The economic impact of alcohol consumption: a systematic review

<p>Abstract</p> <p>Background</p> <p>Information on the economic impact of alcohol consumption can provide important evidence in supporting policies to reduce its associated harm. To date, several studies on the economic costs of alcohol consumption have been conducted worldwide. This study aims to review the economic impact of alcohol worldwide, summarizing the state of knowledge with regard to two elements: (1) cost components included in the estimation; (2) the methodologies employed in works conducted to date.</p> <p>Methods</p> <p>Relevant publications concerning the societal cost of alcohol consumption published during the years 1990-2007 were identified through MEDLINE. The World Health Organization's global status report on alcohol, bibliographies and expert communications were also used to identify additional relevant studies.</p> <p>Results</p> <p>Twenty studies met the inclusion criteria for full review while an additional two studies were considered for partial review. Most studies employed the human capital approach and estimated the gross cost of alcohol consumption. Both direct and indirect costs were taken into account in all studies while intangible costs were incorporated in only a few studies. The economic burden of alcohol in the 12 selected countries was estimated to equate to 0.45 - 5.44% of Gross Domestic Product (GDP).</p> <p>Conclusion</p> <p>Discrepancies in the estimation method and cost components included in the analyses limit a direct comparison across studies. The findings, however, consistently confirmed that the economic burden of alcohol on society is substantial. Given the importance of this issue and the limitation in generalizing the findings across different settings, further well-designed research studies are warranted in specific countries to support the formulation of alcohol-related policies.</p

Discursos de médicos de família brasileiros e italianos sobre autonomia na perspectiva bioética

Este artigo analisa discursos de médicos de família brasileiros e italianos sobre o potencial de impulsão à autonomia de sujeitos-usuários competentes cognitivamente nas decisões do cuidado, em ações de atenção primária à saúde, na perspectiva bioética. Pesquisa qualitativa de caráter exploratório, realizada em 2007, em Florianópolis, Santa Catarina, Brasil, e na província de Roma, região Lazio, Itália, com 15 médicos de família brasileiros, 15 médicos de família italianos e um diretor sanitário do Serviço Sanitário Nacional (SSN), Itália. Foram utilizados como instrumentos de coleta entrevistas semiestruturadas e diário de campo. O tratamento e a sistematização do conteúdo das mensagens geraram duas categorias analíticas: "racionalidade biomédica versus racionalidade emancipatória" e "da condição histórica de menoridade ao desejo de ser autônomo". Em ambos os países, depoimentos revelaram: a) fragilidade na materialização da autonomia diante do imperativo biomédico contemporâneo de prevenir riscos probabilísticos; e b) movimentos emancipatórios geradores de estratégias concretas e simbólicas para o enfrentamento da desconstrução da prática médica, historicamente produzida através do lastro obediência. Discursos brasileiros apontaram os protocolos produtivistas, impostos por gestões, como instrumento de preservação de menoridades. Médicos de família italianos sinalizaram um maior reconhecimento de sujeitos-cidadão de direitos na condução do cuidado. A pesquisa revelou a necessidade de a APS brasileira dialogar com teorias das ciências humanas e investir em mecanismos de impulsão ao exercício ético para rever o sentido que vem ocupando a adoção da bipolítica de prevenção ao risco na continência da saúde concreta do tempo presente

La salute degli immigrati. Opportunità e criticità di una situazione in evoluzione

The principles of equality and non-discrimination are especially relevant when considering people or communities who are particularly disadvantaged due to their specific frailties. This heterogeneous population includes, but is not limited to, the elderly, women, the patients suffering from chronic-degenerative diseases, the minors and the migrants. With regard to each of these groups, there is strong evidence deriving from scientific, sociological and juridical research that, even in our Western societies, their rights are often neglected or, even worse, denied. Therefore, to making sure that these rights are respected has profound implications for their status. This is most evident in the field of healthcare, where the professionals’ choices, decisions and actions impact the lives of all these people in a profound and intimate way. On the other hand, to recognize and respect the right to health of these populations must be perceived neither as a paternalistic option nor as an expression of some kind of charitable work. Otherwise, respecting the right to health of frail people generates obligations and responsibilities that have to be carefully considered, honored and embedded in the culture of all healthcare professionals as well as in the culture of the entire community. This article analyzes the economic, organizational and cultural problems and limitations that, still today and especially in the current post-pandemic phase, the elderly, women, the chronically ill, minors and migrants face in seeing their right to health recognized and respected in a country whose national health system claims to be universalist