National Estimates of Incremental Work Absenteeism Costs Associated With Adult Children of Parents With Alzheimer's Disease and Related Dementias.

OBJECTIVE: More than half of primary caregivers for ADRD patients are adult children, yet there is little empirical evidence on how caring for parents with ADRD affects their employment. Using a nationally representative dataset, this study aimed to estimate incremental work absenteeism costs for adult children of parents with ADRD. DESIGN, SETTING, AND PARTICIPANTS: The study used the data from the 2015-2021 Medical Expenditure Panel Survey (MEPS). Multivariate regressions and two-part models were employed to estimate the incremental work absenteeism costs among adult children aged 40 to 64 who had at least one parent diagnosed with ADRD, compared with those who did not have ADRD parents. MEASUREMENTS: The incremental work absenteeism costs due to caregiving for adult children with ADRD parents was a cumulated estimation of labor productivity cost at three stages: (1) the likelihood of not working due to unemployment, (2) the likelihood of missing any workdays for caregiving, and (3) the number of workdays missed due to caregiving. RESULTS: Adult children with ADRD parents were more likely to be unemployed (OR = 1.80, p = 0.024) and 2.95 times more likely to miss work for caregiving (p = 0.002) than those with non-ADRD parents. The difference in the number of workdays missed for caregiving between children with and without ADRD parents was not significant. The incremental effects of having ADRD parents were estimated to be $4,510.29 ($1,702.09-$6,723.69) per person per year. CONCLUSIONS: Having ADRD parents significantly increases the chances of unemployment and missing any workdays for caregiving, leading to higher lost labor productivity costs for adult children with ADRD parents.

Medicare Payments and ACOs for Dementia Patients Across Race and Social Vulnerability.

OBJECTIVES: This study investigated variations in Medicare payments for Alzheimer's disease and related dementia (ADRD) by race, ethnicity, and neighborhood social vulnerability, together with cost variations by beneficiaries' enrollment in Accountable Care Organizations (ACOs). METHODS: We used merged datasets of longitudinal Medicare Beneficiary Summary File (2016-2020), the Social Vulnerability Index (SVI), and the Medicare Shared Savings Program (MSSP) ACO to measure beneficiary-level ACO enrollment at the diagnosis year of ADRD. We analyzed Medicare payments for patients newly diagnosed with ADRD for the year preceding the diagnosis and for the subsequent 3 years. The dataset included 742,175 Medicare fee-for-service (FFS) beneficiaries aged 65 and older with a new diagnosis of ADRD in 2017 who remained in the Medicare FFS plan from 2016 to 2020. RESULTS: Among those newly diagnosed, Black and Hispanic patients encountered higher total costs compared to White patients, and ADRD patients living in the most vulnerable areas experienced the highest total costs compared to patients living in other regions. These cost differences persisted over 3 years postdiagnosis. Patients enrolled in ACOs incurred lower costs across all racial and ethnic groups and SVI areas. For ADRD patients living in the areas with the highest vulnerability, the cost differences by ACO enrollment of the total Medicare costs ranged from $4,403.1 to $6,922.7, and beneficiaries' savings ranged from $114.5 to $726.6 over three years post-ADRD diagnosis by patient's race and ethnicity. CONCLUSIONS: Black and Hispanic ADRD patients and ADRD patients living in areas with higher social vulnerability would gain more from ACO enrollment compared to their counterparts.

The influence of accelerometer epoch length on physical activity output in adolescent athletes.

Epoch in accelerometer measurements is an important option that affects the results of physical activity (PA) analysis. Many studies have been conducted to investigate the effect of epoch on PA output in adolescents, but few have been performed on highly active youth athletes. We aimed to examine the differences in energy expenditure and time spent in different activity intensities by applying various epoch lengths in adolescent athletes. The participants of this study comprised 31 male athletes aged 12 to 13 in basketball, soccer, and taekwondo teams. Athletes wore a tri-axial accelerometer attached to the right hip for 6 to 7 consecutive days, including sleeping time. Subsequently, the recorded data from the accelerometer were downloaded using the ActiLife software and analyzed by varying the epoch to 1, 10, 30, and 60 sec. Daily average metabolic equivalents (METs) increased as the epoch increased (F=2.918, P=0.037), showing a significant difference between 1 and 60-sec epochs. As epoch length increased, sedentary (0-1.5 METs) (F=94.001, P=0.000) and high intensity (6 METs and higher) activity time (F=3.536, P=0.017) decreased, while low (1.5-3 METs) (F=173.949, P= 0.000), moderate (3-6 METs) (F=70.792, P=0.000), and moderate-to-vigorous activity (3 METs and higher intensity) (F=34.683, P=0.000) times increased. Comparing PA among adolescent athletes by varying epoch settings of accelerometers revealed differences in PA levels and time spent in different activity intensities. Future studies should consider the characteristic changes in the PA outputs according to the epoch length in very active adolescent athletes.

Large-area transparent biocomposite films based on nanocellulose and nanochitin via horizontal centrifugal casting.

In this study, we introduce the horizontal centrifugal casting (HCC) process that enables centrifugal force-assisted, scalable production of large-area (10 in.) polymer composite films based on nanocellulose (CNF) and nanochitin (ChNF). The HCC employs a cylinder mold with its rotation pivot being in a horizontal posture to harness centrifugal force to help flatten the film being cast, from which polymer composite films with excellent uniformity and flatness can be reliably produced in the size of the lateral surface of the cylinder mold. The combination of centrifugal force and horizontal layout of cylinder mold can allow reliable fabrication of large-area self-standing films from both polymeric solution and/or suspension in a scalable and simple fashion, which is a task not readily achieved in common film-forming techniques, such as solvent casting and vacuum filtration. We demonstrate such reliability and versatility of the HCC process by fabricating typical biocomposite films out of both a solution blend of ChNF/silk fibroin and a colloidal suspension of CNF/nanoclay as well as investigating their processing-structure-property relation as an optically transparent composite film targeting for structural component for flexible green optoelectronics and fire-retardant film, respectively.

Prescription Drug Costs Among People With Alzheimer Disease and Related Dementias.

This cross-sectional study examines the association of Alzheimer disease and related dementias with prescription drug expenditures across cost distributions.

Evaluation of the osteoporosis health belief scale in korean women.

BACKGROUND: The Osteoporosis Health Belief Scale (OHBS) is a 42-item questionnaire designed to assess susceptibility, seriousness, calcium benefits, calcium barriers, exercise benefits, exercise barriers, and health motivation related to osteoporosis. We aimed to evaluate its psychometric properties to enable the provision of educational tips regarding osteoporosis. METHODS: All women who had visited the department of obstetrics and gynecology (OBGYN) and whose bone mineral density was measured from January 2010 to December 2011 were enrolled by interview using the OHBS. We also evaluated the women's general clinical characteristics. RESULTS: One hundred seventy-seven women were enrolled in the present study. In the present study, the barriers to calcium intake subscale had the lowest mean score (15.03±3.02), and the Benefit of Exercise subscale had the highest (23.02±3.03). The scores for participants in their 20s were significantly higher than scores for those in their 70s on the Benefits of Exercise subscale and Barriers to Exercise subscale (P=0.014 and P=0.022, respectively). CONCLUSIONS: Education for health motivation to prevent osteoporosis is important for young women. Additional systematic education programs are needed for the general population.