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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]

• 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]

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]

Violence is a leading cause of morbidity and mortality among U.S. youth. More information on the health and economic burden of the most frequent assault mechanisms—or, causes (e.g., firearms, cut/pierce)—can support the development and implementation of effective public health strategies. Using nationally representative data sources, this study estimated the annual health and economic burden of U.S. youth violence by injury mechanism. In 2023, CDC's WISQARS provided the number of homicides and nonfatal assault ED visits by injury mechanism among U.S. youth aged 10-24 years in 2020, as well as the associated average economic costs of medical care, lost work, morbidity-related reduced quality of life, and value of statistical life. The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample provided supplemental nonfatal assault incidence data for comprehensive reporting by injury mechanism. Of the $86B estimated annual economic burden of youth homicide, $78B was caused by firearms, $4B by cut/pierce injuries, and $1B by unspecified causes. Of the $36B billion estimated economic burden of nonfatal youth violence injuries, $19B was caused by struck by/against injuries, $3B by firearm injuries, and $365M by cut/pierce injuries. The lethality of assault injuries affecting youth when a weapon is explicitly or likely involved is high—firearms and cut/pierce injuries combined account for nearly all youth homicides compared to one-tenth of nonfatal assault injury ED visits. There are numerous evidence-based policies, programs, and practices to reduce the number of lives lost or negatively impacted by youth violence. [ABSTRACT FROM AUTHOR]

[Display omitted] • A sustainability assessment of SCCA produced from bio-wastes has been performed. • CAFIPLA reduces the environmental impact and social risk of the benchmark technology. • The plant is profitable as long as the product is sold above 0.49 €/kg. Bio-based products are a fast-growing market due to increasing consumer consciousness for sustainability. Although this is per se a positive trend, it leads to a higher demand for organic feedstocks which normally comes from primary agricultural sources and can lead to undesired deforestation or other land use changes to farmland. At the same time, Europe is facing another challenge related with the treatment of organic wastes. In this context, the project CAFIPLA developed an integrated process to convert heterogeneous organic materials to building blocks for the bio-based economy. This study performs a life cycle sustainability assessment (life cycle assessment, life cycle costing and social life cycle assessment) of the production of short chain carboxylic acids (SCCA) employing municipal bio-wastes as a feedstock. In addition to a hot-spot identification to detect the main sources of impact, a comparison of the novel technology with the current benchmark is carried out applying a cradle-to-gate approach and using 1 kg of SCCA as a functional unit. Results show the great performance of CAFIPLA in all the environmental categories analysed. Furthermore, the profitability of the plant is also verified, reaching a payback period below 6 years as long as the product is sold above 0.49 €/kg. Finally, the potential social risk associated to the supply chain is also improved with CAFIPLA technology. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is the most common cardiac arrhythmia, with an increasing incidence and prevalence because of progressively aging populations. Costs related to AF are both direct and indirect. This systematic review aims to identify the main cost drivers of the illness, assess the potential economic impact resulting from changes in care strategies, and propose interventions where they are most needed. A systematic literature search of the PubMed and Scopus databases was performed to identify analytical observational studies defining the cost of illness in cases of AF. The search strategy was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 recommendations. Of the 944 articles retrieved, 24 met the inclusion criteria. These studies were conducted in several countries. All studies calculated the direct medical costs, whereas 8 of 24 studies assessed indirect costs. The median annual direct medical cost per patient, considering all studies, was €9409 (13 333 US dollars in purchasing power parities), with a very large variability due to the heterogeneity of different analyses. Hospitalization costs are generally the main cost drivers. Comorbidities and complications, such as stroke, considerably increase the average annual direct medical cost of AF. In most of the analyzed studies, inpatient care cost represents the main component of the mean direct medical cost per patient. Stroke and heart failure are responsible for a large share of the total costs; therefore, implementing guidelines to manage comorbidities in AF is a necessary step to improve health and mitigate healthcare costs. • Atrial fibrillation (AF) has an increasing incidence and prevalence because of progressively aging populations. Costs related to AF, exacerbated by the major complications that the disease can cause, are both direct—related to therapies and hospitalization—and indirect—related to productivity losses. • In most of the analyzed studies in this systematic review, inpatient care cost represented the main component of the mean direct medical cost per patient, whereas the cost of outpatient care was the principal cost item in only 3 studies. In most of the 8 studies that calculated the indirect costs, this cost component was generally much lower than the direct costs. • The presence of comorbidities and complications such as stroke, considerably increase the average annual direct medical cost of AF. Stroke and heart failure are responsible for a large share of the total costs; therefore, implementing guidelines to cope with comorbidities in AF is a necessary step to improve health and mitigate healthcare costs. [ABSTRACT FROM AUTHOR]

• Patients with chronic low back pain have high healthcare resource utilization. • Majority of healthcare costs for chronic low back pain are from outpatient services. • Patients with chronic low back pain needed opioids years after initial diagnosis. • Diabetes, outpatient visits, and prescriptions are associated with high utilization. Chronic low back pain is a leading cause of morbidity and is among the largest cost drivers for the healthcare system. Research on healthcare resource utilization of patients with low back pain who are not surgical candidates is limited, and few studies follow individuals who generate high healthcare costs over time. This claims study aimed to identify patients with high-impact mechanical, chronic low back pain (CLBP), quantify their low back pain-related health resource utilization, and explore associated patient characteristics. We hypothesize that patients in the top quartile of healthcare resource utilization in the second year after initial diagnosis will continue to generate considerable back pain-related costs in subsequent years. IBM MarketScan Research Databases from 2009-2019 were retrospectively analyzed. Adults in the United States with an initial diagnosis of low back pain between 2010 and 2014 who did not have cancer, spine surgery, recent pregnancy, or inflammatory spine conditions, were identified using the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes. To ensure patients had chronic low back pain, it was required that individuals had additional claims with a low back pain diagnosis 6 to 12 and 12 to 24 months after initial diagnosis. Cost and utilization of inpatient visits, outpatient visits, emergency room visits, pharmacologic and nonpharmacologic treatment options and imaging for chronic low back pain. Annual back pain-related costs and the use of pharmacologic and nonpharmacologic treatments for 5 years were analyzed. Logistic regression was utilized to identify factors associated with persistent high spending. Of 16,917 individuals who met the criteria for chronic low back pain, 4,229 met the criteria for having high healthcare utilization, defined as being in the top quartile of back pain-related costs in the 12 to 24 months after their initial diagnosis. The mean and median back pain-related cost in the first year after an initial diagnosis was $7,112 (SD $9,670) and $4,405 (Q1 $2,147, Q3 $8,461). Mean and median back pain related costs in the second year were $11,989 (SD $20,316) and $5,935 (Q1 $3,892, Q3 $10,678). Costs continued to be incurred in years 3 to 5 at a reduced rate. The cumulative mean cost for back pain over the 5 years following the initial diagnosis was $31,459 (SD $39,545). The majority of costs were from outpatient services. Almost a quarter of the high utilizers remained in the top quartile of back pain-related costs during years 3 to 5 after the initial diagnosis, and another 19% remained in the top quartile for 2 of the 3 subsequent years. For these two groups combined (42%), the 5-year cumulative mean cost for back pain was $43,818 (SD $48,270). Patient characteristics associated with a higher likelihood of remaining as high utilizers were diabetes, having a greater number of outpatient visits and pharmacologic prescriptions, and lower utilization of imaging services. This is one of the first studies to use an administrative claims database to identify high healthcare resource utilizers among a population of United States individuals with nonsurgical, chronic low back pain and follow their utilization over time. There was a population of individuals who continued to experience high costs 5 years beyond their initial diagnosis, and the majority of individuals continued to seek outpatient services. Further longitudinal claims research that incorporates symptom severity is needed to understand the economic implications of this condition. [ABSTRACT FROM AUTHOR]

This paper reviews the basic issues involved in identifying and providing solutions to transport problems. The paper argues that solutions focusing solely on investment in capacity or second-best solutions to pricing such as road pricing and free public transport ignore the essential economic relationships involved in transport. The paper provides a critique of investment and pricing and argues for a more integrated approach in which optimal pricing is a core consideration in any investment decisions. This is seen as particularly important in a post Covid-19 world where many of the fundamental drivers of transport demand have changed, and public authorities face significant constraints on budgets whilst new pressures such as commitments to net zero in the face of global warming threats add additional pressures. The paper offers some thoughts on the principles involved in establishing a more suitable structure for dealing with the transport problem. • Identifies the core elements of the transport problem as pricing and investment. • Reviews problems in implementing first-best pricing. • Critiques investment decisions in the light of wider economic impacts. • Considers changes brought about by the Covid-19 pandemic and the move to net-zero. • Offers a set of principles for reforming transport policy. [ABSTRACT FROM AUTHOR]

• One Polish household wasted 0.56 kg of food per day. • In Polish households, fruit, vegetables, bread are wasted the most during the day. • Household characteristics explain food waste more than individual characteristics. • Single-person households waste more food products and semi-products than other. • On a per capita level Polish households with children waste less food. In Poland, to our best knowledge, none of the scientific publications produced to date have addressed the scale of wasted food in households and the impact of sociodemographic and economic factors on this. This study fills this research gap. The study was carried out in 2019 on a nationwide random-quota sample of 500 households, which are representative of all households. The survey was carried out in the respondents' homes for seven consecutive days. It consisted of an interview conducted by an interviewer (Computer-Assisted Personal Interviews method) and a paper diary completed by the respondents themselves. The aim of the study was to present the volume of wasted food, taking five groups into account,and to examine the impact of the sociodemographic and economic characteristics of the households and the person responsible for preparing meals on food waste. The results show that one person, on average, wasted 62.6 kg of edible food per year (98.2 kg of edible and inedible parts combined). According to the results, the most discarded food products include fruit and vegetables, bread, dairy products, drinks and juices, and cold cuts. Statistical analysis showed that the level of food waste in Polish households is conditioned by characteristics such as household size (persons), the presence and number of children, monthly income, as well as the characteristics of the person responsible for preparing meals, such as age and employment status. [ABSTRACT FROM AUTHOR]

The objective of the study was to estimate the economic cost benefit of funding influenza vaccination to all Australian adults 50–64 years and predict its effect on sudden cardiac arrest (SCA) deaths and hospitalisation. We combined SCA hospitalisation data from the Australian Institute of Health and Welfare (AIHW) with survival, vaccination, and cost parameters from published literature to create a model estimating the cost benefit of universally funded influenza vaccinations to prevent SCA deaths and hospitalisation. Costs were considered from a government perspective and included cost of vaccines and GP consultations, whilst averted deaths were estimated through the age-adjusted value of a statistical life. The target policy was estimated to prevent 278 SCA hospitalisations and 1269 SCA deaths. This would result in cost-savings of almost $4 billion annually, with an incremental benefit-cost ratio (BCR) of 59.94. The majority of savings were associate with averted deaths. When a sensitivity analysis was performed by altering statistical life year values and reducing life years left, the cost-saving remained significant with a minimum BCR of 29.97 derived. Reducing SCA through extended vaccination including adults 50–64 years is likely to be a cost beneficial policy from a governmental perspective. SCA deaths account for a significant economic loss due to the high mortality rate, which was far greater than the costs saved through averted hospitalisations. More accurate parameters are needed to improve the reliability of these estimate; however, this model can be used as a basis for further research into the economic impact of SCA. [ABSTRACT FROM AUTHOR]

This study explores the impact of arms embargoes on the economic performance of major international defense companies. The direction of this effect is not immediately clear as it relies on the embargo evading opportunities by exporting companies on the one hand and the stringency of enforcement by the sending state on the other. The main findings in this study indicate that the total revenues of a defense company significantly drop after the introduction of an arms embargo. As a result, the net profits of these companies are under downward pressure when the number of arms embargoes increases globally. It turns out that the ability of a firm to effectively mitigate the negative consequences of an embargo is both related to firm-specific particularities, such as the degree of diversification, as well as, country differences. For instance, the negative effect appears, in particular, to be present in countries with a strong rule of law or effective control of corruption. [ABSTRACT FROM AUTHOR]

Understanding the spatial–temporal dynamics of both natural and planted forests is critical for sustainable forest management and assessing ecological benefits or impacts. In 2020, China's forest area encompassed approximately 220 million hectares, accounting for around 5 % of the global forest area. Furthermore, China boasts the largest planted forest area worldwide. However, knowledge regarding the spatial–temporal dynamics of China's natural and planted forests has remained elusive. To fill this gap, we first generated wall-to-wall natural and planted forest maps at 30-m resolution for China every-five years from 1990 to 2020 by using 447,730 images from Landsat-4/5/7/8/9 surface reflectance archive and 656,920 field samples, which were a combination of crowdsourced data and expert knowledge. Secondly, we analyzed the spatial–temporal dynamics of natural and planted forests at multiple-scales from 1990 to 2020. The resultant maps achieved an overall accuracy ranging from 77.33 %±0.67 % to 81.78 % ± 0.59 % and revealed opposite trends in the areas of natural and planted forests from 1990 to 2020. During these three decades, China's planted forest area increased by 447,500 km2 while the natural forest area decreased by 219,100 km2. The spatial–temporal dynamics of China's natural and planted forests result from China's vast forest management programs in addition to social and economic factors. Variations of these factors at different scales not only determined the primary goals of protecting natural forests and expand planted forests but also resulted in increasing forest areas for many consecutive years by planting forests that offset the loss of natural forests. Our maps provide timely and valuable insights into the benefits and impacts of natural and planted forests in China, which are both closely linked to sustaining human well-being. [ABSTRACT FROM AUTHOR]

Most migration studies and theories focus on understanding the initial migration of people from their home country. Less attention has been paid to the factors influencing immigrants' preferences to either permanently settle in the host country, return to their home country or move onwards to another destination. Understanding the characteristics and motives of those who aspire to leave the host country is, however, valuable for both host and home countries to formulate appropriate and effective policies in order to retain their valued immigrants or citizens and foster their successful (re-)integration. This paper provides a comprehensive global analysis of the characteristics and circumstances that shape first-generation immigrants' aspirations to stay, return or migrate onwards, based on individual-level data from the Gallup World Polls across 138 countries worldwide between 2009 and 2016. Our study reveals that immigrants' stated preferences are strongly influenced by demographics, human and spiritual capital, as well as by soft factors, such as social ties and sociocultural integration, while economic factors have a more feeble influence. Changes in circumstances in the home and host countries are also important determinants of locational aspirations. Some interesting exceptions to our results stand out when we differentiate home and host countries by their economic development levels. [ABSTRACT FROM AUTHOR]

• Explored the impact of environmental policies on nuclear trade within the EU. • Uncovered connection between environmental policies and nuclear trade relationships. • Countries pursuing environmental policies rely less on nuclear-related imports. • Nuclear trade rises as EU environmental policies align. • Environmentally friendly exporting countries shape the nuclear trade network evolution. This study explores the impact of environmental policies on nuclear trade between European Union (EU) countries. The primary research question revolves around understanding the reasons behind and the mechanisms through which nuclear trade relationships evolve. Our analysis uncovers a compelling connection between the degree of alignment in environmental policies among EU states and the emergence of nuclear trade cooperation. Furthermore, it indicates that countries actively pursuing environmental policies tend to have a reduced dependency on imports of nuclear-related goods. Notably, as environmental policies across the EU converge and become more similar, there is a noticeable inclination to engage in nuclear trade activities. Additionally, our research highlights the significant role played by exporting countries that have strong commitments to environmentally friendly policies in shaping the evolution of the nuclear trade network over time. Moreover, we observe that economic factors have a positive impact on the development of this intricate trade network. [ABSTRACT FROM AUTHOR]

• Economic miracles, such as the Asian miracles, are not statistical accident to be ignored, and they are not as rare as commonly assumed i.e., the distribution of cross-country long-term growth follows a Power law. • Disentangling the role of policies from luck implies that economic miracles are alike, and every failure is a failure in its own way. High and sustained growth depends on maintaining the best possible policies while not being too unlucky. • The relatively few successes in achieving high and sustained growth such as the Asian miracles should constitute a focal point for the study of development policies. • In contrast, results derived from a large pool of development failures should be taken with skepticism, especially if it is based on the study of growth in the short to medium run. We show evidence that development "miracles," such as the Asian Miracles, may not be that rare as the distribution of cross-country long-term growth follows a Power Law. We propose a growth theory, disantangling the role of policies from luck, which is consistent with this stylized fact and predicts that high growth depends on maintaining the best possible policies while not being too unlucky. We argue that miracles are all alike and every failure is a failure in its own way, suggesting that the few growth miracles hold more clues about good policies than the vast number of growth failures. We infer important implications for the study of economic development. [ABSTRACT FROM AUTHOR]

This study aimed to develop the scoring functions for the recently developed value assessment framework (VAF) for China, which comprises 12 attributes. We implemented a factorial survey among Chinese healthcare stakeholders from July to September 2022. A total of 240 hypothetical drug value profiles described by the VAF were grouped into 60 blocks and randomly assigned to respondents. Each respondent was assigned with 1 block, each presented in 3 disease scenarios of different levels of severity. For each profile, respondents were asked to assess the drug's value on a scale from 0 (lowest) to 10 (highest) and make 1 of the 3 insurance recommendations: cover, to be negotiated for coverage, or reject. Linear and logistic mixed-effects models were used to develop scoring functions for aggregating the value attributes. A total of 365 respondents participated in the survey. 3968 responses from 331 respondents were included in the analysis. Most of the included respondents were under 45 (n = 256, 77.3%), females (n = 208, 62.8%), living in urban areas (n = 296, 89.4%), and with a bachelor's degree or higher (n = 303, 91.5%). Health benefits and safety carried more weights than other attributes in the scoring functions across disease scenarios. The value and probability of entering negotiation or receiving insurance coverage for the attribute profiles for severe/critical disease were higher than for mild/moderate disease. The scoring functions of the VAF can be used to assess the value of a drug and its probability of entering negotiation or receiving insurance coverage in China. • Through qualitative interviews and document analysis, 12 attributes grouped in 8 categories were identified and included in a value assessment framework for China. The value assessment framework comprises severity of disease, health benefits, safety, economic impact, innovation, organizational impact, health equity, and quality of evidence. • We conducted a factorial survey in which 240 value profiles with 10 attributes experimentally varying in their levels were randomly assigned to 365 healthcare stakeholders in China to assess the value of hypothetical drugs and make insurance coverage recommendations. • The scoring functions can be used to estimate the value of a drug and the probability of its entering negotiation or receiving coverage in China in different disease scenarios. In the scoring functions for severe/critical disease or mild/moderate disease, health benefits and safety carried higher weights than other attributes. The value and probability of entering negotiation or receiving insurance coverage are higher for attribute profiles for severe/critical disease than for mild/moderate disease. [ABSTRACT FROM AUTHOR]

The envisioned role for Türkiye in the context of Europe's energy strategies should be crucial. By promoting countries like Türkiye can contribute significantly to global efforts in advancing sustainable energy transitions. Moreover, Incorporating Türkiye into Europe's energy strategies can reduce reliance on external energy suppliers and enhance energy security. The findings of this study offer fresh perspectives on the intricacies of the energy system dynamics and make valuable contributions to the ongoing discourse surrounding transition routes. The study takes into account several key aspects, including the current state of hydrogen in Türkiye, the country's potential for renewable energy, the existing policy and regulatory framework, and the necessary infrastructure and market conditions required for the establishment of a hydrogen hub. These insights shed light on the feasibility and viability of hydrogen as an indispensable component within the context of Türkiye 's energy landscape, offering valuable guidance for policymakers, industry stakeholders, and researchers involved in shaping the future of the energy sector. • The envisioned role for Türkiye in the context of Europe's energy strategies. • Insights and perspectives on energy dynamics, enrich discourse on transition routes. • EU-Türkiye green Hydrogen collaboration overcomes political setbacks, forging a transformative alliance. • Türkiye has the potential to seize a significant market share and enhance the value of its expansive territory. • Türkiye and Europe can develop clean energy by transporting pure hydrogen or blending it with natural gas. [ABSTRACT FROM AUTHOR]

Tuberculosis remains a major public health problem in South Africa, with an estimated 300,000 cases and 55,000 deaths in 2021. New tuberculosis vaccines could play an important role in reducing this burden. Phase IIb trials have suggested efficacy of the M72/AS01 E vaccine candidate and BCG-revaccination. The potential population impact of these vaccines is unknown. We used an age-stratified transmission model of tuberculosis, calibrated to epidemiological data from South Africa, to estimate the potential health and economic impact of M72/AS01 E vaccination and BCG-revaccination. We simulated M72/AS01 E vaccination scenarios over the period 2030–2050 and BCG-revaccination scenarios over the period 2025–2050. We explored a range of product characteristics and delivery strategies. We calculated reductions in tuberculosis cases and deaths and costs and cost-effectiveness from health-system and societal perspectives. M72/AS01 E vaccination may have a larger impact than BCG-revaccination, averting approximately 80% more cases and deaths by 2050. Both vaccines were found to be cost-effective or cost saving (compared to no new vaccine) across a range of vaccine characteristics and delivery strategies from both the health system and societal perspective. The impact of M72/AS01 E is dependent on the assumed efficacy of the vaccine in uninfected individuals. Extending BCG-revaccination to HIV-infected individuals on ART increased health impact by approximately 15%, but increased health system costs by approximately 70%. Our results show that M72/AS01 E vaccination or BCG-revaccination could be cost-effective in South Africa. However, there is considerable uncertainty in the estimated impact and costs due to uncertainty in vaccine characteristics and the choice of delivery strategy. This work was funded by the Bill & Melinda Gates Foundation (INV-001754). This work used the Cirrus UK National Tier-2 HPC Service at EPCC (https://www.cirrus.ac.uk) funded by the University of Edinburgh and EPSRC (EP/P020267/1). [ABSTRACT FROM AUTHOR]

• Child pedestrian injuries in Greater London are studied. • A host of exposure measures, built environment and socio-economic factors are considered. • School enrolment was found to be a better proxy exposure measure compared to number of schools. • Social inequities are found to be strongly associated with child pedestrian safety. Introduction: Child pedestrian safety remains a challenge despite the remarkable progress that has been attained in recent years, particularly, in high income jurisdictions such as London. This study sought to identify and quantify the magnitude of the effects of various explanatory variables, from the domains of transport, built and natural environment, socio-demographic and economic factors, on ward level child pedestrian injury frequencies in Greater London. Method: We adopted a multilevel random parameters model to investigate the factors associated with child pedestrian injuries given the hierarchical nature of the data comprising of wards nested within boroughs. Results: We found that crime, the Black, Asian, and Minority Ethnic (BAME) population, school enrollment, and the proportion of the population who walk five times a week had an increasing effect on the number of child pedestrian casualties. Conversely, the proportion of the population with a level 4 qualification and the number of cars per household had a decreasing effect. Conclusions: Our study identified high child pedestrian injury frequency wards and boroughs: Stratford and New Town had the highest expected child pedestrian injury frequencies followed by Selhurst, Westend, and Greenford Broadway. Some inner London boroughs are among the highest injury frequency areas; however, a higher number of high child pedestrian injury boroughs are in outer London. Practical Applications: The paper provides recommendations for policy makers for targeted child pedestrian safety improvement interventions and prioritization to optimize the utilization of often constrained resources. The study also highlights the importance of considering social inequities in policies that aim at improving child traffic safety. [ABSTRACT FROM AUTHOR]

We use an art-based approach to engage and involve members of African, African Caribbean and Muslim communities' in exploring barriers to accessing and using mental health services in the co creation and co-production of mental health communication material. A creative practice approach underpinned by the principles of participatory action research was used. Seven community-based interactive workshops were held between February and June 2022 at three community centres in Nottingham, UK Attendees were invited to take part in open discussions around the conceptualisations of mental health, well-being and emotional health and to draw or describe their experiences of accessing mental health services. Attendance was higher than anticipated, with 72 individuals from African, African Caribbean and Pakistan communities taking part in the workshops. What emerged was the low level of understanding of the services available in addressing mental health. In addition, it was felt that health professionals in the National Health Service (NHS) do not sufficiently acknowledge or consider the ethnic, social, cultural and economic factors influencing the mental health and emotional well-being of minoritised communities. Attendees critiqued and provided feedback on service providers' posters and leaflets. They commented on the lack of key information provided, the inclusion of what was viewed as irrelevant content and the use of unfamiliar terminology. Some attendees created mock-ups of what they believed a good poster should look like. A creative practice approach that follows the principles of participatory action research can play an important role in engaging members of minoritised communities in the co-production and co-design of services. This approach highlighted the need to establish trust and shared ownership among marginalized communities affected by inequities of mental health service provision. [ABSTRACT FROM AUTHOR]

• We propose an advanced model to assess municipal waste management impacts. • We propose an approach to improve data reporting on generated waste amounts. • The C-footprint varies from a burden of 539 to a saving of 490 kg CO 2 -eq. t−1. • The cost of managing municipal waste in EU27 averages 162 EUR t−1. • The Full-Environmental-Cost of managing municipal waste in EU27 averages 109 EUR t−1. The Monitoring Framework proposed in the EU27 New Circular Economy Action Plan comprises two mass-based indicators, namely overall recycling rate and recycling rate for specific waste streams. Yet, to monitor and assess the impacts of circular economy, indicators cannot be limited to mass-based indicators; we argue assessments should also include environmental and economic effects. Towards this end, these impacts can be quantified by an advanced model based on life cycle thinking, entailing the use of life cycle assessment and costing (LCA/LCC). Calculating these effects for municipal waste management is challenging due to gaps in available data for estimating generated waste. We propose a methodology to estimate more finely the amounts of waste generated in the Member States, complemented with LCA/LCC. The results highlight that important inconsistencies in municipal waste data reporting exist and that recycling rates calculated from these are lower than hitherto estimated. The impacts quantification shows great performance variation across EU27, with C-footprint ranging from −490 to 539 kg CO 2 -eq. t−1. Potentials for improvement are substantial and can bring up to 103 Mt CO 2 -eq. additional annual saving, reducing costs (calculated as Full Environmental LCC) of waste management by 8.4 billion EUR and bringing 206,100 new jobs in the sector. The approach presented highlights the rationale for improved data management on waste statistics and the potential for harmonised models. It also paves the way for more sophisticated impact analyses relevant for policymaking, by bringing a richer perspective to the environmental and economic impacts of waste management on top of tracking generated, collected and recycled waste flows. [ABSTRACT FROM AUTHOR]

Depression affects approximately 4 % of the global population and has huge social and economic implications. Social factors, including support, engagement, and stigma, play a crucial role in the development and severity of depression. We provide a synthesis of the consistency and magnitude of the association between measures of social connection and depression. We searched PubMed, PsycINFO, Cochrane Library, and EMBASE and 47 meta-analyses were included in the umbrella review. The strength of the associations was extracted and compared among different populations. The quality/certainty of evidence was assessed using AMSTAR-2 and GRADE tool. Results indicate that social support serves as a protective factor against depression, particularly in peripartum populations, while its impact is weaker in clinical populations. No association was found between social support and depression in post-disaster populations. Stigma and discrimination favour the development and maintenance of depressive symptoms in clinical populations, but have a weaker effect in ethnic minorities. The quality and certainty of evidence should be taken into account when interpreting our findings. Further research with more rigorous methodology and higher-quality evidence is needed to better understand the complex relationship between depression and social connection across various populations and contexts. Our findings confirm the role of social determinants in the emergence and severity of depression, particularly in the case of vulnerable populations. Efforts to counteract disconnection at the societal and individual levels and to reduce stigma should be central to an effective depression prevention agenda. • Social determinants play a significant role in influencing health. • Social connection represents a major protective/risk factors for depression. • Social support is protective against depression, especially in peripartum populations. • Stigma/discrimination represents risk factors for depression in clinical populations. • Social determinants should be central to an effective depression prevention agenda. [ABSTRACT FROM AUTHOR]

This study examined the threshold effect of debt on economic growth in Nigeria, with a view to investigating debt sustainability levels in the country. The analysis included yearly data from 1981 to 2021. To achieve its objectives, the study used two-regime threshold ARDL regression approaches. Findings reveal that the optimal thresholds for total debt as a ratio of GDP (TDB/GDP), GNI (TDB/GNI), total revenue (TDB/REV), and exports of goods and services (TDB/EXP) are 46.1%, 54.5%, 355.3%, and 24.9%, respectively. Findings also indicate that debt ratios below the threshold levels have a significant positive impact on economic growth. This is true for all the debt ratios, except debt-to-export ratio. However, debt ratios above the threshold levels have a negative and significant effect on Nigeria's economic growth. Furthermore, findings reveal that only the level of domestic debt is sustainable over the long and short run, whereas external debt and total debt are only sustainable over the long run. When expressed as ratios of GDP and GNI, evidence indicates that Nigeria's debt is not sustainable by all the five measures of debt adopted in the study, both in the short run and in the long run while total debt to revenue ratio is only sustainable only in the long run. The paper adequately explores the implications of these findings and offers relevant policy recommendations. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to examine the socio-demographic and economic factors associated with the consumption of processed foods in South Africa. This is an empirical study where secondary data analysis was performed from the South African Demographic and Health Survey VII. A nationally representative sample of 10,336 participants (aged ≥15 years) was included in the analysis. Using regression models, we studied the association between socio-demographic and economic predictors and the intake of processed foods. The regression models found that the odds of consumption of any type of processed foods were significantly high in all South African provinces but specifically higher in urban settings, those with any level of education, and young adults. The odds of processed meat consumption were significantly higher among the coloured population, while that of fried food, fast food, and salty snacks was significant in the white population. The odds of consumption increased irrespective of marital status and were higher among males, specifically among those in the poorer and poorest wealth quintiles. These findings warrant advocacy and action for healthy food choices in the population. The role of industry, ethnic vulnerability, and gender stereotypes in food preparation are areas that need priority attention. [ABSTRACT FROM AUTHOR]

Emissions from road traffic, power generation and industry were substantially reduced during pandemic lockdown periods globally. Thus, we analysed reductions in traffic-related air pollution in Australian capital cities during March–April 2020 and then modelled the mortality benefits that could be realised if similar reductions were sustained by structural policy interventions. Satellite, air pollution monitor and land use observations were used to estimate ground-level nitrogen dioxide (NO 2) concentrations in all Australian capital cities during: (a) a typical year with no prolonged air pollution events; (b) a hypothetical sustained reduction in NO 2 equivalent to the COVID-19 lockdowns. We use the WHO recommended NO 2 exposure-response coefficient for mortality (1.023, 95 % CI: 1.008–1.037, per 10 μg/m3 annual average) to assess gains in life expectancy and population-wide years of life from reduced exposure to traffic-related air pollution. We attribute 1.1 % of deaths to anthropogenic NO 2 exposures in Australian cities, corresponding to a total of 13,340 years of life lost annually. Although COVID-19-related reductions in NO 2 varied widely between Australian cities during April 2020, equivalent and sustained reductions in NO 2 emissions could reduce NO 2 -attributable deaths by 27 %, resulting in 3348 years of life gained annually. COVID-19 mobility restrictions reduced NO 2 emissions and population-wide exposures in Australian cities. When sustained to the same extent by policy interventions that reduce fossil fuel consumption by favouring the uptake of electric vehicles, active travel and public transport, the health, mortality and economic benefits will be measurable in Australian cities. [Display omitted] [ABSTRACT FROM AUTHOR]

Limitations in conventional cost-effectiveness methods have led to calls for incorporation of additional value elements in assessments of health technologies. However, gaps remain in how additional value elements may inform decision making. This study aimed to prioritize additional value elements from the perspective of healthy individuals without a specific condition or indicated for a specific treatment in the United States among a multistakeholder panel and compare the importance of perspective-specific value elements. Additional value elements were prioritized in 2 phases: (1) we identified and categorized additional value elements in a targeted literature review, and (2) we convened a multistakeholder group-based preference elicitation study (N = 28) to evaluate the description of each value element and rank and generate normalized weights of each value element for its significance in value assessment. The importance of additional value elements was also weighted relative to patient-centric value elements. The rank and weight of contextual value elements among 28 stakeholders were "severity of the disease" (26.2%), "disadvantaged and vulnerable target populations highly represented" (21.8%), "broader economic impact" (17.3%), "risk protection" (13.8%), "rarity of the disease" (11.3%), and "novel mechanism of action" (9.7%). Relative weight of the additional value elements versus patient-centric value elements was 52% and 48%, respectively. Study findings may inform priority setting for value frameworks and emerging US government assessments. The group-based elicitation method is repeatable and useful for structured deliberative processes in value assessment and may help improve the consistency and predictability of what is important to stakeholders. • To address some remaining gaps in value assessment when considering additional value elements, we conducted a group-based preference elicitation study to separate and prioritize additional value elements by perspective. • The elicitation method is reproducible, not resource intensive, and designed to incorporate additional value elements beyond those included in current US value assessment. • Future research on additional value elements among general US population members may inform efficient allocation of research and development costs for companies developing innovative technologies. [ABSTRACT FROM AUTHOR]

The performance of robots working alongside humans might positively or negatively affect humans' earnings, depending on the economic setting. In a new real-effort lab experiment, we study the impact of economic conditions in hybrid human-robot workplaces on workers' effort provision and attitudes. In a previous subtractive -earnings experiment (Kshirsagar et al., 2019), subjects' expected earnings negatively depend on a robot's performance, while in our new additive -earnings experiment, they depend on the robot's performance positively. Both experiments are guided by a past human-human experiment and by a model of expectations-based reference-dependent preferences. As the theory predicts and as previously found, increasing robot performance discourages effort under subtractive earnings—but, as the theory also predicts and as we find here, this effect disappears and perhaps reverses under additive earnings. Additionally, increasing robot performance negatively affects subjects' perceptions of themselves and of their robotic coworker under subtractive earnings, but we find that these effects weaken or reverse under additive earnings. These findings suggest a relationship between workers' earning structures and robots' performance that should be considered when designing hybrid workplaces. [ABSTRACT FROM AUTHOR]

The Planetary Defense Conference 2023 addressed an asteroid threat scenario as difficult to confront. This article examines potential actions of relevant stakeholders, including States, the International Asteroid Warning Network, the Space Mission Planning Advisory Group, Committee on the Peaceful Uses of Outer Space, and the United Nations Security Council. To that effect, different sources are taken into consideration in this analyisis, such as the legal international framework, the practice of States in multilateral fora and the opinion of scholars. The conclusions shed light on the challenges that the international community will have to face and proposes a preventive approach to mitigate the impact of such a potential catastrophe. • The impact of a huge asteroid would have catastrophic consequences on Earth. • Deflection would be difficult or impossible with a 12.5-year lead time. • Several issues would play out within the international scientific community. • Legal, social and economic aspects that governments will address are presented. [ABSTRACT FROM AUTHOR]

To evaluate the association of state-level lack of health insurance among women of reproductive age with variation in state low birth weight (LBW) rates. This cross-section study analyzes data from the 2016–2019 Pregnancy Risk Assessment Monitoring Survey for respondents with singleton, live births. Respondents were divided into groups by state-level percent of uninsured women aged 19–44 years. Poisson regression was used to model the association between state percent uninsured and likelihood of LBW, controlling for individual sociodemographic and clinical risk factors. Sensitivity analyses were done for Medicaid and non-Hispanic Black subpopulations and alternative state characteristics, including Gini coefficients, total and public welfare expenditures, and state reproductive rights rankings. In adjusted multiple regression analyses, compared to respondents from states with <7% uninsured, respondents from states with 7% or more uninsured had an increased risk of LBW status (7–8.99% uninsured: adjusted incidence rate ratio [aIRR] 1.11, 95% confidence interval [CI] 1.04–1.18; 9–11.99% uninsured: aIRR 1.09, 95% CI 1.02–1.17; >11.99% uninsured: aIRR 1.15, 95% CI 1.08–1.22). However, there was no evident dose–response gradient. Sensitivity analyses produced virtually identical findings for subpopulations, and no other state characteristics were significant. States with the highest level of insurance coverage had a significantly lower LBW rate than other states. However, there was little evidence for greater odds of LBW with the highest levels of uninsured. Individual risk factors dominated LBW models, while state differences in income inequality, reproductive health policy, and per capita spending explained little of the variance in LBW. [ABSTRACT FROM AUTHOR]

This paper analyses the EU's strategy for recovering from the economic and social consequences of the pandemic, of which the NextGenerationEU temporary stimulus package forms part. That strategy is compared to the diametrically opposite approach taken by EU institutions in the crisis of 2008. The most significant elements and economic policy references adopted in the two cases are identified. The paradigm shift in economic policy is evident, and the errors that led to a double dip in European economies in the handling of the earlier crisis have been avoided. In spite of the better discretionary response, it is argued that there is a need for a permanent, amply endowed, well-designed European stabilisation mechanism free from complexes in regard to the mutualisation of debt, so as to simplify procedures and reduce reaction times in the face of further crises. [ABSTRACT FROM AUTHOR]

• Examine industrial trends in six Central American economies, and find that the industrial employment share has declined by an average of 2.5 percentage points over the past two decades. • Decline not due to a trade-driven deindustrialization but rather due to an increase in barriers that restrict the efficient flow of labor across sectors. • Policy interventions targeting these barriers could potentially lead to significant industrial expansion, but the economic impact may be marginal, with aggregate output projected to increase by 3.2 percent or less. • Boosting productivity could be a more prudent growth strategy. This paper analyses industrial trends in six Central American economies by assembling and harmonizing sectoral data from multiple sources. Industrial employment share has declined by an average of 2.5 percentage points over the past two decades. Contrary to a trade-driven deindustrialization hypothesis, which suggests that cheaper imports have replaced domestic production of industrial goods, the findings indicate that this decline is primarily driven by an increase in barriers that restrict the efficient flow of labor across sectors. The paper argues that policy interventions that target these barriers could potentially lead to significant industrial expansion. However, the economic impact of such policies may be marginal, with aggregate output projected to increase by 3.2 percent or less upon eliminating these barriers. Moreover, this approach also carries risks, as it may introduce new distortions that could further hinder economic efficiency. Perhaps a more prudent growth strategy will be to concentrate on boosting productivity, which though challenging, directly affects the output. [ABSTRACT FROM AUTHOR]

• A new index is proposed to quantify the economic impact of COVID-19 on countries. • The index shows an extreme heterogeneity in the economic impact of COVID-19. • The factors behind this heterogeneity are explored using regression techniques. • The analysis includes pandemic-specific factors and structural factors. • Results stress the importance of industrial development for resilience. The socioeconomic impact of COVID-19 has been widely uneven across regions and countries, reflecting underlying differences in their resilience against shocks. This paper tries to explain this heterogeneity by identifying factors of resilience and vulnerability. To fully capture the impact of the crisis on economic activity, we propose a novel index of GDP loss that measures both the initial shock and recovery rate at the country level. With a dataset of 125 countries, we implement cross-sectional regression techniques to estimate the impact of pandemic-specific and structural factors on the index. The focus of the analysis is placed on a dimension that was not sufficiently explored yet in the specialized literature: the role of industrial capabilities. Results show that industrial capabilities were crucial in supporting countries' ability to absorb and resist the global shock. The paper thus provides new empirical evidence on the role played by manufacturing industries in strengthening resilience to face unexpected events. [ABSTRACT FROM AUTHOR]

The usefulness of transportation project evaluation depends on the completeness of its benefit measures. Since transportation networks are intrinsically spatial, transportation improvement projects have spatial access and location characteristics that can lead to a variety of non-user economic benefits. Recent research has enabled us to better understand how spatial context and spatial heterogeneity play further roles in generating efficiency gains for non-users, in the form of productivity, income, and cost savings for both private and public sectors of the economy. This paper draws upon that body of research to expand our understanding of the means by which transportation projects can generate economic efficiency gains, and approaches needed to measure them. It covers topics beyond those captured by current definitions of "wider economic benefits," including additional sources of scale economies associated with freight distribution and connectivity, and further public and private sector economic gains enabled by environmental and social inclusion improvement. It points to ways that non-user economic benefits can be more comprehensively defined and better measured by recognizing their spatial scale, context, and threshold effects. It also identifies ways that current benefit measurement methods introduce unintended bias into transportation investment decision-making through omission and mismeasurement. The result is a case for a refresh of thinking about how we classify and recognize non-user economic benefits in transportation evaluation, and how we apply transportation planning and economic models to support their measurement. • Transport decisions biased when non-user benefits are ignored or mis-measured. • Non-user economic benefits depend on spatial access, proximity, or connectivity. • Spatial scale, context, and heterogeneity affect measurement of non-user benefit. • Benefits from freight density, virtual density, effective density, non-user cost. • Rigid travel modeling standards hold back non-user benefits. [ABSTRACT FROM AUTHOR]

The incidence of Japanese Encephalitis (JE) in Bali Province remains high, and is one among the highest in Indonesia. The Indonesian Government initiated the JE vaccination campaign followed by a JE vaccine introduction program in Bali Province in 2018. The JE vaccination program then has been fully integrated into the provincial routine immunization program since 2019. We conducted a retrospective economic analysis of JE vaccination program in Bali Province, Indonesia; considering multiple vaccination strategies. We conducted a cost-effectiveness analysis using a decision analytic model comparing two vaccination strategies with no vaccination from the societal and government perspectives. These vaccination strategies were: (1) JE vaccination campaign and introduction program, and (2) a routine JE vaccination program. We compared costs and outcomes for three hypothetical cohorts of 100,000 children followed from birth to the age of 10 years, with impacts measured throughout the child's life-time. We measured the economic consequences as costs per case, per death, and per disability-adjusted life year (DALY) averted. A routine JE immunization program was the most cost-effective strategy with a cost per DALYs averted of US$ 212.59 and US$ 94.09 from the government and societal perspectives respectively. In contrast, costs per DALYs averted through the JE vaccination campaign and introduction strategy was US$ 1,473.53 and US$ 1,224.20 from the government and societal perspectives respectively. Both JE vaccination strategies are cost-effective but they are not cost-saving when compared to no immunization program. [ABSTRACT FROM AUTHOR]

• Cultural heritage institutions are evaluated by combining objective and subjective value indicators that reveal their economic value and social impact. • Services linked to public goods are higher valuated than those closer to the market. • The most satisfied users are more likely to make a monetary contribution. • Results justify the function of libraries as providers of public goods and enhancing social wellbeing. • The set of public libraries in Medellín is taken as a case study, enlarging applications in developing countries. Evaluation of cultural heritage organisations and the returns on the resources they are provided with is becoming increasingly important, not only because of the economic efficiency implications but also vis-à-vis measuring their performance in terms of social policy and public governance. The present study seeks to estimate the social impact of libraries, as heritage representative institutions, from the case of the Medellin Public Library System (Spanish acronym – SBPM) in Colombia. This network of libraries is made up of 26 units that – in addition to traditional functions involving loans and custody – offer activities geared towards personal development and the enhancement of the community. The proposed method entails a combination of direct observation indicators together with other indirect or subjective indicators aimed at gauging social impact, applying two different yet complementary techniques; social return on investment (SROI), and contingent valuation (CV). The indicators obtained evidence different results when including subjective valuations in the calculations based on direct observations and financial returns, in line with the differences between the notions of price and value. Based on the findings to emerge, we show that public libraries are socially viable institutions and that they contribute towards the subjective well-being of their users, thereby legitimizing the public investment made to ensure their existence and functioning in the areas where they are located. [ABSTRACT FROM AUTHOR]

This paper uses a recursive dynamic general equilibrium model to study the impact of the 2015 terrorist attacks in Tunisia. It examines the government's fiscal responses: increased security spending and the reduction of the tourism sector's value-added tax (VAT) rate. It finds that these responses accounted for a significant share of the attacks' total cost. The results also underscore the need for a comprehensive approach to addressing the economic consequences of terrorism. Increased security spending mitigates future risks but does not directly help the affected sector. Direct support to the sector by reducing VAT has an immediate and positive impact. [ABSTRACT FROM AUTHOR]

Semi-subsistence households in developing countries play a considerable role as both producers and consumers of agricultural products, with a substantial part of their consumption contributed by home production for home consumption (HPHC). This study employs a modeling framework that integrates an HPHC augmented database with a modified economywide model that accommodates the distinct features of these households. Results from model simulations with border price shocks and several policy responses indicate that farm households are less influenced by external price shocks but are more responsive to enhancements in the local marketing system. Subsidies to strategic non-food imports during soaring prices appear less effective in inducing agents to engage in production. This finding suggests that the welfare gains reported by studies on price incentives locally, and agricultural policy reforms in developed market economies are likely to be large overestimates of the welfare implications for semi-subsistence households in many of the least developed economies. [ABSTRACT FROM AUTHOR]

The area adjacent to the milking parlor, accessible for grazing by lactating dairy cows (i.e., the grazing platform [GP]), can be limited on fragmented pasture-based dairy farms. Such farms, with a moderate overall farm stocking rate, typically have a much higher stocking rate of dairy cows on the GP. This study quantified the effects of farm fragmentation on milk and herbage production and profitability in a whole-farm systems-scale study over 3 yr (2017–2019). Four systems, each with an overall farm stocking rate of 2.5 cows/ha but with different grazing platform stocking rates (GPSR), were examined. The proportions of the overall farm area within the GP were 100%, 83%, 71%, and 63% in each of the 4 systems, respectively. Hence, the 4 systems had a GPSR of 2.5, 3.0, 3.5, and 4.0 cows/ha. The GP was used for grazing and silage (ensiled herbage) production, and the non-GP portion of each GPSR system was used solely for silage production. Concentrate supplementation per cow was the same across all GPSR systems; approximately 10% of the annual feed budget. All systems were compact spring-calving with 24 cows per system. We discovered a lower proportion of grazed herbage in the diet with higher GPSR. All silage produced on the non-GP areas was required to support higher GPSR on each of the systems. Annual herbage production and milk production per cow were not different between GPSR systems, resulting in similar milk production per hectare of the overall system area. The economic implications of different GPSR on fragmented farms were modeled in 2 scenarios: (1) quantifying the cost associated with different levels of farm area fragmentation; (2) investigating the optimum GPSR on fragmented pasture-based dairy farms, depending on variable criteria. A greater level of farm fragmentation lowered the profitability of pasture-based dairy production. Costs of production increased with higher GPSR and longer distances between GP and non-GP areas. At a fixed GP area, it was most profitable to increase GPSR up to 4 cows/ha on the GP when milk price was high, land rental price was low, and shorter distance existed between GP and non-GP areas. [ABSTRACT FROM AUTHOR]

Home blood pressure monitoring is more convenient and effective than clinic-based monitoring in diagnosing and managing hypertension. Despite its effectiveness, there is limited evidence of the economic impact of home blood pressure monitoring. This study aims to fill this research gap by assessing the health and economic impact of adopting home blood pressure monitoring among adults with hypertension in the U.S. A previously developed microsimulation model of cardiovascular disease was used to estimate the long-term impact of adopting home blood pressure monitoring versus usual care on myocardial infarction, stroke, and healthcare costs. Data from the 2019 Behavioral Risk Factor Surveillance System and the published literature were used to estimate model parameters. The averted cases of myocardial infarction and stroke and healthcare cost savings were estimated among the U.S. adult population with hypertension and in subpopulations defined by sex, race, ethnicity, and rural/urban area. The simulation analyses were conducted between February and August 2022. Compared with usual care, adopting home blood pressure monitoring was estimated to reduce myocardial infarction cases by 4.9% and stroke cases by 3.8% as well as saving an average of $7,794 in healthcare costs per person over 20 years. Non-Hispanic Blacks, women, and rural residents had more averted cardiovascular events and greater cost savings related to adopting home blood pressure monitoring compared with non-Hispanic Whites, men, and urban residents. Home blood pressure monitoring could substantially reduce the burden of cardiovascular disease and save healthcare costs in the long term, and the benefits could be more pronounced in racial and ethnic minority groups and those living in rural areas. These findings have important implications in expanding home blood pressure monitoring for improving population health and reducing health disparities. [ABSTRACT FROM AUTHOR]

To evaluate how educational, economic, and racial residential segregation may impact congenital heart disease infant mortality (CHD-IM). This is a population-based US ecological study. This study evaluated linked live birth-infant death files from the National Center for Health Statistics for live births from 2006 to 2018 with cause of death attributed to CHD. Maternal race and education data were obtained from the live birth-infant death files, and income data were obtained from the American Community Survey. A spatial social polarization measure termed the Index of Concentration at the Extremes (ICE) was calculated and split by quintiles for maternal education, household income, and race for all US counties (n = 3142). The lowest quintile represents counties with highest concentration of disadvantaged groups (income < $25K, non-Hispanic Black, no high school degree). Proximity to a pediatric cardiac center (PCC) was also analyzed in a categorical manner based on whether each county was in a metropolitan area with a US News and World Report top 50 ranked PCC, a lower ranked PCC, or not proximal to any PCC. Between 2006 and 2018, 17,489 infant deaths were due to CHD, an unadjusted CHD-IM of 0.33 deaths per 1000 live births. The risk of CHD-IM was 1.5 times greater among those in the lowest ICE-education quintile (0.41 [0.39–0.44] vs 0.28 deaths/1000 live births [0.27–0.29], P < 0.0001) and the lowest ICE-income quintile (0.44 [0.41–0.47] vs 0.29 [0.28–0.30], P < 0.0001) in comparison to those in the highest quintiles. CHD-IM increases with higher ICE-race value (counties with a higher concentration of non-Hispanic White mothers). However, after adjusting for proximity to a US News and World Report top 50 ranked PCC in the multivariable models, CHD-IM decreases with higher ICE-race value. Counties with the highest concentration of lower-educated mothers and the highest concentration of low-income households were associated with higher rates of CHD-IM. Mortality as a function of race is more complicated and requires further investigation. [ABSTRACT FROM AUTHOR]

There is extensive evidence documenting the economic consequences of discrimination patterns between individuals belonging to the same or different group identities. However, many group identities rely on convictions and beliefs that are non-observable, and therefore, might be uncertain. This paper investigates the effects of group identity uncertainty on individual interaction preferences and willingness to coordinate. Results from a laboratory experiment using a weakest-link game with endogenous group formation show that group identity uncertainty and diversity differently affect individual interaction preferences. Interestingly, the negative discrimination against individuals with a different group identity weakens and vanishes faster than the negative discrimination against individuals whose group identity is not observable. Furthermore, most discrimination patterns vanish when interactions entail high and mutual economic incentives for individuals. The findings offer several managerial implications for deterring discrimination and increasing coordination efficiency in teams. [ABSTRACT FROM AUTHOR]

The last decade witnessed a wide expansion of a fossil fuel divestment movement. Fossil fuel free (FFF) financial products—which are portfolios that exclude companies involved in the production of oil, gas, and coal—have proliferated, initiating a debate on their financial and ecological implications for economic agents. This paper examines whether and the extent to which these financial products are immune to fluctuations in the price of fossil fuels. To do so, we empirically assess the daily effects of changes in oil, gas, and coal prices on returns on fossil fuel free indices provided by S&P. While we find no evidence that the FFF indices underperforms their conventional counterparts on average, the results from our model further show that the returns on FFF portfolios have more exposure to movements in fossil fuel prices than those on mainstream portfolios. The insights from our estimations have important implications for investors and other economic agents. [ABSTRACT FROM AUTHOR]

Public subsidy, a frequently applied tool of economic development is often provided to the business sector assuming that it promotes investments, employment, and income generation. In this paper a micro economic model based empirical analysis is presented that shows the possible impact of public subsidy on economic growth. The outcomes are derived by investigating the investment decision of the enterprise with and without public subsidy. It is demonstrated that public subsidy may increase social welfare, but under certain circumstances it also may decrease it, partly because authorities deciding about them fail to consider the information on the investment projects that determines the outcome. The empirical analysis of corporate subsidies proves that both cases occur. The number of firms that performed well and presumably had not enough own resources to fund the investment was less than 10% of all subsidized firms. The programs had an overall negative impact on economic growth. We provide recommendations on how methods of evaluations, project selection and monitoring should be modified to achieve better results of subsidy programs. [ABSTRACT FROM AUTHOR]

The high-speed rail (HSR) network in China has experienced rapid development since the 2000s. In 2016, the State Council of the People's Republic of China issued a revised version of the "Mid- and Long-term Railway Network Plan", detailing the expansion of the railway network and construction of an HSR system. In the future, the HSR construction efforts in China will further increase, which is considered to impact regional development and air pollutant emissions. Therefore, in this paper, we apply a transportation network-multiregional computable general equilibrium (CGE) model to estimate the dynamic effects of HSR projects on economic growth, regional disparities, and air pollutant emissions in China. The results indicate that HSR system improvement could generate a positive economic impact but could also increase emissions. The gross domestic product (GDP) growth per unit investment cost stimulated by HSR investment is found to be the largest in eastern China but the smallest in the northwest regions. Conversely, HSR investment in Northwest China contributes to a substantial reduction in regional disparities in terms of the GDP per capita. In regard to air pollution emissions, HSR construction in South-Central China results in the largest increase in CO 2 and NO X emissions, while for CO, SO 2 , and fine particulate matter (PM 2.5) emissions, the largest increase occurs due to HSR construction in Northwest China. At the regional level, the provinces with large changes in accessibility also experience large changes in their air pollutant emissions. [ABSTRACT FROM AUTHOR]

This research investigates the asymmetric impact of renewable electricity energy usage and industrialization on the environmental sustainability of South Africa. The load capacity factor (LF) is a more extensive measure of environmental deterioration when compared to carbon emissions and the ecological footprint, which cover a range of both the demand on and supply of nature. The series dataset used for the empirical analysis spans between 1990 and 2019. The study also investigates the effect of human capital, industrialization, and economic growth on load capacity factor. The result of the NARDL estimator reveals that the increase in renewable electricity energy usage increases LF in the long and short term. However, the decline in renewable electricity energy usage has a neutral impact on LF. Furthermore, the results indicate that industrialization and economic growth impact LF negatively. Lastly, human capital improves environmental quality due to the increasing effect on LF. The spectral Granger causality approach outcomes show that all the parameters can forecast load capacity factors in the long term. Some policy implications, restrictions, and potential future study pathways have been explored in light of this paper's results. • The nonlinear autoregressive distributive lag is employed. • Asymmetric impact of renewable electricity consumption on environmental sustainability. • A broad environmental indicator is used, load capacity factor. • The positive change in renewable electricity consumption promotes environmental sustainability. [ABSTRACT FROM AUTHOR]

The New International Land-Sea Trade Corridor (ILSTC) is a rail-sea intermodal transport corridor whose fundamental purpose is to closely connect western China and ASEAN through shortening the transport distance and trade time cost. Since the ILSTC is still a new initiative, there are few research focusing on its performance and implementation effects. Using computable general equilibrium (CGE) model, this paper attempts to analyze the economic impacts of the ILSTC since 2019 by simulating the scenario of transport time cost reduction. Results show that the ILSTC can promote the gross domestic product of China and the entire ASEAN by 0.20% and 0.84%, respectively; China's and the whole ASEAN's social welfare are both improved by more than US$10 billion; China's export and import with the whole ASEAN increases by 9.97% and 9.54%, respectively; The value-added trade flow contained in China's intermediate products which export to ASEAN countries first and finally return to China become larger; The impact on different sectors are heterogeneous, in which bilateral value-added and gross trade of grains and crops would increase most significantly; The value-added provided from service industry are also improved. Overall, the ILSTC plays a more important role in promoting the macro-economy of China and ASEAN countries than trade liberalization. On these basis, related conclusions for the promotion of commercial relationship between China and ASEAN countries are proposed, hoping to provide reference for traders and policy makers. • Measure the economic effects of China and ASEAN countries from the New International Land-Sea Trade Corridor (ILSTC). • Expand the simulation results from the perspective of value-added trade to track changes in intra-industry trade. • Shed lights on better policy options between trade liberalization and the ILSTC for policy makers. [ABSTRACT FROM AUTHOR]

Weak ties are becoming mainstream in daily relationships and play an essential role in the improvement of individuals' mental health. Despite growing concerns on depression, inclusion of weak ties is limited. To address the gap, this study empirically shed light on the role of weak ties on individual depression in the context of economic development. A cross-sectional study was conducted based on 2018 China Health and Retirement Longitudinal Study (CHARLS) with a sample of 16,545 individuals. A moderated mediation model is constructed to evaluate the impact of economic development (GDP) on the degrees of depression, the mediating effect of weak ties, and the moderating effect of residents' residence types (living in urban or rural areas). Economic development exerts a significant direct impact on depression (β = − 1.027 , p <0.001). Weak ties are significantly negatively correlated with depression (β = − 0.574 , p <0.001), and act as a mediator between economic development and local individual depression. In addition, the residence type plays a moderating role between economic development and weak ties (β = 0.193 , p <0.001). That is, living in urban areas would introduce the higher the level of weak ties. Higher economic development is largely conducive to alleviating the degrees of depression, weak ties play a mediating role between economic development and depression, and residence types exert a positive moderating effect on the economic development and weak ties. • This study empirically shed light on the role of weak ties on individual depression based on 2018 CHARLS. • Economic development could significantly affect degrees of individual depression through the mediating effect of weak ties. • Residence types play a moderating role between economic development and weak ties. [ABSTRACT FROM AUTHOR]

Assessment of zooarchaeological data for the principal livestock (i.e., cattle, sheep, goats and pigs) reveals regional and cultural variability in how animals were manipulated, marketed, bred, and utilized over the course of antiquity. This paper focuses upon those developments, as reconstructed through zooarchaeological frequency and morphometric data for the period from c. 1000 BCE to c. 700 CE. Regionally, North Africa encompasses a vast territory, from Egypt, in the East, to Mauretania, in the West. Ecologically, there are variations within each of these zones. Culturally, moreover, these regions witnessed the introduction and influence of different social and economic agents and factors over the timeframe under investigation. This paper examines patterns in these components in a broad synthetic manner, using zooarchaeological data across the entire expanse of Roman North Africa—from Egypt to Mauretania. Focus centers upon the nature and degree of size and shape changes within the principal livestock, modifications that were in part influenced by aspects such as the scale and pattern in trade, dietary appeal for animal products (notably fatty meats), market demands, ecological adaptations, as well as economic and cultural contact among areas. Key similarities and differences in faunal patterns, across time and space within ancient North Africa, and the links these share with changes in animal husbandry schemes are outlined. [ABSTRACT FROM AUTHOR]