Helping to prioritise interventions for depression and schizophrenia: use of Population Impact Measures

BACKGROUND: To demonstrate the potential of Population Impact Measures in helping to prioritise alternative interventions for psychiatry, this paper estimates the number of relapses and hospital readmissions prevented for depression and schizophrenia by adopting best practice recommendations. The results are designed to relate to particular local populations. METHODS: Literature-based estimates of disease prevalence, relapse and re-admission rates, current and best practice treatment rates, levels of adherence with interventions and relative risk reduction associated with different interventions were obtained and calculations made of the Number of Events Prevented in your Population (NEPP). RESULTS: In a notional population of 100,000 adults, going from current to 'best' practice for different interventions, the number of relapses prevented in the next year for schizophrenia were 6 (increasing adherence to medication), 23 (family intervention), 43 (relapse prevention), and 44 (early intervention); and for depression the number of relapses prevented in the next year were 100 (increasing care management), 227 (continuing treatment with antidepressants), 279 (increasing rate of diagnosis), and 325 (Cognitive Behaviour Therapy). Hospital re-admissions prevented in the next year for schizophrenia were 6 (increasing adherence to medication), 36 (relapse prevention) and 40 (early intervention). CONCLUSION: Population Impact measures provide the possibility for a policy-maker to see the impact of a new intervention on the population as a whole, and to compare alternative interventions to best improve psychiatric disease outcomes. The methods are much simpler than others, and have the advantage of being transparent

In vitro activity of Iclaprim against Methicillin-resistant Staphylococcus aureus nonsusceptible to Daptomycin, Linezolid, or Vancomycin: A pilot study

Iclaprim is a bacterial dihydrofolate reductase inhibitor in Phase 3 clinical development for the treatment of acute bacterial skin and skin structure infections and hospital-acquired bacterial pneumonia caused by Gram-positive bacteria. Daptomycin, linezolid, and vancomycin are commonly used antibiotics for these indications. With increased selective pressure to these antibiotics, outbreaks of bacterial resistance to these antibiotics have been reported. This in vitro pilot study evaluated the activity of iclaprim against methicillin-resistant Staphylococcus aureus (MRSA) isolates, which were also not susceptible to daptomycin, linezolid, or vancomycin. Iclaprim had an MIC ≤ 1 µg/ml to the majority of MRSA isolates that were nonsusceptible to daptomycin (5 of 7 (71.4%)), linezolid (26 of 26 (100%)), or vancomycin (19 of 28 (66.7%)). In the analysis of time-kill curves, iclaprim demonstrated ≥ 3 log10 reduction in CFU/mL at 4–8 hours for tested strains and isolates nonsusceptible to daptomycin, linezolid, or vancomycin. Together, these data support the use of iclaprim in serious infections caused by MRSA nonsusceptible to daptomycin, linezolid, or vancomycin

OAO-3 end of mission tests report

Twelve engineering type tests were performed on several subsystems and experiment(s) of the OAO 3 spacecraft near its end of mission. The systems tested include: Princeton experiment package (PEP), fine error system guidance, inertial reference unit, star trackers, heat pipes, thermal control coatings, command and data handling, solar array; batteries, and onboard processor/power boost regulator. Generally, the systems performed well for the 8 1/2 years life of OAO 3, although some degradation was noted in the sensitivity of PEP and in the absorptivity of the skin coatings. Battery life was prolonged during the life of the mission in large part by carefully monitoring the charge-discharge cycle with careful attention not to overcharge

Corporate Taxation and Productivity Catch-Up: Evidence from European firms

Firms that lie far behind the technological frontier have the most to gain from imitating the technology or management practices of others. That some firms converge relatively slowly to the productivity frontier suggests the existence of factors that cause them to underinvest in their productivity. In this paper we explore how far higher rates of corporate taxation affect firm productivity convergence by reducing the after tax returns to productivity enhancing investments for small firms. Using data for 11 European countries we find evidence for such an effect; productivity growth in small firms is slower the higher are corporate tax rates. Our results are robust to the use of instrumental variable and panel data techniques with quantitatively similar effects found from a natural experiment following the German tax reforms in 2001

Corporate taxation and productivity catch-up: evidence from European firms

This paper explores whether higher corporate tax rates reduce the speed with which small firms converge to the productivity frontier by lowering the after-tax returns to productivity-enhancing investments. Using data for 11 European countries we find evidence that their productivity catch-up is slower the higher are statutory corporate tax rates. In contrast, we find large firms are instead affected by effective marginal rates. Using the reduced form model of productivity convergence due to Griffith et al. (2009) our results are robust to a host of robustness checks and a natural experiment that exploits the 2001 German tax reforms

Will the Scottish Cancer Target for the year 2000 be met? The use of cancer registration and death records to predict future cancer incidence and mortality in Scotland.

Cancer mortality data reflect disease incidence and the effectiveness of treatment. Incidence data, however, reflect the burden of disease in the population and indicate the need for prevention measures, diagnostic services and cancer treatment facilities. Monitoring of targets mandates that both be considered. The Scottish Cancer Target, established in 1991, proposed that a reduction of 15% in mortality from cancer in the under-65s should be achieved between 1986 and 2000. Each year in Scotland approximately 8300 persons under 65 are diagnosed with cancer and 4500 die from the disease. The most common malignancies, in terms of both incident cases and deaths, in the under-65s, are lung and large bowel cancer in males, and breast, large bowel and lung cancer in females. A decrease of 6% in the number of cancer cases diagnosed in males under 65 is predicted between 1986 and 2000, whereas the number of cases in females in the year 2000 is expected to remain at the 1986 level. In contrast, substantial reductions in mortality are expected for both sexes: 17% and 25% in males and females respectively. Demographic changes will influence the numbers of cancer cases and deaths in the Scottish population in the year 2000. However, long-term trends in the major risk factors, such as smoking, are likely to be the most important determinants of the future cancer burden

Evaluation of the impact of 2 years of a dosing intervention on canine echinococcosis in the Alay Valley, Kyrgyzstan

Echinococcosis is a re-emerging zoonotic disease in Kyrgyzstan. In 2012, an echinococcosis control scheme was started that included dosing owned dogs in the Alay Valley, Kyrgyzstan with praziquantel. Control programmes require large investments of money and resources; as such it is important to evaluate how well these are meeting their targets. However, problems associated with echinococcosis control schemes include remoteness and semi-nomadic customs of affected communities, and lack of resources. These same problems apply to control scheme evaluations, and quick and easy assessment tools are highly desirable. Lot quality assurance sampling was used to assess the impact of approximately 2 years of echinococcosis control in the Alay valley. A pre-intervention coproELISA prevalence was established, and a 75% threshold for dosing compliance was set based on previous studies. Ten communities were visited in 2013 and 2014, with 18-21 dogs sampled per community, and questionnaires administered to dog owners. After 21 months of control efforts, 8/10 communities showed evidence of reaching the 75% praziquantel dosing target, although only 3/10 showed evidence of a reduction in coproELISA prevalence. This is understandable, since years of sustained control are required to effectively control echinococcosis, and efforts in the Alay valley should be and are being continued

Corporate Taxation and the Productivity and Investment Performance of Heterogeneous Firms: Evidence from OECD Firm-Level Data

Abstract This paper adds to the recent literature use micro-level data to examine the response of firms' productivity levels or growth rates to various policy settings. Our particular interest is to investigate how far corporate tax settings might affect firms' innovation and risk-taking activity. Previous investigations of this issue have examined the link between higher corporate taxes and firm-level total factor productivity (TFP) as mediated through higher profitability. That is, firms with higher corporate profits but in regimes involving higher corporate tax rates are expected to have lower TFP than equivalent firms in low corporate tax regimes. In this paper we re-examine this evidence -which has suggested apparently large and persistent impacts of corporate tax on firm-level TFP, as mediated through profits. We then consider how far alternative indicators of firm-level innovation/technology can provide better proxies for the impact of taxes on productivity via innovation effects than those based on firm profits. Using an econometric model of innovation and productivity similar to that proposed by • Using a similar sized sample to S&A (2008) but which does not exclude small (<20 employee) firms, the estimated impact of higher corporate tax rates on TFP when interacted with firm profit levels is no longer implausibly large and occurs relatively quickly (within 4-5 years rather than over decades). • Using alternative measures of industries' innovative characteristics such as research intensity, the extent of intra-industry trade and firm entry-exit rates, we find stronger evidence that firms in those 'innovation intensive' industries are more adversely affected by high corporate tax rates than those in low 'innovation intensive' industries. • Higher corporate tax rates, via their effect on the post-tax user cost of capital have significant adverse effects on firm's investment levels. 2 Introduction Macro-dynamic modelling in recent years has made great strides in analysing the potential impact of changes in tax policy on a variety of macro variables including output and productivity levels and the transitional/long-run rates of output or productivity growth (e.g. Micro-level evidence -at the firm, industry or sector levels -is comparatively scarce; what there is tends to focus on tax impacts on investment in particular or factors expected to contribute to overall investment or productivity performance -such as research and exhibit lower total factor productivity (TFP) and investment levels compared to firms facing lower corporate tax rates. Based on the identifying assumption that "firm level TFP growth in very profitable sectors should be lower relative to sectors with low profitability in countries with high corporate taxes" they find that firm-level productivity appears to be lower in high tax country-year combinations. This may partly reflect companion evidence that investment is also lower in high tax contexts (in response to a higher user cost of capital) and if technological advances are at least partly embodied in this investment. 3 The Schwellnus and Arnold (S&A) analysis is an innovative and helpful advance in the methodologies applied to the study of the productivity effects of corporate tax changes but is limited by two aspects (methodological issues are discussed in more detail below (S&A, 2008, p.16). Arguably this estimate puts it in the 'implausibly large' category, in the same way that previous estimates based on aggregate level data have been described as implausibly large. In this paper, we examine a firm-level dataset for OECD countries very similar to that used by S&A to re-test for the tax-profitability effects on TFP measured by S&A. We further argue that, to the extent that corporate tax can be expected to impact on firms' innovation or risk-taking characteristics that are hypothesised to generate different TFP growth across firms, this may be captured by a number of firm characteristics, not just firms' overall profit levels. In particular we argue that corporate tax may impact on productivity via interactions with inter-firm differences in 'research intensity', the degree of intra-industry trade, and firms' entry/exit/survival characteristics. The remainder of the paper is structured as follows. In section 2 we discuss the relevant hypotheses linking corporate tax and firm productivity within an overall model of firm productivity. Section 3 then describes the data and methodology we use and section 4 discusses our econometric results. Section 5 draws some conclusions. How might firm-level taxation affect innovation/productivity processes? As S&A (2008) note, if successful innovations are measured by the net-of-tax rate of return, then to the extent that tax parameters drive a wedge between a firm's gross and net returns, they can be expected to discourage that innovative activity, that in turn impacts negatively on a firm's ability to improve its productivity levels, other things equal. In principle this applies to both incorporated and unincorporated enterprises -such that the relevant tax parameters will differ in each case depending on these enterprises' liabilities under personal, corporate and other tax schedules. In our empirical work we focus on incorporated firms so that it is the impact of effective rates of corporate tax that are most relevant. Corporate Tax, Technology and Total Factor Productivity Standard features of corporate tax in OECD countries typically include (i) the use of one or more statutory rates (e.g. some countries set lower rates at low profit levels); (ii) limitations on the extent of tax rebates for negative profits (losses) generating asymmetric treatment of profits and losses (e.g. 1 Where technological improvements are embodied in new capital, and the measurement of this capital is unable to fully capture 'quality' improvements, some of this innovative improvement may appear to be attributable to firms' investment rather than TFP. This raises important issues for the measurement and interpretation of changes in capital stock and TFP. 5 These have the effect of generating firm-specific ETRs that can be quite different from statutory rates of tax and also contributing some progressivity to most corporate tax regimes. This latter effect is especially associated with loss-making, and its tax treatment. As Auerbach (1') 2 Note that (1) can be re-arranged to be expressed in terms of the change in TFP, and Griffith et al allow for it to be applied only to firms whose TFP remains high enough to remain in the industry, with implications for methods of testing (see below). 6 where is the long-run growth rate of frontier technology and is the error correction parameter. Equation (1') captures heterogeneity in firm productivity across industries (and countries). It allows for endogenous productivity catch-up but the presence of γ i ensures that firms may converge towards their own equilibrium productivity path relative to that of the frontier firm(s). In the long-run, even if all firms' TFPs grow at the same rate, they are not necessarily converging to the same level. In addition, stochastic shocks to TFP together with the speed of correction to the steady-state mean that firms observed TFP may be 'transitional' for many periods. With the addition of a homogeneity assumption (that in the long-run all firms TFPs will grow at the rate of the frontier TFP), equation (1') can be rewritten in terms of firm's TFP relative to frontier levels, as: Equation 3 Conceptually this operates via the tax-wedge driven between the pre-and post-tax rates of return on innovations that drive each firm's productivity improvements (or declines -where tax affects declining firms or induces that decline). How we capture those tax impacts in our empirical model, we turn to next. An interesting question concerns what country-, industry-of firm-specific characteristics might drive firm-level productivity and which are also susceptible to corporate tax settings? Information of firms' individual corporate tax liabilities would allow us to explore this question directly; for example, is a higher tax liability via effective marginal tax rate associated with lower TFP? Unfortunately firm-level corporate tax data is unavailable. Statutory corporate tax rate data by country and time period is however available, and we can 3 Griffith et al (2006) include a firm-specific fixed effect to pick up those firm-level sources of innovation. Doing so in our case would effectively remove the firm-specific sources of variation that may be due to corporate tax effects and that it is desired to identify here. We therefore include country, industry and time fixed effects but exclude firm fixed effects. 7 examine how far this affects industry-specific factors expected to be impacted by corporate tax -such as profitability. The key insight of S&A The rationale is as follows. Ragan and Zingales (1998) argue that, if the level of financial development of an economy is important for its growth then, within a country, firms that have better access to sources of finance external to the firm should be less constrained, other things equal, than firms relying on internal finance. This suggests an empirical testing strategy that exploits the difference-in-difference approach recognising that firms within sectors that are inherently less dependent on internal finance should be observed to growth faster in countries that are more financially developed compared to firms in the same sectors in countries that are less financially developed. For present purposes, in effect S&A It is also worth noting that, since firm-level TFP might be expected to be positively, and endogenously, correlated with the firm's profitability (the tax base), the predicted negative impact on TFP of higher corporate tax rates arises despite this positive, endogenous relationship. That is, to the extent that profitability is thought to be determined simultaneously with TFP, this endogeneity should reduce, not increase, our likelihood of 8 finding a negative observed association between corporate tax liabilities and TFP. In addition, the use of industry-level profitability mitigates this possible endogeneity at firm level. The values of a firm's profits as reflected in company accounts (the S&A data source, and the one used in this paper) are often very different from profits liable to corporate tax (at the host country rate). Nevertheless, as a 'tax base' proxy, accounting profit might be expected to broadly capture the potential for more profitable industries to face higher tax liabilities. With profit measured relative to value added, a measure of industry 'profitability' interacted with the corporate tax rate represents a form of industry-level effective average tax rate. However, two important elements of the potential impact of corporate tax on TFP are the particular effects on innovation and risk-taking, with successful ventures (as evidenced, for example, in greater profitability) typically penalised disproportionately by corporate tax regimes. Various aspects of corporate tax regimes, other than the statutory rate, such as R&D tax credits or deductions for some or all types of investment, are aimed at reducing the adverse impact of corporation tax on firm's 'success'. These may not be observed through levels of firms' accounting profits, but rather through choices over types of investment or the extent of activities that give rise to reductions in taxable profits via increased deductions. To the extent that these aspects, stimulated by the corporate tax regime, generate productivity improvements (as opposed to corporate tax minimising strategies with no 'real' economic benefits) they should be evident in firm-level TFP. Of course, even where taxable profits are available, these will allow tests of the influence of corporate tax on TFP via profitability which cannot specifically test the hypothesis that it is the impact of tax on firms' innovation and risk-taking activities that acts as the mechanism by which higher corporate tax rates reduce productivity. Any firm with a higher level of profitability but where these profits are taxed more highly could expect to experience lower TFP levels of growth. For example, the availability of internal sources of finance may be the binding constraint on firms' investment that would enhance productivity. In this case corporate tax will adversely affect productivity but it may be unrelated to firms' willingness or ability to innovate or make risky investment choices. While measures of innovation or risk-taking are necessarily imprecise and difficult to pin down, we propose to test how far indictors that are more likely to be closely associated with innovation/risk-taking (than is profitability) are associated with lower TFP when 9 combined with higher corporate tax rates. In particular, innovation is often argued to be associated with research-intensity, with Research & Development (R&D) argued to be a prerequisite for successful innovative products and processes Hence, if firms in similar industries (for example, in terms of R&D intensity) are located in different countries (x and z), and hence face different corporate tax rates, this should generate lower TFP in the higher-tax equivalent firms in country x compared to those in lower-tax country z. We discuss these issues further below. Data and Methodology Our firm-level data comes from the Amadeus database (Bureau van Dijk). In general we follow the approach of S&A European Countries from the sample to preserve greater homogeneity across the EU sample. Unlike S&A Sampling Procedures Our procedures for randomly selecting a sample of firms is described in detail in Appendix 1. We follow S&A 11 sector. When using R&D intensity data we lose firms from service sector industries, focusing only on manufacturing industries. Estimating Productivity Measures To estimate total factor productivity, we take residuals from the estimated log-linear (Cobb-Douglas) production function in which value added (for firm i in year, t) is regressed on labour and capital stock inputs, where value added has been calculated as operating revenue minus material inputs. Labour inputs are measured by the firm's total wage bill, with capital stocks defined as tangible fixed assets. Sector-specific price indices from the EUKLEMS database have been used to transform nominal into real values, except for capital stocks for which we use a gross fixed capital formation deflator (from EUROSTAT National Accounts). In line with S&A Estimating Corporate Tax Effects Following Griffith et al. (3) where terms are as defined in equation 5 The Levinsohn and Petrin 12 Equation (3) allows for both a 'frontier effect' on firms' TFP levels as well as 'convergence or catch-up effect' and some persistence in TFP levels over time 8 . The interaction term Π s τ c t−1 captures the differences-in-differences impact of corporate taxes whereby firms in the more profitable industries are expected to have lower TFP when they are also in countries and/or years with high corporate tax rates. Note that the interaction component terms Π s and τ c,t−1 cannot be introduced separately while industry (s) and interactive country-year (ct) fixed effects are also included. However, as a robustness check we can investigate whether, omitting these fixed effects, the two interactive components display the expected signs (positive for profitability; negative for corporate tax rates). To estimate the impact of corporate taxes on productivity therefore requires data on industry-level profitability and country-time specific statutory corporate tax rates, as For each industry at the 2 digit ISIC level a profitability ratio is calculated from data on gross operating surplus divided by value added; this is applied to the whole period of our analysis, 1995-2008. We follow Furthermore, if we were to use an industry profitability measure differentiated by country there is increased risk that such a measure would reflect biases in reported profit. As S&A 8 In contrast to 13 report their profits (and/or over-report their deductions). This can be compounded if high statutory corporate taxes are positively related to other conditions that adversely affect firm profitability (e.g. where corporate tax regimes with high rates occur simultaneously with government regulatory or similar interventions that harm profitability), this would further bias any country-specific profitability measures. Taxes, the User Cost of Capital and Investment Since Jorgenson (1963) introduced the concept of the user cost of capital, , the relationship between this tax adjusted rental price and the dynamics of investment demand remains central in the empirical literature. Therefore, in the analysis of investment behaviour we have computed this concept as captured in equation The value of the standard depreciation allowance is given by the legal method provided by the tax system, normally one of the following: straight-line depreciation, constant declining balance depreciation or the method of the 'sum-of-the-years'-digits -see Appendix 2. In determining the value of the firm's discount rate we also follow King and Fullerton (1984). However, since our interest is restricted to the impact of the corporate tax, in determining the magnitude of this discount rate we discard the tax treatment of savings under personal income taxation. Therefore, for the case of debt finance we assume whereas if the 14 investment is financed using own resources the nominal discount rate coincides with the market interest rate, i.e. . 10 In generating the user cost of capital as a country-specific regressor in our estimations, equation (4) has been computed for 6 different investment types in each of the 16 countries included in the study for the period 1996-2008. By an investment type we mean the combination of two forms of finance -debt and equity -and three alternative general asset types -buildings, machinery and technology. As a result, for each year every country has six basic measures of the user cost of capital (3 assets 2 financial instruments). These basic measures of the cost of capital are weighted to be included in our estimations. The weighting procedure for the assets uses the shares of the real fixed capital stocks of buildings, machinery (the sum of transport equipment, other machinery and equipment, and other non-residential investment) and technology (Information and Communications Technologies, ICTs) based on the information provided in EU KLEMS growth and productivity accounts. The weighting procedure for forms of finance is based on the information from Morningstars on the market debt-to-capital ratio for more than 8.000 companies traded in US stock exchanges. This information has then been averaged by industry. Both the asset and form-of-financing weighting procedures are based on information for the US; that is, we assume again that industry-level technologies are similar across countries. In this way we also reduce the potential endogeneity between productivity and the user cost of capital, since more productive firms may have more access to loans and be more intensive in ICT use. By using US assets and form of financing shares, we also reduce the correlation between the user cost of capital and corporate tax rates if firms using more debt than equity tend to be found in countries with higher corporate tax rates. 10 In doing this we avoid our results being contaminated by the tax treatment of savings in the personal income tax. Originally, King and Fullerton (1984) determined the nominal discount rates for three alternative forms of finance: debt, retained earnings and equity. In quantifying these discount rates they took into account the tax treatment in personal income taxation. Specifically, for debt finance, for retained earnings and for new share issues, where is marginal tax rates for interest income, is the effective tax rate for capital gains and is the imputation rate in the case of dividend payments. The assumption of different discount rates depending on the form of finance has been subject to some criticisms however; see Scott (1987). 15 In computing equation Lammersen and Schwager, 2005). Summary of values for non-tax variables Economic depreciation rates ( ) Buildings (3.80%); Machinery (18.04%); Technology (43.10%

Coupling undetected sensing modes by quantum erasure

The effect known as ``induced coherence without induced emission'' has spawned a field dedicated to imaging with undetected photons (IUP), where photons from two distinct photon-pair sources interfere if their outputs are made indistinguishable. The indistinguishability is commonly achieved in two setups. Induced coherence IUP (IC-IUP) has only the idler photons from the first source passing through the second, whilst nonlinear interferometry (NI-IUP) has both signal and idler photons from the first source passing through the second and can be simpler to implement. In both cases, changes in the idler path between sources can be detected by measuring the interference fringes in the signal path in a way that allows image information to be moved between different wavelengths. Here we model and implement a novel setup that uses a polarization state quantum eraser approach to move continuously between IC-IUP and NI-IUP operation. We find excellent agreement between experiment and theory in the low-gain or quantum regime. The system also provides a new route for optimizing IUP interference by using controllable quantum erasure to balance the interferometer