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.     

哈尔滨市快递自提点空间布局与影响因素研究

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水质评价关系到水质质量,常见的评价方法有层次分析法、综合评价法等,这些方法评价过程非常复杂,单因子评价方法相比具有操作容易.实际中单因子进行评价时存在概念理解难、计算容易出错等问题.为解决单因子计算问题,本文提出采用Python编程语言进行单因子评价.本文详细分析了Python进行单因子评价流程,从数据采集、数据清洗、数据处理、系统实现进行分析.应用结果表明基于Python编程的单因子评价方法具有评价效率高、准确度高优点.     

内隔墙对小尺寸基坑围护结构变形特性影响研究

深基坑开挖对基坑变形及周围环境的影响一直是工程中关心的问题.而利用好基坑的空间效应则可以控制好变形.本文采用plaxis有限元分析对利用内隔墙产生的二次空间效应来控制基坑变形的影响,分析了内隔墙的刚度、埋入深度和基坑尺寸之间的相互影响.分析结果对城市中心复杂环境下施工过程中对基坑的监测和周围环境保护有较好的指导作用.     

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南宋时期的城市,迫于军事对峙形势,在强化其经济功能之外,防御性能也日渐加强,表现为军事性城寨普遍存在。南宋凭借强大的人力和财力支持,在南渡之初练兵与筑城之争后,形成了筑城防御之风。在城郭的结构和防御设计上,呈现出对唐城的因袭和创新,采取城砖包砌法,并设有专门的筑城队伍和人员。在中国古代城市发展史上,具有重要的意义。     

基于社会服务的示范性高职院校师资队伍建设——以广东农工商职业技术学院为例

服务是高职院校的第一宗旨,而社会服务能力的高低关键在于示范院校师资队伍建设。该文从广东农工商职业技术学院社会服务能力的实际情况出发,分析了该院师资队伍建设存在的问题,认为,首先应通过体制创新,提高教师社会服务意识;其次通过不同途径打造"双师型"教师团队,从而提升教师社会服务能力。     

C++对象布局分析

分析了目前最为流行的面向对象的开发工具C 的对象布局，并进一步分析了其形成原因。     

巢湖市实施长江禁渔期制度的调查与思考

本文通过总结分析巢湖市实施长江春季禁渔的做法与经验，探讨了实施长江禁渔的重要性，指出了存在的问题，提出了今后实施的具体措施。     

对纳税筹划问题的理性思考

纳税筹划近年来日益受到人们的关注,但国内研究多侧重于筹划策略和方法。本文试图从理论上对纳税筹划的必然性、可能性及其经济和社会效应进行较深入的探讨,完善纳税筹划的指导思想,纠正对其错误的认识。     

浅析公共服务有效供给的新模式

通过对公共服务的属性分析，结合新政治经济学理论和政府失败的现实因素，探索公益物品的有效供给模式，提出了公共服务的签约转包机制，并分析了这一机制的不足和政府的作用。