What is the optimal subsidy for exercise? Informing health insurance companies\u27 fitness reimbursement programs

Health care costs account for 17% of US GDP and many programs and policies seek to reduce these costs. This paper focuses on exercise as preventive care due to its immense physiological benefits. I model the profit-maximizing choice of health insurance companies to subsidize exercise and the utility-maximizing choice of individuals to engage in exercise using a traditional principal-agent framework. I then use principles from behavioral economics and psychology to critique these models and provide further insight into understanding our underconsumption of such preventive services. I end with an evaluation of current programs and suggestions for improvement using empirical findings

Appearance of the canine meninges in subtraction magnetic resonance images

The canine meninges are not visible as discrete structures in noncontrast magnetic resonance (MR) images, and are incompletely visualized in T1‐weighted, postgadolinium images, reportedly appearing as short, thin curvilinear segments with minimal enhancement. Subtraction imaging facilitates detection of enhancement of tissues, hence may increase the conspicuity of meninges. The aim of the present study was to describe qualitatively the appearance of canine meninges in subtraction MR images obtained using a dynamic technique. Images were reviewed of 10 consecutive dogs that had dynamic pre‐ and postgadolinium T1W imaging of the brain that was interpreted as normal, and had normal cerebrospinal fluid. Image‐anatomic correlation was facilitated by dissection and histologic examination of two canine cadavers. Meningeal enhancement was relatively inconspicuous in postgadolinium T1‐weighted images, but was clearly visible in subtraction images of all dogs. Enhancement was visible as faint, small‐rounded foci compatible with vessels seen end on within the sulci, a series of larger rounded foci compatible with vessels of variable caliber on the dorsal aspect of the cerebral cortex, and a continuous thin zone of moderate enhancement around the brain. Superimposition of color‐encoded subtraction images on pregadolinium T1‐ and T2‐weighted images facilitated localization of the origin of enhancement, which appeared to be predominantly dural, with relatively few leptomeningeal structures visible. Dynamic subtraction MR imaging should be considered for inclusion in clinical brain MR protocols because of the possibility that its use may increase sensitivity for lesions affecting the meninges

An Impact Factor for Tropical Medicine and Infectious Disease

Tropical Medicine and Infectious Disease (TMID or TropicalMed) was established in 2016 [1] as the Official Publication of The Australasian College of Tropical Medicine [2] and published by the Multidisciplinary Digital Publishing Institute (MDPI) based in Switzerland and many other countries [3], being one of the oldest online publishers still existing after 25 years. It was founded with an international editorial board that continues to expand and organize under the leadership of A/Professor John Frean, Editor-in-Chief, from the National Institute for Communicable Diseases and Wits Research Institute for Malaria, University of the Witwatersrand, South Africa, and Professor Peter A Leggat, Deputy Editor-in-Chief, from James Cook University, Australia. It is indexed by all of the major indexing and abstracting services, including PubMed and Web of Science. Hence, it is tracked for impact factor and recently received its first one, a very creditable 3.711

Tick bite fever in South Africa

Tick bite fever has been a constant feature of the South African medical landscape. While it was recognised many years ago that there was a wide spectrum of clinical severity of infection, only recently has it been established that there are two aetiological agents, with different epidemiologies and clinical presentations. Rickettsia conorii infections resemble the classical Mediterranean spotted fever (fièvre boutonneuse), and patients are sometimes at risk of severe or even fatal complications. On the other hand, African tick bite fever is a separate entity caused by Rickettsia africae and tends to be a milder illness, with less prominent rash and little tendency to progress to complicated disease. Irrespective of the agent, the treatment of choice for tick bite fever in South Africa remains doxycycline or tetracycline, and the role of macrolide and quinolone antibiotics is still unclear, or at least restricted. South African Family Practice Vol. 50 (2) 2008: pp. 33-3