The increasing prevalence of obesity in New Zealand: is it related to recent trends in smoking and physical activity?
Recent trends in smoking cessation explain only a small percentage of the increase in body mass while the trends in physical activity would have predicted a small decrease in the prevalence of obesity, contrary to the observed trends. By exclusion, an increase in total energy intake, is the most likely explanation for the observed trends.
The evidence is not yet strong enough to draw a general conclusion that management costs in NHS acute hospitals are too high or that an undiscriminating reduction in management costs would have no detrimental effects on hospital performance. However, the findings should prompt managers to identify ways in which their activities are productive and how these can be measured, and what distinguishes effective from ineffective management.