Making decisions about antibiotic use in the Australian primary healthcare sector

Background Australia has one of the highest rates of antibiotic use amongst OECD countries. Data from the Australian primary healthcare sector suggests unnecessary antibiotics were prescribed for self-resolving conditions. We need to better understand what drives general practitioners (GPs) to prescribe antibiotics, consumers to seek antibiotics, and pharmacists to fill repeat antibiotic prescriptions. It is also not clear how these individuals trade-off between the possible benefits that antibiotics may provide in the immediate/short term, against the longer term societal risk of antimicrobial resistance. This project investigates what factors drive decisions to use antibiotics for GPs, pharmacists and consumers, and how these individuals discount the future. Methods Factors will be gleaned from published literature and from semi-structured interviews, to inform the development of Discrete Choice Experiments (DCEs). Three DCEs will be constructed – one for each group of interest – to allow investigation of which factors are more important in influencing (a) GPs to prescribe antibiotics, (b) consumers to seek antibiotics, and (c) pharmacists to fill legally valid but old or repeat prescriptions of antibiotics. Regression analysis will be conducted to understand the relative importance of these factors. A Time Trade Off exercise will be developed to investigate how these individuals discount the future. Results Findings from the DCEs will provide an insight into which factors are more important in driving decision making in antibiotic use for GPs, pharmacists and consumers. Findings from the Time Trade Off exercise will show what individuals are willing to trade for preserving the miracle of antibiotics. Conclusion Research findings will contribute to existing national programs to bring about a reduction in inappropriate use of antibiotic in Australia. Specifically, influencing how key messages and public health campaigns are crafted, and clinical education and empowerment of GPs and pharmacists to play a more responsive role as stewards of antibiotic use in the community.

Analyzing changes in macro-level drivers of country-specific emissions : The role of consumption, technology and trade

Industrial ecology is an important field of sustainability science. It can be applied to study environmental problems in a policy relevant manner. Industrial ecology uses ecosystem analogy; it aims at closing the loop of materials and substances and at the same time reducing resource consumption and environmental emissions. Emissions from human activities are related to human interference in material cycles. Carbon (C), nitrogen (N) and phosphorus (P) are essential elements for all living organisms, but in excess have negative environmental impacts, such as climate change (CO2, CH4 N2O), acidification (NOx) and eutrophication (N, P). Several indirect macro-level drivers affect emissions change. Population and affluence (GDP/capita) often act as upward drivers for emissions. Technology, as emissions per service used, and consumption, as economic intensity of use, may act as drivers resulting in a reduction in emissions. In addition, the development of country-specific emissions is affected by international trade. The aim of this study was to analyse changes in emissions as affected by macro-level drivers in different European case studies. ImPACT decomposition analysis (IPAT identity) was applied as a method in papers I III. The macro-level perspective was applied to evaluate CO2 emission reduction targets (paper II) and the sharing of greenhouse gas emission reduction targets (paper IV) in the European Union (EU27) up to the year 2020. Data for the study were mainly gathered from official statistics. In all cases, the results were discussed from an environmental policy perspective. The development of nitrogen oxide (NOx) emissions was analysed in the Finnish energy sector during a long time period, 1950 2003 (paper I). Finnish emissions of NOx began to decrease in the 1980s as the progress in technology in terms of NOx/energy curbed the impact of the growth in affluence and population. Carbon dioxide (CO2) emissions related to energy use during 1993 2004 (paper II) were analysed by country and region within the European Union. Considering energy-based CO2 emissions in the European Union, dematerialization and decarbonisation did occur, but not sufficiently to offset population growth and the rapidly increasing affluence during 1993 2004. The development of nitrogen and phosphorus load from aquaculture in relation to salmonid consumption in Finland during 1980 2007 was examined, including international trade in the analysis (paper III). A regional environmental issue, eutrophication of the Baltic Sea, and a marginal, yet locally important source of nutrients was used as a case. Nutrient emissions from Finnish aquaculture decreased from the 1990s onwards: although population, affluence and salmonid consumption steadily increased, aquaculture technology improved and the relative share of imported salmonids increased. According to the sustainability challenge in industrial ecology, the environmental impact of the growing population size and affluence should be compensated by improvements in technology (emissions/service used) and with dematerialisation. In the studied cases, the emission intensity of energy production could be lowered for NOx by cleaning the exhaust gases. Reorganization of the structure of energy production as well as technological innovations will be essential in lowering the emissions of both CO2 and NOx. Regarding the intensity of energy use, making the combustion of fuels more efficient and reducing energy use are essential. In reducing nutrient emissions from Finnish aquaculture to the Baltic Sea (paper III) through technology, limits of biological and physical properties of cultured fish, among others, will eventually be faced. Regarding consumption, salmonids are preferred to many other protein sources. Regarding trade, increasing the proportion of imports will outsource the impacts. Besides improving technology and dematerialization, other viewpoints may also be needed. Reducing the total amount of nutrients cycling in energy systems and eventually contributing to NOx emissions needs to be emphasized. Considering aquaculture emissions, nutrient cycles can be partly closed through using local fish as feed replacing imported feed. In particular, the reduction of CO2 emissions in the future is a very challenging task when considering the necessary rates of dematerialisation and decarbonisation (paper II). Climate change mitigation may have to focus on other greenhouse gases than CO2 and on the potential role of biomass as a carbon sink, among others. The global population is growing and scaling up the environmental impact. Population issues and growing affluence must be considered when discussing emission reductions. Climate policy has only very recently had an influence on emissions, and strong actions are now called for climate change mitigation. Environmental policies in general must cover all the regions related to production and impacts in order to avoid outsourcing of emissions and leakage effects. The macro-level drivers affecting changes in emissions can be identified with the ImPACT framework. Statistics for generally known macro-indicators are currently relatively well available for different countries, and the method is transparent. In the papers included in this study, a similar method was successfully applied in different types of case studies. Using transparent macro-level figures and a simple top-down approach are also appropriate in evaluating and setting international emission reduction targets, as demonstrated in papers II and IV. The projected rates of population and affluence growth are especially worth consideration in setting targets. However, sensitivities in calculations must be carefully acknowledged. In the basic form of the ImPACT model, the economic intensity of consumption and emission intensity of use are included. In seeking to examine consumption but also international trade in more detail, imports were included in paper III. This example demonstrates well how outsourcing of production influences domestic emissions. Country-specific production-based emissions have often been used in similar decomposition analyses. Nevertheless, trade-related issues must not be ignored.

Trade Liberalization, Heterogeneous Firms and Industrial Dynamics

This master thesis studies how trade liberalization affects the firm-level productivity and industrial evolution. To do so, I built a dynamic model that considers firm-level productivity as endogenous to investigate the influence of trade on firm’s productivity and the market structure. In the framework, heterogeneous firms in the same industry operate differently in equilibrium. Specifically, firms are ex ante identical but heterogeneity arises as an equilibrium outcome. Under the setting of monopolistic competition, this type of model yields an industry that is represented not by a steady-state outcome, but by an evolution that rely on the decisions made by individual firms. I prove that trade liberalization has a general positive impact on technological adoption rates and hence increases the firm-level productivity. Besides, this endogenous technology adoption model also captures the stylized facts: exporting firms are larger and more productive than their non-exporting counterparts in the same sector. I assume that the number of firms is endogenous, since, according to the empirical literature, the industrial evolution shows considerably different patterns across countries; some industries experience large scale of firms’ exit in the period of contracting market shares, while some industries display relative stable number of firms or gradually increase quantities. The special word “shakeout” is used to describe the dramatic decrease in the number of firms. In order to explain the causes of shakeout, I construct a model where forward-looking firms decide to enter and exit the market on the basis of their state of technology. In equilibrium, firms choose different dates to adopt innovation which generate a gradual diffusion process. It is exactly this gradual diffusion process that generates the rapid, large-scale exit phenomenon. Specifically, it demonstrates that there is a positive feedback between firm’s exit and adoption, the reduction in the number of firms increases the incentives for remaining firms to adopt innovation. Therefore, in the setting of complete information, this model not only generates a shakeout but also captures the stability of an industry. However, the solely national view of industrial evolution neglects the importance of international trade in determining the shape of market structure. In particular, I show that the higher trade barriers lead to more fragile markets, encouraging the over-entry in the initial stage of industry life cycle and raising the probability of a shakeout. Therefore, more liberalized trade generates more stable market structure from both national and international viewpoints. The main references are Ederington and McCalman(2008,2009).

An approach to scenario analysis of the sustainability of an industrial sector applied to clothing and textiles in the UK

Companies aiming to be 'sustainability leaders' in their sector and governments wanting to support their ambitions need a means to assess the changes required to make a significant difference in the impact of their whole sector. Previous work on scenario analysis/scenario planning demonstrates extensive developments and applications, but as yet few attempts to integrate the 'triple bottom line' concerns of sustainability into scenario planning exercises. This paper, therefore, presents a methodology for scenario analysis of large change to an entire sector. The approach includes calculation of a 'triple bottom line graphic equaliser' to allow exploration and evaluation of the trade-offs between economic, environmental and social impacts. The methodology is applied to the UK's clothing and textiles sector, and results from the study of the sector are summarised. In reflecting on the specific study, some suggestions are made about future application of a similar methodology, including a template of candidate solutions that may lead to significant reduction in impacts. © 2007 Elsevier Ltd. All rights reserved.

Una valoración del sector vinícola riojano

Este trabajo es resultado de la investigación realizada en el marco de la Tesis Doctoral sobre Impacto socioeconómico del sector del vino en Rioja, que elabora M. Larreina.

Transformaciones económicas en el sector costero guipuzcoano central durante el siglo XVII

[ES]El presente artículo pretende analizar cómo se desarrolló en el sector costero central de Guipúzcoa (Orio, Zarauz y Guetaria) la llamada «crisis del XVII» y qué mecanismos arbitraron sus habitantes para sobreponerse a las dificultades. En realidad, se trata de analizar y descubrir qué mecanismos utilizaron para llevar a cabo la reconversión y transformación de sus actividades. En el mencionado ámbito tres fueron las principales actividades económicas relacionadas con el mar: el comercio, la construcción naval y la pesca. Las tres actividades tuvieron que llevar a cabo una serie de reestructuraciones y amoldarse continuamente a lo cambiante de la realidad económica de la época a fin de perdurar y sobrevivir.

The Vietnamese shrimp trade: livelihoods analysis of stakeholders and market chain analysis

Aquaculture and capture fisheries in Vietnam have been increasing fast in the last decade, especially aquaculture growth rate is 12% for the 1999 – 2003 period, contributing a significant part into the hunger eradication and poverty reduction1. Vietnam is to be ranked into one of the countries potential to produce the aquatic economic in the world, and the fact is that, after 40 years of establishing, the fisheries sector has made remarkable contributions to the country. By the list, at the moment the aquatic products make up about 4 - 5% of GDP and create job opportunities for over 3 three million employees (VASEP, 2004), in which the largest contribution is from shrimp farming. [PDF contains 124 pages.]

Market survey of the periwinkle Tympanotonus fuscatus in Rivers State: Sizes, prices, trade routes and exploitation levels

Tympanotonus fuscatus was collected from 23 markets through Rivers State (Nigeria), a few in neighbouring states, and from an unexploited population at Buguma. The size distribution of shells was determined,and information on prices and trade routes was also obtained. The mean shell length of specimens from the unexploited Buguma population was 46.4 mm, compared to 30.4 mm for the Buguma market samples. Mean sizes in other markets showed a geographic pattern: the smallest were from the Adoni-Ogoni-Opobo sector (28.1-30.9); the largest were from the Nembe-Brass sector (37.7-44.2) and Bendel State (35.7-45.6); The results suggest the population structure of Tympanotonus in much of Rivers State has been strongly impacted by overharvesting. They show that local market as well as some in Cross River State, are increasingly being supplied by road with specimens from the Benin River area of Bendel State. Differences between shell types; and relations between shell size, selling price and market distance from source, are also discussed

Análisis económico-financiero de las empresas del sector de comercio al por menor en el Pais Vasco

El trabajo consiste en realizar un análisis económico-financiero de las empresas del sector del comercio al por menor en establecimientos no especializados, con predominio en productos alimenticios establecidas en el País Vasco, centrándose especialmente en el diagnóstico de su situación actual y la evolución reciente de su liquidez, riesgo y rentabilidad. The work consists of carry out an economic and financial analysis of companies in the retail trade in non-specialized sector, stores with food products based in the Basque Country, especially focusing on the diagnosis of the current situation and recent developments their liquidity, risk and profitability.

Análisis económico-financiero de las empresas del sector de comercio al por menor en el País Vasco

Con las herramientas adecuadas, hemos explicado las características económico-financieras esenciales del sector del comercio al por menor en el País Vasco, su comparación con respecto a España, la influencia de Eroski en él y cómo ha sido la evolución del sector respecto a 1994. Hemos querido conocer el estado de salud de este grupo de empresas, para así poder conocer qué tipo de medidas deben tomar estas empresas y cuál es su futuro. La caída de la rentabilidad que surge con el inicio de la crisis en 2008 y unos fondos propios elevados, son los puntos más destacados en nuestro informe.

Una aproximación al sector eléctrico

Español:Este TFG pretende exponer de un modo sencillo el mercado eléctrico español. Se trata de un tema de elevada complejidad y gran extensión. Con el fin de alcanzar una idea clara, hemos decidido centrarnos en los puntos de mayor relevancia. En las secciones siguientes abordamos cuestiones relativas al mercado mayorista (pool) y minorista español así como la incipiente reforma eléctrica llevada a cabo por el Gobierno. Después de una breve Introducción, la sección 2 enumera una serie de términos que se utilizan con frecuencia en esta área. La sección 3 proporciona algunos antecedentes sobre el sector eléctrico. La sección 4 se refiere al mercado mayorista, en el cual se realiza la compra-venta diaria de electricidad. En él participan los productores, los distribuidores y los comercializadores de electricidad, así como los consumidores cualificados de energía eléctrica. Dentro de éste nos encontramos el mercado a plazo (o forward), el mercado diario (o spot) y el mercado a corto plazo (o de ajuste). La sección 5 trata del mercado minorista, su diseño y composición. Aquí, las empresas encargadas de comercializar energía (que compran en el mercado mayorista a las empresas generadoras) se la venden a los consumidores finales. En la sección 6 se aborda la Reforma Eléctrica, aclarando los cambios sufridos desde su implantación. Los hechos más llamativos a este respecto son: la eliminación de las subastas CESUR y el cambio de la Tarifa de Último Recurso (TUR) a un Precio Voluntario para el Pequeño Consumidor (PVPC). Por último, hay una sección final con las principales conclusiones.

Estrategia de internacionalización en el sector vitivinícola: análisis de casos

[ES]En este Trabajo de Fin de Grado se trata el tema de la internacionalización en el sector vitivinícola, expresando brevemente la importancia del sector agroalimentario, del cual es parte el área analizada. Será analizado mediante casos prácticos, se estudiarán dos de las bodegas más importantes de España, establecidas en dos comunidades autónomas que son productoras y distribuidoras de vino históricamente; Bodegas Eguren-Ugarte, afincada en el País Vasco y una de las marcas más conocidas a nivel nacional; Bodegas Torres, afincada en la Cataluña y una de las marcas más conocidas tanto a nivel nacional como mundial. Mediante la realización de entrevistas a responsables de comercio exterior busco por una parte afianzar mis aptitudes en cuanto a la relación con grandes empresarios, intentando conocer mejor como trabajan e intentando mejorar el cara a cara con personas influyentes. Por otro lado, pretendo identificar las características diferenciales del proceso de internacionalización del sector vitivinícola, para conocer mejor el sector y la manera en la que las empresas bodegueras realizan su expansión internacional. En tercer lugar, y debido a que el sector vitivinícola crece y se moderniza a grandes velocidades, conocer las nuevas vías de comercialización de producto. Por último, y en menor grado, debido a la falta de información, trato de valorarla participación de los entes públicos (estatales, autonómicos o europeos) dentro del proceso de internacionalización y si esta participación es influyente.

U. S. Trade in Tuna for Canning, 1987

U.S. tuna fleet activity, canned tuna processing, ex-vessel, wholesale and retail prices and imports in 1987 are described and compared to their counterparts in previous years. Industry statistics gathered from government agencies and industry contacts are presented in 14 figures and 8 tables. In 1987, U.S. tuna fisheries delivered 253,136 short tons (tons) of tuna to U.S. canneries. Domestic deliveries of albacore (white-meat) tuna were 2,836 tons, down 20 percent from 1986 levels. Domestic deliveries of tropical (light-meat) tuna (bigeye, blackfin, bluefin, skipjack, and yellowfin) were 251,000 tons, up 12 percent. Contract prices for tuna delivered by U. S. vessels to U. S. canneries increased dramatically in 1987. Depending on the size of fish in the delivery, ex-vessel prices of white-meat tuna increased as much as 27 percent, and prices of light-meat tuna increased as much as 47 percent. U. S. cannery receipts of imported and domestically caught raw frozen tuna for canning totaled 532,704 tons in 1987, up 2 percent from 1986 levels. U.S. cannery receipts of white-meat tuna were 104,197 tons, down 10 percent from 1986. Imports made up 97 percent of the total cannery supply. Total 1987 U. S. cannery receipts of raw, frozen light meat tuna were 428,507 tons, up 5 percent from 1986 levels. Imports made up 41 percent of the total cannery supply. The 1987 U.S. pack of canned tuna was 33.6 million standard cases, up 3 percent from 1986. The pack of white-meat tuna was 7.2 million standard cases, down 11 percent from 1986; the pack of light-meat tuna was 26.4 million standard cases, up 7 percent. U. S. imports of canned tuna in 1987 were 10.8 million standard cases, down 11 percent from 1986 levels, the first time in recent years that imports have declined. Per capita consumption of canned tuna in the United States was 3.5 pounds in 1987, down slightly from 1986. The retail composite price was $2.26 per pound, unchanged from 1986.

Trade unions, civil society organisations and health reforms

This article provides an analysis of resistance to neoliberalism and commodification in the public healthcare sector as seen from a trade union perspective. It uses recent research on social-movement unionism and new labour internationalism to structure a series of case studies examining resistance to different dimensions of healthcare commodification in four countries. The range of alliances trade unions are making do not fit tidily into one model, but give insights into the movement elements of trade unionism. This dimension must be strengthened, but can also be in tension with collective bargaining and other institutional processes. How to constantly reconcile these different positions is the future challenge facing trade unions.

The trade unions membership dynamics and union members’ trajectories

This text presents an analysis of aggregated membership’s dynamics for Spanish trade unions, using ECVT data, as well as union memberships’ trajectories, or members’ decisions about joining the organization, permanency and responsibilities, and subsequent attrition. For the analysis of trajectories we make use of information of the records of actual memberships and the record of quitting of CCOO, and of a survey-questionnaire to a sample of leavers of the same union. This study allows us to confirm a linkage between the decision and motivations to become union member, to participate in union activities, the time of permanency, and the motives to quit the organization. We also identify five types of union members’ trajectories, indicating that, far from views that assert a monolithic structure, unions are complex organizations.