Religion, social interactions, and COVID-19 incidence in Western Germany.

This paper investigates how social interactions, as shaped by religious denomination, are related to COVID-19 incidence and associated mortality in Western Germany. We observe that the number of infections and deaths during the early pandemic phase were much higher in predominantly Catholic counties with arguably stronger family and social ties. The relationship was confirmed at the county level through numerous robustness checks, and after controlling for a series of characteristics and county fixed effects. At the individual level, we confirmed that Catholics, relative to non-Catholics, have tighter and more frequent interactions with their family and friends. Moreover, the intensity of social interaction was able to partially explain the relationship between COVID-19 incidence and share of Catholics at the county level. Our results highlight the number of dimensions that have to be taken into account when designing and implementing mitigation measures in the early stages of disease outbreaks.

Effects of Primary Biliary Cholangitis on Quality of Life and Health Care Costs in the United Kingdom.

BACKGROUND & AIMS: There have been few high-quality studies of the costs, preference-based health-related quality of life (HRQoL) and cost effectiveness of treatments for primary biliary cholangitis (PBC). We aimed to estimate the marginal effects of PBC complications and symptoms, accounting for treatment, on HRQoL and the annual cost of health care in the United Kingdom (UK). These are essential components for evaluation of cost effectiveness and this information will aid in evaluation of new treatments. METHODS: Questionnaires were mailed to 4583 participants in the UK-PBC research cohort and data were collected on HRQoL and use of the National Health Service (NHS) in the UK from 2015 through 2016. HRQoL was measured using the EQ-5D-5L instrument. The annual cost of resource use was calculated using unit costs obtained from NHS sources. We performed econometric analyses to determine the effects of treatment, symptoms, complications, liver transplantation status, and patient characteristics on HRQoL and annual costs. RESULTS: In an analysis of data from 2240 participants (over 10% of all UK PBC patients), we found that PBC symptoms have a considerable effect on HRQoL. Ursodeoxycholic acid therapy was associated with significantly higher HRQoL regardless of response status. Having had a liver transplant and ascites were also independently associated with reduced HRQoL. Having had a liver transplant (US$4294) and esophageal varices (US$3401) were the factors with the two greatest mean annual costs to the NHS. Symptoms were not independently associated with cost but were associated with reduction in HRQoL for patients, indicating the lack of effective treatments for PBC symptoms. CONCLUSIONS: In an analysis of data from 2240 participants in the UK PBC, we found that HRQoL and cost estimates provide greater insight into the relative importance of PBC-related symptoms and complications. These findings provide estimates for health technology assessments of new treatments for PBC.

The (Agri-)Cultural origins of obesity.

Previous research has shown that societies that historically focused on agricultural production demonstrate higher levels of long-term orientation. This suggests that the deep-rooted cultural origins of time preference may have a scarring impact on modern obesity rates through intergenerational transmission. We hypothesize that a historically long-term oriented culture could result in the behavioural choices of better diet and more exercise today, via the reinforced ability of individuals to delay gratification. Using a sample of 132 countries, we employ regression analysis to first estimate the historical determinants of time preference, and then examine the impact of long-term orientation on obesity. Controlling for other factors, we find that, on average, historically long-term oriented countries exhibit significantly lower obesity rates today. Results are robust to different methodological approaches and sensitivity analyses. Policies targeting obesity should consider those deep-rooted behavioural factors that can determine the differential response of individuals to policy instruments.

A Randomised Controlled Feasibility Trial of Immersive Virtual Reality Treatment with Cognitive Behaviour Therapy for Specific Phobias in Young People with Autism Spectrum Disorder.

We examined the feasibility and acceptability of using an immersive virtual reality environment (VRE) alongside cognitive behaviour therapy (CBT) for young people with autism experiencing specific phobia. Thirty-two participants were randomised to treatment or control. Treatment involved one session introducing CBT techniques and four VRE sessions, delivered by local clinical therapists. Change in target behaviour was independently rated. Two weeks after treatment, four treatment participants (25%) and no control participants were responders; at 6 months after treatment, six (38%) treatment and no control participants were responders. At 6 months post-treatment, symptoms had worsened for one treatment and five control (untreated) participants. Brief VRE exposure with CBT is feasible and acceptable to deliver through child clinical services and is effective for some participants.

Economic Growth, Climate Change, and Obesity.

Human and planetary health as well as economic growth are firmly interlinked and subject to complex interaction effects. In this paper, we provide an overview of interlinkages between economic growth, climate change, and obesity focusing on recent advances in the literature. In addition to empirical findings, we discuss different theoretical frameworks used to conceptualize these complex links and highlight policy options and challenges. We conclude that policies addressing both climate change and obesity simultaneously are particularly promising and often suitable for ensuring sustainable development.