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1.
Nicotine Tob Res ; 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38747187

RESUMO

INTRODUCTION: High prevalence of commercial tobacco product (CTP) use among American Indian and Alaska Native (AI/AN) youth is a public health crisis. A multi-level Tribal-community-based participatory research project under Tribal public health authority implemented a retailer-focused intervention to reduce AI/AN youth CTP use. METHODS: We sought resolutions in support of a retailer-focused CTP intervention from Tribal Nations organized by a tribally-directed research program. We identified tobacco retail outlets operating on and within 5 miles of 9 Tribal reservations, and CTP products sold at these outlets. We conducted a four-wave Reward and Reminder intervention with apparent minor buyers. Clerks who complied with the law received a modest reward and commendation in social media posts to the local Tribal communities, while clerks who sold without age verification were reminded of the laws. RESULTS: Of 18 retail outlets selling CTP, 8 sold e-cigarettes, and all sold combustible cigarettes. The Reward and Reminder intervention showed an approximate 25% reduction in sales of CTP to apparent minors, with a 33% baseline CTP sales rate without age verification and an 8% intervention CTP sales rate without age verification. CONCLUSIONS: The intervention increased awareness of laws prohibiting CTP sales to minors and mandating age verification for young adults seeking to buy CTP. The intervention, which had support from all governing Tribal Nations, builds the evidence base of effective practices which Tribal public health authorities may utilize to reduce youth access to CTP on and around Tribal reservations. IMPLICATIONS: Sovereign Tribes have authority over commercial businesses operating on their lands. Tobacco 21 laws aiming to restrict commercial tobacco availability to youth are supported by Tribes. A retailer intervention in which apparent minors attempt commercial tobacco purchases can offer accountability feedback to retailers both on and near Tribal reservations. Obtaining Tribal support and publicizing the interventions helps mobilize Tribal communities to support commercial tobacco prevention and promote healthy youth.

2.
Alcohol Alcohol ; 59(3)2024 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-38632828

RESUMO

AIMS: Sweeping policy changes during the COVID-19 pandemic increased alcohol availability through permitted to-go sales, potentially posing unique risks to college students. While to-go sales may make binge drinking more convenient, little remains known about these practices. Therefore, this study aimed to assess whether drinking establishments' to-go sales practices are associated with their other operational practices and state policy. METHOD: This cross-sectional analysis included 221 randomly selected bars, nightclubs, and restaurants within two miles of a large public university. Telephone interviews assessed establishment practices, and the Alcohol Policy Information System provided state alcohol to-go laws. Regression models tested whether establishment to-go sales practices were associated with their business practices (logistic regression) and state policy (generalized estimating equations). RESULTS: Nearly one-half (44.8%) of drinking establishments sold alcohol to-go. Establishments with higher vodka prices had nearly 30% higher odds of selling spirits to-go (aOR = 1.29) and establishments offering happy hours specials had more than twice the odds of selling beer (aOR = 2.22), wine (aOR = 2.53), and spirits to-go (aOR = 2.60). Additionally, establishments that implemented physical distance requirements had higher odds of selling wine to-go (aOR = 3.00). State to-go laws were associated with higher odds of selling wine (aOR = 3.99) and spirits to-go (aOR = 5.43) in the full sample and beer to-go (aOR = 4.92) in urban counties. CONCLUSIONS: Establishments that sell alcohol to-go tend to engage in other practices designed to drive sales. Evaluations of alcohol to-go sales laws on risky consumption among priority populations, including college students, are urgently needed to inform decisions about how to appropriately regulate sales.


Assuntos
Consumo de Bebidas Alcoólicas , COVID-19 , Humanos , Universidades , Estudos Transversais , Pandemias , Etanol , Bebidas Alcoólicas , Comércio , Política Pública
3.
BMC Public Health ; 24(1): 422, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38336621

RESUMO

BACKGROUND: Eye examinations and eyeglasses acquisition are typically integrated into a cohesive procedure in China. We conducted a randomized controlled trial using incognito standardized patient (SP) approach to evaluate the impact of separating eyeglasses sales on the accuracy of final prescription. METHODS: 52 SPs were trained to provide standardized responses during eye examinations, and undergoing refraction by a senior ophthalmologist at a national-level clinical center. SPs subsequently received eye examinations at 226 private optical shops and public hospitals in Shaanxi, northwestern China. The visits were randomly assigned to either control group, where SPs would typically purchase eyeglasses after refraction, or treatment group, where SPs made an advance declaration not to purchase eyeglasses prior to refraction. The dioptric difference between the final prescriptions provided by local refractionists and expert in the better-seeing eye was determined using the Vector Diopteric Distance method, and the completeness of exams was assessed against national standards. Multiple regressions were conducted to estimate the impact of no eyeglasses sales on the accuracy of the final prescription of local refractionists, as well as the completeness of examinations. RESULTS: Among 226 eye exams (73 in public hospitals, 153 in private optical shops), 133 (58.8%) were randomized to control group and 93 (41.2%) to no eyeglasses sales group. The inaccuracy rate of final prescriptions provided by local refractionists (≥ 1.0 D, experts' final prescription as the reference) was 25.6% in control group, while 36.6% in no-sale group (P = 0.077). The likelihood of providing inaccurate final prescriptions was significantly higher in no-sale group compared to control group (OR = 1.607; 95% CI: 1.030 to 2.508; P = 0.037). This was particularly evident in private optical shops (OR = 2.433; 95% CI: 1.386 to 4.309; P = 0.002). In terms of process quality, the no-sale group performed significantly less subjective refraction (OR = 0.488; 95% CI: 0.253 to 0.940; P = 0.032) and less testing SP's own eyeglasses (OR = 0.424; 95% CI: 0.201 to 0.897; P = 0.025). The duration of eye exams was 3.917 min shorter (95% CI: -6.798 to -1.036; P = 0.008) in no-sale group. CONCLUSIONS: Separating eyeglasses sales from optical care could lead to worse quality of eye care. Policy makers should carefully consider the role of economic incentives in healthcare reform.


Assuntos
Erros de Refração , Humanos , Erros de Refração/diagnóstico , Erros de Refração/terapia , Acuidade Visual , Óculos , Refração Ocular , China
4.
BMC Health Serv Res ; 24(1): 771, 2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38951849

RESUMO

BACKGROUND: In 2018, the National Centralized Drug Procurement (NCDP) policy has been implemented in 11 provinces, and promoted across the country in 2019. The main feature of the policy is "volume for price", therefore, it is necessary to measure the price relationship, not only to reduce the price of drugs, reduce the burden of patients' medical costs, but also facilitate pharmaceutical companies to access enough innovation incentives. The aim of this study was to assess the vacated space effect of the drug centralized procurement by national organizations in exchange of price for quantity. METHODS: A difference-in-differences (DID) model was employed to analyze the effect of the 4 + 7 pilot drugs centralized purchasing policy on drug sales volume and selected versus clinically substitutable unselected varieties, using observational data from 2018 to 2019. We compared drug procurement data between secondary and above public hospitals in pilot and non-pilot cities throughout China. RESULTS: The study showed that the average treatment effect (ATE) of sales in the in-hospital market for the selected supply varieties in centralized purchasing is -0.42, and with a sales volume of 0.49. This indicates a volume-price vacated space of 1.16 ~ 1.17 DDD (defined daily dose)/Yuan, implying that for every 1 defined daily dose (DDD) increase in reported volume, the standardized price decreased by 1.16-1.17 Yuan. The ATE of in-hospital market sales for drugs not selected in centralized procurement shows a decrease of 0.13. This finding highlights the presence of the price linkage effect. The ATE of sales volume is 0.57, indicating a volume-price space of 4.38 ~ 4.39 DDD/Yuan for unselected drugs, approximately 3.75 higher relative to that of the selected ones. CONCLUSIONS: The ratio of the volume-price space of clinically substitutable unselected and selected drugs may serve as direct evidence for evaluating the shift from centralized purchasing of drug varieties to clinically substitutable other ones. To strengthen the volume-based negotiation approach and maximize the effectiveness of centralized purchasing policies, we recommend the strategic implementation of a three-tiered centralized purchasing system, the expansion of drug coverage, and the introduction of relevant constraints and incentives.


Assuntos
Custos de Medicamentos , Hospitais Públicos , China , Humanos , Serviço Hospitalar de Compras
5.
Public Health ; 231: 116-123, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38677098

RESUMO

OBJECTIVES: Evidence suggests that cigarette costs significantly impact tobacco use, yet the effect of state-level cost variations on cigarette sales per capita in the US remains uncertain. This study investigates how state-level cigarette costs affect pack sales per capita consumption. STUDY DESIGN: This was an observational study of cigarette-pack sales per capita consumption in the United States. METHODS: We used the tobacco tax burden data (1989-2019) and a two-way fixed-effects model to analyse how cigarette costs affect consumption. Our predictor variables were average cost per pack, state tax per pack, and combined federal and state tax as a percentage of the retail price. Additionally, we compared the percentage change in state cigarette taxes per pack for each state in five-year intervals, adjusting for inflation. RESULTS: Regression analysis revealed that a 10% increase in the average cost per pack was related to a 9.59% decrease in per capita cigarette consumption (ß_average cost = -0.959, P < 0.001). Similarly, a rise in state tax per pack and a higher tax as a proportion of the retail price per pack were related to a decline in consumption (ß_ state tax = -0.176, P < 0.001), (ß_retail price = -0.323, P < 0.001). States that raised cigarette taxes beyond the rate of inflation had a higher reduction in cigarette per capita sales than those maintaining stable tax rates. CONCLUSIONS: Some states have not raised their cigarette taxes sufficiently to account for inflation. It appears that cigarette costs have significantly reduced cigarette consumption in the US.


Assuntos
Comércio , Impostos , Produtos do Tabaco , Estados Unidos , Produtos do Tabaco/economia , Produtos do Tabaco/estatística & dados numéricos , Humanos , Impostos/estatística & dados numéricos , Impostos/economia , Comércio/estatística & dados numéricos , Comércio/economia , Fumar/epidemiologia , Fumar/economia
6.
Subst Use Misuse ; 59(5): 727-731, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38226661

RESUMO

Background: Research is needed to identify the determinants of motivation to quit smoking among non-Hispanic Black (NHB) adults who smoke menthol cigarettes and reside in communities covered by menthol cigarette bans. Objectives: This study examined the associations between motivation to quit smoking and a range of individual-level predictors, including measures of demographics, harm/risk perception of menthol cigarettes, and awareness of a ban on menthol cigarettes in Los Angeles County unincorporated communities. Self-identified NHB adults who currently smoke menthol cigarettes (N=50; M=47.2 years; SD=13.7; 46% female) were recruited in Los Angeles County unincorporated communities. Participants completed an interviewer-administered cross-sectional survey between January to September 2021. Results: Participants (74%) reported an annual household income of less than $25,000. Participants' mean age at cigarette initiation was 15.7 years old (SD=5.68). Most (88%) were aware of the ordinance banning menthol cigarette sales. Employing multivariable linear regression analysis, harm/risk perception of menthol cigarettes (B=14.69, p<0.01) and awareness of the local menthol ban (B=26.18, p<0.05) were found to be independently associated with motivation to quit smoking. Conclusions: Findings from this community-based sample suggest that among NHB adults who smoke menthol cigarettes, motivation to quit smoking is influenced by their perception of menthol cigarettes as harmful and awareness of local policy banning the sale of menthol cigarettes. Findings underscore the need for community-centered and culturally grounded interventions to facilitate quitting among NHB adults who smoke in order for communities covered by menthol bans to achieve health equity in reducing preventable racial inequities due to menthol cigarettes.


Assuntos
Abandono do Hábito de Fumar , Produtos do Tabaco , Adulto , Humanos , Feminino , Adolescente , Masculino , Motivação , Mentol , Estudos Transversais , Los Angeles
7.
Ann Pharm Fr ; 82(3): 493-506, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-37925145

RESUMO

CONTEXT AND OBJECTIVES: Demand forecasting is a vital step for production planning and consequently, for supply chain efficiency, especially for the pharmaceutical (pharma) supply chain due to its unique characteristics. Numerous models and techniques that are proposed in the literature but little in concrete and generic framework to forecasting process, mainly for pharmaceutical supply chain. Unlike studies in the literature, this study not only perfectly predict the sales of a pharma manufacturer, but also visualize the results via a developed dashboard using modern information technology and business intelligence. MATERIAL AND METHODS: In this research, a rolling forecasting framework comprising of different steps and specialized tools is proposed that can assist supply chain managers to perform an accurate sales forecasting and consequently a better performance and specifically patient satisfaction. The proposed generic framework combines the use of Visual studio C++ software to extract optimal forecasting and the Power BI software to monitor the accuracy of the obtained sales forecasts. Three exponential smoothing methods are integrated in the proposed framework, which is open to adding more new forecasting methods. RESULTS: The proposed framework is tested for many data sets from a pharmaceutical manufacturer company, and the results obtained show superior performance, especially a clear decline in both forecast errors, which can reach 75% and a drop of stock level to 50%. Therefore, the company is currently using it and a future integration with their ERP is being carried out. CONCLUSION: The proposed rolling forecasting framework contributes to insightful decision-making through the visualization of accurate future sales and turnover, and consequently, an efficient stock management and effective production planning.

8.
J Surg Res ; 281: 143-154, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36155271

RESUMO

INTRODUCTION: The effects of firearm sales and legislation on crime and violence are intensely debated, with multiple studies yielding differing results. We hypothesized that increased lawful firearm sales would not be associated with the rates of crime and homicide when studied using a robust statistical method. METHODS: National and state rates of crime and homicide during 1999-2015 were obtained from the United States Department of Justice and the Centers for Disease Control and Prevention. National Instant Criminal Background Check System background checks were used as a surrogate for lawful firearm sales. A general multiple linear regression model using log event rates was used to assess the effect of firearm sales on crime and homicide rates. Additional modeling was then performed on a state basis using an autoregressive correlation structure with generalized estimating equation estimates for standard errors to adjust for the interdependence of variables year to year within a particular state. RESULTS: Nationally, all crime rates except the Centers for Disease Control and Prevention-designated firearm homicides decreased as firearm sales increased over the study period. Using a naive national model, increases in firearm sales were associated with significant decreases in multiple crime categories. However, a more robust analysis using generalized estimating equation estimates on state-level data demonstrated increases in firearms sales were not associated with changes in any crime variables examined. CONCLUSIONS: Robust analysis does not identify an association between increased lawful firearm sales and rates of crime or homicide. Based on this, it is unclear if efforts to limit lawful firearm sales would have any effect on rates of crime, homicide, or injuries from violence committed with firearms.


Assuntos
Armas de Fogo , Homicídio , Estados Unidos/epidemiologia , Homicídio/prevenção & controle , Violência , Comércio , Centers for Disease Control and Prevention, U.S.
9.
Nicotine Tob Res ; 2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-37947271

RESUMO

INTRODUCTION: There has been a rapid proliferation of synthetic nicotine products in recent years, despite newly established regulatory authority and limited research into its health risks. Previous research has implicated social media platforms as an avenue for nicotine product unregulated sales. Yet, little is known about synthetic nicotine product content on social media. We utilized natural language processing to characterize the sales of synthetic nicotine products on Instagram. METHODS: We collected Instagram posts by querying Instagram hashtags (e.g., "#tobaccofreenicotine) related to synthetic nicotine. Using BERT, collected posts were categorized into thematically related topic clusters. Posts within topic clusters relevant to study aims were then manually annotated for variables related to promotion and selling (e.g., cost discussion, contact information for offline sales). RESULTS: A total of 7,425 unique posts were collected with 2,219 posts identified as related to promotion and selling of synthetic nicotine products. Nicotine pouches (52.9%, n=1174), ENDS (30.6%, n=679), and flavored e-liquids (14.1%, n=313) were most commonly promoted. 16.1% (n=345) of posts contained embedded hyperlinks and 5.8% (n=129) provided contact information for purported offline transactions. Only 17.6% (n=391) of posts contained synthetic nicotine specific health warnings. CONCLUSIONS: In the United States, synthetic nicotine products can only be legally marketed if they have received premarket authorization from the FDA. Despite these prohibitions, Instagram appears to be a hub for potentially unregulated sales of synthetic and "tobacco-free" products. Efforts are needed by platforms and regulators to enhance content moderation and prevent unregulated online sales of existing and emerging synthetic nicotine products. IMPLICATIONS: There is limited clinical understanding of synthetic nicotine's unique health risks and how these novel products are changing over time due to regulatory oversight. Despite synthetic nicotine specific regulatory measures, such as the requirement for premarket authorization and FDA warning letters issued to unauthorized sellers, access to and promotion of synthetic nicotine is widely occurring on Instagram, a platform with over 2 billion users and one that is popular among youth and young adults. Activities include direct-to-consumer sales from questionable sources, inadequate health warning disclosure, and exposure with limited age restrictions, all conditions necessary for the sale of various tobacco products. Notably, the number of these Instagram posts increased in response to the announcement of new FDA regulations. In response, more robust online monitoring, content moderation, and proactive enforcement is needed from platforms who should work collaboratively with regulators to identify, report, and remove content in clear violation of platform policies and federal laws. Regulatory implementation and enforcement should prioritize digital platforms as conduits for unregulated access to synthetic nicotine products and other future novel and emerging tobacco products.

10.
Health Econ ; 32(1): 65-89, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36176056

RESUMO

This paper studies the impact of a ban on late-night off-premise alcohol sales between 10 p.m. and 5 a.m. in Germany. We use three large administrative data sets: (i) German diagnosis related groups-Statistik, (ii) data from a large social health insurance, and (iii) Road Traffic Accident Statistics. Applying difference-in-differences and synthetic-control-group methods, we find that the ban had no effects on alcohol-related road casualties, but significantly reduced alcohol-related hospitalizations (doctor visits) among young people by around 9 (18) percent. The decrease is driven by fewer hospitalizations due to acute alcohol intoxication during the night-when the ban is in place-but not during the day.


Assuntos
Intoxicação Alcoólica , Comércio , Humanos , Adolescente , Etanol , Alemanha , Consumo de Bebidas Alcoólicas , Acidentes de Trânsito/prevenção & controle
11.
Public Health Nutr ; 26(9): 1743-1753, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37339927

RESUMO

OBJECTIVE: A dietary pattern dominated by ultra-processed foods has been associated with non-communicable diseases in several studies. A previous study from 2013 found a high share of ultra-processed foods in Norwegian food sales. This study aimed to investigate the current share of ultra-processed foods in Norway and the development in expenditure on ultra-processed foods from 2013. DESIGN: A repeated cross-sectional analysis of scanner data from the Consumer Price Index from September 2013 and 2019 and an investigation of the processing degree according to the NOVA classification system. SETTING: Food sales in Norway. PARTICIPANTS: Norwegian grocery stores (n 180, for both time periods). RESULTS: The share of expenditure in 2019 was highest for ultra-processed foods (46·5 %) and minimally or unprocessed foods (36·3 %), followed by processed foods (8·5 %) and processed culinary ingredients (1·3 %). An increasing degree of processing was found for several of the food groups between 2013 and 2019; however, most effect sizes were weak. In 2019, soft drinks became the most frequently purchased food item, surpassing milk and cheese, with the highest expenditure in Norwegian grocery stores. Increases in expenditure on ultra-processed foods were mainly due to increased expenditures on soft drinks, sweets and potato products. CONCLUSIONS: A high share of expenditure on ultra-processed food was found in Norway, which may imply a high consumption of these foods. The change in expenditure of NOVA groups between 2013 and 2019 was small. Carbonated and non-carbonated soft drinks were the most frequently purchased products in Norwegian grocery stores and contributed to most of the expenditures.


Assuntos
Queijo , Alimento Processado , Humanos , Estudos Transversais , Dieta , Manipulação de Alimentos , Noruega , Fast Foods
12.
Bioethics ; 37(9): 831-837, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37638703

RESUMO

I shall argue, first, that potential kidney donors may be subject to harmful pressure to donate. This pressure may take almost any form; people have diverse interests, and anything that could set them back may qualify as pressure. Given features of the context-the high stakes, the involvement of family, and the social meaning of donation-such pressure may be especially harmful. This problem is less tractable than the more familiar worry that pressure may compromise consent. Screening may ensure donors validly consent, but it provides no protection against harmful pressure. I shall argue, second, that the use of such pressure is the predictable consequence of the prohibition on kidney sales. Potential donors have something-a transplantable kidney-that is both valuable and scarce. Many of them, informed about donation, decide against it. Those in need of a transplant may seek to persuade the unwilling. Given the prohibition, the donation cannot be made more attractive in absolute terms by, say, the addition of money. However, it can be made more attractive in relative terms. If declining the option is made worse, then, by comparison, accepting it is made better. The application of harmful pressure has the desired effect. With so much at stake, and no good alternatives, its use is predictable. I conclude that potential donors' interests should figure more prominently in the discussion of transplant policy. Those who defend the prohibition have made virtually no attempt to account for its impact on that group.


Assuntos
Transplante de Rim , Obtenção de Tecidos e Órgãos , Humanos , Doadores de Tecidos , Políticas , Doadores Vivos
13.
Harm Reduct J ; 20(1): 65, 2023 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-37161460

RESUMO

BACKGROUND: Electronic nicotine delivery systems (ENDS), such as the JUUL system, are nicotine products for adults who currently smoke cigarettes but are looking for an alternative to combustible cigarettes. Sales of ENDS products were legislatively acknowledged and authorized federally in Canada with the Royal Assent of the Tobacco and Vaping Products Act in 2018. METHODS: With the unique dataset from a major chain retailer in Canada, we evaluated the impacts of JUUL market entry on cigarette sales across Canada from January 2017 to August 2019 using two-way fixed effects panel regression models by leveraging on the entry time variation at the city level. We conducted various robustness checks and a permutation test to validate our results. RESULTS: Our estimates suggested that JUUL market entry was, on average, significantly correlated with a 1.65% per-month decrease in cigarette sales during the initial months, and with a potentially larger impact on urban areas. Our results were robust across various specifications and tests. These findings implied that JUUL and combustible cigarettes act as economic substitutes during the study time period in Canada. CONCLUSIONS: These results suggested that local availability of ENDS products, such as JUUL, has the potential to reduce local cigarette consumption.


Assuntos
Produtos do Tabaco , Adulto , Humanos , Nicotina , Canadá , Comércio
14.
Plant Dis ; 107(7): 2185-2196, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36480730

RESUMO

Boxwood blight (BB) caused by Calonectria pseudonaviculata (Cps), an economically devastating disease affecting everyone in the supply chain from growers to gardeners, was first officially documented in the United States in 2011. This disease has taken a heavy toll on boxwood, an iconic landscape plant and the number one evergreen nursery crop. Instead of abandoning boxwood production and switching to other evergreens, growers in the United States, informed by the latest research, have elected to combat this disease. One of the strategies employed has been to shift boxwood production from highly susceptible to less-susceptible cultivars. The objective of this study was to investigate the ongoing shift by comparing boxwood sales of 17 selected nurseries from seven states across the country in 2011, 2016, and 2021. Results revealed an additional 21.24% (from 38.58 to 60.04%) in sales of less-susceptible boxwood cultivars in 2021 compared with 2016. The less-susceptible cultivars responsible for increased boxwood sales are 'Winter Gem', 'Wintergreen', 'SB 300' (Freedom), 'SB 108' (Independence), and 'Little Missy'. The potential for long-term positive impact on sustainable boxwood production and plantings in the United States through the use of less-susceptible cultivars is discussed. This shift in boxwood choices builds crop health into new plantings of this landmark plant and sustains growth in demand for boxwood. This sets a new example of sustainable protection for a crop that is under serious pressure from an invasive pathogen.


Assuntos
Buxus , Hypocreales , Estados Unidos , Doenças das Plantas/prevenção & controle
15.
Gastroenterol Hepatol ; 46(8): 577-584, 2023 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36372257

RESUMO

There is uncertainty regarding Wilson's disease (WD) management. OBJECTIVES: To assess, in a multicenter Spanish retrospective cohort study, whether the approach to WD is homogeneous among centers. METHODS: Data on WD patients followed at 32 Spanish hospitals were collected. RESULTS: 153 cases, 58% men, 20.6 years at diagnosis, 69.1% hepatic presentation, were followed for 15.5 years. Discordant results in non-invasive laboratory parameters were present in 39.8%. Intrahepatic copper concentration was pathologic in 82.4%. Genetic testing was only done in 56.6% with positive results in 83.9%. A definite WD diagnosis (Leipzig score ≥4) was retrospectively confirmed in 92.5% of cases. Chelating agents were standard initial therapy (75.2%) with frequent modifications (57%), particularly to maintenance zinc. Enzyme normalization was not achieved by one third, most commonly in the setting of poor compliance, lack of genetic mutations and/or presence of cardiometabolic risk factors. Although not statistically significant, there were trends for sex differences in number of diagnosed cases, age at diagnosis and biochemical response. CONCLUSIONS: Significant heterogeneity in diagnosis and management of WD patients emerges from this multicenter study that includes both small and large reference centers. The incorporation of genetic testing will likely improve diagnosis. Sex differences need to be further explored.


Assuntos
Degeneração Hepatolenticular , Humanos , Feminino , Masculino , Degeneração Hepatolenticular/diagnóstico , Degeneração Hepatolenticular/genética , Estudos Retrospectivos , Quelantes/uso terapêutico , Zinco , Cobre , Penicilamina/uso terapêutico
16.
Trop Anim Health Prod ; 55(3): 204, 2023 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-37195342

RESUMO

Goats are a common ruminant in livestock husbandry systems in communal areas of southern Africa, but less so in peri-urban areas. While dynamics of goat farming in the former are relatively well-understood, little is known about it in peri-urban environments. We investigated the contribution of small-scale farming of goats to household livelihoods in rural and peri-urban areas in KwaZulu-Natal Province of South Africa. We used a semi-structured questionnaire survey to elicit views of 115 respondents on the contribution of goats to household income at two rural (Kokstad, Msinga) and two peri-urban (Howick, Pietermaritzburg) locations. Goats contributed to household income as a source of cash and meat in various sociocultural contexts such as at weddings, funerals and festive period gatherings (e.g. Easter and Christmas), including payment for household needs and expenses including food, school fees and medico-cultural consultations. These findings were more pronounced in rural areas, where more goats were kept than in peri-urban areas, which also had smaller herds per household. Goats were a source of cash in numerous ways including sales of their skins after slaughter and use of skins through value addition to make household craft items such as stools that could be sold for cash. None of the farmers milked their goats. Goat famers also kept cattle (52%), sheep (23%) and chickens (67%). Goat ownership appeared to be more profitable in rural areas and contributed to a lesser extent as a source of income in peri-urban areas where goats were largely kept for sale. There is potential for increased value addition of goat products to increase returns from small-scale goat farming in rural and peri-urban settings. Artefacts and cultural symbols derived from goat products are pervasive amongst Zulu people, and represent an additional avenue of research into 'hidden' valuation of goats.


Assuntos
Criação de Animais Domésticos , Galinhas , Animais , Bovinos , Ovinos , África do Sul , África Austral , Cabras
17.
Inf Technol Manag ; : 1-30, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36742340

RESUMO

Although lead scoring is an essential component of lead management, there is a lack of a comprehensive literature review and a classification framework dedicated to it. Lead scoring is an effective and efficient way of measuring the quality of leads. In addition, as a critical Information Technology tool, a proper lead scoring model acts as an alleviator to weaken the conflicts between sales and marketing functions. Yet, little is known regarding lead scoring models and their impact on sales performance. Lead scoring models are commonly categorized into two classes: traditional and predictive. While the former primarily relies on the experience and knowledge of salespeople and marketers, the latter utilizes data mining models and machine learning algorithms to support the scoring process. This study aims to review and analyze the existing literature on lead scoring models and their impact on sales performance. A systematic literature review was conducted to examine lead scoring models. A total of 44 studies have met the criteria and were included for analysis. Fourteen metrics were identified to measure the impact of lead scoring models on sales performance. With the increased use of data mining and machine learning techniques in the fourth industrial revolution, predictive lead scoring models are expected to replace traditional lead scoring models as they positively impact sales performance. Despite the relative cost of implementing and maintaining predictive lead scoring models, it is still beneficial to supersede traditional lead scoring models, given the higher effectiveness and efficiency of predictive lead scoring models. This study reveals that classification is the most popular data mining model, while decision tree and logistic regression are the most applied algorithms among all the predictive lead scoring models. This study contributes by systematizing and recommending which machine learning method (i.e., supervised and/or unsupervised) shall be used to build predictive lead scoring models based on the integrity of different types of data sources. Additionally, this study offers both theoretical and practical research directions in the lead scoring field.

18.
Cities ; : 104457, 2023 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38620167

RESUMO

The spread of COVID-19 greatly restricted physical and economic activities in global cities due to growing fears of infection and lockdown policies. Accordingly, the transfer of shopping activities from traditional markets to e-commerce has accelerated. Urban retail has substantially declined by competing with these disrupting factors, but resilience capabilities are known to vary by scale and regional characteristics. This study identifies which types of retail clusters were more resilient to the economic shock caused by the pandemic. This research focuses on the changes in online and in-store sales and how retailers recovered differently at the neighborhood and district levels in 2019 and 2020. This research compares the resilience of two types of retail clusters by calculating the loss of resilience and online adaptivity. The findings suggest that neighborhood-level retail areas were more resilient and bounced back in sales at a faster rate than district-level retail areas during the pandemic. These findings suggest that retail clusters are more resilient if they have steady populations and low-rent loads and can accommodate online shopping. The study contributes theoretical insights into how sales have changed and how e-commerce has increased the resilience of retail clusters throughout the pandemic by examining in-store and online sales.

19.
Environ Dev Sustain ; : 1-27, 2023 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-37362968

RESUMO

With the deep integration of the digital economy and agricultural development, agricultural digital transformation promotes agricultural production, and industrial upgrading and broadens sales channels to achieve the strategic goal of rural revitalization in China. To explore whether agricultural digitization can help farmers increase their income and what path can be achieved, this study is based on the theoretical framework of rural revitalization theory and digitization. Through a questionnaire survey of 1500 farmers in Hubei Province, the impact mechanism of agricultural digitization transformation on farmers' income is empirically studied. The empirical results show that the digital transformation of agriculture can promote the increase in farmers' income, and promote the increase in farmers' income by improving production efficiency, broadening sales channels, and promoting the upgrading of agricultural structure. At the same time, both production efficiency and sales channels form a chain double intermediary path with the upgrading of agricultural structure. Under the background of rural revitalization, this study provides theoretical references and guidance for further promoting agricultural digital transformation to increase farmers' income. The marginal contribution of this study is to construct a theoretical model of agricultural digitization to promote farmers' income increase, which has important theoretical reference and guiding significance for guiding the development direction of agricultural digitization and promoting farmers' income increase.

20.
Int Tax Public Financ ; : 1-27, 2023 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-37359092

RESUMO

Policymakers were surprised to find increases in sales tax revenues in 2020 due to expectations that they would drop 8-20%. We investigate this puzzle and provide novel insights into consumption taxes based on this experience. Using a case study from the State of Utah, we document that shifts in the structure of consumption played a significant role in the robustness of sales tax revenue. Two factors stand out in our results. The first factor is the structure of the tax base for sales taxes in the USA. This tax base covers only a subset of personal consumption, excluding, for example, many services. During the pandemic, when services were restricted or shut down, this caused a shift in spending toward goods that are more likely to be in the sales tax base. The second factor is the boom in e-commerce during the pandemic, which boosted sales tax collections. This was catalyzed by recent legal changes that made the collection of sales taxes in e-commerce easier. Interestingly, this e-commerce boost also shifted the point of sale and related sales tax revenues away from urban areas toward suburban areas. Our case study of the pandemic's effect on sales taxes in the USA generally, and Utah's experience specifically, provides lessons for consumption taxes, such as the VAT more broadly, and lessons on the role of consumption taxes for tax revenue volatility.

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