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Long-term Costs (long-term + cost)
Selected AbstractsIf you try to stop smoking, should we pay for it?ADDICTION, Issue 6 2010The cost, utility of reimbursing smoking cessation support in the Netherlands ABSTRACT Background Smoking cessation can be encouraged by reimbursing the costs of smoking cessation support (SCS). The short-term efficiency of reimbursement has been evaluated previously. However, a thorough estimate of the long-term cost,utility is lacking. Objectives To evaluate long-term effects of reimbursement of SCS. Methods Results from a randomized controlled trial were extrapolated to long-term outcomes in terms of health care costs and (quality adjusted) life years (QALY) gained, using the Chronic Disease Model. Our first scenario was no reimbursement. In a second scenario, the short-term cessation rates from the trial were extrapolated directly. Sensitivity analyses were based on the trial's confidence intervals. In the third scenario the additional use of SCS as found in the trial was combined with cessation rates from international meta-analyses. Results Intervention costs per QALY gained compared to the reference scenario were approximately ,1200 extrapolating the trial effects directly, and ,4200 when combining the trial's use of SCS with the cessation rates from the literature. Taking all health care effects into account, even costs in life years gained, resulted in an estimated incremental cost,utility of ,4500 and ,7400, respectively. In both scenarios costs per QALY remained below ,16 000 in sensitivity analyses using a life-time horizon. Conclusions Extrapolating the higher use of SCS due to reimbursement led to more successful quitters and a gain in life years and QALYs. Accounting for overheads, administration costs and the costs of SCS, these health gains could be obtained at relatively low cost, even when including costs in life years gained. Hence, reimbursement of SCS seems to be cost-effective from a health care perspective. [source] Autotomy-induced life history plasticity in band-legged ground cricket Dianemobius nigrofasciatusENTOMOLOGICAL SCIENCE, Issue 1 2010Nobuhiro MATSUOKA Abstract Crickets can autotomize their limbs when attacked by predators. This enables them to escape death, but imposes a short-term cost on their escape speed and a long-term cost on their future mating ability. Therefore, adaptive response compensated for the cost of autotomy might be advantageous for autotomized individuals. In the present study, we examined whether autotomy induced life history plasticities compensating for the future cost in the band-legged ground cricket Dianemobius nigrofasciatus. Life history traits of D. nigrofasciatus were compared between autotomized and intact individuals. The developmental time and head width of the individuals that were autotomized as fourth instar nymphs were significantly shorter and smaller, respectively, than those of intact individuals. However, the adult longevity, number of eggs laid and oviposition schedule did not vary between autotomized and intact individuals. In addition, there was no difference between individuals autotomized at the fourth instar and adult stages in these three traits. Early maturation in the autotomized individuals might be advantageous through reducing the risk of predation owing to the shorter period in nymphal stages. The cost of small body size in the autotomized females might not be so great because of no significant difference in fecundity between autotomized and intact individuals. However, the cost of small body size was unclear in the autotomized males because in general larger males were preferred by females. These results indicated autotomy-induced life history that might reduce the cost of autotomy. [source] The Liquidity Demand for Corporate Property InsuranceJOURNAL OF RISK AND INSURANCE, Issue 2 2006Arthur Hau This article suggests that liquidity may be an important reason for a corporation to purchase property insurance. A model of a risk-neutral producer facing an endogenously determined risk of property damage under an output contract that penalizes underproduction is formulated to exemplify such a real need of liquidity. Under the output contract, the producer may purchase full unfavorable property insurance even when postloss financing is available. Surprisingly, the conclusion may still hold when the cost of postloss financing equals that of long-term capital, provided that the rate of underproduction penalty is sufficiently high. Similar conclusions apply when postloss financing is replaced by planned internal reserve (self-insurance) that may be invested in the short run at an interest rate that is lower than the long-term cost of capital. When the capital market is perfect, however, the holding of planned internal reserve eliminates the purchase of actuarially unfavorable property insurance. [source] Global Energy and Environmental Impacts of an Expanding ChinaCHINA AND WORLD ECONOMY, Issue 4 2006Warwick J. McKibbin Q53; Q56; Q58 Abstract China accounts for 10 percent of global energy use and will continue to rely on coal for generating approximately 75 percent of its energy over coming decades. The environmental problems associated with coal burning are a concern for China as well as regionally and globally. The present paper summarizes China's energy structure and likely future energy requirements, while exploring the impact of energy use on air quality, black carbon emission, sulphur dioxide (SO2) emissions, and carbon dioxide emissions. Although China has begun to take action on local environmental problems from energy, there is still much to be done. In particular, the problem of black carbon and carbon dioxide emissions needs to be addressed. The present paper proposes addressing carbon dioxide emissions through a longer-term strategy that acknowledges the need for China to continue to grow without a short-term carbon constraint but with clear pricing of the short-term and long-term cost of carbon dioxide. (Edited by Xiaoming Feng) [source] SELF-CONTROL, CRIMINAL MOTIVATION AND DETERRENCE: AN INVESTIGATION USING RUSSIAN RESPONDENTSCRIMINOLOGY, Issue 2 2005CHARLES R. TITTLE With data from respondents in Nizhni Novgorod, Russia, we address the generality of self-control theory. We also assess two hypotheses. The first focuses on the attractiveness of criminal acts, that is, motivation toward crime. The second concerns the contention that the mediating link between self-control and criminal conduct is the failure of those with less self-control to anticipate the long-term costs of misbehavior. Although the magnitude of associations between self-control and indicators of criminal behavior is about the same in this study as it is in others, which suggests that the theory is not culturally bound, those associations are largely overshadowed by criminal attraction. Consistent with that, failure to anticipate costly long-term consequences does not appear to be the mediating link between self-control and criminal behavior: the evidence shows no tendency for sanction fear to be greater among those with greater self-control. In fact, sanction fear is modestly and significantly related to the crime measures independent of self-control, though sanction fear also appears to be influenced by criminal attraction. The results suggest that in the production of criminal behavior, motivation may be more important than controls inhibiting criminal impulses. [source] Economic aspects of diabetic foot care in a multidisciplinary setting: a reviewDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 5 2007Giovanni A. Matricali Abstract Background To evaluate the economic aspects of diabetic foot care in a multidisciplinary setting. Method A review of the English language literature, published from 1966 to November 2005. Results The results of available studies on the cost-of-illness of diabetic foot problems are difficult to compare. Nevertheless trends concerning excess of costs, protraction in time of costs, positive correlation to severity of ulcer and/or peripheral vascular disease, contribution of in-hospital stay and length of stay, and the patient's own contribution to total costs, are obvious. Only a few cost-effectiveness and cost-utility studies are available. Most use a Markov based model to predict outcome and show an acceptable result on long-term. Conclusions Diabetic foot problems are frequent and are associated with high costs. A multidisciplinary approach to diabetic foot problems has proved to be cost saving with regard to cost of treatment itself. Nevertheless, it remained unclear if these savings could offset the overall costs involved in implementing this kind of approach. The few studies that address this issue specifically all show an acceptable cost-effectiveness, but often the profit will be evident after some years only, because long-term costs are involved. Based on these data, policymakers should foresee sufficient reimbursement for preventive and early curative measures, and not only for ,salvage manoeuvres'. Copyright © 2007 John Wiley & Sons, Ltd. [source] SOCIALITY IN THERIDIID SPIDERS: REPEATED ORIGINS OF AN EVOLUTIONARY DEAD ENDEVOLUTION, Issue 11 2006Ingi Agnarsson Abstract Evolutionary ,dead ends' result from traits that are selectively advantageous in the short term but ultimately result in lowered diversification rates of lineages. In spiders, 23 species scattered across eight families share a social system in which individuals live in colonies and cooperate in nest maintenance, prey capture, and brood care. Most of these species are inbred and have highly female-biased sex ratios. Here we show that in Theridiidae this social system originated eight to nine times independently among 11 to 12 species for a remarkable 18 to 19 origins across spiders. In Theridiidae, the origins cluster significantly in one clade marked by a possible preadaptation: extended maternal care. In most derivations, sociality is limited to isolated species: social species are sister to social species only thrice. To examine whether sociality in spiders represents an evolutionary dead end, we develop a test that compares the observed phylogenetic isolation of social species to the simulated evolution of social and non-social clades under equal diversification rates, and find that sociality in Theridiidae is significantly isolated. Because social clades are not in general smaller than their nonsocial sister clades, the spindly phylogenetic pattern,many tiny replicate social clades,may be explained by extinction rapid enough that a nonsocial sister group does not have time to diversify while the social lineage remains extant. In this case, this repeated origin and extinction of sociality suggests a conflict between the short-term benefits and long-term costs of inbred sociality. Although benefits of group living may initially outweigh costs of inbreeding (hence the replicate origins), in the long run the subdivision of the populations in relatively small and highly inbred colony lineages may result in higher extinction, thus an evolutionary dead end. [source] The effects of perceived predation risk on pre- and post-metamorphic phenotypes in the common frogJOURNAL OF ZOOLOGY, Issue 3 2009C. E. Stamper Abstract Where organisms undergo radical changes in habitat during ontogeny, dramatic phenotypic reshaping may be required. However, physiological and functional interrelationships may constrain the extent to which an individual's phenotype can be equally well adapted to their habitat throughout the life cycle. The phenotypic response of tadpoles to the presence of a predator has been reported for several species of anuran but the potential post-metamorphic consequences have rarely been considered. We reared common frog Rana temporaria tadpoles in the presence or absence of a larval odonate predator, Aeshna juncea, and examined the consequences of the resulting phenotypic adjustment in the aquatic larval stage of the life cycle for the terrestrial juvenile phenotype. In early development tadpoles developed deeper tail fins and muscles in response to the predator and, in experimental trials, swam further than those reared in the absence of a predator. While the difference in swimming ability remained significant throughout the larval period, by the onset of metamorphosis we could no longer detect any differences in the morphological parameters measured. The corresponding post-metamorphic phenotypes also did not initially differ in terms of morphology. At 12 weeks post-metamorphosis, however, froglets that developed from predator-exposed tadpoles swam more slowly and less far than those that developed from tadpoles reared in the absence of predators, the opposite trend to that observed in the larval stage of the life cycle, and had narrower femurs. These results suggest that there may be long-term costs for subsequent life-history stages of tailoring the larval phenotype to prevailing environmental conditions. [source] Longevity differs among sexes but is not affected by repeated immune activation in voles (Microtus arvalis)BIOLOGICAL JOURNAL OF THE LINNEAN SOCIETY, Issue 2 2009GODEFROY DEVEVEY Investment of resources in immune defences, despite obvious short-term benefits, may be detrimental to long-term maintenance and thus decrease longevity in absence of parasites. In addition, females and males may differ in immune investment and intrinsic longevity because they are subjected to different degrees of sexual competition and extrinsic mortality. In order to test if sex-specific investment in mounting an immune response reduced longevity, we compared the longevity of captive male and female common voles Microtus arvalis regularly challenged with keyhole limpet haemocyanin, an antigen which elicits the production of antibodies, to the longevity of voles injected with the corresponding antigen-free buffer (phosphate-buffered saline). Injections were repeated every 28 days to mimic a chronic infection. The magnitude of immune response did not vary between males and females and did not affect longevity. Overall, females lived longer than males, independently of the immune challenge. Thus, the long-term costs of immunity seem small in voles. The longevity pattern is consistent with the prediction that male-biased predation or parasitism in the wild causes reduced intrinsic lifespan, but this reduction is not mediated by a decrease in male immunity. © 2009 The Linnean Society of London, Biological Journal of the Linnean Society, 2009, 97, 328,333. [source] The impetus for family-centred early childhood interventionCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2007B. Carpenter Abstract In this article, the current climate of early intervention is considered, advocating the necessity for it to remain a cutting-edge service that attends to the changing needs profiles of children and their families. The article reviews the difficulties experienced by families in the UK, where, as the government acknowledges, life chances are still unequal. It emphasises that early interventions can increase the likelihood of the family being able to engage or re-engage with mainstream societal services, thus reducing the long-term costs to society. It discusses the past and present UK policy context from 2004, when Sohns reported that the UK was the only country without a national policy of infrastructure in relation to early childhood intervention, until the present when, a raft of legislation is in place acknowledging its importance and the need for priority. Central to many effective early intervention programmes is the goal of establishing shared communication in the infant,key carer dyad, using alternative communication and therapy-based interventions. The article discusses parent-inclusive programmes which meet the needs of both parents and children, and receive endorsement from parents. Finally, the article considers evaluation of early childhood services, and the necessity of increasing the centrality of the family in service delivery in order to provide services which are integrated, relevant and efficacious. [source] | ||||||||||||||||