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Background: Interactions between societies and nature are regulated by complex systems of beliefs, symbolism, customs, and worldviews (kosmos), ecological knowledge (corpus), and management strategies and practices (praxis), which are constructed as product of experiences and communication of people throughout time. These aspects influence social relations, life strategies, and cultural identity, and all of them in turn influence and are influenced by local and regional patterns of interchange. In this study, we analyze the interchange of wild and weedy plants and mushrooms in traditional markets of the Phurépecha region of Mexico. Particularly, the social relations constructed around the interchange of these products; how knowledge, cultural values, and ecological factors influence and are influenced by interchange; and how all these factors influence the type and intensity of biotic resources management. Methods: We studied three main traditional markets of the Phurépecha region of Michoacán, Mexico, through 140 visits to markets and 60 semi-structured interviews to sellers of wild and weedy plants and mushrooms. In nearly 2 years, we carried out 80 visits and 30 interviews in the "Barter Market", 20 visits and 15 interviews in the "Phurépecha Tiánguis", and 40 visits and 15 interviews to the "Municipal Market". We documented information about the spaces of interchange that form the markets, the types of interchange occurring there, the cultural and economic values of the resources studied, the environmental units that are sources of such resources, the activities associated to resources harvesting and, particularly, the management techniques practiced to ensure or increase their availability. We analyzed the relations between the amounts of products interchanged, considered as pressures on the resources; the perception of their abundance or scarcity, considered as the magnitude of risk in relation to the pressures referred to; and the management types as response to pressures and risk. Results: We recorded 38 species of wild and weedy plants and 15 mushroom species interchanged in the markets. We characterized the spaces of interchange, the interchange types, and social relations among numerous Phurépecha communities which maintain the main features of pre-Columbian markets. The products analyzed are differentially valued according to their role in people's life, particularly food, medicine, rituals, and ornamental purposes. The highest cultural values were identified in multi-purpose plant and mushroom resources and, outstandingly, in ornamental and ritual plants. In markets, women are the main actors and connectors of the regional households' activities of use and management of local resources and ecosystems. The interrelationships between worldviews, knowledge, and practices are visible through the interchange of the products analyzed, including the types of environments comprised in communitarian territories, agricultural calendars, and feasts. Those plants and mushrooms are highly valued but relatively scarce according to the demand on them receiving special attention and management practices directed to ensure or increase their availability. With the exception of most mushrooms and ornamental and ritual plants, which have high economic and cultural values, there are those that are relatively scarce and under high risk, but are obtained through simple gathering from the wild. Conclusions: Traditional markets are crucial part of the subsistence strategy of Phurépecha people based on the multiple use of resources and ecosystems at the local and regional levels. The markets influence social relations, cultural identity, and preservation of traditional knowledge and biodiversity. In general, the demand of products in markets enhances innovation and practices for ensuring or increasing their availability, particularly those that are naturally scarce. However, it was notorious that, althoug mushrooms and ritual plants have high demand and value in markets, most of them are obtained by simple gathering. [ABSTRACT FROM AUTHOR]

Background: Alcohol-related harm is a substantial burden on the community in Australia and internationally, particularly harm related to risky drinking practices of young people in the night-time economy. This protocol paper describes a study that will report on the changes in a wide range of health and justice outcome measures associated with major policy changes in the state of Queensland, Australia. A key element includes trading hours restrictions for licensed premises to 2 am for the state and 3 am in Safe Night Precincts (SNPs). Other measures introduced include drinks restrictions after midnight, increased patron banning measures for repeat offenders, mandatory ID scanning of patrons in late-night venues, and education campaigns.Methods: The primary aim of the study is to evaluate change in the levels of harm due to these policy changes using administrative data (e.g., police, hospital, ambulance, and court data). Other study elements will investigate the impact of the Policy by measuring foot traffic volume in SNPs, using ID scanner data to quantify the volume of people entering venues and measure the effectiveness of banning notices, using patron interviews to quantify the levels of pre-drinking, intoxication and illicit drug use within night-time economy districts, and to explore the impacts of the Policy on business and live music, and costs to the community.Discussion: The information gathered through this project aims to evaluate the effectiveness of the Policy and to draw on these findings to inform future prevention and enforcement approaches by policy makers, police, and venue staff. [ABSTRACT FROM AUTHOR]

Background: Food product reformulation is seen as one among several tools to promote healthier eating. Reformulating the recipe for a processed food, e.g. reducing the fat, sugar or salt content of the foods, or increasing the content of whole-grains, can help the consumers to pursue a healthier life style. In this study, we evaluate the effects on calorie sales of a 'silent' reformulation strategy, where a retail chain's private-label brands are reformulated to a lower energy density without making specific claims on the product. Methods: Using an ecological study design, we analyse 52 weeks' sales data - enriched with data on products' energy density - from a Danish retail chain. Sales of eight product categories were studied. Within each of these categories, specific products had been reformulated during the 52 weeks data period. Using econometric methods, we decompose the changes in calorie turnover and sales value into direct and indirect effects of product reformulation. Results: For all considered products, the direct effect of product reformulation was a reduction in the sale of calories from the respective product categories - between 0.5 and 8.2%. In several cases, the reformulation led to indirect substitution effects that were counterproductive with regard to reducing calorie turnover. However, except in two insignificant cases, these indirect substitution effects were dominated by the direct effect of the reformulation, leading to net reductions in calorie sales between -3.1 and 7.5%. For all considered product reformulations, the reformulation had either positive, zero or very moderate negative effects on the sales value of the product category to which the reformulated product belonged. Conclusions: Based on these findings, 'silent' reformulation of retailer's private brands towards lower energy density seems to contribute to lowering the calorie intake in the population (although to a moderate extent) with moderate losses in retailer's sales revenues. [ABSTRACT FROM AUTHOR]

Background: There is a need for accurate and precise food price elasticities (PE, change in consumer demand in response to change in price) to better inform policy on health-related food taxes and subsidies.Methods/design: The Price Experiment and Modelling (Price ExaM) study aims to: I) derive accurate and precise food PE values; II) quantify the impact of price changes on quantity and quality of discrete food group purchases and; III) model the potential health and disease impacts of a range of food taxes and subsidies. To achieve this, we will use a novel method that includes a randomised Virtual Supermarket experiment and econometric methods. Findings will be applied in simulation models to estimate population health impact (quality-adjusted life-years [QALYs]) using a multi-state life-table model. The study will consist of four sequential steps: 1. We generate 5000 price sets with random price variation for all 1412 Virtual Supermarket food and beverage products. Then we add systematic price variation for foods to simulate five taxes and subsidies: a fruit and vegetable subsidy and taxes on sugar, saturated fat, salt, and sugar-sweetened beverages. 2. Using an experimental design, 1000 adult New Zealand shoppers complete five household grocery shops in the Virtual Supermarket where they are randomly assigned to one of the 5000 price sets each time. 3. Output data (i.e., multiple observations of price configurations and purchased amounts) are used as inputs to econometric models (using Bayesian methods) to estimate accurate PE values. 4. A disease simulation model will be run with the new PE values as inputs to estimate QALYs gained and health costs saved for the five policy interventions.Discussion: The Price ExaM study has the potential to enhance public health and economic disciplines by introducing internationally novel scientific methods to estimate accurate and precise food PE values. These values will be used to model the potential health and disease impacts of various food pricing policy options. Findings will inform policy on health-related food taxes and subsidies.Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12616000122459 (registered 3 February 2016). [ABSTRACT FROM AUTHOR]

Background: Free trade agreements (FTAs) can affect food environments and non-communicable disease risks through altering the availability of highly-processed foods. Few studies have quantified such effects. Using a natural experiment this paper quantifies changes in Peru's soft-drink market before/after entry into the US-Peru FTA, compared with Bolivia, a county with no such agreement.Methods: Difference-in-difference models were used to test for between country differences in the rate of per capita foreign direct investment (FDI) inflows, soft-drink imports, the volumes of various soft-drinks sold, and the volumes of sugar from soft-drinks before/after FTA ratification (2006) and enforcement (2009).Results: In Peru average per capita FDI-inflows rose from US$103.11 in the pre-ratification period to US$269.79 post-ratification, with little change in Bolivia. This corresponded with a 122 % increase in Peruvian soft-drink production. There was a significant between-country difference in FDI-inflows pre-/post-ratification (DID:1.07, 95 % CI:0.19-1.96; p = 0.01). Despite little difference in total per capita soft-drink sales volumes there was a significant between-country difference in per capita sugar from soft-drinks pre-/post enforcement (DID:-0.99, 95 % CI: -1.91-0.06; p = 0.03) with stagnated growth in Peru and continued growth in Bolivia. This resulted from stagnated sugar sweetened carbonates growth and increased bottled water, juice and sports & energy drinks growth in Peru, with continued carbonates growth in Bolivia. There was a significant between-country difference in per capita carbonates (DID: -1.44, 95 % CI: -2.52-0.36, p = 0.01) and bottled water (DID:0.63; 95 % CI: -0.01-1.26; p = 0.04) sales volumes.Conclusions: The FTA may have resulted in increased FDI-inflows and soft-drink production and also contributed to the diversification of soft drinks produced and sold in Peru with some positive (stagnated carbonates and increased bottled water) and some negative (increased juice and sports & energy drinks) implications for nutrition. These changes were not evident in Bolivia. These results should be interpreted cautiously given the study design limitations. [ABSTRACT FROM AUTHOR]

Background: Rising greenhouse gas emissions (GHGEs) have implications for health and up to 30 % of emissions globally are thought to arise from agriculture. Synergies exist between diets low in GHGEs and health however some foods have the opposite relationship, such as sugar production being a relatively low source of GHGEs. In order to address this and to further characterise a healthy sustainable diet, we model the effect on UK non-communicable disease mortality and GHGEs of internalising the social cost of carbon into the price of food alongside a 20 % tax on sugar sweetened beverages (SSBs).Methods: Developing previously published work, we simulate four tax scenarios: (A) a GHGEs tax of £2.86/tonne of CO2 equivalents (tCO2e)/100 g product on all products with emissions greater than the mean across all food groups (0.36 kgCO2e/100 g); (B) scenario A but with subsidies on foods with emissions lower than 0.36 kgCO2e/100 g such that the effect is revenue neutral; (C) scenario A but with a 20 % sales tax on SSBs; (D) scenario B but with a 20 % sales tax on SSBs. An almost ideal demand system is used to estimate price elasticities and a comparative risk assessment model is used to estimate changes to non-communicable disease mortality.Results: We estimate that scenario A would lead to 300 deaths delayed or averted, 18,900 ktCO2e fewer GHGEs, and £3.0 billion tax revenue; scenario B, 90 deaths delayed or averted and 17,100 ktCO2e fewer GHGEs; scenario C, 1,200 deaths delayed or averted, 18,500 ktCO2e fewer GHGEs, and £3.4 billion revenue; and scenario D, 2,000 deaths delayed or averted and 16,500 ktCO2e fewer GHGEs. Deaths averted are mainly due to increased fibre and reduced fat consumption; a SSB tax reduces SSB and sugar consumption.Conclusions: Incorporating the social cost of carbon into the price of food has the potential to improve health, reduce GHGEs, and raise revenue. The simple addition of a tax on SSBs can mitigate negative health consequences arising from sugar being low in GHGEs. Further conflicts remain, including increased consumption of unhealthy foods such as cakes and nutrients such as salt. [ABSTRACT FROM AUTHOR]

Background: School-located vaccination against influenza (SLV-I) has the potential to improve current suboptimal influenza immunization coverage for U.S. school-aged children. However, little is known about SLV-I's cost-effectiveness. The objective of this study is to establish the cost-effectiveness of SLV-I based on a two-year community-based randomized controlled trial (Year 1: 2009-2010 vaccination season, an unusual H1N1 pandemic influenza season, and Year 2: 2010-2011, a more typical influenza season).Methods: We performed a cost-effectiveness analysis on a two-year randomized controlled trial of a Western New York SLV-I program. SLV-I clinics were offered in 21 intervention elementary schools (Year 1 n = 9,027; Year 2 n = 9,145 children) with standard-of-care (no SLV-I) in control schools (Year 1 n = 4,534 (10 schools); Year 2 n = 4,796 children (11 schools)). We estimated the cost-per-vaccinated child, by dividing the incremental cost of the intervention by the incremental effectiveness (i.e., the number of additionally vaccinated students in intervention schools compared to control schools).Results: In Years 1 and 2, respectively, the effectiveness measure (proportion of children vaccinated) was 11.2 and 12.0 percentage points higher in intervention (40.7 % and 40.4 %) than control schools. In year 2, the cost-per-vaccinated child excluding vaccine purchase ($59.88 in 2010 US $) consisted of three component costs: (A) the school costs ($8.25); (B) the project coordination costs ($32.33); and (C) the vendor costs excluding vaccine purchase ($16.68), summed through Monte Carlo simulation. Compared to Year 1, the two component costs (A) and (C) decreased, while the component cost (B) increased in Year 2. The cost-per-vaccinated child, excluding vaccine purchase, was $59.73 (Year 1) and $59.88 (Year 2, statistically indistinguishable from Year 1), higher than the published cost of providing influenza vaccination in medical practices ($39.54). However, taking indirect costs (e.g., averted parental costs to visit medical practices) into account, vaccination was less costly in SLV-I ($23.96 in Year 1, $24.07 in Year 2) than in medical practices.Conclusions: Our two-year trial's findings reinforced the evidence to support SLV-I as a potentially favorable system to increase childhood influenza vaccination rates in a cost-efficient way. Increased efficiencies in SLV-I are needed for a sustainable and scalable SLV-I program. [ABSTRACT FROM AUTHOR]

Background: Trade and investment liberalization may facilitate the spread of sugar-sweetened carbonated beverages (SSCBs), products associated with increased risk factors for obesity, type II diabetes, and cardiovascular diseases (Circulation 121:1356-1364, 2010). Apart from a limited set of comparative cross-national studies, the majority of analyses linking liberalization and the food environment have drawn on case studies and descriptive accounts. The current failure of many countries to reverse the obesity epidemic calls for investigation into both individual and systemic factors, including trade and investment policies.Methods: Using a natural experimental design we tested whether Vietnam's removal of restrictions on foreign direct investment (FDI) subsequent to its accession to the World Trade Organization in 2007 increased sales of SSCBs compared with a matched country, the Philippines, which acceded in 1995. Difference-in-difference (DID) models were used to test pre/post differences in total SSCB sales and foreign company penetration covering the years 1999-2013.Results: Following Vietnam's removal of restrictions on FDI, the growth rate of SSCB sales increased to 12.1 % per capita per year from a prior growth rate of 3.3 %. SSCB sales per capita rose significantly faster pre- and post-intervention in Vietnam compared with the control country the Philippines (DID: 4.6 L per annum, 95 % CI: 3.8 to 5.4 L, p < 0.008). Vietnam's increase in SSCBs was primarily attributable to products manufactured by foreign companies, whose annual sales growth rates rose from 6.7 to 23.1 %, again unmatched within the Philippines over this period (DID: 12.3 %, 95 % CI: 8.6 to 16.0 %, p < 0.049).Conclusions: Growth of SSCB sales in Vietnam, led by foreign-owned companies, significantly accelerated after trade and investment liberalization. [ABSTRACT FROM AUTHOR]