This paper considers the predictions for factor demand of a two-sector vertically integrated model of firms producing output using firm-specific capital along with a second sector producing ...firm-specific capital that adapts raw capital purchased in the market. Analysts rarely observe each sector separately. Aggregating over both sectors produces short-run and long-run factor demand functions that appear to be perverse, but when disaggregated obey standard neoclassical properties. For example, a firm’s response to a minimum wage could appear to violate the law of demand because it hires labor to install machines to replace the more expensive labor in the final output sector. Adjustment costs create the appearance of static inefficiency in the presence of dynamic efficiency.
Background
Constipation is highly prevalent in the United States. The association of dietary fat intake with constipation has not been well studied. We recently reported that mice fed a high‐fat diet ...had higher incidence of constipation than regular diet fed mice. The aim of this study was to assess if increased intake of dietary saturated fat in humans is also associated with higher risk of constipation and reduced stool frequency.
Methods
Analyses were based on data from 6207 adults (≥20 years) from the 2005–2006 and 2007–2008 cycles of the National Health and Nutrition Examination Surveys who had completed the bowel health questionnaire. Constipation was defined as a stool frequency of less than three times per week. Multivariable logistic regression analysis was used to calculate adjusted prevalence odds ratio (OR) estimates. Statistical analyses were performed using R and RStudio softwares.
Key Results
The prevalence of constipation in this sample was 3.1%. After multivariable adjustment high saturated fat remained associated with constipation. The OR for high saturated fat intake associated with constipation was much higher in diabetics above 65 years, especially in non‐Hispanic blacks, females, and those with poor glycemic control, compared to the control group.
Conclusions & Inferences
To the best of our knowledge, this is the first report to investigate the association of high saturated fat diet, bowel frequency, and diabetes. This study demonstrates that a high dietary saturated fat intake is associated with significant increase in the prevalence of constipation, especially in the uncontrolled diabetic, non‐Hispanic black, female patients.
Education on dietary fat control in the people consuming high‐fat diets might be worthwhile, particularly in elderly and diabetic patients, who are at higher risk of constipation. Present findings provide new evidence supporting dietary recommendations to consume diets that have low saturated fat, specifically in those who suffer from constipation. After multivariable adjustment, high saturated fat remained associated with constipation. The odds ratio for high saturated fat intake associated with constipation was much higher in diabetics greater than 65 years old, especially those with poor glycemic control, non‐Hispanic blacks and females, compared to the control group.
Background
Alcohol increases breast cancer risk. Epidemiological studies suggest folate may modify this relationship.
Objective
To examine the relationship among breast cancer, alcohol and folate in ...the Women’s Health Initiative-Observational Study (WHI-OS).
Methods
88,530 postmenopausal women 50–79 years completed baseline questionnaires between October 1993 and December 1998, which addressed alcohol and folate intake and breast cancer risk factors. Cox proportional hazards analysis examined the relationship between self-reported baseline alcohol and folate intake and incident breast cancer.
Results
1,783 breast cancer cases occurred over 5 years. Alcohol was associated with increased risk of breast cancer (RR = 1.005, 95%CI 1.001–1.009). Risk increased with consumption of alcohol (up to 5 g/d, adjusted HR = 1.10, 95%CI 0.96–1.32; >5–15 g/d HR = 1.14, 95%CI 0.99–1.31; and >15 g/d HR = 1.13 95%CI 0.96–1.32). We found no significant interaction between alcohol and folate in our adjusted model.
Conclusions
We found no evidence for folate attenuating alcohol’s effect on breast cancer risk in postmenopausal women. Our results may be due to misclassification of folate intake or the relatively short follow-up period.
The extraction behavior of new bi-functional ligands containing sulfoxide and amide groups viz. N,N′-dibutyl carbamoyl methyl phenyl sulfoxide (L1) and N,N′-dibutyl carbamoyl methyl benzyl sulfoxide ...(L2) towards the U(VI), Pu(IV) and Am(III) ions from nitric acid was studied. Both of these extractants showed appreciable extractions for U(VI) and Pu(IV) from 1 to 9.5 M nitric acid concentrations. Am(III) did not show an appreciable extraction under the conditions studied. The species extracted from a nitric acid medium correspond to the compositions of UO2(NO3)2·2L and Pu(NO3)4·2L for L1 and a mixture of UO2(NO3)2·2L, UO2(NO3)2·L and Pu(NO3)4·2L for the L2. The conditional extraction constant (Kex) values for the Pu(IV) with L1 and L2 were estimated for the first time, and found to be 6.21 × 102 and 5.64 × 102 mol−4 dm, respectively.
The rate of low birth weight (LBW) of Black women is more than twice that of White women. This study explores if the rate of LBW differs between Haitian and African-American women with chronic ...hypertension.
A retrospective cohort study of all Black women self-identified as African-American (n = 12,258) or Haitian (n = 4320) delivering a singleton infant in Massachusetts between 1996 and 2000.
Haitian women were more likely than African-American women to have chronic hypertension (2.7% vs. 2.1%, p = 0.006), but had similar rates of preeclampsia (3.1% vs. 3.3%, p = 0.27). The LBW rate was 10% among African-American women and 8.2% among Haitian women. After adjustment for sociodemographic, medical, and prenatal care characteristics, the greatest risks for delivering a LBW infant for Haitian women were chronic hypertension (OR = 6.8; 95% CI, 4.3, 10.6) and preeclampsia (OR = 3.2; 95% CI, 2.0, 5.1). For African-American women, the greatest risks for LBW infants were a history of delivering a LBW infant (OR = 3.9; 95% CI, 2.8, 5.4) and chronic hypertension (OR = 2.9; 95% CI, 2.1, 4.0). In a combined logistic regression model including interaction terms, chronic hypertension and preeclampsia continued to be associated with the greatest risk of LBW among all women.
Differences in maternal risk factors and rates of LBW (8.2% vs. 10%) exist between Haitian and African-American women delivering infants in Massachusetts. While chronic hypertension and preeclampsia are strong risk factors for LBW for both Haitian and African-American women, unknown factors make these disorders much more potent for Haitian women.
ObjectiveIn the 30 days after hospital discharge, hospital utilisation is common and costly. This study evaluated the association between gender and hospital utilisation within 30 days of ...discharge.DesignSecondary data analysis using Poisson regression stratified by gender.Participants737 English-speaking hospitalised adults from general medical service in urban, academic safety-net medical centre who participated in the Project Re-Engineered clinical trial (clinicaltrials.gov identifier: NCT00252057).Main outcome measureThe primary end point was hospital utilisation, defined as total emergency department visits and hospital readmissions within 30 days after index discharge.ResultsFemale subjects had a rate of 29 events for every 100 people and male subjects had a rate of 47 events for every 100 people (incident rate ratio (IRR) 1.62, 95% CI 1.28 to 2.06). Among men, risk factors included hospital utilisation in the 6 months prior to the index hospitalisation (IRR 3.55, 95% CI 2.38 to 5.29), being unmarried (IRR 1.72, 95% CI 1.12 to 2.64), having a positive depression screen (IRR 1.53, 95% CI 1.09 to 2.13) and no primary care physician (PCP) visit within 30 days (IRR 1.64, 95% CI 1.08 to 2.50). Among women, the only risk factor was hospital utilisation in the 6 months prior to the index hospitalisation (IRR 3.08, 95% CI 1.86 to 5.10).ConclusionsIn our data, male subjects had a higher rate of hospital utilisation within 30 days of discharge than female subjects. For men—but not for women—risk factors were being retired, unmarried, having depressive symptoms and having no PCP visit within 30 days. Interventions addressing these factors might lower hospital utilisation rates observed among men.
To assess the relationship between the presence of a mental health condition and health care utilization among family medicine patients.
We used the Patient Health Questionnaire plus a posttraumatic ...stress disorder screen to measure 6 common mental health conditions. In a sample of 367 patients recruited from 3 urban family medicine practices affiliated with Boston University Medical Center, we measured self-reported health care utilization of primary care provider visits, emergency department visits, nonpsychiatric hospitalizations, and outpatient mental health visits. We determined the association between screening positive for the mental health conditions and health care utilization using both multivariable logistic regression and Poisson regression methods while controlling for sex, age, race, income, insurance status, marital status, educational level, and the presence of chronic medical conditions.
After controlling for potential confounders, generalized anxiety disorder, panic disorder, and posttraumatic stress disorder were statistically significantly associated with more PCP visits, ED visits, and nonpsychiatric hospitalizations. Neither major nor minor depression were associated with more PCP visits, ED visits, or nonpsychiatric hospitalizations, except that minor depression was associated with 103% increase in PCP visits (P < .001). Alcohol use disorder was associated with 16% fewer PCP visits (P = .01) but 238% more nonpsychiatric hospitalizations (P < .001).
After controlling for confounders we found that mental health conditions among a sample of family medicine patients were associated with increased use of ED services, nonpsychiatric hospitalizations, and, to a lesser extent, PCP visits.
This paper reports the effect of recycling of local garnet abrasives (origin: southern India) while cutting aluminium using abrasive water jet machining. The influence of pressure, traverse rate, and ...abrasive flow rate on American Foundrymen’s Society grain fineness number, average particle size, depth of cut, top kerf width, bottom kerf width, kerf taper, and surface finish obtained using a specially formulated optimised abrasive test sample have been studied. The performance of the test sample has been compared with that of commercial grade abrasive of mesh size 80. Recycling studies, undertaken with used abrasives after screening out particles less than 90
μm size and also with all particles without screening are reported. It is found that the test sample performed better than mesh size 80 abrasives, in terms of achievable depth of cut and surface finish. Recycled abrasives reduces kerf taper, improving the parallelism of cut surface. These results indicate that the proper selection of abrasive particle size distribution is necessary for achieving improved results. The reusability percentage of test sample of the local abrasives that can be recycled is determined as 81%.
Background. In South Africa (SA), intensive care is faced with the challenge of resource scarcity as well as an increasing demand for intensive care unit (ICU) services. ICU services are expensive, ...and practitioners in low- to middle-income countries experience daily the consequences of limited resources. Critically limited resources necessitate that rationing and triage (prioritisation) decisions are frequently necessary in SA, particularly in the publicly funded health sector. Purpose. The purpose of this consensus statement is to examine key questions that arise when considering the status of ICU resources in SA, and more specifically ICU admission, rationing and triage decisions. The accompanying guideline in this issue is intended to guide frontline triage policy and ensure the best utilisation of intensive care in SA, while maintaining a fair distribution of available resources. Fair and efficient triage is important to ensure the ongoing provision of high-quality care to adult patients referred for intensive care. Recommendations. In response to 14 key questions developed using a modified Delphi technique, 29 recommendations were formulated and graded using an adapted GRADE score. The 14 key questions addressed the status of the provision of ICU services in SA, the degree of resource restriction, the efficiency of resource management, the need for triage, and how triage could be most justly implemented. Important recommendations included the need to formally recognise and accurately quantify the provision of ICU services in SA by national audit; actively seek additional resources from governmental bodies; consider methods to maximise the efficiency of ICU care; evaluate lower level of care alternatives; develop a triage guideline to assist policy-makers and frontline practitioners to implement triage decisions in an efficient and fair way; measure and audit the consequence of triage; and promote research to improve the accuracy and consistency of triage decisions. The consensus document and guideline should be reviewed and revised appropriately within 5 years. Conclusion. In recognition of the absolute need to limit patient access to ICU because of the lack of sufficient intensive care resources in public hospitals, recommendations and a guideline have been developed to guide policy-making and assist frontline triage decision-making in SA. These documents are not a complete plan for quality practice but rather the beginning of a long-term initiative to engage clinicians, the public and administrators in appropriate triage decision-making, and promote systems that will ultimately maximise the efficient and fair use of available ICU resources.
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