We analyze household-level changes in alcohol consumption in response to pregnancy. Using scanner data, we identify households with a pregnant household member. Within an event study and a dynamic difference-in-differences estimation, we find that during a first pregnancy, households reduce their alcohol purchases by 35%. After pregnancy, purchases of alcohol are 31% lower than before pregnancy. We do not find any effect during the second pregnancy. We argue that lower consumption during pregnancy changes habits and reduces consumption in the long term. We exclude other explanations and comment on policy implications.
{"title":"Pregnancy and Alcohol Purchases: Evidence from Scanner Data","authors":"Aljoscha Janssen, Elle Parslow","doi":"10.2139/ssrn.3446559","DOIUrl":"https://doi.org/10.2139/ssrn.3446559","url":null,"abstract":"We analyze household-level changes in alcohol consumption in response to pregnancy. Using scanner data, we identify households with a pregnant household member. Within an event study and a dynamic difference-in-differences estimation, we find that during a first pregnancy, households reduce their alcohol purchases by 35%. After pregnancy, purchases of alcohol are 31% lower than before pregnancy. We do not find any effect during the second pregnancy. We argue that lower consumption during pregnancy changes habits and reduces consumption in the long term. We exclude other explanations and comment on policy implications.","PeriodicalId":335359,"journal":{"name":"Obstetrics & Gynecology eJournal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129093520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shomesh E. Chaudhuri, Katherine A. Cheng, A. Lo, S. Pepke, Sergio Rinaudo, L. Roman, R. Spencer
Biomedical innovation in oncology has become riskier and more expensive, precipitating a withdrawal of private sector funding from the sector. In this article, we consider a portfolio-based approach to funding in which multiple distinct ovarian cancer treatment candidates are funded within a single structure. Twenty-five potential early-stage drug development projects were identified for inclusion in a hypothetical portfolio through interviews with gynecological oncologists and leading experts, a review of ovarian cancer-related trials registered in the ClinicalTrials.gov database, and an extensive literature review. The annualized returns of this portfolio were simulated under a purely private sector structure both with and without partial funding from philanthropic grants, and a public-private partnership that included government guarantees. We find that public-private structures of this type can increase expected returns and reduce tail risk, allowing greater amounts of private sector capital to fund early-stage research and development.
{"title":"A Portfolio Approach to Accelerate Therapeutic Innovation in Ovarian Cancer","authors":"Shomesh E. Chaudhuri, Katherine A. Cheng, A. Lo, S. Pepke, Sergio Rinaudo, L. Roman, R. Spencer","doi":"10.2139/ssrn.3286330","DOIUrl":"https://doi.org/10.2139/ssrn.3286330","url":null,"abstract":"Biomedical innovation in oncology has become riskier and more expensive, precipitating a withdrawal of private sector funding from the sector. In this article, we consider a portfolio-based approach to funding in which multiple distinct ovarian cancer treatment candidates are funded within a single structure. Twenty-five potential early-stage drug development projects were identified for inclusion in a hypothetical portfolio through interviews with gynecological oncologists and leading experts, a review of ovarian cancer-related trials registered in the ClinicalTrials.gov database, and an extensive literature review. The annualized returns of this portfolio were simulated under a purely private sector structure both with and without partial funding from philanthropic grants, and a public-private partnership that included government guarantees. We find that public-private structures of this type can increase expected returns and reduce tail risk, allowing greater amounts of private sector capital to fund early-stage research and development.","PeriodicalId":335359,"journal":{"name":"Obstetrics & Gynecology eJournal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127172243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Bhalotra, Atheendar S. Venkataramani, Selma Walther
We investigate women's fertility, labor and marriage market responses to large declines in child and maternal mortality that occurred following a major medical innovation in the US. In response to the decline in child mortality, women delayed childbearing and had fewer children overall. Fewer women had three or more children, and a larger share remained childless. We present a new theory of the extensive margin response, premised upon improvements in child survival reducing the time women need to achieve their target number of children. This prompts fertility delay and labor market entry which, coupled with wage or fecundity shocks, can result in childlessness. Consistent with these predictions, we find that reductions in child mortality increased women's labor force participation, improved their occupational status and reduced their chances of ever having married. Maternal mortality decline had opposing effects on all of these outcomes.
{"title":"Fertility and Labor Market Responses to Reductions in Mortality","authors":"S. Bhalotra, Atheendar S. Venkataramani, Selma Walther","doi":"10.2139/SSRN.3213304","DOIUrl":"https://doi.org/10.2139/SSRN.3213304","url":null,"abstract":"We investigate women's fertility, labor and marriage market responses to large declines in child and maternal mortality that occurred following a major medical innovation in the US. In response to the decline in child mortality, women delayed childbearing and had fewer children overall. Fewer women had three or more children, and a larger share remained childless. We present a new theory of the extensive margin response, premised upon improvements in child survival reducing the time women need to achieve their target number of children. This prompts fertility delay and labor market entry which, coupled with wage or fecundity shocks, can result in childlessness. Consistent with these predictions, we find that reductions in child mortality increased women's labor force participation, improved their occupational status and reduced their chances of ever having married. Maternal mortality decline had opposing effects on all of these outcomes.","PeriodicalId":335359,"journal":{"name":"Obstetrics & Gynecology eJournal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128917118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Javier Díaz Rojas, M. García Molina, Liliana Chicaíza, Alexander Moreno Calderón, V. Prieto Martínez, H. Gaitán, Ariel Ruiz Prieto, Andrea Rodríguez Hernández, C. Rincón, J. Urrego
Objective: To estimate the cost-effectiveness of local vs. oral antibiotic in non-pregnant women with vaginal discharge suggestive of bacterial vaginosis.Methods: We compared four combinations of antibiotics for the first option and for the treatment of clinical failure: vaginal clindamycin and tinidazol PO, single dose; vaginal clindamycin and secnidazol PO, single dose; tinidazol PO, single dose y vaginal clindamycin; secnidazol PO, single dose, and vaginal clindamycin. A Markov model was built in TreeAge® to represent the natural history of bacterial vaginosis. Treatment changes in the face of recurrence without adverse events where modeled separately as a decision tree. The perspective was that of the health system, including all direct costs. All monetary amounts were expressed in Colombian pesos of 2010. The outcome was clinical improvement. Effectiveness, security, persistence and recurrence data were extracted from the literature. The incremental cost-effectiveness ratio was calculated; univariate and probabilistic sensitivity analyses were performed.Results: Both for the general and the particular cases, treatment with vaginal clindamycin as the first choice and tinidazole PO, single dose, to treat recurrence and persistence with adverse events is a dominant strategy because it is less costly and more effective than the other treatment regimes evaluated. Per 1.000 patients, the cost of the dominant alternative is $ 16.795.411 COP with 985,6 clinical improvements in the general case and $ $ 23.979.230 COP with 903,4 clinical improvements in the particular case.Conclusion: Vaginal clindamycin as the first choice for treatment of bacterial vaginosis and tinidazole PO, single dose, to treat recurrence and persistence with adverse events of clindamycin is cost effective in Colombia. The results were robust to variations in the parameters of the model.
{"title":"Cost Effectiveness of Local vs. Oral Antibiotic in Non-Pregnant Women with Vaginal Discharge Suggestive of Bacterial Vaginosis","authors":"Javier Díaz Rojas, M. García Molina, Liliana Chicaíza, Alexander Moreno Calderón, V. Prieto Martínez, H. Gaitán, Ariel Ruiz Prieto, Andrea Rodríguez Hernández, C. Rincón, J. Urrego","doi":"10.2139/SSRN.2194561","DOIUrl":"https://doi.org/10.2139/SSRN.2194561","url":null,"abstract":"Objective: To estimate the cost-effectiveness of local vs. oral antibiotic in non-pregnant women with vaginal discharge suggestive of bacterial vaginosis.Methods: We compared four combinations of antibiotics for the first option and for the treatment of clinical failure: vaginal clindamycin and tinidazol PO, single dose; vaginal clindamycin and secnidazol PO, single dose; tinidazol PO, single dose y vaginal clindamycin; secnidazol PO, single dose, and vaginal clindamycin. A Markov model was built in TreeAge® to represent the natural history of bacterial vaginosis. Treatment changes in the face of recurrence without adverse events where modeled separately as a decision tree. The perspective was that of the health system, including all direct costs. All monetary amounts were expressed in Colombian pesos of 2010. The outcome was clinical improvement. Effectiveness, security, persistence and recurrence data were extracted from the literature. The incremental cost-effectiveness ratio was calculated; univariate and probabilistic sensitivity analyses were performed.Results: Both for the general and the particular cases, treatment with vaginal clindamycin as the first choice and tinidazole PO, single dose, to treat recurrence and persistence with adverse events is a dominant strategy because it is less costly and more effective than the other treatment regimes evaluated. Per 1.000 patients, the cost of the dominant alternative is $ 16.795.411 COP with 985,6 clinical improvements in the general case and $ $ 23.979.230 COP with 903,4 clinical improvements in the particular case.Conclusion: Vaginal clindamycin as the first choice for treatment of bacterial vaginosis and tinidazole PO, single dose, to treat recurrence and persistence with adverse events of clindamycin is cost effective in Colombia. The results were robust to variations in the parameters of the model.","PeriodicalId":335359,"journal":{"name":"Obstetrics & Gynecology eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121991884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Ignat, Livia-Andreea Pătru, Cristina Ciora, Mădălina Laura Cuciurianu, Dragoș Tîrnoveanu, F. Mărcău, R. Munteanu, S. Sulima, Andreea-Emilia Duta, P. Duta, C. Borcosi, A. Lavric, V. Popa, S. Zaharia, C. Morariu, Alice Mihaela Postavaru, D. Paraschiv, Elena Paraschiv, Gavril Paraschiv, Ramona-Gabriela Paraschiv, V. Voinea, Blendea Sevastian, A. Cecal, M. Curelar, Elena Bran, Răzvan Bran, Oana Dumitrescu, A. Gheorghe, Monica Daniela Pop, C. Tătaru, Constantin Mihai, Miruna, O. Bodean, Diana, O. Munteanu, E. Brătilă, Bohâlțea, D. Davițoiu, M. Cirstoiu, Andra Ionescu, M. Diculescu, C. Ciora, Lucian Ionescu, B. Dorobat
Research and Science Today Journal is a publication founded in 2011 and it is dedicated to the students of all levels (license, master and doctoral) of faculties in the country and abroad. We want to offer the participants the opportunity to present their scientific works in the following areas: Social Sciences, Economic Sciences, Legal Sciences, Humanities, Education Sciences, Engineering, Medicine and Sport.This journal provides students the opportunity to create and/or to improve their abilities to write scientific papers. So each appearance (two appearances per year at which we can add supplements) contains a number of papers written by students, masters and doctoral from the faculties from the country or/and abroad. The journal promotes original studies contributing to the progress of knowledge and it is motivated by the need to address issues of theory and practice in the areas mentioned above.
{"title":"Research and Science Today","authors":"E. Ignat, Livia-Andreea Pătru, Cristina Ciora, Mădălina Laura Cuciurianu, Dragoș Tîrnoveanu, F. Mărcău, R. Munteanu, S. Sulima, Andreea-Emilia Duta, P. Duta, C. Borcosi, A. Lavric, V. Popa, S. Zaharia, C. Morariu, Alice Mihaela Postavaru, D. Paraschiv, Elena Paraschiv, Gavril Paraschiv, Ramona-Gabriela Paraschiv, V. Voinea, Blendea Sevastian, A. Cecal, M. Curelar, Elena Bran, Răzvan Bran, Oana Dumitrescu, A. Gheorghe, Monica Daniela Pop, C. Tătaru, Constantin Mihai, Miruna, O. Bodean, Diana, O. Munteanu, E. Brătilă, Bohâlțea, D. Davițoiu, M. Cirstoiu, Andra Ionescu, M. Diculescu, C. Ciora, Lucian Ionescu, B. Dorobat","doi":"10.2139/SSRN.2364857","DOIUrl":"https://doi.org/10.2139/SSRN.2364857","url":null,"abstract":"Research and Science Today Journal is a publication founded in 2011 and it is dedicated to the students of all levels (license, master and doctoral) of faculties in the country and abroad. We want to offer the participants the opportunity to present their scientific works in the following areas: Social Sciences, Economic Sciences, Legal Sciences, Humanities, Education Sciences, Engineering, Medicine and Sport.This journal provides students the opportunity to create and/or to improve their abilities to write scientific papers. So each appearance (two appearances per year at which we can add supplements) contains a number of papers written by students, masters and doctoral from the faculties from the country or/and abroad. The journal promotes original studies contributing to the progress of knowledge and it is motivated by the need to address issues of theory and practice in the areas mentioned above.","PeriodicalId":335359,"journal":{"name":"Obstetrics & Gynecology eJournal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114120198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Using data from a 2003 survey of 1,476 obstetrician-gynecologists, the effects of malpractice pressure on the specialty are investigated. Physicians report having made substantial changes to their practice in response to the general environment and to liability pressures. Regression analysis finds that liability pressure increases reports of income and practice reductions, but direct effects on actual income and productivity are less clear. Liability pressures may lead to a specialization effect, with some physicians concentrating more in obstetrics and others in gynecological surgery. Overall, the evidence suggests that liability pressure has moderate but significant effects on the specialty.
{"title":"The Effect of Malpractice Liability on the Specialty of Obstetrics and Gynecology","authors":"J. W. Reyes","doi":"10.3386/W15841","DOIUrl":"https://doi.org/10.3386/W15841","url":null,"abstract":"Using data from a 2003 survey of 1,476 obstetrician-gynecologists, the effects of malpractice pressure on the specialty are investigated. Physicians report having made substantial changes to their practice in response to the general environment and to liability pressures. Regression analysis finds that liability pressure increases reports of income and practice reductions, but direct effects on actual income and productivity are less clear. Liability pressures may lead to a specialization effect, with some physicians concentrating more in obstetrics and others in gynecological surgery. Overall, the evidence suggests that liability pressure has moderate but significant effects on the specialty.","PeriodicalId":335359,"journal":{"name":"Obstetrics & Gynecology eJournal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116385572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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