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Understanding if the reward is worth the influenza risk: The true cost of showing pigs. Prev Vet Med 2024; 222:106083. [PMID: 38071873 DOI: 10.1016/j.prevetmed.2023.106083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/14/2023] [Accepted: 11/26/2023] [Indexed: 12/24/2023]
Abstract
Influenza A virus transmission between pigs and humans has been reported periodically worldwide, and spillover events across the animal-human species barrier could lead to the next influenza pandemic. Swine exhibitions serve as a unique interface conducive to zoonotic disease transmission due to extensive commingling of pigs and humans for prolonged periods of time. The majority of zoonotic influenza A virus transmission in the United States has been linked to swine exhibitions, leading some to suggest additional controls for influenza A virus at the swine-human interface. Determining the value of the exhibition swine industry and gauging the financial impacts influenza A virus outbreaks could have on society, helps to inform adoption decisions of mitigation recommendations. This study estimates the total value of the exhibition swine industry in the United States and calculates the predicted costs of the most extreme mitigation strategy, cancelling swine exhibitions to reduce zoonotic influenza A virus transmission. Mixed methods, including a survey, were used to collect data and inform the study model. We estimated that the direct economic impact of the exhibition swine sector in 2018 was $1.2 billion. If pig shows were to be cancelled for one year, the estimated direct economic impact would be $357.1 million. A permanent, > 3-year ban on swine exhibitions would result in a $665 million economic impact, which is a 45% reduction from baseline. The direct economic impact of cancelling the swine show circuit could not be determined, as youth exhibitors may pursue alternative activities that cannot be precisely accounted for. However, the estimated loss to the swine industry justifies seeking enhanced mitigation to prevent disease transmission. Moreover, economic losses secondary to exhibition cancellations may explain hesitancy to participate in active influenza A virus surveillance efforts.
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When considering whether to waste food, consumers focus attention on food label dates rather than phrases. WASTE MANAGEMENT (NEW YORK, N.Y.) 2023; 168:230-234. [PMID: 37315374 DOI: 10.1016/j.wasman.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 05/08/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
Date labels have been implicated as a driver of premature discard of food by consumers, which has led to recommendations to change date labels as a way to reduce food waste. However, most proposed date label reform has focused on changing the phrase that accompanies the date on the label, and not how the date is selected. To explore the relative importance of these date label elements, we track consumers' eye movements when evaluating milk container images. When making decisions about the possible discard of milk, participants fixate significantly more on the date printed on the container than on the phrase (e.g., "use by") with >50% of decisions involving no visual fixation on the phrase. This relative inattentiveness to phrases suggests regulation of food date labels should include more focus on the process of choosing label dates.
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Learning about Our Vices from Devices: A Model of Individual Learning with an Application to Consumer Food Waste. JOURNAL OF AGRICULTURAL AND RESOURCE ECONOMICS 2023; 48:296-308. [PMID: 37333048 PMCID: PMC10274380 DOI: 10.22004/ag.econ.320676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
The proliferation of personal, household and workplace sensors and devices has created individual environments rich with purposeful and incidental feedback capable of altering behavior. We formulate an empirical learning model suitable for understanding individual behavioral responses in such environments. We estimate this model using data collected about the joint personal decisions of food selection, intake, and waste during a study in which users photographed their meal selections and plate waste over the course of a week with a cell phone. Despite neutral recruitment language and no expectation that participants would alter food intake in response to the assessment procedures, we found a substantial learning-by-doing effect in plate waste reduction as those who document greater plate waste in their captured photographs waste less on subsequent days. Further we identified that participants reduced plate waste by learning to eat more rather than by learning to reduce the amount of food selected.
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Evaluation of a community-based food waste campaign using a national control group. WASTE MANAGEMENT (NEW YORK, N.Y.) 2023; 160:101-111. [PMID: 36807025 DOI: 10.1016/j.wasman.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 01/14/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Communities are increasingly interested in bolstering sustainability by implementing local campaigns to reduce wasted food and divert it from landfills. Evaluation can be challenging, however, as community-engaged interventions may reach all community members, making it difficult to find an appropriate control group. We leverage a recently validated online survey instrument with samples from both the treated community of Upper Arlington, Ohio, USA, and from the United States at large to provide an additional mode for assessing community-based campaign efficacy. We find that the amount of wasted food reported by Upper Arlington households declined by 23% after a multi-modal local implementation of the 'Save More Than Food' campaign while the national sample reported a 29% increase in wasted food over the same period with the 52% net difference between these trends being statistically significant. A contemporaneous curbside audit of Upper Arlington households revealed a 17% reduction in wasted food and a 30% reduction in inedible food scraps where only the latter pre/post campaign reduction was statistically significant and no parallel national curbside audit data was available. There were few significant differences across neighborhoods that received differential intensities of campaign elements, which emphasizes the importance of identifying and conducting parallel measurement in a control group. The inclusion of the parallel national control group survey provided a cost-effective means to improve the accuracy and robustness of local campaign evaluation. We also discuss the campaign's effects on awareness, attitudes, composting behaviors, and non-organic waste rates.
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Consumer behavior during the COVID-19 pandemic: An analysis of food purchasing and management behaviors in U.S. households through the lens of food system resilience. SOCIO-ECONOMIC PLANNING SCIENCES 2022; 82:101107. [PMID: 35721385 PMCID: PMC9192140 DOI: 10.1016/j.seps.2021.101107] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/07/2021] [Accepted: 06/21/2021] [Indexed: 05/08/2023]
Abstract
The COVID-19 pandemic has stimulated considerable interest in the resilience of the U.S. food system. Less attention has been paid to the resiliency characteristics of the final link in the food system - individual households. We use national survey data from July 2020 to understand the food acquisition, preparation, and management strategies that households implemented in response to the pandemic. We find a substantial increase in the amount of food prepared and consumed at home which scales with respondents' time availability, perceived risks of dining out, and pandemic-induced income disruption. We then identify several household responses to support this increase in home food consumption that are in line with practices suggested to enhance resiliency at other links in the food supply chain, including increased cold storage capacity and enhanced in-house capability via improved cooking and food management skills. We discuss how responses such as improved food skills can reduce the propagation of shocks through the supply chain by allowing greater flexibility and less waste, while actions such as increased home cold storage capacity could undermine system resilience by exacerbating bullwhip effects, i.e., amplifying consumer demand shocks that are propagated to upstream food supply chain actors.
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A Randomized Controlled Trial to Address Consumer Food Waste with a Technology-aided Tailored Sustainability Intervention. RESOURCES, CONSERVATION, AND RECYCLING 2022; 179:106121. [PMID: 35087261 PMCID: PMC8788996 DOI: 10.1016/j.resconrec.2021.106121] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
There is growing concern whether pro-environmental behavioral interventions can generate sufficient reductions in carbon emissions to address climate change. While many have suggested enhanced tailoring of interventions to increase effect sizes, and while individual tailoring is common among health interventions, little is known about how individual tailoring may impact effect sizes for pro-environmental behavioral interventions. Using a novel technology-aided delivery and measurement approach, we conduct a randomized controlled trial featuring an individually tailored intervention focused on reducing the amount of food wasted by participants over approximately one week in their normal living conditions. We find large significant effects for the focal area of food wasted during dining (a 79% reduction), a null effect on food wasted over all household stages (preparation, dining and clean outs), and desirable or null effects for critical antecedent (e.g., waste during preparation, continued purchases of fresh produce), concurrent (e.g., food selection and consumption), and attendant behaviors (e.g., waste from storage clean outs, avoiding waste deposits in landfills).
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A Public-Private Partnership to Locate Fields for Implementation and Monitoring of Best Management Practices to Treat Legacy Phosphorus. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.742817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Legacy nutrients stored in agricultural soils are a substantial component of riverine nutrient discharge contributing to the eutrophication of aquatic ecosystems. These nutrient loads can persist and delay water quality initiatives, for example, those of the Great Lakes Water Quality Agreement which seek to reduce phosphorus (P) loads entering the Western Lake Erie Basin. In this watershed, approximately 5% of fields have P concentrations 2.5-fold greater than the maximum agronomic recommendations for corn and soybeans. Fields with these elevated-P concentrations (>100 mg P kg−1 soil) act as a source of legacy-P and discharge greater P loads. Implementing best management practices to treat runoff from these fields is desirable but finding them has been a challenge as soil test data are proprietary information creating an asymmetric information barrier. To overcome this barrier, we formed a public-private partnership that included agricultural retailers who conduct soil testing for farmers. Agricultural retailers who partnered with this project provided their soil P data and contacted farmers to gauge their interest, maintaining privacy for farmers until they expressed interest. Only 3.8% of soil samples in the provided data had elevated-P concentrations. In many cases, these elevated-P soils were confined to zones within fields, and 13% of fields had at least one elevated-P zone. We pursued these elevated-P fields as research sites for the implementation and monitoring of management practices. The agricultural retailers contacted 77 farmers with surveys, and 25 responded with interest in meeting the research team to discuss the project. Following a preliminary evaluation with the spatial data of fields operated by interested farmers, visits were arranged so that 12 research sites could be located. As indicated through the surveys, discussions with farmers, and soil data, many of the fields had accumulated elevated-P due to historic land-use (livestock, manure, or biosolid application) creating legacy sources. We conclude that public-private partnerships featuring agricultural retailers are a promising tool that may help overcome asymmetric information barriers to finding and managing agricultural fields with legacy-P that that disproportionately contribute to nutrient runoff.
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Perceived vulnerability to COVID-19 infection from event attendance: results from Louisiana, USA, two weeks preceding the national emergency declaration. BMC Public Health 2020; 20:1922. [PMID: 33349247 PMCID: PMC7750394 DOI: 10.1186/s12889-020-10035-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 12/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Individual perceptions of personal and national threats posed by COVID-19 shaped initial response to the pandemic. The aim of this study was to investigate the changes in residents’ awareness about COVID-19 and to characterize those who were more aware and responsive during the early stages of the pandemic in Louisiana. Methods In response to the mounting threat of COVID-19, we added questions to an ongoing food preference study held at Louisiana State University from March 3rd through March 12th, 2020. We asked how likely it was that the spread of the coronavirus will cause a national public health crisis and participants’ level of concern about contracting COVID-19 by attending campus events. We used regression and classification tree analysis to identify correlations between these responses and (a) national and local COVID case counts; (b) personal characteristics and (c) randomly assigned information treatments provided as part of the food preference study. Results We found participants expressed a higher likelihood of an impending national crisis as the number of national and local confirmed cases increased. However, concerns about contracting COVID-19 by attending campus events rose more slowly in response to the increasing national and local confirmed case count. By the end of this study on March 12th, 2020 although 89% of participants agreed that COVID-19 would likely cause a public health crisis, only 65% of the participants expressed concerns about contracting COVID-19 from event attendance. These participants were significantly more likely to be younger students, in the highest income group, and to have participated in the study by responding to same-day, in-person flyer distribution. Conclusions These results provide initial insights about the perceptions of the COVID-19 public health crisis during its early stages in Louisiana. We concluded with suggestions for universities and similar institutions as in-person activities resume in the absence of widespread vaccination. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10035-6.
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Selection, intake, and plate waste patterns of leftover food items among U.S. consumers: A pilot study. PLoS One 2020; 15:e0238050. [PMID: 32903260 PMCID: PMC7480863 DOI: 10.1371/journal.pone.0238050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 08/08/2020] [Indexed: 11/18/2022] Open
Abstract
Many campaigns promote the preservation and consumption of leftover food items as a critical household strategy to accomplish national consumer food waste reduction goals. We fill a gap in knowledge about the consumption and creation of leftovers in the United States by analyzing data from a pilot study in which 18 subjects tracked food selection, intake, and plate waste across all eating occasions for about one week. Subjects noted which items selected for consumption were leftovers, i.e., previously prepared but uneaten items that were stored for future consumption, and which unfinished items were saved to become leftovers. We found that 12% of items selected for consumption were leftovers while 24% of selected items that were not fully consumed were kept to become a leftover. Leftovers were most frequently vegetables, cheeses, and meats, and most frequently selected on Mondays and for lunch. Regression analyses isolate significant dining patterns with respect to leftovers, including evidence that leftovers were less likely to be fully consumed than non-leftover items, and that larger meals led to more uneaten food. This suggests that strategies to reduce meal size may be most effective in reducing food waste by limiting the creation of leftovers in the first place. Strategies to make leftovers more attractive and appealing may also reduce food waste.
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The Validity, Time Burden, and User Satisfaction of the FoodImage™ Smartphone App for Food Waste Measurement Versus Diaries: A Randomized Crossover Trial. RESOURCES, CONSERVATION, AND RECYCLING 2020; 160:104858. [PMID: 32773964 PMCID: PMC7409719 DOI: 10.1016/j.resconrec.2020.104858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The FoodImage™ smartphone app transmits to researchers users' photographs of food selection and food waste, and includes user-tagged information about waste reasons and destination. Twenty-four participants were trained to record food waste using FoodImage, food waste diaries requiring visual estimation of waste quantities, and diaries requiring scale weights. Participants used each method during three staged food-waste scenarios (food preparation, eating, and clean-out) in a randomized crossover trial. Two participants had extreme values for the weighed diary method; therefore, accuracy results are reported with and without these two participants' data. Error was calculated as waste estimated with the experimental method minus directly weighed waste. Mean absolute error from FoodImage was significantly smaller than or equal to the error from both diary methods in each scenario. Furthermore, the mean values from FoodImage were equivalent to directly weighed values in two out of the three tasks; while weighed diaries were equivalent in two tasks only when the two participants with extreme values were removed. Visually estimated diaries were equivalent for only one task. All 24 participants preferred FoodImage to diaries and all rated FoodImage as less time consuming. Over one week, FoodImage would require ~24 fewer minutes of users' time to record all data. Unlike food waste diaries, FoodImage also transmits data to researchers in real-time and provides detailed data on food selection and intake. ClinicalTrials.gov Identifier: NCT03309306.
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Unpacking the Decline in Food Waste Measured in Chinese Households from 1991 to 2009. RESOURCES, CONSERVATION, AND RECYCLING 2020; 160:104893. [PMID: 32661454 PMCID: PMC7357877 DOI: 10.1016/j.resconrec.2020.104893] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Food waste reduction is an explicit goal for many countries, yet a paucity of highquality primary measurements of food waste are available to inform policy. We analyze repeated physical measurements of discarded food from more than 37,000 households enrolled in the China Health and Nutrition Survey (CHNS) from 1991 to 2009 and describe relevant food waste patterns and trends within households over a period of dramatic change. Over a period in which average real household incomes tripled, food discarded per person declined by about 20% on a quantity basis and by about 40% on a Calorie basis during the study, with an estimated annual per capita household waste of 14.9 kg in 2009. Comparing across households within narrower periods of the data, we find changing associations between income and food waste, with a weakly negative association during the 1990s and a significant positive association during the 2000s. Carbohydrates, particularly grains and vegetables and fruits, experienced the greatest reduction in waste. Food waste reduction rates over the study period were greatest among small households and rural households. Certain characteristics were associated with higher per person waste levels throughout the study period, including rural residence, intense physical activity levels, and a lack of home refrigeration.
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Some issues in the ethics of food waste. Physiol Behav 2020; 219:112860. [PMID: 32151617 DOI: 10.1016/j.physbeh.2020.112860] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 11/27/2022]
Abstract
It is estimated that nearly one-third of food produced on the planet never meets its intended purpose of human nourishment. This represents a substantial stock of resources available for reallocation. Any potential reallocation of resources raises ethical issues - who should sacrifice (change current behaviors), who should benefit, and what methods are appropriate to induce the behavioral change required to invoke the reallocation? In this brief article, we will discuss several topics in the food waste literature that, in our opinion, raise ethical issues that warrant further thought and consideration. These include the emphasis on food donation as a means to reduce food waste, the emergence of markets for food with cosmetic imperfection (i.e., "ugly food"), the appropriateness of guilt appeals to motivate reductions in wasted food, and the ethical tensions in choosing dates on food labels.
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The impact of intensity on perceived risk from unconventional shale gas development. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2018; 218:630-638. [PMID: 29730087 DOI: 10.1016/j.jenvman.2018.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
The recent boom in the extraction of natural gas from subsurface shale deposits due to advances in hydraulic fracturing and horizontal drilling technologies has raised concern around environmental risks. Reliable measures of how residents view these risks are therefore a necessary first step in evaluating policies that regulate the industry through risk mitigation measures. We conduct a choice experiment targeting residents in an area of Ohio with significant shale drilling activity, and find that households are willing to pay to avoid high intensities of shale development and truck traffic. Our analysis presents new policy-relevant evidence of preferences associated with unconventional shale gas reserves, and highlights the tradeoffs between activity intensity at each site and the number of sites in aggregate.
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Plate waste of adults in the United States measured in free-living conditions. PLoS One 2018; 13:e0191813. [PMID: 29444094 PMCID: PMC5812590 DOI: 10.1371/journal.pone.0191813] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/11/2018] [Indexed: 11/28/2022] Open
Abstract
We analyze food-item level data collected from 50 adults from the United States using the Remote Food Photography Method® to provide the first estimates of plate waste gathered from adults across multiple consecutive meals and days in free-living conditions, and during laboratory-based meals with fixed food items and quantities. We find average plate waste in free-living conditions is 5.6 grams (7.7 kcals) per item and that 3.3% of all food selected is returned as plate waste, where the percent waste figure is substantially lower than previously published plate waste estimates gathered primarily from dine-out settings in the United States such as buffets and institutional settings with limited-choice meals (e.g., school cafeterias). Plate waste from the same participants during the laboratory-based meals is significantly higher with an average of 203.2 grams of solid plate waste per meal (531.3 kcals) or 39.1% of the food provided, which is similar to the plate waste percentages found reported in some school cafeteria settings. The amount of plate waste generated in free-living conditions is significantly positively associated with portion size selected for an item. In a multivariate analysis that controls for macronutrient profile, items selected from the vegetables, fats/oils/dressings, and grains categories are associated with significantly greater amounts of plate waste per item. We find no significant associations between free-living plate waste and gender, age, race or body mass index but find that women leave more plate waste in the lab meal where portion sizes are pre-determined by the researcher and similar for all respondents. We discuss possible implications of these findings for programs focused on reducing plate waste and food waste among consumers.
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Household Food Waste: Multivariate Regression and Principal Components Analyses of Awareness and Attitudes among U.S. Consumers. PLoS One 2016; 11:e0159250. [PMID: 27441687 PMCID: PMC4956302 DOI: 10.1371/journal.pone.0159250] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 06/29/2016] [Indexed: 11/19/2022] Open
Abstract
We estimate models of consumer food waste awareness and attitudes using responses from a national survey of U.S. residents. Our models are interpreted through the lens of several theories that describe how pro-social behaviors relate to awareness, attitudes and opinions. Our analysis of patterns among respondents’ food waste attitudes yields a model with three principal components: one that represents perceived practical benefits households may lose if food waste were reduced, one that represents the guilt associated with food waste, and one that represents whether households feel they could be doing more to reduce food waste. We find our respondents express significant agreement that some perceived practical benefits are ascribed to throwing away uneaten food, e.g., nearly 70% of respondents agree that throwing away food after the package date has passed reduces the odds of foodborne illness, while nearly 60% agree that some food waste is necessary to ensure meals taste fresh. We identify that these attitudinal responses significantly load onto a single principal component that may represent a key attitudinal construct useful for policy guidance. Further, multivariate regression analysis reveals a significant positive association between the strength of this component and household income, suggesting that higher income households most strongly agree with statements that link throwing away uneaten food to perceived private benefits.
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A comparative effectiveness analysis of treatment for latent tuberculosis infection using multilevel selection models. J Comp Eff Res 2015; 4:239-257. [PMID: 25965321 DOI: 10.2217/cer.15.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Nine months of isoniazid (9INH) is the gold standard for treatment of latent tuberculosis infection (LTBI). This paper compares the effectiveness of 9 months of isoniazid with 4 months of transitional rifampin (9H4R) to alternative therapies, including 9INH, 6 months of isoniazid (6INH) and 6 months of isoniazid with 4 months of transitional rifampin (6H4R), for treatment of LTBI. MATERIALS & METHODS Using an ethnically diverse clinic sample of 552 patients given treatment for LTBI with 9H4R, we use multilevel selection models to examine the adjusted comparative effectiveness of the regimens among ethnic groups that feature distinct genetic predispositions to side effects on INH. For unadjusted/absolute effectiveness, we simulated cost-effectiveness ratios for 4 months of rifampin (4RIF) and compared with bootstrapped confidence intervals for the alternative therapies. RESULTS There are variations in the comparative effectiveness across ethnic groups, with the most notable differences for 9H4R. For unadjusted/absolute effectiveness, 4RIF presents the greatest net benefit for US born black and African patients. For all other ethnic groups, 6H4R was the most effective. CONCLUSION Patient ethnicity affects tolerance to INH. 9H4R was the most effective LTBI treatment for all ethnicities. However, this result heavily depends on whether adjustments are made for self-selection.
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Financial and psychological risk attitudes associated with two single nucleotide polymorphisms in the nicotine receptor (CHRNA4) gene. PLoS One 2009; 4:e6704. [PMID: 19693267 PMCID: PMC2724734 DOI: 10.1371/journal.pone.0006704] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Accepted: 07/21/2009] [Indexed: 11/19/2022] Open
Abstract
With recent advances in understanding of the neuroscience of risk taking, attention is now turning to genetic factors that may contribute to individual heterogeneity in risk attitudes. In this paper we test for genetic associations with risk attitude measures derived from both the psychology and economics literature. To develop a long-term prospective study, we first evaluate both types of risk attitudes and find that the economic and psychological measures are poorly correlated, suggesting that different genetic factors may underlie human response to risk faced in different behavioral domains. We then examine polymorphisms in a spectrum of candidate genes that affect neurotransmitter systems influencing dopamine regulation or are thought to be associated with risk attitudes or impulsive disorders. Analysis of the genotyping data identified two single nucleotide polymorphisms (SNPs) in the gene encoding the alpha 4 nicotine receptor (CHRNA4, rs4603829 and rs4522666) that are significantly associated with harm avoidance, a risk attitude measurement drawn from the psychology literature. Novelty seeking, another risk attitude measure from the psychology literature, is associated with several COMT (catechol-O-methyl transferase) SNPs while economic risk attitude measures are associated with several VMAT2 (vesicular monoamine transporter) SNPs, but the significance of these associations did not withstand statistical adjustment for multiple testing and requires larger cohorts. These exploratory results provide a starting point for understanding the genetic basis of risk attitudes by considering the range of methods available for measuring risk attitudes and by searching beyond the traditional direct focus on dopamine and serotonin receptor and transporter genes.
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Abstract
OBJECTIVE Return to work is associated with diminished breastfeeding intensity and duration. Although more mothers breastfeed after returning to work now than earlier, research has not documented the strategies that mothers use for combining paid work and breastfeeding or their effect on breastfeeding outcomes. This study examined which strategies are associated with smaller decrements in breastfeeding intensity and longer durations. PARTICIPANTS AND METHODS We analyzed 810 mothers from the Infant Feeding Practices Study II who worked and breastfed. We used regression and censored regression models to analyze 4 strategies that mothers used to combine these 2 activities: (1) feed directly from the breast only; (2) both pump and feed directly; (3) pump only; and (4) neither pump nor breastfeed during the work day. Outcomes were the difference in percentage of milk feeds that were breast milk between the month before and after return to work and duration of breastfeeding after return to work. RESULTS Forty-three percent of mothers pumped milk at work only; 32% fed the infant directly from the breast only. These 2 strategies, along with pumping and feeding directly, were statistically similar and superior to neither pumping nor breastfeeding during the work day for the outcome of change in breastfeeding intensity. For the outcome of breastfeeding duration, the 2 strategies that included directly feeding from the breast were associated with longer duration than pumping only, whereas the strategy of neither pumping nor breastfeeding during the work day was associated with the shortest duration. CONCLUSIONS Feeding the infant from the breast during the work day is the most effective strategy for combining breastfeeding and work. Ways to enable direct feeding include on-site child care, telecommuting, keeping the infant at work, allowing the mother to leave work to go to the infant, and having the infant brought to the work site. Establishing ways for mothers to feed from the breast after return to work is important to meet US breastfeeding goals.
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