Changes in body mass index and short-term healthcare expenditures in a Medicare population

Purpose. The main objective of the study was to estimate the short-term changes in healthcare expenditures that result from weight gain or loss in a population of Medicare patients using longitudinal data. Changes in total healthcare expenditures and its components (inpatient, outpatient, prescription, dental and other) by changes in body mass index (BMI) categories were analyzed.;To examine the relationship between BMI changes and expenditures, three specifications of expenditures were used. The primary measure of expenditures was relative changes in expenditures transformed into log-ratio. Under the log-ratio approach positive values indicate increased expenditures, and negative values indicate decreased expenditures. Other measures included logged expenditures (Year 3) derived after BMI changes were measured and relative changes in healthcare expenditures (i.e. percent change in expenditures) grouped into (1) no change; (2) greater than 10% decline; (3) greater than 10% increase and (4) minimal variations.;Results. Only a small fraction of the elderly experienced weight loss as measured by changes in BMI: Of 10,698 individuals, 9% experienced BMI loss (N=982) and 8.2% experienced BMI gain (N=867). Subgroup differences in BMI changes were noted: females were less likely than males to experience BMI loss or BMI gain [AOR 0.81, 95% CI 0.68-0.97; AOR 0.73 95%CI 0.60-0.90 ]. Increased age (80 + years) decreased the likelihood of BMI loss or BMI gain as compared to individuals 65-69 years [AOR 0.57, 95%CI 0.45-0.73; AOR 0.40 95%CI 0.31-0.52]; individuals older than 80 years were the only age group with increased risk of staying underweight/other.;After controlling for all the independent variables measured in this study, results from OLS regression for short-term logged expenditures revealed that compared to persons who stayed in normal BMI group, individuals with BMI loss had outpatient expenditures that were 23% higher. Compared to individuals who belonged to stayed normal BMI group, individuals with BMI gain had total expenditures that were 11% higher, outpatient expenditures that were 25% higher, and other expenditures that were 20% higher (p\u3c0.05).;OLS regressions on log-ratio of expenditures suggested that when compared to individuals who stayed in normal BMI group, individuals who experienced BMI loss had significantly lower inpatient expenditures (beta = -0.54). When compared to individuals who stayed in normal BMI group, individuals with BMI gain significantly higher outpatient expenditures (beta = 0.172). Comorbid mental illness did not substantially alter the magnitude or direction of association between BMI and changes in expenditures in the population studied.;Conclusions/implications. Obesity has become an epidemic affecting all ages including the elderly, and is associated with increased morbidity, mortality and healthcare expenditures. Previous studies have focused primarily on the effects of weight loss on healthcare expenditures and have several limitations: The current study explored how changes in BMI affect a variety of healthcare expenditures within a Medicare population and additionally how comorbid mental illness impacts this relationship.;The current findings highlight the importance of maintaining normal weight and avoiding weight fluctuations. In light of the increased expenditures due to overweight and obesity, and the positive association between increasing BMI values and healthcare expenditures in the elderly, having a stable BMI is necessary to reduce healthcare costs. Collectively, findings from the current study emphasize the need for preventing overweight and obesity rather than treating these conditions and their negative effects. In this context, weight management and wellness programs that include nutrition and physical activity need to be an integral part of health promotion efforts for all individuals including the elderly. (Abstract shortened by UMI.)

Interactive Execution Monitoring of Agent Teams

There is an increasing need for automated support for humans monitoring the activity of distributed teams of cooperating agents, both human and machine. We characterize the domain-independent challenges posed by this problem, and describe how properties of domains influence the challenges and their solutions. We will concentrate on dynamic, data-rich domains where humans are ultimately responsible for team behavior. Thus, the automated aid should interactively support effective and timely decision making by the human. We present a domain-independent categorization of the types of alerts a plan-based monitoring system might issue to a user, where each type generally requires different monitoring techniques. We describe a monitoring framework for integrating many domain-specific and task-specific monitoring techniques and then using the concept of value of an alert to avoid operator overload. We use this framework to describe an execution monitoring approach we have used to implement Execution Assistants (EAs) in two different dynamic, data-rich, real-world domains to assist a human in monitoring team behavior. One domain (Army small unit operations) has hundreds of mobile, geographically distributed agents, a combination of humans, robots, and vehicles. The other domain (teams of unmanned ground and air vehicles) has a handful of cooperating robots. Both domains involve unpredictable adversaries in the vicinity. Our approach customizes monitoring behavior for each specific task, plan, and situation, as well as for user preferences. Our EAs alert the human controller when reported events threaten plan execution or physically threaten team members. Alerts were generated in a timely manner without inundating the user with too many alerts (less than 10 percent of alerts are unwanted, as judged by domain experts)

Liminal experience of East Asian backpackers

Acknowledging the increasing popularity of independent travel from East Asia, this article explores the backpacking experience of young travellers of the region, from a socio-anthropological angle. Using liminality theory as a guideline and adopting a qualitative investigative approach, 31 interviews with East Asian backpackers were conducted. The findings suggest there are dual facets of the liminal experiences of the backpackers. On one hand, young travellers were motivated to escape from temporal, spatial and social pressures at home. On the other, their narratives reflected a strong commitment to home through a sense of filial piety, an awareness of their identity and positive evaluation of home. These findings advance our understanding of the liminal experiences in an Asian backpacking context

K-Space at TRECVid 2007

In this paper we describe K-Space participation in TRECVid 2007. K-Space participated in two tasks, high-level feature extraction and interactive search. We present our approaches for each of these activities and provide a brief analysis of our results. Our high-level feature submission utilized multi-modal low-level features which included visual, audio and temporal elements. Specific concept detectors (such as Face detectors) developed by K-Space partners were also used. We experimented with different machine learning approaches including logistic regression and support vector machines (SVM). Finally we also experimented with both early and late fusion for feature combination. This year we also participated in interactive search, submitting 6 runs. We developed two interfaces which both utilized the same retrieval functionality. Our objective was to measure the effect of context, which was supported to different degrees in each interface, on user performance. The first of the two systems was a ‘shot’ based interface, where the results from a query were presented as a ranked list of shots. The second interface was ‘broadcast’ based, where results were presented as a ranked list of broadcasts. Both systems made use of the outputs of our high-level feature submission as well as low-level visual features

TRECVid 2005 experiments at Dublin City University

In this paper we describe our experiments in the automatic and interactive search tasks and the BBC rushes pilot task of TRECVid 2005. Our approach this year is somewhat different than previous submissions in that we have implemented a multi-user search system using a DiamondTouch tabletop device from Mitsubishi Electric Research Labs (MERL).We developed two versions of oursystem one with emphasis on efficient completion of the search task (Físchlár-DT Efficiency) and the other with more emphasis on increasing awareness among searchers (Físchlár-DT Awareness). We supplemented these runs with a further two runs one for each of the two systems, in which we augmented the initial results with results from an automatic run. In addition to these interactive submissions we also submitted three fully automatic runs. We also took part in the BBC rushes pilot task where we indexed the video by semi-automatic segmentation of objects appearing in the video and our search/browsing system allows full keyframe and/or object-based searching. In the interactive search experiments we found that the awareness system outperformed the efficiency system. We also found that supplementing the interactive results with results of an automatic run improves both the Mean Average Precision and Recall values for both system variants. Our results suggest that providing awareness cues in a collaborative search setting improves retrieval performance. We also learned that multi-user searching is a viable alternative to the traditional single searcher paradigm, provided the system is designed to effectively support collaboration

Mass media framing of biotechnology news

In fast-changing scientific fields like biotechnology, new information and discoveries should influence the balance of risks and rewards and their associated media coverage. This study investigates how reporters interpret and report such information and, in turn, whether they frame the public debate about biotechnology. Mass media coverage of medical and agricultural biotechnology is compared over a 12-year period and in two different countries: the United States and the United Kingdom. We examine whether media have consistently chosen to emphasize the potential risks over the benefits of these applications, or vice versa, and what information might drive any relevant changes in such frames. We find that the two sets of technologies have been framed differently—more positive for medical applications, more negative for agricultural biotechnology. This result holds over time and across different geographic locations. We also find that international events influence media coverage but have been locally framed. This local newsworthiness extends to both medical and agricultural applications. We conclude that such coverage could have led to differences in public perception of the two sets of technology: more negative (or ambivalent) for agricultural, positive for medical applications. Our findings suggest that understanding news frames, and the events that drive them, provides some insight into the long-term formation of public opinion as influenced by news coverage

Development of the Private Church-related Junior Colleges in Oklahoma

Higher Educatio