Fiellin: Keep the prescriber training for buprenorphine

It seems that almost everyone wants to deregulate buprenorphine for opioid use disorder (OUD) — with proposed legislation focused on getting rid of the Drug Addiction Treatment Act of 2000 (DATA 2000) waiver altogether (see ADAW, Oct. 11, “Bill to deregulate buprenorphine raises concerns among OTPs,” https://onlinelibrary.wiley.com/doi/10.1002/adaw.32510 ).     

NAMA and AATOD warn Senators not to raise cap

Last week, Mark W. Parrino, president of the American Association for the Treatment of Opioid Dependence (AATOD), and Zachary Talbott, president of the National Alliance for Medication Assisted Recovery (NAMA Recovery), wrote a letter to Congress warning against raising the DATA 2000 (buprenorphine prescribing) patient cap from 275 to 500 during the pandemic. The letter to Senators Ed Markey (D‐Mass.), Jeanne Shaheen (D‐N.H.), Maggie Hassan (D‐N.H.), Elizabeth Warren (D‐Mass.) and Dianne Feinstein (D‐Calif.) was in response to an April 17 letter from the senators to Health and Human Services Secretary Alex Azar and Assistant Secretary Elinore McCance‐Katz urging them to increase the cap.     

More on independent decisiveness and Arrow's theorem

Denicolò [2, Theorem 1] strengthens Arrow's [1, p. 97] theorem by replacing the independence of irrelevant alternatives (IIA) condition by a strictly weaker one, relational independent decisiveness (RID). It is shown here that RID can be still substantially weakened. Yet, the new condition is equivalent to RID under the weak Pareto principle P and unrestricted domain U. In fact, any condition that can be put in place of IIA in Arrow's theorem must imply RID in the presence of P and U. Incidentally, it is argued that Denicolò's proof of his Theorem 1 contains an imprecision. Received: 7 March 2000/Accepted: 11 December 2000     

The effects of backpack load carrying on dynamic balance as measured by limits of stability

PURPOSE: The purpose of this research was to determine if standing dynamic balance was affected by carrying a backpack. SUBJECTS: Data was obtained from 50 healthy college students. MATERIALS AND METHODS: Limits of stability was assessed using the Smart Equitest Balance Master System(R). Reaction time, movement velocity, end point excursion, maximum excursion, and directional control were measured to evaluate movement, with and without a loaded backpack. DATA ANALYSIS: Reliability was established using an Intra-Class Correlation Coefficient (2,1). MANOVA was utilized to analyze the effect of the backpack. SUMMARY DATA: Movement velocity significantly decreased during backpack loaded trials (p=0.004). Directional control was significantly different with respect to direction (p=0.006). No significant difference in reaction time, maximum excursion, or end point excursion was observed with backpack loading (p=0.10-0.93). CONCLUSION: This study concludes that backpack load carrying has an effect on movement velocity and directional control.     

Positive class compromise in globalized production? The Freedom of Association Protocol in the Indonesian sportswear industry

This article investigates the role of voluntary initiatives (VIs) as nongovernmental systems of labour regulation in global value chains (GVCs). To identify the conditions conducive to a more active role for labour in VIs, the authors apply Wright's (2000) theory of the factors enabling positive class compromise to a VI implemented in the Indonesian sportswear industry and extend it to the more complex realities of GVCs. They conclude that if VIs are to create conditions under which decent work can be strengthened, the involvement of strong local labour organizations is required while producers' and/or buyers' dependence on workers' cooperation acts as a catalyst.     

A nail-biting election

In the first competitive election for President of the Social Choice and Welfare Society, the (official) approval-voting winner differed from the (hypothetical) Borda count winner, who was also the Condorcet winner. But because the election was essentially a toss-up, it is impossible to say who should have won. The election for Council was more true to form of other professional-society elections, with the winners identical, and even their rankings almost duplicative, under both voting systems. Received: 11 April 2000/Accepted: 26 March 2001     

WHY ARE U.S. WOMEN DECREASING THEIR LABOR FORCE PARTICIPATION IF THEIR WAGES ARE RISING?

Given the traditional interpretation of women's labor force participation rate (LFPR) trends as movements along a positively sloped labor supply curve, it is surprising that the recent downward trend in U.S. women's LFPR has occurred over a period when women's real wages were commonly believed to be rising. I find that almost two‐thirds of the decline since 2000 is attributable to aging of the adult female population. The remainder, due to declining labor force participation for women under 55, becomes less puzzling in light of my evidence that the wage/education locus faced by women actually may have worsened since 2000. (JEL J21, J31, J82)     

Demystifying reflective practice: Using the DATA model to enhance evaluators’ professional activities

Reflective practice (RP), one of six essential competency domains in evaluation identified by Stevahn, King, Ghere, and Minnema (2005), refers to thinking critically about one's evaluation practice, alone or with other people, and using critical insights to improve one's practice. Currently, evaluators have minimal guidance in navigating this essential professional competency, professed to be a necessary part of their practice. This article focuses on how RP can serve as a tool for evaluators through the use of the “DATA” integrated RP framework, developed by Peters, 1991, Peters, 2009. DATA is an acronym with each letter standing for a different step in the process of reflective practice. The “D” step of the acronym focuses on (D)escribing what is or has been happening in practice. The “A” step refers to (A)nalyzing the current state of practice—why is this happening the way it is? The “T” concentrates on a practice-oriented form of (T)heorizing, which comes from analysis and serves as a basis for the resulting (A)ct. The last “A” focuses on the specifics of an action plan to change one's evaluation practice in light of the practical theory developed through theorizing. This paper describes the DATA model and introduces the application of the framework in a practice context.     

Sources of health insurance and characteristics of the uninsured: analysis of the March 2011 current population survey

LATEST CENSUS DATA: This Issue Brief provides historical data through 2010 on the number and percentage of nonelderly individuals with and without health insurance. Based on EBRI estimates from the U.S. Census Bureau's March 2011 Current Population Survey (CPS), it reflects 2010 data. It also discusses trends in coverage for the 1994-2010 period and highlights characteristics that typically indicate whether an individual is insured. HEALTH COVERAGE RATE CONTINUES TO DECREASE, UNINSURED INCREASE: The percentage of the nonelderly population (under age 65) with health insurance coverage decreased to 81.5 percent in 2010. Increases in health insurance coverage have been recorded in only three years since 1994, when 36.5 million nonelderly individuals were uninsured. The percentage of nonelderly individuals without health insurance coverage was 18.5 percent in 2010, up from 18.3 percent in 2009, and its highest level during the 1994-2010 period. EMPLOYMENT-BASED COVERAGE REMAINS DOMINANT SOURCE OF HEALTH COVERAGE, BUT CONTINUES TO ERODE: Employment-based health benefits remain the most common form of health coverage in the United States. In 2010, 58.7 percent of the nonelderly population had employment-based health benefits, down from 69.3 percent in 2000. SHIFTING COMPOSITION OF EMPLOYMENT-BASED COVERAGE: Between 2007 and 2010, the percentage of individuals under age 65 with employment-based coverage in their own name has dropped. In 2007, 54.2 percent had coverage in their own name. By 2010, it was down to 51.5 percent. Dependent coverage during this time period fell slightly from 17.5 percent to 17.1 percent, and increased slightly from 16.8 percent to 17.1 percent between 2009 and 2010. PUBLIC PROGRAM COVERAGE IS GROWING: Public program health coverage expanded as a percentage of the population in 2010, accounting for 21.6 percent of the nonelderly population. Enrollment in Medicaid and the State Children's Health Insurance Program increased, reaching a combined 45 million in 2010, and covering 16.9 percent of the nonelderly population, significantly above the 10.2 percent level of 1999. INDIVIDUAL COVERAGE STABLE: Individually purchased health coverage was unchanged in 2010 and has basically hovered in the 6-7 percent range since 1994. WHAT TO EXPECT IN 2011: 2010 is the most recent year for data on sources of health coverage. Unemployment in 2011 has been about 9 percent since the beginning of the year. While down from the 2010 average of 9.6 percent, it remains high and there is a continued threat of a double-dip recession increasing it even further. As a result, the nation is likely to see continued erosion of employment-based health benefits when the data for 2011 are released in 2012. Fewer working individuals translates into fewer individuals with access to health benefits in the work place, especially after COBRA subsidies have been exhausted.     

DEA allows buprenorphine inductions based on telephone only

Last week, the Drug Enforcement Administration (DEA) said opioid treatment programs (OTPs) and Drug Addiction Treatment Act (DATA)–waived prescribers can treat new patients with buprenorphine based on a telephone call only. The Controlled Substances Act (CSA), enforced by the DEA, requires all new patients being treated with controlled substances to have an in‐person — or, for now, telemedicine — physical exam. Now, however, because of the coexisting COVID‐19 pandemic and opioid overdose crisis, the DEA has dropped this requirement. This follows the decision of the Substance Abuse and Mental Health Services Administration (SAMHSA) to allow exemptions from the OTP take‐home regulations allowing stable patients to be given 14 or 28 days of methadone doses, instead of coming in more frequently (see DEA, SAMHSA relax OTP/OBOT regulations due to COVID‐19, ADAW March 23, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32664 ).     

The Impact of Economic Freedom and Personal Freedom on Net In-Migration in the U.S.: A State-Level Empirical Analysis, 2000 to 2010

Arguably, private enterprise flourishes under conditions of increased freedom. However, increases in economic freedom can sometimes impose costs on others (negative externalities and monopoly power being prominent examples). Nevertheless, on balance, it is typically expected that the greater the degree of economic freedom, the more successfully and efficiently markets perform and the greater the prosperity created through private enterprise. These net outcomes from greater freedom accelerate economic growth and development, which in turn creates opportunities for yet further success. From a different perspective, it can be argued that greater personal freedom promotes higher levels of utility for consumers in non-economic ways. Accordingly, the present study empirically investigates whether the prospects of greater economic freedom and/or greater personal freedom in any given state vis-à-vis other states act(s) to induce a greater net influx of migrants. This empirical study of internal U.S. migration over the study period from 2000 to 2010 finds clear evidence that migrants prefer to move to those states with greater economic freedom on the one hand and greater personal freedom on the other hand.     

Sex/Gender: Which Is Which? A Rejoinder to Mary Riege Laner

This article is a challenge to Mary Riege Laner's exhortation to "Let sex be sex and let gender be gender" as expressed recently in the pages of Sociological Inquiry (Laner 2000, p. 471). I examine the theoretical and linguistic underpinnings of such a view, critique the sex/gender distinction on which it is based, and endorse the maneuvers of a number of poststructuralist thinkers who have sought to problematize that very distinction. I argue instead that the classic sex/gender distinction of second-wave feminism goes wrong on (at least) three counts: (1) it is ahistorical in an area where historical specificity matters; (2) it rests on a simplistic and untenable account of language; (3) the conceptual dichotomy it posits—demarcating gender from sex—is not sustainable and cannot withstand close scrutiny. Finally, I question whether the import of the poststructuralist critique necessitates a move to epistemological and ethical relativism in the field of sex/gender studies.
When language games change then there is a change of concepts, and with the concepts the meanings of words change. (Wittgenstein 1969, § 65)     

The probability of ties with scoring methods: Some results

The main flaw of the Condorcet method is that a Condorcet winner does not always exist (when there is a top cycle). Moreover, in some cases, all candidates are contained in one cycle and, therefore, a society or committee using the Condorcet method risks to face a severe indeterminacy. An indeterminacy can also happen when using other methods: for example the Borda method, plurality voting or any scoring method; but the origin of the indeterminacy is completely different. It happens when all candidates are tied. We study the probability that all candidates are tied when using a scoring method. We show that it is equivalent to some random walk problems. Some analytical and numerical results show that, under the assumptions underlying our study, the probability is very small and decreases when the number of voters or candidates increases. Received: 18 December 1998/Accepted: 17 March 2000     

Estimate of the Number of International Children in Japan, Based on Trends in Intermarriage

Abstract  This paper focuses on international children (that is, children whose parents have different nationalities) in Japanese society. Using statistics on intermarriage in Japan between 1965 and 1990, we project the numbers of such children from 1991 to 2000. The important findings are summarized below:
1. There were estimated 165,000 international children under the age of 21 in Japan as of 1991. The number will increase to 528,000 by the end of the century if the intermarriage rate continues to increase as it has recently, but this will still represent less than 2% of the Japanese population under 21.
2. By the year 2000 roughly 75% of these will be children of foreign mothers, due to the rapid increase in marriages between Japanese grooms and foreign brides.
3. The number of children with dual nationality continues to remain much lower in Japan than advanced countries in Europe, despite concern expressed when the Nationality Law was revised in 1985. The number of children born to international couples in Japan is surprisingly small with respect to the number of international marriages, so a dramatic increase is not likely.     

Twofold optimality of the relative utilitarian bargaining solution

Given a bargaining problem, the relative utilitarian (RU) solution maximizes the sum total of the bargainer’s utilities, after having first renormalized each utility function to range from zero to one. We show that RU is “optimal” in two very different senses. First, RU is the maximal element (over the set of all bargaining solutions) under any partial ordering which satisfies certain axioms of fairness and consistency; this result is closely analogous to the result of Segal (J Polit Econ 108(3):569–589, 2000). Second, RU offers each person the maximum expected utility amongst all rescaling-invariant solutions, when it is applied to a random sequence of future bargaining problems generated using a certain class of distributions; this is recalls the results of Harsanyi (J Polit Econ 61:434–435, 1953) and Karni (Econometrica 66(6):1405–1415, 1998).     

Trends in author characteristics and diversity issues in the Journal of Marital and Family Therapy from 1990 to 2000

In this article, we present an analysis and comparison of published articles in the Journal of Marital and Family Therapy (JMFT) between 1990-1995 and 1996-2000. This study focused on trends in author gender, highest degree, and professional affiliation, and article content on issues of cultural and family diversity (race/ethnicity, class, religion/spirituality, gender, sexual orientation, and varied family forms). Key findings show a significant shift from 69% male first authors in 1990-1995 to equal gender representation in authorship for 1996-2000 articles, with a particular increase in female PhDs. Articles addressing diversity issues doubled from 15.6% of all 1990-1995 articles to 31% in 1996-2000. Of note, women authored 73% of the 1996-2000 articles on the wide range of diversity issues. Implications for the field are discussed.     

An auction theoretical approach to fiscal wars

I examine a situation where a firm chooses to locate a new factory in one of several jurisdictions. The value of the factory may differ among jurisdictions and it depends on the private information held by each jurisdiction. Jurisdictions compete for the location of the new factory. This competition may take the form of expenditures already incurred on infrastructure, commitments to spend on infrastructure, tax incentives or even cash payments. The model combines two elements that are usually considered separately; competition is desirable because we want the factory to be located in the jurisdiction that values it the most, but competition in itself is wasteful. I show that the expected total amount paid to the firm under a large family of arrangements is the same. Moreover, I show that the ex-ante optimal mechanism – that is, the mechanism that guarantees that the firm chooses the jurisdiction with the highest value for the factory, minimizes the total expected payment to the firm, and balances the budget in an ex-ante sense – can be implemented by running a standard auction and subsidizing participation. Received: 6 December 2000/Accepted: 18 February 2002 I gratefully acknowledge the financial support of CNPQ (Grant no. 300065/93-0) and ARC (Grant no. A000000055). The author is grateful to the editor and an anonymous referee for many helpful comments.     

The Role of Joint Control in the Manded Selection Responses of Both Vocal and Non-vocal Children with Autism

In the present study, joint-control training was applied when teaching manded selection responses to children with autism. Four vocal children with autism participated in the first experiment, two males (ages seven and eight) and two females (ages seven and nine). The results showed that it was only after object-word naming was trained under joint control that the symmetrical performance of manded selection responses appeared with no additional training. Four non-vocal children with autism participated in the second experiment, two males (ages six and seven), and two females (ages twelve and thirteen). These results also showed that it was only after the joint tact/self-mimetic/sequelic control training that the symmetrical performance of manded selection responses appeared with no additional training.     

A nationwide cohort study of the role of CHADS2 score in predicting lower extremity amputation and death among patients with peripheral arterial occlusive disease

Objectives: The current study aimed to explore whether the CHADS₂ score was predictive of lower extremity amputation (LEA) and death in people with peripheral arterial occlusive disease (PAOD).

Methods: This nationwide cohort came from Taiwan, with 16,888 PAOD patients, from 2000 through 2011, extracted from the Longitudinal Health Insurance Database 2000. Cox proportional hazard regression models were employed to identify the LEA and mortality risk according to CHADS₂ score. The discriminatory properties of the score in predicting the outcomes were quantified by the area under the receiver operating characteristic curve (AUROC) and the Cox C-index.

Results: The AUROC of the CHADS₂ score in predicting LEA and death were 0.75 (95% CI?=?0.73–0.77) and 0.70 (95% CI?=?0.69–0.71), respectively. The CHADS₂ score had an acceptable stratification capacity for LEA (C-index?=?0.79) and death (C-index?=?0.76) based on Cox-regression analysis.

Conclusions: This study correlates the CHADS₂ score with risk of developing LEA and death in patients with PAOD. The acceptable discriminative power of the score diversifies its predictive role in this population.