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Background The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is used in the Japanese National Immunization Program for older adults and adults with increased risk for pneumococcal disease, however, disease incidence and associated burden remain high. We evaluated the cost-effectiveness of pneumococcal conjugate vaccines (PCVs) for adults aged 65 years and high-risk adults aged 60–64 years in Japan.Research design and methods Using a Markov model, we evaluated lifetime costs using societal and healthcare payer perspectives and estimated quality-adjusted life-years (QALYs), and number of prevented cases and deaths caused by invasive pneumococcal disease (IPD) and non-IPD. The base case analysis used a societal perspective.Results In comparison with PPSV23, the 20-valent PCV (PCV20) prevented 127 IPD cases 10,813 non-IPD cases (inpatients: 2,461, outpatients: 8,352) and 226 deaths, and gained more QALYs (+0.0015 per person) with less cost (-JPY22,513 per person). All sensitivity and scenario analyses including a payer perspective analysis indicated that the incremental cost-effectiveness ratios (ICERs) were below the cost-effectiveness threshold value in Japan (JPY5 million/QALY).Conclusions PCV20 is both cost saving and more effective than PPSV23 for adults aged 65 years and high-risk adults aged 60–64 years in Japan.

Current approaches to the provision of shelter, largely driven by national governments and/or the commercial private sector, continue to fall short of what is needed to reduce housing deficits. The number of people without access to adequate housing continues to grow, especially in cities of the Global South. Increasing attention is being paid to alternative models for organizing land and housing delivery, such as those led by, or at least including, civil society. In this paper, we consider two national land and housing programs—the 20,000 Plots Project in Tanzania, and Basic Services for the Urban Poor (BSUP) in India—alongside community-led housing initiatives from each country. We explore the extent to which community participation in housing delivery can have social and environmental advantages when compared to ‘business as usual’ methods and find that, given appropriate state support, community-based, and civil society actors (including organizations of the urban poor) have significant potential to contribute to acquiring land, building homes and improving the quality of life of vulnerable segments of the population. This paper echoes calls for community-led housing to become a recognized part of formal housing policy whilst emphasizing the need for theoretical refinement of the process so as to prevent it from being captured by prevailing market-led narratives.

Background: The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is used in the Japanese National Immunization Program for older adults and adults with increased risk for pneumococcal disease, however, disease incidence and associated burden remain high. We evaluated the cost-effectiveness of pneumococcal conjugate vaccines (PCVs) for adults aged 65 years and high-risk adults aged 60–64 years in Japan. Research design and methods: Using a Markov model, we evaluated lifetime costs using societal and healthcare payer perspectives and estimated quality-adjusted life-years (QALYs), and number of prevented cases and deaths caused by invasive pneumococcal disease (IPD) and non-IPD. The base case analysis used a societal perspective. Results: In comparison with PPSV23, the 20-valent PCV (PCV20) prevented 127 IPD cases 10,813 non-IPD cases (inpatients: 2,461, outpatients: 8,352) and 226 deaths, and gained more QALYs (+0.0015 per person) with less cost (-JPY22,513 per person). All sensitivity and scenario analyses including a payer perspective analysis indicated that the incremental cost-effectiveness ratios (ICERs) were below the cost-effectiveness threshold value in Japan (JPY5 million/QALY). Conclusions: PCV20 is both cost saving and more effective than PPSV23 for adults aged 65 years and high-risk adults aged 60–64 years in Japan. [ABSTRACT FROM AUTHOR]

As current action remains insufficient to meet the goals of the Paris agreement let alone to stabilize the climate, there is increasing hope that solutions related to demand, services and social aspects of climate change mitigation can close the gap. However, given these topics are not investigated by a single epistemic community, the literature base underpinning the associated research continues to be undefined. Here, we aim to delineate a plausible body of literature capturing a comprehensive spectrum of demand, services and social aspects of climate change mitigation. As method we use a novel double-stacked expert—machine learning research architecture and expert evaluation to develop a typology and map key messages relevant for climate change mitigation within this body of literature. First, relying on the official key words provided to the Intergovernmental Panel on Climate Change by governments (across 17 queries), and on specific investigations of domain experts (27 queries), we identify 121 165 non-unique and 99 065 unique academic publications covering issues relevant for demand-side mitigation. Second, we identify a literature typology with four key clusters: policy, housing, mobility, and food/consumption. Third, we systematically extract key content-based insights finding that the housing literature emphasizes social and collective action, whereas the food/consumption literatures highlight behavioral change, but insights also demonstrate the dynamic relationship between behavioral change and social norms. All clusters point to the possibility of improved public health as a result of demand-side solutions. The centrality of the policy cluster suggests that political actions are what bring the different specific approaches together. Fourth, by mapping the underlying epistemic communities we find that researchers are already highly interconnected, glued together by common interests in sustainability and energy demand. We conclude by outlining avenues for interdisciplinary collaboration, synthetic analysis, community building, and by suggesting next steps for evaluating this body of literature.