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.

Health care renunciation for economic reasons in Switzerland.

BACKGROUND: Most societies elaborate ways to contain increasing health care expenditures. In Switzerland out of pocket payments and cuts in the catalogue of reimbursed services are used as cost-containment measures. The aims of the study were to estimate the extent of health care renunciation for economic reasons and to identify associated factors. METHODS: A population-based cross-sectional survey (2008-2009) of a representative sample in the Canton of Geneva, Switzerland. Health care underuse, income level categories (<CHF 3000/month, 3000-4999, 5000-6999, 7000-9499, 9500-13 000, >13 000), education, occupation, insurance status and cardiovascular comorbidities were collected using self-rated questionnaires. RESULTS: 765 men and 814 women aged 35-74 years participated. 14.5% (229/1579) (95%CI 12.7-16.2) renounced health care for economic reasons. Among those who renounced (N = 229), 74% renounced dental care, 37% physician consultation (22% specialist, 15% general practitioner), 26% health devices, 13% medication, and 5% surgery. Income was negatively correlated with renouncement (r = -0.18, p <.0001). Each decrease in income level category provided a 48% increased risk of renouncing health care for economic reasons (OR 1.48, 1.31-1.65). This association remained when dental care was excluded from the definition of health care renunciation. CONCLUSIONS: In a region of Switzerland with a high cost of living, such as Geneva, socioeconomic status may influence the use of the health care system, and renunciation for economic reasons was not uncommon. More than 30% of the lowest income group renounced health care for economical reasons in the previous year. Health care underuse and renunciation may worsen the health status of a substantial part of society.

Iowa Department of Economic Development Performance Plan, FY2014

Agency Performance Plan, Iowa Department of Economic Development

The statistical accuracy of surveys on business and economic perspectives: a case study

In this paper, we develop a new decision making model and apply it in political Surveys of economic climate collect opinions of managers about the short-term future evolution of their business. Interviews are carried out on a regular basis and responses measure optimistic, neutral or pessimistic views about the economic perspectives. We propose a method to evaluate the sampling error of the average opinion derived from a particular type of survey data. Our variance estimate is useful to interpret historical trends and to decide whether changes in the index from one period to another are due to a structural change or whether ups and downs can be attributed to sampling randomness. An illustration using real data from a survey of business managers opinions is discussed.

Production of Acetic Acid by Fermentation with Propionibacteria, HR-321, 1993

This project was undertaken jointly with a project supported by the Iowa Corn Promotion Board. Together the projects aimed at producing the organic acids, propionic acid and acetic acid, by fermentation. The impacts were to provide agriculturally-based alternatives to production of these acids, currently produced mainly as petrochemicals. The potentially high-demand use for acetic acid is as the "acetate" in Calcium Magnesium Acetate (CMA), the non-corrosive road deicer. Fermentation was, however, far from being an economically acceptable alternative. Gains were made in this work toward making this a feasible route. These advances included (1) development of a variant strain of propionibacteria capable of producing higher concentrations of acids; (2) comparison of conditions for several ways of cultivating free cells and establishment of the relative benefits of each; (3) achievement of the highest productivity in fermentations using immobilized cells; (4) identification of corn steep liquor as a lower cost substrate for the fermentation; (5) application of a membrane extraction system for acid recovery and reduction of product inhibition; and (6) initial use of more detailed economic analysis of process alternatives to guide in the identification of where the greatest payback potential is for future research. At this point, the fermentation route to these acids using the propionibacteria is technically feasible, but economically unfeasible. Future work with integration of the above process improvements can be expected to lead to further gains in economics. However, such work can not be expected to make CMA a less expensive deicer than common road salt.

Feasibility of Cooperative Development of Wetland Mitigation Projects, TR-526, 2006

The Iowa Department of Transportation (Iowa DOT) currently performs wetland mitigation on a project-by-project basis. At the same time, other agencies like the Iowa Department of Natural Resources and Natural Resource Conservation Service are performing wetland restoration projects, and counties and cities may be mitigating wetland losses as well. This project examined the feasibility of developing cooperative wetland mitigation projects in order to utilize state and local resources more efficiently to benefit both Iowa and local communities. The project accomplished the following objectives: (1) Identified and characterized cooperative wetland mitigation programs nationwide; (2) Developed a needs assessment through a survey of state, county, and large city agencies in Iowa to describe wetland mitigation programs and determine challenges with mitigation and program improvements, including long-term risks associated with maintenance and monitoring programs; (3) Surveyed state, county, and city agencies and organizations to identify resources available for developing cooperative mitigation projects and procedures; (4) Developed a conceptual framework for cooperative wetland mitigation.

Field Demonstration and Laboratory Evaluation of Foamed Asphalts - Muscatine County, HR-233, 1985

In view of the energy, environmental, and economic advantages of the foamed asphalt process using local aggregates in cold mixes and the promising results from Research Project HR-212, a 4.2-mile section of county road in Muscatine County was built with foamed asphalt and local aggregates during August-September 1983. Extensive laboratory evaluation was carried out on five plant mixes representing foamed mixes used in the nine test sections, a laboratory prepared foamed mix, and a laboratory prepared hot mix similar to Plant Mix 1. The foamed mixes were compacted, cured under 15 curing conditions and tested for bulk specific gravity, Marshall stability at 77° F and at 140° F, cured moisture content, resilient modulus and effects of moisture damage due to freeze-thaw cycles, water soaking, and vacuum saturation. In addition, four sets of 83 core samples were taken at 1 to 15 months and tested for moisture content, specific gravity, Marshall stability, and resilient modulus. In summary, the test road has performed satisfactorily for almost two years. The few early construction problems encountered were to be expected for experimental projects dealing with new materials and technologies. Overall results to date are encouraging and foamed asphalt mixes have proved to have the potential as a viable base material in areas where marginal aggregates are available. It is hoped and expected that performance evaluation of the test sections will be continued and that more foamed asphalt trial projects will be constructed and monitored so that experiences and findings from this project can be verified and mix design criteria can be gradually established. For future foamed asphalt projects it is recommended that anti-stripping additives, such as hydrated lime, be added in view of the potential moisture susceptibility of foamed mixes observed in the laboratory evaluation.

Power Fund Awarded Projects, 2010

Power Fund Awarded Projects from the Office of Energy Independence.

Iowa Power Fund Approved Projects, June 30, 2011

Power Fund Awarded Projects from the Office of Energy Independence.

Review of Cold In-Place Recycled Asphalt Concrete Projects, HR-392, 1998

Highway Research Project HR-392 was undertaken to evaluate cold in-place asphalt recycled (CIR) projects in the State of Iowa. The research involved assessment of performance levels, investigation of factors that most influence pavement performance and economy, and development of guidelines for CIR project selection. The performance was evaluated in two ways: Pavement Condition Indices (PCI, U.S. Corps of Engineers) were calculated and overall ratings were given on ride and appearance. A regression analysis was extrapolated to predict the future service life of CIR roads. The results were that CIR roads within the State of Iowa, with less than 2000 annual average daily traffic (AADT), have an average predicted service life of fifteen to twenty-six years. Subgrade stability problems can prevent a CIR project from being successfully constructed. A series of Dynamic Cone Penetrometer (DCP) tests were conducted on a CIR project that experienced varying levels of subgrade failure during construction. Based on this case study, and supporting data, it was determined that the DCP test can be used to evaluate subgrades that have insufficient stability for recycling. Overall, CIR roads in Iowa are performing well. It appears that the development of transverse cracking has been retarded and little rutting has occurred. Contracting agencies must pay special attention to the subgrade conditions during project selection. Because of its performance, CIR is a recommended method to be considered for rehabilitating aged low volume (<2000 AADT) asphalt concrete roads in Iowa.