Estimating net lottery revenues for states

Based on 1980–95 data, this paper estimates and forecasts net lottery revenues for states with and without lotteries. This study indicates that a multi-state estimation is improved when a time-series and cross-section technique is used. Forecasting results are also improved when unequal time series in the data and less-than-full first years of operating lottery are controlled. For states without lotteries, the time-series and cross-section estimation indicates that only two of 14 states without a lottery would have generated net lottery revenue of more than $100 million. The number increases to five of 14 in the cross-section estimation.     

The evolution of morality and the end of economic man

1871 saw the publication of two major treatises in economics, with self-seeking economic man at their center. In the same year Darwin published The Descent of Man, which emphasized sympathy and cooperation as well as self-interest, and contained a powerful argument that morality has evolved in humans by natural selection. Essentially this stance is supported by modern research. This paper considers the nature of morality and how it has evolved. It reconciles Darwin’s notion that a developed morality requires language and deliberation (and is thus unique to humans), with his other view that moral feelings have a long-evolved and biologically-inherited basis. The social role of morality and its difference with altruism is illustrated by an agent-based simulation. The fact that humans combine both moral and selfish dispositions has major implications for the social sciences and obliges us to abandon the pre-eminent notion of selfish economic man. Economic policy must take account of our moral nature.     

Evaluating drug cost per responder and number needed to treat associated with lixisenatide on top of glargine when compared to rapid-acting insulin intensification regimens on top of glargine,in patients with type 2 diabetes in the UK,Italy, and Spain

Objectives: This study investigated the cost per responder and number needed to treat (NNT) in type 2 diabetes mellitus (T2DM) patients for lixisenatide compared to insulin intensification regimens using composite endpoints in the UK, Italy, and Spain.

Methods: Efficacy and safety outcomes were obtained from GetGoal Duo-2, a 26-week phase 3 trial comparing lixisenatide vs insulin glulisine (IG) once daily (QD) and three times daily (TID). Response at week 26 was extrapolated to 52 weeks, assuming a maintained treatment effect, based on long-term evidence in other T2DM populations. Responders were defined using composite end-points, based on an HbA1c threshold and/or no weight gain and/or no hypoglycemia. The HbA1c threshold was varied in sensitivity analyses. Annual treatment costs were estimated in euros (1 GBP?=?1.26 EUR), including drug acquisition and resource use costs. Cost per responder was computed by dividing annual treatment costs per patient by the proportion of responders.

Results: Lixisenatide was associated with the lowest cost per responder for all composite end-points that included a weight-related component. For the main composite end-point of HbA1c ≤7.5% AND no weight gain AND no symptomatic hypoglycemia, cost per responder results were: UK: 6,867€, 8,746€, and 12,410€; Italy: 7,057€, 9,160€, and 12,844€; Spain: 8,370€, 11,365€, and 17,038€, for lixisenatide, IG QD, and TID, respectively. The NNT analysis showed that, for every 6.85 and 5.86 patients treated with lixisenatide, there was approximately one additional responder compared to IG QD and TID, respectively.

Limitations: A limitation of the clinical inputs is the lack of 52-week trial data from GetGoal Duo-2, which led to the assumption of a maintained treatment effect from week 26 to 52.

Conclusions: This analysis suggests lixisenatide is an efficient economic resource allocation in the UK, Italy, and Spain.     

Making tourism work for the poor: Strategies and challenges in southern Africa

This article analyses strategies for 'pro-poor tourism' (PPT), ie strategies that increase the benefits to poor people from tourism development. Based on an international review of six pro-poor tourism case studies, it outlines the wide range of pro-poor tourism strategies used and their impacts to date, with particular focus on southern African case studies. By analysing their progress, problems and the critical factors influencing them, the article identifies implications for the way forward. This review underpins four propositions. First, despite commercial constraints, much can be done to enhance the contribution of tourism to poverty reduction, and a 'PPT' perspective assists in this endeavour. Secondly, PPT strategies can, and should be, incorporated by all actors in tourism, whether in government or business, at local or policy level. Thirdly, a wide range of impacts on poor people, going well beyond jobs, need to be recognised and enhanced. Finally, PPT strategies are difficult, but particularly relevant in southern Africa given the challenges of economic and political transformation, as well as the opportunity to influence international discussions on 'sustainable tourism' at the World Summit on Sustainable Development in Johannesburg in 2002.     

Author Index

In 1998, in response to the escalating problem of violence and its impact on all sectors of the society, the Ministry of Health (MOH), Jamaica, established a pilot violence-related injury surveillance system (VRISS) in the country's leading public hospital, the Kingston Public Hospital (KPH) situated in the nation's capital. After six months' operation, VRISS was extended to include all injuries. Nine months later, the Jamaican Injury Surveillance System (JISS) was successfully introduced to four other hospitals and has been in operation since. Extension to an additional six institutions was implemented at the end of 2001. What were the challenges faced in introducing an injury surveillance system into the Accident &; Emergency Department (A&;E) of a general hospital, how they were overcome and what were the lessons learnt in the process?     

Non-fatal violence-related injuries in Kingston,Jamaica: a preventable drain on resources

Using data for a one-year period from the Kingston Public Hospital (KPH) in Jamaica, we describe patterns of non-fatal violence-related injuries, and carry out simulation analysis to estimate rates of hospital admission under various injury reduction scenarios, and the potential savings that can be realized by reducing violent crimes. In this period there were 6107 registered violence-related visits to the KPH representing 11.5% of all recorded visits. Of these 16.6% (1001) were admitted. The most common methods of inflicting injury was by stabbing (52.1%), blunt injuries (37.9%) and gunshot wounds (7.3%). Multivariate analyses indicated that gunshot injuries, stab injuries, being male between the ages of 15 and 44 years, receiving the injury in November or December, and being injured by a stranger or unknown assailant, were significant correlates of a higher probability of admission. Simulation analysis with various injury reduction scenarios indicated decreases in the probability of admission ranging from 12% to 44%, with estimated savings of up to 31% of the annual supplies budget of KPH.     

Can the Beast be Tamed?: Reflections on John McMurtry's Unequal Freedoms: The Global Market as an Ethical System

My paper responds to certain themes of Professor John McMurtry's recent book, Unequal Freedoms: The Global Market as an Ethical System. Although I am in general sympathy with McMurtry's penetrating critique of conventional market theory and practice, I find Unequal Freedoms ambivalent on the critical question of whether endorsing and enacting the life-value code McMurtry proposes would require only a mitigation of the principles and definitive activities of the competitive market system or whether significant reforms within the system would have to be deep structural ones. It is argued that the second alternative is inescapable. I defend my perspective from the point of view of a philosophical analysis of orthodox or neo-classical theory-construction about the competitive market order. In particular, I examine three fundamental principles of such modelling: the maximization of the satisfaction of self-interest, the unboundedness of consumer desire for material goods, and the distribution of monetized wealth. In order for McMurtry's "civil commons" to survive, the practice of each of these principles would need to be radically modified. However, in doing so, competitive capitalism would lose its essential identity as a socio-economic order.