Incidence and prevalence of obesity is increasing worldwide. According to current trends, there is a high risk of pandemy of obesity in 21. century. WHO announced 1 bilion of obese people worldwide. In the majority of countries in Europe the prevalence of obesity is about 10-25%. Obesity has very negative impact on the public health, quality of life but also very high economic burden. The economic cost on obesity achieve 5% of teh whole healthcare cost in EU and 12% in the USA. Assumption of the direct and indirect cost was 32,8 bilion Euros in EU. It comes up to 0,3% of HDP. The aim of my analysis is to estimate direct cost on the healthcare in the direct connection with obesity in Czech Republic.

Prevalence of obesity worldwide has increased rapidly in the last decade. In the Czech Republic, a similar trend has been observed. Every fifth adult has a problem with obesity, a fact which puts the Czech Republic among the countries with the highest obesity rates in European and global context. Obesity is a risk factor leading to a number of serious diseases. The growing prevalence of obesity is directly causing higher health care spending and also incurs costs indirectly, in terms of productivity losses. Present thesis is the first study in the Czech Republic, providing an estimate of both direct and indirect costs related to the obesity. Using a cost-of-illness method, the overall social costs of obesity in the Czech Republic for 2013 were estimated at 12.1 billion CZK which corresponds to 0.3% of GDP in the given year. Direct costs accounted for two thirds of this amount. The highest costs, attributable to the obesity, were inflicted by back pain diseases, arthritis, ischemic heart diseases and type 2 diabetes.

Background: National School Lunch Program (NSLP) meals have been found to be of higher dietary quality than home-packed lunches. Objective: To explore the cost, including time, of NSLP versus different categories of home-packed lunches. Methods: Data from pre-kindergarten and kindergarten lunches from three schools in southwest Virginia were used for this study. Each lunch item was priced, and a direct cost was assigned based on the lunches contents. Time assessments were conducted to determine the amount of time to prepare each lunch, with a monetary value for time computed based on average salary of the respective county. A non-parametric Kruskal Wallis test was used to compare the direct cost, time, time cost, and the full cost of the meals. Medians were computed based on outlier data. Results: The lowest median direct cost was found for homemade packed lunches ($1.55), followed by homemade school lunches ($2.11), then convenience packed lunches ($2.12), and then NSLP lunches ($2.15). When incorporating preparation time, the NSLP lunch cost the least ($2.15), followed by convenience packed lunches ($2.56), then homemade packed lunches ($2.92), and then homemade school lunches ($11.32). Seventy-six percent (n=414) of home-packed lunches contained sugar-sweetened beverages and/or dessert food items, accounting for almost one-quarter (21.8%) of the cost of all home-packed lunches. Conclusion: When time is computed as part of the total cost of NSLP versus home-packed lunches, the NSLP is the least expensive option. In conjunction with the nutritional benefits of the NSLP, this time-cost data may help shift purchasing and consumption patterns. / Master of Science

Made available in DSpace on 2015-03-05T19:12:39Z (GMT). No. of bitstreams: 0 Previous issue date: 24 / Nenhuma / As instituições de ensino superior, principalmente as privadas, estão expostas ao reflexo de questões ambientais externas, ou seja, mercado competitivo e dinâmico, instabilidade econômica e social, política educacional governamental, entre outras, que podem causar impacto no desempenho econômico, ameaçando a sua continuidade. Nesse contexto o requisito informacional ganha maior relevância ainda. Diante de tal realidade, o presente trabalho tem como objetivo o desenvolvimento e a apresentação de um conjunto de relatórios gerenciais que auxiliem o controle dos resultados, por meio da adoção da contabilidade divisional, apoiando uma gestão econômica descentralizada, por unidades de negócios, no âmbito das IES. A pesquisa realizada caracterizou-se como exploratória, com um estudo de caso de uma universidade do estado do Rio Grande do Sul, da qual foram selecionadas duas unidades, para a elaboração dos relatórios propostos. Os dados foram coletados em documentos disponibilizados pela instituição, entrevistas com o / The higher education institutions (HEI), especially the private ones, are exposed to the reflection of external environmental matters, that is, competitive and dynamic market, economic and social instability, government educational politics, among others, that can cause impact on their economic performance, jeopardizing their continuity. In this context the informational requirement gets even more relevance. In light of such reality, the current paper aims the development and presentation of a set of managerial reports that aid the results control, by adopting a divisional accountancy, supporting a decentralized economic management, by business units, in the higher education institutions scope. The research carried out was exploratory, through case study in a university in Rio Grande do Sul, from which two units were selected, base for the development of the proposed reports. The data were gathered from documents provided by the institution, interviews with the academic managers, the controller and the high e

Research object – agricultural enterprises. Research subject – methodics of plant production cost calculation. Research aim – to analyze references and practical methods employed in plant produce cost calculation and to propose methodics improvements of plant production cost calculation. Objectives: 1) to analyze the essence of expenditure and production cost; 5) to examine the structure of production cost and to substantiate the expedience of expenditure calculation into cost; 6) to study methodics of plant production cost calculation in agricultural enterprises; 7) to submit proposals for improvement methodics of plant production cost calculation based on references study and research results. Research methods – logical and comparative analysis and synthesis of literature by Lithuanian and foreign authors, questionnaire questioning of agricultural enterprises, methods of logical and graphic modeling. After the study of produce cost essence, indices and their composition, calculation system and plant produce cost calculation methodology applied at agricultural enterprises, proposals were submitted for improvement methodics of plant production cost calculation.

Le but de cette étude est l’estimation du coût direct médical annuel de l’excès de poids corporel chez la population adulte qui a reçu une assistance médicale au sein de l'Institut Mexicain de la Sécurité Sociale (IMSS) pendant l'année 2006. Méthodes. Une analyse épidémiologique, au niveau national, a été effectuée à partir d’une population adulte mexicaine ayant demandé en 2006 une aide médicale à l'Institut Mexicain de la Sécurité Sociale. Nous avons utilisé la base de donnée informatique « DataMart-2006 » fournie par la DTISS (Division Technique d’Information Statistique en Santé) pour estimer la prévalence de l’excès de poids corporel : surpoids 25kgm2 ≤ IMC <30kgm2, obésité IMC ≥ 30 kgm2 et la fraction de la population attribuable (FAP) atteinte d'hypertension artérielle (HTA), de diabète mellites de type 2 (DM2) ou de dyslipidémie. On a utilisé l’analyse de régression logistique pour estimer les risques appelés odds ratio, également désignée comme rapport des chances. Le coût direct médical de l’hypertension artérielle et du diabète mellites de type 2 a été établi pour l’exercice de l’année 2002 et mis à jour pour l’année de l’étude, à savoir l’année 2006. Le coût direct médical annuel attribué à l’excès de poids corporel a été calculé en multipliant le coût de chaque maladie par la FAP [...] Conclusion. Il y a un pourcentage élevé des patients qui souffrent d’excès de poids corporel, et par conséquent la répartition de patients souffrant de cette maladie par catégorie de personnel de santé, pour s’occuper globalement de la prévention, du traitement et du contrôle, est aussi élevée. Alors, il est nécessaire, d’établir des stratégies afin de diminuer et contrôler ce problème de santé publique au Mexique. Ainsi donc, comme on vient de le voir, le pourcentage élevé de cette maladie affect directement les dépenses au sein de l’IMSS. Finalement les résultats confirment que le coût direct médical annuel par patient, qui souffre d’obésité au sein de l'Institut Mexicain de la Sécurité Sociale, est plus élevé que dans les autres pays. / The aim of this study is the assessment of the yearly direct medical cost due to excess body weight among the adult population who received medical assistance from the Mexican Institute of Social Security (IMSS) in 2006. Methods. An epidemiological analysis on a national scale has been carried out taking into account an adult population who asked the Mexican Institute of Social Security for medical assistance in 2006. We have used a database “DataMart-2006” provided by DTISS (Technical Division of Health Statistical Information) in order to assess the prevalence of excess body weight: excess weight 25kgm2 ≤ BMI (Body Mass Index) < 30kgm2, obesity BMI ≥ 30 kgm2 and the fraction of related population affected by arterial hypertension (HTA), type 2 diabetes mellitus (DM2) or dyslipidemia. We have used logical regression analysis to evaluate risks called odds ratio also dubbed occurrence ratio. The direct medical cost of arterial hypertension and type 2 diabetes mellitus was established for year 2002 and updated for the year of this study, namely 2006. The yearly medical cost ascribed to excess body weight has been calculated by multiplying the cost of each disease by the fraction of related population [...] Conclusion. There is a high percentage of patients suffering from excess body weight and as a result the distribution of patients suffering from this disorder per health personnel category dealing with prevention, treatment and control is also high. Then it is necessary to devise strategies so as to restrain and keep a check on this issue of public health in Mexico. Thus, as we have seen it, the high occurrences of this illness directly impact IMSS expenditures. Finally, for the Mexican Institute of Social Security, results confirm that the direct yearly medical cost per patient affected by obesity is higher compared to estimated yearly expenses in other countries.

This thesis report aims at illustrating and describing how e-procurement can contribute in creating value and reducing overheads associated with the procurement process through adopting and implementing e-procurement systems and applications in the supply chain network of an organization. It is an obvious fact that e-procurement plays a vital role in managing the supply chain especially now that outsourcing has become very common in the business market environment around the world. The main purpose of our bachelor thesis work is to find out how e-procurement can contribute in creating value, reducing cost and gaining more profit out of the procurement process. Since this thesis report is meant to cover the available literature on procurement and e-procurement only limited areas of the supply chain management is presented.When it comes to methodologies, available literatures on procurement and e-procurement have been covered to extract the most plausible information and data related how e-procurement contributes in creating value and reducing costs and overheads in the supply chain management. First a framework of modern procurement processes and stages is given as a basis and then e-procurement is treated being the technologies and key factors in implementation of e-procurement.This thesis work tries to consolidate prevalent ideas as well as facts that have been tested by means of academic researches carried out by scholars of the field and interdisciplinary of industrial engineering. / Program: BSc in Industrial Engineering - International Business Engineering

Introduction: More than half of all patients seeking care for chest pain do not have a cardiac cause for this pain. Despite recurrent episodes of chest pain, many patients are discharged without a clear explanation of the cause for their pain. A lack of explanation may result in a misinterpretation of the pain as being cardiac-related, causing worry and uncertainty, which in turn leads to substantial use of healthcare resources. Psychological distress has been associated with non-cardiac chest pain (NCCP), but there is limited research regarding the relationship between different psychological factors and their association with healthcare utilization. There is a need for interventions to support patients to manage their chest pain, decrease psychological distress, and reduce healthcare utilization and costs. Aim: The overall aim of this thesis was to improve care for patients with  non-cardiac chest pain by describing related psychological distress, healthcare utilization and societal costs, and by evaluating an Internet-delivered cognitive behavioural intervention. Designs and methods: This thesis presents results from four quantitative studies. Studies I and II had a longitudinal descriptive and comparative design. The studies used the same initial cohort. Patients were consecutively approached within 2 weeks from the day of discharge from a general hospital in southeast Sweden. In study I, 267 patients participated (131 with NCCP, 66 with acute myocardial infarction (AMI), and 70 with angina pectoris (AP)). Out of these, 199 patients (99 with NCCP, 51 with AMI, 49 with AP) participated in study II. Participants were predominantly male (about 60 %) with a mean age of 67 years. Data was collected on depressive symptoms (Study I), healthcare utilization (Study I, II), and societal costs (Study II). Study III had a cross-sectional explorative and descriptive design. Data was collected consecutively on depressive symptoms, cardiac anxiety and fear of body sensations in 552 patients discharged with diagnoses of NCCP (51 % women, mean age 64 years) from four hospitals in southeast Sweden. Patients were approached within one month from the day of discharge. Study IV was a pilot randomized controlled study including nine men and six women with a median age of 66 years, who were randomly assigned to an intervention (n=7) or control group (n=8). The intervention consisted of a four-session guided Internet-delivered cognitive behavioural therapy (CBT) program containing psychoeducation, exposure to physical activity, and relaxation. The control group received usual care. Data was collected on chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms. Results: Depressive symptoms were prevalent in 20 % (Study IV) and 25 % (Study I, III) of the patients, and more than half of the patients still experienced depressive symptoms one year later (Study I). There were no significant differences in prevalence and severity of depressive symptoms between patients diagnosed with NCCP, AMI or AP. Living alone and younger age were independently related to more depressive symptoms (Study I). Cardiac anxiety was reported by 42 % of the patients in study III and 67 % of the patients in study IV. Fear of body sensations was reported by 62 % of the patients in study III and 93 % of the patients in study IV. On average, patients with NCCP had 54 contacts with primary care or the outpatient clinic per patient during the two-year study period. This was comparable to the number of contacts among patients with AMI (50 contacts) and AP (65). Patients with NCCP had on average 2.6 hospital admissions during the two years, compared to 3.6 for patients with AMI and 3.9 for patients with AP (Study II). Four out of ten patients reported seeking healthcare at least twice during the last year due to chest pain (Study III). On average, 14 % of patients with NCCP were on sick-leave annually, compared to 18 % for patient with AMI and 25 % for patient with AP. About 11-12 % in each group received a disability pension. The mean annual societal costs for patients with NCCP, AMI and AP were €10,068, €15,989 and €14,737 (Study II). Depressive symptoms (Study I, III), cardiac anxiety (Study III) and fear of body sensations (Study III) were related to healthcare utilization. Cardiac anxiety was the only variable independently associated with healthcare utilization (Study III). In the intervention study (Study IV), almost all patients in both the intervention and control groups improved with regard to chest pain  frequency, cardiac anxiety, fear of body sensations, and depressive symptoms. There was no significant difference between the groups. The intervention was perceived as feasible and easy to manage, with comprehensible language, adequate and varied content, and  manageable homework assignments. Conclusions: Patients with NCCP experienced recurrent and persistent chest pain and psychological distress in terms of depressive symptoms, cardiac anxiety and fear of body sensations. The prevalence and severity of depressive symptoms in patients with NCCP did not differ from patients with AMI and patients with AP. NCCP was significantly associated with healthcare utilization and patients had similar amount of primary care and outpatient clinic contacts as patients with AMI. The estimated cumulative annual national societal cost for patients with NCCP was more than double that of patients with AMI and patients with AP, due to a larger number of patients with NCCP. Depressive symptoms, cardiac anxiety and fear of body sensations were related to increased healthcare utilization, but cardiac anxiety was the only variable independently associated with healthcare utilization. These findings imply that screening and treatment of psychological distress should be considered for implementation in the care of patients with NCCP. By reducing cardiac anxiety, patients may be better prepared to handle chest pain. A short guided Internet-delivered CBT program seems to be feasible. In the pilot study, patients improved with regard to chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms, but this did not differ from the patients in the control group who received usual care. Larger studies with longer follow-up are needed to evaluate both the short and long- term effects of this intervention.