Abstract Introduction The opioid epidemic is a severe problem in the world, especially in the United States, where prescription opioid overdose accounts for a quarter of drug overdose deaths. Objective To describe psychiatrists’ prescription of opioid, benzodiazepine, and buprenorphine in the United States. Methods We conducted a retrospective cross-sectional study of the 2016 Medicare Part D claims data and analyzed psychiatrists’ prescriptions of: 1) opioids; 2) benzodiazepines, whose concurrent prescription with opioids can cause overdose death; 3) buprenorphine, a partial opioid agonist for treating opioid addiction; 4) and naltrexone microsphere, a once-monthly injectable opioid antagonist to prevent relapse to opioid dependence. Prescribers with 11 or more claims were included in the analysis. Results In Medicare Part D in 2016, there were a total of 1,131,550 prescribers accounting for 1,480,972,766 total prescriptions and 78,145,305 opioid prescriptions, including 25,528 psychiatrists (2.6% of all prescribers) accounting for 44,684,504 total prescriptions (3.0% of all prescriptions) and 131,115 opioid prescriptions (0.2% of all opioid prescriptions). Psychiatrists accounted for 17.3% of benzodiazepine, 16.3% of buprenorphine, and 33.4% of naltrexone microsphere prescriptions. The opioid prescription rate of psychiatrists was much lower than that of all prescribers (0.3 vs 5.3%). The buprenorphine prescription rate of psychiatrists was much higher than that of all prescribers (2.3 vs. 0.1%). There was a substantial geographical variation across the United States. Conclusions The results show that, proportionally, psychiatrists have lower rates of opioid prescription and higher rates of benzodiazepine and buprenorphine prescription.

En mercadeo, administración y literatura sobre organizaciones, los conceptos de valor del consumidor y creación de valor son fundamentales, aunque casi nunca se examinan en el contexto de los bienes de experiencia en pantalla. En este artículo, nos apartamos de enfoques imperantes sobre audiencia o estudios de recepción y estudiamos el valor experimental que produce en el espectador el consumo de un producto visto en pantalla. Aplicando la metodología Q y el esquema de Holbrook sobre valor del consumidor (1999), identificamos segmentos de audiencia empíricamente, partiendo de la experiencia subjetiva de los telespectadores de un producto filmado de manera innovadora: Ryan, breve y laureado documental animado por computador. Este documental utiliza el estado del arte de la animación creativa para contar una historia convincente en un estilo que amplía el género documental. Descubrimos y describimos cuatro segmentos de audiencia que, sin que nos lo propusiéramos, se parecen mucho a los cuatro modos principales de recepción de medios, planteados recientemente por Michelle (2007). Esto crea un vínculo potencialmente útil entre el esquema sobre el valor experiencial del consumidor y los estudios sobre recepción de medios.

Consumer value and value creation are fundamental concepts in marketing, management and in literature on organizations, but are almost never considered in the context of screen-based "experience" products. In this paper, the authors depart from the prevailing approaches to audience or reception studies by investigating the experience value the consumption of a screen-based product has for the spectator. Using the Q-methodology and Holbrook's consumer value framework (1999), they empirically identify audience segments based on television viewers' subjective experience with an innovative film product: the award-winning, computer-animated short documentary Ryan. The film uses creative state-of-the art animation to tell a compelling story in ways that stretch the documentary genre. The authors uncover and describe four audience segments. Unexpectedly, these four segments bear a strong resemblance to the four principal modes of media reception proposed recently by Michelle (2007), thereby creating a potentially fruitful link between the framework for consumer experience value and media reception studies.

Using survey data collected in Mexico in 1991 and 1996, this study examines empirically the regional bases of public support for neoliberal reforms (privatization and NAFTA) . Citizen support for these reforms was found to be higher in the more economically developed northern states and the Federal District than in the southern and central states even though the level of support declined in all regions between 1991 and 1996.Two alternative hypotheses for regional variation in citizen support for these reforms are examined. First, support for neoliberal reforms will be higher in those regions in which citizens are more like ly to have benefited from these reforms and in which citizens are satisfied with economic and political conditions (a utilitarian explanation). Second, citizen support for neoliberal reforms will be higher in those regions in which citizens exhibit more favorable orientations toward the United States (a cultural explanation). The data analysis shows more consistent support for the utilitarian hypothesis; however, more favorable orientations toward the United States help to explain why support for neoliberal reforms is higher in northern Mexico than in the other regions.

Por medio de encuestas de opinión pública llevadas a cabo en México en los años de 1991 y 1996, el presente estudio examina empíricamente las bases regionales de apoyo popular a las reformas neoliberales (privatizaciones y el TLC). Se encontró que el apoyo ciudadano a estas reformas fue mayor en las regiones económicamente más avanzadas como el norte y el Distrito Federal y menor en los estados sureños y centrales, a pesar de que el nivel de este apoyo declinó en todas las regiones entre 1991 y 1996. Se analizan dos hipótesis alternativas para explicar las variaciones regionales de apoyo ciudadano. La primera, el apoyo a las reformas neoliberales será mayor en aquellas regiones donde los ciudadanos estén más propensos a beneficiarse por dichas reformas y donde estén más satisfechos con las condiciones políticas y económicas (explicación utilitarista). La segunda, el apoyo ciudadano a las reformas neoliberales será mayor en aquellas regiones donde los ciudadanos muestren orientaciones más favorables hacia los Estados Unidos (explicación cultural). El análisis estadístico muestra consistentemente mayor sustento a la explicación utilitarista; sin embargo, orientaciones más favorables a Estados Unidos ayudan a explicar por qué el apoyo a las reformas neoliberales es mayor en el norte de México que en las otras regiones.