The Cost of US Pharmaceutical Price Reductions: A Financial Simulation Model of R&D Decisions

Previous empirical studies that have examined the links between pharmaceutical price controls, profits, cash flows, and investment in research and development (R&D) have been largely based on retrospective statistical analyses of firm- and/or industry-level data. These studies, which have contributed numerous insights and findings to the literature, relied upon ad hoc reduced-form model specifications. In the current paper we take a very different approach: a prospective micro-simulation approach. Using Monte Carlo techniques we model how future price controls in the U.S. will impact early-stage product development decisions in the pharmaceutical industry. This is done within the context of a net present value (NPV) framework that appropriately reflects the uncertainty associated with R&D project technical success, development costs, and future revenues. Using partial-information estimators calibrated with the most contemporary clinical and economic data available, we demonstrate how pharmaceutical price controls will significantly diminish the incentives to undertake early-stage R&D investment. For example, we estimate that cutting prices by 40 to 50 percent in the U.S. will lead to between 30 to 60 percent fewer R&D projects being undertaken (in early-stage development). Given the recent legislative efforts to control prescription drug prices in the U.S., and the likelihood that price controls will prevail as a result, it is important to better understand the firm response to such a regulatory change.

Calibration Transients In LIGO Detectors

This dissertation describes a novel method of analyzing fluctuations in the time-dependent calibration models of the LIGO interferometers to estimate their effect on strain reconstruction for gravitational-wave detections. The time-dependence of the calibration model of each detector is tracked with a set of parameters which are continuously measured while the interferometers are operating. These parameters track slow variations in the sensing function of the detectors as well as the actuators that hold the detectors in an operational state. The time-dependent parameter data during the second observation run (O2 [November 30, 2016 16:00 UTC to August 25, 2017 22:00:00 UTC]) and the first epoch of the third observation run (O3a [April 1, 2019 15:00 UTC to October 1, 2019 15:00 UTC]) were combed for significant fluctuations. A modified z-score was used as a standardized metric to identify and sort time segments which correspond to noise transients in the time-dependent calibration parameters for both detectors. The results of our search through O2 data from the LIGO Hanford Observatory (LHO) identified a set of relatively few noise transients all with negligible statistical significance, demonstrating that the behavior of the time-dependent calibration parameters at LHO were largely consistent with Gaussian noise on 30-minute or less time scales. Our search through O2 data from the LIGO Livingston Observatory (LLO) showed similar results for the parameters that track variations in actuation. Likewise, the sensing function parameters were mostly consistent with Gaussian noise as well; however, our search identified a small set of statistically significant noise transients. None of which were coincident with gravitational-wave signals, and the most significant of which were estimated to momentarily increase the strain reconstruction 1-sigma uncertainty from 1% to 3% in the regime of the interferometers\u27 most sensitive frequency band (150Hz). Like the O2 results, analysis of O3a data revealed that all the time-dependent calibration parameters at each detector were mostly consistent with Gaussian noise on 30-minute or less time scales. Our results demonstrate that overall, the time-dependent calibration parameters experienced very few significant fluctuations throughout O2 and O3a, and even largest transient we found would have minimal impact on gravitational-wave measurements

White Knowledge and the Cauldron of Story: The Use of Allusion in Terry Pratchett\u27s Discworld.

In the last twenty years, Terry Pratchett\u27s Discworld series has become very popular. Pratchett\u27s success hinges in part on his use of allusion, in what Tolkien called the Cauldron of Story, and what Pratchett refers to as white knowledge. This paper explores the Discworld novels and illustrates Pratchett\u27s use and success of storytelling through a few key directions: folk tales, fantasy literature, movies, and rock music. Pratchett has received limited critical review, mostly of a negative nature, while producing a strong literary series, one crafted with both obvious and subtle recognition of his genre\u27s sources. While standing on the shoulders of giants, Pratchett both respects and scrutinizes the myths and stories that construct our reality. Critically, Pratchett\u27s fiction deserves more respect and closer study; this paper attempts to give him his due

When Disasters Strike: An Interview by Linda Silka with Joyce Rumery and Tom Abbott

Joyce Rumery and Tom Abbott in this interview with Linda Silka describe their experiences when they helped libraries devastated by Hurricane Katrina in New Orleans, and how Maine libraries might prepare for disasters

Experiences of midwifery care in English prisons

© 2022 The Authors. Birth published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution License. https://creativecommons.org/licenses/by/4.0/Background: In the United Kingdom (UK), all prisoners must receive healthcare equivalent to that available in the community. However, evidence suggests that equality in healthcare provision for perinatal women in UK prisons is not always achieved. The aim of this research was to examine pregnant women prisoners' and custody staffs' experiences and perceptions of midwifery care in English prisons. Methods: A qualitative approach based on institutional ethnography was used to research women's experiences in three English prisons over a period of 10 months. In total, 28 women participated in audio‐recorded, semi‐structured interviews. Ten staff members were interviewed, including six prison service staff and four health care personnel. Ten months of prison fieldwork enabled observations of everyday prison life. NVivo was used for data organization with an inductive thematic analysis method. Results: Women's experiences included: disempowerment due to limited choice; fear of birthing alone; and a lack of information about rights, with a sense of not receiving entitlements. Some women reported favorably on the continuity of midwifery care provided. There was confusion around the statutory role of UK midwifery. Discussion: Experiences of perinatal prisoners contrast starkly with best midwifery practice—women are unable to choose their care provider, their birth companions, or their place of birth. In addition, a reliance upon “good behavior” in return for appropriate treatment may be detrimental to the health, safety, and well‐being of the pregnant woman and her unborn baby. Conclusion: Prison is an adverse environment for a pregnant woman. This study provides key insights into imprisoned women's experiences of midwifery care in England and shows that midwives play an essential role in ensuring that perinatal prisoners receive safe, high‐quality, respectful care.Peer reviewe

Compulsory separation of women prisoners from their babies following childbirth: Uncertainty, loss and disenfranchised grief

© 2021 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL (SHIL).There is growing evidence to show increased mental ill health in women compulsorily separated from their babies at birth (Cantwell et al., MBRRACE‐UK, 2018:56). For imprisoned women, the risk of self‐harm and suicide may be exacerbated. This article draws on in‐depth interviews with a sample of 28 imprisoned pregnant women/new mothers, 10 prison staff and observations to discuss the experience of separation from or anticipation of separation of women from their babies. Oakley (Signs, 4:607–631, 1980) reflected on the transition to motherhood with reference to the sociology of loss of identity. Women who have been compulsorily separated from their babies experience subjugated loss out of place with societal norms. The experiences of compulsory separation, in relation to concepts of disenfranchised grief, resonate with Lovell's (Social Science & Medicine, 17:755–761, 1983) research into the altered identities of mothers when loss occurs through late miscarriage or stillbirth. Additionally, this type of complex loss also denies a woman her identity as a ‘mother’. This article offers a fresh sociological perspective on the ways loss and grief are experienced by women facing separation from their babies in prison, drawing on concepts of uncertainty, loss and disenfranchised grief.Peer reviewedFinal Published versio

Saturation Spectroscopy of Iodine in Hollow-core Optical Fibre

We present high-resolution spectroscopy of Iodine vapour that is loaded and trapped within the core of a hollow-core photonic crystal fibre (HC-PCF). We compare the observed spectroscopic features to those seen in a conventional iodine cell and show that the saturation characteristics differ significantly. Despite the confined geometry it was still possible to obtain sub-Doppler features with a spectral width of ~6 MHz with very high contrast. We provide a simple theory which closely reproduces all the key observations of the experiment.Comment: 12 pages, 7 figure