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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.  相似文献   
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军民融合产业园区高质量发展对于推进军民深度融合、在全国形成可复制可推广经验具有重要意义。军民融合协同创新通过促进新知识涌现、推进新产业集聚发展,最终汇聚经济发展新动能,驱动园区高质量发展。在提出军民融合协同创新驱动园区高质量发展的机理与组织框架基础上,将发展模式归纳为以分享经济为背景的资源共享模式、以新型研发机构为核心的第三方模式、以产业联盟为核心的产业链拓展模式和以交易平台为核心的“PPP”模式,最后提出相关对策建议。  相似文献   
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近年来,在科技支撑和制度支持的背景下,我国的现代农业得到了长足发展,取得了举世瞩目的成绩。但是在发展过程中也出现了很多问题,例如:与发达国家相比,科技装备相对落后,现代农业人才严重短缺,金融支持力度不足,市场机制不完善等,因此深入研究现代农业具有重要的现实意义。文章首先对何为现代农业进行了详细阐述;然后分析了我国现代农业发展的现状;再次分析了我国现代农业发展中存在的主要问题;最后提出了切实可行的对策,为现代农业发展提供一些参考,促进现代农业科学发展。  相似文献   
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企业创新是国家经济可持续增长的关键,受到管理层意愿的影响,因而需要对内部经营者的权力进行制衡。以2010-2018年我国A股上市公司为研究样本,实证检验管理层权力制衡强度对企业创新投资的影响,以及不同债务约束情境下高商业信用配置、高负债水平的调节效应,此外,还考察了产权性质的差异化影响。研究表明,管理层权力制衡强度越大,企业创新投资水平越高;高商业信用强化了该促进作用,而高负债水平弱化了该促进作用。进一步研究发现,管理层权力制衡强度与企业创新投资的关系在民企中更显著;国企能够更好地获得和运用商业信用,使其高商业信用对该关系的强化效应更显著;民企具有更强的债务约束,其高负债水平对该关系的弱化效应更明显。  相似文献   
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This paper examines the pattern of settlements, investor wins and state wins in investor-state dispute settlement cases, focusing on the impact of arbitration rules, the resources and experience of the litigants, the type of treaty breach under investigation, and the pattern of state intervention. Logistic regression results show that settlements are more likely when investors do not disclose their allegations publicly, when the host state has been involved in a greater number of past cases, and when the respondent state has a higher control-of-corruption rating. Panel awards to investors are more likely in cases of alleged direct expropriation and less likely for indirect expropriation. Panel decisions favoring the state increase with higher per capita income and rule-of-law ratings.  相似文献   
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In this paper we explore the micro-level determinants of conformity. Members of the social networking service Facebook express positive support to content on the website by clicking a Like button. We set up a natural field experiment to test whether users are more prone to support content if someone else has done so before. To find out to what extent conformity depends on group size and social ties we use three different treatment conditions: (1) one stranger has Liked the content, (2) three strangers have Liked the content, and (3) a friend has Liked the content. The results show that one Like from a single stranger had no impact. However, increasing the size of the influencing group doubled the probability that subjects expressed positive support. Friendship ties were also decisive. People were, on average, four times more likely to press the Like button if a friend, rather than a stranger, had done so before them. The existence of threshold effects in our experiment clearly shows that both group size and social proximity matters when opinions are shaped.  相似文献   
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Cuba sought economic independence from the U.S. and its reliance on sugar exports after its 1959 revolution, but subsequently developed new dependency relationships. In the meantime, Cuba remained inside the General Agreement on Tariffs and Trade (GATT), despite conducting most of its trade outside it. This paper explores the political economy of Cuba’s participation in the GATT and later the World Trade Organization (WTO). Documents show that Cuba sought to use its participation to gain new markets and influence in the developing world. While Cuba has gained little economically from its participation, in recent years it has diversified its exports and trade partners, and its trade interests now align more closely with WTO rules. Economic reforms will be necessary in order for Cuba to benefit.  相似文献   
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