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Distributed to depository libraries in paper, ending with v. 81, no. 4 (Apr. 2001) issue

The impact of a reduction in drug supply on demand for and compliance with treatment for drug dependence

Background: In early 2001, Australia experienced a sudden, dramatic and;sustained decrease in heroin availability that was accompanied by sharp increases in price and decreases in street level purity-the so-called heroin shortage. These unprecedented changes occurred in a context of widespread treatment availability, which made it possible for the first time to examine the impact of a sharp reduction in heroin supply in New South Wales (NSW) on entry to and adherence with treatment for heroin dependence. Given the evidence of drug substitution by some users. the current paper also examines the effects of the shortage on entry to treatment for other forms of drug dependence. Methods: Interrupted time-series analysis of the number of persons entering opioid pharmacotherapy and other treatment modalities in NSW for heroin dependence and for the treatment for other types of drug dependence. Findings: The heroin shortage was associated with a reduction in the number of younger persons entering opioid pharmacotherapy. There was a dramatic decrease in the number of persons entering heroin withdrawal or assessment only treatment episodes. There appear to have been small improvements in adherence to and retention in heroin treatment after the reduction in heroin supply. Relatively small increases were observed in numbers being treated for cocaine dependence. Conclusions: In the context of good treatment provision, a reduction in heroin supply appeared to produce modest improvements in intermediate outcomes. Supply and demand reduction measures, when both are implemented successfully, may be complementary. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

The economics of inclusion body processing

Many recombinant proteins are often over-expressed in host cells, such as Escherichia coli, and are found as insoluble and inactive protein aggregates known as inclusion bodies (IBs). Recently, a novel process for IB extraction and solubilisation, based on chemical extraction, has been reported. While this method has the potential to radically intensify traditional IB processing, the process economics of the new technique have yet to be reported. This study focuses on the evaluation of process economics for several IB processing schemes based on chemical extraction and/or traditional techniques. Simulations and economic analysis were conducted at various processing conditions using granulocyte macrophage-colony stimulating factor, expressed as IBs in E. coli, as a model protein. In most cases, IB processing schemes based on chemical extraction having a shorter downstream cascade demonstrated a competitive economic edge over the conventional route, validating the new process as an economically more viable alternative for IB processing.

Wage spillovers, inter-regional effects and the impact of inward investment

This paper evaluates the extent of inter-industry and inter-regional wage spillovers across the UK. An extensive body of literature exists suggesting that wages elsewhere affect wage determination and levels of satisfaction, but this paper extends the analysis of wage determination to examine the effects of inward investment in the process. Thus far the specific effect of foreign wages on domestic wage determination has not been evaluated. We employ industry- and regional-level panel data for the UK, and contrast results from alternative approaches to space-time modelling. Each supports the notion that such wage spillovers do occur, though assumptions made concerning the modelling of spatial interaction are important. Further, such wage spillovers are more widespread for skilled than for unskilled workers and also lower in areas of high unemployment. © 2006 Regional Studies Association.

Profit sharing, technical efficiency change and finance constraints

This paper analyses the mechanisms through which profit-sharing schemes may induce debt constrained firms to improve technical efficiency over time to guarantee positive profits. This hypothesis is first formalised in a partial equilibrium framework and then is tested on a sample of Italian traditional and cooperative firms. Technical efficiency change indexes are computed by DEA. These are regressed on a measure of finance constraints to analyse their impact on firms’ efficiency growth. The results support the hypothesis that a restriction in the availability of financial resources can affect positively the growth in efficiency in firms with profit-sharing schemes.

Organizational capital, product market competition and technical efficiency in Italian cooperatives

This paper tries to identify under which conditions increasing market competition may help cooperatives to improve technical efficiency to guarantee positive profits. This hypothesis is first formalized in a partial equilibrium framework and then is tested on a sample of Italian conventional and cooperative firms, using frontier analysis. Technical efficiency indexes are computed by using the one-stage approach as suggested by Battese and Coelli (1995), where proxies for competition are introduced as determinants of efficiency, along with other exogenous factors accounting for the firms’ heterogeneity. However, the overall impact of increasing competition on efficiency is negative.

Structured packing in air distillation

An economic analysis has been performed to establish when it is advantageous to use structured packing in air separation plant. A model of a low pressure cycle was developed to calculate the power saved when packing is used, and cost models were developed for the columns and cold box. The rate of return was calculated on the extra investment required for a packed plant based on the annual power saving. Structured packing was found to be economic only in larger plants, where economies of scale mean that the increased capital cost becomes less significant compared with the power saved. It was also found that different sized plants favour different packings. The analysis identified that the packing variable with the biggest impact on the economic balance was the efficiency and that increasing the efficiency of current packings could enhance their balance in air distillation. A new packing was therefore developed to have a higher efficiency than conventional ones. The vapour phase resistance was targeted for reduction, since most packing models predict this to be dominant. The final shape was chosen as the easiest and most economic to make. It has converging and diverging channels and was manufactured in two specific areas and with two block heights by Tianjin University Packing Factory. A 0.3 m diameter distillation column test rig was designed, built and commissioned with the standard Sulzer Mellapak 500YW. It was then used to test the new packing alongside some standard ones. Because the packings had different specific areas, correlations of published results were developed to allow a true comparison to be made. The test results show that, unexpectedly, the packings with 0.1 m high blocks have an efficiency about 8% greater than the standard 0.2 m blocks. The new shape as implemented in the 350Y packing shows an additional 7% greater efficiency, so it is 15% better than a standard packing with the same area. It has a better efficiency than the Mellapak 500YW and the higher capacity associated with its lower area. The new 500Y did not show a significant advantage.

Estimation of the production cost of fast pyrolysis bio-oil

A number of papers and reports covering the techno-economic analysis of bio-oil production has been published. These have had different scopes, use different feedstocks and reflected national cost structures. This paper reviews and compares their cost estimates and the experimental results that underpin them. A comprehensive cost and performance model was produced based on consensus data from the previous studies or stated scenarios where data is not available that reflected UK costs. The model takes account sales of bio-char that is a co-product of pyrolysis and the electricity consumption of the pyrolysis plant and biomass pre-processing plants. It was concluded that it should be able to produce bio-oil in the UK from energy crops for a similar cost as distillate fuel oil. It was also found that there was little difference in the processing cost for woodchips and baled miscanthus. © 2011 Elsevier Ltd.

Enhanced diabetes care to patients of south Asian ethnic origin (the United Kingdom Asian Diabetes Study):a cluster randomised controlled trial

Background - Delivery of high-quality, evidence-based health care to deprived sectors of the community is a major goal for society. We investigated the effectiveness of a culturally sensitive, enhanced care package in UK general practices for improvement of cardiovascular risk factors in patients of south Asian origin with type 2 diabetes. Methods - In this cluster randomised controlled trial, 21 inner-city practices in the UK were assigned by simple randomisation to intervention (enhanced care including additional time with practice nurse and support from a link worker and diabetes-specialist nurse [nine practices; n=868]) or control (standard care [12 practices; n=618]) groups. All adult patients of south Asian origin with type 2 diabetes were eligible. Prescribing algorithms with clearly defined targets were provided for all practices. Primary outcomes were changes in blood pressure, total cholesterol, and glycaemic control (haemoglobin A1c) after 2 years. Analysis was by intention to treat. This trial is registered, number ISRCTN 38297969. Findings - We recorded significant differences between treatment groups in diastolic blood pressure (1·91 [95% CI -2·88 to -0·94] mm?Hg, p=0·0001) and mean arterial pressure (1·36 [-2·49 to -0·23] mm?Hg, p=0·0180), after adjustment for confounders and clustering. We noted no significant differences between groups for total cholesterol (0·03 [-0·04 to 0·11] mmol/L), systolic blood pressure (-0·33 [-2·41 to 1·75] mm?Hg), or HbA1c (-0·15% [-0·33 to 0·03]). Economic analysis suggests that the nurse-led intervention was not cost effective (incremental cost-effectiveness ratio £28?933 per QALY gained). Across the whole study population over the 2 years of the trial, systolic blood pressure, diastolic blood pressure, and cholesterol decreased significantly by 4·9 (95% CI 4·0–5·9) mm?Hg, 3·8 (3·2–4·4) mm?Hg, and 0·45 (0·40–0·51) mmol/L, respectively, and we recorded a small and non-significant increase for haemoglobin A1c (0·04% [-0·04 to 0·13]), p=0·290). Interpretation - We recorded additional, although small, benefits from our culturally tailored care package that were greater than the secular changes achieved in the UK in recent years. Stricter targets in general practice and further measures to motivate patients are needed to achieve best possible health-care outcomes in south Asian patients with diabetes. Funding - Pfizer, Sanofi-Aventis, Servier Laboratories UK, Merck Sharp & Dohme/Schering-Plough, Takeda UK, Roche, Merck Pharma, Daiichi-Sankyo UK, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Bristol-Myers Squibb, Solvay Health Care, and Assurance Medical Society UK.

Sustainable energy from paper industry wastes

Secondary fibre paper mills are significant users of both heat and electricity which is mainly derived from the combustion of fossil fuels. The cost of producing this energy is increasing year upon year. These mills are also significant producers of fibrous sludge and reject waste material which can contain high amounts of useful energy. Currently the majority of these waste fractions are disposed of by landfill, land-spread or incineration using natural gas. These disposal methods not only present environmental problems but are also very costly. The focus of this work was to utilise the waste fractions produced at secondary fibre paper mills for the on-site production of combined heat and power (CHP) using advanced thermal conversion methods (gasification and pyrolysis), well suited to relatively small scales of throughput. The heat and power can either be used on-site or exported. The first stage of the work was the development of methods to condition selected paper industry wastes to enable thermal conversion. This stage required detailed characterisation of the waste streams in terms of proximate and ultimate analysis and heat content. Suitable methods to dry and condition the wastes in preparation for thermal conversion were also explored. Through trials at pilot scale with both fixed bed downdraft gasification and intermediate pyrolysis systems, the energy recovered from selected wastes and waste blends in the form of product gas and pyrolysis products was quantified. The optimal process routes were selected based on the experimental results, and implementation studies were carried out at the selected candidate mills. The studies consider the pre-processing of the wastes, thermal conversion, and full integration of the energy products. The final stage of work was an economic analysis to quantify economic gain, return on investment and environmental benefits from the proposed processes.

Decentralised off-grid electricity generation in India using intermediate pyrolysis of residue straws

Use of agricultural residues, like wheat or rice straw for energy generation, is the most effective measure in terms of costs and availability. The present paper focuses the need of such measure, its impact on the environment as practiced today (open burning). The application of intermediate pyrolysis technology for straw conversion in India is discussed herein. A 20 kg/h Pyroformer has been coupled to a direct quenching system without filtration. The process temperature was around 360 ?C and the yields for the product fractions, char pyrolysis oil, and non-condensable gas fractions were, 32%, 35%, and 33% respectively. The pyrolysis oil was condensed in a quenching unit using bio-diesel or diesel. The blend produced was 30 % pyrolysis liquid and 70 % bio-diesel. The engine has been tested with the pyro-oil/biooil mixture over a long term (75 hours). An overall economic analysis of the process has been carried out.

Europa i świat zachodni:szkodliwe dla gospodarki niedostrzegane lub lekceważone zjawiska

The paper presents an abbreviated version of the second part of the report on problems of Europe, prepared by a team of teachers at the University of Information Technology and Management in Rzeszow, Poland. We stress therein that the hotly debated problems of the Eurozone and the global financial crisis and its aftermath are, at best, medium-term ones, while real issues Europe faces are of the long-term nature and result from policies pursued for decades. Their consequences are also long-term – and increasingly harmful. Our diagnosis is as follows. Long-term problems related to the increasing burden of the welfare state and its side effects, like the slowing economic growth rate, are not subject to serious policy debates. It applies to both traditional elites from parties belonging to the moderate political spectrum, and to anti-elites on both extremes. Both elites and anti-elites reject the reality as a starting point to developing corrective policy measures. Our economic analysis has revealed that incentives to create wealth in old Western countries have been weakening for a long time. Yet, without deep cuts in public (especially welfare) expenditures and accompanying institutional reforms, economic performance of European (and generally Western) economies is going to worsen over time. The chances of continued stagnation in the next 5–10 years are very high. Finally, we look at the socio-psychological behavioral framework of the ever-expanding welfare state. We point at the phenomenon of the learned helplessness which appears as a result of the people’s lacking perception of linkages between their actions and economic results of these actions. We interpret it as a consequence of the welfare state. It further weakens the prospects for successful reforms and the resultant avoidance of the long-term stagnation.

Business case development

Today, focus is shifting to creation of bio-energy, biofuel and bioproducts from cellulosic biomass derived from various sources, including existing and new crops and their residues, trees and forest residues, and municipal or industrial wastes. At present, biomass co-firing in modern coal power plants with efficiencies up to 45% is the most cost-effective biomass use for power generation. Due to feedstock availability issues, dedicated biomass plants for combined heat and power (CHP), are typically of smaller size and lower electrical efficiency compared to coal plants. The financial model discussed in the chapter is suitable for all countries both in the West and in the developing world. From the economic analysis given in the chapter it can be concluded that intermediate pyrolysis technology proves to be very effective in terms of product qualities of the oil produced and also the return on investment is around 4 to 5 years.

Effectiveness of the interventions in preventing the progression of pre-frailty and frailty in older adults:a systematic review protocol

REVIEW QUESTION / OBJECTIVE : The objective of this review is to identify the effectiveness of the interventions in preventing progression of pre-frailty and frailty in older adults. More specifically, the review questions are: - What is the effectiveness of interventions in preventing or reducing frailty in older adults? - How does effectiveness vary with degree of frailty? - Are there factors that influence the effectiveness of interventions? - What is the economic feasibility of interventions for pre-frailty and frailty? INCLUSION CRITERIA : Types of participants This review will consider studies that include older adults (female and male) aged 65 years and over, explicitly identified as pre-frail or frail by the researchers or associated medical professionals according to a pre-specified scale or index, and who have received health care and support services in any type of setting (primary care, nursing homes, hospitals). This review will exclude studies that: - Include participants who have been selected because they have one specific illness - Consider people with a terminal diagnosis only. - Types of intervention(s)/phenomena of interest: The clinical/medical component of the review will consider studies that evaluate any type of interventions to prevent the progression of pre-frailty and frailty in older adults. These interventions will include, but will not be limited to, physical activity, multifactorial intervention, psychosocial intervention, health and social care provision, and cognitive, nutrition or medication/medical maintenance and adherence focused interventions. The economic component of the review will consider studies that have performed any type of health economic analysis of ...

The Role of Price Floor in a Differentiated Product Retail Market

The ability of a manufacturer to enhance competition among its retailers by imposing a price floor was recently introduced in the literature. The purpose of this article is to revisit this anti-collusive explanation of the retail price maintenance in a more general model in which we introduce asymmetric retailers. We find that a manufacturer can amplify the retail market’s competition by imposing a price foor when retailers sell differentiated products. This result contradicts the prevailing concept of retail price maintenance.