Economic growth and equality of opportunity

In this paper we argue that a better understanding of the relationship between inequality and growth can be obtained by shifting the analisys from the space of final achievements to the space of opportunities. To this end, we introduce the Opportunity Growth Incidence Curve, that can be used to evaluate the income dynamics of specific groups of the population and to infer the role of growth in the evolution of inequality of opportunity over time. By employng a rank dependent social welfare function we provide a rigorous normative justification for the use of the OGIC: we obtain suitable dominance conditions and we show how they can be interpreted in terms of OGIC dominance. We also propose an index that can be used to measure the impact of growth in terms of ooopotunity redistribution. Finally, we provide two empirical illustrations, for Italy and for Brasil, which show the potentials of the tools we have introduced.INCOME INEQUALITY, INEQUALITY OF OPPORTUNITY, ECONOMIC GROWTH

Long-term prediction of adherence to continuous positive air pressure therapy for the treatment of moderate/severe obstructive sleep apnea syndrome

BACKGROUND: Continuous positive airway pressure (CPAP) therapy is a highly effective treatment for obstructive sleep apnea syndrome (OSAS). However, poor adherence is a limiting factor, and a significant proportion of patients are unable to tolerate CPAP. The aim of this study was to determine predictors of long-term non-compliance with CPAP. METHODS: CPAP treatment was prescribed to all consecutive patients with moderate or severe OSAS (AHI ≥15 events/h) (n = 295) who underwent a full-night CPAP titration study at home between February 1, 2002 and December 1, 2016. Adherence was defined as CPAP use for at least 4 h per night and five days per week. Subjects had periodical follow-up visits including clinical and biochemical evaluation and assessment of adherence to CPAP. RESULTS: Median follow-up observation was 74.8 (24.2/110.9) months. The percentage of OSAS patients adhering to CPAP was 41.4% (42.3% in males and 37.0% in females), and prevalence was significantly higher in severe OSAS than in moderate (51.8% vs. 22.1%; p < 0.001; respectively). At multivariate analysis, lower severity of OSAS (HR = 0.66; CI 95 0.46-0.94) p < 0.023), cigarette smoking (HR = 1.72; CI 95 1.13-2.61); p = 0.011), and previous cardiovascular events (HR = 1.95; CI 95 1.03-3.70; p = 0.04) were the only independent predictors of long-term non-adherence to CPAP after controlling for age, gender, and metabolic syndrome. CONCLUSIONS: In our cohort of patients with moderate/severe OSAS who were prescribed CPAP therapy, long-term compliance to treatment was present in less than half of the patients. Adherence was positively associated with OSAS severity and negatively associated with cigarette smoking and previous cardiovascular events at baseline

Genome analysis and physiological comparison of Alicycliphilus denitrificans strains BC and K601T

The genomes of the Betaproteobacteria Alicycliphilus denitrificans strains BC and K601T have been sequenced to get insight into the physiology of the two strains. Strain BC degrades benzene with chlorate as electron acceptor. The cyclohexanol-degrading denitrifying strain K601T is not able to use chlorate as electron acceptor, while strain BC cannot degrade cyclohexanol. The 16S rRNA sequences of strains BC and K601T are identical and the fatty acid methyl ester patterns of the strains are similar. Basic Local Alignment Search Tool (BLAST) analysis of predicted open reading frames of both strains showed most hits with Acidovorax sp. JS42, a bacterium that degrades nitro-aromatics. The genomes include strain-specific plasmids (pAlide201 in strain K601T and pAlide01 and pAlide02 in strain BC). Key genes of chlorate reduction in strain BC were located on a 120 kb megaplasmid (pAlide01), which was absent in strain K601T. Genes involved in cyclohexanol degradation were only found in strain K601T. Benzene and toluene are degraded via oxygenase-mediated pathways in both strains. Genes involved in the meta-cleavage pathway of catechol are present in the genomes of both strains. Strain BC also contains all genes of the ortho-cleavage pathway. The large number of mono- and dioxygenase genes in the genomes suggests that the two strains have a broader substrate range than known thus far.This research was supported by the Technology Foundation, the Applied Science Division (STW) of the Netherlands Organization for Scientific Research (NWO), project number 08053, the graduate school WIMEK (Wageningen Institute for Environment and Climate Research, which is part of SENSE Research School for Socio-Economic and Natural Sciences of the Environment, www.wimek-new.wur.nl and www.sense.nl), SKB (Dutch Centre for Soil Quality Management and Knowledge Transfer, www.skbodem.nl) and the Consolider project CSD-2007-00055. The research was incorporated in the TRIAS (TRIpartite Approaches 469 toward Soil systems processes) program (http://www.nwo.nl/en/research-and-results/programmes/alw/trias-tripartite-approach-to-soil-system-processes/index. html). Flávia Talarico Saia was supported by a FAPESP (the State of São Paulo Research Foundation) scholarship (2006-01997/5). The work conducted by the DOE JGI is supported by the Office of Science of the United States Department of Energy under contract number DE-AC02-05CH11231. Alfons Stams acknowledges support by an ERC (European Research Counsil) advanced grant (project 323009). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Younger medical specialists and longer waiting time:cohort study of the duration of medical training

OBJECTIVE: To describe trends and developments in the total duration of training medical specialists in the Netherlands, including their ages upon completion of the components of medical education: undergraduate medical program, waiting time and further post-graduate specialist training.DESIGN: Population cohort study.METHOD: From the combined data from Statistics Netherlands and the Registration Committee for Medical Specialists for the period 1986 to 2018 relevant populations were selected and training trajectories were mapped. The population size was 40,604 individuals for undergraduate medical programs, 41,885 for the duration of post-graduate specialist training, 31,915 for the waiting periods and 21666 for the total duration of the trajectory from the start of medical school until registration as a specialist.RESULTS: The median duration of undergraduate medical programs was 7.1 years, which is longer than the nominal duration and this remained unchanged over the observation period. The average waiting time between graduating medical school and postgraduate specialist training has increased from 2010 onwards to 3.7 years in 2018. The average duration of postgraduate specialist training is increasing. The average age at graduation of medical school fell by 1.7 years to 26.1. The average age at the start of post-graduate specialist training decreased, as did the average age at registration as a specialist.CONCLUSION: The total duration of training of medical specialists is stable. Changes such as "dedicated transition year" and flexible arrangements for postgraduate training have had no discernible influence on the total duration of medical training. Because the average age at start of postgraduate specialist training has decreased, medical specialists are on average younger upon registration.</p