The Economic Costs of Health Service Treatments for Asbestos-Related Mesothelioma Deaths

This article explores the complex and neglected picture of occupational and environmental disease healthcare costs specifically relating to asbestos. Diagnosed mesothelioma cases in Scotland in one calendar year were used to investigate the subject in greater depth. Data from UK sources on asbestos disease types recorded in 2000 and their disease treatment costs were obtained. Acute care economic costs of these diseases are estimated. One hundred and twenty diagnosed, recorded, and treated cases of asbestos-related diseases occurred in 2000 in Scotland. Mesothelioma accounted for 100 cases and directly cost Scottish National Health Service hospitals an estimated 942,038 pounds. The estimated UK figure in 2000 was at least 16,014,646 pounds because official figures for diagnosed and recorded deaths from mesothelioma are running at over 1700 a year with rises predicted for 2010 of 2000 deaths. By 2003, 50,000 people in the UK had died from diagnosed and recorded mesothelioma since records began. Earlier disease treatment costs would have been significantly lower than those in 2000 but, at 2000 prices, cost to the UK was roughly 471,019,000 pounds in acute hospital expenditure. Figures for primary care costs, including caregiver costs, are incomplete or unknown. These disease costs are substantial and have some international generalizability. Treatment patterns and costs vary greatly. Many lung cancer cases due to asbestos exposure occur globally for each mesothelioma case. Hence figures provided in this article are certain to be gross underestimates of the total health service and personal economic costs of asbestos illness and treatment in Scotland.

The Costs of Taking It Slowly Fast and Slow Movement Timing in Older Age

We investigated adult age differences in timing control of fast vs slow repetitive movements using a dual task approach Twenty two young (M = 24 23 yr) and 22 older adults (M = 66 64 yr) performed three cognitive tasks differing in working memory load and response production demands and they tapped series of 550 ms or 2100 ms target Intervals Single task timing was comparable in both groups Dual task timing was characterized by shortening of produced intervals and increases in drift and variability Dual task costs for both cognitive and timing performances were pronounced at slower tapping tempos an effect exacerbated in older adults Our findings implicate attention and working memory processes as critical components of slow movement timing and sources of specific challenges thereof for older adults

Responsive homes of old Cairo:Learning from the past, feeding in the future

This is a working paper published in On-line E-book

Studies on the biodegradation of fosfomycin: Synthesis of 13C-labeled intermediates, feeding experiments with rhizobium huakuii PMY1, and Isolation of Labeled Amino Acids from Cell Mass by HPLC

Racemic (1R*,2R*)-1,2-dihydroxy-[1- ^{13C ₁]propylphosphonic acid and 1-hydroxy-[1- 13C ₁]acetone were synthesized and fed to R. huakuii PMY1. Alanine and a mixture of valine and methionine were isolated as their N-acetyl derivatives from the cell hydrolysate by reversed-phase HPLC and analyzed by NMR spectroscopy. It was found that the carbon atoms of the respective carboxyl groups were highly 13C-labeled (up to 65 %). Hydroxyacetone is therefore considered an obligatory intermediate of the biodegradation of fosfomycin by R. huakuii PMY1.}

Responsive homes of old Cairo: Learning from the past, feeding in the future

By investigating the social dynamics of home in one of the enduring communities of Cairo, this paper reveals the way ordinary people construct and consume their private and public domains on a daily basis. It reveals what is central and what is marginal in the cognitive idea of home. This paper adopts an interdisciplinary strategy of investigation, utilizing sociological and anthropological data to read and visit spatial practices in the home. Building on historical as well as contemporary accounts of residents and families, the concept of home is envisioned as a spectrum of social spheres that is liberated from the physical determinants of space, hence revealing a new domain of part-time spaces and dynamic spatiality. The emergent idea of home intertwines work, domesticity, recreation and hospitality in interplay of space-activity-time relationships. Homes of old Cairo have proved to be responsive to continuous change, and have evolved dynamic forms of the temporal settings required for accommodation of emerging home-based professional activities such as hospitality, home-workers, and care-homes.

Behaviour of Brent geese Branta bernicla hrota and wigeon Anas penelope feeding on intertidal Zostera spp

Mixed flocks of pale-bellied Brent geese (Branta bernicla hrota) and wigeon (Anas penelope L.) feeding on intertidal Zostera spp were studied during October 1993 with respect to tidal position, feeding method and duration, and competitive: interactions within and between species. Owing to many disturbance incidents affecting the use of the site by wildfowl, only complete data on flow tides were presented. Brent geese fed over a greater period of the tidal cycle than wigeon. Differences in feeding methods indicated that Brent geese exploited the rhizomes, which are energetically more profitable than the shoot on which wigeon fed. Aggressive interactions were recorded within species but there were no records of aggression between species. More subtle competition for space, however, may have occurred during feeding. Brent geese could reach Zostera spp For a short period after increasing depth of water prevented access by wigeon. However, individual wigeon were observed foraging near feeding Brent geese, picking up the scraps oi material discarded by the latter, and small numbers of wigeon may benefit from the presence of the geese. These benefits for some individual wigeon are not considered to compensate for the disadvantages to the latter species population as a whole in feeding on poorer-quality food for a shorter period of the tidal cycle. This disadvantage is likely to have contributed to the decline in the wigeon population on Strangford Lough, Co. Down, while numbers of Brent geese have been maintained at a high level.

Relationships between lameness and feeding behaviour in cubicle-housed Holstein-Friesian dairy cows

The relationship between lameness and feeding behaviour in dairy cows is not yet fully understood. This study examined the effect of lameness on feeding behaviour at two points during lactation. Forty-five Holstein–Friesian dairy cows (average parity 3.3) were housed in cubicle accommodation after calving and fed a total mixed ration (TMR). At approximately 60 and 120 days post partum, 48 h of information on feeding behaviour (including number of meals eaten, meal duration, meal size and feeding rate) was collected for each animal using feed boxes fitted to a data recording system. At the same time points, locomotion scores were recorded for each cow as a measure of lameness (1.0-sound to 4.5-severely lame). Relationships between feeding behaviour and locomotion score were analysed using Residual Maximum Likelihood (REML) analysis. At both time points, cows with higher locomotion scores ate fewer (P < 0.001), larger meals (P < 0.001) and had a shorter total feeding time (P < 0.001). At day 60 post partum, an increase in locomotion score was associated with a decrease in dry matter intake (P < 0.05), but at day 120 post partum no relationship was found between locomotion score and DMI. No relationship was found at either time point between locomotion score and mean meal duration or rate of feeding. The results of this study suggest that the effect of lameness on feeding behaviour in dairy cows does not remain constant across lactation.

Breast-feeding and childhood-onset type 1 diabetes:A pooled analysis of individual participant data from 43 observational studies

OBJECTIVE: To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders.
RESEARCH DESIGN AND METHODS: Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies.
RESULTS: Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64-0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75-1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I(2) = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I(2) = 0%). Adjustments for potential confounders altered these estimates very little.
CONCLUSIONS: The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies.

The impact of nonadherence to inhaled long-acting β - adrenoceptor agonist/corticosteroid combination therapy on healthcare costs in difficult-to-control asthma

Background: Asthma is a leading, preventable cause of morbidity, mortality and cost. A disproportionate amount of the cost is generated by the 5-10%of patients with difficult-to-control asthma, who are prescribed treatment at step 4/5 of the Global Initiative for Asthma (GINA) guidelines. We have previously demonstrated a high prevalence of nonadherence to inhaled combination therapy (i.e. long-acting ß -adrenoceptor agonist [ß - agonist] and corticosteroid) in this population. The aim of this study was to examine the costs of healthcare utilization in a nonadherent group of patients with difficult-to-control asthma compared with adherent subjects. We also wished to examine potential savings if nonadherence to inhaled combination therapy could be addressed. All costs were measured from the perspective of a publicly funded health service Methods: Adherence was determined through examination of patient prescription refill behaviour and validated with a medical concordance interview. Data on healthcare use were collected from a patient survey and hospital records that included prescribed medicines, hospital admissions, intensive care unit (ICU) admissions and other unscheduled healthcare visits associated with asthma care. Activity was monetized using standard UK references and between-group comparisons based on a series of univariate and multivariate regression analyses. Results: Cost differences were identified for inhaled combination therapy, nebulizer, short acting b2-agonists and hospital costs excluding and including ICU admissions between adherent and nonadherent subjects. Compared with a group who have refractory asthma and who are adherent with medication, additional healthcare costs in nonadherent subjects are offset by the reduction in costs associated with reduced medication utilization. However, if nonadherence can be successfully targeted and hospital admissions avoided in this population, there is a potential $475 ($843-$368) saving per patient, per annum. Conclusion: Nonadherence is an important cause of difficult-to-control asthma. A uniform cost for subjects with difficult-to-control disease can be applied to economic analyses, independent of adherence, as increased healthcare utilization costs are offset by the reduced medication cost due to poor adherence. However, there are substantial potential savings in subjects with difficult-to-control asthma, who are nonadherent to inhaled combination therapy, if cost effective strategies for nonadherence are developed. © 2011 Adis Data Information BV. All rights reserved.