The economic burden of depression among adults with rheumatoid arthritis in the United States

Aims: Depression is the most frequent comorbidity reported among patients with rheumatoid arthritis (RA). Comorbid depression negatively impacts RA patients’ health-related quality-of-life, physical function, mental function, mortality, and experience of pain and symptom severity. The objective of this study was to assess healthcare utilization, expenditures, and work productivity among patients with RA with or without depression.

Materials and methods: Data from adult patients who had at least two visits each related to RA and depression over a 1-year period were extracted from the Truven Health MarketScan research databases. Outcomes comprised healthcare resource utilization, work productivity loss, and direct healthcare costs comparing patients with RA with depression (n?=?3,478) vs patients with RA without depression (n?=?43,222).

Results: Patients with RA and depression had a significantly greater relative risk of hospitalization and number of all-cause and RA-related hospitalizations, utilization of emergency services, days spent in the hospital, physician visits, and RA-related surgeries compared with RA patients without depression. Patients with RA and depression had a higher risk of and experienced more events and days of short-term disability compared with patients without depression. The incremental adjusted annual all-cause and RA-related direct costs were $8,488 (95% CI = $6,793–$10,223) and $578 (95% CI = –$98–$1,243), respectively, when comparing patients with RA and depression vs RA only.

Limitations: The current analysis is subject to the known limitations of retrospective studies based on administrative claims data.

Conclusions: This study suggested increased healthcare utilization, work productivity loss, and economic burden among RA patients due to comorbid depression. These findings emphasize the importance of managing depression and including depression as a factor when devising treatment algorithms for patients with RA.     

加征关税如何影响美国贸易逆差及全球福利——基于美元本位下两国动态一般均衡框架的分析

本文构建了一个包含美元本位特征的两国模型,在此基础上分析了美国加征关税及引发的贸易摩擦对美国贸易逆差和全球福利的影响,并详细探讨了相关传导机制。在基准模型设定下,美国单方面加征20%关税会使得美国贸易逆差占GDP比重小幅缩小约0.40个百分点,美国长期稳态GDP下降约2.50%,其他国家GDP下降约1.10%,美国居民福利上升约0.60%,其他国家居民福利下降约1.20%。美国单方面加征关税在抑制全球贸易和生产的同时,会通过更加不公平的国际贸易恶化全球福利分配。当其他国家采取报复性措施时,其他国家自身福利并不会进一步恶化,但美国福利会大幅下滑,同时美国贸易逆差相对规模变化不大。贸易摩擦博弈的“囚徒困境”特征在一定程度上能够解释贸易战的发生。削弱美元本位地位能促进国际贸易公平性的提升,进而能减弱贸易摩擦带来的负面影响、提升全球福利水平,并能有效缩窄美国贸易逆差。     

New development: China renews reform of central–local fiscal relations and provides for basic national public services

China’s reform on central–local fiscal reform has slowed down in recent years. The appointment of a new finance minister experienced in local government affairs is expected to renew the reform affirmed by the Chinese Communist Party (CCP) congress in late 2017. China has unprecedentedly identified a comprehensive list of 81 national basic public services as entitlements. Eighteen of them are subject to national and local standards, and co-financed by central and local governments. A new cost-sharing method for 10 of these services classifies sub-national jurisdictions into five tiers, in which the central government’s share declines from 80% to 10%. These measures, effective in 2019, aim at creating a ‘harmonious and moderately prosperous society’.     

施工企业引导EPC项目初步设计策划

EPC工程总承包合同模式不同于施工总承包,通常情况下业主不提供施工图纸,业主只对工程的功能性提出相应要求.承包商可以综合协调建筑的使用功能、结构安全、工期、成本等诸多因素,最大限度地发挥设计的主导作用,为业主提供优质服务的同时,增加自身的盈利水平.EPC项目不论何种模式,从成本造价控制角度讲,其设计阶段管控效果要远远大于采购与施工阶段.通过商务创效引导初步设计,从源头落实商务策划,锁定工程概算,降低EPC项目设计风险,加强设计前段管理,能有效地提升项目生产经营能力.     

LEADERSHIP IN CLIMATE CHANGE MITIGATION: CONSEQUENCES AND INCENTIVES

Initiatives in favor of unilateral action on climate change are frequently challenged by concerns over free riding. Nevertheless, we observe an increasing number of unilateral efforts at different administrative levels and in different parts of the world. Previous academic literature described various individual mechanisms where emissions abroad may increase or decrease as a reaction to unilateral emission reductions. In this paper, we collect a comprehensive set of both positive and negative reactions and analyze them in stylized models. This allows us to identify the most important characteristics that determine the potential of a leader to boost mitigation efforts abroad. We find that this potential depends on (i) a strong ability to generate knowledge through leadership, (ii) a high degree of credibility in the international community, and (iii) a similar economic structure to the most important emitters. While most effects are difficult to quantify, this comprehensive assessment suggests that leakage effects resulting from unilateral mitigation may well be outweighed by positive reactions.     

Labour market characteristics and surviving import shocks

This paper investigates whether different labour market characteristics amplify or dampen the local labour market impacts from Chinese import competition exposure. I exploit state‐level variation in initial, pre‐shock labour market characteristics and regional variation across local labour markets in exposure to Chinese imports for identification. I find that local labour markets in states with higher union density experience more severe adverse consequences as a result of increased import exposure. Conversely, higher initial minimum wages help mute the negative impacts of the China shock. I also provide some evidence that exceptions to employment‐at‐will legislation can affect employment responses to increased Chinese imports. Finally, examining all policies together in an index, I show that higher levels of policies intended to benefit and protect workers can actually magnify the extent of the damage inflicted by import competition. My results suggest that initial labour market characteristics and policies can play an important role in understanding why local labour markets react differently to trade shocks.     

国家助学贷款中信息不对称问题及其矫正

国家助学贷款工作的实施,为帮助贫困大学生顺利完成学业发挥着重要作用。但是由于助学贷款中的信息不对称所引起的逆向选择和道德风险问题使该项工作陷入了贷还两难的窘境。因此,必须通过建立完善的信用制度,健全法律法规,设计合理的还贷激励机制,构建风险分担体系,加大高校的工作投入,使助学贷款工作能够顺利实施,发挥更大的作用。     

A Bayesian analysis of a variance decomposition for stock returns

We apply Bayesian methods to study a common vector autoregression (VAR)-based approach for decomposing the variance of excess stock returns into components reflecting news about future excess stock returns, future real interest rates, and future dividends. We develop a new prior elicitation strategy, which involves expressing beliefs about the components of the variance decomposition. Previous Bayesian work elicited priors from the difficult-to-interpret parameters of the VAR. With a commonly used data set, we find that the posterior standard deviations for the variance decomposition based on these previously used priors, including “non-informative” limiting cases, are much larger than classical standard errors based on asymptotic approximations. Therefore, the non-informative researcher remains relatively uninformed about the variance decomposition after observing the data. We show the large posterior standard deviations arise because the “non-informative” prior is implicitly very informative in a highly undesirable way. However, reasonably informative priors using our elicitation method allow for much more precise inference about components of the variance decomposition.