The economic burden of alcohol dependence in europe.

AIMS: To determine the economic burden pertaining to alcohol dependence in Europe. METHODS: Database searching was combined with grey literature searching to identify costs and resource use in Europe relating to alcohol dependence as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or the World Health Organisation's International Classification of Diseases (ICD-10). Searches combined MeSH headings for both economic terms and terms pertaining to alcohol dependence. Relevant outcomes included direct healthcare costs and indirect societal costs. Main resource use outcomes included hospitalization and drug costs. RESULTS: Compared with the number of studies of the burden of alcohol use disorders in general, relatively few focussed specifically on alcohol dependence. Twenty-two studies of variable quality were eligible for inclusion. The direct costs of alcohol dependence in Europe were substantial, the treatment costs for a single alcohol-dependent patient lying within the range euro1591-euro7702 per hospitalization and the annual total direct costs accounting for 0.04-0.31% of an individual country's gross domestic product (GDP). These costs were driven primarily by hospitalization; in contrast, the annual drug costs for alcohol dependence were low. The indirect costs were more substantial than the direct costs, accounting for up to 0.64% of GDP per country annually. Alcohol dependence may be more costly in terms of health costs per patient than alcohol abuse. CONCLUSIONS: This review confirms that alcohol dependence represents a significant burden for European healthcare systems and society. Difficulties in comparing across cost-of-illness studies in this disease area, however, prevent specific estimation of the economic burden.

Geomorphological method in the elaboration of hazard maps for flash-floods in the municipality of Jucuarán (El Salvador)

This work deals with the elaboration of flood hazard maps. These maps reflect the areas prone to floods based on the effects of Hurricane Mitch in the Municipality of Jucuarán of El Salvador. Stream channels located in the coastal range in the SE of El Salvador flow into the Pacific Ocean and generate alluvial fans. Communities often inhabit these fans can be affected by floods. The geomorphology of these stream basins is associated with small areas, steep slopes, well developed regolite and extensive deforestation. These features play a key role in the generation of flash-floods. This zone lacks comprehensive rainfall data and gauging stations. The most detailed topographic maps are on a scale of 1:25 000. Given that the scale was not sufficiently detailed, we used aerial photographs enlarged to the scale of 1:8000. The effects of Hurricane Mitch mapped on these photographs were regarded as the reference event. Flood maps have a dual purpose (1) community emergency plans, (2) regional land use planning carried out by local authorities. The geomorphological method is based on mapping the geomorphological evidence (alluvial fans, preferential stream channels, erosion and sedimentation, man-made terraces). Following the interpretation of the photographs this information was validated on the field and complemented by eyewitness reports such as the height of water and flow typology. In addition, community workshops were organized to obtain information about the evolution and the impact of the phenomena. The superimposition of this information enables us to obtain a comprehensive geomorphological map. Another aim of the study was the calculation of the peak discharge using the Manning and the paleohydraulic methods and estimates based on geomorphologic criterion. The results were compared with those obtained using the rational method. Significant differences in the order of magnitude of the calculated discharges were noted. The rational method underestimated the results owing to short and discontinuous periods of rainfall data with the result that probabilistic equations cannot be applied. The Manning method yields a wide range of results because of its dependence on the roughness coefficient. The paleohydraulic method yielded higher values than the rational and Manning methods. However, it should be pointed out that it is possible that bigger boulders could have been moved had they existed. These discharge values are lower than those obtained by the geomorphological estimates, i.e. much closer to reality. The flood hazard maps were derived from the comprehensive geomorphological map. Three categories of hazard were established (very high, high and moderate) using flood energy, water height and velocity flow deduced from geomorphological and eyewitness reports.

Using toxicokinetic modeling approach to determine biological reference values (BRVs) and to assess human exposure to pesticides

Exposure to various pesticides has been characterized in workers and the general population, but interpretation and assessment of biomonitoring data from a health risk perspective remains an issue. For workers, a Biological Exposure Index (BEI®) has been proposed for some substances, but most BEIs are based on urinary biomarker concentrations at Threshold Limit Value - Time Weighted Average (TLV-TWA) airborne exposure while occupational exposure can potentially occurs through multiple routes, particularly by skin contact (i.e.captan, chlorpyrifos, malathion). Similarly, several biomonitoring studies have been conducted to assess environmental exposure to pesticides in different populations, but dose estimates or health risks related to these environmental exposures (mainly through the diet), were rarely characterized. Recently, biological reference values (BRVs) in the form of urinary pesticide metabolites have been proposed for both occupationally exposed workers and children. These BRVs were established using toxicokinetic models developed for each substance, and correspond to safe levels of absorption in humans, regardless of the exposure scenario. The purpose of this chapter is to present a review of a toxicokinetic modeling approach used to determine biological reference values. These are then used to facilitate health risk assessments and decision-making on occupational and environmental pesticide exposures. Such models have the ability to link absorbed dose of the parent compound to exposure biomarkers and critical biological effects. To obtain the safest BRVs for the studied population, simulations of exposure scenarios were performed using a conservative reference dose such as a no-observed-effect level (NOEL). The various examples discussed in this chapter show the importance of knowledge on urine collections (i.e. spot samples and complete 8-h, 12-h or 24-h collections), sampling strategies, metabolism, relative proportions of the different metabolites in urine, absorption fraction, route of exposure and background contribution of prior exposures. They also show that relying on urinary measurements of specific metabolites appears more accurate when applying this approach to the case of occupational exposures. Conversely, relying on semi-specific metabolites (metabolites common to a category of pesticides) appears more accurate for the health risk assessment of environmental exposures given that the precise pesticides to which subjects are exposed are often unknown. In conclusion, the modeling approach to define BRVs for the relevant pesticides may be useful for public health authorities for managing issues related to health risks resulting from environmental and occupational exposures to pesticides.

Snowmobile Reference Guide, 2013

This booklet contains rules and regulations most likely needed for motorized recreational use in Iowa. However, it is not a complete list of all regulations or laws, nor is it a legal document. For more information, please reference Iowa Code Chapters 321 and 321G and Iowa Administrative Code, Chapter 571.

Off-Highway Vehicle Reference Guide, 2012

This booklet contains rules and regulations most likely needed for motorized recreational use in Iowa. However, it is not a complete list of all regulations or laws, nor is it a legal document. For more information, please reference Iowa Code Chapters 321 and 321G and Iowa Administrative Code, Chapter 571.

Phosphorus in Finnish soils in the 1900s with particular reference to the acid ammonium acetate soil test

Selostus: Suomen maaperän fosforin tutkiminen 1900-luvulla ja viljavuustutkimuksen kehittäminen

Performance of a chromatographic procedure used in the certification of reference material for polycyclic aromatic hydrocarbons in sewage sludge

Semi-automatic capillary gas chromatographic method with classical flame ionization detection, which satisfies the conditions for required performance and gave acceptable results within the framework of an interlaboratory certification programme for PAHs in sewage sludge, is described. The interesting feature of the procedure is that it incorporates automatic operations such as sample fractionation by semi-preparative HPLC, fraction collection at signal level recognition and evaporation under nitrogen flow. Multiple injections in the GC capillary column are performed in the on-column mode via an autosampler with temperature-programmable injector. Automatic data acquisition and chromatogram treatment are made via computer software. This partially automatic procedure releases personnel from tedious and time-consuming tasks and its robust character was validated through the certification of reference material for PAHs in sewage sludge, demonstrating its reliable performance.

Coûts humains de la dépendance au tabac [Human costs of tobacco dependence]

Human costs are an indicator of the value attributed to human burden related to diseases. The present paper summarizes a Swiss study. led by economists and physicians, which estimate the monetary value attributed by the general population regarding the consequences on quality of life of smoking related diseases. Such economic study may contribute to better understand smokers' concerns and beliefs and to improve effective strategies for smoking cessation in primary care.

Cost-plus-loss analyses of forest inventory strategies based on kNN-assigned reference sample plot data

Abstract

Yield formation of spring rye at high latitudes with reference to seeding rate and plant growth regulation

Selostus: Kylvötiheyden ja kasvunsääteiden vaikutus kevätrukiin satoon

The quest for blood pressure reference values in children

Do we need country-specific blood pressure reference values for children? This question will sound weird for clinicians caring for adult hypertensive patients or researchers working in the domain of adult hypertension. Indeed, there are no country-specific reference values for adults. This contrasts with hypertension in children, for whom there is an increasing number of published sets of country-specific reference values [1-5].