Avoidable Portion of Tobacco-Attributable Acute Care Hospital Days and Its Cost Due to Implementation of Different Intervention Strategies in Canada

The impact of four effective population-based interventions, focusing on individual behavioural change and aimed at reducing tobacco-attributable morbidity, was assessed by modeling with respect to effects on reducing prevalence rates of cigarette smoking, population-attributable fractions, reductions of disease-specific morbidity and its cost for Canada. Results revealed that an implementation of a combination of four tobacco policy interventions would result in a savings of 33,307 acute care hospital days, which translates to a cost savings of about $37 million per year in Canada. Assuming 40% coverage rate for all individually based interventions, the two most effective interventions, in terms of avoidable burden due to morbidity, would be nicotine replacement therapy and physicians’ advice, followed by individual behavioural counselling and increasing taxes by 10%. Although a sizable reduction in the number of hospital days and accumulated costs could be achieved, overall these interventions would reduce less than 3% of all tobacco-attributable costs in Canada

Determining the best population-level alcohol consumption model and its impact on estimates of alcohol-attributable harms

BACKGROUND: The goals of our study are to determine the most appropriate model for alcohol consumption as an exposure for burden of disease, to analyze the effect of the chosen alcohol consumption distribution on the estimation of the alcohol Population- Attributable Fractions (PAFs), and to characterize the chosen alcohol consumption distribution by exploring if there is a global relationship within the distribution. METHODS: To identify the best model, the Log-Normal, Gamma, and Weibull prevalence distributions were examined using data from 41 surveys from Gender, Alcohol and Culture: An International Study (GENACIS) and from the European Comparative Alcohol Study. To assess the effect of these distributions on the estimated alcohol PAFs, we calculated the alcohol PAF for diabetes, breast cancer, and pancreatitis using the three above-named distributions and using the more traditional approach based on categories. The relationship between the mean and the standard deviation from the Gamma distribution was estimated using data from 851 datasets for 66 countries from GENACIS and from the STEPwise approach to Surveillance from the World Health Organization. RESULTS: The Log-Normal distribution provided a poor fit for the survey data, with Gamma and Weibull distributions providing better fits. Additionally, our analyses showed that there were no marked differences for the alcohol PAF estimates based on the Gamma or Weibull distributions compared to PAFs based on categorical alcohol consumption estimates. The standard deviation of the alcohol distribution was highly dependent on the mean, with a unit increase in alcohol consumption associated with a unit increase in the mean of 1.258 (95% CI: 1.223 to 1.293) (R2 = 0.9207) for women and 1.171 (95% CI: 1.144 to 1.197) (R2 = 0. 9474) for men. CONCLUSIONS: Although the Gamma distribution and the Weibull distribution provided similar results, the Gamma distribution is recommended to model alcohol consumption from population surveys due to its fit, flexibility, and the ease with which it can be modified. The results showed that a large degree of variance of the standard deviation of the alcohol consumption Gamma distribution was explained by the mean alcohol consumption, allowing for alcohol consumption to be modeled through a Gamma distribution using only average consumption

Combining best evidence: A novel method to calculate the alcohol-attributable fraction and its variance for injury mortality

<p>Abstract</p> <p>Background</p> <p>The alcohol-attributable fraction for injury mortality is defined as the proportion of fatal injury that would disappear if consumption went to zero. Estimating this fraction has previously been based on a simplistic view of drinking and associated risk. This paper develops a new way to calculate the alcohol-attributable fraction for injury based on different dimensions of drinking, mortality data, experimental data, survey research, new risk scenarios, and by incorporating different distributions of consumption within populations. For this analysis, the Canadian population in 2005 was used as the reference population.</p> <p>Methods</p> <p>Binge drinking and average daily consumption were modeled separately with respect to the calculation of the AAF. The acute consumption risk was calculated with a probability-based method that accounted for both the number of binge drinking occasions and the amount of alcohol consumed per occasion. The average daily consumption was computed based on the prevalence of daily drinking at various levels. These were both combined to get an overall estimate. 3 sensitivity analyses were performed using different alcohol consumption parameters to test the robustness of the model. Calculation of the variance to generate confidence limits around the point estimates was accomplished via Monte Carlo resampling methods on randomly generated AAFs that were based on the distribution and prevalence of drinking in the Canadian population.</p> <p>Results</p> <p>Overall, the AAFs decrease with age and are significantly lower for women than men across all ages. As binge drinking increases, the injury mortality AAF also increases. Motor vehicle collisions show the largest relative increases in AAF as alcohol consumption is increased, with over a 100% increase in AAF from the lowest to highest consumption category. Among non-motor vehicle collisions, the largest change in total AAF occurred both for homicide and other intentional injuries at about a 15% increase in the AAF from the lowest to the highest binge consumption scenarios.</p> <p>Conclusions</p> <p>This method combines the best available evidence to generate new alcohol-attributable fractions for alcohol-attributable injury mortality. Future research is needed to refine the risk function for non-motor vehicle injury types and to investigate potential interactions between binge drinking and average volume of alcohol consumption.</p

Linear approaches to intramolecular Förster Resonance Energy Transfer probe measurements for quantitative modeling

Numerous unimolecular, genetically-encoded Forster Resonance Energy Transfer (FRET) probes for monitoring biochemical activities in live cells have been developed over the past decade. As these probes allow for collection of high frequency, spatially resolved data on signaling events in live cells and tissues, they are an attractive technology for obtaining data to develop quantitative, mathematical models of spatiotemporal signaling dynamics. However, to be useful for such purposes the observed FRET from such probes should be related to a biological quantity of interest through a defined mathematical relationship, which is straightforward when this relationship is linear, and can be difficult otherwise. First, we show that only in rare circumstances is the observed FRET linearly proportional to a biochemical activity. Therefore in most cases FRET measurements should only be compared either to explicitly modeled probes or to concentrations of products of the biochemical activity, but not to activities themselves. Importantly, we find that FRET measured by standard intensity-based, ratiometric methods is inherently non-linear with respect to the fraction of probes undergoing FRET. Alternatively, we find that quantifying FRET either via (1) fluorescence lifetime imaging (FLIM) or (2) ratiometric methods where the donor emission intensity is divided by the directly-excited acceptor emission intensity (denoted R&lt;sub&gt;alt&lt;/sub&gt;) is linear with respect to the fraction of probes undergoing FRET. This linearity property allows one to calculate the fraction of active probes based on the FRET measurement. Thus, our results suggest that either FLIM or ratiometric methods based on R&lt;sub&gt;alt&lt;/sub&gt; are the preferred techniques for obtaining quantitative data from FRET probe experiments for mathematical modeling purpose

Developing a method to derive alcohol-attributable fractions for HIV/AIDS mortality based on alcohol's impact on adherence to antiretroviral medication

<p>Abstract</p> <p>Background</p> <p>Alcohol consumption is causally linked to nonadherence to antiretroviral treatment that in turn causes an increase in HIV/AIDS mortality. This article presents a method to calculate the percentage of HIV/AIDS deaths attributable to alcohol consumption and the associated uncertainty.</p> <p>Methods</p> <p>By combining information on risk relations from a number of published sources, we estimated alcohol-attributable fractions (AAFs) of HIV/AIDS in a stepwise procedure. First, we estimated the effect of alcohol consumption on adherence to antiretroviral treatment, and then we combined this estimate with the impact of nonadherence on death. The 95% uncertainty intervals were computed by estimating the variance of the AAFs using Taylor series expansions of one and multiple variables. AAFs were determined for each of the five Global Burden of Disease regions of Africa, based on country-specific treatment and alcohol consumption data from 2005.</p> <p>Results</p> <p>The effects of alcohol on HIV/AIDS in the African Global Burden of Disease regions range from 0.03% to 0.34% for men and from 0% to 0.17% for women, depending on region and age category. The detrimental effect of alcohol consumption was statistically significant in every region and age category except for the North Africa/Middle East region.</p> <p>Conclusions</p> <p>Although the method has its limitations, it was shown to be feasible and provided estimates of the impact of alcohol use on the mortality outcome of HIV/AIDS.</p

“Is it me or should my friends take the credit?” The role of social networks and social identity in recovery from addiction

This study explored the role of social network and social identity factors in recovery from addiction. The sample consisted of 537 individuals who completed a survey about their experiences of recovery. Results indicated that the transition from addiction to recovery was characterized by an increase in social connectedness and changes in social network composition coupled with the emergence of a “recovery” identity. These factors accounted for 14% of the variance in quality of life when controlling for known predictors, accounting for a greater proportion of variance than substance use variables. Results suggest that recovery from addiction can be understood as a socially mediated transition characterized by social network and social identity change, which drive broader improvements in quality of lif

Umsetzungskonzept der Universitäten des Landes Baden-Württemberg für das High Performance Computing (HPC), Data Intensive Computing (DIC) und Large Scale Scientific Data Management (LS² DM)

Computational Sciences1 und damit die HPC-Systeme als ihr technisches Fundament gewinnen unablässig an Bedeutung, wie auch der Wissenschaftsrat in seinen jüngsten Empfehlungen zur „Finanzierung des Nationalen Hoch- und Höchstleistungsrechnens in Deutschland“2 betont. Die fortschreitende Digitalisierung der Wissenschaft generiert auf Basis verschiedener Forschungs- infrastrukturen Forschungsdaten und damit Anforderungen, die von der schnellen Speicherung bei der Datenerhebung, über die Verarbeitung in HPC- und Cloudsystemen bis hin zur notwen- digen Aufarbeitung der Daten im Sinne „guter wissenschaftlicher Praxis“ reichen. Die Analyse dieser großen Datenmengen zur Gewinnung von neuen Erkenntnissen wird Data Intensive Computing (DIC) genannt – sie wird heute neben Theorie, Experiment und Simulation als vierte Säule der Wissenschaft3 bezeichnet. Hinzu kommen die notwendigen technischen und organi- satorischen Maßnahmen für eine nachhaltige Nutzung der Daten, die eine langfristige Speiche- rung und eine nach Möglichkeit öffentliche Zugänglichkeit garantieren. Der Erkenntnis folgend, dass diese neuen Anforderungen nicht mehr sinnvoll von einzelnen Universitäten oder Forschungsinstitutionen bedient werden können, koordinieren die wissen- schaftlichen Rechenzentren des Landes Baden-Württemberg ihre Aktivitäten diesbezüglich. Gleichzeitig wollen die Landesuniversitäten den Empfehlungen des Rats für Informationsinfra- strukturen (RfII) folgen und ihre Infrastrukturentwicklungen mit dem Aufbau einer Infrastruk- tur für Forschungsdatenmanagement auf Basis ihrer HPC- und DATA-Konzepte verschränken. Kooperative Lösungen helfen die beschriebenen Herausforderungen zu bewältigen und verspre- chen einen institutionen- und disziplinübergreifenden Mehrwert. Für die Periode von 2018 bis 2024 ist es das Ziel aller beteiligten Akteure, den beschrittenen Weg der Kooperation gemäß der HPC Landesstrategie4 weiter zu verfolgen. Damit baut das Land Ba- den-Württemberg ein wesentliches Alleinstellungsmerkmal bei der Unterstützung der Wissen- schaften aus und bekundet ausdrücklich das Interesse und die Bereitschaft, in einer frühen Phase beim Aufbau und der Entwicklung der Nationalen Forschungsdateninfrastruktur (NFDI)5 mitzuwirken. Im Sinne eines integrierten Ansatzes werden die bestehenden Konzepte für HPC, DIC und LS2DM weiterentwickelt und in einer gemeinsamen Strategie zusammengeführt. Gleichzeitig werden die Grundlagen für eine frühe Beteiligung am Aufbau einer NFDI geschaffen und erforderliche Infrastrukturen bereitgestellt

The economic costs of alcohol consumption in Thailand, 2006

<p>Abstract</p> <p>Background</p> <p>There is evidence that the adverse consequences of alcohol impose a substantial economic burden on societies worldwide. Given the lack of generalizability of study results across different settings, many attempts have been made to estimate the economic costs of alcohol for various settings; however, these have mostly been confined to industrialized countries. To our knowledge, there are a very limited number of well-designed studies which estimate the economic costs of alcohol consumption in developing countries, including Thailand. Therefore, this study aims to estimate these economic costs, in Thailand, 2006.</p> <p>Methods</p> <p>This is a prevalence-based, cost-of-illness study. The estimated costs in this study included both direct and indirect costs. Direct costs included health care costs, costs of law enforcement, and costs of property damage due to road-traffic accidents. Indirect costs included costs of productivity loss due to premature mortality, and costs of reduced productivity due to absenteeism and presenteeism (reduced on-the-job productivity).</p> <p>Results</p> <p>The total economic cost of alcohol consumption in Thailand in 2006 was estimated at 156,105.4 million baht (9,627 million US$PPP) or about 1.99$ PPP), followed by cost of productivity loss due to reduced productivity (45,464.6 million baht/2,804 million US$PPP), health care cost (5,491.2 million baht/339 million US$ PPP), cost of property damage as a result of road traffic accidents (779.4 million baht/48 million US$PPP), and cost of law enforcement (242.4 million baht/15 million US$ PPP), respectively. The results from the sensitivity analysis revealed that the cost ranges from 115,160.4 million baht to 214,053.0 million baht (7,102.1 - 13,201 million US$ PPP) depending on the methods and assumptions employed.</p> <p>Conclusions</p> <p>Alcohol imposes a substantial economic burden on Thai society, and according to these findings, the Thai government needs to pay significantly more attention to implementing more effective alcohol policies/interventions in order to reduce the negative consequences associated with alcohol.</p