The Effect of Maternal Employment on Child Obesity

Abstract Obesity has been a major concern for the United States and most other industrialized countries over the past few decades. More than one third of children and adolescents in the United States are obese or overweight. Child obesity is of particular interest because overweight children are more likely to be overweight as adults, and such adults are exposed to various diseases. During the same period that witnessed an increase in child obesity, an important change that occurred was the increase in maternal employment. This study is an attempt to analyze the relationship between maternal employment and child obesity. This study used data from the National Longitudinal Survey of Youth (NLSY)79, child/young adults, 1986-2010 cohorts obtained from the Bureau of Labor Statistics (BLS) website. The results of this study show that maternal employment is significantly and positively correlated with child obesity. Key words: child obesity, maternal employment, overweight childre

Alternate Method of Phycocyanin Extraction

Phycocyanin is an abundant protein-pigment complex in many photosynthetic microbes and the feedstock for several emerging products in the food and pharmaceutical industries. The purpose of this project was to research the effectiveness of sonication technology to improve the efficiency and yields of phycocyanin production from the cyanobacterium Spirulina platensis. Sonication is the application of sound energy to agitate and break particles or cells. When used to augment the current methods of phycocyanin production, it has the potential benefit of reducing cell extraction volumes and increasing the yield of phycocyanin. Experiments were conducted to determine the effects of sonication time on the release of phycocyanin from concentrated S. platensis cell suspensions. The results show that sonication of a cell suspension containing 80 g dry weight S. platensis per 400 mL water for ~ 400 seconds provides maximum release of phycocyanin. The conventional method requires several hours of soaking 90 g dry weight S. platensis per 1000 mL water and achieves a lower degree of extraction. In summary, sonication can improve the efficiency of the conventional phycocyanin production process by shortening the time needed for initial release of phycocyanin from cells and with a smaller volume (more concentrated) cell suspension

Variation in antibiotic prescription rates in febrile children presenting to emergency departments across Europe (MOFICHE) : A multicentre observational study

Funding Information: This project has received funding from the European Union?s Horizon 2020 research and innovation programme under grant agreement No. 668303. The Research was supported by the National Institute for Health Research Biomedical Research Centres at Imperial College London, Newcastle Hospitals NHS Foundation Trust and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. For the remaining authors no sources of funding were declared. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We acknowledge all research nurses for their help in collecting data, and Anda Nagle (Riga) and the Institute of Microbiology at University Medical Centre Ljubljana for their help in collecting data on antimicrobial resistance. Members of the PERFORM consortium are listed in S11 Text. Publisher Copyright: Copyright: © 2020 Hagedoorn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background The prescription rate of antibiotics is high for febrile children visiting the emergency department (ED), contributing to antimicrobial resistance. Large studies at European EDs covering diversity in antibiotic and broad-spectrum prescriptions in all febrile children are lacking. A better understanding of variability in antibiotic prescriptions in EDs and its relation with viral or bacterial disease is essential for the development and implementation of interventions to optimise antibiotic use. As part of the PERFORM (Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union) project, the MOFICHE (Management and Outcome of Fever in Children in Europe) study aims to investigate variation and appropriateness of antibiotic prescription in febrile children visiting EDs in Europe. Methods and findings Between January 2017 and April 2018, data were prospectively collected on febrile children aged 0–18 years presenting to 12 EDs in 8 European countries (Austria, Germany, Greece, Latvia, the Netherlands [n = 3], Spain, Slovenia, United Kingdom [n = 3]). These EDs were based in university hospitals (n = 9) or large teaching hospitals (n = 3). Main outcomes were (1) antibiotic prescription rate; (2) the proportion of antibiotics that were broad-spectrum antibiotics; (3) the proportion of antibiotics of appropriate indication (presumed bacterial), inappropriate indication (presumed viral), or inconclusive indication (unknown bacterial/viral or other); (4) the proportion of oral antibiotics of inappropriate duration; and (5) the proportion of antibiotics that were guideline-concordant in uncomplicated urinary and upper and lower respiratory tract infections (RTIs). We determined variation of antibiotic prescription and broad-spectrum prescription by calculating standardised prescription rates using multilevel logistic regression and adjusted for general characteristics (e.g., age, sex, comorbidity, referral), disease severity (e.g., triage level, fever duration, presence of alarming signs), use and result of diagnostics, and focus and cause of infection. In this analysis of 35,650 children (median age 2.8 years, 55% male), overall antibiotic prescription rate was 31.9% (range across EDs: 22.4%–41.6%), and among those prescriptions, the broad-spectrum antibiotic prescription rate was 52.1% (range across EDs: 33.0%–90.3%). After standardisation, differences in antibiotic prescriptions ranged from 0.8 to 1.4, and the ratio between broad-spectrum and narrow-spectrum prescriptions ranged from 0.7 to 1.8 across EDs. Standardised antibiotic prescription rates varied for presumed bacterial infections (0.9 to 1.1), presumed viral infections (0.1 to 3.3), and infections of unknown cause (0.1 to 1.8). In all febrile children, antibiotic prescriptions were appropriate in 65.0% of prescriptions, inappropriate in 12.5% (range across EDs: 0.6%–29.3%), and inconclusive in 22.5% (range across EDs: 0.4%–60.8%). Prescriptions were of inappropriate duration in 20% of oral prescriptions (range across EDs: 4.4%–59.0%). Oral prescriptions were not concordant with the local guideline in 22.3% (range across EDs: 11.8%–47.3%) of prescriptions in uncomplicated RTIs and in 45.1% (range across EDs: 11.1%–100%) of prescriptions in uncomplicated urinary tract infections. A limitation of our study is that the included EDs are not representative of all febrile children attending EDs in that country. Conclusions In this study, we observed wide variation between European EDs in prescriptions of antibiotics and broad-spectrum antibiotics in febrile children. Overall, one-third of prescriptions were inappropriate or inconclusive, with marked variation between EDs. Until better diagnostics are available to accurately differentiate between bacterial and viral aetiologies, implementation of antimicrobial stewardship guidelines across Europe is necessary to limit antimicrobial resistance.publishersversionPeer reviewe

Determinants Of Productivity In Hospital-based Rural Health Clinics A Growth Curve Modeling Approach

The Patient Protection and Affordable Care Act of 2010 expanded rural Medicaid and Medicare coverage. However, different vehicles of delivering care (e.g., hospitals, health clinics, etc.) have differing organizational capacity that may or may not enable them to overcome the challenges of expanded provision. Consequently, this research employed structural contingency and organizational performance models to investigate the impact of organizational factors on productivity growth, while recognizing that contextual factors also affect the delivery of care. Latent growth curve modeling was used to study a national panel of 708 U.S. hospitalbased Rural Health Clinics for the years 2005 to 2008. Productivity was measured through dynamic slacks-based data envelopment analyses. Unconditional and conditional linear growth curve models were fitted to data. Findings revealed that 1) hospital-based clinics with higher baseline levels of productivity in 2005 had a slower rate of growth in productivity for the years 2006 to 2008, 2) hospital-based clinics with physicians had significantly higher productivity, 3) hospital-based clinics in urban focused areas had significantly higher productivity, 4) newer hospital-based clinics had significantly higher productivity, and 5) prospective payment system was negatively related to the rate of change in productivity growth. Organizational and contextual factors included in this study significantly explained initial differences in productivity but were unable to explain productivity growth. Future research could improve the study by 1) including additional explanatory variables, such as the use of technology and disease management programs, 2) adjusting productivity measures by case mix measures, and 3) conducting truncated panel data regression with Monte Carlo simulation

Housing Vouchers, Benefits And Allowances (Vbas): Comparing Rental Tools In The Us, England And The Netherlands

This paper compares rental housing tools in the US, Britain and the Netherlands in order to determine the best strategy for enhancing rental housing accessibility. In doing so, the authors employ a \u27tools approach\u27 of governance paradigm, based on the work of Salamon\u27s The Tools of Governance (2002). Rental housing tools are called housing vouchers in the US, housing benefits in Britain and housing allowances in the Netherlands. Overall, it was found that Britain and the Netherlands can learn from the US on means and ways of designing more efficient and fiscally responsible housing vouchers, benefits, and allowances (VBAs). The US, in turn, can learn from Britain and the Netherlands on means and needs of achieving higher equity and effectiveness. This analysis contributes in a meaningful way by addressing the missing middle link between policies and programs - namely, the tools perspective. © 2011 Taylor & Francis

Informal Economic Activities In Industrialized Nations: Insights From Belgium And The United Kingdom

This study examines how informal economic activities (IEAs) can be (re)formalized in a way that will not destroy their potential for being assets for community development. The very concept of collaborative development in public administration is applied to social work’s asset-based community development (ABCD). This cross-application enables the exploration of alternatives for the challenges encountered in IEAs within industrialized nations. The authors argue that IEAs differ from the underground economy and deserve a different policy response. Social capital will be the overarching framework. Studies of two Western European countries (specifically, Belgium and the UK) will be used as examples

Housing Vouchers, Benefits and Allowances (VBAs): Comparing Rental Tools in the US, England and the Netherlands

This paper compares rental housing tools in the US, Britain and the Netherlands in order to determine the best strategy for enhancing rental housing accessibility. In doing so, the authors employ a 'tools approach' of governance paradigm, based on the work of Salamon's The Tools of Governance (2002). Rental housing tools are called housing vouchers in the US, housing benefits in Britain and housing allowances in the Netherlands. Overall, it was found that Britain and the Netherlands can learn from the US on means and ways of designing more efficient and fiscally responsible housing vouchers, benefits, and allowances (VBAs). The US, in turn, can learn from Britain and the Netherlands on means and needs of achieving higher equity and effectiveness. This analysis contributes in a meaningful way by addressing the missing middle link between policies and programs - namely, the tools perspective.Britain, governance, housing allowances, housing benefits, housing vouchers, Netherlands, policy analysis, public management, rental tools, United States,

Organizational and Environmental Correlates to Preventive Quality of Care in US Rural Health Clinics

Purpose: To identify organizational and environmental correlates to rural health clinics’ preventive quality of care in the United States. Design: A retrospective observational cohort study design was applied under Donabedian’s Structure-Process-Outcome framework. Three structure measures of care (proportion of nonphysicians, absence of physicians, and provider affiliation) and three measures of process (total clinical visits, prevention use for congestive heart failure and diabetes) were used as explanatory variables. Five environmental correlates were included. The Centers for Medicare and Medicaid Services National Medicare Chronic Care Condition Data Warehouse for 2007 was used to obtain clinical data. Preventive quality of care outcomes were measured through Agency for Healthcare Research and Quality prevention quality indicators. The indicators were risk adjusted for age, sex, race, severity, and comorbidity of patients. Methods: Structural equation modeling with maximum likelihood estimation was used. Findings: Provider affiliation ( P = .03), absence of physicians ( P = .007), and higher proportion of nonphysicians ( P = .007) were negatively related to preventive quality of care. Lower cause-specific mortality rate at the county level as compared to the United States average ( P = .05) and rural location ( P = .001) were positively related to quality of care. Implications: The results of the study showed the need to attract and retain physicians in rural health clinics. The positive relationship between rural location and quality of care reflects more on the limited access to hospitals in remote areas