scholarly journals Assessing the Impact of Lifestyle Interventions on Diabetes Prevention in China: A Modeling Approach

Author(s):  
Linna Luo ◽  
Bowen Pang ◽  
Jian Chen ◽  
Yan Li ◽  
Xiaolei Xie

China’s diabetes epidemic is getting worse. People with diabetes in China usually have a lower body weight and a different lifestyle profile compared to their counterparts in the United States (US). More and more evidence show that certain lifestyles can possibly be spread from person to person, leading some to propose considering social influence when establishing preventive policies. This study developed an innovative agent-based model of the diabetes epidemic for the Chinese population. Based on the risk factors and related complications of diabetes, the model captured individual health progression, quantitatively described the peer influence of certain lifestyles, and projected population health outcomes over a specific time period. We simulated several hypothetical interventions (i.e., improving diet, controlling smoking, improving physical activity) and assessed their impact on diabetes rates. We validated the model by comparing simulation results with external datasets. Our results showed that improving physical activity could result in the most significant decrease in diabetes prevalence compared to improving diet and controlling smoking. Our model can be used to inform policymakers on how the diabetes epidemic develops and help them compare different diabetes prevention programs in practice.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Jason Mackey ◽  
Kathleen Alwell ◽  
Jane C Khoury ◽  
Charles J Moomaw ◽  
Matthew L Flaherty ◽  
...  

Introduction: In the last few decades there have been several medical advances in the care of patients with subarachnoid hemorrhage (SAH). But few population-based studies (and none in the United States) have examined outcomes in the same population over time. Methods: All SAHs among residents of the Greater Cincinnati/Northern Kentucky (GCNK) region at least 20 years of age were identified using ICD-9 codes 430-436 and verified via study physician review in four distinct study periods. An incidence rate for each time period was calculated. Baseline characteristics, including demographics, risk factors, and functional status, were ascertained, along with hospital discharge modified Rankin score and all-cause 30- and 90-day case-fatality. Results: We identified 78 SAHs among residents of the GCNK region in 1988, 85 from 7/1993 to 6/1994, 95 in 1999, and 91 in 2005. The incidence of SAH in the four study periods (age-, race-, and sex-adjusted to the 2000 US population) was 9.4, 9.3, 10.0, and 9.0 per 100,000, respectively. Of the 349 SAHs in the study periods, 326 were diagnosed in an ED or hospital setting, while 23 were diagnosed on autopsy alone. All-cause 30- and 90-day case-fatality rates declined significantly from 1988 to 2005 ( Table ), even when all autopsy-alone cases were excluded. Conclusions: While the incidence of SAH remained stable in this population-based region, the 30-day and 90-day case-fatality rates declined significantly. Advances in surgical and medical management, along with systems-based changes such as the emergence of neurocritical care units, have likely led to reduced case-fatality. Future studies should explore the impact of specific factors related to improved case-fatality rates.


2020 ◽  
Author(s):  
King John Pascual ◽  
Carol Elsakr ◽  
Michael Glicksman ◽  
Cynthia Pham ◽  
Chantal Nguyen ◽  
...  

BACKGROUND The effect of physical activity on migraines is unclear, with some studies showing that it triggers episodes and others finding that it is preventative. Google Trends, a tool that gauges population interest in online searches both geographically and longitudinally, has been previously used for disease surveillance, including migraines. However, the recent COVID-19 Mobility Community Reports, in combination with Google Trends data, offers a unique opportunity to explore migraine epidemiology using real-time, geographic trends in physical activity. OBJECTIVE Our aim is to examine the relationship between physical activity and migraine using a novel infodemiological approach by combining data from Google Trends and the COVID-19 Mobility Community Reports. METHODS We collected data from the COVID-19 Community Mobility Reports (CCMR), specifying a time period of March 1st- 15th, 2020. We were specifically interested in the mobility trends scores for 2 variables: 1) parks and 2) residential. To assess the impact of mobility on migraine-related online searches, we collected Google Trends data by entering “Migraine” for the time period between April 1st-15th, 2020, one month after our CCMR collection period. We then calculated the percent change in migraine Search Volume Index (SVI) using the same CCMR March 2020 dates as baseline. RESULTS The 15 states with the highest and lowest park mobility (PM) scores displayed an average percent change of -29% and -12% in migraine-related online searches, respectively (p=0.0209). Residential mobility (RM) scores, which signal stronger adherence to lockdown, was positively correlated with change in migraine SVI (r=+0.32, p=0.02). CONCLUSIONS In this study, we reveal that there is an association between increased visitation of outdoor areas (i.e., PM scores) and reduction in migraine-related online searches one month after. This is in line with the literature findings on the prophylactic impact of physical exercise on migraine attacks.  Given that studies have linked time spent indoors to increased sedentary behavior, the association between residential mobility (RM) scores and increased frequency of migraine-related online searches (i.e. SVIs) was also expected. Google Trends and CCMR data may provide additional insights into the impact of physical activity on migraine and other neurological conditions.


Hand ◽  
2021 ◽  
pp. 155894472199080
Author(s):  
Danielle A Thornburg ◽  
Nikita Gupta ◽  
Nathan Chow ◽  
Jack Haglin ◽  
Shelley Noland

Background: Medicare reimbursement trends across multiple surgical subspecialties have been analyzed; however, little has been reported regarding the long-term trends in reimbursement of hand surgery procedures. The aim of this study is to analyze trends in Medicare reimbursement for commonly performed hand surgeries. Methods: Using the Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File, we determined the 20 hand surgery procedure codes most commonly billed to Medicare in 2016. Reimbursement rates were collected and analyzed for each code from The Physician Fee Schedule Look-Up Tool for years 2000 to 2019. We compared the change in reimbursement rate for each procedure to the rate of inflation in US dollars, using the Consumer Price Index (CPI) over the same time period. Results: The reimbursement rate for each procedure increased on average by 13.9% during the study period while the United States CPI increased significantly more by 46.7% ( P < .0001). When all reimbursement data were adjusted for inflation to 2019 dollars, the average reimbursement for all included procedures in this study decreased by 22.6% from 2000 to 2019. The average adjusted reimbursement rate for all procedures decreased by 21.92% from 2000 to 2009 and decreased by 0.86% on average from 2009 to 2019 ( P < .0001). Conclusion: When adjusted for inflation, Medicare reimbursement for hand surgery has steadily decreased over the past 20 years. It will be important to consider the implications of these trends when evaluating healthcare policies and the impact this has on access to hand surgery.


2021 ◽  
pp. 0145482X2110466
Author(s):  
Justin A. Haegele ◽  
Xihe Zhu ◽  
Sean Healy

Introduction: This study sought to examine: (a) the associations between physical activity, sedentary time, and sleep duration, as discrete behaviors, with depression among adults with visual impairments; and (b) the impact of meeting none, one, two, or three of the guidelines for these behaviors on depression among adults with visual impairments. Materials: One hundred eighty-two ( Mage = 44.8) adults with visual impairments, recruited via email through two visual impairment organizations in the United States, completed the International Physical Activity Questionnaire–Short Form, a sleep duration question, the Major Depression Inventory, and a demographic questionnaire. Based on results from the questionnaires, dichotomous variables for meeting or not meeting physical activity, sleep, and sitting guidelines were created. Data were analyzed using three components: a descriptive analysis, Pearson product-moment correlation analyses, and hierarchical regression analyses. Results: Overall, 14.8% of participants were categorized as having some degree of depression. Meeting the sleep guideline was a significant negative predictor of depression scores in the hierarchical regression analyses. The number of guidelines met was a negative predictor for depression score controlling for other variables. Discussion: Adequate sleep, as well as meeting all three guidelines synergistically, was meaningful in influencing depression among this population. The current study’s results should prompt the continued examination of health-behaviors among adults with visual impairment using a more holistic 24-hour activity cycle framework. Implications for practitioners: This study supports the utilization of multi-behavioral interventions to reduce the risk of depression by enhancing physical activity and sleep, while reducing sitting time, among this population.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nathan Maassel ◽  
Abbie Saccary ◽  
Daniel Solomon ◽  
David Stitelman ◽  
Yunshan Xu ◽  
...  

Abstract Background Despite a national decrease in emergency department visits in the United States during the first 10 months of the pandemic, preliminary Consumer Product Safety Commission data indicate increased firework-related injuries. We hypothesized an increase in firework-related injuries during 2020 compared to years prior related to a corresponding increase in consumer firework sales. Methods The National Electronic Injury Surveillance System (NEISS) was queried from 2018 to 2020 for cases with product codes 1313 (firework injury) and narratives containing “fireworks”. Population-based national estimates were calculated using US Census data, then compared across the three years of study inclusion. Patient demographic and available injury information was also tracked and compared across the three years. Firework sales data obtained from the American Pyrotechnics Association were determined for the same time period to examine trends in consumption. Results There were 935 firework-related injuries reported to the NEISS from 2018 to 2020, 47% of which occurred during 2020. National estimates for monthly injuries per million were 1.6 times greater in 2020 compared to 2019 (p < 0.0001) with no difference between 2018 and 2019 (p = 0.38). The same results were found when the month of July was excluded. Firework consumption in 2020 was 1.5 times greater than 2019 or 2018, with a 55% increase in consumer fireworks and 22% decrease in professional fireworks sales. Conclusions Firework-related injures saw a substantial increase in 2020 compared to the two years prior, corroborated by a proportional increase in consumer firework sales. Increased incidence of firework-related injuries was detected even with the exclusion of the month of July, suggesting that the COVID-19 pandemic may have impacted firework epidemiology more broadly than US Independence Day celebrations.


PLoS Biology ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. e3001211
Author(s):  
Seyed M. Moghadas ◽  
Thomas N. Vilches ◽  
Kevin Zhang ◽  
Shokoofeh Nourbakhsh ◽  
Pratha Sah ◽  
...  

Two of the Coronavirus Disease 2019 (COVID-19) vaccines currently approved in the United States require 2 doses, administered 3 to 4 weeks apart. Constraints in vaccine supply and distribution capacity, together with a deadly wave of COVID-19 from November 2020 to January 2021 and the emergence of highly contagious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants, sparked a policy debate on whether to vaccinate more individuals with the first dose of available vaccines and delay the second dose or to continue with the recommended 2-dose series as tested in clinical trials. We developed an agent-based model of COVID-19 transmission to compare the impact of these 2 vaccination strategies, while varying the temporal waning of vaccine efficacy following the first dose and the level of preexisting immunity in the population. Our results show that for Moderna vaccines, a delay of at least 9 weeks could maximize vaccination program effectiveness and avert at least an additional 17.3 (95% credible interval [CrI]: 7.8–29.7) infections, 0.69 (95% CrI: 0.52–0.97) hospitalizations, and 0.34 (95% CrI: 0.25–0.44) deaths per 10,000 population compared to the recommended 4-week interval between the 2 doses. Pfizer-BioNTech vaccines also averted an additional 0.60 (95% CrI: 0.37–0.89) hospitalizations and 0.32 (95% CrI: 0.23–0.45) deaths per 10,000 population in a 9-week delayed second dose (DSD) strategy compared to the 3-week recommended schedule between doses. However, there was no clear advantage of delaying the second dose with Pfizer-BioNTech vaccines in reducing infections, unless the efficacy of the first dose did not wane over time. Our findings underscore the importance of quantifying the characteristics and durability of vaccine-induced protection after the first dose in order to determine the optimal time interval between the 2 doses.


2018 ◽  
Vol 20 (3) ◽  
pp. 401-408
Author(s):  
Anamica Batra ◽  
Richard C. Palmer ◽  
Elena Bastida ◽  
H. Virginia McCoy ◽  
Hafiz M. R. Khan

Objective. In 2015, only half (48%) of older adults in the United States (≥60 years) reported engaging in any kind of physical activity. Few studies examine the impact of evidence-based programs when adopted in community-based settings. The purpose of this study is to assess the effectiveness of EnhanceFitness (EF) upto 12-months. Method. EF was offered to older adults in South Florida. A total of 222 EF classes were offered between October 2008 and December 2014. Program consisted of a 1-hour session held three times a week. Even though participation was required for 4 months, 1,295 participants continued the program for at least 1 year. Results. All participants showed significant improvement in outcome measures. A mean change of 1.5, 1.7, and 1.9 was seen in number of chair stands at 4, 8, and 12 months (p < .001), respectively. The number of arm curls performed improved from 16.8 at baseline to 18.8, 18.8, and 19.2 at 4-, 8-, and 12-months, respectively. Participants improved their up-and-go time by decreasing from 9.1 (baseline) to 8.7 (4 months) to 8.6 (12 months; p = .001). Discussion. Randomized controlled trials are commonly used to determine the efficacy of an intervention. These interventions when disseminated at the population level have the potential to benefit large masses. EF is currently offered at more than 700 locations. This tremendous success of EF brings attention to an important question of continuous monitoring of these programs to ensure program consistency and intended outcomes. The model used by the Healthy Aging Regional Collaborative could be replicated by other communities.


2020 ◽  
pp. 0148558X2093012
Author(s):  
Steven Balsam ◽  
Hong Fan ◽  
Amin Mawani ◽  
Daqun Zhang

CEO compensation in Canada is significantly lower than that in the United States. In this article, we examine the choice of, and impact on Canadian CEO Compensation, using U.S. firms in their compensation peer groups. Using a two-stage model to control for endogeneity, while we find the choice of peers associated with labor market factors, we still find that the use of U.S. peers positively associated with higher Canadian CEO compensation. This finding is after controlling for the traditional determinants of CEO compensation, as well as use of domestic peers. While this result holds for all components of the compensation package, we also find that having U.S. peers is associated with a greater proportion of equity in the compensation package. Our results are robust to various formulations including change models and using an earlier time period when peer disclosure was voluntary.


2019 ◽  
Vol 60 (5) ◽  
pp. e367-e377 ◽  
Author(s):  
Baowen Xue ◽  
Jenny Head ◽  
Anne McMunn

Abstract Background and Objectives People are now spending longer in retirement than ever before and retirement has been found to influence health. This study systematically reviewed the impact of retirement on cardiovascular disease (CVD) and its risk factors (metabolic risk factors, blood biomarkers, physical activity, smoking, drinking, and diet). Research Design and Methods Longitudinal studies published in Medline, Embase, Social Science Citation Index, PsycINFO, and Social Policy and Practice were searched. No language restrictions were applied if there was an English abstract. Eighty-two longitudinal studies were included after critical appraisals. Results Studies in the United States often found no significant effect of retirement on CVD, while studies in European countries, except France, showed a detrimental effect of retirement on CVD. Results from the United States and several European countries consistently show that retirement increase adiposity measures among those retired from physically demanding jobs. For diabetes and hypertension, five out of nine studies suggest no effect of retirement. Retirement has been repeatedly linked to increasing leisure-time physical activity but may reduce work- and transport-related physical activity in turn. Most studies showed that retirement either decreased smoking or had no effect on smoking. The evidence did not show a clear conclusion on drinking. Only a few studies have assessed the impact on diet and blood biomarkers. Discussion and Implications Effect of retirement varies according to the health outcomes studied and country of the study population. Policy concerning extending the retirement age needs to focus on ensuring they are suited to the individual.


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