Prevalence and cost of musculoskeletal disorders: a population-based, public hospital system healthcare consumption approach.

Objective: To use a population-level, public-hospital approach to compare the prevalence and cost of musculoskeletal diseases (MSD) with other clinical specialties.

Methods: A healthcare utilization survey of 4 million individual records over 4 years, from all major public hospitals in the state of Victoria (estimated population 4.8 million residents in 2000/01) from 1997/98 to 2000/01. Main outcome measures were inpatient episodes of care, bed-days, and outpatient clinic encounters. MSD was defined as the combination of orthopedics and rheumatology.

Results: After obstetrics, MSD was the most frequent outpatient service, with orthopedics accounting for 9.9% of all visits in 2000/01. The proportion of MSD outpatient encounters (on average 11.6% of the total) was constant over the study period. Among 26 medical specialties, MSD had the sixth highest number of inpatient episodes (6.2% in 2000/01), following renal dialysis (14.6%), general surgery (8.2%), obstetrics (7.6%), gastroenterology (7.1%), and general medicine (6.7%). MSD was the fifth highest consumer of bed-days, occupying on average 7.7% of all beds per annum in the period 1997/98 to 2000/01, behind psychiatry (10.1%), respiratory medicine (8.5%), rehabilitation (8.3%), and general medicine (7.8%). MSD was the third most-costly discipline in 2000/01, with total costs of over A dollars 169 million (9.7% of total inpatient costs that year), behind respiratory medicine (11.6%) and general surgery (11.5%).

Conclusion: Compared to other diseases, MSD consumes a substantial proportion of healthcare resources in Victorian public hospitals. These data have important implications for allocation of healthcare resources, clinical care pathways, and prevention strategies.

The cost of granting executive stock options with strike prices adjusted by the cost of capital

Purpose – The purpose of this paper is to estimate the cost of granting executive stocks with strike prices adjusted by the cost of capital.

Design/methodology/approach – In the paper a Monte Carlo simulation approach developed in Longstaff and Schwartz is used in conjunction with the subjective valuation model developed in Ingersoll to value these executive stock options that are subject to performance hurdles.

Findings – The paper finds that standard European Black-Scholes-Merton option values overstate the true cost to the firm of granting these executive stock options. The option values also decrease with a higher dividend yield, a higher performance hurdle, a longer vesting period, and a shorter maturity.

Research limitations/implications – While the study in the paper is limited to the valuation of executive options, the methodology can be used to study incentive effects of executive stock options that have a performance hurdle.

Practical implications – The approach used in this paper to estimate the cost of granting executive stock options is a clear improvement over standard European option pricing approaches that often result in biased estimates.

Originality/value – This paper presents a first attempt to integrate the Ingersoll utility-theoretic model and the Longstaff and Schwartz least squares Monte Carlo algorithm to estimate the subjective value and the objective cost of executive stock options with a performance hurdle. This valuation approach will be useful in the study of other types of executive compensation.

Prolactin, body condition and the cost of good parenting: an interyear study in a long-lived seabird, Gould's Petrel (Pterodroma leucoptera)

1. The pituitary hormone prolactin is thought to play an important role in the promotion of parental care in birds and mammals. The level of care parents provide is, however, likely to be influenced by additional factors, such as their physiological condition at the time of breeding.

2. We examined relationships between parental body condition, plasma prolactin levels and reproductive performance in Gould's Petrels (Pterodroma leucoptera), a long-lived seabird. We predicted that parental body condition would correlate positively with both prolactin level and parenting intensity, as measured by the quality of the chick they produced. We also examined the effects of parenting intensity on parental body condition and reproductive success in the subsequent breeding season.

3. Body condition of male parents positively correlated with prolactin levels at the start of their second protracted incubation bout. The body condition of both parents correlated positively with the body condition of their chick at its peak mass. However, producing a good-quality chick did not negatively affect parental body condition or reproductive success the following year.

4. These results suggest that prolactin reinforces parental behaviour in parents in good body condition, which facilitates production of good-quality chicks. Moreover, good-quality parents consistently produce good-quality chicks with no apparent trade-off to their physical condition.

Adventurous girls of the empire : the pre-war novels of Bessie Marchant

Historically, the genre of adventure fiction most readily recalls books for boys and male heroes rather than girl readers and protagonists. These include enduringly well-known works such as H. Rider Haggard's King Solomon's Mines (1885) and She (1887), the early to mid-Victorian boys' stories of Frederick Marryat, W. H. G. Kingston, and R. M. Ballantyne and the late-Victorian G. A. Henty's tales (his more than one hundred adventure stories sold in excess of 25 million copies). The novel of adventure at the conclusion of the nineteenth century recounted tales of male exploration on land or sea, and quests or conquests in real or imagined lands removed from the gentility of civilized England. These generic features were aligned with masculine traits of activity and strength, and while girls could and did indeed read boys' adventure books, examples with female protagonists were uncommon in the Victorian period. Joseph Bristow argues that between 1870 and 1900, "narratives celebrating empire and techniques in teaching reading and writing gradually converged . . . [B]oth inside and outside the classroom, there was more and more emphasis on heroic adventure, and this involved a number of shifts in attitude towards juvenile publishing and curriculum design" (20–21). The works Bristow refers to were, of course, written by male authors about masculine adventurers.

The novels of Bessie Marchant—sometimes called "the girls' Henty" —began to be published as the nineteenth century drew to a close. Her girl heroines act independently in isolated areas in Australia, New Zealand, Canada, India, South America, India, South Africa, Siberia, and Central America. From 1894 until her death in 1941, Marchant wrote more than a 130 novels, many of which celebrated the capacity of British or colonial girls to rise to any challenge set before them in rugged.

Height and cost of buildings in Shanghai and Hong Kong

Initial findings indicated that the curved relationships of height-cost of residential buildings in Shanghai and Hong Kong exhibit different profiles. The differences suggest that, Hong Kong contractors have more expertise in multi-story and high-rise construction than contractors in Shanghai. The dissimilarities also imply that different sets of criteria should be applied in the judgement of height affects on cost in different locations.

Comparing the physiological cost of step-powered video gaming, sedentary video gaming and self paced ambulatory activity in university students

Objectives: Methods for converting inactive video gaming to active video gaming have gained popularity in recent years. This study compared the physiological cost of a new peripheral device that used steps to power video gaming in an interactive manner against sedentary video gaming and self-paced ambulatory activity of university students (aged 19-29 years).
Methods: Nineteen adults (9 male, 10 female) performed six 10-minute activities, namely self-paced leisurely walking, self-paced brisk walking, self-paced jogging, two forms of sedentary video gaming, and step-powered video gaming. Activities were performed in a random order. Physiological cost during the activities was measured using Actiheart.
Results: Energy expenditure during step-powered video gaming (388.8 kcal.h-1) was comparable to the energy expended during brisk walking (373.8 kcal.h-1), and elicited a higher energy cost than sedentary video gaming (124.1 kcal.h-1) but a lower energy cost than jogging (694.5 kcal.h-1).
Conclusion: Overall, step-powered video gaming could be used as an entertaining and appealing tool to increase physical activity, though it should not be used as a complete substitute for traditional exercise, such as jogging.

The cost of housing : more than just dollars

Australians were recently awarded the dubious honour of building the largest homes in the world. Our new homes are now seven percent larger than those in the United States and nearly three times larger than those in the United Kingdom. At the same time, the price of an average residential property is now five times what it was 20 years ago. Although incomes have risen over the same period, they have not kept pace with rising house prices. In terms of disposable income, the cost of housing has almost doubled. While traditional housing affordability is measured in terms of house prices and incomes, a broader and more encompassing perspective also indicates that we can no longer ‘afford’ to build houses as we have done in the past. The environmental impact of modern Australian housing is significant. Australians have resisted the need for increased urban density as their capital city populations grow and new houses have been built on the outskirts of the existing cities, encroaching on the greenwedge and agricultural lands, destroying and degrading existing fauna and flora. The houses built have increased carbon emissions because of their size, embodied energy and reliance on the motor car. This paper discusses the environmental ‘affordability’ of current Australian housing and argues that this must be considered alongside traditional affordability criteria so that a more holistic approach to the issues is adopted.

The human cost of fracture

In this population-based, observational study, we document the personal burden of fracture and utilization of community and health services for women during the 12-month period following a fracture. Participants were 598 women (aged 35-92 years) with incident fracture in the years 1994-1996 who were enrolled in the Geelong Osteoporosis Study. Almost all hip fracture cases and 27% of nonhip fracture cases were hospitalized. Homes were modified in 14% of cases, and 32% of the women purchased or hired equipment to assist with activities of daily living. Three-quarters of women with hip, pelvis, or lower limb fractures were confined to the home, had to walk with a walking aid, or could walk only short distances for several weeks. After a year, nearly one-half had not regained prefracture mobility. One-seventh of women with upper-limb fractures did not venture outside the home for at least 6 weeks. Nearly half of all fracture cases needed help with personal care and housework during the first 6 weeks. After 6 months, 3.4% of all patients and 19.6% of hip, 12.8% of humeral, and 4.7% of spine fracture patients required assistance with bathing and showering. After a year, more than half of the hip fracture cases remained restricted regarding housework, gardening, and transport. These findings have important implications for rehabilitation therapy. A fracture, regardless of site, had a major impact on a woman's lifestyle and well-being. Most women were restricted in their activities of daily living and suffered loss of confidence and independence. Short-term morbidity was common for all fractures, with varying degrees of prolonged morbidity often extending to at least a year postfracture.

Associations between mothers’ perceptions of the cost of fruit and vegetables and children’s diets : Will children pay the price?

Background/Objectives:
Perceptions that fruit and vegetables are expensive are more common among the socio-economically disadvantaged groups and are linked to poor dietary outcomes. Such perceptions may be exacerbated in countries recently affected by natural disasters, where devastation of fruit and vegetable crops has resulted in increase in prices of fruit and vegetables. Examining the associations of perceptions of fruit and vegetable affordability and children's diets can offer insights into how the high prices of fruit and vegetables might have an impact on the diets of children.
Subjects/Methods:
We analysed the data from 546 socio-economically disadvantaged mother–child pairs to assess the relationship between maternal perceptions of fruit and vegetable affordability and the diets of their children.
Results:
Fruit consumption was lower among children whose mothers felt the cost of fruit was too high. Maternal perceptions of fruit and vegetable affordability were not associated with any other aspect of child's diet.
Conclusions:
Our results suggest a possible role for maternal perceptions of fruit affordability in children's diet, though further research is warranted.