The Impact of Antihypertensive Drugs on the Number and Risk of Death, Stroke and Myocardial Infarction in the United States

Estimating the value of medical innovation is a continual challenge. In this research, we quantify the impact of antihypertensive therapy on U.S. blood pressures, risk and number of heart attacks, strokes, and deaths. We also consider the potential for further improvements. We estimate the value of innovation using equations relating blood pressure to adverse outcomes from the Framingham Heart Study. Our results show that without antihypertensive therapy, 1999-2000 average blood pressure for the U.S. population age 40 plus would have been 10-13 percent higher. 86,000 excess premature deaths from cardiovascular disease (2001), and 833,000 hospital discharges for stroke and heart attacks (2002) would have occurred. Life expectancy would be 0.5 (men) and 0.4 (women) years lower. At guideline care, there would have been 89,000 fewer premature deaths (2001) and 420,000 fewer hospital discharges for stroke and heart attack (2002) than observed. Our analysis suggests that antihypertensive therapy has had a significant impact on cardiovascular health outcomes but that mortality gains would have been approximately twice as high if guideline care had been achieved for all.

A Second Look at the Association between Gender and Mortality on Antiretroviral Therapy

Objective: We assessed the association between gender and mortality on antiretroviral therapy (ART) using identical models with and without sex-specific categories for weight and hemoglobin. Design: Cohort study of adult patients on ART. Setting: GHESKIO Clinic in Port-au-Prince, Haiti. Participants: 4,717 ART-naïve adult patients consecutively enrolled on ART at GHESKIO from 2003 to 2008. Main Outcome Measure: Mortality on ART; multivariable analyses were conducted with and without sex-specific categories for weight and hemoglobin. Results: In Haiti, male gender was associated with mortality (OR 1.61; 95% CI: 1.30–2.00) in multivariable analyses with hemoglobin and weight included as control variables, but not when sex-specific interactions with hemoglobin and weight were used. Conclusions: If sex-specific categories are omitted, multivariable analyses indicate a higher risk of mortality for males vs. females of the same weight and hemoglobin. However, because males have higher normal values for weight and hemoglobin, the males in this comparison would generally have poorer health status than the females. This may explain why gender differences in mortality are sometimes observed after controlling for differences in baseline variables when gender-specific interactions with weight and hemoglobin are omitted

Eclipse in the Dark Years: Pick-up Flights, Routes of Resistance and the Free French

This article charts the importance of clandestine flights from Britain into occupied France during the Second World War as a route of resistance. These pick-up flights were coordinated from London and were an example of the inter-allied cooperation and Franco-British negotiation that took place between the BCRA, SIS, and SOE. The flights allowed General Charles de Gaulle to hold court with the leaders of resistance networks, smoothing problems on the route to a unified resistance council. Likewise, they allowed him to build bridges between vying factions in France and in London, drawing together the movements under his command and personalising the narrative of resistance. From busy London restaurants and family homes via secret flights to darkened fields in Occupied France, the route of these transfers shaped the character of resistance. This article draws out the personal interactions and connections that underpinned these networks and describes the enduring connections of this route of resistance, starting with the commemoration of Jean Moulin's crash landing at RAF Tangmere, the forward station for many of these flights

THE DETERMINANTS OF SOCIAL ASSISTANCE RATES: EVIDENCE FROM A PANEL OF CANADIAN PROVINCES, 1997-1996

In this study, we focus on several potential determinants of provincial social assistance rates: the unemployment rate, the UI wage replacement rate and eligibility rules, the SA benefit level, the minimum wage, and the average industrial wage. Specifically, we try to quantify their respective contributions to observed fluctuations in provincial social assistance rates over the period 1977-1996. This is facilitated by the fact that there was plenty of movement across provinces in these various influences over the last 20 years.

Enforcement of Anticollusion Laws against Domestic and Foreign Firms

Antitrust authorities must decide whether and how to consider the national identities of firms. Authorities may follow a neutral enforcement approach or focus on either foreign or domestic firms. We investigate these issues in the context of cartel enforcement against EU, US, and rest-of-the-world (ROW) firms by the European Union and the United States—the two jurisdictions with the longest and most robust enforcement histories. Our results suggest a mix of behaviors. The European Union is more likely to fine domestic and ROW firms than US firms, and the United States is no more likely to fine EU firms than domestic firms but disproportionately targets ROW firms. With respect to the size of fines, EU enforcement outcomes show no significant differences among categories of firms. The United States, however, levies significantly higher fines on foreign firms than domestic firms, whether from the European Union or the rest of the world

Enforcement of Anticollusion Laws against Domestic and Foreign Firms

Antitrust authorities must decide whether and how to consider the national identities of firms. Authorities may follow a neutral enforcement approach or focus on either foreign or domestic firms. We investigate these issues in the context of cartel enforcement against EU, US, and rest-of-the-world (ROW) firms by the European Union and the United States—the two jurisdictions with the longest and most robust enforcement histories. Our results suggest a mix of behaviors. The European Union is more likely to fine domestic and ROW firms than US firms, and the United States is no more likely to fine EU firms than domestic firms but disproportionately targets ROW firms. With respect to the size of fines, EU enforcement outcomes show no significant differences among categories of firms. The United States, however, levies significantly higher fines on foreign firms than domestic firms, whether from the European Union or the rest of the world