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.     

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’.     

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.     

Effect Sizes in Qualitative Research: A Prolegomenon

The American Psychological Association Task Force recommended that researchers always report and interpret effect sizes for quantitative data. However, no such recommendation was made for qualitative data. Thus, the first objective of the present paper is to provide a rationale for reporting and interpreting effect sizes in qualitative research. Arguments are presented that effect sizes enhance the process of verstehen/hermeneutics advocated by interpretive researchers. The second objective of this paper is to provide a typology of effect sizes in qualitative research. Examples are given illustrating various applications of effect sizes. For instance, when conducting typological analyses, qualitative analysts only identify emergent themes; yet, these themes can be quantitized to ascertain the hierarchical structure of emergent themes. The final objective is to illustrate how inferential statistics can be utilized in qualitative data analyses. This can be accomplished by treating words arising from individuals, or observations emerging from a particular setting, as sample units of data that represent the total number of words/observations existing from that sample member/context. Heuristic examples are provided to demonstrate how inferential statistics can be used to provide more complex levels of verstehen than is presently undertaken in qualitative research.     

Substance, Form and PFI Contracts

The Private Finance Initiative (PFI) was launched by the United Kingdom Government in 1992 in order to encourage the private sector in the UK to become more involved in public sector development projects. A key theme of the initiative was that the public should receive 'value for money'. This article investigates the accounting issue as to whether or not the private or the public sector should record any property related to PFI projects on balance sheet. It argues that although both HM Treasury and the Accounting Standards Board (ASB) might agree on the accounting principles, the practical impact is that in order for related properties to stay off the public sector's balance sheet, substantial risk needs to be transferred to the private sector. As a consequence of this, the objective of providing value for money to the public may not be achieved.     

Taxes and the acquisition of depreciable assets: The Tax Reform Act of 1986 and the alternative minimum tax

Analysis of firm investment behavior during 1982–1993 shows that the Tax Reform Act of 1986 (TRA 86) Public Law No. 99-514 substantially affects both purchases and leases of depreciable assets. The changes in the regular corporate income tax rules are shown to lower asset acquisition. The effect of the alternative minimum tax (AMT) is found to vary with the debt share in firms’ capital structure and with the frequency of AMT exposure during the life of the assets acquired. On average, TRA86 depresses asset purchases less for firms that are subject to the AMT: AMT somewhat mitigates the negative effects of the regular tax rules.     

Mining and Social Movements: Struggles Over Livelihood and Rural Territorial Development in the Andes

Social movements have been viewed as vehicles through which the concerns of poor and marginalized groups are given greater visibility within civil society, lauded for being the means to achieve local empowerment and citizen activism, and seen as essential in holding the state to account and constituting a grassroots mechanism for promoting democracy. However, within development studies little attention has been paid to understanding how social movements can affect trajectories of development and rural livelihood in given spaces, and how these effects are related to movements’ internal dynamics and their interaction with the broader environment within which they operate. This paper addresses this theme for the case of social movements protesting contemporary forms of mining investment in Latin America. On the basis of cases from Peru and Ecuador, the paper argues that the presence and nature of social movements has significant influences both on forms taken by extractive industries (in this case mining) and on the effects of this extraction on rural livelihoods. In this sense, one can usefully talk about rural development as being co-produced by movements, mining companies, and other actors, in particular the state. The terms of this co-production, however, vary greatly among different locations, reflecting the distinct geographies of social mobilization and of mineral investment, as well as the varying power relationships among the different actors involved.