Educated millennials and credence attributes of food products with genetically modified organisms: Knowledge, trust and social media

In this paper, we investigated educated millennials’ evaluation of credence attributes in food products containing genetically modified organisms (GMO products). Our goal is to assess whether beliefs about GMO products are determined by scientific knowledge alone or if they are affected by other factors such as trust in information providers and use of social media. The focus on millennials is motivated by the increasing relevance of this social group in the public debate and by their extensive use of social media. We surveyed a sample of 215 Italian college students, confronting them with questions about safety, environmental impact and ethical issues in GMO product consumption. Using an ordered probit regression model, we found that educated millennials build their beliefs using a mix of scientific knowledge and trust in information providers. The role of the two drivers depended on the issue considered. Scientific knowledge drove beliefs in health claims, while trust in information providers was a driving factor in almost all claims. After controlling for trust effects, we did not find evidence of impact of confidence in the reliability of traditional and social media on beliefs. This result contradicts previous literature

Determinação rápida de extrato etéreo utilizando extrator a alta temperatura.

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Predição do teor de proteína bruta em biomassa de capins braquiária por meio de espectroscopia NIR.

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Cost and Utilization of Behavioral Health Medications Associated with Rescission of an Exemption for Prior Authorization for Severe and Persistent Mental Illness in the Vermont Medicaid Program

BACKGROUND: In recent years, many state Medicaid programs have implemented preferred drug lists (PDL) to control pharmaceutical costs by generating supplemental rebate revenues and directing providers to the most cost-effective treatments. Two states, Michigan and Vermont, sought approval from the Centers for Medicare and Medicaid Services for supplemental rebates for their Medicaid fee-for-service programs in 2002. Behavioral health medications were largely excluded from PDLs and other managed care initiatives implemented by state Medicaid programs because of significant opposition to any impact on this vulnerable population. In November 2001, the Vermont Medicaid program implemented the Vermont Health Access Pharmacy Benefit Management Program, a PDL designed to promote cost-effective use of medications. Despite the potential cost savings resulting from implementation of a PDL, behavioral health providers and advocates in the state of Vermont opposed the implementation of the managed care initiative for beneficiaries with severe mental illness, and after January of 2002, Vermont\u27s program was changed to exempt beneficiaries meeting the severe and persistent mental illness (SPMI) criteria from prior authorization (PA) for behavioral health medications not on the Medicaid PDL. The SPMI exemption was phased out by June 30, 2006. OBJECTIVES: To determine the effects of the rescission of the PA exemption on utilization and costs of 3 classes of behavioral health medications (antidepressants, antipsychotics, and anxiolytics/sedatives). Secondary analyses were conducted to assess the association between rescission of the PA exemption and 2 quality measures that might be associated with pharmacy management policy: (a) behavioral health hospitalizations and (b) high-dose prescribing of antipsychotics, defined as dosing that exceeded the manufacturer-recommended maximum dose by 25%. METHODS: This was a retrospective analysis of pharmacy claims for beneficiaries of the Office of Vermont Health Access Medicaid Program for dates of service from July 1, 2005, through December 31, 2007. The 12-month PA exemption period for 3 categories of drugs (antidepressants, antipsychotics, and anxiolytics/sedatives) was July 1, 2005, through June 30, 2006; and the post-PA exemption period was the 12 months from January 1, 2007, through December 31, 2007, following rescission of the SPMI exemption. Costs in this analysis were defined as the amount paid by Medicaid, excluding federal drug rebates paid by drug manufacturers and supplemental rebates associated with the PDL program. Costs were adjusted for inflation using the Consumer Price Index for medical costs. Frequencies were used to identify trends between medication classes and time periods. Medical claims from the 2 time periods were used to assess inpatient hospitalization trends. Descriptive statistics, Pearson chi-square tests (for categorical data), and t-tests (for continuous data) were used to assess the 2 study cohorts. RESULTS: 17.8% (n=22,130) of 124,169 eligible beneficiaries in the PA exemption period had 1 or more pharmacy claims in the 3 classes of medications exempt from PA versus 19.2% (n=23,717) of 123,499 eligible beneficiaries in the post-PA exemption period. Utilization of behavioral medications per member per month (PMPM) increased by 14.3% from 0.14 claims PMPM in the PA exemption period to 0.16 claims PMPM in the post-PA exemption period, similar to the 14.1% increase in the utilization of nonbehavioral medications (from 0.64 to 0.73 claims PMPM). Utilization changed little between the PA exemption period and the post-PA exemption period for the 3 individual classes of behavioral health drugs, 0.08 claims PMPM versus 0.09 claims PMPM for antidepressants and 0.03 for both study periods for both antipsychotics and anxiolytics/sedative hypnotics. PMPM costs for the 3 drug classes exempt from PA increased by 2.1% from $12.76 to$13.03, compared with a 12.2% increase from $42.58 PMPM to$47.79 PMPM for nonbehavioral health medications. The small 2.1% increase in PMPM costs for the 3 formerly PA-exempt drug classes was attributable in part to a 12.9% reduction in average cost per pharmacy claim, from $94.05 to$81.92, including a 24.8% reduction in the average cost per antidepressant claim, from $65.59 to$49.33. For the subgroup of beneficiaries taking atypical antipsychotic medications, the percentage with high-dose prescriptions decreased from 3.1% to 2.2%. Mental health inpatient hospitalizations also decreased from 0.6% of beneficiaries in the PA exemption period to 0.4% in the post-PA exemption period. CONCLUSIONS: In a Medicaid population excluding Medicare dual-eligible beneficiaries, the rescission of a PA exemption for 3 major classes of behavioral health medications in a PDL was not associated with decreased utilization of formerly PA-exempt behavioral health medications. The increase in PMPM spending for the formerly PA-exempt behavioral health medications was small compared with the increase in PMPM cost for nonbehavioral health medications, and there were fewer beneficiaries with hospitalization for mental health reasons in the period after rescission of the PA exemption

Time boundary terms and Dirac constraints

Time boundary terms usually added to action principles are systematically handled in the framework of Dirac's canonical analysis. The procedure begins with the introduction of the boundary term into the integral Hamiltonian action and then the resulting action is interpreted as a Lagrangian one to which Dirac's method is applied. Once the general theory is developed, the current procedure is implemented and illustrated in various examples which are originally endowed with different types of constraints.Comment: 12 page

Determinação da glicemia e índice glicêmico do cogumelo Agaricus brasiliensis em modelo de ratos Wistar normais e efeitos diabéticos por aplicação de estreptozotocina.

Trabalho apresentado no XV Congresso Latinoamericano de Nutricion e XVI Jornadas de la Sociedad Chilena de Nutrición, 2009, Santiago do Chile