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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]

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]

Flashbulb memories (FBMs) refer to vivid and long-lasting autobiographical memories for the circumstances in which people learned of a shocking and consequential public event. A cross-national study across eleven countries aimed to investigate FBM formation following the first COVID-19 case news in each country and test the effect of pandemic-related variables on FBM. Participants had detailed memories of the date and others present when they heard the news, and had partially detailed memories of the place, activity, and news source. China had the highest FBM specificity. All countries considered the COVID-19 emergency as highly significant at both the individual and global level. The Classification and Regression Tree Analysis revealed that FBM specificity might be influenced by participants' age, subjective severity (assessment of COVID-19 impact in each country and relative to others), residing in an area with stringent COVID-19 protection measures, and expecting the pandemic effects. Hierarchical regression models demonstrated that age and subjective severity negatively predicted FBM specificity, whereas sex, pandemic impact expectedness, and rehearsal showed positive associations in the total sample. Subjective severity negatively affected FBM specificity in Turkey, whereas pandemic impact expectedness positively influenced FBM specificity in China and negatively in Denmark. [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]

Research has shown that people frequently fail at exerting self‐control. Yet, having good self‐control is essential for being trusted and relied on. In this research, I test which common and frequent excuses for self‐control failures (i.e., resulting from lack of time vs. money) allow people to maintain an image of good self‐control despite failure. In six studies (five pre‐registered), using different types of self‐control domains, I show that participants perceived someone who failed at a resolution to nevertheless have good self‐control if they failed because they lacked money (vs. time) to follow through (Study 1). This effect was due to the mediated (Study 2a) and manipulated (Study 2b) perceived controllability of the excuse. This effect had downstream consequences for participants' hypothetical and real behaviour toward the individual when their outcomes were interdependent (Studies 3 and 4). Finally, participants lacked insight into these patterns when communicating their own self‐control failures, which they attributed to a lack of time over money (Study 5). [ABSTRACT FROM AUTHOR]

Accepted by: Prof. M. Zied Babai This research empirically identifies the best-performing forecasting methods for the Effective Reproduction Number Rt of coronavirus disease 2019, the most used epidemiological parameter for policymaking during the pandemic. Furthermore, based on the most accurate forecasts for the United Kingdom, we model the excess exports and imports during the pandemic (using World Trade Organization data), whilst simultaneously controlling for governmental decisions, i.e. lockdown(s) and vaccination. We provide empirical evidence that the longer the lockdown lasts, the larger the cost to the economy is, predominantly for international trade. We show that imposing a lockdown leads to exports falling by 16.55% in the United Kingdom; without a lockdown, the respective decrease for the same period would be only 1.57%. On the other hand, efforts towards fast population vaccination improve the economy. We believe our results can help policymakers to make better decisions before and during future pandemics. [ABSTRACT FROM AUTHOR]

Abstract: Developed countries are increasingly dependent on international trade to meet seafood requirements, which has important social, environmental, and economic implications. After becoming an independent coastal state following Brexit, the UK faces increased trade barriers and changes in seafood availability and cost. We compiled a long-term (120-year) dataset of UK seafood production (landings and aquaculture), imports, and exports, and assessed the influence of policy change and consumer preference on domestic production and consumption. In the early twentieth century, distant-water fisheries met an increasing demand for large, flaky fish such as cod and haddock that are more abundant in northerly waters. Accordingly, from 1900 to 1975, the UK fleet supplied almost 90% of these fish. However, policy changes in the mid-1970s such as the widespread establishment of Exclusive Economic Zones and the UK joining the European Union resulted in large declines in distant-water fisheries and a growing mismatch between seafood production versus consumption in the UK. While in 1975, UK landings and aquaculture accounted for 89% of seafood consumed by the British public, by 2019 this was only 40%. The combination of policy changes and staunch consumer preferences for non-local species has resulted in today's situation, where the vast majority of seafood consumed in the UK is imported, and most seafood produced domestically is exported. There are also health considerations. The UK public currently consumes 31% less seafood than is recommended by government guidelines, and even if local species were more popular, total domestic production would still be 73% below recommended levels. In the face of climate change, global overfishing and potentially restrictive trade barriers, promoting locally sourced seafood and non-seafood alternatives would be prudent to help meet national food security demands, and health and environmental targets. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the impact of work-related musculoskeletal (MSK) lower body pain on health-related quality of life (HRQoL) and work productivity in a large sample of workers in the United Kingdom, as well as evaluating the potential economic impact of MSK pain. Methods: Participants with self-reported work-related MSK pain were recruited from an online panel maintained by a third party (Qualtrics LLC). Participants completed three validated instruments online: the Brief Pain Inventory (BPI), the Assessment of Quality of Life Instrument (AQoL-4D), and the 6-item Work Productivity and Activity Impairment Questionnaire (WPAI). Sociodemographic details, work patterns and healthcare resource utilisation were also reported. One-way analysis of variance (ANOVA) and t-tests were used to explore differences between variables. Linear regression was applied to determine the impact of work-related MSK pain on HRQoL. Results: All 1035 recruited participants completed the survey (57.4% female; mean age 43.4 years). Participants reported spending all (25.2%) or most (53%) of their time at work on their feet. Mean pain severity was 4.63 (standard deviation: 2.07); mean pain interference was 4.37 (2.49). There was a linear relationship between length of shift, time on feet and pain. Mean AQoL-4D scores were 0.609 (0.254). A mean of 4.12 h was lost per week due to pain. Absenteeism (last 7 days) was 9.5% (20.7%), and presenteeism 33.3% (24.9%). An average 1.55 visits were made to family practitioners (total cost: £19,866) and 1 hospital visit (£37,320) due to work-related MSK pain. Conclusion: This study demonstrated that work-related lower body pain has a significant impact in terms of individual HRQoL and as an economic societal burden. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the impact of work-related musculoskeletal (MSK) lower body pain on health-related quality of life (HRQoL) and work productivity in a large sample of workers in the United Kingdom, as well as evaluating the potential economic impact of MSK pain. Methods: Participants with self-reported work-related MSK pain were recruited from an online panel maintained by a third party (Qualtrics LLC). Participants completed three validated instruments online: the Brief Pain Inventory (BPI), the Assessment of Quality of Life Instrument (AQoL-4D), and the 6-item Work Productivity and Activity Impairment Questionnaire (WPAI). Sociodemographic details, work patterns and healthcare resource utilisation were also reported. One-way analysis of variance (ANOVA) and t-tests were used to explore differences between variables. Linear regression was applied to determine the impact of work-related MSK pain on HRQoL. Results: All 1035 recruited participants completed the survey (57.4% female; mean age 43.4 years). Participants reported spending all (25.2%) or most (53%) of their time at work on their feet. Mean pain severity was 4.63 (standard deviation: 2.07); mean pain interference was 4.37 (2.49). There was a linear relationship between length of shift, time on feet and pain. Mean AQoL-4D scores were 0.609 (0.254). A mean of 4.12 h was lost per week due to pain. Absenteeism (last 7 days) was 9.5% (20.7%), and presenteeism 33.3% (24.9%). An average 1.55 visits were made to family practitioners (total cost: £19,866) and 1 hospital visit (£37,320) due to work-related MSK pain. Conclusion: This study demonstrated that work-related lower body pain has a significant impact in terms of individual HRQoL and as an economic societal burden. [ABSTRACT FROM AUTHOR]

Across the UK, people's lives are being cut short because of obesity, and the lives of the most deprived members of our communities are being cut the most. The role of the medical professional in managing overweight and obesity is extensive, but, for many patients, maintaining a healthy weight needs to be supported by creating environments that help people to stay healthy in the first place. The building blocks of health are the environmental, commercial, economic and social factors that largely determine our health and wellbeing and impact our capability, opportunity and motivation to maintain healthy-weight behaviours. Although the role of the healthcare professional generally is to focus on the individual patient, clinicians can still influence these building blocks. Clinicians have the skills to create change, they often hold power in organisations with local to international impact and there are actions, big or small, that every clinician can take to improve obesity prevention. Here, we outline an environmental--behavioural framework for the primary prevention of obesity and consider the role of clinicians in catalysing change. [ABSTRACT FROM AUTHOR]

The negative impact of economic inequality on social issues and wellbeing is of importance to social psychology that historically has an interest in social justice. Social Identity Theory is explored as an approach that acknowledges the wider context of social issues. The use of experiments encounters challenges in categorizing wealth and how individuals account for extreme wealth. Mainstream research agendas in psychology are not neutral and draw upon current ideology (such as neoliberalism) that can often maintain inequality. These difficulties are addressed by Critical Social Psychology driven by a social justice agenda that challenges the acceptance of neoliberal values. The application of Critical Social Psychology to wealth inequality is demonstrated with research using UK media data. Critical feminist psychology is discussed to explore the role of class and how to challenge the stigmatization of working‐class people. Finally, this paper outlines how Discursive Psychology addresses how extreme wealth and the practices of the super‐rich are warranted. A discursive approach questions the acceptance of wealth inequality as an everyday assumption and demonstrates how dominant discourse draws upon individualism. Furthermore, Discursive Psychology has examined how accountability for problematic practices, such as tax avoidance that maintain inequality, are managed in media broadcasts. [ABSTRACT FROM AUTHOR]

This article shows how late-life incomes from work and pensions evolved in the United Kingdom between 1991 and 2007, the year the Great Recession began. Our main contribution comes from focusing on changes across cohorts in different educational groups while also considering the gender divide. Our statistical analyses based on the British Household Panel Survey (BHPS) suggest that deindustrialisation, the expansion of jobs in the knowledge economy and pension reforms affected senior workers' incomes before and after retirement. Highly qualified senior male workers have profited from increasing income across the cohorts more than any other social group. Such a trend is not observed among highly qualified female workers. Male and female low-qualified senior workers do not show major income loses, but have not benefited to the same extent as highly educated male workers. As a result, pension income inequalities between highly qualified men and the rest have increased. The increasing pensions gap between educational groups can be traced back to the improving situation on the labour market for highly qualified male workers, and to reforms benefiting private pension schemes, where the highly qualified are overrepresented. Thus, the shift in pension provisions towards private pension schemes is clearly disadvantageous for low-qualified male workers and for women of all educational levels, and contributes to the increase of social inequalities. [ABSTRACT FROM AUTHOR]

Economic geographers have paid much attention to the cultural and creative industries, both for their propensity to cluster in urban settings, and their potential to drive urban economic development. However, evidence on the latter is surprisingly sparse. In this article, we explore the long-term, causal impacts of the cultural and creative industries on surrounding urban economies. Adapting Moretti's local multipliers framework, we build a new twenty-year panel of UK cities, using historical instruments to identify causal effects of creative activity on noncreative firms and employment. We find that each creative job generates at least 1.9 nontradable jobs between 1998 and 2018. Prior to 2007, these effects seem more rooted in creative services employees' local spending than visitors to creative amenities. Given the low numbers of creative jobs in most cities, the overall impact of the creative multiplier is small. On average, the creative sector is responsible for over 16 percent of nontradable job growth in our sample, though impacts will be larger in bigger clusters. We do not find the same effects for workplaces, and we find no causal evidence for spillovers from creative activity to other tradable sectors. In turn, this implies that creative city policies will have partial, uneven local economic impacts. Given extensive urban clusters of creative activity in many countries, our results hold value beyond the UK setting. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) emergency has led to numerous attempts to assess the impact of the pandemic on population mental health. The findings indicate an increase in depression and anxiety but have been limited by the lack of specificity about which aspects of the pandemic (e.g. viral exposure or economic threats) have led to adverse mental health outcomes. Methods: Network analyses were conducted on data from wave 1 (N = 2025, recruited 23 March–28 March 2020) and wave 2 (N = 1406, recontacts 22 April–1 May 2020) of the COVID-19 Psychological Research Consortium Study, an online longitudinal survey of a representative sample of the UK adult population. Our models included depression (PHQ-9), generalized anxiety (GAD-7) and trauma symptoms (ITQ); and measures of COVID-specific anxiety, exposure to the virus in self and close others, as well as economic loss due to the pandemic. Results: A mixed graphical model at wave 1 identified a potential pathway from economic adversity to anxiety symptoms via COVID-specific anxiety. There was no association between viral exposure and symptoms. Ising network models using clinical cut-offs for symptom scores at each wave yielded similar findings, with the exception of a modest effect of viral exposure on trauma symptoms at wave 1 only. Anxiety and depression symptoms formed separate clusters at wave 1 but not wave 2. Conclusions: The psychological impact of the pandemic evolved in the early phase of lockdown. COVID-related anxiety may represent the mechanism through which economic consequences of the pandemic are associated with psychiatric symptoms. [ABSTRACT FROM AUTHOR]

The application of International Financial Reporting Standards (IFRS) has been introduced in many countries to enhance efficiencies in financial markets and improve communication in financial reporting. However, extant studies have suggested that the introduction of IFRS has increased narrative complexity, owing to the demand for more reporting. Considering that accounting complexity can be either informative (enhancing understanding) or non-informative, thereby causing obfuscation, this study performs an empirical analysis to highlight which of the two types of complexities may be affected by IFRS application. Using the setting of IFRS adoption in the UK and a word list-adjusted component of the fog index, this study decomposes complexity into two components: information (common complexity) and obfuscation (uncommon complexity). The results reveal that IFRS adoption has increased the common complexity of accounting narratives (information) but does not necessarily increase obfuscation. The study's contribution is twofold: methodological through the decomposition of complexity using the term weighting concept and policy-related by identifying areas of increased narrative comparability in IFRS reports. Moreover, the study's application of complexity decomposition to IFRS is novel. Future studies may apply this by using the identified information and obfuscation components to investigate the economic consequences of IFRS-associated complexity. [ABSTRACT FROM AUTHOR]

We present our agent-based CoronAvirus Lifelong Modelling and Simulation (CALMS) model that aspires to predict the lifelong impacts of Covid-19 on the health and economy of a population. CALMS considers individual characteristics as well as comorbidities in calculating the risk of infection and severe disease. We conduct two sets of experiments aiming at demonstrating the validity and capabilities of CALMS. We run simulations retrospectively and validate the model outputs against hospitalisations, ICU admissions and fatalities in a UK population for the period between March and September 2020. We then run simulations for the lifetime of the cohort applying a variety of targeted intervention strategies and compare their effectiveness against the baseline scenario where no intervention is applied. Four scenarios are simulated with targeted vaccination programmes and periodic lockdowns. Vaccinations are targeted first at individuals based on their age and second at vulnerable individuals based on their health status. Periodic lockdowns, triggered by hospitalisations, are tested with and without vaccination programme in place. Our results demonstrate that periodic lockdowns achieve reductions in hospitalisations, ICU admissions and fatalities of 6-8% compared to the baseline scenario, with an associated intervention cost of £173 million per 1,000 people and targeted vaccination programmes achieve reductions in hospitalisations, ICU admissions and fatalities of 89-90%, compared to the baseline scenario, with an associated intervention cost of £51,924 per 1,000 people. We conclude that periodic lockdowns alone are ineffective at reducing health-related outputs over the long-term and that vaccination programmes which target only the clinically vulnerable are sufficient in providing healthcare protection for the population as a whole. [ABSTRACT FROM AUTHOR]

Background: Cow's milk allergy (CMA) is one of the most common food allergies among children. Whilst avoidance of cow's milk protein is the cornerstone of management, further treatment of symptoms including those affecting the gastrointestinal, skin and respiratory systems plus other allergic comorbidities, maybe required. This study aimed to quantify the wider economic impact of CMA and its management in the United Kingdom (UK). Methods: We conducted a retrospective matched cohort study on children with CMA (diagnosis read code and/or hypoallergenic formula prescription for ≥3 months) examining healthcare data (medication prescriptions and healthcare professional contacts) from case records within The Health Improvement Network (A Cegedim Proprietary Database) in the UK. A comparative cost analysis was calculated based on healthcare tariff and unit costs in the UK. Results: 6998 children (54% male; mean observation period 4.2 years) were included (n = 3499 with CMA, mean age at diagnosis 4.04 months; n = 3499 matched controls without CMA). Compared to those without CMA, medications were prescribed to significantly more children with CMA (p < 0.001) at a higher rate (p < 0.001). Children with CMA also required significantly more healthcare contacts (p < 0.001) at higher rate (p < 0.001) compared to those without CMA. CMA was associated with additional potential healthcare costs of £1381.53 per person per year. Conclusion: The findings of this large cohort study suggest that CMA and its associated co‐morbidities presents a significant additional healthcare burden with economic impact due to higher prescribing of additional medications. Further research into management approaches that may impact these clinical and economic outcomes of CMA is warranted. [ABSTRACT FROM AUTHOR]

Summary: Background: Previous studies have demonstrated a substantial economic impact of irritable bowel syndrome (IBS). Aims: To provide contemporaneous estimates of direct healthcare costs of IBS in the United Kingdom. Methods: We collected demographic, gastrointestinal and psychological symptoms, quality of life and healthcare usage data from adults with Rome IV or Rome III IBS in the United Kingdom. We calculated the mean annual direct healthcare costs of IBS per person and used contemporaneous IBS prevalence data, together with census data, to estimate annual direct costs of IBS. We also examined predictors of higher costs. Results: The mean annual direct cost of IBS per person among 752 individuals with Rome IV IBS was £556.65 (SD £1023.92) and £474.16 (SD £897.86) for 995 individuals with Rome III IBS. We estimate the annual direct healthcare cost of IBS in the United Kingdom is £1.27 billion if the Rome IV criteria are used to define IBS, and £2.07 billion using Rome III. Among individuals with Rome IV IBS, mean annual costs were higher in those with opiate use (£907.90 vs £470.58, p < 0.001), more severe symptoms (p < 0.001 for trend), a shorter duration of IBS (1 year, £1227.14 vs >5 years £501.60, p = 0.002), lower quality of life (p < 0.001 for trend), and higher depression, somatisation and gastrointestinal symptom‐specific anxiety scores (P < 0.001 for trend for all). Conclusion: We estimate annual direct healthcare costs of IBS of between £1.3 and £2 billion in the United Kingdom. [ABSTRACT FROM AUTHOR]

Although no human papillomavirus (HPV) vaccine is indicated for single-dose administration, some observational evidence suggests that a 1-dose regimen might reduce HPV infection risk to that achieved with 2 doses. This study estimated the potential health and economic outcomes associated with switching from a 2-dose HPV vaccination program for girls and boys aged 13–14 years to an off-label 9-valent (9vHPV), 1-dose regimen, accounting for the uncertainty of the effectiveness and durability of a single dose. A dynamic HPV transmission infection and disease model was adapted to the United Kingdom and included a probabilistic sensitivity analysis using estimated distributions for duration of protection of 1-dose and degree of protection of 1 relative to 2 doses. One-way sensitivity analyses of key inputs were performed. Outcomes included additional cancer and disease cases and the difference in net monetary benefit (NMB). The 1-dose program was predicted to result in 81,738 additional HPV-related cancer cases in males and females over 100 years compared to the 2-dose program, ranging from 36,673 to 134,347 additional cases (2.5% and 97.5% quantiles, respectively), and had a 7.8% probability of being cost-effective at the £20,000/quality-adjusted life years willingness-to-pay (WTP) threshold. In one-way sensitivity analyses, the number of additional cancer cases was sensitive to the median of the duration of protection distribution and coverage rates. The differences in NMBs were sensitive to the median of the duration of protection distribution, dose price and discount rate, but not coverage variations. Across sensitivity analyses, the probability of 1 dose being cost-effective vs 2 doses was < 50% at the standard WTP threshold. Adoption of a 1-dose 9vHPV vaccination program resulted in more vaccine-preventable HPV-related cancer and disease cases in males and females, introduced substantial uncertainty in health and economic outcomes, and had a low probability of being cost-effective compared to the 2-dose program. [ABSTRACT FROM AUTHOR]

Purpose: Using survey datasets, the purpose of this work explores the impact of economic freedom on the gender pay gap in the UK. Design/methodology/approach: The analysis combines Economic Freedom of the World data with the Understanding Society (USoc) Microdata series. Findings: The results document that economic freedom positively affects the gender pay gap. When the components of the index are considered, the findings indicate different effects of various types of policy, i.e. less government spending, stronger trade liberalization conditions and levels of corruption lead to higher gaps; stronger legal and property rights and a sounder money system have no impact on the gap. Moreover, a stronger impact in the manufacturing industry, part-time workers and those who work in the non-London regions is observed. Practical implications: The findings imply that reductions to government spending programmes can potentially aggravate the gap in hourly wages paid between males and females and should, therefore, be implemented. It may be also possible to provide females the training or education necessary to effectively compete in the workforce, before eliminating any spending programme they rely on. Originality/value: The first study explores the link between economic freedom and gender pay gap through a unique survey dataset with UK households. [ABSTRACT FROM AUTHOR]

The wind energy sector has experienced a significant expansion during the past two decades. With the current global appetite for the further expansion of offshore wind farms (OWFs) as one of the main renewable energy resources, a vast number of OWFs are expected to enter the decommissioning stage in the near future which may potentially create serious environmental and economic challenges to different countries. Hence, effective decision-making procedures are required to protect the environment, taxpayers, and local communities against the potential economic and environmental impacts of OWF assets at the end of their lifetime. The main contribution of this study is to develop a new approach for the economic and environmental assessments of OWF decommissioning projects based on a bottom-up model. The approach formulates the costs and emissions based on the available data and experience in the field and tries to provide appropriate assumptions to predict the costs and emissions caused by the different decommissioning activities. To validate and show the applicability of the approach, the economic and environmental assessments of two OWF decommissioning case studies in the UK continental shelf are investigated; the Lincs and Gunfleet Sands OWFs. A cost sensitivity analysis is also performed for different duration and vessel/equipment leasing parameters to identify the most sensitive parameters in the OWF decommissioning projects. The study suggests a set of interesting conclusions on the economic and environmental assessments of OWF decommissioning projects that may be beneficial for policymakers, operators, and local communities in the wind energy sector. [Display omitted] • Economic and environmental assessments approach proposed for OWF decommissioning. • The approach is developed based on the available data and experience in the field. • Two OWFs, the Lincsand Gunfleet Sands, are investigated. • A decommissioning cost sensitivity analysis for different parameters is performed. • Interesting conclusions on the economic and environmental assessments are provided. [ABSTRACT FROM AUTHOR]

By collecting more data at a higher resolution and by creating the capacity to implement detailed crop management, autonomous crop equipment has the potential to revolutionise precision agriculture (PA), but unless farmers find autonomous equipment profitable it is unlikely to be widely adopted. The objective of this study was to identify the potential economic implications of autonomous crop equipment for arable agriculture using a grain-oilseed farm in the United Kingdom as an example. The study is possible because the Hands Free Hectare (HFH) demonstration project at Harper Adams University has produced grain with autonomous equipment since 2017. That practical experience showed the technical feasibility of autonomous grain production and provides parameters for farm-level linear programming (LP) to estimate farm management opportunities when autonomous equipment is available. The study shows that arable crop production with autonomous equipment is technically and economically feasible, allowing medium size farms to approach minimum per unit production cost levels. The ability to achieve minimum production costs at relatively modest farm size means that the pressure to "get big or get out" will diminish. Costs of production that are internationally competitive will mean reduced need for government subsidies and greater independence for farmers. The ability of autonomous equipment to achieve minimum production costs even on small, irregularly shaped fields will improve environmental performance of crop agriculture by reducing pressure to remove hedges, fell infield trees and enlarge fields. [ABSTRACT FROM AUTHOR]

Understanding the resilience of transport networks is critical for efficient asset management. This paper takes an innovative approach to studying the operability of the Queensferry Crossing (QFC), UK, including cost–benefit aspects. A key driver for the QFC was to increase the resilience of the A90/M90 link by reducing weather-related closures. The first weather-related closure of the QFC was in February 2020, when ice formed on the superstructure cables and fell on the carriageway and vehicles, creating a safety risk for bridge users. The bridge was closed for 41 h and, in this paper, the estimated monetary losses are compared with those of past Forth Road Bridge (FRB) closures. The costs of potential mitigation measures are then assessed in the context of closure costs, thus improving the resilience of the QFC. Although the QFC has only been open for 3 years, it is already apparent that it is significantly more resilient than the largely replaced FRB, whether this is considered as the number, duration or costs of closures and that this will be substantially improved by the planned use of the FRB during future closures of the QFC. Investment in mitigation measures is a potentially cost-effective solution although the form of any suitable ice prevention or removal system is, as yet, far from clear. [ABSTRACT FROM AUTHOR]

Introduction: In the UK, biologic interventions for plaque psoriasis can either be administered in a hospital setting or following delivery to a patient's home. To date, limited research has been undertaken on how the administration route affects the overall treatment costs and the implications for this on UK clinical practice. The objective was to explore the cost implications of different administration routes for plaque psoriasis biologic interventions in the UK. Methods: A simple economic model was developed to estimate and compare the total cost of drug administration over 2 years for all biologic interventions that have been approved by the National Institute of Health and Care Excellence for use in patients with moderate-to-severe plaque psoriasis. Administration costs were estimated for two different scenarios: administration in a hospital setting or following home delivery [paid for by the National Health Service (NHS)]. Results: Costs of home delivery and administration in hospital over a 2-year time horizon varied substantially based on the choice of intervention. For home delivery, the lowest cost of £693 occurred with risankizumab, tildrakizumab and ustekinumab, while the highest cost of £3445 occurred with adalimumab, brodalumab, certolizumab and etanercept. For the scenario in which the interventions were administered in a hospital setting the costs ranged from £4224 for ustekinumab to £7463 for brodalumab. Conclusion: These results indicate that drug administration costs are meaningful and should be given greater consideration in the selection process of treatments for plaque psoriasis. Additionally, the NHS could save money by paying for drugs to be delivered to a patient's home, rather than administering them in a hospital setting. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a chronic progressive neurological disorder with a high psychosocial and economic burden. As part of the European Brain Council (EBC)‐led Value of Treatment project, this study aimed to capture the economic benefit of timely, adequate, and adherence to PD treatment. Methods: The EBC Value of Treatment Initiative combined different stakeholders to identify unmet needs in the patients' journey according to Rotterdam methodology. The economic evaluation focused on three major topics identified as major gaps: start of treatment; best treatment for advanced disease; and adherence to treatment. Two separate healthcare systems (Germany and the UK) were chosen. Cost‐effectiveness was determined by using decision‐analytical modelling approaches. Effectiveness was expressed as quality‐adjusted life‐years (QALYs) gained and incremental cost‐effectiveness ratio (ICER). Results: Treatment intervention in PD was found to be cost‐effective regardless of the initial health state of the patient receiving the treatment. Cost savings were between ‐€1000 and −€5400 with 0.10 QALY gain and ‐€1800 and ‐€7600 with 0.10 QALY gain for Germany and the UK, respectively. Treatment remains cost‐effective within the National Institute for Health and Care Excellence thresholds. Availability of adequate treatment to more patients was also found to be cost‐effective, with an ICER of €15,000–€32,600 across country settings. Achieving the target adherence to treatment would generate cost‐savings of €239,000–€576,000 (Germany) and €917,000–€2,980.000 (UK) for every 1,000 patients treated adequately. Conclusions: The analyses confirmed that timely, adequate, and adherence to PD treatment will not only improve care of the patients but is also cost‐effective across healthcare systems. Further studies with a distinct identification of gaps in care are necessary to develop better and affordable care. [ABSTRACT FROM AUTHOR]

Financial transactions are part of everyday life, yet banking has largely withstood the digital transformation within most European countries. Recently, there have been initiatives that merge the digital and the financial sphere by integrating the transactions that run through established financial infrastructures into digital platforms. Large data-driven companies hereby seek access to financial transactions and try to embed payments within their platforms. This contribution discusses differing models of how tech-driven companies gain access to financial infrastructures, and how recently introduced policies engender these processes. Within Europe and the United Kingdom, banks that operate through financial infrastructures and hold most transactional data are now required by regulators to provide access to their customers' accounts. The platformization of financial transactions is thus not purely a technical question, but it also is a remarkable example of how politically enforced changes in the materiality of data lead to reconfigurations with broader economic and social consequences. It results in the transformation of money into a form of (transactional) data and shows how the value of money and data depends on the technological underpinnings that determine the capability of their circulation. In order to understand their valuation, we need to take the material assemblages that enable their distribution into account. [ABSTRACT FROM AUTHOR]

Climate policy has distributional effects, and ratcheting up climate ambition will only become politically feasible if the general public believes that their country can win from ambitious climate action. In this article, we develop a theory of belief formation that anchors distributional effects from climate action at the sector level. Specifically, we study how knowing about these impacts shapes public beliefs about collective economic consequences from climate policy--not only in a home country but also abroad. A nationally representative survey experiment in the United Kingdom demonstrates that respondents are biased toward their home country in assessing information about winning and losing sectors: while beliefs brighten for good news and worsen for bad news when the home country is involved, distributional effects from abroad are discounted for belief formation. We also show that feelings of "international embeddedness," akin to globalization attitudes, make UK respondents consistently hold more positive beliefs that the country can benefit from ambitious climate action. Ruling out several alternative explanations, these results offer a first step toward a better understanding of how distributional effects in one issue area, such as globalization, can spill over to other issue areas, such as climate change. [ABSTRACT FROM AUTHOR]

Many different countries have been under lockdown or extreme social distancing measures to control the spread of COVID-19. The potentially far-reaching side effects of these measures have not yet been fully understood. In this study we analyse the results of a multi-country survey conducted in Italy (N = 3,504), Spain (N = 3,524) and the United Kingdom (N = 3,523), with two separate analyses. In the first analysis, we examine the elicitation of citizens' concerns over the downplaying of the economic consequences of the lockdown during the COVID-19 pandemic. We control for Social Desirability Bias through a list experiment included in the survey. In the second analysis, we examine the data from the same survey to predict the level of stress, anxiety and depression associated with being economically vulnerable and having been affected by a negative economic shock. To accomplish this, we have used a prediction algorithm based on machine learning techniques. To quantify the size of this affected population, we compare its magnitude with the number of people affected by COVID-19 using measures of susceptibility, vulnerability and behavioural change collected in the same questionnaire. We find that the concern for the economy and for "the way out" of the lockdown is diffuse and there is evidence of minor underreporting. Additionally, we estimate that around 42.8% of the populations in the three countries are at high risk of stress, anxiety, and depression, based on their level of economic vulnerability and their exposure to a negative economic shock. [ABSTRACT FROM AUTHOR]

Objectives: To inform allocation decisions in any healthcare system, robust cost data are indispensable. Nevertheless, recommendations on the most appropriate valuation approaches vary or are nonexistent, and no internationally accepted gold standard exists. This costing analysis exercise aims to assess the impact and implications of different calculation methods and sources based on the unit cost of general practitioner (GP) consultations in Austria.Methods: Six costing methods for unit cost calculation were explored, following 3 Austrian methodological approaches (AT-1, AT-2, AT-3) and 3 approaches applied in 3 other European countries (Germany, The Netherlands, United Kingdom). Drawing on Austrian data, mean unit costs per GP consultation were calculated in euros for 2015.Results: Mean unit costs ranged from €15.6 to €42.6 based on the German top-down costing approach (DE) and the Austrian Physicians' Chamber's price recommendations (AT-3), respectively. The mean unit cost was estimated at €18.9 based on Austrian economic evaluations (AT-1) and €17.9 based on health insurance payment tariffs (AT-2). The Dutch top-down (NL) and the UK bottom-up approaches (UK) yielded higher estimates (NL: €25.3, UK: €29.8). Overall variation reached 173%.Conclusions: Our study is the first to systematically investigate the impact of differing calculation methods on unit cost estimates. It shows large variations with potential impact on the conclusions in an economic evaluation. Although different methodological choices may be justified by the adopted study perspective, different costing approaches introduce variation in cross-study/cross-country cost estimates, leading to decreased confidence in data quality in economic evaluations. [ABSTRACT FROM AUTHOR]

This article provides an educational review covering the consideration of conducting 'value for money' analyses as part of non-randomised study designs including service evaluations. These evaluations represent a vehicle for producing evidence such as value for money of a care intervention or service delivery model. Decision makers including charities and local and national governing bodies often rely on evidence from non-randomised data and service evaluations to inform their resource allocation decision-making. However, as randomised data obtained from randomised controlled trials are considered the 'gold standard' for assessing causation, the use of this alternative vehicle for producing an evidence base requires careful consideration. We refer to value for money analyses, but reflect on methods associated with economic evaluations as a form of analysis used to inform resource allocation decision-making alongside a finite budget. Not all forms of value for money analysis are considered a full economic evaluation with implications for the information provided to decision makers. The type of value for money analysis to be conducted requires considerations such as the outcome(s) of interest, study design, statistical methods to control for confounding and bias, and how to quantify and describe uncertainty and opportunity costs to decision makers in any resulting value for money estimates. Service evaluations as vehicles for producing evidence present different challenges to analysts than what is commonly associated with research, randomised controlled trials and health technology appraisals, requiring specific study design and analytic considerations. This educational review describes and discusses these considerations, as overlooking them could affect the information provided to decision makers who may make an 'ill-informed' decision based on 'poor' or 'inaccurate' information with long-term implications. We make direct comparisons between randomised controlled trials relative to non-randomised data as vehicles for assessing causation; given 'gold standard' randomised controlled trials have limitations. Although we use UK-based decision makers as examples, we reflect on the needs of decision makers internationally for evidence-based decision-making specific to resource allocation. We make recommendations based on the experiences of the authors in the UK, reflecting on the wide variety of methods available, used as documented in the empirical literature. These methods may not have been fully considered relevant to non-randomised study designs and/or service evaluations, but could improve and aid the analysis conducted to inform the relevant value for money decision problem. [ABSTRACT FROM AUTHOR]

The evidence on why students from lower social origin are persistently underrepresented in higher education (HE) suggests social, educational and economic factors all play a role. We concentrate on the influence of monetary costs/benefits and how these are influenced by social origin. In particular, we consider the effect of a class-based wage penalty in the labour market and, using evidence from a large-scale survey of Scottish students, we show how the greater financial constraints facing working-class students affects the incentive to participate in HE. Using a simple model of human capital investment, the low rate of working-class participation in HE is shown to be consistent with rational behaviour, i.e. weighing the monetary costs and benefits, participating in HE is a less attractive investment proposition for some students. We conduct simulations which suggest this could be mitigated by generous income-contingent support. [ABSTRACT FROM AUTHOR]

Deploying energy storage (ES), alongside renewable generation, can help to decarbonise electricity grids. A key aspect of deploying these is choosing a suitable location, which is both geographically feasible and economical. Previous studies identify locations with suitable geographies; here we focus on the economic impact of location. We explore how the maximised profits, determined using a mixed integer linear programming (MILP) optimisation model, of a solar farm co-located with ES vary in different regions around Great Britain (GB) as a case study. We perform a cost–benefit analysis from the point of view of a distribution-connected solar farm owner. Real solar generation data is used, along with a weather model, to accurately represent forecast and actual output. For solar farms without ES profits are higher in locations with greater solar irradiance. However for sites with ES we find greater profit variation, primarily due to different distribution charges. For the majority of GB, ES does not add sufficient value to offset its high upfront costs and is not worth adding to solar sites. Additionally, it is found to be uneconomical to add ES to most existing solar farms, despite many studies highlighting the grid benefits this would bring. We recommend that distribution network operator and market pricing better reflects the value which ES can bring to the electricity system economical to add to solar sites. To encourage increased co-location distribution operators should offer greater a differential between non-intermittent generation and intermittent generation payments, in particular at times of high system demand. • Profits of solar farm with energy storage in different locations maximised. • Regional discrepancies in profits due mainly to distribution network charges. • Retrofitting storage with 75% pre-existing solar farms uneconomical. • Under the studied conditions, only small storage economical in remaining 25%. [ABSTRACT FROM AUTHOR]

Cavell Nurses' Trust aims to assist healthcare workers experiencing hardship, providing emotional and financial support to nurses, midwives, maternity support workers and healthcare assistants [ABSTRACT FROM AUTHOR]

• Generation rates of 13 solid waste streams of 10 European countries were recorded. • The data were correlated with four socioeconomic indices using data from 2008 to 2015. • GDP was a significant predictor for the generation rates of 9 waste streams. • The CO 2 emissions was the least influential factor for waste generation. • DE and UK were preventive countries, whilst DK and ES wasteful. The standard of living and certain socioeconomic and development indices can influence solid waste generation. This potential association can aid to focus on, and to establish, appropriate policies to reduce waste generation, with waste prevention being the cornerstone of those policies so that to eventually decouple waste generation from economic growth. Although, several studies have been performed at a regional or municipal level to study the impact of socioeconomic factors on waste generation, this impact on a European scale using data of several individual special solid waste streams from the years of the economic crisis has not been studied. The goal of the work was to investigate the impact of the Gross Domestic Product (GDP), the Human Development Index (HDI), the Unemployment Rate (UR), and the CO 2 emissions on the generation rates of thirteen solid waste streams using data from ten European countries. Annual data ranged from years 2008/2009 to 2015. Regression modeling between the waste generation rates and each of the four indices was developed and significant correlations were calculated. Results revealed that nine solid waste streams were positively correlated to the GDP, with waste electronic and electric equipment (WEEE) having the strongest positive correlation. With the aid of a novel graphical methodology, the countries were grouped into "normally behaving", "affected", "preventive" and "wasteful". Greece and Portugal were the countries that belonged to the "affected" countries for most waste streams, whilst Germany and the United Kingdom belonged most frequently to the preventive countries. [ABSTRACT FROM AUTHOR]

Several international proclamations in the last decades have advocated for the dignity and autonomy of persons with mental disorders. Few discussions have been generated regarding the implication of this transition in low- and middle-income countries. The objective of this publication is to review how the concept of mental capacity has been defined in Colombian law. We then briefly compare the Colombian and UK situations and propose a few points of discussion, addressing some difficulties and challenges of both countries. Finally, we propose that the first steps in the Colombian context would be to strengthen understanding about mental capacity in medical schools, postgraduate and other health related programmes, the adoption of standardized tools to improve its assessment in everyday clinical settings and the establishment of community care services from collaborative efforts between governmental and civil organizations. [ABSTRACT FROM AUTHOR]

Researchers from the University of Southampton have collaborated with the rail industry's independent safety body RSSB on a pilot project for a geospatial risk model. The aim was to use the model to analyse and map derailments, suicides and slip, trip and fall risks across the UK rail network, initially in the Wessex region. The research has been extended to incorporate the impact of historic and real-time environmental data on rail risk. This paper presents a detailed description of the investigations, the resulting methodology and a prototype toolkit. The toolkit incorporates environmental conditions combined with rail incident data to help model and predict increased risk in real time. [ABSTRACT FROM AUTHOR]

International headlines over the last few years have been dominated by extreme weather events, and floods have been amongst the most frequent and devastating. These disasters represent high costs and functional disruptions to societies and economies. The consequent breakdown of the economic equilibrium exacerbates the losses of the initial physical damages and generates indirect costs that largely amplify the burden of the total damage. Neglecting indirect damages results in misleading results regarding the real dimensions of the costs and prevents accurate decision-making in flood risk management. To obtain an accurate assessment of total flooding costs, this paper introduces the flood footprint concept, as a novel accounting framework that measures the total economic impact that is directly and indirectly caused to the productive system, triggered by the flooding damages to the productive factors, infrastructure and residential capital. The assessment framework account for the damages in the flooded region as well as in wider economic systems and social networks. The flood footprint builds on previous research on disaster impact analysis based on Input-Output methodology, which considers inter-industry flows of goods and services for economic output. The framework was applied to the 2007 summer floods in the UK to determine the total economic impact in the region of Yorkshire and The Humber. The results suggest that the total economic burden of the floods was approximately 4% of the region's GVA (£2.7 billion), from which over half comes from knock-on effects during the 14 months that the economy of Yorkshire and The Humber last to recover. This paper is the first to apply the conceptual framework of flood footprint to a real past event, by which it highlights the economic interdependence among industrial sectors. Through such interrelationships, the economic impacts of a flooding event spill over into the entire economic system, and some of the most affected sectors can be those that are not directly damaged. Neglecting the impact of indirect damages would underestimate the total social costs of flooding events, and mislead the correspondent actions for risk management and adaptation. [ABSTRACT FROM AUTHOR]

Background: Flowable haemostatic agents have been shown to be superior to non-flowable agents in terms of haemostatic control and need for transfusion products in patients undergoing cardiac surgery. We investigated the economic impact of the use of a flowable haemostatic agent (Floseal) compared with non-flowable oxidised regenerated cellulose (ORC) agent in primary elective cardiac surgery from the perspective of the UK National Health Service (NHS).Methods: A cost-consequence framework based upon clinical data from a prospective trial and an observational trial and NHS-specific actual reference costs (2016) was developed to compare the economic impact of Floseal with that of ORC. The individual domains of care investigated comprised complications (major and minor) avoided, operating room time savings, surgical revisions for bleeding avoided and transfusions avoided. The cost impact of Floseal versus ORC on ICU days and extended bed days avoided was modelled separately.Results: Compared with ORC, the use of Floseal would be associated with overall net savings to the NHS of £178,283 per 100 cardiac surgery patients who experience intraoperative bleeding requiring haemostatic therapy. Cost savings were apparent in all individual domains of care (complications avoided: £83,536; operating room time saved: £63,969; surgical revisions avoided: £34,038; and blood transfusions avoided: £22,317). Cost savings per 100 patients with Floseal over ORC in terms of ICU days avoided (n = 30) and extended bed days avoided (n = 51.7) were £57,960 and £21,965, respectively. A sensitivity analysis indicated that these findings remained robust when the model parameters representing the clinical benefit of Floseal over ORC were reduced by up to 20%.Conclusions: Despite higher initial acquisition costs, the use of flowable haemostatic agents achieves substantial cost savings over non-flowable agents in cardiac surgery. These cost savings commence during the operating theatre and appear to continue to be realised throughout the postoperative period. [ABSTRACT FROM AUTHOR]

Assessments of the combined ecological impacts of ocean acidification and warming ( OAW) and their social and economic consequences can help develop adaptive and responsive management strategies in the most sensitive regions. Here, available observational and experimental data, theoretical, and modelling approaches are combined to project and quantify potential effects of OAW on the future fisheries catches and resulting revenues and employment in the UK under different CO2 emission scenarios. Across all scenarios, based on the limited available experimental results considered, the bivalve species investigated were more affected by OAW than the fish species considered, compared with ocean warming alone. Projected standing stock biomasses decrease between 10 and 60%. These impacts translate into an overall fish and shellfish catch decrease of between 10 and 30% by 2020 across all areas except for the Scotland >10 m fleet. This latter fleet shows average positive impacts until 2050, declining afterwards. The main driver of the projected decreases is temperature rise (0.5-3.3 °C), which exacerbate the impact of decreases in primary production (10-30%) in UK fishing waters. The inclusion of the effect of ocean acidification on the carbon uptake of primary producers had very little impact on the projections of potential fish and shellfish catches (<1%). The <10 m fleet is likely to be the most impacted by-catch decreases in the short term (2020-50), whereas the effects will be experienced more strongly by the >10 m fleet by the end of the century in all countries. Overall, losses in revenue are estimated to range between 1 and 21% in the short term (2020-50) with England and Scotland being the most negatively impacted in absolute terms, and Wales and North Ireland in relative terms. Losses in total employment (fisheries and associated industries) may reach approximately 3-20% during 2020-50 with the >10 m fleet and associated industries bearing the majority of the losses. [ABSTRACT FROM AUTHOR]

Economic impact assessment methodology was applied to UK fisheries data to better understand the implications of European Commission proposal for regulations to fishing for deep-sea stocks in the North-East Atlantic (EC COM 371 Final 2012) under the Common Fisheries Policy (CFP). The aim was to inform the on-going debate to develop the EC proposal, and to assist the UK fishing industry and Government in evaluating the most effective options to manage deep sea fish stocks. Results indicate that enforcing the EC proposal as originally drafted results in a number of implications for the UK fleet. Because of the proposed changes to the list of species defined as being deep sea species, and a new definition of what constitutes a vessel targeting deep sea species, a total of 695 active UK fishing vessels would need a permit to fish for deep sea species. However, due to existing and capped capacity limits many vessels would potentially not be able to obtain such a permit. The economic impact of these changes from the status quo reveals that in the short term, landings would decrease by 6540 tonnes, reducing gross value added by £3.3 million. Alternative options were also assessed that provide mitigation measures to offset the impacts of the proposed regulations whilst at the same time providing more effective protection of deep sea Vulnerable Marine Ecosystems (VMEs). The options include setting a 400 m depth rule that identifies a depth beyond which vessels would potentially be classified as fishing for deep sea species and designating ‘core areas’ for deep sea fishing at depths > 400 m to minimise the risk of further impacts of bottom fishing gear on deep sea habitats. Applying a 400 m depth limit and ‘core fishing’ area approach deeper than 400 m, the impact of the EC proposal would essentially be reduced to zero, that is, on average no vessels (using the status quo capacity baseline) would be impacted by the proposal. [ABSTRACT FROM AUTHOR]

Endemic sheep and cattle diseases represent a constant strain and impact to animal health and welfare, the environment, public health, and the economy. Quantifying this impact helps to inform decisions on surveillance and control of livestock diseases. This systematic literature review had two objectives; to describe the economic impact of endemic sheep and cattle diseases in the United Kingdom using a broad conceptualisation of impact, and to investigate what variables (e.g. medication costs, loss of production) and methods are included in these calculations. The Prisma protocol for systematic literature reviews was followed. Searches were performed in Pubmed, Scopus and Web of Science using selected and trialled search terms. A total of 1129 papers were identified and screened for relevancy; 38 papers were selected for full review extracting and analysing data on disease, impact and methods. From this final selection of papers it was found that; 1) research in this area is mainly focused on the dairy sub-sector, 2) the most mentioned diseases were mastitis and lameness in dairy cattle; bovine viral diarrhoea in beef cattle; and ectoparasites in sheep with reported animal-level costs of £ 77-£ 548/cow/year, £ 26-£ 185/bovine animal/year and £ 40-£ 47/ewe/year, respectively, 3) numerous methods and variables were used to calculate or estimate the economic impact with most studies focussing on the direct producer impacts and less on the wider implications and affected stakeholders; and 4) it was common for studies to look at one disease in isolation rather than consider disease impact on the farm as a whole. It is recommended that future economic impact calculations on livestock disease include wider implications to estimate the true cost of disease. To generate the necessary data, a wider, more inclusive conceptualisation of impact will be needed to support the collection of data and facilitate communication between stakeholders. Systematic health data recording combined with assessment calculations and metrics that allow comparability within or across livestock sub-sectors will increase the informative value of these impact calculations. • Research is heavily weighted towards the dairy industry. • The range in costs demonstrates work is still needed to reduce the avoidable costs. • Few externalities are captured thereby underestimating the societal impact. • Disease interactions and total disease burden on farm needs to be considered. [ABSTRACT FROM AUTHOR]

Pigmeat is the most consumed red meat globally and consumption is expected to continue to increase. The sector is faced by the risk of epidemic and endemic disease impacts and other adverse influences. The aim of this study was to develop a dynamic simulation model of pig growing and finishing that can be used to model the financial and economic impacts of a variety of scenarios both related to disease effects and other influences on production. The model consists of a physical performance module and financial performance module. The core of the physical performance module comprises three stocks to model the flow of pigs from purchase to slaughter. Mortality rates, daily live weight gain and feed conversion ratios influence the dynamics of the physical performance. Since contracts between farmers and slaughterhouses often include large price penalties for over- and underweight pigs, carcase weight distribution is an important determinant of revenues. The physical performance module, therefore, simulates slaughter weight variations. The financial performance module calculates revenue, costs and gross margins. The revenue calculations take into account price penalties for over- and underweight pigs. To demonstrate the capabilities of the model, we apply the model to assess the economic consequences of production impacts associated with respiratory disease. We use estimated production impacts associated with respiratory disease from a study of all-in-all out growing and finishing systems based on pig production data and information from slaughterhouse monitoring in the UK. Our model suggests a reduction in the gross margin of nearly 40 % as a consequence of the estimated production impacts associated with a 10% increase in respiratory disease prevalence. Due to the lack of reliable information on slaughter weight variation, we also simulate the model using different assumptions about the slaughter weight distribution. An increase in the standard deviation of carcase weights from 8 kg to 12 kg, holding average weights constant, more than halves gross margins under our scenarios. We suggest that for all-in-all-out systems, carcase weight variation is likely to be a substantial factor in reducing income in the presence of respiratory disease and the economic impact of respiratory disease may be underestimated if the effects of disease on variation in carcase weights are not included in any analysis. • A flexible modeling tool for physical and financial performance of pig production. • Variation in carcase weights is important due to common contract arrangements. • Respiratory disease is estimated to decrease gross margins by nearly 40 %. [ABSTRACT FROM AUTHOR]

This paper reflects on approaches to collaborative knowledge exchange projects between UK universities and the creative economy. It develops a preliminary account of cultural ecology as a systematic approach to producing impact in the creative economy. It argues that such an approach is a powerful way to aggregate micro-businesses and small and medium sized enterprises in a meaningful network of new relationships. The paper uses social network analysis software to begin to visualise the pattern of relationships that constitute the ecosystem. The paper reports on the work of the Research and Enterprise for Arts and Creative Technologies Hub, one of four Knowledge Exchange Hubs for the Creative Economy established by the Arts and Humanities Research Council. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression are common among women during pregnancy and the year after birth. The consequences, both for the women themselves and for their children, can be considerable and last for many years. This study focuses on the economic consequences, aiming to estimate the total costs and health-related quality of life losses over the lifetime of mothers and their children.Method: A pathway or decision modelling approach was employed, based on data from previous studies. Systematic and pragmatic literature reviews were conducted to identify evidence of impacts of perinatal anxiety and depression on mothers and their children.Results: The present value of total lifetime costs of perinatal depression (anxiety) was £75,728 (£34,811) per woman with condition. If prevalence estimates were applied the respective cost of perinatal anxiety and depression combined was about £8500 per woman giving birth; for the United Kingdom, the aggregated costs were £6.6 billion. The majority of the costs related to adverse impacts on children and almost a fifth were borne by the public sector.Limitations: The method was exploratory in nature, based on a diverse range of literature and encountered important data gaps.Conclusions: Findings suggest the need to allocate more resources to support women with perinatal mental illness. More research is required to understand the type of interventions that can reduce long-term negative effects for both mothers and offspring. [ABSTRACT FROM AUTHOR]