[Cost-Effectiveness of Pharmacological Smoking Cessation Therapies - A Systematic Literature Review]. / Kosteneffektivität von pharmakologischen Raucherentwöhnungsmaßnahmen ­ ein systematisches Literaturreview.

Aim of the Study: Through the promotion of smoking cessation premature mortality can be prevented. Therefore it is necessary to provide effective and cost-effective smoking cessation interventions. In Germany the cost of pharmacological smoking cessation measures are not yet reimbursed by the statutory health insurance. The aim of this study is to present the evidence on the cost-effectiveness of already approved pharmacological smoking cessation therapies and to evaluate their quality. Method: A systematic literature research was conducted in the databases by DIMDI (Medline, Embase, etc.) in April 2013 (update April 2014). The study research was focused on studies for cost effectiveness of nicotine replacement therapy (NRT), varenicline and bupropion. The assessment of study quality was performed using the "Quality of Health Economic Studies" (QHES) instrument. Results: 33 Of the original 10 340 identified studies were finally included. The majority of the studies show that an additional prescription of NRT or bupropion to a medical consultation is a cost-effective strategy. In addition, in most studies varenicline is a dominant strategy compared to bupropion. Overall, the study quality was found to be very heterogeneous between 45 and 80 points (Ø 63.7 points). Conclusion: The studies show that treatment with varenicline is the most cost effective strategy followed by bupropion and the NRT. However, the studies can only be compared inadequately due to different levels of age and country-specific intervention costs.

Relation between long-term trends of oxygen-18 isotope composition of precipitation and climate.

Stable isotope ratios of oxygen ((18)O/(16)O) and hydrogen (D/H) in water have long been considered powerful indicators of paleoclimate. However, quantitative interpretation of isotope variations in terms of climate changes is hampered by a limited understanding of physical processes controlling the global isotope behavior. Analysis was conducted of time series of (18)O content (delta (18)O) of monthly precipitation and surface air temperature available through the International Atomic Energy Agency-World Meteorological Organization global network, "Isotopes in Precipitation." This study indicates that long-term changes of isotopic composition of precipitation over mid-and high-latitude regions during the past three decades closely followed long-term changes of surface air temperature with the average 8180-temperature coefficient around 0.6 per mil per degree Celsius.

Isotope studies in the Caspian Sea.

Oceanographic and isotopic investigations in the Caspian Sea and the analyses of the available data on the discharge to the sea and the observed sea level changes suggest that climatically caused changes of river inflow are the major cause of the sea level fluctuations over the last century. Hydrogen-3 and 3H-3He data indicate that the deep basins of the sea are rapidly ventilated, although the hydraulic turnover time of the sea is approximately 200 years. The concentration levels of the anthropogenic radionuclides 90Sr, 137Cs and 239,240Pu in the water column can be explained by global fallout and therefore, at the sampling sites visited, there were no signs of dumping of radioactive wastes. The anthropogenic radionuclide data support the idea of fast exchange of water masses in the Caspian Sea. The isotopic and oceanographic data collected during the cruises have shown potential to allow for a better understanding of the water circulation in the Caspian Sea.

The use of a custom mode electron capture detector to determine mixing ratios of environmental tracers: Sulfur hexafluoride, chlorotrifluoromethane and bromotrifluoromethane.

Atmospheric concentrations of anthropogenic trace gases, such as sulfur hexafluoride, SF6, chlorotrifluoromethane, CF3Cl, and bromotrifluoromethane, CF3Br, are increasing. Their long lifetimes and limited chemical reactivity make them attractive environmental tracers for hydrology and oceanography. While ambient SF6 concentrations can be readily measured using GC-ECD, the simultaneous analysis of CF3Cl and CF3Br is hampered due to their low ECD sensitivity. The response of a commercial ECD for those gases was enhanced using the resonance detection mode which is based on shifting the mean energy of electrons in the ECD detector towards the region where the electron-capture reaction reveals a distinct maximum. A custom electronic system enabled operation of a commercial ECD in the resonance detection mode. An approximately 50-fold amplification of the ECD signal was obtained for CF3Cl by application of high-frequency electric field (amplitude of 50V and frequency of 40MHz). For CF3Br, a 3.5-fold increase of the ECD signal was obtained, with a lower HF field (20-30V). In the case of SF6 the application of the HF field reduces the magnitude of ECD signal by a factor of 40. The electron-capture coefficients for SF6, CF3Cl and CF3Br were determined from 453 to 633K in the standard and the resonance modes. The electron-capture coefficients for CF3Cl and CF3Br increase with increasing temperature for both modes, while that for SF6 decreases slightly with increasing temperature. The application of the resonance detection mode to a commercial ECD provides an attractive and cost-effective alternative to GCMS for high-quality quantitative analyses of CF3Cl and CF3Br as environmental tracers.