Consumers’ willingness to pay for food safety: the case of mycotoxins in milk

European statistics show that one of the most widespread source of health risks related to food is mycotoxins. The objective of this paper is to evaluate the Italian consumers’ perception of the mycotoxins’ risk and, more specifically, their willingness-to-pay (WTP) for a hypothetical bottle of milk obtained by cows in which the feed ration contains maize certified for the ‘good practices’ that reduce such risk. For this purpose, a web-based stated choice (SC) experiment involving a representative sample of 973 Italian consumers has been carried out and WTP has been measured using the panel data version of a Random Parameters Logit (RPL) model. The results show that Italian consumers are willing to pay a rather high average price premium for “reduced-micotoxin” milk. This premium becomes even higher for female, middle-age and low-education consumers.Food safety, Mycotoxins, Willingness to pay, Mixed logit, Agricultural and Food Policy, Consumer/Household Economics, Demand and Price Analysis, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, Health Economics and Policy, C35, D12,

Sirtuin functions and modulation: from chemistry to the clinic

Sirtuins are NAD+ -dependent histone deacetylases regulating important metabolic pathways in prokaryotes and eukaryotes and are involved in many biological processes such as cell survival, senescence, proliferation, apoptosis, DNA repair, cell metabolism, and caloric restriction. The seven members of this family of enzymes are considered potential targets for the treatment of human pathologies including neurodegenerative diseases, cardiovascular diseases, and cancer. Furthermore, recent interest focusing on sirtuin modulators as epigenetic players in the regulation of fundamental biological pathways has prompted increased efforts to discover new small molecules able to modify sirtuin activity. Here, we review the role, mechanism of action, and biological function of the seven sirtuins, as well as their inhibitors and activators

Farmaci oppioidi e Cannabis nella terapia del dolore

[English]:“Opioid and Cannabis in Pain Control” is the result of studies performed by the Pharmacy Department and the “Centro Interdipartimentale di Ricerca in Farmacoeconomia e Farmacoutilizzazione” (CIRFF) of the University of Naples, “Federico II”. This book is aimed to those who work in a pharmacy and who, scholars, teachers or students, are interested in delve into the issue. The text analyzes different topics with an interdisciplinary approach. A large part is devoted to the chemical and pharmacological aspects related to this topic. Subsequently, the text focuses the theme, still very debated, of using opioids and Cannabis in therapy through an exhaustive analysis of the entire existing legislation: from the first laws promulgated by the Kingdom of Italy until the last ministerial circulars by Italian republic. Finally yet importantly, an important part of the book focuses on medical and therapeutic interpretation with regard to the effects on pain control, where opioids and Cannabis are not only a fruitful frontier of research, but also a consolidated and effective tool to counteract some types of pain / [Italiano]: “Farmaci oppioidi e Cannabis nella terapia del dolore” rappresenta il frutto di alcuni studi, condotti per almeno tre lustri nel Dipartimento di Farmacia e nel Centro Interdipartimentale di Ricerca in Farmacoeconomia e Farmacoutilizzazione (CIRFF) della Federico II, e si rivolge sia a chi presta servizio ogni giorno in una farmacia, sia a chi, studioso, docente o studente, è interessato ad approfondire l’argomento. Il testo, utilizzando un approccio interdisciplinare, si muove su piani euristici differenti. Naturalmente, ampio spazio è stato dedicato alla parte farmaceutica, analizzando tutti gli aspetti chimici e farmacologici connessi a questo tema. Un secondo punto di rilievo riguarda la problematica normativa legata alla dibattuta questione dell’utilizzo in terapia degli oppioidi e della Cannabis. In tal senso, si è cercato di offrire una prospettiva chiara ed esauriente del complesso quadro legislativo vigente: a partire dalle prime leggi promulgate dal Regno d’Italia, fino ad arrivare alle ultime circolari ministeriali in materia, è stata rivista ed esaminata l’intera normativa sulle sostanze stupefacenti, spiegandone anche i passaggi più delicati e controversi. Infine, soprattutto per ciò che concerne le ricadute sulla terapia del dolore, una parte significativa del libro si è concentrata sull’interpretazione medica e terapeutica, dove i farmaci oppioidi e la Cannabis costituiscono non solo una feconda frontiera di ricerca, ma anche un consolidato ed efficace strumento per contrastare alcune tipologie di dolore

Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results: This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed

Consumers’ willingness to pay for food safety: the case of mycotoxins in milk

European statistics show that one of the most widespread source of health risks related to food is mycotoxins. The objective of this paper is to evaluate the Italian consumers’ perception of the mycotoxins’ risk and, more specifically, their willingness-to-pay (WTP) for a hypothetical bottle of milk obtained by cows in which the feed ration contains maize certified for the ‘good practices’ that reduce such risk. For this purpose, a web-based stated choice (SC) experiment involving a representative sample of 973 Italian consumers has been carried out and WTP has been measured using the panel data version of a Random Parameters Logit (RPL) model. The results show that Italian consumers are willing to pay a rather high average price premium for “reduced-micotoxin” milk. This premium becomes even higher for female, middle-age and low-education consumers

A hypothetical road mapto reduce acid related diseases costs management.

OBJECTIVES: To assess if acid related diseases are better managed by empiric treatment or by a diagnostic approach. METHODS: We analyzed the outcome of 182 patients with dyspepsia and/or gastro-oesophageal reflux disease (GERD) in primary care, over a period of 12 months, in the Campania region (southern Italy). Patients were divided in two groups: therapeutic group, if patients received pharmacological treat- ment since the beginning, and diagnostic group, if underwent a diagnostic approach. After 12 months the direct management costs (consultations, diagnostic procedures, drugs) were calcu- lated for both groups using National Health Service prospective (expressed in Euro 2005). We analyzed the diagnostic procedures defined as “not useful”, procedures that did not provide addi- tional information to help us decide on therapy changes, whether the prescription had been prescribed only on the basis of the symptoms (therapeutic group) or it had only been hypothesized before the diagnostic approach (diagnostic group). RESULTS: Ninety-eight patients were in therapeutic group (median age 49; Males 53%) and 84 in diagnostic group (median age 50; Males 52%). For patients in the diagnostic group there were higher management costs than for other patients (268 vs € 156/year on average). Diagnostic procedures did not modify the prescribed or hypothesized therapy and clinical management in 75% (21/28) of patients with GERD, 52% (26/50) with dyspepsia and 58% (15/26) with both GERD and dyspepsia. Based on the estimated prevalence of clinically relevant acid related diseases in Campa- nia, the cost/year of “not useful” diagnostic procedures could be of about 2.64, 4.16 and 10.73 million euros for GERD, dyspepsia and dyspepsia-GERD, respectively. CONCLUSIONS: Although the concept of “not useful” diagnostic procedure is debatable, the results of this analysis further suggest to address more attention to the improvement of education for disease management with the aim to contain health care cost

Influence of generic drugs on proton pump inhibitor prescription in primary care.

OBJECTIVES: The aim of this study is to evaluate general practitioners’ prescription (GPs) of different Proton Pump Inhibitors (PPIs) in the period between 2005 to 2008. METHODS: Analysis has been performed on a database of 99 medical practitioners that have managed an average of 150.000 inhabitants. We evaluate the PPIs prescriptions from January 2005 to December 2008. Evaluations performed are the following:1) PPI prescription (total and separately for lansoprazole, esomeprazole, pantoprazole,rabeprazole, and omeprazole); 2) prevalence of the reimbursement purpose (Gastroprotection—G; Acid-Related Disease—ARD); 3) prevalence of patients with ARD categorized on the basis of PPI prescriptions as drugs box/year (1–3 short treatment— ST; 4–11 long treatment—LT; >12 very long treatment—VLT). Data were expressed as Compound Annual Growth Rate (CAGR). RESULTS: The total volume of PPI’s prescribing increased progressively over the 4 years (CAGR +15%). The growth for each molecule was: L +42%; E +11%; P +16; R +3%; O 1%. The reimbursement purpose was significantly higher for G (CAGR +41%) than for ARD (CAGR +6%; p < 0.01). We found an increase of ARD patients with VLT with a significant highest CAGR (ST +3.9%, LT +4.8%, VLT +7.4%; p < 0.01). PPI prescription showed a highest CAGR for L in all patients (27%), while the lowest one was for O in VLT patients (-9%). CONCLUSIONS: Generic PPIs has unexpectedly increased the prescription of whole drug class during the period 2005–2008. We observed a marked increase in a very long duration PPI treatment for ARD that caused a relevant resource consumption. Our data suggest that the appropriateness of PPI prescription after generic PPI introduction should be carefully monitored to distinguish between costeffective from cost-ineffective PPI treatment