Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates

Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation. A retrospective chart review was conducted for 154 intubated adult patients (77 = S-ETT; 77 = CSS-ETT). The S-ETT group had one case of VAP; the CSS-ETT group had none. The mean total hospital charges were higher for the S-ETT group ($103,600; CSS-ETT= $88,500) (p = 0.3). Although the average number of intubation days and ICU days were greater for the CSS-ETT group, there were no cases of VAP compared to the S-ETT group. ased upon the one S-ETT VAP case and the VAP attributable costs, it is cost effective to use the CSS-ETT.     

Growth Trends and Systematic Patterns of Booms and Busts‐Testing 200 Years of Business Cycle Dynamics

We study the dynamic pattern of business cycles using US GDP data between 1790 and 2015. To address difficulties in trend and cycle decomposition, we introduce a semiparametric estimation approach with an iterative plug‐in (IPI) algorithm for endogenous bandwidth selection. This algorithm identifies continuously moving growth trends with trend‐supporting growth periods. A simulation study demonstrates the value‐added of our trend identification. Afterwards, nonlinear SETAR models are fitted parametrically. Further, we test the trend using a recently developed test and the estimated SETAR models against their linear alternatives. The results indicate asymmetric characteristics during booms and busts.     

Corporate profitability and effective tax rate: the enforcement effect of large taxpayer units

This paper examines how Large Taxpayer Units (LTUs), a commonly-used tool for enforcing tax compliance, affect large firms’ reported profitability and effective tax rate. Increased scrutiny may either improve reporting and compliance efforts, or lead to adverse reactions from large taxpayers such as profit shifting to reduce tax liabilities. As a source of exogenous enforcement shock, we exploit the actions of Jamaica's LTU around its large-taxpayer eligibility cutoff using a before-during regression discontinuity approach. We find the LTU increases pre-tax profit margin by 2–3 percentage points. Increased effective tax rates are also evidenced, albeit less robustly.     

Anticonsumption beyond consumers: The role of small organic producers in environmentally oriented anticonsumption

Recent studies recognize that environmentally oriented anticonsumption gives power to individuals who are willing to express their environmental concerns. Yet, it goes beyond consumers’ decisions and should also include producers’ practices and discourses. In this study, we explore the food system context and the emergence of organic food as a more sustainable and healthy food production mode to describe the role of organic farmers in building social and material arrangements against conventional food production and consumption. Our empirical study involved an interpretative approach based on 29 interviews with Brazilian organic farmers and experts in organic production. The findings indicate that farmers explore two different discursive mechanisms to build arguments that support the hegemonic and conventional food production system. Farmers also perform two sets of supporting practices that allow the construction of an alternative approach to food production and consumption. We conclude that farmers’ discourses and practices build an alternative food system, enabling conventional food anticonsumption. This study contributes to the literature of anticonsumption by expanding the traditional consumer-centric perspective through the inclusion of the producer perspective.     

Adolescent alcohol use,sociability and income as a young adult

We use data from the National Longitudinal Survey of Adolescent Health (Add Health) to study how sociability and adolescent alcohol use impact personal income as a young adult. We find that factors which enhance not only individual sociability but also social interaction at the community level are positively linked to future earnings of adolescents. Adolescents whose friends and friends of friends have greater sociability reap long-term labour market rewards into adulthood. After adjusting for individual and community sociability, the effect of teenage alcohol consumption on labour market earnings as young adults is reduced. Our results suggest that earnings premiums associated with adolescent alcohol consumption may be partially explained by social network dynamics.     

Evidence on the sectoral monetary transmission process under a fixed exchange rate regime

Traditional macroeconomic models suggest that monetary policy changes are largely ineffective in fixed exchange rate economies. However, Edwards and Végh (1997) present a model that shows this might not be the case, as a tightening in monetary policy raises financial costs faced by firms and therefore lowers real wages and, by extension, consumption. This paper empirically tests this hypothesis using data on a country with one of the longest running fixed exchange rate regimes (1975–present). The results of the study confirm the theoretical predictions of Edwards and Végh, but they also show that the propagation of nominal shocks in fixed exchange rate systems is comparatively slower than in countries with a more flexible exchange rate regime.     

Detecting local environmental change: the role of experience in shaping risk judgments about global warming

Anthropogenic climate change is increasing the frequency and severity of extreme weather events (e.g. flooding, heat waves, and wildfires). As a result, it is often reasoned that as more individuals experience unusual weather patterns that are consistent with changing climate conditions, the more their concern about global warming will increase, and the more motivated they will become to respond and address the problem effectively. Social science research evaluating the relationships between personal experiences with and risk perceptions of climate change, however, show mixed results. Here, we analyze a representative statewide survey of Floridians and compare their risk perceptions of five-year trends in climate change with local weather station data from the five years preceding the survey. The results show that Floridians are unable to detect five-year increases in temperature, but some can detect changes in precipitation. Despite an inability to detect the correct direction of change, respondents were significantly more likely than not to correctly identify the season in which most change occurred. Nevertheless, compared to local experience, risk perceptions of climate change were more strongly predicted by subjective experiences of environmental change, personal beliefs about climate change, and political ideology. Results from the study suggest that long-term changes in climate patterns and extreme weather events need to be interpreted by weather and climate experts within the context of climate change; individuals cannot be expected to detect or comprehend such complex linkages directly.     

Use-Value Assessment Tax Expenditures in Urban Areas

Use-value assessment is the practice of valuing land for property tax purposes in its current use, rather than at its full market value. This practice is widespread in the U.S. and is intended to reduce the property tax burden on agricultural land near urban areas and slow the pace of land development. We examine the foregone property tax revenue, or tax expenditure, due to use-value assessment. Data sets for two case studies are employed in empirical estimation of spatial models of the difference between market value and use value, providing the analytic basis for estimates of tax expenditures.