6 research outputs found

    The cost-effectiveness of providing antenatal lifestyle advice for women who are overweight or obese: the LIMIT randomised trial

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    Background: Overweight and obesity during pregnancy is common, although robust evidence about the economic implications of providing an antenatal dietary and lifestyle intervention for women who are overweight or obese is lacking. We conducted a health economic evaluation in parallel with the LIMIT randomised trial. Women with a singleton pregnancy, between 10+0-20+0weeks, and BMI ≥ 25 kg/m2were randomised to Lifestyle Advice (a comprehensive antenatal dietary and lifestyle intervention) or Standard Care. The economic evaluation took the perspective of the health care system and its patients, and compared costs encountered from the additional use of resources from time of randomisation until six weeks postpartum. Increments in health outcomes for both the woman and infant were considered in the cost-effectiveness analysis. Mean costs and effects in the treatment groups allocated at randomisation were compared, and incremental cost effectiveness ratios (ICERs) and confidence intervals (95%) calculated. Bootstrapping was used to confirm the estimated confidence intervals, and to generate acceptability curves representing the probability of the intervention being cost-effective at alternative monetary equivalent values for the outcomes avoiding high infant birth weight, and respiratory distress syndrome. Analyses utilised intention to treat principles. Results: Overall, the increase in mean costs associated with providing the intervention was offset by savings associated with improved immediate neonatal outcomes, rendering the intervention cost neutral (Lifestyle Advice Group 11261.19±14573.97 versus Standard Care Group 11306.70±14562.02; p=0.094). Using a monetary value of 20,000asathresholdvalueforavoidinganadditionalinfantwithbirthweightabove4kg,theprobabilitythattheantenatalinterventioniscosteffectiveis0.85,whichincreasesto0.95whenthethresholdmonetaryvalueincreasesto20,000 as a threshold value for avoiding an additional infant with birth weight above 4 kg, the probability that the antenatal intervention is cost-effective is 0.85, which increases to 0.95 when the threshold monetary value increases to 45,000. Conclusions: Providing an antenatal dietary and lifestyle intervention for pregnant women who are overweight or obese is not associated with increased costs or cost savings, but is associated with a high probability of cost effectiveness. Ongoing participant follow-up into childhood is required to determine the medium to long-term impact of the observed, short-term endpoints, to more accurately estimate the value of the intervention on risk of obesity, and associated costs and health outcomes

    Marketing Source-Verified Beef to Restaurant Patrons

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    To determine consumer ordering behaviors in high-end restaurants and to see if consumers are interested in the origin of their beef, both an online survey and in-restaurant taste testing were conducted. About two-thirds of the participants in the in-restaurant taste testing ordered the steak with either the state or farm-of-origin description. Compared to a non-source verified steak, taste participants were willing to pay 4.74moreforthesteakwiththestateoforigindescription,and4.74 more for the steak with the state-of-origin description, and 8.75 more for the steak with the farm-of-origin description. Almost all of the participants acknowledged the best beef comes from the Midwest, specifically naming Nebraska as a state that raises high-quality beef. These data suggest there is consumer interest in a source-verified beef product in high-end restaurants

    Range Livestock Strategies Given Extended Drought and Different Price Cycles

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    Portions of the U.S. have recently or are currently experiencing extended periods of drought. Producers considering the purchase of breeding stock to rebuild herds while forage supplies recover could be doing so at or near the top of the current cattle price cycle. This research investigates purchasing additional hay and partial liquidation as management strategies under various scenarios of drought and price cycles. Results indicate that purchasing hay may be a more risky strategy than partial liquidation, and it only provides positive returns over a 12-year planning horizon when extended drought occurs during a trough-to-trough price cycle

    Ranchers Diverse in Their Drought Management Strategies

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    Portions of the western U.S. are experiencing the worst drought in 80 years (Piechota et al. 2004). Figure 1 indicates that Wyoming has experienced multiple periods where precipitation was below normal for consecutive years, with the most recent period being between 2000 and 2005. Average annual precipitation has been trending downward since 1895 when official records were kept. Moreover, research suggests that drier summers could become more common as the global climate changes (Hengeveld 2000). The most recent period of drought has reduced range productivity, lowered irrigation water supplies and ultimately forced some ranchers to reduce herd sizes. Many producers culled their herds at a time when cattle prices were below the cyclic peak (between the years of 2000 to 2004), resulting in lower sales revenue. They also incurred higher feed costs to maintain the remaining herd. Together, these factors contribute to reduced profitability. Additionally, breeding livestock purchased now to restock drought liquidated herds would be done so at or near the peak of the most recent cattle price cycle. Current forecasts suggest that cattle prices are likely to start their cyclical decline within the next two years (Livestock Marketing Information Center 2006). Livestock purchased now or in the next several years would likely generate negative returns throughout their productive life, even if a ranch had the available feed resources, causing restocking to be less desirable at this time (O’Neill et al. 1998). The economic consequences of restocking at this point in time coupled with smaller herd sizes from drought liquidation puts ranchers in a weaker financial position to survive the downside of this most recent price cycle. The combined effect of these events has concerned many ranchers, and they are turning to professionals from land grant universities and elsewhere for help or they are selling off their ranches altogether
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