative chlorophyll content and dry weight of maize shoots and roots were recorded. In the case of sunflower these physiological parameters were measured after 21 day. The applied arsenic decreased the relative chlorophyll content of maize and sunflower leaves, especially at concentration of30 mg kg-1. The increasing amount of As treatment were resulted the lower weight of the experimental plants, which was more considerable in the case of the roots. The results indicate that the sunflower plants is more sensitive to arsenic toxicity than maize plants and all data demonstrate that the As(III is more toxic to these crop plants than the As(V.

  6. Preliminary notes on brain weight variation across labrid fish species with different levels of cooperative behaviour

    Institute of Scientific and Technical Information of China (English)

    Marta C.SOARES; Gon(c)alo I.ANDR(E); José R.PAULA

    2015-01-01

    Brain size and weight vary tremendously in the animal kingdom.It has been suggested that brain structural development must evolve balanced between the advantages of dealing with greater social challenges and the energetic costs of maintaining and developing larger brains.Here we ask if interspecific differences in cooperative behaviour (i.e.cleaning behaviour) are related to brain weight variations in four close-related species of Labrid fish:two are obligatory cleanerfish throughout their entire life (Labroides dimidiatus and L.bicolor),one facultative cleaner fish Labropsis australis and one last species that never engage in cleaning Labrichthys unilineatus.We first search for the link between the rate of species' cooperation and its relative brain weight,and finally,if the degree of social complexity and cooperation are reflected in the weight of its major brain substructures.Overall,no differences were found in relative brain weight (in relation to body weight) across species.Fine-scale differences were solely demonstrated for the facultative cleaner L.australis,at the brainstem level.Furthermore,data visual examination indicates that the average cerebellum and brainstem weights appear to be larger for L.dimidiatus.Because variation was solely found at specific brain areas (such as cerebellum and brainstem) and not for the whole brain weight values,it suggests that species social-ecological and cognitive demands may be directly contributing to a selective investment in relevant brain areas.This study provides first preliminary evidence that links potential differences in cognitive ability in cooperative behaviour to how these may mediate the evolution of brain structural development in non-mammal vertebrate groups [Current Zoology 61 (2):274-280,2015].

  7. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample.

    Science.gov (United States)

    Fox, Caroline S; Pencina, Michael J; D'Agostino, Ralph B; Murabito, Joanne M; Seely, Ellen W; Pearce, Elizabeth N; Vasan, Ramachandran S

    2008-03-24

    Overt hypothyroidism and hyperthyroidism may be associated with weight gain and loss. We assessed whether variations in thyroid function within the reference (physiologic) range are associated with body weight. Framingham Offspring Study participants (n=2407) who attended 2 consecutive routine examinations, were not receiving thyroid hormone therapy, and had baseline serum thyrotropin (TSH) concentrations of 0.5 to 5.0 mIU/L and follow-up concentrations of 0.5 to 10.0 mIU/L were included in this study. Baseline TSH concentrations were related to body weight and body weight change during 3.5 years of follow-up. At baseline, adjusted mean weight increased progressively from 64.5 to 70.2 kg in the lowest to highest TSH concentration quartiles in women (Pweight increased by 1.5 (5.6) kg in women and 1.0 (5.0) kg in men. Baseline TSH concentrations were not associated with weight change during follow-up. However, an increase in TSH concentration at follow-up was positively associated with weight gain in women (0.5-2.3 kg across increasing quartiles of TSH concentration change; Pweight in both sexes. Our findings raise the possibility that modest increases in serum TSH concentrations within the reference range may be associated with weight gain.

  8. [Challenges in nutrition-based treatment for weight control in adolescents suffering from schizophrenia].

    Science.gov (United States)

    Shani, Michal; Levi, Mazal; Zalsman, Gil

    2008-11-01

    The rate of overweight people amongst schizophrenia sufferers is higher than it is in the general population and this is true even prior to starting drug treatment. It is well known that anti-psychotic medications increase the severity of weight control problems. It seems that weight gain is even more significant in adolescents than in adults. The mechanisms in those medications which cause weight gain are not well understood. Hormones like Leptin, Ghrelin and others are being investigated in relation to this issue. Various interventions, like weight loss medications, were investigated in adults suffering from schizophrenia but not in adolescents. Other weight loss interventions, for example behavior therapy, were also investigated in adults, both as preventive measures and as treatment for already present excessive weight. Even caloric limitation was attempted in closed adult wards. The majority of studies show that there is only a small loss of weight and the patients maintain their high Body Mass Index (BMI). Among adolescents suffering from schizophrenia it was found that weight gain results mostly from increase in caloric intake. The easy availability of processed foods and their relatively low cost, result in the positive caloric balance. During adolescence there is increased sensitivity to outer appearance, however, those youngsters have great difficulty following professionals' advice for a balanced diet. This is particularly hard for those adolescents who are treated with antipsychotics and suffer from increased appetite. In a comparative study of various weight loss treatments for children it was found that the most efficient one is group weight loss clinics intended strictly for parents. The efficacy of such group weight loss clinics for parents of schizophrenia suffering adolescents should also be investigated.

  9. Antiepileptic Drug Titration and Related Health Care Resource Use and Costs.

    Science.gov (United States)

    Fishman, Jesse; Kalilani, Linda; Song, Yan; Swallow, Elyse; Wild, Imane

    2018-02-27

    Unexpected breakthrough seizures resulting from suboptimal antiepileptic drug (AED) dosing during the titration period, as well as adverse events resulting from rapid AED titration, may influence the titration schedule and significantly increase health care resource use (HRU) and health care costs. To assess the relationship between AEDs, HRU, and costs during AED titration and maintenance. Practicing neurologists were recruited from a nationwide panel to provide up to 3 patient records each for this retrospective medical chart review. Patients with epilepsy who were aged ≥ 18 years and had initiated an AED between January 1, 2014, and January 1, 2016, were followed for 6 months from AED initiation. Titration duration was the time from AED initiation to the beginning of treatment maintenance as determined by the physician. Outcomes were epilepsy-specific HRU (hospitalizations, emergency department visits, outpatient visits, physician referral, laboratory testing/diagnostic imaging, and phone calls) and related costs that occurred during the titration or maintenance treatment periods. Of 811 patients, 156, 128, 125, 120, 114, 107, and 61 initiated the following AEDs: levetiracetam, lamotrigine, lacosamide, valproate, topiramate, carbamazepine, and phenytoin, respectively. Most patients (619/803 [77.1%] with complete AED data) received monotherapy. Baseline characteristics were similar across AEDs (mean [SD] age, 36.6 [14.4] years; 59.0% male). Kaplan-Meier estimates of titration duration ranged from 3.3 weeks (phenytoin) to 8.1 weeks (lamotrigine). From titration to maintenance, the overall incidence of HRU per person-month decreased 54.5%-89.3% for each HRU measure except outpatient visits (24.6% decrease). Total epilepsy-related costs decreased from $80.48 to $42.77 per person-month, or 46.9% from titration to maintenance. AED titration periods had higher HRU rates and costs than AED maintenance, suggesting that use of AEDs with shorter titration requirements

  10. Child health-related quality of life following neurocritical care for traumatic brain injury: an analysis of preference-weighted outcomes.

    Science.gov (United States)

    Tilford, John M; Aitken, Mary E; Goodman, Allen C; Fiser, Debra H; Killingsworth, Jeffrey B; Green, Jerril W; Adelson, P David

    2007-01-01

    Cost-effectiveness analysis relies on preference-weighted health outcome measures as they form the basis for quality adjusted life years. Studies of preference-weighted outcomes for children following traumatic brain injury are lacking. This study seeks to describe the preference-weighted health outcomes of children following a traumatic brain injury at 3- and 6-months following pediatric intensive care unit (ICU) discharge. Children aged 5-17 who required ICU admission and endotracheal intubation or mechanical ventilation. The Quality of Well-being (QWB) score was used to describe preference-weighted outcomes. Clinical measures from the intensive care unit stay were used to estimate risk of mortality. Risk of mortality, Glasgow coma scores, patient length of stay in the intensive care unit, and parent-reported items from the Child Health Questionnaire (CHQ) were used to test construct validity. Subject data were obtained from nine pediatric intensive care units with consent procedures approved by representative institutional review boards. Medical records containing clinical information from the ICU stay were abstracted by the study coordinating center. Caregivers of children were contacted by telephone for follow-up interviews at 3- and 6-months following ICU discharge. All interviews were conducted by telephone with the primary caregiver of the injured child. Preference score statistics are presented overall and in relation to characteristics of the patient and their ICU admission. A response rate of 59% was achieved for the 3-month interviews (N = 56) and 67% for the 6-month interviews (N = 65) for caregivers of children aged 5 years and above that consented to participate. Overall, QWB scores averaged 0.508 (95% CI: 0.454-0.562) at the 3-month interview and 0.582 (95% CI: 0.526-0.639) at the 6-month interview. For both interview periods, scores ranged from 0.093 to 1.0 on a 0-1 value scale, where 0 represents death and 1 represents perfect health. Specific

  11. A cost summary applicable to seismic construction and maintenance of nuclear safety related piping

    International Nuclear Information System (INIS)

    Stevenson, J.D.

    1995-01-01

    This paper presents a summary of costs applicable to nuclear power plant piping for an earthquake defined as 0.2 SSE-PGA as a function of three eras of initial construction: 1967--1974, 1974--1981 and 1981--1990. Costs have been presented for both new construction and maintenance in operating plants using both the original PSAR-FSAR design criteria and current SRP requirements. It is recommended that the cost information contained in this report be considered in evaluating the cost benefit relationships associated with current and proposed future changes in seismic design procedures applicable to safety-related piping systems

  12. International cost relations in electric power generation

    International Nuclear Information System (INIS)

    Schmitt, D.; Duengen, H.; Wilhelm, M.

    1986-01-01

    In spite of the fact that analyses of the cost of electric power generation as the result of international comparative evaluations are indisputably relevant, problems pending in connection with the costs of representative power plant technologies are of the methodological bind. German authors have hitherto also been failing to clear up and consider all aspects connected with the problems of data acquisition and the adequate interpretation of results. The analysis presented by the paper abstracted therefore aims at the following: 1) Systematization of the different categories of cost relevant in connection with international comparative evaluation. Classification into different categories of decision making and development of standards meeting the requirements of international comparative evaluation. 2) Calculation of relevant average financial costs of Western German, America and French fossil-fuel and nuclear power plants by means of adequate calculation models, that is the assessment of costs with regard to countries and power plant technologies which are relevant to the Federal Republic of Germany. 3) Analysis of the resulting differences and determinantal interpretation. (orig./UA) [de

  13. Efficiency of Individual Tree Detection Approaches Based on Light-Weight and Low-Cost UAS Imagery in Australian Savannas

    Directory of Open Access Journals (Sweden)

    Grigorijs Goldbergs

    2018-01-01

    Full Text Available The reliability of airborne light detection and ranging (LiDAR for delineating individual trees and estimating aboveground biomass (AGB has been proven in a diverse range of ecosystems, but can be difficult and costly to commission. Point clouds derived from structure from motion (SfM matching techniques obtained from unmanned aerial systems (UAS could be a feasible low-cost alternative to airborne LiDAR scanning for canopy parameter retrieval. This study assesses the extent to which SfM three-dimensional (3D point clouds—obtained from a light-weight mini-UAS quadcopter with an inexpensive consumer action GoPro camera—can efficiently and effectively detect individual trees, measure tree heights, and provide AGB estimates in Australian tropical savannas. Two well-established canopy maxima and watershed segmentation tree detection algorithms were tested on canopy height models (CHM derived from SfM imagery. The influence of CHM spatial resolution on tree detection accuracy was analysed, and the results were validated against existing high-resolution airborne LiDAR data. We found that the canopy maxima and watershed segmentation routines produced similar tree detection rates (~70% for dominant and co-dominant trees, but yielded low detection rates (<35% for suppressed and small trees due to poor representativeness in point clouds and overstory occlusion. Although airborne LiDAR provides higher tree detection rates and more accurate estimates of tree heights, we found SfM image matching to be an adequate low-cost alternative for the detection of dominant and co-dominant tree stands.

  14. The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol.

    Science.gov (United States)

    Spencer, Lisa; Rollo, Megan; Hauck, Yvonne; MacDonald-Wicks, Lesley; Wood, Lisa; Hutchesson, Melinda; Giglia, Roslyn; Smith, Roger; Collins, Clare

    2015-01-01

    What are the effects of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women?The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aimed at limiting gestational weight gain and postpartum weight retention in women.The second objective of this systematic review is to investigate included intervention components with respect to effect on weight-related outcomes. This may include, but is not limited to: length of intervention, use of face-to-face counselling, group or individual consultations, use of other interventions components including exercise, use of goals and use of support tools like food diaries, coaching, including email or text message support. Around half of all women of reproductive age are either overweight or obese, with women aged 25-34 years having a greater risk of substantial weight gain compared with men of all ages. Excessive gestational weight gain (GWG) and postpartum weight retention (PPWR) may play a significant role in long term obesity. Having one child doubles the five- and 10-year obesity incidence for women, with many women who gain excessive weight during pregnancy remaining obese permanently. Excessive GWG and/or PPWR can also significantly contribute to short- and long-term adverse health outcomes for mother, baby and future pregnancies.Maternal obesity increases the risk of pregnancy related complications such as pre-eclampsia, gestational diabetes mellitus, stillbirth and the rate of caesarean section. Childhood obesity is a further long term complication of maternal obesity for offspring, which may persist in to adulthood. Excess GWG is also a risk factor for PPWR both in the short and long-term. Nehring et al. conducted a meta-analysis with over 65,000 women showing that, compared to women who gained weight within recommendations during pregnancy, women with GWG

  15. 77 FR 11778 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

    Science.gov (United States)

    2012-02-28

    ... and II Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and... available on OMB's Web site at http://www.whitehouse.gov/omb/circulars_default/ . The Cost Principles for... E (Principles for Determining Costs Applicable to Research and Development Under Grants and...

  16. 78 FR 7282 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

    Science.gov (United States)

    2013-02-01

    ... II Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and... further review, the Cost Principles for Hospitals at 45 CFR Part 74, Appendix E. The proposal consolidates... instructed the OMB Director to ``review and where appropriate revise guidance concerning cost principles...

  17. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight

    Science.gov (United States)

    Chao, Ariana M.; Jastreboff, Ania M.; White, Marney A.; Grilo, Carlos M.; Sinha, Rajita

    2017-01-01

    Objective To examine whether baseline chronic stress, morning cortisol, and other appetite-related hormones (leptin, ghrelin, and insulin) predict future weight gain and food cravings in a naturalistic longitudinal 6-month follow-up study. Methods A prospective community cohort of three hundred and thirty-nine adults (age=29.1± 9.0 years; BMI=26.7±5.4 kg/m2; 56.9% female; 70.2% White) completed assessments at baseline and 6-month follow-up. Fasting blood draws were used to assess cortisol and other appetite-related hormones levels at baseline. At baseline and follow-up, body weight was measured and the Cumulative Adversity Interview and Food Craving Inventory were administered. Data were analyzed using linear mixed models adjusting for demographic and clinical covariates. Results Over the 6-month period, 49.9% of the sample gained weight. Food cravings and chronic stress decreased over 6 months (psfood cravings at 6 months (p=0.04). Furthermore, higher cortisol, insulin, and chronic stress were each predictive of greater future weight gain (psfood cravings and reward-driven eating behaviors. Studies are needed that examine the utility of stress reduction methods for normalizing disrupted cortisol responses and preventing future weight gain. PMID:28349668

  18. Weight gain in healthy pregnant women in relation to pre-pregnancy BMI, diet and physical activity.

    Science.gov (United States)

    Merkx, Astrid; Ausems, Marlein; Budé, Luc; de Vries, Raymond; Nieuwenhuijze, Marianne J

    2015-07-01

    to explore gestational weight gain in healthy women in relation to pre-pregnancy Body Mass Index, diet and physical activity. a cross-sectional survey was conducted among 455 healthy pregnant women of all gestational ages receiving antenatal care from an independent midwife in the Netherlands. Weight gain was assessed using the Institute of Medicine (IOM) guidelines and classified as below, within, or above the guidelines. A multinomial regression analysis was performed with weight gain classifications as the dependent variable (within IOM-guidelines as reference). Independent variables were pre-pregnancy Body Mass Index, diet (broken down into consumption of vegetables, fruit and fish) and physical activity (motivation to engage in physical activity, pre-pregnancy physical activity and decline in physical activity during pregnancy). Covariates were age, gestational age, parity, ethnicity, family income, education, perceived sleep deprivation, satisfaction with pre-pregnancy weight, estimated prepregnancy body mass index, smoking, having a weight gain goal and having received weight gain advice from the midwife. forty-two per cent of the women surveyed gained weight within the guidelines. Fourteen per cent of the women gained weight below the guidelines and 44 per cent gained weight above the guidelines. Weight gain within the guidelines, compared to both above and below the guidelines, was not associated with pre-pregnancy Body Mass Index nor with diet. A decline in physical activity was associated with weight gain above the guidelines (OR 0.54, 95 per cent CI 0.33-0.89). Weight gain below the guidelines was seen more often in women who perceived a greater sleep deprivation (OR 1.20, 95 per cent CI 1.02-1.41). Weight gain above the guidelines was seen less often in Caucasian women in comparison to non-Caucasian women (OR 0.22, 95 per cent CI 0.08-0.56) and with women who did not stop smoking during pregnancy (OR 0.49, 95 per cent CI 0.25-0.95). a decline in

  19. Occupational-Specific Strength Predicts Astronaut-Related Task Performance in a Weighted Suit.

    Science.gov (United States)

    Taylor, Andrew; Kotarsky, Christopher J; Bond, Colin W; Hackney, Kyle J

    2018-01-01

    Future space missions beyond low Earth orbit will require deconditioned astronauts to perform occupationally relevant tasks within a planetary spacesuit. The prediction of time-to-completion (TTC) of astronaut tasks will be critical for crew safety, autonomous operations, and mission success. This exploratory study determined if the addition of task-specific strength testing to current standard lower body testing would enhance the prediction of TTC in a 1-G test battery. Eight healthy participants completed NASA lower body strength tests, occupationally specific strength tests, and performed six task simulations (hand drilling, construction wrenching, incline walking, collecting weighted samples, and dragging an unresponsive crewmember to safety) in a 48-kg weighted suit. The TTC for each task was recorded and summed to obtain a total TTC for the test battery. Linear regression was used to predict total TTC with two models: 1) NASA lower body strength tests; and 2) NASA lower body strength tests + occupationally specific strength tests. Total TTC of the test battery ranged from 20.2-44.5 min. The lower body strength test alone accounted for 61% of the variability in total TTC. The addition of hand drilling and wrenching strength tests accounted for 99% of the variability in total TTC. Adding occupationally specific strength tests (hand drilling and wrenching) to standard lower body strength tests successfully predicted total TTC in a performance test battery within a weighted suit. Future research should couple these strength tests with higher fidelity task simulations to determine the utility and efficacy of task performance prediction.Taylor A, Kotarsky CJ, Bond CW, Hackney KJ. Occupational-specific strength predicts astronaut-related task performance in a weighted suit. Aerosp Med Hum Perform. 2018; 89(1):58-62.

  20. Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study

    Directory of Open Access Journals (Sweden)

    V. Brown

    2017-05-01

    Full Text Available Abstract Background Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. Methods A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs were reported and results were tested through sensitivity analysis. Results Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings, measured against a comparator of no additional increase in fuel excise. Under “best case” assumptions, the intervention

  1. Human health risks analysis: assessment of health costs of energy related pollutants

    International Nuclear Information System (INIS)

    Ginevan, M.E.; Grahn, D.; Lundy, R.T.; Brown, C.D.; Curtiss, J.B.

    1979-01-01

    This section contains a summary of research on the assessment of health costs of energy related pollutants. It includes the development of new statistical methodology, mathematical models, and data bases relevant to the assessment

  2. 77 FR 17360 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles And...

    Science.gov (United States)

    2012-03-26

    ... II Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles And...; cost principles and administrative requirements (including Single Audit Act). The original comment...-idx?c=ecfr&tpl=/ecfrbrowse/Title02/2cfrv1_02.tpl . The Cost Principles for Hospitals are in the...

  3. Executive function in weight loss and weight loss maintenance: a conceptual review and novel neuropsychological model of weight control.

    Science.gov (United States)

    Gettens, Katelyn M; Gorin, Amy A

    2017-10-01

    Weight loss maintenance is a complex, multifaceted process that presents a significant challenge for most individuals who lose weight. A growing body of literature indicates a strong relationship between cognitive dysfunction and excessive body weight, and suggests that a subset of high-order cognitive processes known as executive functions (EF) likely play an important role in weight management. Recent reviews cover neuropsychological correlates of weight status yet fail to address the role of executive function in the central dilemma of successful weight loss maintenance. In this paper, we provide an overview of the existing literature examining executive functions as they relate to weight status and initial weight loss. Further, we propose a novel conceptual model of the relationships between EF, initial weight loss, and weight loss maintenance, mapping specific executive functions onto strategies known to be associated with both phases of the weight control process. Implications for the development of more efficacious weight loss maintenance interventions are discussed.

  4. The cost of lost productivity due to premature cancer-related mortality: an economic measure of the cancer burden.

    Science.gov (United States)

    Hanly, Paul A; Sharp, Linda

    2014-03-26

    Most measures of the cancer burden take a public health perspective. Cancer also has a significant economic impact on society. To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland. All cancers combined and the 10 sites accounting for most deaths in men and in women were considered. To compute YPPLL, deaths in 5-year age-bands between 15 and 64 years were multiplied by average working-life expectancy. Valuation of costs, using the human capital approach, involved multiplying YPPLL by age-and-gender specific gross wages, and adjusting for unemployment and workforce participation. Sensitivity analyses were conducted around retirement age and wage growth, labour force participation, employment and discount rates, and to explore the impact of including household production and caring costs. Costs were expressed in €2009. Total YPPLL was lower in men than women (men = 10,873; women = 12,119). Premature cancer-related mortality costs were higher in men (men: total cost = €332 million, cost/death = €290,172, cost/YPPLL = €30,558; women: total cost = €177 million, cost/death = €159,959, cost/YPPLL = €14,628). Lung cancer had the highest premature mortality cost (€84.0 million; 16.5% of total costs), followed by cancers of the colorectum (€49.6 million; 9.7%), breast (€49.4 million; 9.7%) and brain & CNS (€42.4 million: 8.3%). The total economic cost of premature cancer-related mortality in Ireland amounted to €509.5 million or 0.3% of gross domestic product. An increase of one year in the retirement age increased the total all-cancer premature mortality cost by 9.9% for men and 5.9% for women. The inclusion of household production and caring costs increased the total cost to €945.7 million. Lost productivity costs due to cancer-related premature mortality are significant. The higher premature mortality cost in males than

  5. A Latent Class Analysis of Weight-Related Health Behaviors among 2-and 4-Year College Students and Associated Risk of Obesity

    Science.gov (United States)

    Mathur, Charu; Stigler, Melissa; Lust, Katherine; Laska, Melissa

    2014-01-01

    Little is known about the complex patterning of weight-related health behaviors in 2-and 4-year college students. The objective of this study was to identify and describe unique classes of weight-related health behaviors among college students. Latent class analysis was used to identify homogenous, mutually exclusive classes of nine health…

  6. Interaction between genetic predisposition to obesity and dietary calcium in relation to subsequent change in body weight and waist circumference

    DEFF Research Database (Denmark)

    Larsen, Sofus C; Angquist, Lars; Ahluwalia, Tarun Veer Singh

    2014-01-01

    Studies indicate an effect of dietary calcium on change in body weight (BW) and waist circumference (WC), but the results are inconsistent. Furthermore, a relation could depend on genetic predisposition to obesity.......Studies indicate an effect of dietary calcium on change in body weight (BW) and waist circumference (WC), but the results are inconsistent. Furthermore, a relation could depend on genetic predisposition to obesity....

  7. Increased Burden of Healthcare Utilization and Cost Associated with Opioid-Related Constipation Among Patients with Noncancer Pain

    Science.gov (United States)

    Fernandes, Ancilla W.; Kern, David M.; Datto, Catherine; Chen, Yen-Wen; McLeskey, Charles; Tunceli, Ozgur

    2016-01-01

    Background Opioids are widely accepted as treatment for moderate to severe pain, and opioid-induced constipation is one of the most common side effects of opioids. This side effect negatively affects pain management and patients’ quality of life, which could result in increased healthcare utilization and costs. Objective To assess healthcare utilization and costs (all-cause, constipation-related, and pain-related) for individuals with and without opioid-induced constipation during the 12 months after initiation of opioid therapy for noncancer pain. Methods This retrospective cohort study was conducted using administrative claims data from HealthCore Integrated Research Environment between January 1, 2006, and June 30, 2014. The analysis was limited to patients aged ≥18 years who filled a prescription for continuous opioid treatment (≥28 days) for noncancer pain. Propensity scores were used to match opioid users with constipation (cohort 1) and opioid users without constipation (cohort 2), using a 1:1 ratio. Generalized linear models were used to estimate all-cause, constipation-related, and pain-related healthcare utilization and costs during the 12 months after the initiation of opioid therapy. Results After matching and balancing for all prespecified variables, 17,384 patients were retained in each cohort (mean age, 56 years; 63% female). Opioid users with constipation were twice as likely as those without constipation to have ≥1 inpatient hospitalizations (odds ratio, 2.28; 95% confidence interval [CI], 2.17–2.39) during the 12 months. The total mean adjusted overall costs per patient during the study period were $12,413 higher for patients with constipation versus those without it (95% CI, $11,726–$13,116). The total mean adjusted overall pain-related costs per patient were $6778 (95% CI, $6293–$7279) higher for the patients with constipation than those without. Among patients using opioids for noncancer pain, the annual mean constipation-related

  8. Hospitalisations and costs relating to ambulatory care sensitive conditions in Ireland.

    LENUS (Irish Health Repository)

    Sheridan, A

    2012-03-08

    BACKGROUND: Ambulatory care sensitive conditions (ACSCs) are conditions for which the provision of timely and effective outpatient care can reduce the risks of hospitalisation by preventing, controlling or managing a chronic disease or condition. AIMS: The aims of this study were to report on ACSCs in Ireland, and to provide a baseline for future reference. METHODS: Using HIPE, via Health Atlas Ireland, inpatient discharges classified as ACSCs using definitions from the Victorian ACSC study were extracted for the years 2005-2008. Direct methods of standardisation allowed comparison of rates using the EU standard population as a comparison for national data, and national population as comparison for county data. Costs were estimated using diagnosis-related groups. RESULTS: The directly age-standardised discharge rate for ACSC-related discharges increased slightly, but non-significantly, from 15.40 per 1,000 population in 2005 to 15.75 per 1,000 population in 2008. The number of discharges increased (9.5%) from 63,619 in 2005 to 69,664 in 2008, with the estimated associated hospital costs increasing (31.5%) from 267.8 million in 2005 to 352.2 million in 2008. Across the country, there was considerable variation in the discharge rates for the Top-10 ACSCs for the years 2005-2008. Significantly lower rates of hospitalisation were observed in more urban areas including Cork, Dublin and Galway. The most common ACSC in 2008 was diabetes with complications (29.8%). CONCLUSIONS: The variation in rates observed indicates the scope of reducing hospitalisations and associated costs for ACSCs, across both adult\\'s and children\\'s services and particularly in relation to diabetes complications.

  9. Extent, nature and hospital costs of fireworks-related injuries during the Wednesday Eve festival in Iran.

    Science.gov (United States)

    Alinia, Siros; Rezaei, Satar; Daroudi, Rajabali; Hadadi, Mashyaneh; Akbari Sari, Ali

    2013-01-01

    Fireworks are commonly used in local and national celebrations. The aim of this study is to explore the extent, nature and hospital costs of injuries related to the Persian Wednesday Eve festival in Iran. Data for injuries caused by fireworks during the 2009 Persian Wednesday Eve festival were collected from the national Ministry of Health database. Injuries were divided into nine groups and the average and total hospital costs were estimated for each group. The cost of care for patients with burns was estimated by reviewing a sample of 100 patients randomly selected from a large burn center in Tehran. Other costs were estimated by conducting semi structured interviews with expert managers at two large government hospitals. 1817 people were injured by fireworks during the 2009 Wednesday Eve festival. The most frequently injured sites were the hand (43.3%), eye (24.5%) and face (13.2%), and the most common types of injury were burns (39.9%), contusions/abrasions (24.6%) and lacerations (12.7%). The mean length of hospital stay was 8.15 days for patients with burns, 10.7 days for those with amputations, and 3 days for those with other types of injury. The total hospital cost of injuries was US$ 284 000 and the average cost per injury was US$ 156. The total hospital cost of patients with amputations was US$ 48 598. Most of the costs were related to burns (56.6%) followed by amputations (12.2%). Injuries related to the Persian Wednesday Eve festival are common and lead to extensive morbidity and medical costs. © 2013 KUMS, All rights reserved.

  10. State-Level Estimates of Cancer-Related Absenteeism Costs

    Science.gov (United States)

    Tangka, Florence K.; Trogdon, Justin G.; Nwaise, Isaac; Ekwueme, Donatus U.; Guy, Gery P.; Orenstein, Diane

    2016-01-01

    Background Cancer is one of the top five most costly diseases in the United States and leads to substantial work loss. Nevertheless, limited state-level estimates of cancer absenteeism costs have been published. Methods In analyses of data from the 2004–2008 Medical Expenditure Panel Survey, the 2004 National Nursing Home Survey, the U.S. Census Bureau for 2008, and the 2009 Current Population Survey, we used regression modeling to estimate annual state-level absenteeism costs attributable to cancer from 2004 to 2008. Results We estimated that the state-level median number of days of absenteeism per year among employed cancer patients was 6.1 days and that annual state-level cancer absenteeism costs ranged from $14.9 million to $915.9 million (median = $115.9 million) across states in 2010 dollars. Absenteeism costs are approximately 6.5% of the costs of premature cancer mortality. Conclusions The results from this study suggest that lost productivity attributable to cancer is a substantial cost to employees and employers and contributes to estimates of the overall impact of cancer in a state population. PMID:23969498

  11. Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness.

    Science.gov (United States)

    Reilly, Kathryn L; Reeves, Penny; Deeming, Simon; Yoong, Sze Lin; Wolfenden, Luke; Nathan, Nicole; Wiggers, John

    2018-03-20

    No evaluations of the cost or cost effectiveness of interventions to increase school implementation of food availability policies have been reported. Government and non-government agency decisions regarding the extent of investment required to enhance school implementation of such policies are unsupported by such evidence. This study sought to i) Determine cost and cost-effectiveness of three interventions in improving school implementation of an Australian government healthy canteen policy and; ii) Determine the relative cost-effectiveness of the interventions in improving school implementation of such a policy. An analysis of the cost and cost-effectiveness of three implementation interventions of varying support intensity, relative to usual implementation support conducted during 2013-2015 was undertaken. Secondly, an indirect comparison of the trials was undertaken to determine the most cost-effective of the three strategies. The economic analysis was based on the cost of delivering the interventions by health service delivery staff to increase the proportion of schools 'adherent' with the policy. The total costs per school were $166,971, $70,926 and $75,682 for the high, medium and low intensity interventions respectively. Compared to usual support, the cost effectiveness ratios for each of the three interventions were: A$2982 (high intensity), A$2627 (medium intensity) and A$4730 (low intensity) per percent increase in proportion of schools reporting 'adherence'). Indirect comparison between the 'high' and 'medium intensity' interventions showed no statistically significant difference in cost-effectiveness. The results indicate that while the cost profiles of the interventions varied substantially, the cost-effectiveness did not. This result is valuable to policy makers seeking cost-effective solutions that can be delivered within budget.

  12. Costs of biodiesel supply chain in Latvia

    International Nuclear Information System (INIS)

    Birzietis, G.; Kunkule, D.

    2003-01-01

    Biodiesels has already become reality in Latvia, but still not are extensively used due to number of reasons. Cost reduction would be one of the most efficient tools that could encourage wider use of biodiesel. Identifying costs in biodiesel supply chain and evaluating their weight in total cost of final product is the first step to finding most costly elements and potential for cost reduction. General cost breakdown in final price is calculated and analysed in this study (authors)

  13. Impact of quadrivalent influenza vaccine on public health and influenza-related costs in Australia

    Directory of Open Access Journals (Sweden)

    Aurélien Jamotte

    2016-07-01

    Full Text Available Abstract Background Annual trivalent influenza vaccines (TIV containing three influenza strains (A/H1N1, A/H3N2, and one B have been recommended for the prevention of influenza. However, worldwide co-circulation of two distinct B lineages (Victoria and Yamagata and difficulties in predicting which lineage will predominate each season have led to the development of quadrivalent influenza vaccines (QIV, which include both B lineages. Our analysis evaluates the public health benefit and associated influenza-related costs avoided which would have been obtained by using QIV rather than TIV in Australia over the period 2002–2012. Methods A static model stratified by age group was used, focusing on people at increased risk of influenza as defined by the Australian vaccination recommendations. B-lineage cross-protection was accounted for. We calculated the potential impact of QIV compared with TIV over the seasons 2002–2012 (2009 pandemic year excluded using Australian data on influenza circulation, vaccine coverage, hospitalisation and mortality rates as well as unit costs, and international data on vaccine effectiveness, influenza attack rate, GP consultation rate and working days lost. Third-party payer and societal influenza-related costs were estimated in 2014 Australian dollars. Sensitivity analyses were conducted. Results Using QIV instead of TIV over the period 2002–2012 would have prevented an estimated 68,271 additional influenza cases, 47,537 GP consultations, 3,522 hospitalisations and 683 deaths in the population at risk of influenza. These results translate into influenza-related societal costs avoided of $46.5 million. The estimated impact of QIV was higher for young children and the elderly. The overall impact of QIV depended mainly on vaccine effectiveness and the influenza attack rate attributable to the mismatched B lineage. Conclusion The broader protection offered by QIV would have reduced the number of influenza infections

  14. Preventing Weight Gain

    Science.gov (United States)

    ... Local Programs Related Topics Diabetes Nutrition Preventing Weight Gain Language: English (US) Español (Spanish) Recommend on Facebook ... cancer. Choosing an Eating Plan to Prevent Weight Gain So, how do you choose a healthful eating ...

  15. Effects of diet and exercise on weight-related outcomes for breast cancer survivors and their adult daughters: an analysis of the DAMES trial.

    Science.gov (United States)

    Tometich, Danielle B; Mosher, Catherine E; Winger, Joseph G; Badr, Hoda J; Snyder, Denise C; Sloane, Richard J; Demark-Wahnefried, Wendy

    2017-08-01

    Few trials have aimed to promote diet and exercise behaviors in both cancer survivors and their family members and examine their associations with weight-related outcomes. We conducted a secondary analysis to examine associations between change in diet and exercise behaviors and weight-related outcomes for overweight breast cancer survivors and their overweight adult daughters in the Daughters And MothErS Against Breast Cancer (DAMES) randomized trial. The DAMES trial assessed the impact of two iteratively tailored, mailed print diet and exercise interventions against standard brochures over a 12-month period. This analysis examined change in diet and exercise behaviors and weight-related variables from baseline to post-intervention for the 50 breast cancer survivors and their adult daughters randomized to the intervention arms. To reduce the potential for type II error in this pilot, p values diet quality was uniquely related to change in BMI (β = -0.12, p = 0.082), weight (β = -0.12, p = 0.060), and waist circumference (β = -0.38, p = 0.001), whereas change in caloric intake was related to waist circumference (β = 0.21, p = 0.002). For daughters, change in caloric intake was related to change in waist circumference (β = 0.12, p = 0.055). However, change in diet quality was not associated with weight-related outcomes in daughters. Additionally, change in exercise was not associated with weight-related outcomes in mothers or daughters. Findings support mail-based and other tailored interventions for weight loss in this population, with an emphasis on diet quality for breast cancer survivors and caloric intake for their adult daughters.

  16. 42 CFR 412.60 - DRG classification and weighting factors.

    Science.gov (United States)

    2010-10-01

    ... DRG classification system provides a DRG, and an appropriate weighting factor, for the group of cases... 42 Public Health 2 2010-10-01 2010-10-01 false DRG classification and weighting factors. 412.60... Determining Prospective Payment Federal Rates for Inpatient Operating Costs § 412.60 DRG classification and...

  17. Risk of breast cancer in young women in relation to body size and weight gain in adolescence and early adulthood.

    Science.gov (United States)

    Coates, R J; Uhler, R J; Hall, H I; Potischman, N; Brinton, L A; Ballard-Barbash, R; Gammon, M D; Brogan, D R; Daling, J R; Malone, K E; Schoenberg, J B; Swanson, C A

    1999-09-01

    Findings have been inconsistent on effects of adolescent body size and adult weight gain on risk of breast cancer in young women. These relations were examined in a population-based case control study of 1590 women less than 45 years of age newly diagnosed with breast cancer during 1990-1992 in three areas of the US and an age-matched control group of 1390 women. Height and weight were measured at interview and participants asked to recall information about earlier body size. Logistic regression was used to estimate the relative risk of breast cancer adjusted for other risk factors. Women who were either much heavier or lighter than average in adolescence or at age 20 were at reduced risk. Weight gain after age 20 resulted in reduced risk, but the effect was confined to early-stage and, more specifically, lower grade breast cancer. Neither the risk reduction nor the variation by breast cancer stage or grade was explained by the method of cancer detection or by prior mammography history. These findings suggest that relations between breast cancer risk in young women and body weight at different ages is complex and that the risk reduction with adult weight gain is confined to less aggressive cancers.

  18. Longitudinal social networks impacts on weight and weight-related behaviors assessed using mobile-based ecological momentary assessments: Study Protocols for the SPARC study

    Directory of Open Access Journals (Sweden)

    Meg Bruening

    2016-08-01

    Full Text Available Abstract Background The transition from the home to college is a phase in which emerging adults shift toward more unhealthy eating and physical activity patterns, higher body mass indices, thus increasing risk of overweight/obesity. Currently, little is understood about how changing friendship networks shape weight gain behaviors. This paper describes the recruitment, data collection, and data analytic protocols for the SPARC (Social impact of Physical Activity and nutRition in College study, a longitudinal examination of the mechanisms by which friends and friendship networks influence nutrition and physical activity behaviors and weight gain in the transition to college life. Methods The SPARC study aims to follow 1450 university freshmen from a large university over an academic year, collecting data on multiple aspects of friends and friendship networks. Integrating multiple types of data related to student lives, ecological momentary assessments (EMAs are administered via a cell phone application, devilSPARC. EMAs collected in four 1-week periods (a total of 4 EMA waves are integrated with linked data from web-based surveys and anthropometric measurements conducted at four times points (for a total of eight data collection periods including EMAs, separated by ~1 month. University databases will provide student card data, allowing integration of both time-dated data on food purchasing, use of physical activity venues, and geographical information system (GIS locations of these activities relative to other students in their social networks. Discussion Findings are intended to guide the development of more effective interventions to enhance behaviors among college students that protect against weight gain during college.

  19. Longitudinal social networks impacts on weight and weight-related behaviors assessed using mobile-based ecological momentary assessments: Study Protocols for the SPARC study.

    Science.gov (United States)

    Bruening, Meg; Ohri-Vachaspati, Punam; Brewis, Alexandra; Laska, Melissa; Todd, Michael; Hruschka, Daniel; Schaefer, David R; Whisner, Corrie M; Dunton, Genevieve

    2016-08-30

    The transition from the home to college is a phase in which emerging adults shift toward more unhealthy eating and physical activity patterns, higher body mass indices, thus increasing risk of overweight/obesity. Currently, little is understood about how changing friendship networks shape weight gain behaviors. This paper describes the recruitment, data collection, and data analytic protocols for the SPARC (Social impact of Physical Activity and nutRition in College) study, a longitudinal examination of the mechanisms by which friends and friendship networks influence nutrition and physical activity behaviors and weight gain in the transition to college life. The SPARC study aims to follow 1450 university freshmen from a large university over an academic year, collecting data on multiple aspects of friends and friendship networks. Integrating multiple types of data related to student lives, ecological momentary assessments (EMAs) are administered via a cell phone application, devilSPARC. EMAs collected in four 1-week periods (a total of 4 EMA waves) are integrated with linked data from web-based surveys and anthropometric measurements conducted at four times points (for a total of eight data collection periods including EMAs, separated by ~1 month). University databases will provide student card data, allowing integration of both time-dated data on food purchasing, use of physical activity venues, and geographical information system (GIS) locations of these activities relative to other students in their social networks. Findings are intended to guide the development of more effective interventions to enhance behaviors among college students that protect against weight gain during college.

  20. Health-care costs of underweight, overweight and obesity: Australian population-based study.

    Science.gov (United States)

    Clifford, Susan A; Gold, Lisa; Mensah, Fiona K; Jansen, Pauline W; Lucas, Nina; Nicholson, Jan M; Wake, Melissa

    2015-12-01

    Child health varies with body mass index (BMI), but it is unknown by what age or how much this attracts additional population health-care costs. We aimed to determine the (1) cross-sectional relationships between BMI and costs across the first decade of life and (2) in longitudinal analyses, whether costs increase with duration of underweight or obesity. Baby (n = 4230) and Kindergarten (n = 4543) cohorts in the nationally representative Longitudinal Study of Australian Children. Medicare Benefits Scheme (including all general practitioner plus a large proportion of paediatrician visits) plus prescription medication costs to federal government from birth to sixth (Baby cohort) and fourth to tenth (Kindergarten cohort) birthdays. biennial BMI measurements over the same period. Among Australian children under 10 years of age, 5-6% were underweight, 11-18% overweight and 5-6% obese. Excess costs with low and high BMI became evident from age 4-5 years, with normal weight accruing the least, obesity the most, and underweight and overweight intermediate costs. Relative to overall between-child variation, these excess costs per child were very modest, with a maximum of $94 per year at age 4-5 years. Nonetheless, this projects to a substantial cost to government of approximately $13 million per annum for all Australian children aged less than 10 years. Substantial excess population costs provide further economic justification for promoting healthy body weight. However, obese children's low individual excess health-care costs mean that effective treatments are likely to increase short-term costs to the public health purse during childhood. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  1. Comprehensive Evaluation of the Sustainable Development of Power Grid Enterprises Based on the Model of Fuzzy Group Ideal Point Method and Combination Weighting Method with Improved Group Order Relation Method and Entropy Weight Method

    Directory of Open Access Journals (Sweden)

    Shuyu Dai

    2017-10-01

    Full Text Available As an important implementing body of the national energy strategy, grid enterprises bear the important responsibility of optimizing the allocation of energy resources and serving the economic and social development, and their levels of sustainable development have a direct impact on the national economy and social life. In this paper, the model of fuzzy group ideal point method and combination weighting method with improved group order relation method and entropy weight method is proposed to evaluate the sustainable development of power grid enterprises. Firstly, on the basis of consulting a large amount of literature, the important criteria of the comprehensive evaluation of the sustainable development of power grid enterprises are preliminarily selected. The opinions of the industry experts are consulted and fed back for many rounds through the Delphi method and the evaluation criteria system for sustainable development of power grid enterprises is determined, then doing the consistent and non dimensional processing of the evaluation criteria. After that, based on the basic order relation method, the weights of each expert judgment matrix are synthesized to construct the compound matter elements. By using matter element analysis, the subjective weights of the criteria are obtained. And entropy weight method is used to determine the objective weights of the preprocessed criteria. Then, combining the subjective and objective information with the combination weighting method based on the subjective and objective weighted attribute value consistency, a more comprehensive, reasonable and accurate combination weight is calculated. Finally, based on the traditional TOPSIS method, the triangular fuzzy numbers are introduced to better realize the scientific processing of the data information which is difficult to quantify, and the queuing indication value of each object and the ranking result are obtained. A numerical example is taken to prove that the

  2. Weighted approximation with varying weight

    CERN Document Server

    Totik, Vilmos

    1994-01-01

    A new construction is given for approximating a logarithmic potential by a discrete one. This yields a new approach to approximation with weighted polynomials of the form w"n"(" "= uppercase)P"n"(" "= uppercase). The new technique settles several open problems, and it leads to a simple proof for the strong asymptotics on some L p(uppercase) extremal problems on the real line with exponential weights, which, for the case p=2, are equivalent to power- type asymptotics for the leading coefficients of the corresponding orthogonal polynomials. The method is also modified toyield (in a sense) uniformly good approximation on the whole support. This allows one to deduce strong asymptotics in some L p(uppercase) extremal problems with varying weights. Applications are given, relating to fast decreasing polynomials, asymptotic behavior of orthogonal polynomials and multipoint Pade approximation. The approach is potential-theoretic, but the text is self-contained.

  3. Sequential Optimization of Paths in Directed Graphs Relative to Different Cost Functions

    KAUST Repository

    Abubeker, Jewahir Ali; Chikalov, Igor; Hussain, Shahid; Moshkov, Mikhail

    2011-01-01

    This paper is devoted to the consideration of an algorithm for sequential optimization of paths in directed graphs relative to di_erent cost functions. The considered algorithm is based on an extension of dynamic programming which allows

  4. Depressive symptoms in women's midlife in relation to their body weight before, during and after childbearing years

    DEFF Research Database (Denmark)

    Bliddal, Mette; Pottegård, Anton; Kirkegaard, Hans

    2016-01-01

    OBJECTIVE: This study aimed to examine how weight and weight changes related to pregnancy were associated with depressive symptoms 11-16 years after childbirth. METHOD: We followed 16,998 first-time mothers from the Danish National Birth Cohort up till 16 years after birth and estimated...... associations between depressive symptoms and pre-pregnancy body mass index (BMI) (kg m(-2)), weight changes in different time periods, and BMI-adjusted waist circumference 7 years after birth (WCBMI, cm). Depressive symptoms were estimated by the Center for Epidemiologic Studies Depression 10-item scale....... Multiple logistic regression analyses were used to estimate odds ratios (OR) and 95% confidence intervals. RESULTS: Compared with normal-weight, we found that underweight, overweight and obesity were associated with greater odds of depressive symptoms (1.29, 1.24 and 1.73, respectively). Compared...

  5. The Effects of Twitter Users' Gender and Weight on Viral Behavioral Intentions Toward Obesity-Related News.

    Science.gov (United States)

    Almutairi, Nasser; Alhabash, Saleem; Hellmueller, Lea; Willis, Erin

    2018-01-01

    In this study, male and female participants were exposed to identical news stories covering obesity topics paired with tweets from Twitter users. Our study aimed at understanding how obesity-related news combined with user-generated social media posts (i.e., tweets) affect consumers' evaluations of online content and viral behavioral intentions (the intentions to like, share, and comment). An experiment (N = 316) explored how gender and weight of a Twitter user (tweeter) affect participants' evaluations and viral behavioral intentions toward news stories. Participants differed in their evaluations of and viral behavioral intentions for news stories as a function of Twitter users' gender and weight, as well as participants' gender. While participants expressed more favorable attitudes toward news stories paired with tweets by overweight than healthy females (with the opposite true for tweets by male users), participants expressed greater viral behavioral intentions for news stories paired with tweets by healthy weight than overweight user. These effects were more pronounced among male than female participants. Findings are discussed within the context of social media posts and their persuasive effects in relation to attitude and behavior changes.

  6. Structural optimization procedure of a composite wind turbine blade for reducing both material cost and blade weight

    Science.gov (United States)

    Hu, Weifei; Park, Dohyun; Choi, DongHoon

    2013-12-01

    A composite blade structure for a 2 MW horizontal axis wind turbine is optimally designed. Design requirements are simultaneously minimizing material cost and blade weight while satisfying the constraints on stress ratio, tip deflection, fatigue life and laminate layup requirements. The stress ratio and tip deflection under extreme gust loads and the fatigue life under a stochastic normal wind load are evaluated. A blade element wind load model is proposed to explain the wind pressure difference due to blade height change during rotor rotation. For fatigue life evaluation, the stress result of an implicit nonlinear dynamic analysis under a time-varying fluctuating wind is converted to the histograms of mean and amplitude of maximum stress ratio using the rainflow counting algorithm Miner's rule is employed to predict the fatigue life. After integrating and automating the whole analysis procedure an evolutionary algorithm is used to solve the discrete optimization problem.

  7. Structure of Clavicle In Relation to Weight Transmission

    Science.gov (United States)

    Routatal, Rohini V

    2015-01-01

    Aims and Objectives It is a known fact that weight of upper limb is transmitted to the axial skeleton through clavicle. The present study is an attempt to correlate pattern of compact and trabecular bone of clavicle as a weight transmitting bone. Materials and Methods Sixty clavicles were studied from right and left sides of 30 cadavers donated to the Anatomy department, Pramukhswami Medical College, Karamsad, India. The study was focused on the thickness of compact bone of clavicle and trabecular pattern of this bone. Results Cancellous bone: Cancellous bone near both ends of clavicle presented meshwork of thin bony plates. Between the conoid tubercle and area for attachment of costo-clavicular ligament, cancellous bone showed a definite pattern. Thickness of compact bone The compact bone was thicker between conoid tubercle and area for attachment of costo-clavicular ligament. At midshaft point thickness of compact bone was maximum. Conclusion The structure of clavicle between conoid tubercle and area for costoclavicular ligament showed thick compact bone and definite pattern of cancellous bone. This structure of clavicle between conoid tubercle and area for attachment of costo-clavicular ligament transmits weight from lateral to medial direction and this knowledge of clavicular structure will also be useful to orthopedic surgeons to deal with clavicular fractures and other abnormalities. PMID:26393112

  8. Direct medical cost of influenza-related hospitalizations among severe acute respiratory infections cases in three provinces in China.

    Directory of Open Access Journals (Sweden)

    Lei Zhou

    Full Text Available BACKGROUND: Influenza-related hospitalizations impose a considerable economic and social burden. This study aimed to better understand the economic burden of influenza-related hospitalizations among patients in China in different age and risk categories. METHODS: Laboratory-confirmed influenza-related hospitalizations between December 2009 and June 2011 from three hospitals participating in the Chinese Severe Acute Respiratory Infections (SARI sentinel surveillance system were included in this study. Hospital billing data were collected from each hospital's Hospital Information System (HIS and divided into five cost categories. Demographic and clinical information was collected from medical records. Mean (range and median (interquartile range [IQR] costs were calculated and compared among children (≤15 years, adults (16-64 years and elderly (≥65 years groups. Factors influencing cost were analyzed. RESULTS: A total of 106 laboratory-confirmed influenza-related hospitalizations were identified, 60% of which were children. The mean (range direct medical cost was $1,797 ($80-$27,545 for all hospitalizations, and the median (IQR direct medical cost was $231 ($164, $854 ($890, and $2,263 ($7,803 for children, adults, and elderly, respectively. Therapeutics and diagnostics were the two largest components of direct medical cost, comprising 57% and 23%, respectively. Cost of physician services was the lowest at less than 1%. CONCLUSION: Direct medical cost of influenza-related hospitalizations imposes a heavy burden on patients and their families in China. Further study is needed to provide more comprehensive evidence on the economic burden of influenza. Our study highlights the need to increase vaccination rate and develop targeted national preventive strategies.

  9. Non-clairvoyant weighted flow time scheduling with rejection penalty

    DEFF Research Database (Denmark)

    Chan, Ho-Leung; Chan, Sze-Hang; Lam, Tak-Wah

    2012-01-01

    is defined as the weighted flow time of the job plus the penalty if it is rejected before completion. Previous work on minimizing the total user cost focused on the clairvoyant single-processor setting [BBC+03,CLL11] and has produced O(1)-competitive online algorithm for jobs with arbitrary weights...... algorithm has to decide job rejection and determine the order and speed of job execution. It is interesting to study the tradeoff between the above-mentioned user cost and energy. This paper gives two O(1)-competitive non-clairvoyant algorithms for minimizing the user cost plus energy on a single processor......This paper initiates the study of online scheduling with rejection penalty in the non-clairvoyant setting, i.e., the size (processing time) of a job is not assumed to be known at its release time. In the rejection penalty model, jobs can be rejected with a penalty, and the user cost of a job...

  10. Comparing the Mass, Energy, and Cost Effects of Lightweighting in Conventional and Electric Passenger Vehicles

    Directory of Open Access Journals (Sweden)

    Johannes Hofer

    2014-09-01

    Full Text Available In this work the effect of weight reduction using advanced lightweight materials on the mass, energy use, and cost of conventional and battery electric passenger vehicles is compared. Analytic vehicle simulation is coupled with cost assessment to find the optimal degree of weight reduction minimizing manufacturing and total costs. The results show a strong secondary weight and cost saving potential for the battery electric vehicles, but a higher sensitivity of vehicle energy use to mass reduction for the conventional vehicle. Generally, light weighting has the potential to lower vehicle costs, however, the results are very sensitive to parameters affecting lifetime fuel costs for conventional and battery costs for electric vehicles. Based on current technology cost estimates it is shown that the optimal amount of primary mass reduction minimizing total costs is similar for conventional and electric vehicles and ranges from 22% to 39%, depending on vehicle range and overall use patterns. The difference between the optimal solutions minimizing manufacturing versus total costs is higher for conventional than battery electric vehicles.

  11. The role of higher protein diets in weight control and obesity-related comorbidities

    DEFF Research Database (Denmark)

    Astrup, Arne; Raben, Anne; Geiker, Nina

    2015-01-01

    The importance of the relative dietary content of protein, carbohydrate and the type of carbohydrate (that is, glycemic index (GI)) for weight control under ad libitum conditions has been controversial owing to the lack of large scale studies with high diet adherence. The Diet, Obesity and Genes...... (DioGenes) European multicentre trial examined the importance of a slight increase in dietary protein content, reduction in carbohydrate and the importance of choosing low (LGI) vs high GI (HGI) carbohydrates for weight control in 932 obese families. Only the adults underwent a diet of 800 kcal per day...... for 8 weeks, and after losing ~11kg they were randomized to one of five energy ad libitum diets for 6 months. The diets differed in protein content and GI. The high-protein (HP) diet groups consumed 5.4% points more energy from protein than the normal protein (NP) groups, and the LGI diet groups...

  12. History of Smoking and Postcessation Weight Gain among Weight Loss Surgery Candidates

    OpenAIRE

    Levine, Michele D.; Kalarchian, Melissa A.; Courcoulas, Anita P.; Wisinski, Meghan S.C.; Marcus, Marsha D.

    2007-01-01

    Smoking cessation often results in weight gain. Although smoking cessation frequently is recommended to patients presenting for weight loss surgery (WLS), the relationship between smoking cessation and weight gain among WLS candidates is poorly understood. Thus, we sought to document the history and prevalence of smoking and smoking-related weight gain among WLS candidates. Subjects (N = 67) presenting for bariatric surgery provided demographic information, were interviewed about smoking, and...

  13. The costs of overweight and obesity-related diseases in the Brazilian public health system: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Bahia Luciana

    2012-06-01

    Full Text Available Abstract Background Obesity is a major global epidemic and a burden to society and health systems. It is well known risk factor for a number of chronic medical conditions with high morbidity and mortality. This study aimed to provide an estimate of the direct costs associated to outpatient and inpatient care of overweight and obesity related diseases in the perspective of the Brazilian Health System (SUS. Methods Population attributable risk (PAR was calculated for selected diseases related to overweight and obesity and with the following parameters: Relative risk (RR ≥ 1.20 or RR ≥1.10 and  Results The estimated total costs in one year with all diseases related to overweight and obesity are US$ 2,1 billion; US$ 1,4 billion (68.4% of total costs due to hospitalizations and US$ 679 million due to ambulatory procedures. Approximately 10% of these cost is attributable to overweight and obesity. Conclusion The results confirm that overweight and obesity carry a great economic burden for Brazilian health system and for the society. The knowledge of these costs will be useful for future economic analysis of preventive and treatment interventions.

  14. Comparing the Mass, Energy, and Cost Effects of Lightweighting in Conventional and Electric Passenger Vehicles

    OpenAIRE

    Hofer, Johannes; Wilhelm, Erik; Schenler, Warren

    2014-01-01

    In this work the effect of weight reduction using advanced lightweight materials on the mass, energy use, and cost of conventional and battery electric passenger vehicles is compared. Analytic vehicle simulation is coupled with cost assessment to find the optimal degree of weight reduction minimizing manufacturing and total costs. The results show a strong secondary weight and cost saving potential for the battery electric vehicles, but a higher sensitivity of vehicle energy use to mass reduc...

  15. The Mastery Matrix for Integration Praxis: The development of a rubric for integration practice in addressing weight-related public health problems.

    Science.gov (United States)

    Berge, Jerica M; Adamek, Margaret; Caspi, Caitlin; Grannon, Katherine Y; Loth, Katie A; Trofholz, Amanda; Nanney, Marilyn S

    2018-06-01

    In response to the limitations of siloed weight-related intervention approaches, scholars have called for greater integration that is intentional, strategic, and thoughtful between researchers, health care clinicians, community members, and policy makers as a way to more effectively address weight and weight-related (e.g., obesity, diabetes, cardiovascular disease, cancer) public health problems. The Mastery Matrix for Integration Praxis was developed by the Healthy Eating and Activity across the Lifespan (HEAL) team in 2017 to advance the science and praxis of integration across the domains of research, clinical practice, community, and policy to address weight-related public health problems. Integrator functions were identified and developmental stages were created to generate a rubric for measuring mastery of integration. Creating a means to systematically define and evaluate integration praxis and expertise will allow for more individuals and teams to master integration in order to work towards promoting a culture of health. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Sequential Optimization of Paths in Directed Graphs Relative to Different Cost Functions

    KAUST Repository

    Mahayni, Malek A.

    2011-01-01

    developed to solve the optimal paths problem with different kinds of graphs. An algorithm that solves the problem of paths’ optimization in directed graphs relative to different cost functions is described in [1]. It follows an approach extended from

  17. Data Flow in Relation to Life-Cycle Costing of Construction Projects in the Czech Republic

    Science.gov (United States)

    Biolek, Vojtěch; Hanák, Tomáš; Marović, Ivan

    2017-10-01

    Life-cycle costing is an important part of every construction project, as it makes it possible to take into consideration future costs relating to the operation and demolition phase of a built structure. In this way, investors can optimize the project design to minimize the total project costs. Even though there have already been some attempts to implement BIM software in the Czech Republic, the current state of affairs does not support automated data flow between the bill of costs and applications that support building facility management. The main aim of this study is to critically evaluate the current situation and outline a future framework that should allow for the use of the data contained in the bill of costs to manage building operating costs.

  18. Cue reliability and a landmark stability heuristic determine relative weighting between egocentric and allocentric visual information in memory-guided reach.

    Science.gov (United States)

    Byrne, Patrick A; Crawford, J Douglas

    2010-06-01

    It is not known how egocentric visual information (location of a target relative to the self) and allocentric visual information (location of a target relative to external landmarks) are integrated to form reach plans. Based on behavioral data from rodents and humans we hypothesized that the degree of stability in visual landmarks would influence the relative weighting. Furthermore, based on numerous cue-combination studies we hypothesized that the reach system would act like a maximum-likelihood estimator (MLE), where the reliability of both cues determines their relative weighting. To predict how these factors might interact we developed an MLE model that weighs egocentric and allocentric information based on their respective reliabilities, and also on an additional stability heuristic. We tested the predictions of this model in 10 human subjects by manipulating landmark stability and reliability (via variable amplitude vibration of the landmarks and variable amplitude gaze shifts) in three reach-to-touch tasks: an egocentric control (reaching without landmarks), an allocentric control (reaching relative to landmarks), and a cue-conflict task (involving a subtle landmark "shift" during the memory interval). Variability from all three experiments was used to derive parameters for the MLE model, which was then used to simulate egocentric-allocentric weighting in the cue-conflict experiment. As predicted by the model, landmark vibration--despite its lack of influence on pointing variability (and thus allocentric reliability) in the control experiment--had a strong influence on egocentric-allocentric weighting. A reduced model without the stability heuristic was unable to reproduce this effect. These results suggest heuristics for extrinsic cue stability are at least as important as reliability for determining cue weighting in memory-guided reaching.

  19. Selecting a pharmacy layout design using a weighted scoring system.

    Science.gov (United States)

    McDowell, Alissa L; Huang, Yu-Li

    2012-05-01

    A weighted scoring system was used to select a pharmacy layout redesign. Facilities layout design techniques were applied at a local hospital pharmacy using a step-by-step design process. The process involved observing and analyzing the current situation, observing the current available space, completing activity flow charts of the pharmacy processes, completing communication and material relationship charts to detail which areas in the pharmacy were related to one another and how they were related, researching applications in other pharmacies or in scholarly works that could be beneficial, numerically defining space requirements for areas within the pharmacy, measuring the available space within the pharmacy, developing a set of preliminary designs, and modifying preliminary designs so they were all acceptable to the pharmacy staff. To select a final layout that could be implemented in the pharmacy, those layouts were compared via a weighted scoring system. The weighted aspect further allowed additional emphasis on categories based on their effect on pharmacy performance. The results produced a beneficial layout design as determined through simulated models of the pharmacy operation that more effectively allocated and strategically located space to improve transportation distances and materials handling, employee utilization, and ergonomics. Facilities layout designs for a hospital pharmacy were evaluated using a weighted scoring system to identify a design that was superior to both the current layout and alternative layouts in terms of feasibility, cost, patient safety, employee safety, flexibility, robustness, transportation distance, employee utilization, objective adherence, maintainability, usability, and environmental impact.

  20. Allocation to reproduction and relative reproductive costs in two species of dioecious Anacardiaceae with contrasting phenology.

    Science.gov (United States)

    Matsuyama, Shuhei; Sakimoto, Michinori

    2008-06-01

    The cost of reproduction in dioecious plants is often female-biased. However, several studies have reported no difference in costs of reproduction between the sexes. In this study, the relative reproductive allocation and costs at the shoot and whole-plant levels were examined in woody dioecious Rhus javanica and R. trichocarpa, in order to examine differences between types of phenophase (i.e. physiological stage of development). Male and female Rhus javanica and R. trichocarpa were sampled and the reproductive and vegetative allocation of the shoot were estimated by harvesting reproductive current-year shoots during flowering and fruiting. Measurements were made of the number of reproductive and total current-year shoots per whole plant, and of the basal area increment (BAI). The numbers of reproductive and total current-year shoots per 1-year-old shoot were counted in order to examine the costs in the following year at the shoot level. A female-biased annual reproductive allocation was found; however, the ratio of reproductive current-year shoots per tree and the BAI did not differ between sexes in Rhus javanica and R. trichocarpa. The percentage of 1-year-old shoots with at least one reproductive current-year shoot was significantly male-biased in R. trichocarpa, but not in R. javanica, indicating that there was a relative cost at the shoot level only in R. trichocarpa. The female-biased leaf mass per shoot, an indicator of compensation for costs, was only found in R. javanica. Relative reproductive costs at the shoot level were detected in Rhus trichocarpa, which has simultaneous leafing and flowering, but not in R. javanica, which has leafing followed by flowering. However, the costs for the whole-plant level were diminished in both species. The results suggest that the phenophase type may produce the different costs for R. javanica and R. trichocarpa through the development of a compensation mechanism.

  1. Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series.

    Science.gov (United States)

    Pagoto, Sherry L; Waring, Molly E; Schneider, Kristin L; Oleski, Jessica L; Olendzki, Effie; Hayes, Rashelle B; Appelhans, Bradley M; Whited, Matthew C; Busch, Andrew M; Lemon, Stephenie C

    2015-10-23

    Lifestyle interventions are efficacious at reducing risk for diabetes and cardiovascular disease but have not had a significant public health impact given high cost and patient and provider burden. Online social networks may reduce the burden of lifestyle interventions to the extent that they displace in-person visits and may enhance opportunities for social support for weight loss. We conducted an iterative series of pilot studies to evaluate the feasibility and acceptability of using online social networks to deliver a lifestyle intervention. In Study 1 (n=10), obese participants with depression received lifestyle counseling via 12 weekly group visits and a private group formed using the online social network, Twitter. Mean weight loss was 2.3 pounds (SD 7.7; range -19.2 to 8.2) or 1.2% (SD 3.6) of baseline weight. A total of 67% (6/9) of participants completing exit interviews found the support of the Twitter group at least somewhat useful. In Study 2 (n=11), participants were not depressed and were required to be regular users of social media. Participants lost, on average, 5.6 pounds (SD 6.3; range -15 to 0) or 3.0% (SD 3.4) of baseline weight, and 100% (9/9) completing exit interviews found the support of the Twitter group at least somewhat useful. To explore the feasibility of eliminating in-person visits, in Study 3 (n=12), we delivered a 12-week lifestyle intervention almost entirely via Twitter by limiting the number of group visits to one, while using the same inclusion criteria as that used in Study 2. Participants lost, on average, 5.4 pounds (SD 6.4; range -14.2 to 3.9) or 3.0% (SD 3.1) of baseline weight, and 90% (9/10) completing exit interviews found the support of the Twitter group at least somewhat useful. Findings revealed that a private Twitter weight-loss group was both feasible and acceptable for many patients, particularly among regular users of social media. Future research should evaluate the efficacy and cost-effectiveness of online

  2. Impact of bleeding-related complications and/or blood product transfusions on hospital costs in inpatient surgical patients

    Directory of Open Access Journals (Sweden)

    Reynolds Matthew W

    2011-05-01

    Full Text Available Abstract Background Inadequate surgical hemostasis may lead to transfusion and/or other bleeding-related complications. This study examines the incidence and costs of bleeding-related complications and/or blood product transfusions occurring as a consequence of surgery in various inpatient surgical cohorts. Methods A retrospective analysis was conducted using Premier's Perspective™ hospital database. Patients who had an inpatient procedure within a specialty of interest (cardiac, vascular, non-cardiac thoracic, solid organ, general, reproductive organ, knee/hip replacement, or spinal surgery during 2006-2007 were identified. For each specialty, the rate of bleeding-related complications (including bleeding event, intervention to control for bleeding, and blood product transfusions was examined, and hospital costs and length of stay (LOS were compared between surgeries with and without bleeding-related complications. Incremental costs and ratios of average total hospital costs for patients with bleeding-related complications vs. those without complications were estimated using ordinary least squares (OLS regression, adjusting for demographics, hospital characteristics, and other baseline characteristics. Models using generalized estimating equations (GEE were also used to measure the impact of bleeding-related complications on costs while accounting for the effects related to the clustering of patients receiving care from the same hospitals. Results A total of 103,829 cardiac, 216,199 vascular, 142,562 non-cardiac thoracic, 45,687 solid organ, 362,512 general, 384,132 reproductive organ, 246,815 knee/hip replacement, and 107,187 spinal surgeries were identified. Overall, the rate of bleeding-related complications was 29.9% and ranged from 7.5% to 47.4% for reproductive organ and cardiac, respectively. Overall, incremental LOS associated with bleeding-related complications or transfusions (unadjusted for covariates was 6.0 days and ranged from 1

  3. Neighborhood walkability and hospital treatment costs: A first assessment.

    Science.gov (United States)

    Yu, Yan; Davey, Rachel; Cochrane, Tom; Learnihan, Vincent; Hanigan, Ivan C; Bagheri, Nasser

    2017-06-01

    Health system expenditure is a global concern, with hospital cost a major component. Built environment has been found to affect physical activity and health outcomes. The purpose of the study was a first assessment of the relationship between neighborhood walkability and hospital treatment costs. For 88 neighborhoods in the Australian Capital Territory (ACT), 2011-2013, a total of 30,690 public hospital admissions for the treatment of four diagnostic groups (cancers, endocrine, nutritional and metabolic diseases, circulatory diseases and respiratory diseases) were extracted from the ACT admitted patient care database and analyzed in relation to the Walk Score® index as a measure of walkability. Hospital cost was calculated according to the cost weight of the diagnosis related group assigned to each admission. Linear regressions were used to analyze the associations of walkability with hospital cost per person, admissions per person and cost per admission at the neighborhood level. An inverse association with neighborhood walkability was found for cost per person and admissions per person, but not cost per admission. After adjusting for age, sex and socioeconomic status, a 20-unit increase in walkability was associated with 12.1% (95% CI: 7.1-17.0%) lower cost and 12.5% (8.1-17.0%) fewer admissions. These associations did not vary by neighborhood socioeconomic status. This exploratory analysis suggests the potential for improved population health and reduced hospital cost with greater neighborhood walkability. Further research should replicate the analysis with data from other urban settings, and focus on the behavioral mechanisms underlying the inverse walkability-hospital cost association. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Gut permeability is related to body weight, fatty liver disease, and insulin resistance in obese individuals undergoing weight reduction.

    Science.gov (United States)

    Damms-Machado, Antje; Louis, Sandrine; Schnitzer, Anna; Volynets, Valentina; Rings, Andreas; Basrai, Maryam; Bischoff, Stephan C

    2017-01-01

    Obesity and associated metabolic disorders are related to impairments of the intestinal barrier. We examined lactulose:mannitol (Lac:Man) permeability in obese individuals with and without liver steatosis undergoing a weight-reduction program to test whether an effective weight-loss program improves gut barrier function and whether obese patients with or without liver steatosis differ in this function. Twenty-seven adult, nondiabetic individuals [mean ± SD body mass index (BMI; in kg/m 2 ): 43.7 ± 5.2; 78% with moderate or severe liver steatosis] were included in the follow-up intervention study (n = 13 by month 12). All patients reduced their weight to a mean ± SD BMI of 36.4 ± 5.1 within 12 mo. We assessed barrier functions by the oral Lac:Man and the fecal zonulin tests. Insulin resistance was assessed by the homeostatic model assessment index (HOMA), and liver steatosis by sonography and the fatty liver index (FLI). The Lac:Man ratio and circulating interleukin (IL) 6 concentration decreased during intervention from 0.080 (95% CI: 0.073, 0.093) to 0.027 (95% CI: 0.024, 0.034; P < 0.001) and from 4.2 ± 1.4 to 2.8 ± 1.6 pg/mL (P < 0.01), respectively. At study start, the Lac:Man ratio was higher in patients with moderate or severe steatosis than in those without any steatosis (P < 0.001). The Lac:Man ratio tended to correlate with HOMA (ρ = 0.55, P = 0.052), which correlated with FLI (ρ = 0.75, P < 0.01). A multiple-regression analysis led to a final model explaining FLI best through BMI, waist circumference, and the Lac:Man ratio. Intestinal permeability is increased in obese patients with steatosis compared with obese patients without. The increased permeability fell to within the previously reported normal range after weight reduction. The data suggest that a leaky gut barrier is linked with liver steatosis and could be a new target for future steatosis therapies. This trial was registered at clinicaltrials.gov as NCT01344525. © 2017 American Society

  5. Pounds That Kill: The External Costs of Vehicle Weight

    OpenAIRE

    Michael L. Anderson; Maximilian Auffhammer

    2014-01-01

    Heavier vehicles are safer for their own occupants but more hazardous for the occupants of other vehicles. In this paper we estimate the increased probability of fatalities from being hit by a heavier vehicle in a collision. We show that, controlling for own-vehicle weight, being hit by a vehicle that is 1,000 pounds heavier results in a 47% increase in the baseline fatality probability. Estimation results further suggest that the fatality risk is even higher if the striking vehicle is a ligh...

  6. Weight status and gender-related differences in motor skills and in child care - based physical activity in young children

    Directory of Open Access Journals (Sweden)

    Bonvin Antoine

    2012-03-01

    Full Text Available Abstract Background Over the last decades, a decline in motor skills and in physical activity and an increase in obesity has been observed in children. However, there is a lack of data in young children. We tested if differences in motor skills and in physical activity according to weight or gender were already present in 2- to 4-year-old children. Methods Fifty-eight child care centers in the French part of Switzerland were randomly selected for the Youp'là bouge study. Motor skills were assessed by an obstacle course including 5 motor skills, derived from the Zurich Neuromotor Assessment test. Physical activity was measured with accelerometers (GT1M, Actigraph, Florida, USA using age-adapted cut-offs. Weight status was assessed using the International Obesity Task Force criteria (healthy weight vs overweight for body mass index (BMI. Results Of the 529 children (49% girls, 3.4 ± 0.6 years, BMI 16.2 ± 1.2 kg/m2, 13% were overweight. There were no significant weight status-related differences in the single skills of the obstacle course, but there was a trend (p = 0.059 for a lower performance of overweight children in the overall motor skills score. No significant weight status-related differences in child care-based physical activity were observed. No gender-related differences were found in the overall motor skills score, but boys performed better than girls in 2 of the 5 motor skills (p ≤ 0.04. Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12-25% higher and sedentary activity 5% lower in boys compared to girls (all p Conclusions At this early age, there were no significant weight status- or gender-related differences in global motor skills. However, in accordance to data in older children, child care-based physical activity was higher in boys compared to girls. These results are important to consider when establishing physical activity recommendations or targeting

  7. Activity, inactivity, and screen time in relation to weight and fatness over adolescence in girls.

    Science.gov (United States)

    Must, Aviva; Bandini, Linda G; Tybor, David J; Phillips, Sarah M; Naumova, Elena N; Dietz, William H

    2007-07-01

    The impact of activity and inactivity on relative weight and fatness change are best evaluated longitudinally. We examined the longitudinal relationship of physical activity, inactivity, and screen time with relative weight status and percentage body fat (%BF) and explored how it differed by parental overweight status. Non-obese pre-menarcheal girls (173), 8 to 12 years old, were followed until 4 years post-menarche. %BF, BMI z-score, and time spent sleeping, sitting, standing, walking, and in vigorous activity were assessed annually. We developed a physical activity index to reflect time and intensity of activity. Inactivity was defined as the sum of time spent sleeping, sitting, and standing. Screen time was defined as time spent viewing television, videotapes, or playing video games. Parental overweight was defined as at least one parent with BMI>25. In separate linear mixed effects models, activity, inactivity, and screen time were unrelated to BMI z-score longitudinally, with and without accounting for parental overweight. After controlling for parental overweight, activity was inversely related (phistory of overweight represent a target population of high priority for interventions around physical activity and inactivity.

  8. Parrotfish grazing ability: interspecific differences in relation to jaw-lever mechanics and relative weight of adductor mandibulae on an Okinawan coral reef

    OpenAIRE

    Nanami, Atsushi

    2016-01-01

    Parrotfishes (family Labridae: Scarini) are regarded to have important roles for maintaining the ecosystem balance in coral reefs due to their removal of organic matter and calcic substrates by grazing. The purpose of the present study was to clarify the interspecific differences in grazing ability of five parrotfish species (Chlorurus sordidus, C. bowersi, Scarus rivulatus, S. niger and S. forsteni) in relation to interspecific differences in jaw-lever mechanics and the relative weight of th...

  9. Weight Loss and the Prevention of Weight Regain: Evaluation of a Treatment Model of Exercise Self-Regulation Generalizing to Controlled Eating.

    Science.gov (United States)

    Annesi, James J; Johnson, Ping H; Tennant, Gisèle A; Porter, Kandice J; Mcewen, Kristin L

    2016-01-01

    For decades, behavioral weight-loss treatments have been unsuccessful beyond the short term. Development and testing of innovative, theoretically based methods that depart from current failed practices is a priority for behavioral medicine. To evaluate a new, theory-based protocol in which exercise support methods are employed to facilitate improvements in psychosocial predictors of controlled eating and sustained weight loss. Women with obesity were randomized into either a comparison treatment that incorporated a print manual plus telephone follow-ups (n = 55) or an experimental treatment of The Coach Approach exercise-support protocol followed after 2 months by group nutrition sessions focused on generalizing self-regulatory skills from an exercise support to a controlled eating context (n = 55). Repeated-measures analysis of variance contrasted group changes in weight, physical activity, fruit and vegetable intake, mood, and exercise- and eating-related self-regulation and self-efficacy over 24 months. Regression analyses determined salient interrelations of change scores over both the weight-loss phase (baseline-month 6) and weight-loss maintenance phase (month 6-month 24). Improvements in all psychological measures, physical activity, and fruit and vegetable intake were significantly greater in the experimental group where a mean weight loss of 5.7 kg (6.1% of initial body weight) occurred at month 6, and was largely maintained at a loss of 5.1 kg (5.4%) through the full 24 months of the study. After establishing temporal intervals for changes in self-regulation, self-efficacy, and mood that best predicted improvements in physical activity and eating, a consolidated multiple mediation model suggested that change in self-regulation best predicted weight loss, whereas change in self-efficacy best predicted maintenance of lost weight. Because for most participants loss of weight remained greater than that required for health benefits, and costs for treatment

  10. School District Wellness Policy Quality and Weight-Related Outcomes among High School Students in Minnesota

    Science.gov (United States)

    Hoffman, Pamela K.; Davey, Cynthia S.; Larson, Nicole; Grannon, Katherine Y.; Hanson, Carlie; Nanney, Marilyn S.

    2016-01-01

    Weight-related outcomes were examined among high school students in Minnesota public school districts according to the quality of district wellness policies. Wellness policy strength and comprehensiveness were scored using the Wellness School Assessment Tool (WellSAT) for 325 Minnesota public school districts in 2013. The associations between…

  11. Cost Effectiveness of G:CSF in Chemotherapy and Transplant-related Neutropenia.

    Science.gov (United States)

    Jacobs, P; Wood, L; Schall, R

    1998-01-01

    Sustained fever over 38°C is potentially lethal when neutrophil counts remain below 0.1 × 10(9)/L. To determine whether the addition of a haematopoietic stimulatory peptide to conventional supportive care and antibiotic management was cost-effective, 74 such episodes were analysed. Group I (5μg/kg G: CSF: n = 41); Group II (10 μg/kg: n = 19) and Group III (controls: n = 14): these were similar in respect of race, gender, age and body weight. The median days and range of neutrophil count below 0.1 × 10(9)/Lw as 6 (0-12), 7 (0-20) and 8 (0-20) and the corresponding figures for 0.5 × 10(9)/L were 8 (0-19), 8 (1-23) and 13.5 (3-30) days respectively, while the median hospital period was 26 (18-49), 30 (9-86) and 35 (13-44). Mean, standard deviation and range for bed costs in Group I was R9,528 (2125:6120-1660), the corresponding figures for Group II were Rll,453 (5570:3060-2924), and for Group III Rll,366 (2755: 4420-1496). The approximate fate of exchange is: Rl = US$5.87. When expenditure for growth factor was integrated these figures were approximately R26,071, R37,787 and R27,376. There were no advantages in 10 over 5 μg/kg G: CSF. More red cell transfusions were needed in Group III. The days requiring antimicrobial therapy were 14, 16 and 20 respectively. It is concluded from this study, carried out in reverse isolation at a University Teaching Hospital, that duration of neutropenic fever was significantly shortened on G: CSF but there was no benefit in using the higher dose. Additionally, at equivalent cost, there was a shorter period of hospitalisation thereby reducing risk of acquiring nosocomial infections. Finally, there was concurrently a decreased exposure to potentially nephrotoxic antibiotics. Accordingly, this regimen can be justified in the routine management of this category of patient.

  12. Executive functions predict weight loss in a medically supervised weight loss programme

    OpenAIRE

    Galioto, R.; Bond, D.; Gunstad, J.; Pera, V.; Rathier, L.; Tremont, G.

    2016-01-01

    Summary Background Deficits in executive functions are related to poorer weight loss after bariatric surgery; however, less is known about the role that these deficits may play during participation in nonsurgical weight loss programmes. This study examined associations between objectively measured executive functions and weight loss during participation in a medically supervised weight loss programme. Methods Twenty?three adult patients (age 50.4???15.1, BMI 44.2???8.8, 68% female, 92% White)...

  13. Cost-effectiveness of single versus double embryo transfer in IVF in relation to female age

    NARCIS (Netherlands)

    van Loendersloot, Laura L.; Moolenaar, Lobke M.; van Wely, Madelon; Repping, Sjoerd; Bossuyt, Patrick M.; Hompes, Peter G. A.; van der Veen, Fulco; Mol, Ben Willem J.

    2017-01-01

    Objective: To evaluate the cost-effectiveness of single embryo transfer followed by an additional frozen thawed single embryo transfer, if more embryos are available, as compared to double embryo transfer in relation to female age. Study design: We used a decision tree model to evaluate the costs

  14. Direct health care costs associated with obesity in Chinese population in 2011.

    Science.gov (United States)

    Shi, Jingcheng; Wang, Yao; Cheng, Wenwei; Shao, Hui; Shi, Lizheng

    2017-03-01

    Overweight and obesity are established major risk factors for type 2 diabetes, and major public health concerns in China. This study aims to assess the economic burden associated with overweight and obesity in the Chinese population ages 45 and older. The Chinese Health and Retirement Longitudinal Study (CHARLS) in 2011 included 13,323 respondents of ages 45 and older living in 450 rural and urban communities across China. Demographic information, height, weight, direct health care costs for outpatient visits, hospitalization, and medications for self-care were extracted from the CHARLS database. Health Care costs were calculated in 2011 Chinese currency. The body mass index (BMI) was used to categorize underweight, normal weight, overweight, and obese populations. Descriptive analyses and a two-part regression model were performed to investigate the association of BMI with health care costs. To account for non-normality of the cost data, we applied a non-parametric bootstrap approach using the percentile method to estimate the 95% confidence intervals (95% CIs). Overweight and obese groups had significantly higher total direct health care costs (RMB 2246.4, RMB 2050.7, respectively) as compared with the normal-weight group (RMB 1886.0). When controlling for demographic characteristics, overweight and obese adults were 15.0% and 35.9% more likely to incur total health care costs, and obese individuals had 14.2% higher total health care costs compared with the normal-weight group. Compared with the normal-weight counterparts, the annual total direct health care costs were significantly higher among obese adults in China. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Tackling obesity in areas of high social deprivation: clinical effectiveness and cost-effectiveness of a task-based weight management group programme - a randomised controlled trial and economic evaluation.

    Science.gov (United States)

    McRobbie, Hayden; Hajek, Peter; Peerbux, Sarrah; Kahan, Brennan C; Eldridge, Sandra; Trépel, Dominic; Parrott, Steve; Griffiths, Chris; Snuggs, Sarah; Myers Smith, Katie

    2016-10-01

    An increasing number of people require help to manage their weight. The NHS recommends weight loss advice by general practitioners and/or a referral to a practice nurse. Although this is helpful for some, more effective approaches that can be disseminated economically on a large scale are needed. To assess whether or not a task-based weight management programme [Weight Action Programme (WAP)] has better long-term effects than a 'best practice' intervention provided in primary care by practice nurses. Randomised controlled trial with cost-effectiveness analysis. General practices in east London, UK. Three hundred and thirty adults with a body mass index (BMI) of ≥ 30 kg/m 2 or a BMI of ≥ 28 kg/m 2 plus comorbidities were recruited from local general practices and via media publicity. Those who had a BMI of > 45 kg/m 2 , had lost > 5% of their body weight in the previous 6 months, were currently pregnant or taking psychiatric medications were excluded. Participants were randomised (2 : 1) to the WAP or nurse arms. The WAP intervention was delivered in eight weekly group sessions that combined dietary and physical activity, advice and self-monitoring in a group-oriented intervention. The initial course was followed by 10 monthly group maintenance sessions open to all participants in this study arm. The practice nurse intervention (best usual care) consisted of four one-to-one sessions delivered over 8 weeks, and included standard advice on diet and physical activity based on NHS 'Change4Life' materials and motivational support. The primary outcome measure was weight change at 12 months. Secondary outcome measures included change in BMI, waist circumference and blood pressure, and proportion of participants losing at least 5% and 10% of baseline body weight. Staff collecting measurements at the 6- and 12-month follow-ups were blinded to treatment allocation. The primary outcome measure was analysed according to the intention-to-treat principle

  16. How College Students Search the Internet for Weight Control and Weight Management Information: An Observational Study

    Science.gov (United States)

    Senkowski, Valerie; Branscum, Paul

    2015-01-01

    Background: Few studies have attempted to examine how young adults search for health information on the Internet, especially information related to weight control and weight management. Purpose: The purpose of this study was to determine search strategies that college students used for finding information related to weight control and weight…

  17. The relationship between doctors' and nurses' own weight status and their weight management practices: a systematic review.

    Science.gov (United States)

    Zhu, D Q; Norman, I J; While, A E

    2011-06-01

    It has been established that health professionals' smoking and physical activity influence their related health-promoting behaviours, but it is unclear whether health professionals' weight status also influences their related professional practices. A systematic review was conducted to understand the relationship between personal weight status and weight management practices. Nine eligible studies were identified from a search of the Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and Chinese databases. All included studies were cross-sectional surveys employing self-reported questionnaires. Weight management practice variables studied were classified under six practice indicators, developed from weight management guidelines. Syntheses of the findings from the selected studies suggest that: normal weight doctors and nurses were more likely than those who were overweight to use strategies to prevent obesity in-patients, and, also, provide overweight or obese patients with general advice to achieve weight loss. Doctors' and nurses' own weight status was not found to be significantly related to their referral and assessment of overweight or obese patients, and associations with their relevant knowledge/skills and specific treatment behaviours were inconsistent. Additionally, in female, primary care providers, relevant knowledge and training, self-efficacy and a clear professional identity emerged as positive predictors of weight management practices. This review's findings will need to be confirmed by prospective theoretically driven studies, which employ objective measures of weight status and weight management practices and involve multivariate analyses to identify the relative contribution of weight status to weight management. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

  18. Height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children

    Directory of Open Access Journals (Sweden)

    Mushtaq Muhammad Umair

    2012-03-01

    Full Text Available Abstract Background Child growth is internationally recognized as an important indicator of nutritional status and health in populations. This study was aimed to compare age- and gender-specific height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children. Methods A population-based study was conducted with a multistage cluster sample of 1860 children aged five to twelve years in Lahore, Pakistan. Smoothed height, weight and BMI percentile curves were obtained and comparison was made with the World Health Organization 2007 (WHO and United States' Centers for Disease Control and Prevention 2000 (USCDC references. Over- and under-nutrition were defined according to the WHO and USCDC references, and the International Obesity Task Force (IOTF cut-offs. Simple descriptive statistics were used and statistical significance was considered at P Results Height, weight and BMI percentiles increased with age among both boys and girls, and both had approximately the same height and a lower weight and BMI as compared to the WHO and USCDC references. Mean differences from zero for height-, weight- and BMI-for-age z score values relative to the WHO and USCDC references were significant (P Conclusion Pakistani school-aged children significantly differed from the WHO and USCDC references. However, z score means relative to the WHO reference were closer to zero and the present study as compared to the USCDC reference. Overweight and obesity were significantly higher while underweight and thinness/wasting were significantly lower relative to the WHO reference as compared to the USCDC reference and the IOTF cut-offs. New growth charts for Pakistani children based on a nationally representative sample should be developed. Nevertheless, shifting to use of the 2007 WHO child growth reference might have important implications for child health programs and primary care pediatric clinics.

  19. On the weighting of accident probabilities for evident emotive factors

    International Nuclear Information System (INIS)

    Dukes, J.A.

    1979-01-01

    Problems in risk management of the additive property of; accident risk costs, the special case of the infrequent disaster, and the correct amount to spend on accident prevention, are considered. The need for weighting by additional emotive factors is discussed. Such factors here considered are; the scale factor relating to the number of people who as a result of the accident are killed, the age factor which takes into account the novelty of the situation against the background of common human experience, and the comprehension factor which is a weighting associated with the extent to which the 'man in the street' may be expected to understand the mechanism of the accident. A table shows how these factors combine for a set of accident scenarios including radioactive spills and a loss of coolant reactor accident. (U.K.)

  20. Liraglutide 3.0 mg for weight management: weight-loss dependent and independent effects.

    Science.gov (United States)

    Bays, Harold; Pi-Sunyer, Xavier; Hemmingsson, Joanna Uddén; Claudius, Birgitte; Jensen, Christine B; Van Gaal, Luc

    2017-02-01

    As an adjunct to a reduced-calorie diet and increased physical activity, treatment with liraglutide 3.0 mg for weight management provides a statistically significant and clinically meaningful weight loss of 5.7%-8.0% compared to 1.6%-2.6% with placebo. The objective of this post hoc analysis was to quantify the relative contribution of weight loss to the treatment effects of liraglutide 3.0 mg on key efficacy endpoints. The analysis utilized data from 4725 participants across three randomized, placebo-controlled, double-blind trials that evaluated the efficacy and safety of liraglutide 3.0 mg versus placebo, as an adjunct to a reduced-calorie diet and increased physical activity (ClinicalTrials.gov identifiers: NCT01272219, NCT01272232 and NCT01557166). The duration of two of the trials was 56 weeks; one trial was of 32 weeks' duration. A mediation analysis was performed, which ranked the relative contribution of weight loss to the treatment effects of liraglutide 3.0 mg on key cardiometabolic efficacy endpoints, Apnea-Hypopnea Index (AHI) and health-related quality of life (QoL). A limitation of this type of analysis is that it cannot conclusively prove a causal relationship. In individuals without type 2 diabetes mellitus (T2DM), endpoints predominantly driven by liraglutide-induced weight loss included waist circumference, diastolic blood pressure, triglycerides, high density lipoprotein cholesterol, AHI, and Impact of Weight on Quality of Life-Lite total and physical function scores. Endpoints predominantly independent of weight loss included the glycemic endpoints hemoglobin A1c and fasting plasma glucose in individuals with and without T2DM. Regardless of the degree of dependence on weight loss according to the mediation analysis, greater weight loss was associated with greater improvement in all endpoints. Treatment with liraglutide 3.0 mg contributes to improved cardiometabolic parameters, AHI and health-related QoL through both weight

  1. The Voice of Experience: Diet and Weight Change in Women with Breast Cancer Associate with Psychosocial and Treatment-Related Challenges.

    Science.gov (United States)

    Vance, Vivienne; Campbell, Sharon; Mccargar, Linda; Mourtzakis, Marina; Hanning, Rhona

    2017-06-01

    This study investigated relationships between psychosocial and treatment-related factors, diet, and weight change in women treated with chemotherapy for early-stage breast cancer. Comprehensive qualitative interviews were conducted with 28 women who were within 12 months of completing chemotherapy treatment. Changes in food intake and eating patterns were universal over the course of chemotherapy, with broad variability in treatment effects and associated dietary responses linked to weight change. Increased appetite, food cravings, and intake of energy-dense comfort foods were more common among women who gained weight during treatment (n = 11). Changes in taste, nausea, and emotional distress were central in promoting these dietary responses. Women who lost weight during treatment (n = 6) tended to report more severe and persistent side effects of treatment leading to poor appetite and lower food intake, and they were more likely to live alone. While the etiology of weight change in this population is complex, this study suggests that changes in food intake related to treatment and psychosocial challenges may play an important role for some women. These findings may help to identify women who are most at risk of weight change during treatment and may inform the development of tailored dietary interventions.

  2. Research on the Value Evaluation of Used Pure Electric Car Based on the Replacement Cost Method

    Science.gov (United States)

    Tan, zhengping; Cai, yun; Wang, yidong; Mao, pan

    2018-03-01

    In this paper, the value evaluation of the used pure electric car is carried out by the replacement cost method, which fills the blank of the value evaluation of the electric vehicle. The basic principle of using the replacement cost method, combined with the actual cost of pure electric cars, puts forward the calculation method of second-hand electric car into a new rate based on the use of AHP method to construct the weight matrix comprehensive adjustment coefficient of related factors, the improved method of value evaluation system for second-hand car

  3. [Weight control behaviors in dieting adolescent girls and their relation to body dissatisfaction and obsession with thinness].

    Science.gov (United States)

    Contreras, M Liliana A; Morán, Javier K; Frez, Scarlett H; Lagos, Carola O; Marín, María Paz F; de los Ángeles Pinto B, María; Suzarte, Érika A

    2015-01-01

    Obsession with thinness and body dissatisfaction can lead adolescents to follow unsupervised diets, which could result in risky weight control behaviors such as fasting, vomiting, use of diuretics and laxatives. The aim of the current study is to examine weight control behaviors in dieting adolescents and relate them to body dissatisfaction (BD) and obsession with thinness (OT). A cross-sectional study was conducted on 439 adolescents from Valparaiso public schools to investigate risky weight control behaviors due to BD and OT scales from the Eating Disorders Inventory-2 (EDI-2), comparing restrained eaters and non-restrained eaters. A total of 43% adolescents had followed a weight loss diet without medical supervision. The dieters had higher BD and OT values. Moderate to severe food restriction, based on expert judgment, was observed in 29.6%, and differences in the presence and severity of purging behaviors were found between the 2 groups. One third of the adolescents studied followed diets without professional supervision and had higher BD and OT values, as well as risky weight control behaviors. Overweight and obese adolescents followed more restrictive diets and developed riskier weight control behaviors. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  4. Household coping strategies for delivery and related healthcare cost: findings from rural Bangladesh.

    Science.gov (United States)

    Hoque, Mohammad Enamul; Dasgupta, Sushil Kanta; Naznin, Eva; Al Mamun, Abdullah

    2015-10-01

    This study aims to measure the economic costs of maternal complication and to understand household coping strategies for financing maternal healthcare cost. A household survey of the 706 women with maternal complication, of whom 483 had normal delivery, was conducted to collect data at 6 weeks and 6 months post-partum. Data were collected on socio-economic information of the household, expenditure during delivery and post-partum, coping strategies adopted by households and other related information. Despite the high cost of health care associated with maternal complications, the majority of families were capable of protecting consumption on non-health items. Around one-third of households spent more than 20% of their annual household expenditure on maternal health care. Almost 50% were able to avoid catastrophic spending because of the coping strategies that they relied on. In general, households appeared resilient to short-term economic consequences of maternal health shocks, due to the availability of informal credit, donations from relatives and selling assets. While richer households fund a greater portion of the cost of maternal health care from income and savings, the poorer households with severe maternal complication resorted to borrowing from local moneylenders at high interest, which may leave them vulnerable to financial difficulties. Financial protection, especially for the poor, may benefit households against economic consequences of maternal complication. © 2015 John Wiley & Sons Ltd.

  5. Sexual inactivity and occurrence of STIs in relation to weight status in women

    DEFF Research Database (Denmark)

    Gunge, Vibeke B; Juul, Kirsten E; van den Brule, Adriaan Jc

    2018-01-01

    The aim of this study was to examine sexual inactivity and occurrence of selected sexually transmitted infections in relation to body mass index. We used data from two large Danish population-based cross-sectional studies conducted in 1991-1995 (HPV study: 6869 women, aged 22-32 years) and in 2004......-2005 (Liva study: 19,484 women, aged 18-45 years). Data were collected using a structured interview and measured weight, height, high-risk human papillomavirus DNA, Chlamydia DNA for the HPV study and a structured questionnaire for the Liva study. Overweight and obese women were more likely to have had...... no lifetime sexual partner or no sexual partner in the last year, e.g., obese women had a threefold (95 percent CI: 1.95-5.04) odds ratio of having had no sexual partner in the last year compared to normal weight women. Additionally, overweight and obese women had a lower likelihood of genital warts and high...

  6. Specific count model for investing the related factors of cost of GERD and functional dyspepsia

    Science.gov (United States)

    Abadi, Alireza; Chaibakhsh, Samira; Safaee, Azadeh; Moghimi-Dehkordi, Bijan

    2013-01-01

    Aim The purpose of this study is to analyze the cost of GERD and functional dyspepsia for investing its related factors. Background Gastro-oesophageal reflux disease GERD and dyspepsia are the most common symptoms of gastrointestinal disorders. Recent studies showed high prevalence and variety of clinical presentation of these two symptoms imposed enormous economic burden to the society. Cost data that related to economics burden have specific characteristics. So this kind of data needs to specific models. Poisson regression (PR) and negative binomial regression (NB) are the models that were used for analyzing cost data in this paper. Patients and methods This study designed as a cross-sectional household survey from May 2006 to December 2007 on a random sample of individual in the Tehran province, Iran to find the prevalence of gastrointestinal symptoms and disorders and its related factors. The Cost in each item was counted. PR and NB were carried out to the data respectively. Likelihood ratio test was performed for comparison between models. Also Log likelihood, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare performance of the models. Results According to Likelihood ratio test and all three criterions that we used to compare performance of the models, NB was the best model for analyzing this cost data. Sex, age and insurance statues were being significant. Conclusion PR and NB models were carried out for this data and according the results improved fit of the NB model over PR, it clearly indicates that over-dispersion is involved due to unobserved heterogeneity and/or clustering. NB model in cost data more appropriate fit than PR. PMID:24834282

  7. Measuring the societal burden of cancer: the cost of lost productivity due to premature cancer-related mortality in Europe.

    Science.gov (United States)

    Hanly, Paul; Soerjomataram, Isabelle; Sharp, Linda

    2015-02-15

    Every cancer-related death in someone of working age represents an economic loss to society. To inform priorities for cancer control, we estimated costs of lost productivity due to premature cancer-related mortality across Europe, for all cancers and by site, gender, region and country. Cancer deaths in 2008 were obtained from GLOBOCAN for 30 European countries across four regions. Costs were valued using the human capital approach. Years of productive life lost (YPLL) were computed by multiplying deaths between 15 and 64 years by working-life expectancy, then by country-, age- and gender-specific annual wages, corrected for workforce participation and unemployment. Lost productivity costs due to premature cancer-related mortality in Europe in 2008 were €75 billion. Male costs (€49 billion) were almost twice female costs (€26 billion). The most costly sites were lung (€17 billion; 23% of total costs), breast (€7 billion; 9%) and colorectum (€6 billion; 8%). Stomach cancer (in Southern and Central-Eastern Europe) and pancreatic cancer (in Northern and Western Europe) were also among the most costly sites. The average lost productivity cost per cancer death was €219,241. Melanoma had the highest cost per death (€312,798), followed by Hodgkin disease (€306,628) and brain and CNS cancer (€288,850). Premature mortality costs were 0.58% of 2008 European gross domestic product, highest in Central-Eastern Europe (0.81%) and lowest in Northern Europe (0.51%). Premature cancer-related mortality costs in Europe are significant. These results provide a novel perspective on the societal cancer burden and may be used to inform priority setting for cancer control. © 2014 UICC.

  8. Fractional-Fourier-domain weighted Wigner distribution

    NARCIS (Netherlands)

    Stankovic, L.; Alieva, T.; Bastiaans, M.J.

    2001-01-01

    A fractional-Fourier-domain realization of the weighted Wigner distribution (or S-method), producing auto-terms close to the ones in the Wigner distribution itself, but with reduced cross-terms, is presented. The computational cost of this fractional-domain realization is the same as the

  9. Perceived Physician-informed Weight Status Predicts Accurate Weight Self-Perception and Weight Self-Regulation in Low-income, African American Women.

    Science.gov (United States)

    Harris, Charlie L; Strayhorn, Gregory; Moore, Sandra; Goldman, Brian; Martin, Michelle Y

    2016-01-01

    Obese African American women under-appraise their body mass index (BMI) classification and report fewer weight loss attempts than women who accurately appraise their weight status. This cross-sectional study examined whether physician-informed weight status could predict weight self-perception and weight self-regulation strategies in obese women. A convenience sample of 118 low-income women completed a survey assessing demographic characteristics, comorbidities, weight self-perception, and weight self-regulation strategies. BMI was calculated during nurse triage. Binary logistic regression models were performed to test hypotheses. The odds of obese accurate appraisers having been informed about their weight status were six times greater than those of under-appraisers. The odds of those using an "approach" self-regulation strategy having been physician-informed were four times greater compared with those using an "avoidance" strategy. Physicians are uniquely positioned to influence accurate weight self-perception and adaptive weight self-regulation strategies in underserved women, reducing their risk for obesity-related morbidity.

  10. Obesity and Surgical Treatment – A Cost-Effectiveness Assessment for Sweden

    Directory of Open Access Journals (Sweden)

    Sixten Borg

    2014-07-01

    Full Text Available Background:The rising trend in the prevalence of obesity has during the past decades become a major public health concern in many countries, as obesity may lead to comorbidities and death. A frequent used marker for obesity is the Body Mass Index (BMI. The cost of treatment for obesity related diseases has become a heavy burden on national health care budget in many countries. While diet and exercise are the cornerstones of weight management, pharmaco­therapy is often needed to achieve and maintain desired weight loss.  In some cases of extreme obesity, bariatric surgery may be recommended. It is expected to increase by 50% in Sweden.Objective: The overall objective was to develop a cost-effectiveness model using the best available evidence to assess the cost-effectiveness of gastric bypass (GBP surgical treatments for obesity in adult patients, in comparison with conventional treatment (CT, in Sweden from a healthcare perspective. With the model we also seeked to identify the lower cut-off point using BMI criteria, for the surgical intervention to be cost-effective. Methods:A micro-simulation model with an underlying Markov methodology was developed, that simulates individual patients. It simulates the outcomes of the patients in terms of treatment costs, life years, and quality adjusted life years (QALY over his/her remaining lifetime. The costs are presented in SEK in the year 2006 price level (1 SEK ≈ 0.11 EUR ≈ 0.14 USD.Results: We estimated that the incremental cost per QALY gained will not exceed SEK 33,000 per QALY in patients with BMI < 35. In patients with BMI > 35 kg/m2, gastric bypass surgery has lower costs compared to conventional treatment. Conclusion: Gastric bypass surgery is a cost-effective intervention compared to conventional treatment consisting of watchful waiting, diet and exercise.

  11. Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors.

    Science.gov (United States)

    Tucker, Larry A.; Clegg, Alan G.

    2002-01-01

    Examined the relationship between lifestyle-related health risks and health care costs and utilization among young adults. Data collected at a primarily white collar worksite in over 2 years indicated that health risks, particularly obesity, stress, and general lifestyle, were significant predictors of health care costs and utilization among these…

  12. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight.

    Science.gov (United States)

    Chao, Ariana M; Jastreboff, Ania M; White, Marney A; Grilo, Carlos M; Sinha, Rajita

    2017-04-01

    To examine whether baseline chronic stress, morning cortisol, and other appetite-related hormones (leptin, ghrelin, and insulin) predict future weight gain and food cravings in a naturalistic, longitudinal, 6-month follow-up study. A prospective community cohort of 339 adults (age 29.1 ± 9.0 years; BMI = 26.7 ± 5.4 kg/m 2 ; 56.9% female; 70.2% white) completed assessments at baseline and 6-month follow-up. Fasting blood draws were used to assess cortisol and other appetite-related hormone levels at baseline. At baseline and follow-up, body weight was measured, and the Cumulative Adversity Interview and Food Craving Inventory were administered. Data were analyzed using linear mixed models adjusting for demographic and clinical covariates. Over the 6-month period, 49.9% of the sample gained weight. Food cravings and chronic stress decreased over 6 months (Ps < 0.05). However, after adjusting for covariates, individuals with higher baseline total ghrelin had significantly higher food cravings at 6 months (P = 0.04). Furthermore, higher cortisol, insulin, and chronic stress were each predictive of greater future weight gain (Ps < 0.05). These results suggest that ghrelin plays a role in increased food cravings and reward-driven eating behaviors. Studies are needed that examine the utility of stress reduction methods for normalizing disrupted cortisol responses and preventing future weight gain. © 2017 The Obesity Society.

  13. COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

    Directory of Open Access Journals (Sweden)

    Moisello Anna Maria

    2012-07-01

    Full Text Available Firms are coping with a competitive scenario characterized by quick changes produced by internationalization, concentration, restructuring, technological innovation processes and financial market crisis. On the one hand market enlargement have increased the number and the segmentation of customers and have raised the number of competitors, on the other hand technological innovation has reduced product life cycle. So firms have to adjust their management models to this scenario, pursuing customer satisfaction and respecting cost constraints. In a context where price is a variable fixed by the market, firms have to switch from the cost measurement logic to the cost management one, adopting target costing methodology. The target costing process is a price driven, customer oriented profit planning and cost management system. It works, in a cross functional way, from the design stage throughout all the product life cycle and it involves the entire value chain. The process implementation needs a costing methodology consistent with the cost management logic. The aim of the paper is to focus on Activity Based Costing (ABC application to target costing process. So: -it analyzes target costing logic and phases, basing on a literary review, in order to highlight the costing needs related to this process; -it shows, through a numerical example, how to structure a flexible ABC model – characterized by the separation between variable, fixed in the short and fixed costs - that effectively supports target costing process in the cost measurement phase (drifting cost determination and in the target cost alignment; -it points out the effectiveness of the Activity Based Costing as a model of cost measurement applicable to the supplier choice and as a support for supply cost management which have an important role in target costing process. The activity based information allows a firm to optimize the supplier choice by following the method of minimizing the

  14. Research Costs Investigated: A Study Into the Budgets of Dutch Publicly Funded Drug-Related Research.

    Science.gov (United States)

    van Asselt, Thea; Ramaekers, Bram; Corro Ramos, Isaac; Joore, Manuela; Al, Maiwenn; Lesman-Leegte, Ivonne; Postma, Maarten; Vemer, Pepijn; Feenstra, Talitha

    2018-01-01

    The costs of performing research are an important input in value of information (VOI) analyses but are difficult to assess. The aim of this study was to investigate the costs of research, serving two purposes: (1) estimating research costs for use in VOI analyses; and (2) developing a costing tool to support reviewers of grant proposals in assessing whether the proposed budget is realistic. For granted study proposals from the Netherlands Organization for Health Research and Development (ZonMw), type of study, potential cost drivers, proposed budget, and general characteristics were extracted. Regression analysis was conducted in an attempt to generate a 'predicted budget' for certain combinations of cost drivers, for implementation in the costing tool. Of 133 drug-related research grant proposals, 74 were included for complete data extraction. Because an association between cost drivers and budgets was not confirmed, we could not generate a predicted budget based on regression analysis, but only historic reference budgets given certain study characteristics. The costing tool was designed accordingly, i.e. with given selection criteria the tool returns the range of budgets in comparable studies. This range can be used in VOI analysis to estimate whether the expected net benefit of sampling will be positive to decide upon the net value of future research. The absence of association between study characteristics and budgets may indicate inconsistencies in the budgeting or granting process. Nonetheless, the tool generates useful information on historical budgets, and the option to formally relate VOI to budgets. To our knowledge, this is the first attempt at creating such a tool, which can be complemented with new studies being granted, enlarging the underlying database and keeping estimates up to date.

  15. Physico-mathematical model of motor vehicle of divided weight with unifying energetic element

    Directory of Open Access Journals (Sweden)

    Leonid M. Petrov

    2015-12-01

    Full Text Available The traction characteristics are important for ensuring of motor vehicle work process. In providing the traction characteristics the average velocity of mobile energetic transport grows, energy costs for work process execution are uprating and operation costs are reducing. The implementation of traction characteristics is performed by transmission of mobile energetic transport. Aim: The aim of the work is improvement of torque transfer technology from the engine to the wheel driving forces through the establishment of new construction of divided weight vehicle transmission. Materials and Methods: Consider a motor vehicle of divided weight with unifying energetic element which performs rotary motions relative to the vehicle frame. Results: It was shown that, the momentum which creates the rotational motion depends on the module and the direction of rotation speed of the unifying energetic element. For the first time, the technology and design of vehicle transmission which differs from previous designs by significant simplifying of the torque transmission from the engine to driving wheels at increased value of efficiency coefficient were proposed.

  16. Birth weight, childhood body mass index, and height in relation to mammographic density and breast cancer

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Baker, Jennifer Lyn; Bihrmann, Kristine

    2014-01-01

    High breast density, a strong predictor of breast cancer may be determined early in life. Childhood anthropometric factors have been related to breast cancer and breast density, but rarely simultaneously. We examined whether mammographic density (MD) mediates an association of birth weight, child...

  17. [Relationship between cost systems and hospital expenditure].

    Science.gov (United States)

    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.

  18. Weight-related sport motive and girls’ body image, weight control behaviors and self-esteem

    NARCIS (Netherlands)

    de Bruin, A.P.; Woertman, L.; Bakker, F.C.; Oudejans, R.R.D.

    2009-01-01

    Research has shown that exercise for weight control is associated with disordered eating indices in older adolescent or adult exercisers in fitness centers. This study examined whether these relationships could be replicated in a more general sample of 140 Dutch adolescent girls between 13 and 18

  19. Cost-of-illness and disease burden of food-related pathogens in the Netherlands, 2011

    NARCIS (Netherlands)

    Mangen, Marie Josée J; Bouwknegt, Martijn; Friesema, Ingrid H M; Haagsma, Juanita A.; Kortbeek, Laetitia M.; Tariq, Luqman; Wilson, Margaret; van Pelt, Wilfrid; Havelaar, Arie H.|info:eu-repo/dai/nl/072306122

    2015-01-01

    To inform risk management decisions on control and prevention of food-related disease, both the disease burden expressed in Disability Adjusted Life Years (DALY) and the cost-of-illness of food-related pathogens are estimated and presented. Disease burden of fourteen pathogens that can be

  20. Costs of treating patients with schizophrenia who have illness-related crisis events

    Directory of Open Access Journals (Sweden)

    Peng Xiaomei

    2008-08-01

    Full Text Available Abstract Background Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18, psychiatric hospitalization in the past 6 months (n = 240, arrest in the past 6 months (n = 56, violent behaviors in the past 4 weeks (n = 62, and diagnosis of a co-occurring substance use disorder (n = 413. Results Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024, followed by persons with psychiatric hospitalization in

  1. The cost of preventing undernutrition: cost, cost-efficiency and cost-effectiveness of three cash-based interventions on nutrition outcomes in Dadu, Pakistan.

    Science.gov (United States)

    Trenouth, Lani; Colbourn, Timothy; Fenn, Bridget; Pietzsch, Silke; Myatt, Mark; Puett, Chloe

    2018-07-01

    Cash-based interventions (CBIs) increasingly are being used to deliver humanitarian assistance and there is growing interest in the cost-effectiveness of cash transfers for preventing undernutrition in emergency contexts. The objectives of this study were to assess the costs, cost-efficiency and cost-effectiveness in achieving nutrition outcomes of three CBIs in southern Pakistan: a 'double cash' (DC) transfer, a 'standard cash' (SC) transfer and a 'fresh food voucher' (FFV) transfer. Cash and FFVs were provided to poor households with children aged 6-48 months for 6 months in 2015. The SC and FFV interventions provided $14 monthly and the DC provided $28 monthly. Cost data were collected via institutional accounting records, interviews, programme observation, document review and household survey. Cost-effectiveness was assessed as cost per case of wasting, stunting and disability-adjusted life year (DALY) averted. Beneficiary costs were higher for the cash groups than the voucher group. Net total cost transfer ratios (TCTRs) were estimated as 1.82 for DC, 2.82 for SC and 2.73 for FFV. Yet, despite the higher operational costs, the FFV TCTR was lower than the SC TCTR when incorporating the participation cost to households, demonstrating the relevance of including beneficiary costs in cost-efficiency estimations. The DC intervention achieved a reduction in wasting, at $4865 per case averted; neither the SC nor the FFV interventions reduced wasting. The cost per case of stunting averted was $1290 for DC, $882 for SC and $883 for FFV. The cost per DALY averted was $641 for DC, $434 for SC and $563 for FFV without discounting or age weighting. These interventions are highly cost-effective by international thresholds. While it is debatable whether these resource requirements represent a feasible or sustainable investment given low health expenditures in Pakistan, these findings may provide justification for continuing Pakistan's investment in national social safety

  2. Weighted Watson-Crick automata

    Energy Technology Data Exchange (ETDEWEB)

    Tamrin, Mohd Izzuddin Mohd [Department of Information System, Kulliyyah of Information and Communication Technology, International Islamic University Malaysia, 50728 Gombak, Selangor (Malaysia); Turaev, Sherzod; Sembok, Tengku Mohd Tengku [Department of Computer Science, Kulliyyah of Information and Communication Technology, International Islamic University Malaysia, 50728 Gombak, Selangor (Malaysia)

    2014-07-10

    There are tremendous works in biotechnology especially in area of DNA molecules. The computer society is attempting to develop smaller computing devices through computational models which are based on the operations performed on the DNA molecules. A Watson-Crick automaton, a theoretical model for DNA based computation, has two reading heads, and works on double-stranded sequences of the input related by a complementarity relation similar with the Watson-Crick complementarity of DNA nucleotides. Over the time, several variants of Watson-Crick automata have been introduced and investigated. However, they cannot be used as suitable DNA based computational models for molecular stochastic processes and fuzzy processes that are related to important practical problems such as molecular parsing, gene disease detection, and food authentication. In this paper we define new variants of Watson-Crick automata, called weighted Watson-Crick automata, developing theoretical models for molecular stochastic and fuzzy processes. We define weighted Watson-Crick automata adapting weight restriction mechanisms associated with formal grammars and automata. We also study the generative capacities of weighted Watson-Crick automata, including probabilistic and fuzzy variants. We show that weighted variants of Watson-Crick automata increase their generative power.

  3. Weighted Watson-Crick automata

    International Nuclear Information System (INIS)

    Tamrin, Mohd Izzuddin Mohd; Turaev, Sherzod; Sembok, Tengku Mohd Tengku

    2014-01-01

    There are tremendous works in biotechnology especially in area of DNA molecules. The computer society is attempting to develop smaller computing devices through computational models which are based on the operations performed on the DNA molecules. A Watson-Crick automaton, a theoretical model for DNA based computation, has two reading heads, and works on double-stranded sequences of the input related by a complementarity relation similar with the Watson-Crick complementarity of DNA nucleotides. Over the time, several variants of Watson-Crick automata have been introduced and investigated. However, they cannot be used as suitable DNA based computational models for molecular stochastic processes and fuzzy processes that are related to important practical problems such as molecular parsing, gene disease detection, and food authentication. In this paper we define new variants of Watson-Crick automata, called weighted Watson-Crick automata, developing theoretical models for molecular stochastic and fuzzy processes. We define weighted Watson-Crick automata adapting weight restriction mechanisms associated with formal grammars and automata. We also study the generative capacities of weighted Watson-Crick automata, including probabilistic and fuzzy variants. We show that weighted variants of Watson-Crick automata increase their generative power

  4. Image and surgery-related costs comparing cone beam CT and panoramic imaging before removal of impacted mandibular third molars

    DEFF Research Database (Denmark)

    Petersen, Lars Bo; Olsen, Kim Rose; Christensen, Jennifer Heather

    2014-01-01

    resource utilization. Differences in resources used for surgical and post-surgical management were calculated for each patient. Results: Converted to monetary units, the total costs for panoramic imaging equalized (sic)49.29 and for CBCT examination (sic)184.44. Modifying effects on this outcome......Objectives: The aim of this prospective clinical study was to derive the absolute and relative costs of cone beam CT (CBCT) and panoramic imaging before removal of an impacted mandibular third molar. Furthermore, the study aimed to analyse the influence of different cost-setting scenarios...... on the outcome of the absolute and relative costs and the incremental costs related to surgery. Methods: A randomized clinical trial compared complications following surgical removal of a mandibular third molar, where the pre-operative diagnostic method had been panoramic imaging or CBCT. The resources implied...

  5. Motivation, self-determination, and long-term weight control.

    Science.gov (United States)

    Teixeira, Pedro J; Silva, Marlene N; Mata, Jutta; Palmeira, António L; Markland, David

    2012-03-02

    This article explores the topics of motivation and self-regulation in the context of weight management and related behaviors. We focus on the role of a qualitative approach to address motivation--not only considering the level but also type of motivation--in weight control and related behaviors. We critically discuss the operationalization of motivation in current weight control programs, present a complementary approach to understanding motivation based on self-determination theory, and review empirical findings from weight control studies that have used self-determination theory measures and assessed their association with weight outcomes. Weight loss studies which used Motivational Interviewing (MI) are also reviewed, considering MI's focus on enhancing internal motivation. We hypothesize that current weight control interventions may have been less successful with weight maintenance in part due to their relative disregard of qualitative dimensions of motivation, such as level of perceived autonomy, often resulting in a motivational disconnect between weight loss and weight-related behaviors. We suggest that if individuals fully endorse weight loss-related behavioral goals and feel not just competent but also autonomous about reaching them, as suggested by self-determination theory, their efforts are more likely to result in long-lasting behavior change.

  6. Psychological, behavioral, and weight-related aspects of patients undergoing reoperative bariatric surgery after gastric band: comparison with primary surgery patients.

    Science.gov (United States)

    Conceição, Eva; Pinto-Bastos, Ana; de Lourdes, Marta; Brandão, Isabel; Teixeira, Cristina; Machado, Paulo P P

    2018-02-15

    Patients experiencing insufficient weight loss or weight regain in their first bariatric surgery may represent a high-risk group with greater problematic eating and general psychopathology levels, which may compromise the success of a reoperative procedure. This study seeks to describe and compare disordered eating-related psychological and behavioral features of primary and reoperative surgery candidates after gastric band. Hospital center and university in Portugal. The baseline (preoperative) data from a longitudinal observational study are presented. Patients were interviewed by trained psychologists to identify binge-eating episodes and grazing and responded to a set of self-report measures: disordered eating, grazing, negative urgency, depression, anxiety, and stress. Two hundred twenty-five patients were undergoing primary surgery, and 166 were undergoing reoperative (REOP group) surgery. The groups did not differ in body mass index preoperatively, but the REOP group had greater weight suppression (t 387 = -5.35, P = .001), higher highest (t 387 = -3.40, P = .001) and lower lowest body mass index (t 381 = 2.22, P = .03). The main reasons for reoperative surgery were weight regain/poor weight loss (42.8%) or medical complications (32.5%). REOP patients with objective binge eating reported a higher frequency of these episodes (t 47 = 2.15, P = .04). No significant difference was found for the self-report measures assessed (only shape concern was higher for REOP group, F 1,216 = 8.30, Psurgeries, the differences in binge eating and weight-related variables may associate with postoperative difficulties. The link between binge eating, weight suppression, and weight gain found in other samples suggests that patients undergoing reoperative surgery may be at increased risk for poor weight outcomes. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  7. About One Approach to Determine the Weights of the State Space Method

    Directory of Open Access Journals (Sweden)

    I. K. Romanova

    2015-01-01

    features of the problem, allowing us to obtain an analytical solution, it should be recognized that this criterion is, essentially, another form of a convolution of individual criteria. The problem to determine the weighting criteria in this quadratic convolution is still relevant and one of the main problems of the method.The author traces the obvious connection between the interactive methods for finding Pareto-optimal solutions of the MOO problem and the classical method for analytical design of optimal controllers (ADOC, in which decision-maker, essentially, specifies the same conditions: assigns the weights of private optimality criteria; imposes restrictions on the values of private optimality criteria; evaluates proposed MOO, using the system of alternatives. An important feature of interactive methods is that during optimization process the decision-makers' preferences may change.The article aims to link both approaches to the MOO problem. The expected advantage is the combination of analytical solutions based on the formulas of ADOC method and overcoming the criteria convolution shortcomings because of the difficult choice of weights. The novelty of the article is that the obvious idea of finding relationships between the weights of criteria by creating an indifference curve (Pareto frontier has been already used for the special type of quadratic integral criteria rather than for non-linear convolution of criteria that have their drawbacks.A modification of the quadratic criterion by breaking it into several components is made. Splitting into two criteria, which allowed us to obtain a graphical interpretation on a plane in the coordinates of the criterion describing the management costs and the criterion of the phase coordinates of the control object turned to be convenient. Since the method is often used for stabilization relative to the reference trajectory, representation of x and u as deviations of the phase coordinates and management costs was visual

  8. Weight Gain Prevention among Midlife Women: A Randomized Controlled Trial to Address Needs Related to the Physical and Social Environment

    Directory of Open Access Journals (Sweden)

    Courtney D. Perry

    2016-05-01

    Full Text Available Women tend to gain weight at midlife (40–60 years increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354 in one U.S. metropolitan area. The intervention group (n = 185 received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169 received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48. Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change.

  9. Plastic packaged microcircuits: Quality, reliability, and cost issues

    Science.gov (United States)

    Pecht, Michael G.; Agarwal, Rakesh; Quearry, Dan

    1993-12-01

    Plastic encapsulated microcircuits (PEMs) find their main application in commercial and telecommunication electronics. The advantages of PEMs in cost, size, weight, performance, and market lead-time, have attracted 97% of the market share of worldwide microcircuit sales. However, PEMs have always been resisted in US Government and military applications due to the perception that PEM reliability is low. This paper surveys plastic packaging with respect to the issues of reliability, market lead-time, performance, cost, and weight as a means to guide part-selection and system-design.

  10. Innovation in technology for the least product price and cost - a new minimum cost relation for reductions during technological learning

    International Nuclear Information System (INIS)

    Duffey, R.B.

    2004-01-01

    By analogy with the concepts of human learning, we show and introduce a new method to obtain least product cost and price that includes the effect of innovation and technological learning in manufacturing and production. This key result is a new paradigm instead of the usual economic 'power law' formulation. The new analysis is based on extensive analysis of many technological systems, and is directly related to the presence of learning as experience is accumulated. The results agree with the observed data. By using a consistent basis, the method replaces previous empirical 'power law' descriptions of the technological learning curve with a new 'marginal minimum cost equation' (MCE). (author)

  11. Stereo Disparity through Cost Aggregation with Guided Filter

    Directory of Open Access Journals (Sweden)

    Pauline Tan

    2014-10-01

    Full Text Available Estimating the depth, or equivalently the disparity, of a stereo scene is a challenging problem in computer vision. The method proposed by Rhemann et al. in 2011 is based on a filtering of the cost volume, which gives for each pixel and for each hypothesized disparity a cost derived from pixel-by-pixel comparison. The filtering is performed by the guided filter proposed by He et al. in 2010. It computes a weighted local average of the costs. The weights are such that similar pixels tend to have similar costs. Eventually, a winner-take-all strategy selects the disparity with the minimal cost for each pixel. Non-consistent labels according to left-right consistency are rejected; a densification step can then be launched to fill the disparity map. The method can be used to solve other labeling problems (optical flow, segmentation but this article focuses on the stereo matching problem.

  12. Costs and cost-effectiveness of periviable care.

    Science.gov (United States)

    Caughey, Aaron B; Burchfield, David J

    2014-02-01

    With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Level of voluntary disclosure and the cost of capital of Brazilian companies: 2008 to 2012

    Directory of Open Access Journals (Sweden)

    Ariana Ballestero

    2016-12-01

    Full Text Available This study analyzed whether the level of voluntary disclosure in the Brazilian market affects the cost of capital of companies listed on Bovespa during the period covering 2008 through 2012.  The sample was composed of 46 Brazilian non-financial institutions, building on and complementing previous research such as that carried out by Lima, Lima, Favero and Galdi (2007, Murcia and Santos (2009a, and Li and Yang (2013. The panel data regression model is employed to relate the independent variables with the following dependent variables: Cost of Equity, Cost of Debt and Weighted Average Cost of Capital. Findings permit the conclusion that some voluntary disclosure practices influence the cost of capital, i.e., when a company chooses to voluntarily disclose information in its annual reports, this information can affect its cost of equity and cost of debt.

  14. Development of simplified decommissioning cost estimation code for nuclear facilities

    International Nuclear Information System (INIS)

    Tachibana, Mitsuo; Shiraishi, Kunio; Ishigami, Tsutomu

    2010-01-01

    The simplified decommissioning cost estimation code for nuclear facilities (DECOST code) was developed in consideration of features and structures of nuclear facilities and similarity of dismantling methods. The DECOST code could calculate 8 evaluation items of decommissioning cost. Actual dismantling in the Japan Atomic Energy Agency (JAEA) was evaluated; unit conversion factors used to calculate the manpower of dismantling activities were evaluated. Consequently, unit conversion factors of general components could be classified into three kinds. Weights of components and structures of the facility were necessary for calculation of manpower. Methods for evaluating weights of components and structures of the facility were studied. Consequently, the weight of components in the facility was proportional to the weight of structures of the facility. The weight of structures of the facility was proportional to the total area of floors in the facility. Decommissioning costs of 7 nuclear facilities in the JAEA were calculated by using the DECOST code. To verify the calculated results, the calculated manpower was compared with the manpower gained from actual dismantling. Consequently, the calculated manpower and actual manpower were almost equal. The outline of the DECOST code, evaluation results of unit conversion factors, the evaluation method of the weights of components and structures of the facility are described in this report. (author)

  15. Educational level, relative body weight, and changes in their association over 10 years : an international perspective from the WHO MONICA Project

    NARCIS (Netherlands)

    Molarius, A.; Seidell, J C; Sans, S.; Tuomilehto, J.; Kuulasmaa, K.

    OBJECTIVES: This study assessed the consistency and magnitude of the association between educational level and relative body weight in populations with widely different prevalences of over-weight and investigated possible changes in the association over 10 years. METHODS: Differences in age-adjusted

  16. Link prediction in weighted networks

    DEFF Research Database (Denmark)

    Wind, David Kofoed; Mørup, Morten

    2012-01-01

    Many complex networks feature relations with weight information. Some models utilize this information while other ignore the weight information when inferring the structure. In this paper we investigate if edge-weights when modeling real networks, carry important information about the network...... is to infer presence of edges, but that simpler models are better at inferring the actual weights....

  17. Gestational weight gain.

    Science.gov (United States)

    Kominiarek, Michelle A; Peaceman, Alan M

    2017-12-01

    Prenatal care providers are advised to evaluate maternal weight at each regularly scheduled prenatal visit, monitor progress toward meeting weight gain goals, and provide individualized counseling if significant deviations from a woman's goals occur. Today, nearly 50% of women exceed their weight gain goals with overweight and obese women having the highest prevalence of excessive weight gain. Risks of inadequate weight gain include low birthweight and failure to initiate breast-feeding whereas the risks of excessive weight gain include cesarean deliveries and postpartum weight retention for the mother and large-for-gestational-age infants, macrosomia, and childhood overweight or obesity for the offspring. Prenatal care providers have many resources and tools to incorporate weight and other health behavior counseling into routine prenatal practices. Because many women are motivated to improve health behaviors, pregnancy is often considered the optimal time to intervene for issues related to eating habits and physical activity to prevent excessive weight gain. Gestational weight gain is a potentially modifiable risk factor for a number of adverse maternal and neonatal outcomes and meta-analyses of randomized controlled trials report that diet or exercise interventions during pregnancy can help reduce excessive weight gain. However, health behavior interventions for gestational weight gain have not significantly improved other maternal and neonatal outcomes and have limited effectiveness in overweight and obese women. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. [The impact of weight management and related diuretic medication intervention based on body weight changes on cardiac function and re-hospitalization rate in patients with chronic congestive heart failure].

    Science.gov (United States)

    Wang, F W; Shi, J; Shi, J; Yang, J W; Wang, Z H; Ye, J H; Ye, Y; Zheng, H Q; Huang, J

    2017-10-24

    Objective: To explore the impact of weight management and related medication intervention based on body weight changes on cardiac function among patients with chronic congestive heart failure (CHF). Methods: Using prospective, randomized, controlled study methods, consecutive CHF patients, who hospitalized in our department from June 2014 to June 2016 ( n =350), were randomly divided into intervention group ( n =175) and control group ( n =175). Patients in the intervention group received weight management guidance and the post discharge diuretic drugs regimen was adjusted based on body weight changes. The control group received routine medical care post discharge. Left ventricular ejection fraction (LVEF), B type natriuretic peptide precursor (NT-proBNP), 6 minutes walk distance and NYHA classification at one day before discharge and after 6 months were compared between the two groups respectively. Results: Follow-up visit data were not available from 6 patients in the control and intervention group respectively. NYHA classification, LVEF, NT-proBNP and 6 minutes walk distance were similar between the two groups at one day before discharge (all P >0.05). After 6 months, the LVEF and 6 minutes walk distance were significantly higher while NT-proBNP level was significantly lower in the intervention group compared to the control group (all P weight remained unchanged in the intervention group, while body weight tended to be higher in the control group compared to one day before discharge. Conclusion: The weight management and diuretic drug regimen adjudgment intervention based on body weight changes can improve cardiac function and reduced re-hospitalization rate in CHF patients.

  19. Randomised controlled trial and economic analysis of an internet-based weight management programme: POWeR+ (Positive Online Weight Reduction).

    Science.gov (United States)

    Little, Paul; Stuart, Beth; Hobbs, Fd Richard; Kelly, Jo; Smith, Emily R; Bradbury, Katherine J; Hughes, Stephanie; Smith, Peter Wf; Moore, Michael V; Lean, Mike Ej; Margetts, Barrie M; Byrne, Christopher D; Griffin, Simon; Davoudianfar, Mina; Hooper, Julie; Yao, Guiqing; Zhu, Shihua; Raftery, James; Yardley, Lucy

    2017-01-01

    Behavioural counselling with intensive follow-up for obesity is effective, but in resource-constrained primary care settings briefer approaches are needed. To estimate the clinical effectiveness and cost-effectiveness of an internet-based behavioural intervention with regular face-to-face or remote support in primary care, compared with brief advice. Individually randomised three-arm parallel trial with health economic evaluation and nested qualitative interviews. Primary care general practices in the UK. Patients with a body mass index of ≥ 30 kg/m 2 (or ≥ 28 kg/m 2 with risk factors) identified from general practice records, recruited by postal invitation. Positive Online Weight Reduction (POWeR+) is a 24-session, web-based weight management intervention completed over 6 months. Following online registration, the website randomly allocated participants using computer-generated random numbers to (1) the control intervention ( n  = 279), which had previously been demonstrated to be clinically effective (brief web-based information that minimised pressure to cut down foods, instead encouraging swaps to healthier choices and increasing fruit and vegetables, plus 6-monthly nurse weighing); (2) POWeR+F ( n  = 269), POWeR+ supplemented by face-to-face nurse support (up to seven contacts); or (3) POWeR+R ( n  = 270), POWeR+ supplemented by remote nurse support (up to five e-mails or brief telephone calls). The primary outcome was a modelled estimate of average weight reduction over 12 months, assessed blind to group where possible, using multiple imputation for missing data. The secondary outcome was the number of participants maintaining a 5% weight reduction at 12 months. A total of 818 eligible individuals were randomised using computer-generated random numbers. Weight change, averaged over 12 months, was documented in 666 out of 818 participants (81%; control, n  = 227; POWeR+F, n  = 221; POWeR+R, n  = 218). The control group

  20. Medical costs of war in 2035: long-term care challenges for veterans of Iraq and Afghanistan.

    Science.gov (United States)

    Geiling, James; Rosen, Joseph M; Edwards, Ryan D

    2012-11-01

    War-related medical costs for U.S. veterans of Iraq and Afghanistan may be enormous because of differences between these wars and previous conflicts: (1) Many veterans survive injuries that would have killed them in past wars, and (2) improvised explosive device attacks have caused "polytraumatic" injuries (multiple amputations; brain injury; severe facial trauma or blindness) that require decades of costly rehabilitation. In 2035, today's veterans will be middle-aged, with health issues like those seen in aging Vietnam veterans, complicated by comorbidities of posttraumatic stress disorder, traumatic brain injury, and polytrauma. This article cites emerging knowledge about best practices that have demonstrated cost-effectiveness in mitigating the medical costs of war. We propose that clinicians employ early interventions (trauma care, physical therapy, early post-traumatic stress disorder diagnosis) and preventive health programs (smoking cessation, alcohol-abuse counseling, weight control, stress reduction) to treat primary medical conditions now so that we can avoid treating costly secondary and tertiary complications in 2035. (We should help an amputee reduce his cholesterol and maintain his weight at age 30, rather than treating his heart disease or diabetes at age 50.) Appropriate early interventions for primary illness should preserve veterans' functional status, ensure quality clinical care, and reduce the potentially enormous cost burden of their future health care.

  1. Supply disruption cost for power network planning

    International Nuclear Information System (INIS)

    Kjoelle, G.H.

    1992-09-01

    A description is given of the method of approach to calculate the total annual socio-economic cost of power supply disruption and non-supplied energy, included the utilities' cost for planning. The total socio-economic supply disruption cost is the sum of the customers' disruption cost and the utilities' cost for failure and disruption. The mean weighted disruption cost for Norway for one hour disruption is NOK 19 per kWh. The customers' annual disruption cost is calculated with basis in the specific disruption cost referred to heavy load (January) and dimensioning maximum loads. The loads are reduced by factors taking into account the time variations of the failure frequency, duration, the loads and the disruption cost. 6 refs

  2. Validation of generic cost estimates for construction-related activities at nuclear power plants: Final report

    International Nuclear Information System (INIS)

    Simion, G.; Sciacca, F.; Claiborne, E.; Watlington, B.; Riordan, B.; McLaughlin, M.

    1988-05-01

    This report represents a validation study of the cost methodologies and quantitative factors derived in Labor Productivity Adjustment Factors and Generic Methodology for Estimating the Labor Cost Associated with the Removal of Hardware, Materials, and Structures From Nuclear Power Plants. This cost methodology was developed to support NRC analysts in determining generic estimates of removal, installation, and total labor costs for construction-related activities at nuclear generating stations. In addition to the validation discussion, this report reviews the generic cost analysis methodology employed. It also discusses each of the individual cost factors used in estimating the costs of physical modifications at nuclear power plants. The generic estimating approach presented uses the /open quotes/greenfield/close quotes/ or new plant construction installation costs compiled in the Energy Economic Data Base (EEDB) as a baseline. These baseline costs are then adjusted to account for labor productivity, radiation fields, learning curve effects, and impacts on ancillary systems or components. For comparisons of estimated vs actual labor costs, approximately four dozen actual cost data points (as reported by 14 nuclear utilities) were obtained. Detailed background information was collected on each individual data point to give the best understanding possible so that the labor productivity factors, removal factors, etc., could judiciously be chosen. This study concludes that cost estimates that are typically within 40% of the actual values can be generated by prudently using the methodologies and cost factors investigated herein

  3. Motivation, self-determination, and long-term weight control

    Directory of Open Access Journals (Sweden)

    Teixeira Pedro J

    2012-03-01

    Full Text Available Abstract This article explores the topics of motivation and self-regulation in the context of weight management and related behaviors. We focus on the role of a qualitative approach to address motivation - not only considering the level but also type of motivation - in weight control and related behaviors. We critically discuss the operationalization of motivation in current weight control programs, present a complementary approach to understanding motivation based on self-determination theory, and review empirical findings from weight control studies that have used self-determination theory measures and assessed their association with weight outcomes. Weight loss studies which used Motivational Interviewing (MI are also reviewed, considering MI's focus on enhancing internal motivation. We hypothesize that current weight control interventions may have been less successful with weight maintenance in part due to their relative disregard of qualitative dimensions of motivation, such as level of perceived autonomy, often resulting in a motivational disconnect between weight loss and weight-related behaviors. We suggest that if individuals fully endorse weight loss-related behavioral goals and feel not just competent but also autonomous about reaching them, as suggested by self-determination theory, their efforts are more likely to result in long-lasting behavior change.

  4. Motivation, self-determination, and long-term weight control

    Science.gov (United States)

    2012-01-01

    This article explores the topics of motivation and self-regulation in the context of weight management and related behaviors. We focus on the role of a qualitative approach to address motivation - not only considering the level but also type of motivation - in weight control and related behaviors. We critically discuss the operationalization of motivation in current weight control programs, present a complementary approach to understanding motivation based on self-determination theory, and review empirical findings from weight control studies that have used self-determination theory measures and assessed their association with weight outcomes. Weight loss studies which used Motivational Interviewing (MI) are also reviewed, considering MI's focus on enhancing internal motivation. We hypothesize that current weight control interventions may have been less successful with weight maintenance in part due to their relative disregard of qualitative dimensions of motivation, such as level of perceived autonomy, often resulting in a motivational disconnect between weight loss and weight-related behaviors. We suggest that if individuals fully endorse weight loss-related behavioral goals and feel not just competent but also autonomous about reaching them, as suggested by self-determination theory, their efforts are more likely to result in long-lasting behavior change. PMID:22385818

  5. Mid-upper arm circumference in pregnant women and its relation to birth weight

    Directory of Open Access Journals (Sweden)

    Ricalde Anamaría E.

    1998-01-01

    Full Text Available OBJECTIVE: In order to determine the relationship between some maternal anthropometric indicators and birth weight, crown-heel length and newborn's head circumference, 92 pregnant women were followed through at the prenatal service of hospital in S. Paulo, Brazil. MATERIAL AND METHOD: The following variables were established for the mother: weight, height, mid-upper arm circumference, pre-pregnancy weight, gestational weight gain and Quetelet's index. For the newborn the following variables were recorded: birth weight, crown-heel length, head circumference and gestational age by Dubowitz's method. RESULTS: Significant associations were noted between gestational age and newborn variables. In addition, maternal mid-arm circumference (MUAC and pre-pregnancy weight were found to be positively correlated to birth weight (r=0.399; r=0.378, respectively. The multivariate linear regression shows that gestational age, mother's arm circumference and pre-pregnancy weight continue to be significant predictors of birth weight. On the other hand, only gestational age and mother's age was associated with crown-heel length. Similarly MUAC was significantly associated with crown-heel length (r= 0.306; P=0.0030. CONCLUSION: Maternal mid-upper arm circumference is a potential indicator of maternal nutritional status. It could be used in association with other anthropometric measurements, instead of pre-pregnancy weight, as an alternative indicator to assess women at risk of poor pregnancy outcome.

  6. Mid-upper arm circumference in pregnant women and its relation to birth weight

    Directory of Open Access Journals (Sweden)

    Anamaría E. Ricalde

    1998-04-01

    Full Text Available OBJECTIVE: In order to determine the relationship between some maternal anthropometric indicators and birth weight, crown-heel length and newborn's head circumference, 92 pregnant women were followed through at the prenatal service of hospital in S. Paulo, Brazil. MATERIAL AND METHOD: The following variables were established for the mother: weight, height, mid-upper arm circumference, pre-pregnancy weight, gestational weight gain and Quetelet's index. For the newborn the following variables were recorded: birth weight, crown-heel length, head circumference and gestational age by Dubowitz's method. RESULTS: Significant associations were noted between gestational age and newborn variables. In addition, maternal mid-arm circumference (MUAC and pre-pregnancy weight were found to be positively correlated to birth weight (r=0.399; r=0.378, respectively. The multivariate linear regression shows that gestational age, mother's arm circumference and pre-pregnancy weight continue to be significant predictors of birth weight. On the other hand, only gestational age and mother's age was associated with crown-heel length. Similarly MUAC was significantly associated with crown-heel length (r= 0.306; P=0.0030. CONCLUSION: Maternal mid-upper arm circumference is a potential indicator of maternal nutritional status. It could be used in association with other anthropometric measurements, instead of pre-pregnancy weight, as an alternative indicator to assess women at risk of poor pregnancy outcome.

  7. Importance of taste, nutrition, cost and convenience in relation to diet quality: Evidence of nutrition resilience among US adults using National Health and Nutrition Examination Survey (NHANES) 2007-2010.

    Science.gov (United States)

    Aggarwal, Anju; Rehm, Colin D; Monsivais, Pablo; Drewnowski, Adam

    2016-09-01

    Concerns with taste, nutrition, cost, and convenience are said to be key influences on food choices. This study examined the importance of food-related attitudes in relation to diet quality using US national level data. Interactions by socioeconomic status (SES), gender and race/ethnicity were tested. Analyses of 8957 adults from National Health and Nutrition Examination Survey (NHANES 2007-2010) were conducted in 2014-15. Perceived importance of taste, nutrition, cost, and convenience in dietary choices were assessed using 4-point Likert scales. Education and family income-to-poverty ratio (FIPR) were SES indicators. Healthy Eating Index (HEI-2010), a measure of adherence to 2010 dietary guidelines, was the diet quality measure. Survey-weighted regressions examined associations between attitudes and HEI, and tested for interactions. Taste was rated as "very important" by 77.0% of the US adults, followed by nutrition (59.9%), cost (39.9%), and convenience (29.8%). However, it was the perceived importance of nutrition that most strongly predicted HEI (β: +8.0 HEI scores among "very important" vs. "not at all important"). By contrast, greater importance for taste and convenience had a weak inverse relation with HEI (β: -5.1 and -1.5 respectively), adjusting for SES. Significant interactions were observed by race/ethnicity, but not SES and gender. Those who prioritized nutrition during food shopping had higher-quality diets regardless of gender, education and income in the US. Certain racial/ethnic groups managed to eat healthy despite attaching importance to cost and convenience. This is the first evidence of nutrition resilience among US adults using national data, which has huge implications for nutrition interventions. Published by Elsevier Inc.

  8. Control of body weight by eating behavior in children

    Directory of Open Access Journals (Sweden)

    Modjtaba eZandian

    2015-10-01

    Full Text Available Diet, exercise, and pharmacological interventions have limited effects in counteracting the worldwide increase in pediatric body weight. Moreover, the promise that individualized drug design will work to induce weight loss appears to be exaggerated. We suggest that the reason for this limited success is that the cause of obesity has been misunderstood. Body weight is mainly under external control; our brain permits us to eat under most circumstances, and unless the financial or physical cost of food is high, eating and body weight increase by default. When energy-rich, inexpensive foods are continually available, people need external support to maintain a healthy body weight. Weight loss can thereby be achieved by continuous feedback on how much and how fast to eat on a computer screen.

  9. Number of meals eaten in relation to weight status among Norwegian adolescents.

    Science.gov (United States)

    Vik, Frøydis N; Overby, Nina C; Lien, Nanna; Bere, Elling

    2010-11-01

    To assess the relationship between number of meals eaten and weight status, and to assess potential confounders of this relationship. A total of 2870 (participation rate: 85%) 9th and 10th graders (mean age: 15.5 years) at 33 schools completed questionnaires in May 2005. Number of meals was measured with questions asking whether they ate breakfast, lunch, dinner, and supper the day before, giving a scale ranging from zero to four meals/day. Data on gender, height, weight, education plans, intake of fruits and vegetables, consumption of unhealthy snacks, TV/computer time, physical activity level, and dieting were also collected. The proportions of overweight adolescents related to the number of meals eaten were: 10% (0-1 meals, n = 107), 18% (2 meals, n = 399), 14% (3 meals, n = 925), and 10% (4 meals, n = 1402), p ≤ 0.001. Low education plans, high TV/computer time, low physical activity level, and dieting were all positively associated with both being overweight and not having four meals. Being a boy was positively associated with being overweight but negatively associated with not having four meals. High intake of unhealthy snacks was negatively associated with being overweight, but positively associated with not having four meals. In a logistic regression analysis, adjusting for all variables mentioned, odds ratio for being overweight were 0.8 (95% CI 0.3-1.9), 1.8 (95% CI 1.2-2.7) and 1.6 (95% CI 1.2-2.3), respectively, for eating one or zero, two, and three meals compared to four meals. Eating four meals/day was significantly negatively related to being overweight, also when controlling for potential confounding factors.

  10. A cost-controlling treatment strategy of adding liraglutide to insulin in type 2 diabetes.

    Science.gov (United States)

    de Wit, H M; Vervoort, G M M; de Galan, B E; Tack, C J

    2017-09-01

    Addition of the GLP-1 receptor agonist liraglutide to insulin can reverse insulin-associated weight gain, improve HbA1c and decrease the need for insulin, but is expensive. From a cost perspective, such treatment should be discontinued when it is clear that treatment targets will not be achieved. Our aim was to find the best cost-controlling treatment strategy: the shortest possible trial period needed to discriminate successfully treated patients from those failing to achieve predefined targets of treatment success. We used data from the 'Effect of Liraglutide on insulin-associated wEight GAiN in patients with Type 2 diabetes' (ELEGANT) trial, comparing additional liraglutide (n = 47) and standard insulin therapy (n = 24) during 26 weeks, to calculate the costs associated with different trial periods. Treatment success after 26 weeks was defined by having achieved ≥ 2 of the following: ≥ 4% weight loss, HbA1c ≤ 53 mmol/mol (7%), and/or discontinuation of insulin. The additional direct costs of adding liraglutide for 26 weeks were € 699 per patient, or € 137 per 1 kg weight loss, compared with standard therapy. The best cost-controlling treatment strategy (identifying 21 of 23 responders, treating four non-responders) was to continue treatment in patients showing ≥ 3% weight loss or ≥ 60% decrease in insulin dose at 8 weeks, with a total cost of € 246 for this t rial period, saving € 453 in case of early discontinuation. An 8-week trial period of adding liraglutide to insulin in patients with insulin-associated weight gain is an effective cost-controlling treatment strategy if the liraglutide is discontinued in patients not showing an early response regarding weight loss or insulin reduction.

  11. Placental share and hemoglobin level in relation to birth weight in twin anemia-polycythemia sequence.

    Science.gov (United States)

    Zhao, D; Slaghekke, F; Middeldorp, J M; Duan, T; Oepkes, D; Lopriore, E

    2014-12-01

    Twin anemia-polycythemia sequence (TAPS) is a newly described form of chronic twin transfusion. Previous observational studies noted a discordance between birth weight and individual placental share in TAPS. The purpose of this study was to investigate if fetal growth in monochorionic (MC) twins with TAPS is determined by placental share or by the net inter-twin blood transfusion. All consecutive MC twin placentas of live-born twin pairs with and without TAPS examined at our center between June 2002 and February 2014 were included in this study. Hemoglobin (Hb) levels and individual placental share were evaluated at birth and correlated with birth weight share. We excluded MC twin pregnancies with twin-twin transfusion syndrome. A total of 270 MC twin pregnancies (TAPS group, n = 20; control group without TAPS, n = 250) were included in this study. Donors with TAPS had a lower birth weight than recipients in 90% (18/20) of cases, but a larger placental share in 65% (13/20) of cases. In the TAPS group, birth weight share was positively correlated with Hb share at birth (P < 0.01) but not with placental share (P = 0.54). In the control group without TAPS, birth weight share was strongly correlated with placental share (P < 0.01) but not with Hb share (P = 0.14). A relatively larger placental share may enable the survival of the anemic twin in TAPS. In contrast with uncomplicated MC twins, fetal growth in MC twins with TAPS is determined primarily by the net inter-twin blood transfusion instead of placental share. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Common weights under dea control

    International Nuclear Information System (INIS)

    Agrell, P.J.; Bogetoft, P.; Fristrup, P.

    2003-01-01

    DEA relies so far on endogenous local or exogenous general weights, limited to available information. We offer endogenous general prices based on a reformulation of DEA. The potential application could be to precipitate collective bargaining on cost efficiency. The models are exemplified with data from the Danish district heating plants, where the open evaluation of multiple non-priced outputs is relevant (au)

  13. Genetic causal beliefs about obesity, self-efficacy for weight control, and obesity-related behaviours in a middle-aged female cohort.

    Science.gov (United States)

    Knerr, Sarah; Bowen, Deborah J; Beresford, Shirley A A; Wang, Catharine

    2016-01-01

    Obesity is a heritable condition with well-established risk-reducing behaviours. Studies have shown that beliefs about the causes of obesity are associated with diet and exercise behaviour. Identifying mechanisms linking causal beliefs and behaviours is important for obesity prevention and control. Cross-sectional multi-level regression analyses of self-efficacy for weight control as a possible mediator of obesity attributions (diet, physical activity, genetic) and preventive behaviours in 487 non-Hispanic White women from South King County, Washington. Self-reported daily fruit and vegetable intake and weekly leisure-time physical activity. Diet causal beliefs were positively associated with fruit and vegetable intake, with self-efficacy for weight control partially accounting for this association. Self-efficacy for weight control also indirectly linked physical activity attributions and physical activity behaviour. Relationships between genetic causal beliefs, self-efficacy for weight control, and obesity-related behaviours differed by obesity status. Self-efficacy for weight control contributed to negative associations between genetic causal attributions and obesity-related behaviours in non-obese, but not obese, women. Self-efficacy is an important construct to include in studies of genetic causal beliefs and behavioural self-regulation. Theoretical and longitudinal work is needed to clarify the causal nature of these relationships and other mediating and moderating factors.

  14. A Decidable Recursive Logic for Weighted Transition Systems

    DEFF Research Database (Denmark)

    Xue, Bingtian; Larsen, Kim Guldstrand; Mardare, Radu Iulian

    2014-01-01

    In this paper we develop and study the Recursive Weighted Logic (RWL), a multi-modal logic that expresses qualitative and quantitative properties of labelled weighted transition systems (LWSs). LWSs are transition systems labelled with actions and real-valued quantities representing the costs of ...... extends previous results that we have demonstrated for a similar but much more restrictive logic that can only use one variable for each type of resource to encode logical properties....

  15. Adding evidence-based behavioral weight loss strategies to a statewide wellness campaign: a randomized clinical trial.

    Science.gov (United States)

    Leahey, Tricia M; Thomas, Graham; Fava, Joseph L; Subak, Leslee L; Schembri, Michael; Krupel, Katie; Kumar, Rajiv; Weinberg, Brad; Wing, Rena R

    2014-07-01

    We determined the efficacy and cost-effectiveness of adding an evidence-based Internet behavioral weight loss intervention alone or combined with optional group sessions to ShapeUp Rhode Island 2011 (SURI), a 3-month statewide wellness campaign. We randomized participants (n = 230; body mass index = 34.3 ±6.8 kg/m(2); 84% female) to the standard SURI program (S) or to 1 of 2 enhanced programs: SURI plus Internet behavioral program (SI) or SI plus optional group sessions (SIG). The primary outcome was weight loss at the end of the 3-month program. Weight losses differed among all 3 conditions (S: 1.1% ±0.9%; SI: 4.2% ±0.6%; SIG: 6.1% ±0.6%; Ps ≤ .04). Both SI and SIG increased the percentage of individuals who achieved a 5% weight loss (SI: 42%; SIG: 54%; S: 7%; Ps < .001). Cost per kilogram of weight loss was similar for S ($39) and SI ($35); both were lower than SIG ($114). Although weight losses were greatest at the end of SURI with optional group sessions, the addition of an Internet behavioral program was the most cost-effective method to enhance weight losses.

  16. Neural correlates to food-related behavior in normal-weight and overweight/obese participants.

    Directory of Open Access Journals (Sweden)

    Alan Ho

    Full Text Available Two thirds of US adults are either obese or overweight and this rate is rising. Although the etiology of obesity is not yet fully understood, neuroimaging studies have demonstrated that the central nervous system has a principal role in regulating eating behavior. In this study, functional magnetic resonance imaging and survey data were evaluated for correlations between food-related problem behaviors and the neural regions underlying responses to visual food cues before and after eating in normal-weight individuals and overweight/obese individuals. In normal-weight individuals, activity in the left amygdala in response to high-calorie food vs. nonfood object cues was positively correlated with impaired satiety scores during fasting, suggesting that those with impaired satiety scores may have an abnormal anticipatory reward response. In overweight/obese individuals, activity in the dorsolateral prefrontal cortex (DLPFC in response to low-calorie food cues was negatively correlated with impaired satiety during fasting, suggesting that individuals scoring lower in satiety impairment were more likely to activate the DLPFC inhibitory system. After eating, activity in both the putamen and the amygdala was positively correlated with impaired satiety scores among obese/overweight participants. While these individuals may volitionally suggest they are full, their functional response to food cues suggests food continues to be salient. These findings suggest brain regions involved in the evaluation of visual food cues may be mediated by satiety-related problems, dependent on calorie content, state of satiation, and body mass index.

  17. Gestational weight gain among minority adolescents predicts term birth weight.

    Science.gov (United States)

    Ekambaram, Maheswari; Irigoyen, Matilde; DeFreitas, Johelin; Rajbhandari, Sharina; Geaney, Jessica Lynn; Braitman, Leonard Edward

    2018-03-07

    In adolescents, there is limited evidence on the independent and additive effect of prepregnancy body mass index (BMI) and gestational weight gain on infant birth weight. Data also show that this effect may vary by race. We sought to examine the impact of maternal prepregnancy BMI and gestational weight gain on birth weight and risk of large for gestational age (LGA) in term newborns of minority adolescent mothers. This was a retrospective cohort study of 411 singleton live term infants born to mothers ≤ 18 years. Data were abstracted from electronic medical records. Gestational weight gain was related to infant birth weight (ρ = 0.36, P gain, gestational age and Hispanic ethnicity were independent predictors of birth weight, controlling for maternal age, BMI, parity, tobacco/drug use and preeclampsia. The probability of having an LGA infant increased with weight gain [adjusted odds ratio (aOR) 1.14, 95% confidence interval (CI) 1.07-1.21] but not with BMI. Mothers who gained weight in excess of 2009 Institute of Medicine (IOM) recommendations had a greater risk of having an LGA infant compared to those who gained within recommendations (aOR 5.7, 95% CI 1.6-19.5). Minority adolescents with greater gestational weight gain had infants with higher birth weight and greater risk of LGA; BMI was not associated with either outcome. Further studies are needed to examine the applicability of the 2009 BMI-specific IOM gestational weight gain recommendations to adolescents in minority populations.

  18. Partitioning the Metabolic Cost of Human Running: A Task-by-Task Approach

    Science.gov (United States)

    Arellano, Christopher J.; Kram, Rodger

    2014-01-01

    Compared with other species, humans can be very tractable and thus an ideal “model system” for investigating the metabolic cost of locomotion. Here, we review the biomechanical basis for the metabolic cost of running. Running has been historically modeled as a simple spring-mass system whereby the leg acts as a linear spring, storing, and returning elastic potential energy during stance. However, if running can be modeled as a simple spring-mass system with the underlying assumption of perfect elastic energy storage and return, why does running incur a metabolic cost at all? In 1980, Taylor et al. proposed the “cost of generating force” hypothesis, which was based on the idea that elastic structures allow the muscles to transform metabolic energy into force, and not necessarily mechanical work. In 1990, Kram and Taylor then provided a more explicit and quantitative explanation by demonstrating that the rate of metabolic energy consumption is proportional to body weight and inversely proportional to the time of foot-ground contact for a variety of animals ranging in size and running speed. With a focus on humans, Kram and his colleagues then adopted a task-by-task approach and initially found that the metabolic cost of running could be “individually” partitioned into body weight support (74%), propulsion (37%), and leg-swing (20%). Summing all these biomechanical tasks leads to a paradoxical overestimation of 131%. To further elucidate the possible interactions between these tasks, later studies quantified the reductions in metabolic cost in response to synergistic combinations of body weight support, aiding horizontal forces, and leg-swing-assist forces. This synergistic approach revealed that the interactive nature of body weight support and forward propulsion comprises ∼80% of the net metabolic cost of running. The task of leg-swing at most comprises ∼7% of the net metabolic cost of running and is independent of body weight support and forward

  19. How adolescent subjective health and satisfaction with weight and body shape are related to participation in sports.

    Science.gov (United States)

    Dyremyhr, Ase Eriksen; Diaz, Esperanza; Meland, Eivind

    2014-01-01

    Physical exercise has positive effects on health. However, its associations with self-rated health and body image, which are important predictors for adolescents' wellbeing and later morbidity, are complex. Cross-sectional survey among 2527 Norwegian adolescents. We examined the relations between self-reported gender, body size, amount and type of exercise and measures of self-rated health, drive for thinness, and desire to change body, with binary logistic regression analyses. Girls and overweight students reported to a greater extent than their peers impaired self-rated health, weight concerns, and desire to change their body. Increasing amount of time spent on sports was related to improved self-rated health in a dose-response manner. Both girls and boys who engaged in individual sports with an advantage of leanness, but only girls engaged in team sports, reported an increased desire to change the body. However, weight concern was not related to amount or type of sports. Physical exercise is positively related to self-reported health but has negative associations with body image for many adolescents. Health promotion efforts should consider this paradox and stimulate physical activity and sports along with body acceptance.

  20. How Adolescent Subjective Health and Satisfaction with Weight and Body Shape Are Related to Participation in Sports

    Directory of Open Access Journals (Sweden)

    Åse Eriksen Dyremyhr

    2014-01-01

    Full Text Available Background. Physical exercise has positive effects on health. However, its associations with self-rated health and body image, which are important predictors for adolescents’ wellbeing and later morbidity, are complex. Methods. Cross-sectional survey among 2527 Norwegian adolescents. We examined the relations between self-reported gender, body size, amount and type of exercise and measures of self-rated health, drive for thinness, and desire to change body, with binary logistic regression analyses. Results. Girls and overweight students reported to a greater extent than their peers impaired self-rated health, weight concerns, and desire to change their body. Increasing amount of time spent on sports was related to improved self-rated health in a dose-response manner. Both girls and boys who engaged in individual sports with an advantage of leanness, but only girls engaged in team sports, reported an increased desire to change the body. However, weight concern was not related to amount or type of sports. Conclusions. Physical exercise is positively related to self-reported health but has negative associations with body image for many adolescents. Health promotion efforts should consider this paradox and stimulate physical activity and sports along with body acceptance.