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This chapter deals with the economics of prescription drugs and of insurance coverage for them. Sellers of drugs have temporary market power because of patents. Drugs are supplied under a cost structure with high fixed costs of research, discovery, and approval followed by low marginal cost of producing additional units; this structure does not permit competitive markets to exist during the period of patient protection. Health systems buy drugs for inpatients in the usual way, but outpatient and pharmacy sold drugs are priced above marginal cost with prices often distorted by insurance coverage. The result can be high prices (though not necessarily increasing ones). A potential solution to the inefficiencies in this market is an agreement between insurers and drug sellers to buy a predetermined volume with the marginal price of additional units low or zero – the so called “Netflix” model. The intent of above-cost pricing for drugs is to encourage the supply of innovative products, but evidence on whether the current patient system in the US achieves an ideal outcome is lacking.
Death, home, housing, and changes in Iranian identity through the materiality of space and the geography of social relations. Generational change is reflected in architecture, household organization, property values, and historical memory. The modern city and recent speculative residential building developments offer opportunities for more privacy, shiny surfaces, and dedicated space for nuclear families. But the loss of more integrated mixed-class neighborhoods and extended family residential spaces puts different pressures on individuals and the shared urban fabric. One family’s generational and spatial transitions symbolize the changes in Tehran’s social and architectural possibilities.
Platelet-rich plasma (PRP) injections are increasingly performed in outpatient settings to treat select musculoskeletal injuries, arthritis, hair loss, and wounds. There is a need for procedure-specific guidance and standardization of PRP practices to mitigate associated infection prevention (IP) risks such as bloodborne pathogen exposure and unsafe injection use.
Objective:
Develop a standardized approach for PRP administration which incorporates existing IP regulatory and professional society guidance.
Methods:
Observation and descriptive review of PRP injection protocols across subspecialties at a tertiary medical center, focused on ambulatory IP and regulatory standards compliance. Development of a standardized operating procedure (SOP) to mitigate IP risks and align with regulatory guidance.
Results:
Observations were completed in orthopedic, wound care, and oral maxillofacial surgery clinics. Variability in practice was noted for product labeling, centrifugation, and injection modalities. A multidisciplinary workgroup convened to develop and operationalize an SOP. Classification of PRP as a blood product introduced nuances to protocols for product preparation, handling, administration, labeling, and documentation to comply with regulatory standards.
Conclusions:
Development and implementation of an SOP for PRP treatment requires an awareness of the scope of practice in a healthcare system and identification of pertinent regulatory standards for integration into workflows. Partnerships between IP teams, subspecialty clinical providers, blood safety experts, quality and safety teams, and healthcare technology are essential to minimize variability in practice, ensure safety of patients and healthcare personnel, and align with regulatory standards.
Chapter 7 provides a comparative analysis of regime complex effectiveness across cases to better perceive the conditions for impact and how intervening variables such as energy crises or domestic political interests mediate effectiveness. Through the three mechanisms – utility modifier, social learning, capacity building – the regime complex has had a notably different impact in moving renewable energy development in Indonesia and the Philippines. This chapter examines and explains the variable outcomes in geothermal development between the Philippines and Indonesia by illuminating the key role of political will at the domestic level. Major findings of this chapter reveal that throughout the case studies, diverging domestic political interests and lack of political will to develop geothermal energy or adopt renewable energy regulations are key in explaining the variation in effectiveness of the clean energy complex across case studies.
In this article, we develop a novel high-dimensional coefficient estimation procedure based on high-frequency data. Unlike usual high-dimensional regression procedures such as LASSO, we additionally handle the heavy-tailedness of high-frequency observations as well as time variations of coefficient processes. Specifically, we employ the Huber loss and a truncation scheme to handle heavy-tailed observations, while $\ell _{1}$-regularization is adopted to overcome the curse of dimensionality. To account for the time-varying coefficient, we estimate local coefficients which are biased due to the $\ell _{1}$-regularization. Thus, when estimating integrated coefficients, we propose a debiasing scheme to enjoy the law of large numbers property and employ a thresholding scheme to further accommodate the sparsity of the coefficients. We call this robust thresholding debiased LASSO (RED-LASSO) estimator. We show that the RED-LASSO estimator can achieve a near-optimal convergence rate. In the empirical study, we apply the RED-LASSO procedure to the high-dimensional integrated coefficient estimation using high-frequency trading data.
This article argues that Fletcher’s Women Pleased features an overlooked response to Shakespeare’s Othello in terms of dramatic structure, staging, setting, genre, characterization and thematic concerns that calls attention to some crucial aspects of Shakespeare’s play in such a way as to make Fletcher emerge as an early critic of Shakespearian drama.
Inadequate eating habits in adolescence are an important risk factor for obesity and other chronic non-communicable diseases in adulthood. The school environment can have a relevant impact on adolescent behaviour, since many habits acquired in this phase affect the individual throughout life, with visible effects on health. In this study, we aimed to evaluate the association between food sales at Brazilian schools and ultra-processed food consumption among adolescents. The Study of Cardiovascular Risk Factors in Adolescents (ERICA) was a nationwide, school-based survey conducted from 2013 to 2014, including public and private schools in 121 Brazilian cities. Dietary intake was assessed via a 24-h recall, and foods were divided according to the Nova classification based on the degree of processing. Unadjusted and adjusted linear regression models were used to assess the association between exposure to school food sales and intake of ultra-processed food. The prevalence of exposure to food sales was 55·2 %, and the mean diet share of ultra-processed foods was 34·5 %. Exposure to food sales in schools was associated with higher consumption of ultra-processed food (β = 0·11; P = 0·002). The results were similar when the analyses were stratified according to sex, usual intake of school meals and public school attendance (β = 0·11; P = 0·002). The association between exposure to food sales in schools and higher consumption of ultra-processed food suggests that school sales can influence adolescents’ food choices.
This chapter focuses on grammatical writing from the seventh century to the publication of the first grammar of English in the sixteenth. Except for the last one, these texts focus primarily on Latin grammar, though the vernacular languages spoken in England played an important role since the engagement with Latin grammar resulted in grammatical descriptions of the vernaculars themselves. The chapter opens with an introduction to the teaching of Latin grammar and continues with a discussion of the English content of Ælfric’s Grammar. Then it provides insights into grammar writing after the Norman Conquest and takes a detailed look at the grammatical treatises in Middle English and the linguistic data these treatises provide. The chapter finishes with an outlook to the sixteenth century and the publication of the authorised ‘Lily Grammar’ and of Bullokar’s Pamphlet for Grammar (1586), the first grammar of English.
In the wake of the boycott, the British govenment strengthened the warrant chief system, gathered intelligence on these communities to reorganize them into discrete, governable units. Reorganization was carried out in the context of interwar colonial development policy, which sought to increase the efficiency and productivity of the colonies. The British government coerced Africans across their colonies to engage in waged labor, in order to pay taxes and contribute to local development initiatives. In the Niger Delta, ethnic competition was used as a mechanism by which colonial development was distributed. Paramount chieftaincy increased a community’s ability to access colonial resources, contributing to a proliferation of new chieftaincy titles in competition for these resources. The case of the Olu title among the Itsekiri people is exemplary of these developments.
The Palmyrene banqueting tesserae, clay entrance tickets to religious banquets, have been revisited over and over again since the publication of the RTP in 1955. These small but often elaborate objects have been used as lenses into Palmyra’s religious life and the general organization of social, cultural and religious life in the city. However, only in recent years have they become the object of new detailed studies, which aim to systematically examine this unique group of objects within their local context. In this contribution, the focus is on disentangling the tesserae as physical objects to be used, touched and looked at; in particular it seeks to understand a facet of their rich iconographic repertoire, which in so many ways stands in contrast to the otherwise allegedly streamlined visual art repertoire found at Palmyra, namely that of the signet seal impressions. These signet seal impressions were impressed on many of the tesserae, most likely by the sponsor of the banquet, who left his personal mark on the tickets. The seal impressions give us insight into the images circulating in Palmyra in the Roman period in a material group, which today is almost lost to us, namely the glyptic art.
Joseph Haydn’s Il ritorno di Tobia (Hob. XXI:1) has had a complicated reception since its first performance on 2 April 1775 at the semi-annual concerts of Vienna’s Tonkünstler-Societät. Despite its highly praised ‘fiery’ choruses and virtuosic arias, the work was criticised for its length, difficulty, and even monotony. Haydn and others attempted to correct the work’s ‘faults’ – leading to the oratorio’s existence in multiple versions. It seems unfair, however, to critique Haydn’s Tobia oratorio in isolation, without considering local precedents and its original multifaceted context: an audience following a libretto (with stage directions) based on a well-known biblical story; an event raising funds for musicians’ families; a musical dramatisation exploiting through demanding arias the virtuosity of its vocal soloists; and performance in a nearly five-hour ‘multimedia’ concert that included other works.
Trauma and Recovery by Judith Herman was published in 1992. This article explores its relevance and legacy for today in the trauma field, particularly with the new ICD-11 diagnosis of complex post-traumatic disorder.