A review of the economic burden of ADHD

Attention-deficit hyperactivity disorder (ADHD) is a common disorder that is associated with broad functional impairment among both children and adults. The purpose of this paper is to review and summarize available literature on the economic costs of ADHD, as well as potential economic benefits of treating this condition. A literature search was performed using MEDLINE to identify all published articles on the economic implications of ADHD, and authors were contacted to locate conference abstracts and articles in press that were not yet indexed. In total, 22 relevant items were located including published original studies, economic review articles, conference presentations, and reports available on the Internet. All costs were updated and presented in terms of year 2004 US dollars. A growing body of literature, primarily published in the United States, has demonstrated that ADHD places a substantial economic burden on patients, families, and third-party payers. Results of the medical cost studies consistently indicated that children with ADHD had higher annual medical costs than either matched controls (difference ranged from $503 to$1,343) or non-matched controls (difference ranged from $207 to$1,560) without ADHD. Two studies of adult samples found similar results, with significantly higher annual medical costs among adults with ADHD (ranging from $4,929 to$5,651) than among matched controls (ranging from $1,473 to$2,771). A limited number of studies have examined other economic implications of ADHD including costs to families; costs of criminality among individuals with ADHD; costs related to common psychiatric and medical comorbidities of ADHD; indirect costs associated with work loss among adults with ADHD; and costs of accidents among individuals with ADHD. Treatment cost-effectiveness studies have primarily focused on methylphenidate, which is a cost-effective treatment option with cost-effectiveness ratios ranging from $15,509 to$27,766 per quality-adjusted life year (QALY) gained. As new treatments are introduced it will be important to evaluate their cost-effectiveness to provide an indication of their potential value to clinicians, patients, families, and third-party payers

Codas are universally moraic

Abstract: Mismatches in weight criteria across weight-sensitive processes within individual languages present difficulties for theories of moraic structure, particularly regarding coda weight. Previous accounts, which stipulate that codas are variably moraic to account for the typological variation in the weight status of CVC for primary stress, make incorrect predictions for the status of CVC in other weight-sensitive phenomena, including tone, word minimality and secondary stress, among others. This article proposes a theory of Uniform Moraic Quantity coupled with a new syllable weight metric as a solution, which captures CVC’s flexible weight status while maintaining the cross-linguistic moraicity of codas and avoiding the incorrect predictions that frustrate the standard variable-weight approach

Doctor of Philosophy

dissertationIn this dissertation, the process-structure-property relationships of titanium alloys, specifically Ti-6Al-4V, produced via hydrogen sintering and phase transformation (HSPT) is investigated. HSPT is a low-cost, blended elemental (BE), press-and-sinter process for producing titanium alloys that have mechanical properties that are competitive with wrought titanium alloys. Throughout this dissertation, the wrought-like microstructures that are possible by utilizing HSPT with other low-cost postsintering thermal processes, such as solution treatment and ageing (STA) heat treatments, are discussed. Additionally, the exceptional mechanical properties that result from the range of microstructures produced are presented. Currently, wrought processing is the state of the art for producing titanium alloys with the mechanical properties necessary for critical applications. However, wrought processing employs multiple steps of energy-intensive thermomechanical processing (TMP) to both form the shaped products and refine the microstructure. In fact, the majority of cost associated with many titanium products on the market today stems from TMP. Powder metallurgy (PM) has long been sought as a low-cost alternative to wrought processing, owing to its near-net-shape capabilities. However, traditional PM titanium has mechanical properties that are insufficient for many critical applications. In this dissertation, it is shown that HSPT is capable of producing wrought-like microstructures and mechanical properties without resorting to energy-intensive processes such as pressure-assisted sintering or TMP, which is compulsory for other processing routes. The as-sintered microstructure and mechanical properties of HSPT Ti-6Al-4V are discussed and compared with wrought and traditional PM Ti-6Al-4V. Additionally, the as-sintered HSPT Ti-6Al-4V was processed with a range of low-cost thermal processing techniques to produce a range of wrought-like microstructures and mechanical properties. Therefore, it is shown that HSPT is capable of producing different microstructures that have been engineered to meet the application-tailored demands for mechanical properties of titanium alloys. Additionally, the physical metallurgical principles and mechanisms behind these capabilities are discussed. The impetus for this research was the development of a low-cost process to produce high-performance titanium alloys. Therefore, a quantitative energy model, which was developed by the author, of the HSPT process is also presented

Cost of illness of hyponatremia in the United States

BACKGROUND: Hyponatremia is a disorder of fluid and electrolyte balance characterized by a relative excess of body water relative to body sodium content. It is the most common electrolyte disorder encountered in clinical medicine and is associated with negative outcomes in many chronic diseases. However, there is limited information in the literature about health care resource use and costs attributable to the effects of the condition. The purpose of this analysis was to estimate the annual cost of illness of hyponatremia in the United States. METHODS: The study utilized a prevalence-based cost of illness framework that incorporated data from publicly available databases, published literature and a consensus panel of expert physicians. Panel members provided information on: classification of hyponatremia patients, treatment settings for hyponatremia (i.e., hospital, emergency room, doctor's office), and health care resource use associated with the diagnosis and treatment of hyponatremia. Low and high prevalence scenarios were estimated and utilized in a spreadsheet-based cost of illness model. Costs were assigned to units of resources and summarized across treatment settings. RESULTS: The prevalence estimate for hyponatremia ranged from 3.2 million to 6.1 million persons in the U.S. on an annual basis. Approximately 1% of patients were classified as having acute and symptomatic hyponatremia, 4% acute and asymptomatic, 15%–20% chronic and symptomatic, and 75–80% chronic and asymptomatic. Of patients treated for hyponatremia, 55%–63% are initially treated as inpatients, 25% are initially treated in the emergency room, and 13%–20% are treated solely in the office setting. The direct costs of treating hyponatremia in the U.S. on an annual basis were estimated to range between $1.6 billion and$3.6 billion. CONCLUSION: Treatment of hyponatremia represents a significant healthcare burden in the U.S. Newer therapies that may reduce the burden of hyponatremia in the inpatient setting could minimize the costs associated with this condition

A Theory of Luck or How I Learned to Stop Worrying and Make My Own Career

An overview of a set of contingency plans and preparations for working in the music industry using a novel conception of luck

Premodern Secularism

This article argues that secularism is not an exclusively modern phenomenon, but is rather a recurring pattern which arises throughout different periods of premodern and modern history. I begin with a longue durée overview of Japanese history as a case study, proposing a regime of such historical cycles over a 1,200-year period. I then zoom in on changes in religious-political relations which occurred in one specific, important cycle, through the transition from the late medieval into the early modern period. I argue that this period ushered in a new form of political-religious relations where Neo-Confucianism, instead of Buddhism, for the first time represented the religious element in Japanese politics. I demonstrate how this early modern regime of political-religious interaction supported by Neo-Confucianism was particularly stable and functioned to support public discourse. The last part of the article discusses the modern nation state’s destruction of this stable form of political-religious relations and notes that in both Japan and China, right up to the present, new regimes of stable political-religious relations have not emerged. Asian Studie

前近代の世俗主義

This article argues that secularism is not an exclusively modern phenomenon, but is rather a recurring pattern which arises throughout different periods of premodern and modern history. I begin with a longue durée overview of Japanese history as a case study, proposing a regime of such historical cycles over a 1,200-year period. I then focus on changes in religiouspolitical relations which occurred in one specific, important cycle, through the transition from the late medieval into the early modern period. I argue that this period ushered in a new form of political-religious relations where Neo-Confucianism, instead of Buddhism, for the first time represented the religious element in Japanese politics. I demonstrate how this early modern regime of political-religious interaction supported by Neo-Confucianism was particularly stable and functioned to support public discourse. In conclusion, the article notes the destruction of this early modern form of political-religious relations during East Asian modernization, and suggests that the continuing lack of a stable regime of political-religious relations in both contemporary China and Japan can be seen as an ongoing legacy of that destruction

"Civil Religion" and Confucianism: Japan's Past, China's Present, and the Current Boom in Scholarship on Confucianism

This article employs the history of Confucianism in modern Japan to critique current scholarship on the resurgence of Confucianism in contemporary China. It argues that current scholarship employs modernist formulations of Confucianism that originated in Japan’s twentieth-century confrontation with Republican China, without understanding the inherent nationalist applications of these formulations. Current scholarly approaches to Confucianism trace a history through Japanese-influenced U.S. scholars of the midtwentieth century like Robert Bellah to Japanese imperialist and Chinese Republican nationalist scholarship of the early twentieth century. This scholarship employed new individualistic and modernist visions of religion and philosophy to isolate fields of “Confucian values” or “Confucian philosophy” apart from the realities of social practice and tradition, transforming Confucianism into a purely intellectualized “empty box” ripe to be filled with cultural nationalist content. This article contends that current scholarship, by continuing this modernist approach, may unwittingly facilitate similar nationalist exploitations of Confucianism.Asian Studie

Political Modernity and Secularization: Thoughts from the Japanese Eighteenth and Nineteenth Centuries

Asian Studie