RESUMEN
OBJECTIVE: Government alcohol sales data were used to investigate associations between estimates of per capita age 15+ alcohol consumption, policy restrictiveness, and area-level deprivation. METHOD: We analyzed weekly consumption data (expressed as per capita age 15+ Canadian standard drinks [13.45 g of pure ethanol]) collected from all 89 local health areas in British Columbia, Canada, between April 2017 and April 2021. Our analyses were stratified by outlet type (total, on-premise, and off-premise). Our intervention was alcohol policy restrictiveness (operationalized by the Restrictiveness of Alcohol Policy Index), and our moderator was area-level deprivation (Canadian Index of Multiple Deprivation). The Restrictiveness of Alcohol Policy Index included hours of trading, the number of people permitted on site for on-premise venues, the proportion of outlets in operation, and the extent of permissible home delivery. RESULTS: Higher policy restrictiveness was associated with decreased consumption across all outlet types (ps < .001): when the most restrictive policies were implemented, consumption was reduced by 9% and 100% in off- and on-premise outlets, respectively. Area-based deprivation level modified the effect of policy restriction on per capita alcohol consumption (ps < .007): for total and off-premise consumption, the decrease was greatest among more economically deprived areas (ps < .001); for on-premise outlets, areas with a high proportion of racial and ethnic minorities increased their consumption (ps < .001). CONCLUSIONS: Alcohol-specific policy restrictions implemented in response to the COVID-19 pandemic were associated with reduced consumption. However, the magnitude and direction of change was moderated by area-based deprivation level, albeit inconsistently across various deprivation measures.
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Consumo de Bebidas Alcohólicas , COVID-19 , Comercio , Etanol , Política de Salud , Cuarentena , COVID-19/epidemiología , Etanol/economía , Consumo de Bebidas Alcohólicas/economía , Consumo de Bebidas Alcohólicas/epidemiología , Colombia Británica/epidemiología , Comercio/estadística & datos numéricos , Humanos , Adolescente , Adulto Joven , Adulto , Cuarentena/legislación & jurisprudencia , Política de Salud/legislación & jurisprudencia , Persona de Mediana EdadRESUMEN
Bioethanol produced from 2nd generation biomass comprising of agricultural residues and forest wastes is a viable alternate fuel. Besides fermentation and biomass gasification to syngas and its further conversion to ethanol, a direct chemocatalytic conversion of lignocellulosic biomass into ethanol is being investigated as a viable route which avoids the emission of greenhouse gases. In this work, a detailed configuration of chemocatalytic route is simulated and optimized for minimizing the cost of ethanol production. The economic feasibility of ethanol production through the chemocatalytic pathway is analyzed. The techno-economic analysis is conducted in terms of ethanol selectivity and ethanol production cost. The obtained results show that biomass feedstock and catalyst have major contributions to the production cost. The proposed route is found to be giving a lower ethanol selling price as compared to the well-researched routes of biomass fermentation to ethanol and biomass gasification followed by syngas conversion to ethanol.
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Biocombustibles/economía , Biomasa , Biotecnología , Etanol , Lignina , Biotecnología/economía , Biotecnología/métodos , Catálisis , Etanol/economía , Etanol/metabolismo , Lignina/economía , Lignina/metabolismoRESUMEN
The objective of this study was to estimate, from an obesity prevention perspective, the cost-effectiveness of two potential policies that increase the price of alcohol in Australia: a volumetric tax applied to all alcohol (Intervention 1) and a minimum unit floor price (Intervention 2). Estimated changes in alcoholic drink consumption and corresponding changes in energy intake were calculated using the 2011-12 Australian Health Survey data, published price elasticities, and nutrition information. The incremental changes in body mass index (BMI), BMI-related disease outcomes, healthcare costs, and Health Adjusted Life Years (HALYs) were estimated using a validated model. Costs associated with each intervention were estimated for government and industry. Both interventions were estimated to lead to reductions in mean alcohol consumption (Intervention 1: 20.7% (95% Uncertainty Interval (UI): 20.2% to 21.1%); Intervention 2: 9.2% (95% UI: 8.9% to 9.6%); reductions in mean population body weight (Intervention 1: 0.9 kg (95% UI: 0.84 to 0.96); Intervention 2: 0.45 kg (95% UI: 0.42 to 0.48)); HALYs gained (Intervention 1: 566,648 (95% UI: 497,431 to 647,262); Intervention 2: 317,653 (95% UI: 276,334 to 361,573)); and healthcare cost savings (Intervention 1: $5.8 billion (B) (95% UI: $5.1B to $6.6B); Intervention 2: $3.3B (95% UI: $2.9B to $3.7B)). Intervention costs were estimated as $24M for Intervention 1 and $30M for Intervention 2. Both interventions were dominant, resulting in health gains and cost savings. Increasing the price of alcohol is likely to be cost-effective from an obesity prevention perspective in the Australian context, provided consumers substitute alcoholic beverages with low or no kilojoule alternatives.
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Comercio/economía , Análisis Costo-Beneficio , Etanol/economía , Obesidad/economía , Obesidad/prevención & control , Impuestos/economía , Anciano , Consumo de Bebidas Alcohólicas/epidemiología , Australia/epidemiología , Índice de Masa Corporal , Peso Corporal , Humanos , Densidad de Población , Bebidas Azucaradas/economíaRESUMEN
Importance: Alcohol-based surgical scrub is recommended for presurgical antisepsis by leading health organizations. Despite this recommendation, water-based scrub techniques remain common practice at many institutions. Objective: To calculate the potential financial savings that a large, subspecialty ophthalmic surgical center can achieve with a conversion to waterless surgical hand preparation. Design, Setting, and Participants: A review of accounting records associated with the purchase of scrubbing materials and water company invoices was conducted to assess direct costs attributable to water consumption and scrub materials for brushless, alcohol-based surgical scrub and water-based presurgical scrub. The flow rate of scrub sinks to estimate water consumption per year was tested. Savings associated with operating room (OR) and personnel time were calculated based on the prescribed scrub times for waterless techniques vs traditional running-water techniques. The study was conducted from January 5 to March 1, 2019. Main Outcomes and Measures: The primary outcomes for this study were the quantity of water consumed by aqueous scrubbing procedures as well as the cost differences between alcohol-based surgical scrub and water-based scrub procedures per OR per year. Results: Scrub sinks consumed 15.9 L of water in a 2-minute period, projecting a savings of 61â¯631 L and $277 in water and sewer cost per operating room per year. Alcohol-based surgical scrub cost $1083 less than aqueous soap applied from wall-mounted soap dispensers and $271 less than preimpregnated scrub brushes per OR per year in supply costs. The decrease in scrub time from adopting waterless scrub technique could save between approximately $280â¯000 and $348â¯000 per OR per year. Conclusions and Relevance: Adopting waterless scrub techniques has the potential for economic savings attributable to water. Savings may be larger for surgical facilities performing more personnel-intensive procedures.
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Antiinfecciosos Locales/administración & dosificación , Antisepsia/métodos , Clorhexidina/análogos & derivados , Etanol/administración & dosificación , Desinfección de las Manos/economía , Desinfección de las Manos/métodos , Procedimientos Quirúrgicos Oftalmológicos , Agua , Antiinfecciosos Locales/economía , Clorhexidina/administración & dosificación , Clorhexidina/economía , Desinfectantes , Etanol/economía , Femenino , Humanos , Masculino , Quirófanos , Procedimientos Quirúrgicos Oftalmológicos/economía , Cuidados PreoperatoriosRESUMEN
Most epidemiological research on alcohol as a risk factor is based on the assumption that outcomes are linked to pattern and level of alcohol exposure, where different beverages are converted into grams of ethanol. This review examines this basic assumption, that alcohol has the same impact, independent of beverage type. We conducted a systematic search on comparative research of beverage-specific alcohol exposure and consequences. Research was divided by methodology (survey, case-control, cohort, time-series analyses, interventional research). Overall, many studies showed higher risks for spirits compared to beer or wine; however, most research was not controlled adequately for confounders such as patterns of drinking. While there is no conclusive evidence for spirits being associated with more harm, given the same pattern and level of alcohol exposure, some evidence supports for certain outcomes such as injuries and poisonings, a potential excess risk with spirits consumption due to rapid ethanol intake and intoxication. Accordingly, encouraging people to opt for beverages with lower alcohol content via taxation strategies has the potential to reduce alcohol-attributable harm. This does not necessarily involve switching beverage type, but also can achieved within the same beverage category, by shifting from higher to lower concentration beverages.
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Consumo de Bebidas Alcohólicas/efectos adversos , Trastornos Relacionados con Alcohol/epidemiología , Bebidas Alcohólicas/efectos adversos , Etanol/efectos adversos , Formulación de Políticas , Salud Pública , Consumo de Bebidas Alcohólicas/economía , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/prevención & control , Trastornos Relacionados con Alcohol/economía , Trastornos Relacionados con Alcohol/prevención & control , Bebidas Alcohólicas/economía , Bebidas Alcohólicas/legislación & jurisprudencia , Animales , Cerveza/efectos adversos , Etanol/economía , Humanos , Salud Pública/economía , Salud Pública/legislación & jurisprudencia , Medición de Riesgo , Factores de Riesgo , Impuestos , Vino/efectos adversosRESUMEN
Lignocellulosic biomass (LCB) is globally available and sustainable feedstock containing sugar-rich platform that can be converted to biofuels and specialty products through appropriate processing. This review focuses on the efforts required for the development of sustainable and economically viable lignocellulosic biorefinery to produce carbon neutral biofuels along with the specialty chemicals. Sustainable biomass processing is a global challenge that requires the fulfillment of fundamental demands concerning economic efficiency, environmental compatibility, and social responsibility. The key technical challenges in continuous biomass supply and the biological routes for its saccharification with high yields of sugar sources have not been addressed in research programs dealing with biomass processing. Though many R&D endeavors have directed towards biomass valorization over several decades, the integrated production of biofuels and chemicals still needs optimization from both technical and economical perspectives. None of the current pretreatment methods has advantages over others since their outcomes depend on the type of feedstock, downstream process configuration, and many other factors. Consolidated bio-processing (CBP) involves the use of single or consortium of microbes to deconstruct biomass without pretreatment. The use of new genetic engineering tools for natively cellulolytic microbes would make the CBP process low cost and ecologically friendly. Issues arising with chemical characteristics and rigidity of the biomass structure can be a setback for its viability for biofuel conversion. Integration of functional genomics and system biology with synthetic biology and metabolic engineering undoubtedly led to generation of efficient microbial systems, albeit with limited commercial potential. These efficient microbial systems with new metabolic routes can be exploited for production of commodity chemicals from all the three components of biomass. This paper provides an overview of the challenges that are faced by the processes converting LCB to commodity chemicals with special reference to biofuels.
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Biocombustibles , Biomasa , Lignina/metabolismo , Biodegradación Ambiental , Biocombustibles/economía , Biocombustibles/microbiología , Etanol/economía , Etanol/metabolismo , Fermentación , Lignina/química , Lignina/economía , Lignina/provisión & distribución , Ingeniería Metabólica , Azúcares/metabolismo , Biología SintéticaAsunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Medicamentos Falsificados/envenenamiento , Medicamentos Falsificados/toxicidad , Etanol/efectos adversos , Etanol/economía , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Irán , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
An integrated process for bioethanol production from Miscanthus sacchariflorus was used to construct a bench-scale plant constructed and an economic analysis was carried out to investigate the feasibility of its application to a commercial plant. The bench-scale plant was operated for 1 month and an economic analysis and sensitivity analysis was performed on the data acquired. In this study, 100,000 kL of bioethanol could be produced annually from 606,061 tons of M. sacchariflorus and the production cost was calculated to be US$1.76/L. However, the by-products of this process such as xylose molasses and lignin can be sold or used as a heat source, which can decrease the ethanol production costs. Therefore, the final ethanol production cost was calculated to be US$1.31/L, and is considerably influenced by the enzyme cost. The results and data obtained should contribute to the development of a commercial-scale lignocellulosic bioethanol plant.
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Biocombustibles/economía , Biomasa , Etanol/metabolismo , Lignina/metabolismo , Poaceae/metabolismo , Reactores Biológicos , Etanol/economíaRESUMEN
Commercial cellulosic ethanol plants require mature and year-round biomass feedstock supply. Decentralizing pretreatment operation from central ethanol plant into local regional biomass collection depots provides an important solution to reach this goal. In this study, we introduced a newly established pretreatment technology, dry acid pretreatment, into the decentralized pretreatment operation by its advantages on zero wastewater generation and high volumetric density. Collection radius of crop residues feedstock is extended to nearly 100â¯km by decentralizing dry acid pretreatment, and biorefinery scale for cellulosic ethanol production is increased to the scale of modern petroleum refining factories in the densified agricultural regions in China and USA with the minimum ethanol selling price of below $2/gal. The technology overcomes the barrier of cellulosic ethanol cost increase with increasing biomass collection range, and provides a methodology for optimal supply method of large biorefinery plants in agricultural countries.
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Biomasa , Etanol/química , Ácidos/química , Costos y Análisis de Costo , Etanol/economíaRESUMEN
Previously, a predictive model was developed to identify optimal blends of expensive high-quality and cheaper low-quality feedstocks for a given geographical location that can deliver high sugar yields. In this study, the optimal process conditions were tested for application at commercially-relevant higher biomass loadings. We observed lower sugar yields but 100% conversion to ethanol from a blend that contained only 20% high-quality feedstock. The impact of applying this predictive model simultaneously with least cost formulation model for a biorefinery location outside of the US Corn Belt in Lee County, Florida was investigated. A blend ratio of 0.30 EC, 0.45 SG, and 0.25 CS in Lee County was necessary to produce sugars at high yields and ethanol at a capacity of 50 MMGY. This work demonstrates utility in applying predictive model and LCF to reduce feedstock costs and supply chain risks while optimizing for product yields.
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Zea mays , Biomasa , Metabolismo de los Hidratos de Carbono , Carbohidratos , Costos y Análisis de Costo , Etanol/economía , Etanol/metabolismo , Fermentación , FloridaRESUMEN
Abstract The development of new technologies which increase the production of biofuel without directly compete with food production is required. Microalgal biomass has recently been in the highlight. The role of this biomass is here discussed within the concept of biorefinery and industrial sustainability of bioethanol production. The process of cultivation in order to accumulate around 50% of carbohydrates in the biomass (dry weight) and the importance of water and nutrient recycling are reviewed. Saccharification of biomass using enzymes or acids and alternative processes such as hydrothermal liquefaction and flash hydrolysis are addressed. Since the main monosaccharide in microalgal biomass is glucose, high rates of hydrolysis and fermentation were, generally, achieved (more than 80% of the efficiency as a sum of these two processes). Anaerobic digestion to treat vinasse and the recycling of CO2 from the ethanolic fermentation and biogas could increase the process sustainability. Alternative techniques for the concentration of bioethanol from fermentation broth and for the optimization of fuel transportation are mentioned. Finally, the advantage of using microalgae rather than other sources is estimated with reference to the production rate, even though the cultivation costs are still high.
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Biomasa , Etanol/economía , Microalgas , Reciclaje/métodos , HidrólisisRESUMEN
About 20% of spirits consumed in China are "unrecorded", where these spirits are produced in small-scale distilleries and sold outside the systems of taxation and quality control. Researchers visited small distilleries in rural Yunnan, Hubei and Anhui and purchased 56 samples of unrecorded bai jiu. Seven samples of the recorded bai jiu were purchased as reference samples. An independent laboratory conducted a blind analysis of the samples. Results were compared to the standards for unrecorded alcohol adopted by the European Commission's Alcohol Measures for Public Health Research Alliance (AMPHORA). No samples exceeded the AMPHORA guidelines for methanol, ethyl acetate, lead and cadmium; one sample exceeded 1000 g/hL of combined higher alcohols; one sample exceeded 100 mg/L of arsenic; and three samples exceeded 50g/hL of acetaldehyde, but only by relatively small amounts. Low-priced unrecorded bai jiu averaged 9.8 RMB/jin (500 mL), compared to 10.7 RMB/jin for inexpensive recorded bai jiu. The low-priced unrecorded bai jiu samples had a mean alcohol-by-volume of 51.8%, compared to 50.1% for the recorded bai jiu samples. The results did not raise any critical safety issues with unrecorded bai jiu, but there may be long-term health risks related to ethanol, acetaldehyde and arsenic. The social ties between the bai jiu makers and the people who consume their product are a deterrent to adulteration; but when bai jiu is sold outside of the social circle, the deterrent disappears.
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Destilación/métodos , Etanol/análisis , China , Etanol/química , Etanol/economíaRESUMEN
OBJECTIVE: To perform a cost-effectiveness analysis of skin antiseptic solutions (chlorhexidine-alcohol (CHG) versus povidone iodine-alcohol solution (PVI)) for the prevention of intravascular-catheter-related bloodstream infections (CRBSI) in intensive care unit (ICU) in France based on an open-label, multicentre, randomised, controlled trial (CLEAN). DESIGN: A 100-day time semi-markovian model was performed to be fitted to longitudinal individual patient data from CLEAN database. This model includes eight health states and probabilistic sensitivity analyses on cost and effectiveness were performed. Costs of intensive care unit stay are based on a French multicentre study and the cost-effectiveness criterion is the cost per patient with catheter-related bloodstream infection avoided. PATIENTS: 2,349 patients (age≥18 years) were analyzed to compare the 1-time CHG group (CHG-T1, 588 patients), the 4-time CHG group (CHG-T4, 580 patients), the 1-time PVI group (PVI-T1, 587 patients), and the 4-time PVI group (PVI-T4, 594 patients). INTERVENTION: 2% chlorhexidine-70% isopropyl alcohol (chlorhexidine-alcohol) compared to 5% povidone iodine-69% ethanol (povidone iodine-alcohol). RESULTS: The mean cost per alive, discharged or dead patient was of 23,798 (95% confidence interval: 20,584; 34,331), 21,822 (18,635; 29,701), 24,874 (21,011; 31,678), and 24,201 (20,507; 29,136) for CHG-T1, CHG-T4, PVI-T1, and PVI-T4, respectively. The mean number of patients with CRBSI per 1000 patients was of 3.49 (0.42; 12.57), 6.82 (1.86; 17.38), 26.04 (14.64; 42.58), and 23.05 (12.32; 39.09) for CHG-T1, CHG-T4, PVI-T1, and PVI-T4, respectively. In comparison to the 1-time PVI solution, the 1-time CHG solution avoids 22.55 CRBSI /1,000 patients, and saves 1,076 per patient. This saving is not statistically significant at a 0.05 level because of the overlap of 95% confidence intervals for mean costs per patient in each group. Conversely, the difference in effectiveness between the CHG-T1 solution and the PVI-T1 solution is statistically significant. CONCLUSIONS: The CHG-T1 solution is more effective at the same cost than the PVI-T1 solution. CHG-T1, CHG-T4 and PVI-T4 solutions are statistically comparable for cost and effectiveness. This study is based on the data from the RCT from 11 French intensive care units registered with www.clinicaltrials.gov (NCT01629550).
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Alcoholes/uso terapéutico , Bacteriemia/prevención & control , Infecciones Relacionadas con Catéteres/prevención & control , Clorhexidina/uso terapéutico , Análisis Costo-Beneficio/métodos , Fungemia/prevención & control , Povidona Yodada/uso terapéutico , 2-Propanol/economía , 2-Propanol/uso terapéutico , Alcoholes/economía , Bacteriemia/economía , Infecciones Relacionadas con Catéteres/economía , Clorhexidina/economía , Etanol/economía , Etanol/uso terapéutico , Femenino , Francia , Fungemia/economía , Humanos , Unidades de Cuidados Intensivos , Tiempo de Internación/economía , Masculino , Modelos Económicos , Povidona Yodada/economía , Resultado del TratamientoRESUMEN
BACKGROUND: Recent reviews of associations of alcohol availability with alcohol outcomes suggest findings are highly inconsistent and highlight a lack of longitudinal and causal evidence. Effect modification (moderation or statistical interaction), which could contribute to the inconsistent picture in the existing literature, has not been systematically assessed. We examined associations of alcohol availability with onset and recurrence of alcohol use disorder (AUD) using multilevel, longitudinal population data from Sweden and tested hypothesized effect modifiers to identify groups for whom increased alcohol availability may be particularly risky. We also employed cosibling models to assess potential causality for AUD onset by accounting for genetic and shared-environment confounders. METHODS: Data come from all individuals born in Sweden between 1950 and 1975 who were registered in a residential neighborhood at the end of 2005 (N = 2,633,922). We used Cox proportional hazards models to investigate time to AUD onset and logistic regression to assess the odds of AUD recurrence over an 8-year period. RESULTS: Living in a neighborhood with at least 1 alcohol outlet of any type was associated with a small increase in the likelihood of developing AUD, with an adjusted hazard ratio (HR) of 1.16 (95% CI: 1.13 to 1.19). Among people with a prior AUD registration, alcohol availability was not significantly associated with recurrence of AUD, with an adjusted odds ratio of 1.02 (95% CI: 1.00 to 1.05). Associations of alcohol availability with AUD onset varied according to sex, age, education, neighborhood deprivation, and urbanicity. HRs from the sibling models were similar to those in the general population models, with an adjusted HR = 1.19 (95% CI: 1.15 to 1.24). CONCLUSIONS: Effects varied among neighborhood residents, but greater alcohol availability was a risk factor for AUD onset (but not relapse) in all groups examined except women. Cosibling models suggest there may be a causal relationship of greater alcohol availability with adult-onset AUD.
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Trastornos Relacionados con Alcohol/epidemiología , Etanol/provisión & distribución , Hermanos , Adulto , Factores de Edad , Edad de Inicio , Etanol/economía , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Recurrencia , Sistema de Registros , Factores de Riesgo , Factores Sexuales , Hermanos/psicología , Suecia/epidemiologíaRESUMEN
Behavioral economic measures of alcohol reward value and future orientation have received support as predictors of alcohol consumption, alcohol-related problems, and response to intervention. Protective behavioral strategies (PBS) have been shown to be a significant mediator between a variety of risk factors and alcohol-related problems. The current article examines direct and mediating associations between measures of alcohol reward value (proportionate substance-related activity participation and enjoyment) and future orientation, use of PBS, and alcohol-related problems. Participants were 393 undergraduates (39.2% male, 78.9% Caucasian) who reported at least 2 past-month binge drinking episodes (5 and 4 drinks for men and women, respectively). This study is a secondary analysis of data collected previously as part of a brief intervention study. Alcohol reward value and future orientation were significantly associated with both protective behavioral strategies and alcohol problems. PBS was a significant partial mediator between these variables and alcohol-related problems after controlling for gender, level of alcohol consumption, and sensation seeking. This study provides support for the hypothesis that high levels of reinforcement from alcohol relative to alternatives and low consideration of the future may lead to patterns of dysregulated drinking with few harm-reduction strategies that increase risk for alcohol problems. In addition to directly targeting PBS, brief alcohol interventions for college students should attempt to increase future orientation and substance-free activities. (PsycINFO Database Record
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Consumo de Alcohol en la Universidad/psicología , Trastornos Relacionados con Alcohol/psicología , Etanol/farmacología , Factores Protectores , Recompensa , Adolescente , Trastornos Relacionados con Alcohol/economía , Etanol/economía , Femenino , Humanos , Masculino , Factores de Riesgo , Adulto JovenRESUMEN
OBJECTIVES: We compared the efficacy, safety, and cost-effectiveness of ultrasound-guided percutaneous polidocanol injection and percutaneous ethanol injection for the treatment of benign cystic and predominantly cystic thyroid nodules. METHODS: A total of 135 cystic thyroid nodules treated by percutaneous ethanol injection and 136 cystic thyroid nodules treated by percutaneous polidocanol injection were enrolled retrospectively in this study from May 2010 to March 2016. The nodules were followed after 1, 3, 6, and 12 months. Nodule volumes, symptoms scores, and cosmetic scores were assessed before treatment and at follow-up. The therapeutic success rate, safety, and cost-effectiveness between the groups were also compared. RESULTS: No significant differences in the reduction of the nodule volume, volume reduction rate, and therapeutic success were observed between the groups with cystic and predominantly cystic thyroid nodules during follow-up (P > .05). Neither the cosmetic scores (P = .59; P = .42) nor the symptom scores (P = .32; P = .73) in the cystic and predominantly cystic nodules were significantly different between the groups at the last follow-up. The complication rates for ethanol were higher than those for polidocanol (P < .05). However, the cost of polidocanol injection was higher than that of ethanol injection for cystic thyroid nodules (mean ± SD, US$97.18 ± US$22.17 versus US$43.36 ± US$5.51; P < .01). CONCLUSIONS: Ultrasound-guided percutaneous polidocanol injection can be an alternative for sclerotherapy of cystic or predominantly cystic thyroid nodules. However, its cost was higher than that of percutaneous ethanol injection.
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Etanol/uso terapéutico , Polietilenglicoles/uso terapéutico , Soluciones Esclerosantes/uso terapéutico , Escleroterapia/métodos , Nódulo Tiroideo/diagnóstico por imagen , Nódulo Tiroideo/terapia , Ultrasonografía Intervencional/métodos , Adolescente , Adulto , Anciano , Análisis Costo-Beneficio , Etanol/administración & dosificación , Etanol/economía , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intralesiones , Masculino , Persona de Mediana Edad , Polidocanol , Polietilenglicoles/administración & dosificación , Polietilenglicoles/economía , Estudios Retrospectivos , Soluciones Esclerosantes/administración & dosificación , Soluciones Esclerosantes/economía , Escleroterapia/economía , Glándula Tiroides/diagnóstico por imagen , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: The effectiveness of alcohol taxes in reducing excessive alcohol consumption and related problems is well established in research, yet increases in U.S. state alcohol taxes are uncommon. This study examined how alcohol tax increases occurred recently in three U.S. states, what public health's role was, and what can be learned from those experiences. METHOD: Review of available documentation and news media content analysis provided context and, along with snowball sampling, helped identify proponents, opponents, and neutral parties in each state. Thirty-five semi-structured key informant interviews (lasting approximately 1 hour) were conducted, transcribed, and analyzed for common themes. RESULTS: State routes to alcohol tax increases varied, as did the role of public health research. Use of polling data, leveraging existing political champions, coalition building, drawing on past experience with legislative initiatives, deciding revenue allocation strategically, and generating media coverage were universal elements of these initiatives. Tax changes occurred when key policy makers sought new revenue sources or when proponents were able to build coalitions broader than the substance abuse field. CONCLUSIONS: Translation of scientific evidence on the effectiveness of increasing alcohol taxes into public health interventions may occur if legislative leaders seek new revenue sources or if broad-based coalitions can generate support and sustained media coverage. Policy makers are generally unaware of the health impact of alcohol taxes, although public health research may play a valuable role in framing and informing discussions of state alcohol tax increases as a strategy for reducing excessive alcohol use and alcohol-related harms.
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Bebidas Alcohólicas/economía , Etanol/economía , Impuestos/economía , Humanos , Illinois , Maryland , Massachusetts , Salud PúblicaRESUMEN
Young adulthood represents a time of myriad transitions, which leave young adults (YAs) more susceptible to the influences of cancer risk-promoting information. The tobacco, alcohol, indoor tanning, and food and beverage industries engage in aggressive marketing strategies through both traditional and social media to target this age group to consume their products, which have known links to cancer. Despite this barrage of messaging, detailed data are lacking on the communication behaviors of subgroups of this diverse age group, particularly those from low SES. This paper explores the available data on media usage among YAs and describes the cancer risk-promoting information environment, with a focus on communication inequalities and their implications for cancer research and control. Nationally representative data on media consumption patterns indicate that the majority of YAs access a diverse range of traditional and social media platforms, but these data do not fully describe differences at the intersection of age and important factors such as SES, gender, race/ethnicity, or urban/rural residence. Meanwhile, risk-promoting information is heavily marketed to YAs across media, with an increasing focus on using social media sites to normalize products and evade marketing restrictions. Gaps in the available data on YAs' media consumption behaviors, coupled with aggressive risk-promoting marketing strategies toward YAs, may impede cancer control efforts. Relationships between exposure to various cancer risk-promoting information, concurrent risk behaviors, SES disparities, and communication inequalities should be investigated to develop innovative and effective control programs and policies to promote cancer control in this important group.
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Medios de Comunicación/estadística & datos numéricos , Conductas de Riesgo para la Salud , Neoplasias/prevención & control , Medios de Comunicación Sociales/estadística & datos numéricos , Uso de Tabaco/efectos adversos , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/economía , Consumo de Bebidas Alcohólicas/psicología , Comunicación , Etanol/efectos adversos , Etanol/economía , Conducta Alimentaria/psicología , Femenino , Humanos , Masculino , Mercadotecnía/tendencias , Neoplasias/epidemiología , Neoplasias/etiología , Factores de Riesgo , Factores Sexuales , Clase Social , Factores Socioeconómicos , Baño de Sol/psicología , Baño de Sol/estadística & datos numéricos , Encuestas y Cuestionarios , Productos de Tabaco/efectos adversos , Productos de Tabaco/economía , Uso de Tabaco/economía , Uso de Tabaco/psicología , Adulto JovenRESUMEN
This study is to assess the effects of the 2008 economic crisis and a 2009 alcohol tax reduction on alcohol-related morbidity for men of different socioeconomic statuses in Taiwan. Admissions data for the period from 2007 to 2012 for men aged 24-59 years in 2007 was retrieved from the National Health Insurance Research Database. With stratification over three income levels, an interrupted time-series analysis examining the effects of the crisis and taxation reduction on incidence rates of hospitalization for alcohol-attributed diseases (AADs) was employed. The low income group showed a significant (p < 0.05) change in the rate of AAD-related hospitalizations in July 2008; specifically, an abrupt 7.11% increase that was then sustained for several months thereafter. In contrast, while the middle income group exhibited a significant 22.9% decline in the rate of AAD-related hospitalizations over the course of the crisis, that downward trend was gradual. The reduction of the alcohol tax resulted in increased rates of AADs among both the low and high income groups. The economic recession and the reduction of the alcohol tax resulted in an increased rate of AAD among low income men.