The cost of diabetes and obesity in Australia

Aims: To assess and compare the direct healthcare and non-healthcare costs and government subsidies by body weight and diabetes status.

Methods: The Australian Diabetes, Obesity and Lifestyle study collected health service utilization and health-related expenditure data at the 2011–2012 follow-up surveys. Costing data were available for 4,409 participants. Unit costs for 2016–2017 were used where available or were otherwise inflated to 2016–2017 dollars. Age- and sex-adjusted costs per person were estimated using generalized linear models.

Results: The annual total direct cost ranged from $1,998 per person with normal weight to $2,501 per person with obesity in participants without diabetes. For those with diabetes, total direct costs were $2,353 per person with normal weight, $3,263 per person with overweight, and $3,131 per person with obesity. Additional expenditure as government subsidies ranged from $5,649 per person with normal weight and no diabetes to $8,085 per person with overweight and diabetes. In general, direct costs and government subsidies were higher for overweight and obesity compared to normal weight, regardless of diabetes status, but were more noticeable in the diabetes sub-group. The annual total excess cost compared with normal weight people without diabetes was 26% for obesity alone and 46% for those with obesity and diabetes.

Limitations: Participants included in this study represented a healthier cohort than the Australian population. The relatively small sample of people with both obesity and diabetes prevented a more detailed analysis by obesity class.

Conclusion: Overweight and obesity are associated with increased costs, which are further increased in individuals who also have diabetes. Interventions to prevent overweight and obesity or reduce weight in people who are overweight or obese, and prevent diabetes, should reduce the financial burden.     

The consequences of managerial indiscretions: Sex,lies, and firm value

Personal managerial indiscretions are separate from a firm's business activities but provide information about the manager's integrity. Consequently, they could affect counterparties’ trust in the firm and the firm's value and operations. We find that companies of accused executives experience significant wealth deterioration, reduced operating margins, and lost business partners. Indiscretions are also associated with an increased probability of unrelated shareholder-initiated lawsuits, Department of Justice and Securities and Exchange Commission investigations, and managed earnings. Further, chief executive officers and boards face labor market consequences, including forced turnover, pay cuts, and lower shareholder votes at re-election. Indiscretions occur more often at poorly governed firms where disciplinary turnover is less likely.     

Green Demarketing in Advertisements: Comparing “Buy Green” and “Buy Less” Appeals in Product and Institutional Advertising Contexts

This research compares consumer response to traditional green advertising appeals to that of less conventional, “green demarketing” (GD) appeals—messages by for-profit companies encouraging reduced category consumption for the sake of the environment. Rather than encouraging greener consumption, modern environmentalism calls for decreased consumption overall, a trend reflected in recent advertising campaigns (e.g., Patagonia's “Don't Buy This Jacket”). Despite its potential impact and unconventionality, research on GD in general is sparse, and no empirical research has examined consumer response to GD appeals relative to traditional green appeals. In three experiments, we find that, in the context of product advertising, consumers' attitudes for green ads are more favorable than those for GD ads, mediated by greater inferences of genuine environmental concern. However, we find the reverse pattern in the context of institutional ads. Further, an “anti-consumption amplifier” message embedded in the ad—espousing the potential harm of overconsumption—further boosts favorable consumer attitudes for the GD institutional ad relative to its traditional green counterpart. Importantly, we assess all effects while controlling for consumers' individual levels of green consumerism, such that implications may be applied more generally rather than to a specific segment of green consumers.     

Consumer Regulation Strategies: Attenuating the Effect of Consumer References in a Voting Context

Consumption cues (e.g., brands, money, and advertisements) can have powerful effects on cognition, perception, and behavior, yet how people regulate responses to such cues is not well understood. This is surprising given that consumption cues are increasingly present in nontraditional consumer contexts, such as healthcare, education, and politics. This research develops a measure of two types of consumer regulation strategies, cue‐based and budget‐based (studies 1–4), and demonstrates that these strategies influence how people respond to consumption cues in a political context (study 5). Specifically, in a study involving the 2012 American Presidential Election, priming survey participants as consumers (versus citizens) influenced both voting intentions and self‐reported voting behavior, and the newly developed consumer regulation scale was instrumental in detecting this effect. These findings suggest there may be merit in the escalating debate and concern over referring to voters as consumers.     

A Qualitative Analysis to Determine the Domains and Skills Necessary to Lead in Public Health

Leadership programs in public health have been declining in numbers since 2012. The decline in training programs could be due to the lack of outcome‐based results and the lack of a manageable set of standardized skills needed for public health leadership. A comprehensive study was completed in two phases to determine if the current model of public health leadership institutes is effective at generating outcome‐based results. The following paper will focus on the first phase of the study. The first phase included a qualitative analysis to determine the domains, definitions, and skills needed to lead. An analysis of the skills, domains, definitions, and traits included in five established and commonly used leadership models/theories in public health leadership development (Transformational, Servant, Appreciative, Collaborative, and Emotional Intelligence leadership) plus the National Public Health Leadership Development Network (NLN) Leadership for Community Health, Safety & Resilience Competency Framework was completed. Of the 161 different skills, definitions, traits, and/or competencies from the five leadership models and the NLN competency framework, 123 were determined to be related to one of six domains needed for leadership and were defined into 21 skills. The findings could lead to more uniformity in public health leadership development and evaluation.     

Cross-cultural competence in the context of NGOs: bridging the gap between ‘knowing’ and ‘doing’

Abstract

International human resource management research in non-governmental organisations (NGOs) is scarce and it predominantly focuses on the recruitment and retention of volunteers. The context of NGOs is different from conventional for-profit international business settings with different kinds of challenges, especially in terms of providing appropriate training on managing multi-cultural teams and working with local project partners and communities. The literature also tends to focus on expatriate perspective and not on a host country perspective. We address this gap by examining how project managers and hosts experience cross-cultural issues on overseas assignments. We study volunteer project managers leading international and local youth volunteers during the Raleigh International programme in Malaysia. We use a qualitative methodology and data collected at 3 case locations via participant observation during 120 days contact with the respondents as well as interviews and surveys. We propose the CPACE (Curiosity, Passion, Adaptability, Communication and Empathy) framework describing competences needed in cross-cultural encounters and based on respondents’ actions as well as their words and it is relevant to a NGO context. The framework is intended to lay the foundation for future research and in particular to demonstrate the need for cross-cultural competence to be more grounded in particular contexts.     

DO INSIDERS PRACTICE WHAT THEY PREACH? INFORMED OPTION EXERCISES AROUND MERGERS AND ACQUISITIONS

We examine executive stock option exercises around a sample of merger and acquisition announcements between 1996 and 2006, focusing on a subset we identify as potentially informed. For stock‐financed acquisitions, we find a surge in informed exercises by acquirer insiders in the year leading up to the acquisition announcement, but target insiders display no similar increase. We find the market reaction upon the announcement for acquirers is negatively related to extreme early exercises and find some evidence of long‐run underperformance. Overall, our evidence indicates that insiders knowingly bid for firms when they personally believe their own firm is overvalued.     

Full versus quasi MLE for ARMA-GARCH models with infinitely divisible innovations

We compare the backtesting performance of ARMA-GARCH models with the most common types of infinitely divisible innovations, fit with both full maximum likelihood estimation (MLE) and quasi maximum likelihood estimation (QMLE). The innovation types considered are the Gaussian, Student’s t, α-stable, classical tempered stable (CTS), normal tempered stable (NTS) and generalized hyperbolic (GH) distributions. In calm periods of decreasing volatility, MLE and QMLE produce near identical performance in forecasting value-at-risk (VaR) and conditional value-at-risk (CVaR). In more volatile periods, QMLE can actually produce superior performance for CTS, NTS and α-stable innovations. While the t-ARMA-GARCH model has the fewest number of VaR violations, rejections by the Kupeic and Berkowitz tests suggest excessively large forecasted losses. The α-stable, CTS and NTS innovations compare favourably, with the latter two also allowing for option pricing under a single market model.     

Outcomes from use of an evidence-based practice guideline

The aim of evidence-based guidelines is primarily to improve patient outcomes without adding to the existing cost of care because both payers and policymakers want to identify health care costs that do not result in benefit to the patient. The purpose of the reported project was to generate a practice guideline for the treatment of uncomplicated acute cystitis in a female population, to determine the extent to which the guideline would be used by providers and to measure the cost and quality of outcomes from its use. A retrospective chart review was used to gather pre-guideline practice and cost data. Measurements included the type, frequency, and duration of antibiotic therapy and the use of urine cultures and both complications and routine followup visits. The implementation of an outpatient practice guideline resulted in a significant change in antibiotic prescribing and a trend toward a change in ordering cultures and clinic followup. There was also a significant decrease in treatment costs.     

The impact of public investment in medical imaging technology: an interagency collaboration in evaluation

The Canada Foundation for Innovation (CFI) and the Canadian Institutes of Health Research (CIHR) allied to analyze the impact of their investments in medical imaging research. The CFI funds capital and operating programs for research infrastructure, and CIHR's mandate concentrates its funding on research activity. It happens that CIHR-funded research consumes CFI-funded infrastructure as an input in the innovation process. Apart from a few partnered programs, by design there is no coordination between CFI and CIHR funding decisions. Together, these agencies invested $916 million over a 14-year-period. In this paper, we evaluate the economic and health benefits from advancements in one funded area, namely computed tomography perfusion (CTP). CTP is an imaging technique that uses computed tomography to measure blood flow in organs and tissues. It is mostly used to assess acute ischemic stroke. The net social benefits attributable to these investments are substantially positive: the benefit-to-cost ratio is estimated to be between 6.66-to-1 and 9.99-to-1. We review how public investments from multiple funders comingle in the innovation process to deliver social value and improved health outcomes.