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Chatbots are "computer agents that can interact with the user" in a way that feels like human-to-human conversation.1 While the use of chatbots for reference service in academic libraries is a topic of interest for both library professionals and researchers, little is known about how they are used in library reference service, especially in academic libraries in Canada. This article aims to fill this gap by conducting a web-based survey of 106 academic library websites in Canada and analyzing the prevalence and characteristics of chatbot and live chat services offered by these libraries. The authors found that only two libraries were using chatbots for reference service. For live chat services, the authors found that 78 libraries provided this service. The article discusses possible reasons for the low adoption of chatbots in academic libraries, such as accessibility, privacy, cost, and professional identity issues. The article also provides a case study of the authors' institution, the University of Calgary, which integrated a chatbot service in 2021. The article concludes with suggestions for future research on chatbot use in libraries. [ABSTRACT FROM AUTHOR]

Electronic contract signing requires the design of protocols that guarantee that the exchange is fair. In the past 5 years, we have observed that trusted third parties (TTPs) can be replaced by blockchain. However, none of the analyzed blockchain-based solutions meets the abuse-freeness requirement (established by Garay et al. in 1999), i.e., that neither party has the power to decide whether the protocol terminates or aborts. In this article, we present the first blockchain-based contract signing protocol that meets the abuse-freeness requirement. We analyze the economic impact that the use of blockchain has on the participants of a contract signing, concluding that the solution is both technically feasible and cost effective. [ABSTRACT FROM AUTHOR]

The Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination is a mandatory requirement for higher specialty surgical training in the UK. However, there is a significant economic impact on trainees which raises the question of whether the costs of this exam hinder surgical career progression. This study explores the burden of these exams on trainees. A 37-point questionnaire was distributed to all trainees who were preparing for or have sat MRCS examinations. Univariate analyses included the cost of the preparatory resources, extra hours worked to pay for these and the examinations, and the number of annual leave (AL) days taken to prepare. Pearson correlation coefficients were used to identify possible correlation between monetary expenditure and success rate. On average, trainees (n ​= ​145) spent £332.54, worked 31.2 ​h in addition to their rostered hours, and used 5.8 AL days to prepare for MRCS Part A. For MRCS Part B/ENT, trainees spent on average £682.92, worked 41.7 extra hours, and used 5 AL days. Overall, the average trainee spent 5–9% of their salary and one-fifth of their AL allowance to prepare for the exams. There was a positive correlation between number of attempts and monetary expenditure on Part A preparation (r(109)=0.536, p ​< ​0.001). There is a considerable financial and social toll of the MRCS examination on trainees. Reducing this is crucial to tackle workforce challenges that include trainee retention and burnout. Further studies exploring study habits can help reform study budget policies to ease this pressure on trainees. • Little is known around the 'hidden' extra costs of sitting the MRCS examinations • Trainees sacrifice significant amounts in preparation, financially and socially • These expenditures likely impact trainees' job satisfaction and cause burnout • More can be done to support trainees' success at these vital exams [ABSTRACT FROM AUTHOR]

Juvenile Idiopathic Arthritis (JIA) causes caregiver burden on families with children affected with it. Our study aimed to explore this multifaceted burden in the Indian context. In this cross-sectional study, we administered the Hindi translated CAREGIVER questionnaire to adult caregivers in the families of JIA patients ≤ 18 years. The responses to the 28 items were used to calculate the burden scores in various dimensions. The relationship of the global burden scores with demographic and socioeconomic factors were analysed. Non parametric tests were used. Two hundred twenty-one caregivers participated with a median age of 39 years (IQR 32–45). This included 116 fathers, 50 mothers, 32 brothers, 18 uncles, three grandfathers, one sister, and one grandmother. The JIA patients had a median age of 15 (12–17) years, and the male-to-female ratio was 3.2:1. Enthesitis-related arthritis was the predominant subtype (72.4%). Most caregivers (70.6%) expressed sadness at diagnosis, and 29.9% continued to express sadness. Nearly two-thirds (65.6%) had to borrow money from others. More than half (59.3%) of the caregivers neglected their health, and 9.0% became sick. Male gender of the child, systemic JIA subtype, low socioeconomic status, high disease activity, extra-articular damage, high parent-reported disease activity and poor quality of life were associated with higher global caregiver burden. JIA has a significant emotional, social, economic, and labour impact on caregivers. Economic and psychosocial support needs to be given to family caregivers caring for children with JIA. Key Points • JIA causes a chronic emotional toll on caregivers, which is aggravated by high disease activity in the child. • Caregivers from rural areas and lower socioeconomic groups face disproportionate economic burden, often aggravated by losing jobs due to caregiving responsibility. • The use of biologics was low despite high disease activity, highlighting the need for financial support. • Parent-reported outcome measures significantly correlated with caregiver burden, underscoring the importance of integrating family perspectives in care. [ABSTRACT FROM AUTHOR]

• South Asia is geographically connected, but highly dis-integrated, with more than 90 % outward-oriented trade. • The cumbersome procedures, ruthless application of Non-Tariff Measures (NTM's), and restrictions are the biggest challenges for trade in this region. • Against this backdrop, this research measures the economic impact of Mutual recognition of Standards in South Asia. • Simulation results suggest that if standards are mutually recognized then all countries will be better off, and intra-regional trade and welfare are forecasted to increase. • SAFTA should proceed to establish such a mechanism that enables member countries to recognize the certificates and tests approved by the exporting countries. SAFTA (South Asian Free Trade Area) is not a success story. Geographically connected, but highly dis-integrated, with more than 90 % outward-oriented trade, this is the case of South Asia. Of course, military, and political tensions are the major obstacles. However, recent data and studies show that cumbersome procedures, ruthless application of NTMs (Non-Tariff Measures) and restrictions are the biggest challenges for trade in the region. NTMs are important for public health and the environment but if such standards are mutually recognized through bilateral or multilateral agreements then the hectic and lengthy procedures can be avoided. This is the basic hypothesis investigated and checked in this research. Taking four economies, (Bangladesh, India, Pakistan, and SriLanka) two-step process is adopted; firstly, AVEs (Ad Valorem Equivalents) of NTMs are calculated and then incorporated in an extended GTAP (Global Trade Analysis Project) based CGE model. Simulation results suggest that if standards are mutually recognized then all countries will be better off, intra-regional trade and welfare will increase. The study recommends that SAFTA should proceed to establish such a mechanism that enables member countries to recognize the certificates and tests approved by the exporting countries. Further, Port restrictions and the issue of para-tariffs should be discussed in future negotiations. [ABSTRACT FROM AUTHOR]

• We develop a quantitative spatial equilibrium model with emissions regulation. • Counterfactual analyses of regional structural changes due to emissions regulation. • Emissions regulations impact regional GDP via regional-sectoral linkages. • Cross-regional impacts of emissions regulations have typical geographical characteristics. • Sectoral linkages widen variation in emissions regulations' impact on regional GDP. We develop and quantitatively evaluate a spatial general equilibrium model that incorporates carbon emission regulations. We study the impact of emission regulation on the economies of regions within a country under climate change mitigation goals, and how the impact of emission regulation in one region influences other regions through regional‒sectoral linkages. The model is calibrated using Chinese regional and sectoral data, and several counterfactual exercises are performed. The results indicate that undifferentiated increases in emission regulation across regions have resulted in inter-regional differences in real GDP changes; however, "equity-oriented" regionally differentiated emissions regulations reduce this imbalance. Regarding interactions between regions, negative impacts on the economy are characterized by geographical proximity, whereas positive impacts are not geographically constrained. Sectoral linkages exacerbate the negative economic impacts of emission regulations and widen regional disparities. Additionally, we demonstrate the extended application of our model through two case studies. [ABSTRACT FROM AUTHOR]

• Part of UN sustainable development goal 9 is upgrading production capabilities. • Increasing economic complexity is a key driver for sustainable economic growth. • Sequential model selection used for robust generalised method of moments estimation. • Chinese FDI evidently shows a positive impact on host countries' economic complexity. • Global policy makers should deepen their relationships with the belt and road. Upgrading the production capabilities in all countries is a target of the UN's 2030 Agenda for Sustainable Development Goal 9. Increasing economic complexity, that is, a country's ability to manufacture more sophisticated products and thus moving up the value chain, is a key driver for sustainable economic growth. This paper investigates whether Chinese Belt and Road investments have impacted the economic complexity of host countries — a topic not addressed in the literature to date, using a sequential generalised method of moments model selection approach. The research focuses on the countries whose economic complexities are below that of China. Our empirical results show significant positive effects of Chinese investments on such host countries' economic complexities. The inflows of Chinese investments have thus supported the upgrading of production capabilities in these countries. This is encouraging, especially for the Global South countries, to intensify their interactions with the Belt and Road initiative. [ABSTRACT FROM AUTHOR]

Removal of ewes from a flock before the end of their productive life, sometimes described as ewe wastage, can potentially lead to reduced flock productivity. While the main reasons for culling ewes are largely known, their relative importance to New Zealand farmers and farmers' rational behind their culling decisions are not. Therefore, this study involved semi-structured interviews with 38 sheep farmers from throughout New Zealand to explore their ewe culling decisions. Farmers consistently culled mixed-age and two-tooth ewes who failed to become pregnant or who had a vaginal prolapse. For other culling reasons, farmers' use of them and their rationale for doing so was diverse and varied between farmers based on ewe age-group, severity, season, perceived economic consequences and farmers' personal preference. This diversity indicates that there is scope for some farmers to carefully evaluate some of their culling decisions. [ABSTRACT FROM AUTHOR]

Grounding on the theories of economic voting and political opposition, this paper investigates whether the Italian Local Labour Markets (LLMs) most affected by the Great Recession reacted in the ballot box voting against the domestic institutions or in favour of anti-European parties. We exploit a recent econometric technique in the counterfactual framework, which adopts a non-parametric generalisation of the difference-in-differences estimator. Our findings show a causal negative impact on the share of Berlusconi's party, the incumbent party during the crisis, statistically significant in those LLMs with the lowest institutional quality and in the Centre and in the Islands of Italy. We find no causal effect on the anti-European vote whatsoever. People living in the LLMs that suffered the most the effects of the Great Recession used their vote to harm the party in charge, which they deemed responsible for the economic consequences, with a payback effect. [ABSTRACT FROM AUTHOR]

Against a backdrop of the growing crisis in higher education, the economic fallout of the COVID-19 pandemic and a longer-term precaritisation of the youth and graduate labour market, the last 2 years have witnessed an increased visibility and promotion of flexible, entrepreneurial and often digitally mediated forms of self-employment addressed at young women, including the 'side hustle'. With media declarations such as 'the university side hustle has come of age', universities themselves have begun embedding initiatives that seemingly help students launch a 'student side hustle' as they turn passions into entrepreneurial projects. The student side hustle has been advocated as a feasible way of not only supplementing income while studying but also investing in one's future employability in the context of increasingly uncertain graduate outcomes. In this article we connect the emergence of the student side hustle to a broader postfeminist landscape in which (young) women are invited to engage in entrepreneurial self-employment through the promise of 'passionate work', financial autonomy and time-freedom. We demonstrate that in the context of higher education, where women outnumber men and dominate the degree subjects increasingly badged as 'low value' due to declining graduate outcomes, institutional incitements to engage in the student side hustle are distinctly gendered. Crucially, we contend that this framing and promotion of the student side hustle – in which women become the 'poster girls' of entrepreneurialism – works to facilitate and sustain the myths and ideals of postfeminist success while masking the ongoing crises and gendered inequalities that underpin contemporary higher education and the graduate labour market. [ABSTRACT FROM AUTHOR]

This study aims to examine how mothers' poverty differently affects young adult children's self-esteem over time. We consider how young adult children's income moderates the between-subject relationship and the within-subject relationship. This study used two data sets such as the NLSY79 and the NLSY79CY. We used six waves from 2004 to 2014. A total of 3975 mother–adult child dyads were chosen. The hybrid model was employed to explore both the between-subject and the within-subject relationship. There was a significant between-subject relationship regarding the effect of mothers' poverty and adult children's income on adult children's self-esteem. In the between-subjects relationship, an interaction effect was found, such that children's income moderated the between-subject relationship between mothers' poverty and children's self-esteem. Long-term anti-poverty programs should be provided to women with children even after they completely are away from poverty. Minimizing inequality in intergenerational economic mobility may be critical to enhance adult children's self-esteem. [ABSTRACT FROM AUTHOR]

This study investigates the role of energy imports in domestic production function in the case of 15 energy-importing countries for the period of 1995–2015. Apart from energy imports, renewable energy consumption, non-renewable energy consumption, capital, trade openness, and urbanization are included in the growth model. In doing so, long-run elasticity coefficients are estimated with the Dynamic Seemingly Unrelated Regressions (DSUR) model after determining the cointegration relationship between the variables. In addition, for robustness checks, Panel Correlated Standard Errors (PCSE) and Feasible Generalized Least Squares (FGLS) estimators are applied. Our results show that renewable energy consumption, non-renewable energy consumption, trade openness, and capital have a positive effect on economic growth. Energy imports negatively affect economic growth. The Dumitrescu-Hurlin causality analysis reveals a bidirectional causality relationship between renewable energy consumption, capital, trade openness, urbanization, and economic growth. A unidirectional causality relationship exists from economic growth to non-renewable energy consumption and energy imports. This analysis can be interpreted as having a negative impact on economic growth by putting pressure on the current account deficit due to energy imports. Therefore, investments in the renewable energy sector will play an important role in economic growth. [ABSTRACT FROM AUTHOR]

This study examines the short-run and long-run impacts of foreign aid and remittances on economic growth in a panel of 31 African countries from 1980 to 2019 utilizing the ARDL Pool Mean Group (PMG) estimation technique. The PMG is utilized based on the outcome of the Hausman test which justifies it appropriateness. There is long-run association among the regressors and the regressand in the model. Our results indicate that, in the short-run, remittance and foreign aid respectively have a negative impact on economic growth but that impact is statistically insignificant. In the long-run, however, remittances have a positive and significant impact on economic growth while foreign aid has a positive but insignificant effect on economic growth on the continent. These results have substantial policy implications. African governments should adopt effective policies to maximize the usefulness and effectiveness of foreign capital, such as foreign aid and remittances, in boosting economic growth. [ABSTRACT FROM AUTHOR]

The digitization of agriculture is widely discussed today. But despite proven benefits, its acceptance in agricultural practice remains low. In small-structured areas, this trend is even more pronounced. There are even known cases where farmers initially purchased and used technology, but then stopped using it due to lack of profitability or other reasons. Interestingly, despite extensive research on precision agriculture technologies (PATs), the processes of adoption and phase-out with their associated economic impacts have never been studied. This paper provides a methodological framework for evaluating the economics of PAT deployment, taking into account changes during the period of use; the framework provides decision rules for determining the appropriate time to phase out technology. Using a selected PAT, a farm model, and defined entry and exit scenarios, it was shown that farms with outdated technology and farms with retrofittable technology are at a significant economic disadvantage during implementation compared to farms already using technology suitable for site-specific fertilization or farms relying on the use of a contractor. And even in the event of a phase-out, the two disadvantaged starting conditions face significantly greater uncertainties and costs. Moreover, the decision to phase out in time is difficult, as making an informed and fact-based decision is not possible after the first year of use. Therefore, it is advisable that farmers are not only accompanied before and during phase-in, but also receive professional support during use. [ABSTRACT FROM AUTHOR]

Purpose: The use of economic sanctions has grown dramatically in recent decades. Nevertheless, many arguments are presented in the public policy space regarding their effects on target populations. The author presents the first systematic analysis of the effects of sanctions on living conditions in target countries. Design/methodology/approach: This paper provides a comprehensive survey and assessment of the literature on the effects of economic sanctions on living standards in target countries. The author identifies 31 studies that apply quantitative econometric or calibration methods to cross-country and national data to assess the impact of economic sanctions on indicators of human and economic development. The author provides in-depth discussions of three sanctions episodes—Iran, Afghanistan and Venezuela—that illustrate the channels through which sanctions affect living conditions in target countries. Findings: Of the 31 studies, 30 find that sanctions have negative effects on outcomes ranging from per capita income to poverty, inequality, mortality and human rights. The author provides new results showing that 54 countries—27% of all countries and 29% of the world economy— are sanctioned today, up from only 4% of countries in the 1960s. In the three cases discussed, sanctions that restricted the access of governments to foreign exchange limited the ability of states to provide essential public goods and services and generated substantial negative spillovers on private sector and nongovernmental actors. Originality/value: This is the first literature survey that systematically assesses the quantitative evidence on the effect of sanctions on living conditions in target countries. [ABSTRACT FROM AUTHOR]

Purpose: This paper explores whether data back the claim that imports of armaments are inherently bad for economic growth. Regardless of one's point of view, the production and trade of weaponry is a significant industry with serious economic implications that warrant investigation. The financial repercussions of military spending have been extensively studied, but the economic effects of arms importation remain unknown. Design/methodology/approach: This study adopts a pooled mean group approach to investigate the nexus between arms imports, military expenditure and per capita GDP for a balanced panel of twenty-five of the top arms importers in the world from 2000 to 2021. Findings: The authors find that arms imports and military spending negatively impact GDP per capita in the short run, but military spending is beneficial over the long run. The authors also used the Dumitrescu Hurlin Granger causality test, which revealed a unidirectional causation between per capita GDP and military expenditure, and a unidirectional causal relationship from military spending to arms imports. Research limitations/implications: This paper is deficient in a few aspects: first, it looks at only those countries comprising the top 70% of arms imports. Second, it omits many political, technological and legal factors that impact arms imports and military expenditures. Originality/value: This paper looks into the impact of defense spending and arms imports on economic growth for twenty-five nations with the highest share of arms imports in recent times. It is a significant addition to the literature as it resolves the debate of whether or not the military expenditure is wasteful and whether arms imports significantly harm the nation's economic growth. [ABSTRACT FROM AUTHOR]

The Himalayan region and its surrounding area are one of the most seismically active zones in the world which have significant economic and societal impact. It governs the seismicity of highly populous countries like India, China, Pakistan, Nepal, Bhutan and Afghanistan which account for more than 40% population of the world. Therefore, the complex interaction between seismic parameters and transient seismic events needs to be thoroughly addressed at the regional scale. This study highlights the spatial distribution of earthquake hazard parameters and the temporal variation in seismicity of the Himalayas and its nearby regions by employing the maximum likelihood approach using historical records as well as instrumentally recorded earthquake data of the years 1900–2021. An empirical relation is developed to convert the body wave magnitude (Mb) and surface wave magnitude (Ms) to moment magnitude (Mw). The seismic parameters, namely maximum regional magnitude (Mmax), b-value, and mean seismicity rate (λ0), are estimated for 13 defined zones. Further, the seismic behaviours of the study area are evaluated through the return periods (RP) of earthquakes and the fractal dimension (Dc) of the individual zone. Considering the temporal variation of seismicity and RP of Mw ≥ 6, a new index , i.e. earthquake susceptibility index (ESI6), is developed to identify the zones which are susceptible to Mw ≥ 6 earthquakes. The zones: Central Himalayas 2 (CH2), Western Himalayas (WH), North of MCT 1 (NMCT1) and South of MCT 2 (SMCT2) are identified to be highly susceptible to earthquakes of Mw ≥ 6. The present analysis will motivate researchers and engineers from government and non-government organizations to collaborate for improved policy making in the seismically active Himalayan region concerning land-use planning, insurance, and catastrophe preparation. [ABSTRACT FROM AUTHOR]

As donors channel more of their development assistance through private companies, a discussion is growing on what this shift means for international development. This paper focuses on four Central European donors, the Czech Republic, Hungary, Poland and Slovakia, who have recently implemented new incentives to promote the greater engagement of the private sector in their international development programmes. The paper uses new survey data of project managers at organisations implementing aid projects funded by these four donors to explore how private actors differ in their approaches to aid implementation. The analysis reveals that the type of implementing organisation does not affect their focus on internal project goals (budget, schedule, and scope), but project managers at private firms consider long-term impact and economic sustainability of the project less important. These findings support claims that for-profit organisations exercise a short-term approach to satisfy funders, but lack a deeper focus on long-term development. [ABSTRACT FROM AUTHOR]

Aim: Musculoskeletal conditions constitute a remarkable portion of disability cases in the military. This study evaluated the distribution and types of musculoskeletal problems and estimated the direct and indirect costs due to these complaints in an Iranian military hospital. Methods: All medical records of patients with musculoskeletal complaints that were referred to the medical committee of a military hospital, including rheumatology, orthopedics, and neuro-surgical specialists, from 2014 to 2016, were reviewed. Details of each complaint and the final opinion of the medical committees were recorded. The cost of each diagnostic step was calculated based on the recorded data. The treatment costs were estimated for each complaint by calculating the average cost of treatment plans suggested by two specialists, a physical medicine and a rheumatologist. The estimated cost for each part is calculated based on the army insurance low. Indirect costs due to absences, inability to work, and disability were assessed and added to the above-mentioned direct costs. Statistical analysis was performed using SPSS version 21. Results: 2,116 medical records of the committee were reviewed. 1252 (59.16%) cases were soldiers (who had to spend two years of mandatory duty in the army), and 864 (40.83%) cases were non-soldiers. The three most common complaints were fractures (301 cases, 14.22%), low back pain due to lumbar disc bulges and herniations (303 cases, 14.31%), and genu varus/genu valgus (257 cases, 12.14%). The most affected sites were the lower limbs and vertebral column. According to an official document in these subjects' records, 4120 person-days absent from work were estimated annually, and nearly $1,172,149 of annual economic impact was calculated. Conclusion: Musculoskeletal problems are common in the army, and establishing preventive strategies for these conditions is essential. The conservative and medical approach and the proper education for correct movement and the situation should be mentioned for the reduction of disability and its economic burden on the army's staff. [ABSTRACT FROM AUTHOR]

As the LCOE for photovoltaics has decreased several times, it is once again gaining popularity. The intensification of the development of PV installations is contributing to the duck curve phenomenon in an increasing number of countries and, consequently, affecting current electricity prices. Decisions on new investments in large-scale PV sources are driven by potential economic and environmental effects, and these, in turn, are subject to locational considerations, both as to the country and its region. In calculating the economic impact of locating a 1 MWp PV farm, it was assumed that the electricity generated by the farm would be fed into the national grid, and that the life of the PV farm would be 20 years. Poland was considered as an example country for the placement of a photovoltaic farm. The authors of this paper proposed that the main verification parameter is the availability of connection capacities to feed the produced electricity into the country's electricity grid. The methodology proposed by the authors for the selection of the location of a PV farm consists of four steps: step (i) identification and selection of the administrative division of a given country; step (ii) verification of available connection capacities; step (iii) (two stages) verification of other factors related to the location of the PV farm (e.g., information on land availability and the distance of the land from the substation), and analysis of productivity at each potential location and electricity prices achieved on the power exchange; step (iv) economic analysis of the investment—analyses of PV farm energy productivity in monetary terms on an annual basis, cost analysis (CAPEX, OPEX) and evaluation of economic efficiency (DPP, NPV, IRR). The greatest impact on the economic efficiency of a PV project is shown by the value of land (as part of CAPEX), which is specific to a given location, and revenues from energy sales, which are pretty similar for all locations. [ABSTRACT FROM AUTHOR]

To identify barriers and enablers for access to and participation in rehabilitation for people with LLA in East, South, and Southeast Asian developing countries from the perspective of rehabilitation professionals. A mixed-method study involving an anonymous cross-sectional screening survey followed by in-depth interviews of rehabilitation professionals in these regions following the COREQ guidelines. Participants were surveyed online using convenience and snowball sampling techniques to inform a purposive heterogenic sample for semi-structured online interviews, between September 2021 to February 2022. Interview transcripts were analysed and thematically coded using the modified Health Care Delivery System Approach (HCDSA) framework. A total of 201 quantitative survey responses shaped the interview questions and participation of 28 participants from 13 countries for the qualitative investigation. Important factors at the patient level were sex, economics, health issues, language differences, and lack of awareness; at the care team level, peer and/or family support, referrals, and the gender of the professional; at the organizational level, service availability, resources, and quality; and at the environmental level, policies, supports, and physical and/or social accessibility. Identified interlinked factors at multiple levels of the HCDSA underpin the need for a systems approach to develop and address regional rehabilitation service provision but requires contextually adapted policy. Amputation rehabilitation practices need improvements in the developing Asian region including evaluation and redesign of, and processes and policies by, policy makers with increased support for those with lower limb amputation. The consistent factors identified in these regions as negatively impacting rehabilitation services suggest opportunities to collaborate and design common mitigation approaches between rehabilitation providers across countries. Unique local factors impacting rehabilitation in different countries suggest the necessity for customization in consultation with rehabilitation practitioners rather than the adoption of generic charitable models by external agencies. Rehabilitation professionals and others responsible for rehabilitation policy and practice should systematically target factors impacting rehabilitation outcomes for improvements at all levels within the health care systems. [ABSTRACT FROM AUTHOR]

Background and objectives: Correct identification of estrogen receptor (ER) status in breast cancer (BC) is crucial to optimize treatment; however, standard of care, involving biopsy and immunohistochemistry (IHC), and other diagnostic tools such as 2-deoxy-2-[18F]fluoro-D-glucose or 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG), can yield inconclusive results. 16α-[18F]fluoro-17β-fluoroestradiol ([18F]FES) can be a powerful tool, providing high diagnostic accuracy of ER-positive disease. The aim of this study was to estimate the budget impact and cost-effectiveness of adding [18F]FES PET/CT to biopsy/IHC in the determination of ER-positive status in metastatic (mBC) and recurrent breast cancer (rBC) in the United States (US). Methods: An Excel-based decision tree, combined with a Markov model, was developed to estimate the economic consequences of adding [18F]FES PET/CT to biopsy/IHC for determining ER-positive status in mBC and rBC over 5 years. Scenario A, where the determination of ER-positive status is carried out solely through biopsy/IHC, was compared to scenario B, where [18F]FES PET/CT is used in addition to biopsy/IHC. Results: The proportion of true positive and true negative test results increased by 0.2 to 8.0 percent points in scenario B compared to scenario A, while re-biopsies were reduced by 94% to 100%. Scenario B resulted in cost savings up to 142 million dollars. Conclusions: Adding [18F]FES PET/CT to biopsy/IHC may increase the diagnostic accuracy of the ER status, especially when a tumor sample cannot be obtained, or the risk of a biopsy-related complication is high. Therefore, adding [18F]FES PET/CT to biopsy/IHC would have a positive impact on US clinical and economic outcomes. [ABSTRACT FROM AUTHOR]

As the most widely-used data form in the field of finance, the open-high-low-close (OHLC) data is being collected by all kinds of financial trading systems all the time. This paper puts forward a pseudo-principal component analysis (PCA) for multi-dimensional OHLC data, which can extract their useful information in a comprehensible way for visualization and easy interpretation. Firstly, a novel feature-based representation for OHLC data is proposed, which contains fruitful and explicit economic implications. Next, we define a full set of numerical characteristics and variance-covariance structures for the feature-based OHLC data. Then, the pseudo-PCA procedure for OHLC data is deduced based on the proposed algebraic operators. Finally, the effectiveness and interpretability of the proposed pseudo-PCA method are verified through finite simulations and three typical empirical experiments. This paper enriches the application scenarios of classical PCA and contributes to the multivariate statistical modeling of symbolic data. The proposed applications can serve as models for related studies. [ABSTRACT FROM AUTHOR]

Regional population mortality correlates with regional socioeconomic development. This study aimed to identify the key socioeconomic factors influencing mortality patterns in Chinese provinces. Using data from the Seventh Population Census, we analyzed mortality patterns by gender and urban‒rural division in 31 provinces. Using a functional regression model, we assessed the influence of fourteen indicators on mortality patterns. Main findings: (1) China shows notable gender and urban‒rural mortality variations across age groups. Males generally have higher mortality than females, and rural areas experience elevated mortality rates compared to urban areas. Mortality in individuals younger than 40 years is influenced mainly by urban‒rural factors, with gender becoming more noticeable in the 40–84 age group. (2) The substantial marginal impact of socioeconomic factors on mortality patterns generally becomes evident after the age of 45, with less pronounced differences in their impact on early-life mortality patterns. (3) Various factors have age-specific impacts on mortality. Education has a negative effect on mortality in individuals aged 0–29, extending to those aged 30–59 and diminishing in older age groups. Urbanization positively influences the probability of death in individuals aged 45–54 years, while the impact of traffic accidents increases with age. Among elderly people, the effect of socioeconomic variables is smaller, highlighting the intricate and heterogeneous nature of these influences and acknowledging certain limitations. [ABSTRACT FROM AUTHOR]

One component of decisions regarding hepatitis B virus (HBV) treatment simplification and expansion is the economic perspective. Literature was reviewed for studies which provide estimates for the economic impact of simplifying and expanding treatment eligibility. Eight published studies and four unpublished studies were included and all but one subset of one study found that expanding treatment criteria would result in programs that would be at minimum cost‐effective and most often highly cost‐effective. [ABSTRACT FROM AUTHOR]

Objective: This research aimed to identify the fundamental and geographic characteristics of the primary healthcare personnel mobility in Nanning from 2000 to 2021 and clarify the determinants that affect their transition to non-primary healthcare institutions. Methods: Through utilizing the Primary Healthcare Personnel Database (PHPD) for 2000–2021, the study conducts descriptive statistical analysis on demographic, economic, and professional aspects of healthcare personnel mobility across healthcare reform phases. Geographic Information Systems (QGIS) were used to map mobility patterns, and R software was employed to calculate spatial autocorrelation (Moran's I). Logistic regression identified factors that influenced the transition to non-primary institutions. Results: Primary healthcare personnel mobility is divided into four phases: initial (2000–2008), turning point (2009–2011), rapid development (2012–2020), and decline (2021). The rapid development stage saw increased mobility with no spatial clustering in inflow and outflow. From 2016 to 2020, primary healthcare worker mobility reached its peak, in which the most significant movement occurred between township health centers and other institutions. Aside from their transition to primary medical institutions, the primary movement of grassroots health personnel predominantly directs towards secondary general hospitals, tertiary general hospitals, and secondary specialized hospitals. Since 2012, the number and mobility distance of primary healthcare workers have become noticeably larger and remained at a higher level from 2016 to 2020. The main migration of primary healthcare personnel occurred in their districts (counties). Key transition factors include gender, education, ethnicity, professional category, general practice registration, and administrative division. Conclusions: This study provides evidence of the features of primary healthcare personnel mobility in the less developed western regions of China, in which Nanning was taken as a case study. It uncovers the factors that impact the flow of primary healthcare personnel to non-primary healthcare institutions. These findings are helpful to policy refinement and support the retention of primary healthcare workers. [ABSTRACT FROM AUTHOR]

Background: Seasonal influenza epidemics have a substantial public health and economic burden, which can be alleviated through vaccination. The World Health Organization (WHO) recommends a 75% vaccination coverage rate (VCR) in: older adults (aged ≥ 65 years), individuals with chronic conditions, pregnant women, children aged 6–24 months and healthcare workers. However, no European country achieves this target in all risk groups. In this study, potential public health and economic benefits achieved by reaching 75% influenza VCR was estimated in risk groups across four European countries: France, Italy, Spain, and the UK. Methods: A static epidemiological model was used to estimate the averted public health and economic burden of increasing the 2021/2022 season VCR to 75%, using the efficacy data of standard-dose quadrivalent influenza vaccine. For each country and risk group, the most recent data on population size, VCR, pre-pandemic influenza epidemiology, direct medical costs and absenteeism were identified through a systematic literature review, supplemented by manual searching. Outcomes were: averted influenza cases, general practitioner (GP) visits, hospitalisations, case fatalities, number of days of work lost, direct medical costs and absenteeism-related costs. Results: As of the 2021/2022 season, the UK achieved the highest weighted VCR across risk groups (65%), followed by Spain (47%), France (44%) and Italy (44%). Based on modelling, the 2021/2022 VCR prevented an estimated 1.9 million influenza cases, avoiding 375,200 GP visits, 73,200 hospitalisations and 38,400 deaths. To achieve the WHO 75% VCR target, an additional 24 million at-risk individuals would need to be vaccinated, most of which being older adults and patients with chronic conditions. It was estimated that this could avoid a further 918,200 influenza cases, 332,000 GP visits, 16,300 hospitalisations and 6,300 deaths across the four countries, with older adults accounting for 52% of hospitalisations and 80% of deaths. An additional €84 million in direct medical costs and €79 million in absenteeism costs would be saved in total, with most economic benefits delivered in France. Conclusions: Older adults represent most vaccine-preventable influenza cases and deaths, followed by individuals with chronic conditions. Health authorities should prioritise vaccinating these populations for maximum public health and economic benefits. [ABSTRACT FROM AUTHOR]

Background: Respiratory pathogens inflict a substantial burden on public health and the economy. Although the severity of symptoms caused by these pathogens can vary from asymptomatic to fatal, the factors that determine symptom severity are not fully understood. Correlations in symptoms between infector-infectee pairs, for which evidence is accumulating, can generate large-scale clusters of severe infections that could be devastating to those most at risk, whilst also conceivably leading to chains of mild or asymptomatic infections that generate widespread immunity with minimal cost to public health. Although this effect could be harnessed to amplify the impact of interventions that reduce symptom severity, the mechanistic representation of symptom propagation within mathematical and health economic modelling of respiratory diseases is understudied. Methods and findings: We propose a novel framework for incorporating different levels of symptom propagation into models of infectious disease transmission via a single parameter, α. Varying α tunes the model from having no symptom propagation (α = 0, as typically assumed) to one where symptoms always propagate (α = 1). For parameters corresponding to three respiratory pathogens—seasonal influenza, pandemic influenza and SARS-CoV-2—we explored how symptom propagation impacted the relative epidemiological and health-economic performance of three interventions, conceptualised as vaccines with different actions: symptom-attenuating (labelled SA), infection-blocking (IB) and infection-blocking admitting only mild breakthrough infections (IB_MB). In the absence of interventions, with fixed underlying epidemiological parameters, stronger symptom propagation increased the proportion of cases that were severe. For SA and IB_MB, interventions were more effective at reducing prevalence (all infections and severe cases) for higher strengths of symptom propagation. For IB, symptom propagation had no impact on effectiveness, and for seasonal influenza this intervention type was more effective than SA at reducing severe infections for all strengths of symptom propagation. For pandemic influenza and SARS-CoV-2, at low intervention uptake, SA was more effective than IB for all levels of symptom propagation; for high uptake, SA only became more effective under strong symptom propagation. Health economic assessments found that, for SA-type interventions, the amount one could spend on control whilst maintaining a cost-effective intervention (termed threshold unit intervention cost) was very sensitive to the strength of symptom propagation. Conclusions: Overall, the preferred intervention type depended on the combination of the strength of symptom propagation and uptake. Given the importance of determining robust public health responses, we highlight the need to gather further data on symptom propagation, with our modelling framework acting as a template for future analysis. Author summary: Symptom propagation occurs when the symptoms of an infected individual depend, at least partially, on the symptoms of the person who infected them. An example is when an individual is more likely to develop severe symptoms if infected by someone with severe symptoms themselves. Symptom propagation has important implications for infection control strategies and could be harnessed to amplify the impact of vaccines that reduce the probability of severe disease. Evidence for symptom propagation is growing, yet it is rarely included in models of infectious disease transmission. Here, we provide a new infectious disease transmission model with a single parameter representing the strength of symptom propagation and study the consequences for vaccination control strategies. We show that the strength of symptom propagation has profound effects on infectious disease outbreaks, including notably on the proportion of cases that are severe. We demonstrate that vaccines that reduce symptom severity are more effective in reducing severe and overall cases when symptom propagation is stronger. Knowing the strength of symptom propagation can help understand the effectiveness of vaccines that reduce the risk of infection relative to those that reduce symptoms, helping to shape public health strategy. [ABSTRACT FROM AUTHOR]

Aim: An inaugural set of consensus guidelines for malignancy screening in idiopathic inflammatory myopathy (IIM) were recently published by an international working group. These guidelines propose different investigation strategies based on "high", "intermediate" or "standard" malignancy risk groups. This study compares current malignancy screening practices at an Australian tertiary referral center with the recommendations outlined in these guidelines. Methods: We conducted a retrospective analysis of newly diagnosed IIM patients. Relevant demographic and clinical data regarding malignancy screening were recorded. Existing practice was compared with the guidelines using descriptive statistics; costs were calculated using the Australian Medicare Benefit Schedule. Results: Of the 47 patients identified (66% female, median age: 63 years [IQR: 55.5–70], median disease duration: 4 years [IQR: 3–6]), only one had a screening‐detected malignancy. Twenty patients (43%) were at high risk, while 20 (43%) were at intermediate risk; the remaining seven (15%) had IBM, for which the proposed guidelines do not recommend screening. Only three (6%) patients underwent screening fully compatible with International Myositis Assessment and Clinical Studies recommendations. The majority (N = 39, 83%) were under‐screened; the remaining five (11%) overscreened patients had IBM. The main reason for guideline non‐compliance was the lack of repeated annual screening in the 3 years post‐diagnosis for high‐risk individuals (0% compliance). The mean cost of screening was substantially lower than those projected by following the guidelines ($481.52 [SD 423.53] vs $1341 [SD 935.67] per patient), with the highest disparity observed in high‐risk female patients ($2314.29/patient). Conclusion: Implementation of the proposed guidelines will significantly impact clinical practice and result in a potentially substantial additional economic burden. [ABSTRACT FROM AUTHOR]

Purpose: Cluster management organizations (CMOs) have emerged over the past few decades as intermediaries that support the competitiveness of place-based clusters of economic activity. Despite their economic origins, policymakers are now starting to experiment with a broader use for cluster policies that seeks to leverage CMOs to tackle societal challenges in approaches aligned with the concept of creating shared value (CSV). However, there remains a void in conceptual understanding around the specific roles that CMOs might play in overcoming the barriers faced by their members for CSV, which this paper aims to address. Bridging this gap presents an opportunity for cluster practitioners and policymakers in a context in which environmental and social sustainability are at the top of policy agendas. Design/methodology/approach: Based on analysis of literature around collaborative approaches to CSV for mitigating transaction costs, the authors define the contours of a new conceptual framework for the roles that CMOs can play in fostering collective CSV. The authors illustrate how the different components of the framework are reflected in emerging cluster practice in the context of a new wave of European cluster-based projects tackling CSV elements. Findings: The resulting framework reconciles the concepts of clusters and CSV by explicitly positioning CMOs as intermediaries for facilitating the CSV strategies of their members. CMOs embrace emergent strategy making that targets (tangible and intangible) collective CSV capabilities and addresses collective CSV challenges. Collective CSV can provide a theoretical anchor guiding future cluster policies to fully leverage the transformative potential of CMOs. This conceptual framework opens a promising empirical research agenda, particularly around evaluating the plurality of impacts of CMOs. Originality/value: By stressing the social impact of CMOs alongside their well-understood economic impacts, and by enabling a categorization of functions that can support the monitoring of CMO activities toward collective CSV strategies, the framework provides a novel basis for inspiring further empirical research into the evidencing of these roles. [ABSTRACT FROM AUTHOR]

This dataset summarizes the research on the impacts of Invasive Alien Species (IAS) documented in Brazil from 1981 to 2022 and was used to subsidize the Brazilian Platform on Biodiversity and Ecosystem Services. Impacts of non‐native plants and animals, but not microorganisms and fungi, on terrestrial and aquatic (freshwater and marine) environments were included in this review. Most of the literature reviewed consisted of published articles, plus a few book chapters, dissertations, theses, and reports. We found 1003 records of ecological and economic impacts (970 negative and 33 positive) caused by 239 different species, as well as effects on people's well‐being. Understanding and assessing all ecological interactions of IAS in nature, as well as evaluating their contributions to humans, can be a complex task. However, the current scientific evidence from Brazil suggests that negative impacts of IAS are far more common than positive impacts, highlighting the importance of avoiding novel introductions. From a conservationist perspective, the simple presence of IAS may cause the negative impact of changing the original structure and processes of nature. This is of special concern in megadiverse countries like Brazil, where interactions among species are multiple and complex. Therefore, we believe this extensive review is an important contribution to the national knowledge of IAS and the improvement of global databases, which must be periodically reviewed. The complete dataset for this abstract published in the Data Article section of the journal is available in electronic format in MetaCat in JaLTER at http://db.cger.nies.go.jp/JaLTER/metacat/metacat/ERDP-2024-01.1/jalter-en. [ABSTRACT FROM AUTHOR]

The objective of this study is to verify the impacts of the UNESCO title Creative City of Gastronomy (CCGU) for Florianópolis, a city located in southern Brazil. The qualitative research used as instrument an interview script considering economic and cultural impacts. The research showed that Florianópolis has unique elements from the value of specific and local ingredients to a characteristic know-how loaded with social aspects and commensality. Economic benefits are observed with respect to jobs and local development, professionalization of the workforce, and increase in tourists. Cultural benefits related to preservation of recipes and ingredients was observed. [ABSTRACT FROM AUTHOR]

The article discusses the Aranya Theater Festival held in Qinhuangdao, China from June 15–25, 2023, which featured diverse international and domestic productions around the theme "Howls and Whispers," showcasing avant-garde works while reflecting on the festival's cultural and economic impact.

The World Health Organization (WHO) set up the messenger ribonucleic acid (mRNA) technology transfer programme in June 2021 with a development hub in South Africa and 15 partner vaccine producers in middle-income countries. The goal was to support the sustainable development of and access to life-saving vaccines for people in these countries as a means to enhance epidemic preparedness and global public health. This initiative aims to build resilience and strengthen local vaccine research, and development and manufacturing capacity in different regions of the world, especially those areas that could not access coronavirus disease 2019 (COVID-19) vaccines in a timely way. This paper outlines the current global vaccine market and summarizes the findings of a case study on the mRNA technology transfer programme conducted from November 2022 to May 2023. The study was guided by the vision of the WHO Council on the Economics of Health for All to build an economy for health using its four work streams of value, finance, innovation and capacity. Based on the findings of the study, we offer a mission-oriented policy framework to support the mRNA technology transfer programme as a pilot for transformative change towards an ecosystem for health innovation for the common good. Parts of this vision have already been incorporated into the governance of the mRNA technology transfer programme, while other aspects, especially the common good approach, still need to be applied to achieve the goals of the programme. [ABSTRACT FROM AUTHOR]

Decentralisation has frequently been sold as a means to increase well-being and development. Yet, questions remain as to whether decentralisation improves economic performance. This is possibly because decentralisation processes have often led to 'unfunded mandates', that is, a mismatch between the powers transferred to subnational tiers of government and the resources allocated to them. In this article, we analyse how unfunded mandates shape regional economic growth across 518 regions in 30 Organisation for Economic Co-operation and Development countries over the period 1997–2018. There is a negative, statistically significant, and robust impact of unfunded mandates on economic growth. This effect is higher in more politically and less fiscally decentralised regions and in regions with a higher level of wealth. Unfunded mandates thus represent a serious drag on the potential positive economic effect of political decentralisation. Hence, for those benefits to materialise, better not more decentralisation – ensuring that finance follows function – should be pursued. [ABSTRACT FROM AUTHOR]

Purpose: This clinical focus article aims to provide a comprehensive overview of schizophrenia and understanding of communication disorders resulting from its psychopathology. Schizophrenia is a spectrum disorder with varying levels of symptom expression. It is characterized by positive and negative symptoms that can cause communication disorders of different severity levels. Communication difficulties manifest as a range of symptoms such as alogia, disorganized speech, and impaired social communication. These challenges may result in receptive and expressive language deficits that lead to misunderstandings, reduced social interactions, and difficulties expressing thoughts and emotions effectively. The purpose of this clinical focus article is to explore the role of the speech-language pathologist (SLP) in assessing and treating communication disorders presented in schizophrenia. Conclusions: In order to understand the role of the SLP in assessing and treating communication disorders in schizophrenia, it is imperative to understand the overall course, etiology, assessment, and treatment consideration of this condition. SLPs can provide services in the areas of social skills training and community-based intervention contexts. [ABSTRACT FROM AUTHOR]

Calhoun, W.R. and Ezell, E.K., 2024. Marine debris on a protected barrier island in the southeastern United States (St. Catherines Island, Georgia, USA). Journal of Coastal Research, 40(3), 485–498. Charlotte (North Carolina), ISSN 0749-0208. Marine debris is a global issue with ecological, societal, and economic impacts, but its severity on southeastern North American beaches remains poorly understood. Abundance, composition, and distribution of meso- and macrodebris on St. Catherines Island, a protected barrier island off the coast of Georgia, were estimated in June 2021. The island's 19.4 km of beaches hold an estimated 5522 items (95% confidence interval = 4361–6457) of easily visible anthropogenic marine debris, with a total end-to-end length of 1.1 km (0.7–1.6 km). The N and S ends of the island were identified as plastic debris hot spots by comparing the distributions of anthropogenic and natural debris. Although average debris density (0.012 items m–2) was lower than most global and national averages, this study highlights the vulnerability of remote and undeveloped barrier islands as sinks for marine pollution. [ABSTRACT FROM AUTHOR]

The sandwich generation is a group of untrained caregivers involved in the long-term care process. These individuals often face physical, psychological, economic and social problems during care, and according to numerous studies, the number of people falling into this group of caregivers is increasing. The aim of this study was to combine the results of previous studies to better understand and properly manage the consequences of long-term family care for the sandwich generation. To answer the question of what difficulties the sandwich generation cope with, we conducted an extensive review of the literature available on electronic online databases, including PubMed, Web of Science, Scopus and Google Scholar. Using a systematic search, the studies reporting on the issues faced by the sandwich generation were narrowed down to 23 articles. Combining the results of these studies made it evident that caregivers face many physical, psychological, economic, employment and marital problems during care, the complexity and variety of which can be influenced by the intensity and duration of care. The sandwich generation may suffer from myriad issues resulting from their particular line of work; as such, it is of utmost importance that steps are taken identify these problems and understand how they affect their lives in order to facilitate the planning and implementation of support services which can help alleviate the burden these difficulties cause. [ABSTRACT FROM AUTHOR]

This paper examines the various labels ascribed to males in the heterosexual discourse among female undergraduates in Nigeria. Insights from Community of Practice and Sexual Script Theory were used to demonstrate the use of situated linguistic choices to establish the differentials in male sexual behaviours. Data for the study were generated through participant observation and unstructured interviews with the aid of audiotape recordings and field notes. The study involves a representative sample of 22 female undergraduates who served as participants and research assistants. The findings reveal that situated language practices stimulate heterosexual discourses where female undergraduates creatively ascribe labels to the different males' sexual scripts. The labels include those related to male sexual performance, body size and size of sex organs, financial and marital status, familial and gatekeeping roles, and other routine sexual behaviours shown by men in sexual phases such as advances, arousal and intercourse. The scripts are also combined to re-enact the peculiar sexual narratives by the female students that show emerging sexual orientations. It is believed that the categorisation of such males' sexual behaviours in the University social contexts, would provide a basis for comparison with the sexual practices of other young adults' social groups across the globe. The paper discusses the various strands of sexual scripts shown by men in their heterosexual relationships with female undergraduates in a Nigerian University. The students ascribed labels based on the sexual performance, economic and marital status, and other routine behaviours that have an impact on the male sexual lifestyle. [ABSTRACT FROM AUTHOR]

This paper discussed the impact of economic development on carbon emissions in Sichuan Province from 1990 to 2020 and put forward some suggestions to accelerate the development of a low-carbon economy. Firstly, the land use type was reclassified, then the IPCC coefficient method was used to calculate the land use carbon emissions, and then the driving factors affecting the carbon emissions were obtained by the log-average factor index (LMDI) method. Finally, the decoupling elasticity index and its influencing factors were obtained using Tapio decoupling model. The results showed that: (1) Carbon emissions in Sichuan Province increased significantly, with a growth rate of 218.7% from 1990 to 2020. Per capita GDP, land use structure and land use intensity per unit GDP were the main reasons for carbon emissions change. (2) Sichuan Province achieved strong decoupling during 1995-2000 and 2015-2020. However, it was in a state of expanding connection during 2000-2005, and the economic pressure on the environment reached the maximum. (3) Per capita GDP was the main factor promoting the elastic growth of decoupling index, while land use intensity per unit GDP is the main reason inhibiting the elastic growth of decoupling index. [ABSTRACT FROM AUTHOR]

Examining spatial network patterns and factors influencing the development of the green economy in typical urban agglomerations in China is crucial for optimizing resource allocation and achieving sustainable economic development. In this study, we utilized the SBM-GML model and a modified gravity model to analyze the roles and status of different regions in the spatial correlation of green economic development in the Yangtze River Delta urban agglomeration. We also employed social network analysis to visualize the spatial correlation structure and influencing factors. The research results indicate that the development of green economy is showing a fluctuating upward trend, accompanied by complex network structure characteristics. Cities such as Chizhou, Nanjing, and Shanghai exert significant control over other cities. The analysis of the block model indicates close intercity communication across various sectors, with heightened activity observed in the southeastern coastal areas. Moreover, the central region effectively enhances connectivity within the urban cluster, leading to notable spillover effects in certain cities. Government macroeconomic regulation, environmental regulation, industrial structure, external development, green innovation, and the level of new urbanization emerge as significant factors influencing the formation of the spatial correlation network of green economic development in the Yangtze River Delta urban agglomeration. [ABSTRACT FROM AUTHOR]

The impact of economic freedom on income inequality has been inconclusive in the literature. Previous studies also show the importance of economic freedom in boosting economic development, whereas the Kuznets curve theory indicates the inverted U-shaped relationship between economic development and income inequality. Thus, economic development may play an important role in moderating the nexus of economic freedom and income inequality. This study throws light on the effects of economic freedom, economic development, and their interaction on income inequality in 35 Asian economies during 2000–2018 from the Kuznets curve's perspective. Our empirical results demonstrate that initially economic freedom increases income inequality, then until a threshold of economic development, economic freedom reduces income inequality. In addition, the inverted U-shaped Kuznets curve of economic development and income inequality is confirmed in the context of the Asian continent. The robustness of our results is ensured with different proxies of economic freedom and various estimators. [ABSTRACT FROM AUTHOR]

This paper extends the literature on economic consequences of corruption. We simultaneously consider corruption's impacts on output, production efficiency, and environmental performance in an eco-efficiency framework. Pollution is considered as undesirable output in the production process. We construct an eco-efficiency measure from a non-oriented data envelopment analysis model that incorporates a non-convex metafrontier, super-efficiency, and undesirable outputs into a directional distance function. By using panel data from 30 Chinese provinces from 1998 to 2016 in a spatial analysis, we find that corruption, measured by filed-cases of corruption-related crimes, has a significantly negative direct impact on eco-efficiency. The regional spillover effect is not significant for provinces in the same geographical region, but is marginally significant for provinces sharing a common border. [ABSTRACT FROM AUTHOR]

To help mitigate greenhouse gas (GHGs) generation from burning fossil fuels, many state and local governments are requiring utilities to dramatically increase the share of electricity generated from renewable sources. The City of Los Angeles has set a target of 100% renewable energy by 2045 and has formulated a plan that considers nine potential alternative scenarios that differ by technology, location, and timing. Each scenario has a unique set of local investments, operating and maintenance (O&M) costs, and concomitant rate structures. In this study we develop and apply a computable general equilibrium (CGE) model built specifically for LA to estimate and compare the economic impacts for each of the scenarios over time relative to a reference case. We find differences in economic impacts across scenarios, depending on the level and timing of investment and O&M expenditures, as well as differences in the relative rate changes across scenarios. Results show that employment and economic output are positively correlated with greater capital and O&M spending, while higher electricity rates can dampen economic activity. Several scenarios generate positive economic impacts relative to the reference case, showing that the transition need not have harmful economic impacts, and all scenarios generate a number of other positive co-benefits, such as reduced damage to health from the reduction of ordinary air pollutants. The net employment impacts from 2026 to 2045 across the scenarios range from a low of 3,600 job-year losses annually to 4,700 job-year gains, both around only 0.1% of the baseline average annual employment in the city over that period. The analysis also indicates that lower-income households are relatively more affected than others by the scenarios. Overall, even in the most negatively impactful case, the economic output and employment effects are quite small when taken in the context of the overall size of the regional economy and the large reduction in GHGs. The City of Los Angeles can confidently move forward with its transition to 100% renewable electricity without concern of significant negative aggregate economic impacts. Job impacts across all scenarios can be enhanced by attracting renewable equipment manufacturing and support industries to the City. Even the minimal adverse distributional impacts can be reduced by policies such as subsidies for home energy efficiency improvement, modifications to electricity rate structures or rebates. Both aggregate and distributional impacts can be further addressed by providing training for skilled and semi-skilled labour creating employment opportunities for City residents. [ABSTRACT FROM AUTHOR]

Shortages in the physician anaesthesia workforce have led to proposals to introduce new staff groups, notably in the UK National Health Service (NHS) Anaesthesia Associates (AAs) who have shorter training periods than doctors and could potentially contribute to workflow efficiencies in several ways. We analysed the economic viability of the most efficient staffing model, previously endorsed by both the UK Royal College of Anaesthetists and the Association of Anaesthetists, wherein one physician supervises two AAs across two operating lists (1:2 model). For this model to be economically rational (something which neither national organisation considered), the employment cost of the two AAs should be equal to or less than that of a single supervisor physician (i.e. AAs should be paid <50% of the supervisor's salary). As the supervisor can be an autonomous specialty and specialist (SAS) doctor, this sets the economically viable AA salary envelope at less than £40,000 per year. However, we report that actual advertised AA salaries greatly exceed this, with even student AAs paid up to £48,472. Economically, one way to justify such salaries is for AAs to become autonomous such that they eventually replace SAS doctors at a lower cost. We discuss some other options that might increase AA productivity to justify these salaries (e.g. ≥1:3 staffing ratios), but the medico-political consequences of each of them are also profound. Alternatively, the AA programme should be terminated as economically nonviable. These results have implications for any country seeking to introduce new models of working in anaesthesia. [ABSTRACT FROM AUTHOR]

Using data from the 2018 Chinese Family Panel Studies, this study examines the associations between premarital cohabitation, marital satisfaction, and the probability of a subsequent divorce and captures the gradated variations of marital quality by incorporating divorce and self-rated marital satisfaction into a generic measure of marital quality. Findings show positive associations between cohabitation and divorce and negative associations between cohabitation and marital quality. Results further show that the negative association between cohabitation and marital quality is weakened by better education, higher income, and rural origin, and stronger among men. The consistent negative associations between cohabitation and all the marital quality outcomes indicate the persistent strength of the norm of universal marriage, based on which cohabitation is still considered substantively distinct from marriage both in terms of legal status and social recognition. The diverse social gradients of the cohabitation-marital quality links reflect the heterogeneous social meanings of cohabitation in contemporary China. [ABSTRACT FROM AUTHOR]