"Who receives statins? Variations in physicians’ prescribing patterns for patients with coronary heart disease, dyslipidemia, and diabetes"

Our objective is to estimate the extent to which clinical and non-clinical factors are associated with physicians’ prescribing patterns for statins. The data are from the National Ambulatory Medical Care Survey for the period 1992 through 2004. The three samples examined included more than 14,000 patients who were diagnosed with coronary heart disease, high cholesterol, or diabetes, individuals who are most likely to benefit from being prescribed a statin drug. Using a multinomial logit framework, we find disparities in prescribing patterns based on non-clinical factors. Namely, whites and patients who have private insurance are more likely to be prescribed a statin than nonwhites and those with public insurance. Also, even though a large increase occurred in the uptake of statins over the period 1992 to 2004, our results for 2004 show that only about 50 percent of patients diagnosed with coronary heart disease were prescribed a statin. Because coronary heart disease is the leading cause of death in the U.S. and currently is estimated to cost over $150 billion annually in the U.S. in direct and indirect costs, observed differences in prescribing patterns along these dimensions is troubling and should be part of discussions dealing with health care reform.Pharmaceuticals; Statins; Equity in Physician Prescribing Patterns; Insurance

Causes of Litigation in Workers\u27 Compensation Programs

By applying econometric analyses to case data from two states, Falaris, Link and Staten identify the economic incentives influencing the probability of litigation in workers\u27 compensation cases, and the probability that a contested case is pursued to verdict.https://research.upjohn.org/up_press/1075/thumbnail.jp

A Straight Path: Studies in Medieval Philosophy and Culture; Essays in Honor of Arthur Hyman

R. James Long is a co-editor as well as a contributing author, Richard Fishacre\u27s Way to God pp. 174-82. Book description: Collected to honor the scholarship of Arthur Hyman over the past thirty years, the twenty-three articles of this volume are original contributions by established scholars of medieval philosophy. . . --Journal of the History of Philosophyhttps://digitalcommons.fairfield.edu/philosophy-books/1001/thumbnail.jp

Probing Lorentz and CPT violation with space-based experiments

Space-based experiments offer sensitivity to numerous unmeasured effects involving Lorentz and CPT violation. We provide a classification of clock sensitivities and present explicit expressions for time variations arising in such experiments from nonzero coefficients in the Lorentz- and CPT-violating Standard-Model Extension.Comment: 15 page

Experiences of mental illness stigma, prejudice and discrimination: A review of measures

Background: There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. Method. A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. Results: 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. Conclusions: The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose. © 2010 Brohan et al; licensee BioMed Central Ltd

A first in man phase I trial of the oral immunomodulator, indoximod, combined with docetaxel in patients with metastatic solid tumors

BackgroundIndoleamine 2,3-dioxygenase (IDO) is an enzyme that tumors use to create a state of immunosuppression. Indoximod is an IDO pathway inhibitor. Preclinical studies demonstrated that indoximod combined with chemotherapy was synergistic in a mouse model of breast cancer. A phase I 3+3 trial was designed to study the combination of docetaxel and indoximod.MethodsDocetaxel was administered at 60 mg/m2 intravenously every 3 weeks dose levels 1-4 and 75 mg/m2 for dose level 5. Indoximod was given at 300, 600, 1000, 2000, and 1200 mg PO twice daily continuously for levels 1-5, respectively. Serum drug levels were measured.ResultsTwenty-seven patients were treated, with 22 evaluable for response. DLTs included grade 3 dehydration (level 1), hypotension(level 4), mucositis (level 4) and grade 5 enterocolitis (level 2). Dose level 5 is the recommended phase II dose. The most frequent adverse events were fatigue (58.6%), anemia (51.7%), hyperglycemia (48.3%), infection (44.8%), and nausea (41.4%). There were 4 partial responses (2 breast, 1 NSCLC, 1 thymic tumor). No drug-drug interactions were noted.ConclusionsDocetaxel plus indoximod was well tolerated with no increase in expected toxicities or pharmacokinetic interactions. It was active in a pretreated population of patients with metastatic solid tumors

Energy Flow in the Hadronic Final State of Diffractive and Non-Diffractive Deep-Inelastic Scattering at HERA

An investigation of the hadronic final state in diffractive and non--diffractive deep--inelastic electron--proton scattering at HERA is presented, where diffractive data are selected experimentally by demanding a large gap in pseudo --rapidity around the proton remnant direction. The transverse energy flow in the hadronic final state is evaluated using a set of estimators which quantify topological properties. Using available Monte Carlo QCD calculations, it is demonstrated that the final state in diffractive DIS exhibits the features expected if the interaction is interpreted as the scattering of an electron off a current quark with associated effects of perturbative QCD. A model in which deep--inelastic diffraction is taken to be the exchange of a pomeron with partonic structure is found to reproduce the measurements well. Models for deep--inelastic $ep$ scattering, in which a sizeable diffractive contribution is present because of non--perturbative effects in the production of the hadronic final state, reproduce the general tendencies of the data but in all give a worse description.Comment: 22 pages, latex, 6 Figures appended as uuencoded fil