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.

The cost of healthcare for children with mental health difficulties

Objective: Childhood mental health difficulties affect one in every seven children in Australia, posing a potential financial burden to society. This paper reports on the early lifetime individual and population non-hospital healthcare costs to the Australian Federal Government for children experiencing mental health difficulties. It also reports on the use and cost of particular categories of service use, including the Medicare Benefits Schedule (MBS) mental health items introduced in 2006.

Energetic cost of bot fly parasitism in free-ranging eastern chipmunks

The energy and nutrient demands of parasites on their hosts are frequently invoked as an explanation for negative impacts of parasitism on host survival and reproductive success. Although cuterebrid bot flies are among the physically largest and most-studied insect parasites of mammals, the only study conducted on metabolic consequences of bot fly parasitism revealed a surprisingly small effect of bot flies on host metabolism. Here we test the prediction that bot fly parasitism increases the resting metabolic rate (RMR) of free-ranging eastern chipmunks (Tamias striatus), particularly in juveniles who have not previously encountered parasites and have to allocate energy to growth. We found no effect of bot fly parasitism on adults. In juveniles, however, we found that RMR strongly increased with the number of bot fly larvae hosted. For a subset of 12 juveniles during a year where parasite prevalence was particularly high, we also compared the RMR before versus during the peak of bot fly prevalence, allowing each individual to act as its own control. Each bot fly larva resulted in a ~7.6% increase in the RMR of its host while reducing juvenile growth rates. Finally, bot fly parasitism at the juvenile stage was positively correlated with adult stage RMR, suggesting persistent effects of bot flies on RMR. This study is the first to show an important effect of bot fly parasitism on the metabolism and growth of a wild mammal. Our work highlights the importance of studying cost of parasitism over multiple years in natural settings, as negative effects on hosts are more likely to emerge in periods of high energetic demand (e.g. growing juveniles) and/or in harsh environmental conditions (e.g. low food availability).

In-hospital falls and fall-related injuries: a protocol for a cost of fall study

Background:
In-hospital falls are common and pose significant economic burden on the healthcare system. To date, few studies have quantified the additional cost of hospitalisation associated with an in-hospital fall or fall-related injury. The aim of this study is to determine  the additional length of stay and hospitalisation costs associated with in-hospital falls and fall-related injuries, from the acute hospital perspective.

Methods and design: 
A multisite prospective study will be conducted as part of a larger falls-prevention clinical trial—the 6-PACK project. This study will involve 12 acute medical and surgical wards from six hospitals across Australia. Patient and admission characteristics, outcome and hospitalisation cost data will be prospectively collected on approximately 15 000 patients during the 15-month study period. A review of all inhospital fall events will be conducted using a multimodal method (medical record review and daily verbal report from the nurse unit manager, triangulated with falls recorded in the hospital incident reporting and administrative database), to ensure complete case ascertainment. Hospital clinical costing data will be used to calculate patient-level hospitalisation costs incurred by a patient during their inpatient stay. Additional hospital and hospital resource utilisation costs attributable to inhospital falls and fall-related injuries will be calculated using linear regression modelling, adjusting for a prioridefined potential confounding factors.

Discussion:
This protocol provides the detailed statement of the planned analysis. The results from this study will be used to support healthcare planning, policy making and allocation of funding relating to falls prevention within acute hospitals.

The cost of diabetes in adults in Australia

Aims:
To assess and compare costs associated with diabetes and lesser degrees of glucose intolerance in Australia.

Methods:
The Australian Diabetes, Obesity and Lifestyle study collected data on the use of health services and health related expenditure in 2004–2005. Complications data were collected through physical examination and biochemical tests or questionnaire. Data were available on 6101 participants. Age- and sex-adjusted direct healthcare costs, direct non-healthcare costs and government subsidies were estimated according to glucose tolerance status.

Results:
Annual direct per person costs were A$1898 for those with normal glucose tolerance to A$4390 for those with known diabetes. Costs were substantially higher in people with diabetes and both micro- and macrovascular complications. The total annual cost of diabetes in 2005 for Australians aged ≥30 years was A$10.6 billion (A$4.4 billion in direct costs; A$6.2 billion in government subsidies) which equates to A$14.6 billion in 2010 dollars. Total annual excess cost associated with diabetes in 2005 was A$4.5 billion (A$2.2 billion in direct costs; A$2.3 billion in government subsidies).

Conclusion:
The excess cost of diabetes to individuals and government is substantial and is greater in those with complications. Costs could potentially be reduced by preventing the development of diabetes or its complications.

The extra resource burden of in-hospital falls: a cost of falls study

OBJECTIVE: To quantify the additional hospital length of stay (LOS) and costs associated with in-hospital falls and fall injuries in acute hospitals in Australia. DESIGN, SETTING AND PARTICIPANTS: A multisite prospective cohort study conducted during 2011-2013 in the control wards of a falls prevention trial (6-PACK). The trial included all admissions to 12 acute medical and surgical wards of six Australian hospitals. In-hospital falls data were collected from medical record reviews, daily verbal reports by ward nurse unit managers, and hospital incident reporting and administrative databases. Clinical costing data were linked for three of the six participating hospitals to calculate patient-level costs. OUTCOME MEASURES: Hospital LOS and costs associated with in-hospital falls and fall injuries for each patient admission. RESULTS: We found that 966 of a total of 27 026 hospital admissions (3.6%) involved at least one fall, and 313 (1.2%) at least one fall injury, a total of 1330 falls and 418 fall injuries. After adjustment for age, sex, cognitive impairment, admission type, comorbidity and clustering by hospital, patients who had an in-hospital fall had a mean increase in LOS of 8 days (95% CI, 5.8-10.4; P < 0.001) compared with non-fallers, and incurred mean additional hospital costs of $6669 (95% CI, $3888-$9450; P < 0.001). Patients with a fall-related injury had a mean increase in LOS of 4 days (95% CI, 1.8-6.6; P = 0.001) compared with those who fell without injury, and there was also a tendency to additional hospital costs (mean, $4727; 95% CI, -$568 to $10 022; P = 0.080). CONCLUSION: Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. Programs need to target the prevention of all falls, not just the reduction of fall-related injuries.

Corporate opacity and cost of debt for family firms

This paper uses a sample of Chinese firms to examine the impact of corporate opacity on the relationship between family control and firms’ cost of debt. We find that family control is associated with a lower cost of debt on average, and a negative impact exists mainly in firms with relatively low corporate opacity. We further provide evidence that the moderating effect of corporate opacity becomes more pronounced when investors’ perception of controlling families’ moral hazard of expropriation is higher. Our results are robust to alternative opacity proxies and controlling for endogeneity of family control using the instrumental variable method. Our study highlights that controlling families are heterogeneous in their impact on the shareholder–debtholder relationship in family firms, and debtholders view corporate opacity as an important reference in assessing the extent of potential agency conflicts in China.