The impact of diabetes prevention on labour force participation and income of older Australians: an economic study

Background: Globally, diabetes is estimated to affect 246 million people and is increasing. In Australia diabetes has been made a national health priority. While the direct costs of treating diabetes are substantial, and rising, the indirect costs are considered greater. There is evidence that interventions to prevent diabetes are effective, and cost-effective, but the impact on labour force participation and income has not been assessed. In this study we quantify the potential impact of implementing a diabetes prevention program, using screening and either metformin or a lifestyle intervention on individual economic outcomes of pre-diabetic Australians aged 45-64. Methods. The output of an epidemiological microsimulation model of the reduction in prevalence of diabetes from a lifestyle or metformin intervention, and another microsimulation model, Health&WealthMOD, of health and the associated impacts on labour force participation, personal income, savings, government revenue and expenditure were used to quantify the estimated outcomes of the two interventions. Results: An additional 753 person years in the labour force would have been achieved from 1993 to 2003 for the male cohort aged 60-64 years in 2003, if a lifestyle intervention had been introduced in 1983; with 890 person years for the equivalent female group. The impact on labour force participation was lower for the metformin intervention, and increased with age for both interventions. The male cohort aged 60-64 years in 2003 would have earned an additional $30 million in income with the metformin intervention, and the equivalent female cohort would have earned an additional$25 million. If the lifestyle intervention was introduced, the same male and female cohorts would have earned an additional $34 million and$28 million respectively from 1993 to 2003. For the individuals involved, on average, males would have earned an additional $44,600 per year and females an additional$31,800 per year, if they had continued to work as a result of preventing diabetes. Conclusions: In addition to improved health and wellbeing, considerable benefits to individuals, in terms of both additional working years and increased personal income, could be made by introducing either a lifestyle or metformin intervention to prevent diabetes

Artemisia spp. essential oils against the disease-carrying blowfly Calliphora vomitoria

Background: Synanthropic flies play a considerable role in the transmission of pathogenic and non-pathogenic microorganisms. In this work, the essential oil (EO) of two aromatic plants, Artemisia annua and A. dracunculus, were evaluated for their abilities to control the blowfly Calliphora vomitoria. A. annua and A. dracunculus EOs were extracted, analysed and tested in laboratory bioassays. Besides, the physiology of EOs toxicity and the EOs antibacterial and antifungal properties were evaluated. Results: Both Artemisia EOs were able to deter C. vomitoria oviposition on fresh beef meat. At 0.05 μL cm-2 A. dracunculus EO completely inhibited C. vomitoria oviposition. Toxicity tests, by contact, showed LD50 of 0.49 and 0.79 μL EO per fly for A. dracunculus and A. annua, respectively. By fumigation, LC50 values were 49.54 and 88.09 μL L-1 air for A. dracunculus and A. annua, respectively. EOs AChE inhibition in C. vomitoria (IC50 = 202.6 and 472.4 mg L-1, respectively for A. dracunculus and A. annua) indicated that insect neural sites are targeted by the EOs toxicity. Finally, the antibacterial and antifungal activities of the two Artemisia EOs may assist in the reduction of transmission of microbial infections/contaminations. Conclusions: Results suggest that Artemisia EOs could be of use in the control of C. vomitoria, a common vector of pathogenic microorganisms and agent of human and animal cutaneous myiasis. The prevention of pathogenic and parasitic infections is a priority for human and animal health. The Artemisia EOs could represent an eco-friendly, low-cost alternative to synthetic repellents and insecticides to fight synanthropic disease-carrying blowflies

Systematic review on the cost and cost-effectiveness of mHealth interventions supporting women during pregnancy.

OBJECTIVES: The increased integration of digital health into maternity care-alongside growing use of, and access to, personal digital technology among pregnant women-warrants an investigation of the cost-effectiveness of mHealth interventions used by women during pregnancy and the methodological quality of the cost-effectiveness studies. METHODS: A systematic search was conducted to identify peer-reviewed studies published in the last ten years (2011-2021) reporting on the costs or cost-effectiveness of mHealth interventions used by women during pregnancy. Available data related to program costs, total incremental costs and incremental cost-effectiveness ratios (ICERs) were reported in 2020 United States Dollars. The quality of cost-effectiveness studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). FINDINGS: Nine articles reporting on eight studies met the inclusion criteria. Direct intervention costs ranged from $7.04 to$86 per woman, total program costs ranged from $241,341 to$331,136 and total incremental costs ranged from -$21.16 to$1.12 million per woman. The following ICERs were reported: $2168 per DALY averted,$203.44 per woman ceasing smoking, and $3475 per QALY gained. The full economic evaluation studies (n = 4) were moderate to high in quality and all reported the mHealth intervention as cost-effective. Other studies (n = 4) were low to moderate in quality and reported low costs or cost savings associated with the implementation of the mHealth intervention. CONCLUSIONS FOR PRACTICE: Preliminary evidence suggests mHealth interventions may be cost-effective and "low-cost" but more evidence is needed to ascertain the cost-effectiveness of mHealth interventions regarding positive maternal and child health outcomes and longer-term health service utilisation