Analgesic prescribing trends in a national sample of older veterans with osteoarthritis: 2012-2017

Few investigations examine patterns of opioid and nonopioid analgesic prescribing and concurrent pain intensity ratings before and after institution of safer prescribing programs such as the October 2013 Veterans Health Administration system-wide Opioid Safety Initiative (OSI) implementation. We conducted a quasi-experimental pre–post observational study of all older U.S. veterans (≥50 years old) with osteoarthritis of the knee or hip. All associated outpatient analgesic prescriptions and outpatient pain intensity ratings from January 1, 2012 to December 31, 2016, were analyzed with segmented regression of interrupted time series. Standardized monthly rates for each analgesic class (total, opioid, nonsteroidal anti-inflammatory drug, acetaminophen, and other study analgesics) were analyzed with segmented negative binomial regression models with overall slope, step, and slope change. Similarly, segmented linear regression was used to analyze pain intensity ratings and percentage of those reporting pain. All models were additionally adjusted for age, sex, and race. Before OSI implementation, total analgesic prescriptions showed a steady rise, abruptly decreasing to a flat trajectory after OSI implementation. This trend was primarily due to a decrease in opioid prescribing after OSI. Total prescribing after OSI implementation was partially compensated by continuing increased prescribing of other study analgesics as well as a significant rise in acetaminophen prescriptions (post-OSI). No changes in nonsteroidal anti-inflammatory drug prescribing were seen. A small rise in the percentage of those reporting pain but not mean pain intensity ratings continued over the study period with no changes associated with OSI. Changes in analgesic prescribing trends were not paralleled by changes in reported pain intensity for older veterans with osteoarthritis

Recreation Demand Analysis under Truncation, Overdispersion, and Endogenous Stratification: An Application to Gros Morne National Park

Using on-site survey data from Gros Morne National Park in Newfoundland, this paper estimates and compares several truncated count data models of recreation demand. The model that not only accounts for the truncated and overdispersed nature of the data but also for endogenous stratification duet o the oversampling of avid users, while allowing for flexible specification of the overdispersion parameter dominates on the basis of goodness of fit. The results are used to estimate the users’ value of access to the park.on-site sampling, endogenous stratification, consumer surplus, count data, overdispersion, recreation demand, travel cost method, truncation.

Low fertility increases descendant socioeconomic position but reduces long-term fitness in a modern post-industrial society.

Adaptive accounts of modern low human fertility argue that small family size maximizes the inheritance of socioeconomic resources across generations and may consequently increase long-term fitness. This study explores the long-term impacts of fertility and socioeconomic position (SEP) on multiple dimensions of descendant success in a unique Swedish cohort of 14 000 individuals born during 1915-1929. We show that low fertility and high SEP predict increased descendant socioeconomic success across four generations. Furthermore, these effects are multiplicative, with the greatest benefits of low fertility observed when SEP is high. Low fertility and high SEP do not, however, predict increased descendant reproductive success. Our results are therefore consistent with the idea that modern fertility limitation represents a strategic response to the local costs of rearing socioeconomically competitive offspring, but contradict adaptive models suggesting that it maximizes long-term fitness. This indicates a conflict in modern societies between behaviours promoting socioeconomic versus biological success. This study also makes a methodological contribution, demonstrating that the number of offspring strongly predicts long-term fitness and thereby validating use of fertility data to estimate current selective pressures in modern populations. Finally, our findings highlight that differences in fertility and SEP can have important long-term effects on the persistence of social inequalities across generations

Geographic distribution of asthma and chronic obstructive pulmonary disease hospitalisations in Australia: 2007-08 to 2009-10

This report shows how asthma and chronic obstructive pulmonary disease (COPD) hospitalisations vary across Australia. It also examines the association between these hospitalisation rates and socioeconomic status (SES), remoteness and the proportion of Indigenous Australians in different locations across Australia. Maps presented in this report show higher hospitalisation rates for both asthma and COPD in inland Australia and rural areas. Asthma hospitalisation rates are also higher in certain coastal areas in Queensland, in south-east South Australia and in south Western Australia. In comparison, COPD hospitalisation rates are higher in much of the Northern Territory and north-west Western Australia. Further investigation found that SES, remoteness and the proportion of the population that identifies as Indigenous all had a significant association with the hospitalisation rates for asthma and COPD by area. There may be further reasons for the variation in hospitalisation rates for asthma and COPD, such as: location specific factors, such as air pollution and allergic triggersaccess to hospital and primary care servicesvariation in smoking rates. These issues could be explored in further studies

The Value of the Trout Fishery at Rhodes, North Eastern Cape, South Africa, A Travel Cost Analysis Using Count Data Models

The National Environmental Management: Biodiversity Act, no.10 of 2004) makes provision for the presence of alien trout in South African waters by means of a zoning system, partly in recognition of the significant income generating potential of trout fishing in South Africa. This paper reports the first formal recreational valuation of a trout fishery in South Africa, the one in and around Rhodes village, North Eastern Cape. The valuation is carried out by applying the individual travel cost method using several count data models. The zero truncated negative binomial model yielded the most appealing results. It accounts for the non-negative integer nature of the trip data, for truncation and over-dispersion. The paper finds that in 2007 consumer surplus per day visit to the Rhodes trout fishery was R2 668, consumer surplus per trip visit was R13 072, and the total consumer surplus generated was R18 026 288.

PASS-GLM: polynomial approximate sufficient statistics for scalable Bayesian GLM inference

Generalized linear models (GLMs) -- such as logistic regression, Poisson regression, and robust regression -- provide interpretable models for diverse data types. Probabilistic approaches, particularly Bayesian ones, allow coherent estimates of uncertainty, incorporation of prior information, and sharing of power across experiments via hierarchical models. In practice, however, the approximate Bayesian methods necessary for inference have either failed to scale to large data sets or failed to provide theoretical guarantees on the quality of inference. We propose a new approach based on constructing polynomial approximate sufficient statistics for GLMs (PASS-GLM). We demonstrate that our method admits a simple algorithm as well as trivial streaming and distributed extensions that do not compound error across computations. We provide theoretical guarantees on the quality of point (MAP) estimates, the approximate posterior, and posterior mean and uncertainty estimates. We validate our approach empirically in the case of logistic regression using a quadratic approximation and show competitive performance with stochastic gradient descent, MCMC, and the Laplace approximation in terms of speed and multiple measures of accuracy -- including on an advertising data set with 40 million data points and 20,000 covariates.Comment: In Proceedings of the 31st Annual Conference on Neural Information Processing Systems (NIPS 2017). v3: corrected typos in Appendix

Stratified statistical models of North Atlantic basin-wide and regional tropical cyclone counts

Using the historical Atlantic tropical cyclone record, this study examines the empirical relationships between climate state variables and Atlantic tropical cyclone counts. The state variables considered as predictors include indices of the El Niño/Southern Oscillation and Northern Atlantic Oscillation, and both “local” and “relative” measures of Main Development Region sea surface temperature. Other predictors considered include indices measuring the Atlantic Meridional Mode and the West African monsoon. Using all of the potential predictors in a forward stepwise Poisson regression, we examine the relationships between tropical cyclone counts and climate state variables. As a further extension on past studies, both basin-wide named storm counts and cluster analysis time series representing distinct flavors of tropical cyclones, are modeled. A wide variety of cross validation metrics reveal that basin-wide counts or sums over appropriately chosen clusters may be more skillfully modeled than the individual cluster series. Ultimately, the most skillful models typically share three predictors: indices for the main development region sea surface temperatures, the El Niño/Southern Oscillation, and the North Atlantic Oscillation

The Demand for Wine Tourism in Canyon County, Idaho

Many commercial wineries produce a dual product: commercial wine and wine tourism. Since Idaho wineries charge no entry price, wine tourism demand can only be ascertained with a shadow price for winery visitation. Demand for wine tourism visits for Canyon County in southern Idaho was estimated using the travel cost method. Trip demand was inelastic (-0.4 to -0.6) with respect to own price. The average value of Canyon County wine tourism ranged from $6 to$12 per person per trip, depending upon the assumed opportunity cost of travel time. Elasticities of tastes and preferences, closely related goods, and income were estimated with a view to understanding the market for Idaho's emerging wine tourism industry.Travel cost model, Wine tourism, Wine marketing, Resource /Energy Economics and Policy,