Political legitimacy in decisions about experiments in solar radiation management

Some types of solar radiation management (SRM) research are ethically problematic because they expose persons, animals, and ecosystems to significant risks. In our earlier work, we argued for ethical norms for SRM research based on norms for biomedical research. Biomedical researchers may not conduct research on persons without their consent, but universal consent is impractical for SRM research. We argue that instead of requiring universal consent, ethical norms for SRM research require only political legitimacy in decision-making about global SRM trials. Using Allen Buchanan & Robert Keohane's model of global political legitimacy, we examine several existing global institutions as possible analogues for a politically legitimate SRM decision-making body

An Analysis of the Medical Costs of Obesity for Fifth Graders in California and Texas

International Journal of Exercise Science 9(1): 26-33, 2016. The prevalence of childhood obesity in the United States increased more than three-fold from 1976 – 1980 to 2007 – 2008. The Presidential Youth Fitness Program’s FitnessGram® is the current method recommended by the President’s Council on Fitness, Sports & Nutrition for assessing health-related fitness factors, including body composition. FitnessGram® data from California and Texas, the two most populous states, over a three-year time span indicate that more than one-third of fifth grade students, typically ten-year-olds, are obese. Previous studies report that an obese ten-year-old child who remains obese into adulthood will incur elevated direct medical costs beyond his or her normal-weight peers over a lifetime. The recommended elevated cost estimates are approximately $12,660 when comparing against a normal-weight child who gains weight as an adult and approximately$19,000 compared to a child who remains at normal weight as an adult. By applying these figures to FitnessGram® results from California and Texas, each group of fifth grade students in each of the two states will incur between $1.4 and$3.0 billion in direct medical costs over a lifetime. When the percentage of obese fifth graders is extrapolated to the rest of the United States’ 4 million ten-year-olds, this results in more than $17 billion (accounting for adulthood weight gain) or$25 billion (not accounting for adulthood weight gain) in added direct lifetime medical costs attributable to obesity for this single-year age cohort. This information should be used to influence spending decisions and resource allocation to obesity reduction and prevention efforts

Elevated Medical Costs for Obese Fifth Graders in California and Texas

Finkelstein et al. (2014) estimated that an obese ten-year-old, typically in the fifth grade, will incur between $12,660 and$19,630 in direct medical costs beyond those of a normal-weight ten-year-old over a lifetime. PURPOSE: The purpose was to estimate the lifetime direct medical costs attributable to obesity for fifth graders in the two most populous states, Texas and California. METHODS: Body composition data from the Presidential Youth Fitness Program’s FITNESSGRAM® administered in California and Texas each school year from 2010 – 2011 to 2012 – 2013 were used. Data included information on 447,619 – 456,409 fifth graders each year in California and 296,887 – 337,514 fifth graders in Texas. The number and percentage of students in each of the FITNESSGRAM® body composition categories was calculated and those in the Needs Improvement – High Risk (NI – HR) were used for cost estimation. The number of students in the NI – HR category for each year in each state was multiplied by the recommended cost estimate of $19,000 to project the elevated lifetime medical costs attributable to obesity for each group of fifth graders in each state. RESULTS: More than 33$3 billion for each group of fifth graders in California and more than $2 billion for each group of fifth graders in Texas. CONCLUSIONS: When the percentage of obese fifth graders is extrapolated to the entire United States’ 4 million 10-year-olds, this results in more than$25 billion in elevated direct lifetime medical costs attributable to obesity for this 1-year age cohort. These estimates are for obesity and do not include the additional costs associated with overweight (i.e., FITNESSGRAM® Needs Improvement – Some Risk category). This information should be used to influence spending decisions and resource allocation to obesity reduction and prevention efforts

Childhood tuberculosis infection and disease: A spatial and temporal transmission analysis in a South African township

Background. Tuberculosis (TB) remains a leading cause of mortality and morbidity in South Africa. While adult TB results from both recent and past infection, childhood TB results from recent infection and reflects ongoing transmission despite current TB control strategies.Setting. A South African community with high rates of TB and HIV disease.Outcomes. A Geographic Information System was used to spatially and temporally define the relationships between TB exposure, infection and disease in childre

Meeting USDHHS Physical Activity Guidelines and Health Outcomes

International Journal of Exercise Science 10(1): 121-127, 2017 Current public health physical activity (PA) guidelines suggest ≥500 METmin/week of PA, with additional benefits beyond 1000 METmin/week (i.e., a dose response). Revised U.S. PA guidelines are scheduled for 2018. The purpose was to relate health markers (blood pressure, percent fat, BMI, blood glucose, cholesterol, and cardiorespiratory fitness) to verify the dose response for PA guidelines revision. 505 non-smoking participants self-reported PA behaviors and completed medical screening. MANCOVA controlling for age and gender determined the relation between health markers and PA. MANCOVA indicated significantly (P\u3c.001) different health markers of percent fat, BMI, glucose, and treadmill time as a function of PA. Post-hoc Helmert contrasts (1] \u3c500 METmin/week vs. ≥500 METmin/week and 2] 500 to \u3c1000 METmin/week vs. ≥1000 METmin/week) indicated that meeting the PA guidelines was associated with better health markers and higher cardiorespiratory fitness. Effect sizes were greater for contrast 1 than for contrast 2, suggesting a plateauing effect. Revised public health guidelines should consider achievement of ≥500 METmin/week to be most important, with additional modest gain thereafter. Revised PA guidelines should stress the importance of achieving 500-1000 METmin/week

22q11.2 deletion syndrome

22q11.2 deletion syndrome (22q11.2DS) is the most common chromosomal microdeletion disorder, estimated to result mainly from de novo non-homologous meiotic recombination events occurring in approximately 1 in every 1,000 fetuses. The first description in the English language of the constellation of findings now known to be due to this chromosomal difference was made in the 1960s in children with DiGeorge syndrome, who presented with the clinical triad of immunodeficiency, hypoparathyroidism and congenital heart disease. The syndrome is now known to have a heterogeneous presentation that includes multiple additional congenital anomalies and later-onset conditions, such as palatal, gastrointestinal and renal abnormalities, autoimmune disease, variable cognitive delays, behavioural phenotypes and psychiatric illness - all far extending the original description of DiGeorge syndrome. Management requires a multidisciplinary approach involving paediatrics, general medicine, surgery, psychiatry, psychology, interventional therapies (physical, occupational, speech, language and behavioural) and genetic counselling. Although common, lack of recognition of the condition and/or lack of familiarity with genetic testing methods, together with the wide variability of clinical presentation, delays diagnosis. Early diagnosis, preferably prenatally or neonatally, could improve outcomes, thus stressing the importance of universal screening. Equally important, 22q11.2DS has become a model for understanding rare and frequent congenital anomalies, medical conditions, psychiatric and developmental disorders, and may provide a platform to better understand these disorders while affording opportunities for translational strategies across the lifespan for both patients with 22q11.2DS and those with these associated features in the general population