Price elasticity of demand for new and recurring opioid prescriptions

Objective: Several U.S. states have recently enacted excise taxes to curb prescription opioid use and other states are considering similar measures. We assessed the effects of increasing out-of-pocket costs (OPC) on new and recurring opioid fills. Methods: We conducted a retrospective cohort study of opioid-naive individuals presenting with acute back pain using data from a nationwide claims repository. We estimated the effect of OPC on the initiation of opioid treatment in logistic regressions, controlling for socio-demographics, medical history, healthcare utilization, insurance type, and region. With the same covariates plus morphine milligram equivalents and days supplied, we estimated the effect of OPC on the number of opioid fills in negative binomial regressions. We report the price elasticity of demand (PED) for prescription opioids, defined as the percentage change in outcome resulting from a two-fold increase in OPC. Results: Of 25,531 adults diagnosed with acute back pain in Q1 of 2018, 2,451 (9.6%) filled at least one opioid prescription. In multivariable regression, the association between OPC and initiating opioid treatment was not significant (PED= -1.9%; 95% CI: -5.5%, 1.7%). However, by region, the PED was -10.3% (95% CI: -18.1%, -2.4%) in the coastal states and 1.6% (95% CI: -2.5%, 5.7%) in the central-southern states. The PED for the number of prescription fills was -3.7% (95% CI: -7.3%, -0.1%), which also differed by region. In the coastal states, the PED was -15.2% (95% CI: -24.7%, -5.7%) and in the central-southern states -1.5% (95% CI: -5.4%, 2.4%). Conclusions: Opioid fills were price sensitive in the coastal states but not in the central-southern states. Policies that would increase OPC might have a restraining effect on opioid consumption in parts, but not all of the U.S.

White Compromises and American Prosperity

The development and protection of American Prosperity was contingent upon Northern and Southern white men making compromises that allowed the continuance of slavery. These white compromises in 1787, 1820, 1850, and 1877 not only protected white supremacy, but also unity of the settler’s economy. The Federal government invaded the Southern states not to abolish slavery, but to preserve the union. After the War, during Reconstruction, Blacks started schools, farmed the land, and were elected to local, state, and national offices. This period of Black empowerment was cut short when Northern and Southern states compromised again to allow the establishment of the Jim Crow regime, the terrorism of lynching, and the re-establishment of the Ku Klux Klan. This compromise was disrupted with the 1960s civil rights movements, which has left us today without the unity necessary to create a climate of justice.

US South remains distinctive as divisions sharpen

Significance The US South, defined as the eleven states of the 19th-century Confederacy, was a Democratic stronghold for 100 years after the Civil War. Now, with some of the country’s heaviest concentrations of Black Democratic supporters and White evangelical Republican voters, it encompasses the intensified schisms in contemporary politics. Impacts There will be seven Senate races in the South in November, two of which will not have an incumbent. Nine Southern states will have Republican governors in 2022, with Republican-controlled legislatures in ten. Beto O’Rourke, the Democrat who gave Republican Ted Cruz a close Senate race in 2018, is running for governor of Texas.

SARS-CoV-2 transmission potential and rural-urban disease burden disparities across Alabama, Louisiana, and Mississippi, March 2020 — May 2021

Purpose: To quantify and compare SARS-CoV-2 transmission potential across Alabama, Louisiana, and Mississippi and selected counties with populations in the 50th, 75th, and 100th percentile. Methods: To determine the time-varying reproduction number Rt of SARS-CoV-2, we applied the R package EpiEstim to the time series of daily incidence of confirmed cases. Median Rt percentage change when policies changed was determined. Linear regression was performed between log10-transformed cumulative incidence and log10-transformed population size at four time points. Results: Stay-at-home orders, face mask mandates, and vaccinations were associated with the most significant reductions in SARS-CoV-2 transmission in the three southern states. Rt across the three states decreased significantly by 20% following stay-at-home orders. We observed varying degrees of reductions in Rt across states following other policies. Rural Alabama counties experienced higher per capita cumulative cases relative to urban ones as of June 17 and October 17, 2020. Meanwhile, Louisiana and Mississippi saw the disproportionate impact of SARS-CoV-2 in rural counties compared to urban ones throughout the study period. Conclusion: State and county policies had an impact on local pandemic trajectories. The rural-urban disparities in case burden call for evidence-based approaches in tailoring health promotion interventions and vaccination campaigns to rural residents.

A Review on Medicinal Uses of Cinnamomum verum (Cinnamon)

Cinnamomum verum is a spice plant that is well-known for its medicinal and pharmacological qualities. The old botanical synonym for this tree, Cinnamomum zeylanicum, is derived from Sri Lanka's former name, Ceylon. Since ancient times, Cinnamomum zeylanicum has been frequently used as a medicinal condiment. It's native to Sri Lanka and India's southern states. Cinnamomum verum belongs to the Lauraceae family and is also known by the synonym Cinnamomum zeylanicum Blume. It's a dried bark that's been stripped of its outer cork and underlying parenchyma. Cinnamomum verum is a popular medicinal herb with a wide range of applications It has long been used to flavour food and in pharmaceutical preparations to treat a variety of ailments. For commercial purposes, it is commonly used as candies, chewing gums, mouthwash, and toothpaste in the current period. Many volatile oils, primarily cinnamaldehyde, cinnamic acid, and cinnamate, are abundant in the plant. Eugenol is the active principal ingredient linked to a variety of biological functions. This herb is found in almost every pharmacological system on the planet. Each of these features is essential for human health development. Antimicrobial, wound healing, antidiabetic, anti-HIV, anti-anxiety, and anti-are Parkinson's among of the plant's key medical characteristics. The major components of the Cinnamomum verum plant include eugenol, cinnamaldehyde, cinnamyl acetate, copane, and camphor. The pharmacological effects of cinnamon aldehyde have been extensively researched. Every aspect of the plant was thoroughly examined in this study, from its morphological description to its phytochemical profile and therapeutic action. In this review, we've attempted to compile a comprehensive list of its medical and pharmacological qualities. Keywords: Cinnamomum verum, Dalchini, Medicinal Properties, volatile oils, Antimicrobial, Anti-HIV, antidiabetic

White Workers and the American Civil War

From the firing on Fort Sumter in April 1861 until the Confederacy surrendered in the spring of 1865, workers—North and South—labored long hours under often trying conditions at wages that rarely kept pace with wartime inflation. Though many workers initially voiced skepticism of plans for sundering the nation, once Southern states seceded most workers rallied round their rival flags and pledged to support their respective war efforts. The growing demand for war material opened employment opportunities for women and men, girls and boys, across the Union and Confederacy. Yet workers were not always satisfied with a job and appeals to back the boys in blue and gray without question. They often resisted changes pressed on them in the workplace—new technology, military discipline, unskilled newcomers—as well as wages that always lagged behind rising prices. Protests and strikes began in 1861 and increased in number and intensity from 1863 to the war’s conclusion. Labor unions, in decline since the depression of 1857, sprung back to life, especially in the war’s later years. Employers sometimes countered their employees’ increasing organization and resistance with industry associations that tried to break strikes and blacklist those who walked off their jobs. While worker discontent and resentment of “a rich man’s war and a poor man’s fight” were common across the sectional divide, Northern workers exercised greater coordination of their resistance through citywide trade assemblies, national trade unions, traveling organizers, and labor newspapers. Southern workers tended to fight their labor battles in isolation from shop to shop and town to town, so they rarely built a broader labor movement that could survive the hardships of the postwar era.

​Chemistry, Nutritional Properties and Application of Mare’s Milk: A Review

Mare’s milk has long been considered to have special nutritive and therapeutic properties in Mongolia and southern states of the former Soviet Union. It is now gaining popularity in some parts in Europe also. Mares’ milk is characterized by their unique nutritional profile. Therefore, interest has increased in the use of mare’s milk for human nutrition in the past several years, especially in France and Germany. As compared to many other mammal species, mare’s milk is highly appreciated for similarity to human milk in terms of chemical composition allowing its use as a substitute for mother’s milk in infant feeding. Mare’s milk also has been used for the treatment of certain human pathologies such as hepatitis, chronic ulcer and tuberculosis. This review dwells on the chemical composition, nutritional value and various health-promoting properties of mare’s milk.

Perceptions of Log Truck Weight Regulations Among Loggers and Forest Industry in Georgia, USA

Georgia and other southern states have far lower gross vehicle weight (GVW) limits for log trucks than other US regions and other countries. Low GVW limits result in high hauling costs and truck traffic. In 2020, including tolerances, five-axle log tractor-trailers were allowed 38,102 kg (84,000 lb) GVW in Georgia. Telephone surveys of 30 loggers and 32 forest industry representatives from the state of Georgia were conducted to measure perceptions of weight regulations and assess support for alternative weights and configurations. The four alternatives included five axles, 39,916 kg (88,000 lb); six axles, 41,277 kg (91,000 lb); six axles, 45,359 kg (100,000 lb); and seven axles, 45,359 kg (100,000 lb) GVW. The majority of loggers and forest industry representatives stated that GVW limits for log trucks were too low. The average preferred GVW limits were 39,621 kg (87,350 lb) and 40,545 kg (89,387 lb) for loggers and forest industry, respectively. Loggers and forest industry supported the five-axle 39,916 kg (88,000 lb) configuration whereas many loggers opposed both 45,359 kg (100,000 lb) configurations. Loggers, forest industry, and policymakers should work to modernize weight laws to reduce hauling costs, maintain or improve safety, and protect public infrastructure. Study Implications Increasing gross vehicle weight (GVW) limits in combination with adding axles to tractor-trailers has been demonstrated to reduce both timber transportation costs and damage to public roads. This study found that loggers and forest industry supported additional GVW but were hesitant to support configurations that would necessitate upgrading log truck fleets. If Georgia is to make its weight limits competitive regionally and internationally, it will be necessary to clearly communicate the benefits of heavier trucks with more axles to skeptical loggers.

Abolitionist John Brown's Treason against the Commonwealth of Virginia: A Lesson for State Governments about the Culpability of Non-Residents for Treason against the State

This article analyzes the specific issue of whether an individual could be tried for treason by a State government if that individual is not a resident or citizen of that State. This issue is analyzed through the prism of the landmark case of John Brown v. Commonwealth of Virginia, a criminal prosecution which occurred in October 1859. Brown, a resident of New York, was convicted of treason against the Commonwealth of Virginia, insurrection, and murder after he attempted to overthrow the institution of slavery by force on October 16–18, 1859. After a prosecution and trial which occurred within a matter of weeks following Brown's crimes, Brown was executed on December 2, 1859. To this day, John Brown's trial and execution remains one of the leading examples of a State government exercising its power to enforce treason law on the State level and to execute an individual for that offense. Of course, the John Brown case had a major impact on American history, including being a significant factor in the presidential election of 1860 and an often-cited spark to the powder keg of tensions between the Northern and Southern States, which would erupt into a raging conflagration between the North and South in the American Civil War a short eighteen months later. However, in the legal realm, the Brown case is one of the leading and best-known examples of a state government exercising its authority to enforce its laws prohibiting treason against the State. The purpose of this article is not to discuss treason laws generally or even all the issues applicable to John Brown's trial in 1859. Rather, this article focuses only on the very specific issue of the culpability of a non-resident/non-citizen for treason against a State government. With the increased array of hostile actions against State governments in recent years, and criminal actors crossing state lines to commit these hostile acts, this article discusses an issue of importance to contemporary society, namely whether an individual can be prosecuted and convicted for treason by a State of which the defendant is not a citizen or resident.