Potential conflicts in the fight against counterfeit drugs

This analysis looks at the best way to deal with the proliferation of fake drugs, and considers the conflict that arises when government agencies aim to reduce the harmful effects of the fake medicine trade while the pharmaceutical firms seek profit maximization. It is demonstrated that the pharmaceutical industry might wish to encourage better law enforcement rather than improved information policies, even when the latter would lead to a greater reduction in the fake drug trade.fake medicine trade

EL GASTO SANITARIO PÚBLICO EN ESPAÑA Y SU CONTRIBUCIÓN A LOS NIVELES DE SALUD Y LA PRODUCTIVIDAD

This paper analyzes the effect of public health spending on productivity and its influence on the individual health-status. From a descriptive approximation the results suggest that health resources are positively associated with the population health-status measured by subjective indicators. We then develop an extension of the Solow model, which includes current and capital health spending. The estimations use a regional panel data and suggest that current health spending has consistently effects, while investment in health care has no effect on productivity. Classification-JEL : N10, J24, I10Health-status, public health spending, productivity.

Economic Crisis, Unemployment and Illegal Drug Consumption in Spain

[Abstract] Purpose – The purpose of this paper is to analyse the association between drug consumption and unemployment. This paper also studies the differential association between these variables in both the preand current-crisis periods. The results are compared in an attempt to verify that the population of users is more vulnerable in terms of how likely they are to get and hold down a job in the labour market. Design/methodology/approach – Matching methods and microdata from the Survey on Alcohol and Drugs in Spain, EDADES are used. The use of these methods on the estimates carried out prove to be particularly effective in reducing treatment-selection bias. The authors’ interest is also to analyse the differential association between the interest variables in both the pre- and current-crisis periods. For this purpose, the authors also use the differences-in-differences (DID) estimation method between the two periods to check if the impact of drug use on unemployment depends on the economic context. The estimations are compared in an attempt to verify that the population of users is less likely to attain and hold down a job in the labour market than non-drug users. Findings – The results obtained in the current study are consistent with the hypothesis that drug use decreases an individual’s capacity and availability when he or she is trying to enter the labour market. In both 2007 and 2013, drug users were more likely to be unemployed, regardless of the type of drug. Differences in the probability of being unemployed intensify during an economic crisis. In light of these results, it is possible to conclude that the negative effect of drug consumption on an individual’s employability is increased during periods of economic recession. Research limitations/implications – The study presented here has some limitations. Firstly, crosssectional data were used to examine the causal relationship between consumption and employment. In this sense, the results are susceptible to bias. The unavailability of longitudinal data on the same individual made it impossible for the researchers to consider periods of abstinence, the duration of periods of consumption and how this consumption affected an individual’s productivity and his or her working situation. Another limitation is that certain relevant unemployment variables may have been omitted. Among the variables that affect an individual’s labour participation is the existence of sources of income as an alternative to market salaries. With state subsidies, income from illegal activities and money sent by family or friends, an individual may decide not to work. This problem could be mitigated if omitted variables operate in a similar way throughout both of the periods examined. Social implications – Given the results obtained in this paper, the authors believe that public policy conclusions should be mainly concerned with the importance of implementing proactive employment policies, along with family support programmes and a greater role for primary care among the people with the highest risks of exclusion. Health treatment should go jointly with measures that make it easier for individuals to enter the workforce. These steps would only be possible with an improved level of education and more complete professional profiles, to increase motivation when individuals seek employment. Originality/value – This study could make various contributions to the existing body of evidence. In the authors’ knowledge, this is the first attempt to document the effect of the economic crisis on the employability of the drug-using population in contrast with the general population. Moreover, a methodology is presented that provides an alternative to those used in earlier studies, in terms of reducing treatment-selection bias. At the same time, the use of a DID estimation method between pre- and current-crisis periods allow us to check if the impact of drugs consumption on unemployment depends on the economic context.Ministerio de Ciencia e Innovación de España; ECO2013-4821

Provisión de cuidados informales y enfermedad de Alzheimer: valoración económica y estudio de la variabilidad del tiempo.

Alzheimer's disease represents a significant burden in terms of time for the carer of the patient not institutionalized. The aim of this article is to estimate the cost of the time of the informal care depending on the type of disability and study the underlying factors of its variability. The empirical analysis has been made with data obtained through a retrospective questionnaire administered by the caregiver, using a probabilistic estimation model. The results show that most of the time is spent on personal care activities and physical mobility, increasing the average cost when considering more severe stages of the disease. Differences in time are explained mainly by the stage of the disease, the state of health of the caregiver and the availability of professional care.Alzheimer's disease; informal care, cost, time

Comportamiento mecánico del concreto con fibra óptica reciclada como refuerzo al 5%, 10% y 15% del peso del cemento. Lima 2019

El objetivo de la presente investigación es un diseño de mezcla determinando el porcentaje de fibra óptica reciclada como refuerzo, pudiendo ser 5%, 10% y 15% del peso del cemento, según la ACI 211. Se pretende utilizar fibra óptica reciclado como refuerzo del concreto, de esta forma se presenta una alternativa para el uso de materiales reciclados, con el fin de crear un concreto económico y amigable con el medio ambiente, beneficiando a la población en donde predomine el cable de fibra óptica reciclado. El proyecto de investigación se desarrolla, debido a la cantidad de residuos de cables de fibra óptica, que se generan día a día, causando malestar en la población, por ello se busca minimizar la contaminación ambiental, ya que se estaría demostrando que estos residuos tendrían un buen uso en la fabricación de un concreto experimental, el cual a su vez podría ser muy bien utilizado, no solo en la costa peruana, sino en zonas con intenso friaje. En primer lugar, se da a conocer la forma en que se puede aportar la fibra en el concreto para la elaboración del mortero experimental, en esta parte se describen los procedimientos y tratamiento para el plástico obtenido. Seguidamente se determina el porcentaje de fibra óptica reciclado , el cual proponemos 5%, 10% y 15% del peso del cemento, a utilizar como fibra de refuerzo para llegar a la resistencia de 210 kc/cm2 de un concreto experimental, para ello se estudia diferentes dosificaciones y determina las características mecánicas de cada una de ellas, a la vez se realizarán varios ensayos para determinar la cantidad de porcentaje que se cumplirá en todos los parámetros del material utilizando las normas peruanas y finalmente comparar la resistencia de un concreto convencional y el concreto experimental fabricado.The objective of the present investigation is a mixture design determining the percentage of recycled fiber optics, which will partially replace the coarse aggregate to obtain a concrete f´c = 210 kg / cm2, according to ACI 211. It is intended to use recycled fiber optic cable granules as aggregate in the concrete mix replacing a fraction of commonly used fine aggregates (sand). In this way an alternative is presented for the replacement of natural aggregates with recycled materials, in order to create an economical and environmentally friendly concrete, benefiting the population where the recycled fiber optic cable predominates. The research project is developed, due to the amount of fiber optic cable waste, which is generated day by day, causing discomfort in the population, so it seeks to minimize environmental pollution, since it would be demonstrating that these residues would have a good use in the manufacture of an experimental concrete, which in turn could be very well used, not only on the Peruvian coast, but in areas with intense cold. First, the way in which the fiber can be provided in the concrete for the elaboration of the experimental mortar is disclosed, in this part the procedures and treatment for the plastic obtained are described. Next, the percentage of recycled optical fiber to be used to obtain an increase in the compressive strength of an experimental concrete is determined, for this purpose different dosages are studied and the mechanical characteristics of each of them are determined, at the same time several tests will be carried out to determine the amount of percentage that will be met to determine all the parameters of the material using Peruvian standards, to finally compare the strength of a conventional concrete and the experimental concrete manufactured

Efecto del tiempo de hemodiálisis sobre el estado nutricional de los pacientes renales de Contigo Clínica del Riñón de Santo Domingo de los Tsáchilas – 2017.

El objetivo fue determinar el efecto del tiempo de hemodiálisis sobre el estado nutricional de los pacientes renales de Contigo Clínica del Riñón de Santo Domingo de los Tsáchilas, que se dializan tres veces por semana, en horarios establecidos. Se evaluaron 85 pacientes renales. El estudio es no experimental, analítico y transversal. Se tomó medidas antropométricas: índice de masa corporal (IMC), pliegue tricipital, circunferencia media de brazo y circunferencia de cintura. La evaluación de la ingesta alimentaria se hizo con recordatorio de 24 horas. En los parámetros bioquímicos se midió colesterol, Ldl, Hdl, triglicéridos, calcio, fósforo, potasio. Se aplicó el score de malnutrición e inflamación, se registró indicadores de suficiencia dialítica Kt/V, y equivalente proteico de nitrógeno ureico (PNA). Se analizó en IBM SPSS Statistics 23. Se encontró que a mayor tiempo de diálisis hay mayor desnutrición según pliegue tricipital (PT), aumenta los pacientes con hipertrigliceridemia, la hipoalbuminemia está presente a menor o mayor tiempo, y según recordatorio de 24 horas hubo relación estadísticamente significativa (p<0.05), a mayor tiempo en diálisis disminuye ingesta de proteína y aumenta consumo de carbohidratos. En el Score de Malnutrición e Inflamación (MIS) con significancia estadística se encontró; a mayor tiempo de diálisis más malnutrición e inflamación y, a mayor tiempo de diálisis hay déficit proteico según PNA. Se encontró relación entre el tiempo de diálisis y la ingesta de proteína, hallándose relación negativa, evidenciándose una media en la ingesta de 1.1gr/kg/día. El tiempo de diálisis es muy importante para un paciente renal, por lo que se debe tener más cuidado a partir del año de diálisis ya que se evidenció menor ingesta proteica a mayor tiempo de diálisis y los marcadores de suficiencia dialítica son importantes y se deben analizar en conjunto al evaluar el estado nutricional de un paciente sometido a tratamiento de hemodiálisis.The objective was to determine the effect of the hemodialysis time on the nutritional status in renal patients from Contigo Clínica del Riñón in Santo Domingo de los Tsáchilas, who are dialyzed three times a week. We evaluated 85 renal patients. The study is non-experimental, analytical and transversal. Anthropometric measures were taken: body mass index (BMI), triceps fold, middle arm circumference and waist circumference. The evaluation of human consumption was made with a reminder of 24-hours. In the biochemical parameters cholesterol, Ldl, HDL, triglycerides, calcium, phosphorus, potassium were measured. The malnutrition and inflammation score was applied, Kt / V dialysis sufficiency indicators and the protein equivalent of urea nitrogen (ANP) were verified. It was analyzed in IBM SPSS Statistics 23. It was found that the greater the time of dialysis, there is greater malnutrition according to the Tricipital Skinfold Thickness (TST), the increase in patients with hypertriglyceridemia, the hypoalbuminemia is present at a shorter or longer time, and according to a 24-hour reminder there was a relationship statistically significant (p <0.05), the longer on dialysis decreases protein intake and increases carbohydrate consumption. In the Malnutrition and Inflammation Score (MIS) with statistical significance was found; the longer dialysis, more malnutrition and inflammation, and the greater the time of dialysis, there is a protein deficit according to ANP. A relation was found between the time of dialysis and the protein intake, being found a negative relationship, evidencing a measure in the intake of 1.1gr / kg / day. The time of dialysis is very important for a renal patient, so more care should be taken from the year of dialysis since there is less protein intake at longer dialysis time and dialysis sufficiency markers are important and should be analyzed together when assessing the nutritional status of a patient undergoing hemodialysis treatment

Efecto del tiempo de hemodiálisis sobre el estado nutricional de los pacientes renales de Contigo Clínica del Riñón de Santo Domingo de los Tsáchilas – 2017.

El objetivo fue determinar el efecto del tiempo de hemodiálisis sobre el estado nutricional de los pacientes renales de Contigo Clínica del Riñón de Santo Domingo de los Tsáchilas, que se dializan tres veces por semana, en horarios establecidos. Se evaluaron 85 pacientes renales. El estudio es no experimental, analítico y transversal. Se tomó medidas antropométricas: índice de masa corporal (IMC), pliegue tricipital, circunferencia media de brazo y circunferencia de cintura. La evaluación de la ingesta alimentaria se hizo con recordatorio de 24 horas. En los parámetros bioquímicos se midió colesterol, Ldl, Hdl, triglicéridos, calcio, fósforo, potasio. Se aplicó el score de malnutrición e inflamación, se registró indicadores de suficiencia dialítica Kt/V, y equivalente proteico de nitrógeno ureico (PNA). Se analizó en IBM SPSS Statistics 23. Se encontró que a mayor tiempo de diálisis hay mayor desnutrición según pliegue tricipital (PT), aumenta los pacientes con hipertrigliceridemia, la hipoalbuminemia está presente a menor o mayor tiempo, y según recordatorio de 24 horas hubo relación estadísticamente significativa (p<0.05), a mayor tiempo en diálisis disminuye ingesta de proteína y aumenta consumo de carbohidratos. En el Score de Malnutrición e Inflamación (MIS) con significancia estadística se encontró; a mayor tiempo de diálisis más malnutrición e inflamación y, a mayor tiempo de diálisis hay déficit proteico según PNA. Se encontró relación entre el tiempo de diálisis y la ingesta de proteína, hallándose relación negativa, evidenciándose una media en la ingesta de 1.1gr/kg/día. El tiempo de diálisis es muy importante para un paciente renal, por lo que se debe tener más cuidado a partir del año de diálisis ya que se evidenció menor ingesta proteica a mayor tiempo de diálisis y los marcadores de suficiencia dialítica son importantes y se deben analizar en conjunto al evaluar el estado nutricional de un paciente sometido a tratamiento de hemodiálisis.The objective was to determine the effect of the hemodialysis time on the nutritional status in renal patients from Contigo Clínica del Riñón in Santo Domingo de los Tsáchilas, who are dialyzed three times a week. We evaluated 85 renal patients. The study is non-experimental, analytical and transversal. Anthropometric measures were taken: body mass index (BMI), triceps fold, middle arm circumference and waist circumference. The evaluation of human consumption was made with a reminder of 24-hours. In the biochemical parameters cholesterol, Ldl, HDL, triglycerides, calcium, phosphorus, potassium were measured. The malnutrition and inflammation score was applied, Kt / V dialysis sufficiency indicators and the protein equivalent of urea nitrogen (ANP) were verified. It was analyzed in IBM SPSS Statistics 23. It was found that the greater the time of dialysis, there is greater malnutrition according to the Tricipital Skinfold Thickness (TST), the increase in patients with hypertriglyceridemia, the hypoalbuminemia is present at a shorter or longer time, and according to a 24-hour reminder there was a relationship statistically significant (p <0.05), the longer on dialysis decreases protein intake and increases carbohydrate consumption. In the Malnutrition and Inflammation Score (MIS) with statistical significance was found; the longer dialysis, more malnutrition and inflammation, and the greater the time of dialysis, there is a protein deficit according to ANP. A relation was found between the time of dialysis and the protein intake, being found a negative relationship, evidencing a measure in the intake of 1.1gr / kg / day. The time of dialysis is very important for a renal patient, so more care should be taken from the year of dialysis since there is less protein intake at longer dialysis time and dialysis sufficiency markers are important and should be analyzed together when assessing the nutritional status of a patient undergoing hemodialysis treatment