Energy cost of activity assessed by indirect calorimetry and a (CO2)-C-13 breath test

Purpose: The aim of this study was to assess the accuracy of a (CO2)-C-13 breath test for the prediction of short-duration energy expenditure. Methods: Eight healthy volunteers walked at 1.5 km.h(-1) for 60 min followed by 60-min recovery. During this time, the energy cost of physical activity was measured via respiratory calorimetry and a C-13 bicarbonate breath test. A further eight subjects were tested using the same two methods during a 60-min cycle at 0.5 kp. 30 ipm followed by a 60-min recovery. The rate of appearance of (CO2)-C-13, (RaCO2) was measured and the mean ratio, (V) over dot CO2/RaCO2 was used to calculate energy expenditure using the isotopic approach. Results: As would be expected, there was a significant difference in the energy cost of walking and cycling using both methods (P < 0.05). However. no significant differences were observed between respiratory calorimetry and the isotope method for measurement of energy expenditure while walking or cycling. Conclusions: These data suggest that the C-13 breath test is a valid method that can be used to measure the energy cost of short duration physical activity in a field setting.

Cost of malaria control in China: Henan's consolidation programme from community and government perspectives

Objective To assist with strategic planning for the eradication,of malaria in Henan Province, China, which reached the consolidation phase of malaria control in 1992, when only 318 malaria cases were reported, Methods We conducted a prospective two-year study of the costs for Henan's malaria control programme. We used a cost model that could also be applied to other malaria programmes in-mainland China, and analysed the cost of the three components of Henan's malaria programme. suspected malaria case management,, vector surveillance,,and population blood surveys. Primary cost data were collected from the government, and data on suspected malaria patient's were collected in two malaria counties (population 2 093 100). We enlisted the help of 260 village doctors. in six-townships or former communities (population 247 762), and studied all 12 315 reported cases of suspected malaria in catchment areas in 1994 and 1995. Findings The average-annual government investment in malaria control was estimated to be US$ 111 516 (case-management 59%; active blood surveys 25%;vector surveillance 12%; and contingencies and special projects 4%). The average cost (direct and indirect) for-patients seeking-treatment for suspected malaria was US$ 3.48, equivalent,to 10 days' income for rural residents. Each suspected malaria case cost the government an, average of US$ 0.78. Conclusion Further cuts in government funding will increase future costs, when epidemic malaria returns; investment in malaria control should therefore continue at least at current levels,of US$ 0.03 per person a risk.

Technical, allocative, cost and scale efficiencies in Bangladesh rice cultivation: A non-parametric approach

Applying programming techniques to detailed data for 406 rice farms in 21 villages, for 1997, produces inefficiency measures, which differ substantially from the results of simple yield and unit cost measures. For the Boro (dry) season, mean technical efficiency was efficiency was 56.2 per cent and 69.4 per cent, allocative efficiency was 81.3 per cent, cost efficiency was 56.2 per cent and scale efficiency 94.9 per cent. The Aman (wet) season results are similar, but a few points lower. Allocative inefficiency is due to overuse of labour, suggesting population pressure, and of fertiliser, where recommended rates may warrant revision. Second-stage regressions show that large families are more inefficient, whereas farmers with better access to input markets, and those who do less off-farm work, tend to be more efficient. The information on the sources of inter-farm performance differentials could be used by the extension agents to help inefficient farmers. There is little excuse for such sub-optimal use of survey data, which are often collected at substantial costs.

High-performance L-band series and parallel switches using low-cost p-i-n diodes

Low-cost UHF-band p-i-n diodes are used to develop high-performance L-band series and parallel switches. To stop the rectification of large RF, signals, the diodes are biased at a large reverse-bias voltage. Parasitic elements of the diodes are tuned out using LC circuits in biasing circuits without increasing the size of the switches. (C) 2002 John Wiley Sons, Inc.

Feeding ecology of a carnivorous bladderwort (Utricularia uliginosa, Lentibulariaceae)

The terrestrial carnivorous bladderwort, Utricularia uliginosa Vahl. (Lentibulariaceae) was studied to determine the species assemblage present in traps of these plants in situ across four sites over 15 months. The immediate soil environment was also sampled to determine the fauna present, and to compare the fauna present in traps with the fauna in the environment. The soil fauna consisted of 10 taxon types, which occupied either pelagic, epibenthic or interstitial microhabitats. All were found in traps of U. uliginosa, with the main prey being interstitial taxa followed by epibenthic and occasionally pelagic taxa. Numbers of individuals of the two most abundant soil taxa (nematodes, Elaphoidella) varied independently across the four sites over the 15 months of the study, as did numbers of Elaphoidella in the traps of U. uliginosa. Numbers of nematodes in the traps of U. uliginosa showed significant differences among sites, but not differences among times. Comparison of the trap fauna with the soil fauna revealed differences in relative abundance between soil samples and trap samples for two of the three taxa examined. There was an under-representation of nematodes in the traps relative to numbers in surrounding soil. There was an over-representation of the copepod Elaphoidella in the traps of U. uliginosa relative to numbers in soil at some of the times of sampling. Acarina were equally abundant in soil and trap samples. The patterns observed for Elaphoidella and nematodes may be due to selectivity in trapping by U. uliginosa, and/or differences in digestibility of the prey. Elaphoidella individuals were found to be attracted to U. uliginosa in a behavioural experiment. This may contribute to the over-representation of Elaphoidella in the traps of U. uliginosa in the field.

Cholesterol-lowering therapy with pravastatin in patients with average cholesterol levels and established ischaemic heart disease: is it cost-effective?

Objective: To measure the cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with established ischaemic heart disease and average baseline cholesterol levels. Design: Prospective economic evaluation within a double-blind randomised trial (Long-Term Intervention with Pravastatin in Ischaemic Disease [LIPID]), in which patients with a history of unstable angina or previous myocardial infarction were randomised to receive 40 mg of pravastatin daily or matching placebo. Patients and setting: 9014 patients aged 35-75 years from 85 centres in Australia and New Zealand, recruited from June 1990 to December 1992. Main outcome measures: Cost per death averted, cost per life-year gained, and cost per quality-adjusted life-year gained, calculated from measures of hospitalisations, medication use, outpatient visits, and quality of life. Results: The LIPID trial showed a 22% relative reduction in all-cause mortality (P < 0.001). Over a mean follow-up of 6 years, hospital admissions for coronary heart disease and coronary revascularisation were reduced by about 20%. Over this period, pravastatin cost $A4913 per patient, but reduced total hospitalisation costs by $A1385 per patient and other long-term medication costs by $A360 per patient. In a subsample of patients, average quality of life was 0.98 (where 0 = dead and 1 = normal good health); the treatment groups were not significantly different. The absolute reduction in all-cause mortality was 3.0% (95% CI, 1.6%-4.4%), and the incremental cost was $3246 per patient, resulting in a cost per life saved of $107730 (95% Cl, $68626-$209881) within the study period. Extrapolating long-term survival from the placebo group, the undiscounted cost per life-year saved was $7695 (and $10 938 with costs and life-years discounted at an annual rate of 5%). Conclusions: Pravastatin therapy for patients with a history of myocardial infarction or unstable angina and average cholesterol levels reduces all-cause mortality and appears cost effective compared with accepted treatments in high-income countries.

Cost comparison of hospital- and home-based treatment models for acute chronic obstructive pulmonary disease

This trial compared the cost of an integrated home-based care model with traditional inpatient care for acute chronic obstructive pulmonary disease (COPD). 25 patients with acute COPD were randomised to either home or hospital management following request for hospital admission. The acute care at home group costs per separation ($745, CI95% $595-$895, n = 13) were significantly lower (p < 0.01) than the hospital group ($2543, CI95% $1766-$3321, n = 12). There was an improvement in lung function in the hospital-managed group at the Outpatient Department review, decreased anxiety in the Emergency Department in the home-managed group and equal patient satisfaction with care delivery. Acute care at home schemes can substitute for usual hospital care for some patients without adverse effects, and potentially release resources. A funding model that allows adequate resource delivery to the community will be needed if there is a move to devolve acute care to community providers.

Opportunity cost of ad hoc marine reserve design decisions: an example from South Australia

Like many states and territories, South Australia has a legacy of marine reserves considered to be inadequate to meet current conservation objectives. In this paper we configured exploratory marine reserve systems, using the software MARXAN, to examine how efficiently South Australia's existing marine reserves contribute to quantitative biodiversity conservation targets. Our aim was to compare marine reserve systems that retain South Australia's existing marine reserves with reserve systems that are free to either ignore or incorporate them. We devised a new interpretation of irreplaceability to identify planning units selected more than could be expected from chance alone. This is measured by comparing the observed selection frequency for an individual planning unit with a predicted selection frequency distribution. Knowing which sites make a valuable contribution to efficient marine reserve system design allows us to determine how well South Australia's existing reserves contribute to reservation goals when representation targets are set at 5, 10, 15, 20, 30 and 50% of conservation features. Existing marine reserves that tail to contribute to efficient marine reserve systems constitute 'opportunity costs'. We found that despite spanning less than 4% of South Australian state waters, locking in the existing ad hoc marine reserves presented considerable opportunity costs. Even with representation targets set at 50%, more than halt of South Australia's existing marine reserves were selected randomly or less in efficient marine reserve systems. Hence, ad hoc marine reserve systems are likely to be inefficient and may compromise effective conservation of marine biodiversity.