Overweight in Adolescents: Implications for Health Expenditures

We consider two compelling research questions raised by the increased prevalence of overweight among adolescents. First, what factors explain variation in adolescent bodyweight and the likelihood of being overweight? Next, do overweight adolescents incur greater health care expenditures compared to those of normal weight? We address the former question by examining the contribution of individual characteristics, economic factors, parental and family attributes, and neighborhood characteristics to variation in these bodyweight outcomes. For the second question, we estimate a two-part, generalized linear model of health spending. Using data from the Medical Expenditure Panel Survey, our econometric analyses indicate that adolescent bodyweight and the likelihood of being overweight are strongly associated with parental bodyweight, parental education, parental smoking behavior, and neighborhood attributes such as the availability of fresh food markets and convenience/snack food outlets, and neighborhood safety and material deprivation. Our expenditure model indicates that overweight females have annual expenditures that exceed those of normal weight by nearly $800 with part of the disparity explained by differences in mental health expenditures. We use both sets of empirical results to draw implications for policies to address adolescent overweight.

Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness.

Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management

Human rights and ethical reasoning : capabilities, conventions and spheres of public action

This interdisciplinary article argues that human rights must be understood in terms of opportunities for social participation and that social and economic rights are integral to any discussion of the subject. We offer both a social constructionist and a normative framework for a sociology of human rights which reaches beyond liberal individualism, combining insights from the work of Amartya Sen and from French convention theory. Following Sen, we argue that human rights are founded on the promotion of human capabilities as ethical demands shaped by public reasoning. Using French convention theory, we show how the terms of such deliberation are shaped by different constructions of collectively held values and the compromises reached between them. We conclude by demonstrating how our approach offers a new perspective on spheres of public action and the role these should play in promoting social cohesion, individual capabilities and human rights

2-D CFD Computations of the Two-Bladed Darrieus-Type Wind Turbine

In spite of the attractiveness of CFD methods and advanced measurement methods, there is still no full analysis of aerodynamic blade loads for vertical axis Darrieus-type wind turbines. Due to an inherently unsteady flow around the rotor blades, blade-wake-blade interaction and the occurrence of dynamic stall, the aerodynamics of this type of wind turbine is very complex. A two-bladed rotor have been investigated numerically for the tip speed ratio of 5.0. This paper compares results for aerodynamic blade loads obtained applying such turbulence models as: the standard k-ε; the RNG k-ε; the Realizable k-ε and the SST k-ω. As a result, quantitative instantaneous blade forces as well as instantaneous wake profiles behind the rotor have been obtained. Aerodynamic wake behind the rotor is also visualized by using streak lines. All CFD results are compared with experimental data taken from literature. Good agreement between the numerical results and the experiment is shown for the aerodynamic blade loads as well as for aerodynamic wake behind the rotor

Glycan complexity dictates microbial resource allocation in the large intestine.

The structure of the human gut microbiota is controlled primarily through the degradation of complex dietary carbohydrates, but the extent to which carbohydrate breakdown products are shared between members of the microbiota is unclear. We show here, using xylan as a model, that sharing the breakdown products of complex carbohydrates by key members of the microbiota, such as Bacteroides ovatus, is dependent on the complexity of the target glycan. Characterization of the extensive xylan degrading apparatus expressed by B. ovatus reveals that the breakdown of the polysaccharide by the human gut microbiota is significantly more complex than previous models suggested, which were based on the deconstruction of xylans containing limited monosaccharide side chains. Our report presents a highly complex and dynamic xylan degrading apparatus that is fine-tuned to recognize the different forms of the polysaccharide presented to the human gut microbiota.This work was supported in part by grants to D.N.B. (BBSRC BB/G016186/1) and H.J.G. (Wellcome Trust WT097907AIA).This is the final version. It was first published by NPG at http://dx.doi.org/10.1038/ncomms848

Neoliberalism, managerialism and the reconfiguring of social work in Sweden and the United Kingdom

This is the author's manuscript of an article published in Archaeological Dialogues. http://dx.doi.org/10.1177/1350508412448222This paper considers some of the ways in which neoliberalism, through the processes of managerialism, has impacted on the occupation of social work in Sweden and the UK. It is argued that there are similar implications in both countries, through the managerial drive for increased performance in economy, efficiency and effectiveness, but also in the development of evidence based practice. Whilst the key focus of the paper is on similarities between these two countries, differences are also noted. There is also recognition of the way in which resistance to the reconfiguration of social work is taking shape

Bridging senses of place and mobilities scholarships to inform social-ecological systems governance:A research agenda

Uncertainty and change are increasingly commonplace as communities respond to impacts of social-ecological change including climate change, and dangerous levels of pollution. Given the extent of these crises, new approaches are needed to support responses. Here we identify challenges and discuss insights that the nexus of Senses of place (SoP) and mobilities research offers in navigating such uncertainty. We conducted a two-round Delphi, followed by a workshop, and collaborative writing process with a global network of researchers with expertise in either or both SoP and mobilities research. Participants identified five challenges at the place-mobility nexus that emerge when a social-ecological system is disrupted. We use the 2022 Odra River fish die-off to exemplify the identified challenges: 1) accounting for power dynamics, inequalities and motility; 2) doing justice to more-than human actors; 3) integrating multiple and sometimes nested spatial scales; 4) considering temporalities of place and mobilities, and 5) embracing multisensoriality. To address these challenges, we recommend drawing on diverse methods and knowledge co-creation processes that combine more-than-human perspectives, multisensoriality, and engage in the dynamic relations between places to understand people-place disruptions in the face of socio-spatial precarity. Addressing such knowledge gaps requires stronger collaboration of mobilities and place researchers.</p