Effective management of cardio-metabolic risk factors linked to the built environment

Scientists test a novel metric that links cardio-metabolic risk factors in men and women to the built environment

Peer-Reviewed Publication

JAPAN ADVANCED INSTITUTE OF SCIENCE AND TECHNOLOGY

 

IMAGE: RESEARCHERS HAVE USED A NEW METRIC TO SHOW THAT CARDIO-METABOLIC RISK FACTORS FOR MEN AND WOMEN ARE LINKED TO THE BUILT ENVIRONMENT. view more 

CREDIT: SOURCE FREE PICTURE FROM "MONKEYSTYLE3000 AT FLICKR": HTTPS://WWW.FLICKR.COM/PHOTOS/132295270@N07/50065215408

Ishikawa, Japan -- Cardiovascular disease is still one of the two leading causes of non-communicable disease burden and death in North America. A growing body of evidence has linked the built environment to cardiovascular disease risk. A tried and tested approach to preventing cardiovascular disease is to target modifiable risk factors, such as physical activity. For instance, effective population-level interventions have immense potential to reduce cardiovascular disease burdens.

Drawing attention to the built environment's influence on cardio-metabolic health is gaining traction, given its well-known positive influence on physical activity. While many studies have investigated this association, generalizations cannot be applied between different countries due to differences in climate, healthcare systems, and culture. Furthermore, while the metrics employed to establish possible links between cardio-metabolic risk factors and the built environment have proven to be suitable for generating predictions, the information generated cannot be easily incorporated into making changes in urban design policy.

In a new study published in Preventive Medicine, a group of researchers led by Associate Professor Mohammad Javad Koohsari from the Japan Advanced Institute of Science and Technology, an adjunct researcher at the Waseda University as well, propose using a new metric, the space syntax walkability index, to address this limitation. Professor Koichiro Oka from Waseda University, Professor Tomoki Nakaya from Tohoku University, and Associate Professor Gavin R. McCormack from the University of Calgary in Canada were also involved in planning and executing the study.

Elaborating on the team's motivation, Dr. Koohsari says, "There is a growing awareness about the impact of urban design on cardio-metabolic health, but most of this work is based on studies in the US. We wanted to explore this relationship in the Canadian context, since findings from different geographical contexts may lack generalizability. While Canada is similar to Western developed countries in terms of its burden of cardio-metabolic risk factors, the interventions needed must account for local nuances."  

The research team analyzed data collected from 7,171 participants enrolled in the second wave of Alberta's Tomorrow Project (ATP). These participants lived in urban areas, had provided biological samples (serum, blood, and urine) for cardio-metabolic analyses, and had completed the follow-up health and lifestyle survey. Geographic information systems were then used to calculate two metrics, the traditional walkability index and the space syntax walkability index.

The research group's new urban design metric incorporates space syntax theory. By quantifying the degree of connectivity between streets, the space syntax walkability index represents street integration and describes how well connected a particular street is to others in the area. A highly integrated network requires fewer changes in direction to reach one's destination. "We found that the novel space syntax walkability metric was negatively correlated to systolic and diastolic blood pressure in men. This metric was also associated with less obesity among men and women. This shows that walkability in urban areas is linked to cardio-metabolic risk factors," stresses Dr. Koohsari when expanding on the study's conclusions.

So how can urban designers and planners improve our cities and design better interventions using this data?

Population-wide changes in cardio-metabolic risk factors can be implemented by creating health-supportive built environments, which enable people to easily make daily, healthy choices via long-term structural features. Dr. Koohsari explains, "This novel metric is likely to allow urban designers to identify poorly designed neighborhoods and target these environments for interventions specific to improving the cardio-metabolic risk factors. However, further studies are needed to better understand the relationships between neighborhood built environment and cardio-metabolic risk factors.”

Our altered lifestyle patterns and growing urbanization need not necessarily spell doom for our health and wellbeing. Through scientifically informed decision making and health-friendly planning, we can design built environments that support our fitness goals. This study is a right step in that direction.

 

###

Reference

Title of original paper:	Urban design and cardio-metabolic risk factors
Authors:	Mohammad Javad Koohsari*, Koichiro Oka, Tomoki Nakaya, Jennifer Vena, Tyler Williamson, Hude Quan, and Gavin R. McCormack
Journal:	Preventive Medicine
DOI:	10.1016/j.ypmed.2023.107552

 

 

About Japan Advanced Institute of Science and Technology, Japan

Founded in 1990 in Ishikawa prefecture, the Japan Advanced Institute of Science and Technology (JAIST) was the first independent national graduate school in Japan. Now, after 30 years of steady progress, JAIST has become one of Japan’s top-ranking universities. JAIST counts with multiple satellite campuses and strives to foster capable leaders with a state-of-the-art education system where diversity is key; about 40% of its alumni are international students. The university has a unique style of graduate education based on a carefully designed coursework-oriented curriculum to ensure that its students have a solid foundation on which to carry out cutting-edge research. JAIST also works closely both with local and overseas communities by promoting industry–academia collaborative research.  

 

About Associate Professor Mohammad Javad Koohsari from Japan Advanced Institute of Science and Technology, Japan

Dr Koohsari is an Associate Professor at the Creative Society Design Research Area, Japan Advanced Institute of Science and Technology in Japan. He also became an Adjunct Researcher with the Faculty of Sport Sciences at Waseda University, Japan. Dr Koohsari's research focuses on how built and virtual environment science can contribute to health, especially in the context of super-aged societies. Dr Koohsari has a publication record with over 110 refereed journal articles (such as at Nature Reviews Cardiology). In 2020 and 2021, he was recognised in the top 2% of most influential researchers worldwide across all scientific disciplines (Stanford University & Elsevier). He is also included in the 'Top Scientists' list in the field of 'Social Science & Humanities' for the year 2022 (Research.com). Dr Koohsari is on the editorial board member of several major journals in the field, such as Landscape & Urban Planning and Humanities & Social Sciences Communications.

 

Funding information: The Alberta's Tomorrow Project is supported by funding from Alberta Health, Alberta Cancer Foundation, Canadian Partnership Against Cancer, and Health Canada. Mohammad Javad Koohsari is supported by JSPS KAKENHI (Grant 23K09701). Gavin R. McCormack is supported by a Canadian Institutes of Health Research Foundations Scheme Grant (FDN-154331). Tomoki Nakaya received funding from the Japan Society for the Promotion of Science (JSPS) Grants-in-Aid for Scientific Research program (Grant 20H00040). Koichiro Oka received support from the JSPS Grants-in-Aid for Scientific Research program (Grant 20H04113).

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JOURNAL

Preventive Medicine

DOI

10.1016/j.ypmed.2023.107552 

ARTICLE TITLE

Urban design and cardio-metabolic risk factors

Study highlights why people who are sexually harassed might not come forward immediately, or at all

New research has revealed there is a gap between how people imagine they’d act if sexually harassed and how those who experience it respond.

Peer-Reviewed Publication

UNIVERSITY OF EXETER

New research has revealed there is a gap between how people imagine they’d act if sexually harassed and how those who experience it respond.

The study by the University of Exeter, funded by the Economic and Social Research Council and published in Psychology of Women Quarterly, discovered that seeking justice by coming forward is just one of the needs people who experience sexual harassment consider after the event, with other needs, including those for safety, instead rated as more important.

The research may explain why people who are sexually harassed often don’t report their experience formally, with the 2017 Crime Survey England and Wales finding that five out of six people who are targeted by sexual offences do not report it to the police.

Researchers compared answers from a confidential online survey from people who have experienced sexual harassment to those who have not but were asked to imagine how they would react. People who have experienced sexual harassment reported a range of needs and engaged in a variety of actions to meet these needs. Needs for safety, personal control and social support were prioritised over formal actions, such as reporting to police. Those who had not encountered sexual harassment anticipated having stronger needs and taking more actions—especially formal ones.  

Senior author, Professor Manuela Barreto, from the University of Exeter said: “We found there is a widely held belief that quick and formal reporting is the correct response to sexual harassment. It’s what’s generally meant with the phrase ‘coming forward’. Yet most people who are sexually harassed do not report it formally and those who do, often report the offence a significant time after it happened. There’s a focus on procedural barriers with police and other authorities as to why this is, but less attention paid to the actual needs of the person who has experienced sexual harassment.

“Our research suggests there’s a gap between what people expect from those who have been sexually harassed and how those who experience it actually respond. It’s important to consider that the feelings and actions of someone who has experienced sexual harassment might be very different from those who have not. Instead of asking; ‘why people don’t come forward more often?’, we should perhaps ask ourselves; ‘what is the best action for the individual?’”

Across two studies researchers analysed answers from participants who have experienced sexual harassment about the actions they took, alongside those from participants who haven’t experienced sexual assault but were asked to imagine how they’d react if they did. In the first study 415 participants from mixed genders took part (259 experienced, 156 imaginers) and after finding no gender differences, the second study was conducted with women only (589 participants – 301 experienced, 288 imaginers), who are much more commonly sexually harassed.

Lead author, Professor Thomas Morton, worked at the University of Exeter on the research and is now at the University of Copenhagen. He said: “There is an assumption that those who experience sexual harassment are primarily guided by their desire for justice. But this research shows that peoples' needs are wider than what others might expect, and include needs for safety, personal control, and for life to just return to normal. Of all the needs that people expressed, the need for justice was not the highest priority. This might explain why people don’t take the kind of formal actions, like reporting to police, that others expect them to.

“There are often accusations – including high profile recent examples – that if people who experience sexual harassment don’t come forward at the time, it’s because it wasn’t that serious or perhaps even true. But if you have not experienced sexual harassment, it is hard to accurately anticipate what you might need, and therefore what you would do to satisfy those needs. Our research suggests that the assumptions people make are often wrong, or at least don’t reflect what the people who have experienced sexual harassment say they need.”

The paper is entitled “What Would a “Reasonable Person” Do? Exploring the Gap Between Experienced and Anticipated Responses to Sexual Harassment”, and is published in Psychology of Women Quarterly

ENDS

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JOURNAL

Psychology of Women Quarterly

SUBJECT OF RESEARCH

People

ARTICLE TITLE

What Would a “Reasonable Person” Do? Exploring the Gap Between Experienced and Anticipated Responses to Sexual Harassment

Eddies: Circular currents and their influence on the world's hottest ocean

Peer-Reviewed Publication

TOHOKU UNIVERSITY

 

IMAGE: THE LEAD AUTHOR OF THIS PAPER, MOCHAMAD RIZA ISKANDAR, DEEPENED HIS RESEARCH WHILE AT TOHOKU UNIVERSITY BY DISCUSSING HIS FINDINGS WITH A NUMBER OF EXPERTS AT AN INTERNATIONAL WORKSHOP. view more 

CREDIT: TOHOKU UNIVERSITY'S INTERNATIONAL JOINT GRADUATE PROGRAM IN EARTH AND ENVIRONMENTAL SCIENCES

Water from the Pacific Ocean flows into the Indian Ocean via the Indonesia Archipelago Seas thanks to a vast network of currents dubbed the Indonesian Throughflow (ITF). The ITF acts as a heat and moisture conveyer belt, transporting warm and nutrient waters. Yet the ITF is neither a steady nor a straight path, but experiences fluctuations and turbulence as it passes through the various sea regions, straits, and passages.

Currents can sometimes formulate into circular motions, forming a whirlpool-like phenomena. These are known as eddies, and they are prominent in areas where there are strong gradients in temperature, salinity, or velocity. Their rotating motion can cause nutrients from the colder, deeper waters to rise to the surface.

To investigate the role eddies play in determining the path of the ITF, an international research group has harnessed a high-resolution ocean general circulation model that reproduces eddies. The group featured researchers from Tohoku University, JAMSTEC, Kyushu University, the University of Hawai`i at Mānoa, and the National Research and Innovation Agency of Indonesia.

Details of their research were reported in the Journal of Geophysical Research - Oceans on May 14, 2023.

The group's model enabled them to calculate the transport of simulated particles in a daily-averaged flow field with eddies and a monthly-averaged flow field with smoothed eddy currents, respectively, and estimate the flow rate transported by the simulated particles.

In the Sulawesi Sea, which is situated along the northeastern coast of Borneo and also borders the southern Filipino island of Mindanao, the Sulu archipelago, and Sulawesi Island's western coast, the group found that large flow fluctuations occur, and seawater circulates over a wider area for an extended period. Seawater also rises from the middle to near the surface, which may cause significant changes in the water when flowing through due to turbulent mixing.

On the eastern side of Sulawesi Island sits the Banda Sea, which surrounds the Maluku Islands and borders the islands of New Guinea and Timor. Here, the current fluctuation is slight, and the model predicted negligible influence from the eddies on the Indonesian Current.

"Our results indicate that the path and residence time of the ITF, along with the mixing process of seawater, must be appropriately reproduced by an ocean general circulation model to gain further insights into and better predict sea surface temperature fluctuations in each region of the Indonesian Archipelago," points out Toshio Suga, professor of physical oceanography at Tohoku University's Graduate School of Science and co-author of the paper.

Global warming's progression is expected to change the ITF. Such changes could have profound repercussions for water temperatures in the Indonesia Archipelago and the Indian Ocean, El Niño and the Indian Ocean Dipole, and the frequency and scale of marine heatwaves that affect marine ecosystems and local weather. Therefore, it is vital to predict accurately such phenomena.

Looking ahead, the group hopes to improve the accuracy of future predictions by clarifying the degree to which eddies impact the path and residence time of the ITF, something quantitatively linked to the determination of water temperature in these areas.

The figure shows the distribution of the difference between the daily and monthly average kinetic energies. This is an indicator of the magnitude of eddy variability. The eddy variability is large in the Sulawesi Sea and small in the Banda Sea.

Tracks of a number of particles originating in the Pacific Ocean that reach the Makassar Strait.

CREDIT

Iskander et al.

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JOURNAL

Journal of Geophysical Research Oceans

DOI

10.1029/2022JC019610 

Importance of Wolbachia-mediated biocontrol to reduce dengue in Bangladesh and other dengue-endemic developing countries

Peer-Reviewed Publication

COMPUSCRIPT LTD

Mosquito-borne diseases, particularly dengue and chikungunya have become global threats, infecting millions of people worldwide, including developing countries of Southeast Asia and Latin America. Bangladesh, like many other developing countries, is experiencing frequent dengue outbreaks. This article, therefore, critically discusses the current status of dengue disease, vector control approaches, and the need for Wolbachia-mediated intervention in Bangladesh and other dengue-endemic developing countries.

Relevant literature was searched from major databases and search engines such as PubMed, BanglaJol, World Health Organization (WHO)/European Centre for Disease Prevention and Control (ECDC) and Google Scholar. Considering the selection criteria, search strategies finally involved 55 related literature for further investigation. Findings showed that current vector control strategies could not render protection for an extended period, and the disease burden of arboviruses is increasing. The impoverished outbreak preparedness, urbanization, climate change, and less efficacy of existing control methods have made people susceptible to vector-borne diseases. Hence, Wolbachia, a naturally occurring endosymbiont of many mosquito species that can potentially limit virus transmission through several host genetic alterations, would be a potential alternative for dengue prevention.

The authors also critically discuss the challenges and prospects of Wolbachia-based dengue control in developing countries. The evidence supporting the efficacy and safety of this intervention and its mechanism have also been elucidated. Empirical evidence suggests that this introgression method could be an eco-friendly and long-lasting dengue control method. This review helps policymakers and health experts devise a scheme of Wolbachia-based dengue control that can control mosquito-borne diseases, particularly dengue in Bangladesh and other developing countries.

 

Highlights

• Approximately 3.9 billion people are prone to the dengue virus.
• Current vector control strategies have been found less effective and cannot render protection for a long period.
• Wolbachia-mediated biocontrol could be a promising alternative for dengue prevention.
• Wolbachia grow naturally in 40%–60% of all insect species.
• This dengue-control intervention is eco-friendly and confers long-term control.

 

Keywords: Wolbachia-based biocontrol, Mosquitoes-borne diseases, Dengue, Biological control, Developing countries

 

# # # # # #

 

Biosafety and Health is sponsored by the Chinese Medical Association, managed by National Institute for Viral

Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC).

For more information, please visit https://www.journals.elsevier.com/biosafety-and-health

Editorial Board: https://www.sciencedirect.com/journal/biosafety-and-health/about/editorial-board

Biosafety and Health is available on ScienceDirect (https://www.sciencedirect.com/journal/biosafety-and-health).

Submissions to Biosafety and Health may be made using Editorial Manager®

(https://www.editorialmanager.com/bsheal/default.aspx).

CiteScore: 4.8

ISSN 2590-0536

 

# # # # # #

 

Abdullah Al Noman, Debashish Das, Zinnatun Nesa, Md. Tariquzzaman, Fariha Sharzana, Md. Rakibul Hasan, Baizid Khoorshid Riaz, Golam Sharower, Mohammad Meshbahur Rahman, Importance of Wolbachia-mediated biocontrol to reduce dengue in Bangladesh and other dengue-endemic developing countries, Biosafety and Health, Volume 5, Issue 2, 2023, Pages 69-77, ISSN 2590-0536, https://doi.org/10.1016/j.bsheal.2023.03.003

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JOURNAL

Biosafety and Health

DOI

10.1016/j.bsheal.2023.03.003 

New high-tech helmets may protect American football players from debilitating concussions

A helmet containing liquid shock absorbers has the potential to reduce the danger of brain injury in contact sports

Peer-Reviewed Publication

FRONTIERS

Millions of people in the US are concussed every year playing sports. Players of games like American football are at particularly high risk for injuries that can have devastating long-term consequences. Stanford University scientists working with the company Savior Brain have now designed one potential way of protecting players: a helmet containing liquid shock absorbers that could reduce the impact of blows to the head by a third.

“Most of the members of our team have a personal connection to traumatic brain injury and we care deeply about ensuring long-term athlete brain health,” said Nicholas Cecchi, a PhD candidate at Stanford University and lead author of the study in Frontiers in Bioengineering and Biotechnology. “Concussion and repeated head impacts are still a major problem in contact sports, and we believe that improved helmet technology can play an important role in reducing the risk of brain injury.”

HARM reduction

Previous research by the Camarillo Lab at Stanford University had suggested that liquid shock absorbers could provide improved protection in sports helmets. To investigate this, the team built a finite element model, used by engineers to simulate performance before manufacturing, of an American football helmet incorporating 21 liquid shock absorbers. This helmet was tested against simulations of the helmet performance evaluation protocol used by the National Football League (NFL), its performance compared to that of four existing helmets. Due to the mounting evidence that the cumulative effect of impacts which don’t cause diagnosed concussions can also have serious health consequences, the team added lower velocity impacts to the evaluation protocol. They measured the head kinematics for each impact to produce a Head Accelerate Response Metric (HARM) score, which is used to evaluate helmet performance under impact. The kinematics were also fed into a model of the head and brain to gauge the resulting strain on the brain.

Reducing impact by 33%

The results showed that the helmet with liquid shock absorbers could dramatically reduce impact severity and strain on the brain caused by head impacts, potentially significantly cutting injuries. The helmet with liquid shock absorbers performed better than the existing helmet models, producing the lowest HARM value in 33 out of 36 different impact conditions tested, with an average reduction in score of a third. The liquid helmet also had the best ‘Helmet Performance Score’, a measure used in the NFL’s annual helmet safety rankings, which includes a weighting for how well a helmet protects against blows in different areas of the head. The highest-weighted location is the ‘side upper’ portion of the helmet because impacts here are most likely to cause concussions: the helmet with liquid shock absorbers reduced the HARM score in this area by 39-50% across all impact velocities without compromising protection in other areas of the helmet.

“The liquid technology offered an average improvement of over 30% for both low and high velocities,” said Dr Yuzhe Liu, corresponding author, who completed the work as a postdoctoral scholar at Stanford University. “It can dramatically reduce the loading on the brain that is experienced during all kinds of American football impacts.”

The team intends to develop the model significantly to protect players better – for instance by incorporating improvements to the facemask and chinstrap. They also plan to develop the model into a physical helmet that could be tested in real-life conditions, and in the future to produce similar helmets for other sports. However, different levels of play or different sports may need assessment by different metrics and design redevelopment.

“The next step for our team is to translate the computer model to a physical prototype,” said Cecchi. “After successfully completing that, we would also be interested in conducting human studies that could demonstrate either a reduction in concussion incidence or an attenuation of impact severity for sub-concussive impacts. We have plans to expand our implementation of liquid shock absorbers to more areas of the helmet, and more helmeted applications, to further improve brain safety for a wide variety of populations.”

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JOURNAL

Frontiers in Bioengineering and Biotechnology

DOI

10.3389/fbioe.2023.1160387 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Finite element evaluation of an American football helmet featuring liquid shock absorbers for protecting against concussive and subconcussive head impacts

ARTICLE PUBLICATION DATE

9-Jun-2023

COI STATEMENT

David Camarillo has a financial interest in Savior Brain, Inc., a company which has filed a provisional patent application that claims the design of the helmet architecture described in this work. David Camarillo, Nicholas Cecchi, and Hossein Vahid Alizadeh are listed as inventors on this patent application.

 

Genomic resources to help boost climate resilience of fisheries

Peer-Reviewed Publication

EARLHAM INSTITUTE

Candidate genes that could help fish to tolerate warmer and saltier water have been identified in new research from the Earlham Institute, potentially providing a vital resource to guide breeding programmes in freshwater aquaculture.

As water quality and availability is reduced by higher global temperatures, these insights can be used to breed more resilient fish and safeguard a key source of food for millions of people.

The Nile tilapia, Oreochromis niloticus, is widely farmed in freshwater aquaculture, providing essential nutrients and protein. Their use in aquaculture has risen dramatically, largely due to their adaptability to different water conditions and production systems. 

Soaring global temperatures, however, have depleted freshwater resources. Fish farms - and the people who rely on them for food - urgently need strains that can still thrive despite the higher salinity and increased water temperature. 

To address this issue, researchers at the Earlham Institute, University of East Anglia, and University of Stirling have explored the tilapia genome to locate advantageous changes in the genome responsible for an increased tolerance to changing water conditions. 

They examined tissue taken from the gills - an important osmoregulatory organ in fish - and generated DNA and RNA sequence data to study the activity, regulation, and function of different genes. They then identified genetic differences at gene regulatory regions in the Nile tilapia and 27 other tilapia species. 

Their assumption was that differences between the Nile tilapia, a freshwater species, and species adapted to saline waters are likely to have arisen to control genes involved with adapting to different water environments. 

The team optimised a genome sequencing approach that reveals the activity of potential transcription factor binding sites and genetic switches for turning expression on and off.

Their approach identified regions of the genome they believe are responsible for controlling the activity of certain osmoregulatory genes, which in turn influence the function of the gills and how the fish responds to changing water conditions. 

They identified a number of genes relevant to traits that help tilapia to tolerate saltier water and also acclimatise to freshwater. These included genes involved in metabolism and general housekeeping processes responsible for reacting to environmental changes in order to maintain balance.

Dr Tarang Mehta, study author and postdoctoral research scientist at the Earlham Institute, said: “Breeders are in desperate need of genomic resources to inform their breeding programmes so traits offering greater resilience can be quickly and accurately selected for.

“By characterising the genes responsible for these desirable traits, we can now share these new resources with freshwater fish farms to help guide selective breeding programmes.”

Dr Wilfried Haerty, study author and Group Leader at the Earlham Institute, said: “We identified regions of the Nile tilapia genome we can target to help breed fish with higher tolerance to salt - something that has sadly become increasingly important as our freshwater resources are degraded.

“The next steps are to use similar genomic approaches to find genes and their regulators associated with other traits of interest for aquaculture, like growth and disease resistance” 

The input of the Genomics Pipelines Group at the Earlham Institute was critical in the data generation, including preparation of RNA-Seq libraries, pooling, and sequencing.

The research was funded by the Biotechnology and Biological Sciences Research Council (BBSRC), part of UK Research and Innovation. 

END

Notes to editors

'Chromatin accessibility in gill tissue identifies candidate genes and loci associated with aquaculture relevant traits in tilapia' is published in the journal Genomics.

About the Earlham Institute

The Earlham Institute is a hub of life science research, training, and innovation focused on understanding the natural world through the lens of genomics.

Embracing the full breadth of life on Earth, our scientists specialise in developing and testing the latest tools and approaches needed to decode living systems and make predictions about biology.

The Earlham Institute is based within the Norwich Research Park and is one of eight institutes that receive strategic funding from the Biotechnology and Biological Sciences Research Council (BBSRC), part of UKRI, as well as support from other research funders.

earlham.ac.uk

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JOURNAL

Genomics

DOI

10.1016/j.ygeno.2023.110633 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Chromatin accessibility in gill tissue identifies candidate genes and loci associated with aquaculture relevant traits in tilapia

Telemedicine visits cut health system employee care costs by nearly 25%

Peer-Reviewed Publication

UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE

Visits with a 24/7, co-payment-free telemedicine program established by Penn Medicine for its employees were 23 percent less expensive than in-person visits for the same conditions, according to a new analysis published in the American Journal of Managed Care. Researchers at the Perelman School of Medicine at the University of Pennsylvania found that the per-visit costs for the telemedicine program, called Penn Medicine OnDemand, averaged $380 while in-person encounters in primary care offices, emergency departments, or urgent care clinics during the same timeframe cost $493 to conduct, a $113 difference per patient.

“The conditions most often handled by OnDemand are low acuity — non-urgent or semi-urgent issues like respiratory infections, sinus infections, and allergies — but incredibly common, so any kind of cost reduction can make a huge difference for controlling employee benefit costs,” said the study’s lead researcher, Krisda Chaiyachati, MD, an adjunct assistant professor of Medicine at Penn Medicine, who previously served as medical director of Penn Medicine OnDemand and now is the physician lead for Value-based Care and Innovation at Verily. “This research shows the clear financial benefits when hospitals and health systems offer telemedicine services directly to their own employees.”

The study analyzed de-identified data from almost 11,000 total visits by Penn Medicine employees who used the company-sponsored insurance plan. The researchers compared 5,413 visits to Penn’s OnDemand telemedicine service with 5,413 that were conducted in-person during the same period. The timeframe studied started with OnDemand’s initial launch in July 2017 until the end of 2019, a phase chosen to avoid confusion with changes enacted in response to the COVID-19 pandemic.

“The program made care easier, and it lowered the costs of delivering each episode of care,” said David Asch, MD, MBA, a professor of Medicine, and the study’s senior author. “But making care easier makes for more care: People who might otherwise have let that sore throat go without a check-up may seek one when it’s just a phone call away.”

While the researchers saw a 10 percent increase in demand for telemedicine services over the study period, the 23 percent decrease in “unit cost” – which factors in things like providers’ salaries and the equipment needed for calls – made it possible for the service to simultaneously be easier for employees to use and less expensive for the employer overall. The net effect was hundreds of thousands of dollars in savings for the health system.

Even though employers increasingly offer telemedicine options to their workforce, many health systems have been slow to adopt this approach. The study authors argued that, while past research showed that employer-offered telemedicine via third party companies did not lower the costs of care, health systems are uniquely positioned for their telemedicine offerings to drive savings: They can leverage their own providers, make in-system/in-network referrals, and better organize follow-up care.

Penn Medicine OnDemand began by serving Penn Medicine employees only and opened to insured patients just a few months before the pandemic began. Since then, telemedicine has gained steam, driven by COVID-era precautions and reimbursement changes to cover these services.  

Chaiyachati believes there are likely still significant savings in operating costs, for broader populations outside of health systems’ direct workforce. Comfort with telemedicine services increased with the pandemic, leading to marked increases in visits that resulted in health systems delivering telemedicine more efficiently and patients having a better understanding of what can and cannot be accomplished over telemedicine.

“The data we analyzed pre-date the pandemic. It was a time when people were just putting a toe in the water and wondering, ‘Let me see if telemedicine could treat my needs,’” Chaiyachati said. “These days, people seem willing to jump in for an appropriate set of conditions. The good news is that we made care easier while saving money, and we think the savings could be higher in the future.”

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JOURNAL

The American Journal of Managed Care

DOI

10.37765/ajmc.2023.89369 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Economics of a Health System’s Direct-to-Consumer Telemedicine for Its Employees

Price vs. health: Food shoppers choose price

New study finds when healthy buying incentives are removed, food consumers choose price over health

Peer-Reviewed Publication

INSTITUTE FOR OPERATIONS RESEARCH AND THE MANAGEMENT SCIENCES

Key Takeaways:

• When food consumers are properly incentivized, they will choose healthier options.
• When financial incentives are removed, consumers are more likely to choose less healthy options by comparison.

 

BALTIMORE, MD, June 9, 2023 – A new study of food consumer shopping behaviors has found that when faced with a choice – lower prices or healthier foods – they will likely choose lower prices.

The study found that when you give food consumers temporary incentives to buy healthier foods, they will likely to choose those healthier foods. But when you take away the discounts, consumers are more likely to return to old behaviors of buying the less healthy/less expensive options.

The study, “The Persistence of Healthy Behaviors in Food Purchasing,” was conducted by Marit Hinnosaar of the University of Nottingham and Centre for Economic Policy Research in London.

Hinnosaar conducted in-depth research into the U.S. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC gives vouchers for specific foods to mothers and their children age 5 and younger. In 2009, WIC policy reform changed the composition of food vouchers, introducing vouchers to encourage purchase of healthier products. To conduct her research, Hinnosaar used NielsenIQ household-level scanner data of grocery purchases.

“I conducted what you might call ‘difference-in-differences’ analysis to assess the immediate and long-term impacts of the healthier choice incentive program,” says Hinnosaar. “The product categories most targeted by the program were bread and milk.”

Hinnosaar says that the evidence points to a decrease in purchases of healthier options after participants left the program.

“During the incentive program, vouchers were restricted to whole wheat bread and low-fat milk,” she says. “Since some of these options tend to be more expensive, once the vouchers were no longer available for these products, consumers tended to choose items based on price.”

Still, there was no measurable difference in the total quantities of products in the WIC vouchers during or after the program. These products included bread, milk, fruits and vegetables, juice, eggs and cereal.

“Based on these findings, it is possible to conclude that a modest post-program subsidy once program participants leave the program – to incentivize healthier food choices – may be a more sustainable way to lengthen the program’s impact and lead to long-term healthier food purchases.”

 

Link to Study

 

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JOURNAL

Marketing Science

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

“The Persistence of Healthy Behaviors in Food Purchasing”