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Although treatment for the dialysis population is resource intensive, a cost-effectiveness analysis comparing hemodialysis (HD) and peritoneal dialysis (PD) by matched pairs is still lacking. After matching for clinical characteristics and propensity scores, we identified 4,285 pairs of incident HD and PD patients from a Taiwanese national cohort during 1998–2010. Survival and healthcare expenditure were calculated by data of 14-year follow-up and subsequently extrapolated to lifetime estimates under the assumption of constant excess hazard. We performed a cross-sectional EQ–5D survey on 179 matched pairs of prevalent HD and PD patients of varying dialysis vintages from 12 dialysis units. The product of survival probability and the mean utility value at each time point (dialysis vintage) were summed up throughout lifetime to obtain the quality-adjusted life expectancy (QALE). The results revealed the estimated life expectancy between HD and PD were nearly equal (19.11 versus 19.08 years). The QALE’s were also similar, whereas average lifetime healthcare costs were higher in HD than PD (237,795 versus 204,442 USD) and the cost-effectiveness ratios for PD and HD were 13,681 and 16,643 USD per quality-adjusted life year, respectively. In conclusion, PD is more cost-effective than HD, of which the major determinants were the costs for the dialysis modality and its associated complications.

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Background Obesity and the health problems associated with it have substantial economic consequences for health care systems. Little information is available concerning obesity-related problems among people with intellectual disabilities. The aims of this study were to analyse patterns of obesity among children and adolescents with intellectual disabilities in Taiwan and to compare these data with existing national norms in an attempt to identify the scale of the problem of obesity among this population. Methods Information was collected by postal questionnaire on a total of 279 children and adolescents with intellectual disabilities (age 4-18 years). Results Sixty-four per cent of participants in the study had multiple disabilities and 40% had additional health needs. In terms of general health status, most of the persons with intellectual disabilities were reported to be in fair or good health, with 9% of them being reported to be unhealthy or very unhealthy. Body mass index (BMI) was related to age, but not to gender, morbidity or prescribed medication at the time of the survey. However, average BMI was higher than relevant population norms reported in Taiwan's Third National Nutrition and Health Survey (1993-1996). The overall prevalence of obesity was 18%, with 14% of participants aged 4-6 years, 22% of participants aged 7-12 years and 16% of participants aged 13-18 years being obese. In a multiple regression analysis of BMI, age was the only significant predictor of obesity, accounting for 8% of variation. Conclusions The findings suggest that the problem of obesity among children and adolescents with intellectual disabilities should be considered a major public health concern that warrants further attention in health care systems.

Oxygen plays an important role in wound healing, as it is essential to biological functions such as cell proliferation, immune responses and collagen synthesis. Poor oxygenation is directly associated with the development of chronic ischemic wounds, which affect more than 6 million people each year in the United States alone at an estimated cost of $25 billion. Knowledge of oxygenation status is also important in the management of burns and skin grafts, as well as in a wide range of skin conditions. Despite the importance of the clinical determination of tissue oxygenation, there is a lack of rapid, user-friendly and quantitative diagnostic tools that allow for non-disruptive, continuous monitoring of oxygen content across large areas of skin and wounds to guide care and therapeutic decisions. In this work, we describe a sensitive, colorimetric, oxygen-sensing paint-on bandage for two-dimensional mapping of tissue oxygenation in skin, burns, and skin grafts. By embedding both an oxygen-sensing porphyrin-dendrimer phosphor and a reference dye in a liquid bandage matrix, we have created a liquid bandage that can be painted onto the skin surface and dries into a thin film that adheres tightly to the skin or wound topology. When captured by a camera-based imaging device, the oxygen-dependent phosphorescence emission of the bandage can be used to quantify and map both the pO2 and oxygen consumption of the underlying tissue. In this proof-of-principle study, we first demonstrate our system on a rat ischemic limb model to show its capabilities in sensing tissue ischemia. It is then tested on both ex vivo and in vivo porcine burn models to monitor the progression of burn injuries. Lastly, the bandage is applied to an in vivo porcine graft model for monitoring the integration of full- and partial-thickness skin grafts.