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This paper focuses on the role of fertilizers within regional nutrient cycles. Bio-based fertilizers can contribute to regional nutrient circularity, but the question remains whether production and consumption of bio-based fertilizers is beneficial to the farmer and the environment. Therefore, both farmers' private costs and environmental externalities should be taken into account. We formulate a farm-level multi-objective optimization model by considering a range of fertilizers, their costs and the environmental consequences associated with their production and use. The cost-minimization approach is applied to a conceptualized Flemish leek farmer aiming to safeguard nutrient uptake while being constrained by nutrient standards and the availability of on-farm residues. Our results suggest that mineral fertilizers have an important role in the fertilizer mix despite their environmental externalities. Nevertheless, there is also a role for bio-based fertilizers. These results have implications for farmers and policymakers wishing to internalize fertilizer externalities.

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There are competing perspectives on the impact of Hispanic immigrants' social networks on health; the Hispanic health paradox views networks as sources of resilience, whereas the tenuous ties perspective views networks as sources of risk. In this study, I explore the effect of networks on health by examining three network pathways: social capital, social bonding, and network stress. Using egocentric social network data from the VidaSana Study, a survey of 547 Hispanic immigrants in Indiana, I investigate how each network pathway is associated with physical health, mental health, and health care utilization. Results show that networks with greater capital, namely, more network health knowledge, promote physical health and health care access, whereas social bonding, operationalized as close and dense networks, benefits mental health and health care utilization. Network stress contributes to worse mental health yet improved health care access. Implications for social networks and health research among the Hispanics and more broadly are discussed.

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BACKGROUND: Healthcare-associated infections (HAIs) remain a global health challenge, and have elevated rates in Sub-Saharan Africa. HAIs impact patients and their families by causing illness, prolonged hospital stay, potential disability, excess costs and, sometimes, death. The costs of HAIs are increasing due to spreading antimicrobial resistance. A major risk factor for HAIs is lack of water, sanitation and hygiene (WASH); environmental cleaning and healthcare waste management. In Sub-Saharan Africa, these services are lacking in at least 50% of healthcare facilities. AIM: To estimate the costs associated with HAIs at national level in 14 countries in Sub-Saharan Africa. METHODS: Economic methodologies were employed to estimate the medical costs, productivity losses and value of premature death from HAIs, drawing on national statistics and published studies to populate the economic model. RESULTS: In 2022, the number of HAIs was estimated at 4.8 million, resulting in 500,000 deaths. Health-related economic losses amounted to US$13 billion per year, equivalent to 1.14% of combined gross domestic product and US$15.7 per capita. Healthcare costs were US$500 per HAI, and represented 5.6% of total health expenditure. The costs of providing basic WASH were US$0.91 per capita, which, if they reduced HAIs by 50%, would result in benefit-cost ratios of 1.6 (financial healthcare savings alone) and 8.6 (all economic benefits). CONCLUSION: HAIs have a major health and economic burden on African societies, and a significant proportion can be prevented. It is critical that health policy makers and practitioners dedicate policy space, resources and training to address HAIs.

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Assessment of carbon footprint of a crop is an important component of sustainable crop production, as it helps in framing effectual and viable crop management strategies to minimize ecosystem tampering. Thus, in present investigation carbon footprint of potato production system in different agro-climatic zones viz. undulating plain zone, central plain zone and western plain zone of North-west India were estimated, and compared with the recommended practices of these zones. The carbon footprint was higher in undulating plain zone followed by central plain zone and western plain zone with values being 343, 296 and 220 kg CO2 eq./t tuber yield (TY), sequentially, whereas same were 198 kg CO2 eq./t tuber yield (TY) in case of recommended practices. The social cost of carbon (SCC), that represents economic damage from the CO2 emissions, was also estimated. The integrated net economic balance (net return from yield - SCC) was also better in case of recommended practices. The major sources of emission from potato production system were fertilizer (NPK) application (42 %), irrigation (20 %), seed (14 %), fertilizer production (13 %) and energy use (excluding Irrigation) (5 %). Top most in the list of carbon footprint contributors was fertilizer application which was due to imbalanced application of these, and for getting the clear picture of this imbalance as well as its impact, a new and exclusive index- Relative Imbalance Fertilization Index (RIFIcf) was developed and tested. Carbon footprints were also related to tuber yield and an empirical model was developed that can be used to predict tuber yield on the basis of carbon footprint of potato production system. An increase in tuber yield with increasing carbon footprint was noticed, which became somewhat static at higher emissions. The findings of this investigation provide a clear picture of quantitative GHG emissions due to imbalanced inputs that can be plummeted to some extent if already existing recommendations are followed.

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The article presents an attempt to evaluate what factors could contribute into significant changes of both amount and structure of social cost of drug consumption in the region. The analysis, based on preserved basic principles of assessment, was applied to processes that occurred in both state and non-state spheres. The purpose of the study was to analyze main causes of dynamics of social cost of drug consumption during re-assessment. MATERIALS AND METHODS: The social cost of drug consumption in the Samara Oblast was re-assessed in 2017-2020 (first assessment was implemented in 2007-2010). The main causes of increasing of social cost of drug consumption were analyzed on the basis of the study results. RESULTS: In Samara Oblast, due to financial and structural changes in state and non-state spheres, occurred increasing of social cost of drug consumption from 18.0 billion to 25.4 billion rubles per year. At that, percentage of social cost of drug consumption in the gross domestic product decreased from 2.9% to 1.6%. In general structure of expenses greatest changes affected percentage of social aftermath of drug addiction (increase from 17.8% to 26.1%) and expenses of drug consumers (decrease from 69.7% to 62.3%). CONCLUSIONS: The increase of absolute values of financial expenditures of the Oblast related to drug consumption conditioned by financial and structural changes in society, is accompanied by decreasing of percentage of ocial cost of drug consumption in value of gross domestic product. The main cause of its dynamics is significant increasing of gross regional product.

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The present study examines the assumptions, modeling structure, and results of DICE-2023, the revised Dynamic Integrated Model of Climate and the Economy (DICE), updated to 2023. The revision contains major changes in the treatment of risk, the carbon and climate modules, the treatment of nonindustrial greenhouse gases, discount rates, as well as updates on all the major components. Noteworthy changes are a significant reduction in the target for the optimal (cost-beneficial) temperature path, a lower cost of reaching the 2 °C target, an analysis of the impact of the Paris Accord, and a major increase in the estimated social cost of carbon.

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BACKGROUND: The majority of inguinal hernias are usually paucisymptomatic, so are restored electively. The main purpose of this study is to assess the trends in hernia repair surgery before and during the pandemic period, analyzing an Italian hospital series of 390 patients, in an attempt to quantify the negative impact regarding social costs derived from the Covid-19 outbreak. Moreover, we want to focus on the concept of apparently minor pathology as hernioplasty which could represent a life-threatening condition for patients. METHODS: The study population consisted of all patients operated for inguinal hernia in a General Surgery Unit from 2019 to 2021, divided into a pre-pandemic and a pandemic period. RESULTS: The Covid-19 pandemic increased urgent operations in a complicated setting. A statistically significant difference was found regarding the trend of hospitalization length as well as a strong positive correlation between the severity of hernia and the hospitalization length. CONCLUSIONS: During the pandemic, it has been registered a mishandling of inguinal hernias to the detriment of both the healthcare system and patients, due to multifactorial issues and, in particular, to the restrictions imposed by the regional government that erroneously declassed hernia pathology as a minor problem for public health. We do believe that patients, after diagnosis of inguinal hernia, should learn the Taxis maneuver for its feasibility and ease of execution, in order to reduce access to emergencies in many cases and likewise to better pain and discomfort perceived, even in the event of unexpected worldwide healthcare scenario.

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El objetivo de la presente revisión es analizar, mediante las estimaciones realizadas en estudios previos, los costes de atención médica, física y mental, las pérdidas de productividad, los costes para el sistema de protección infantil y los costes para el sistema de justicia penal de la violencia contra la infancia y la adolescencia, con especial énfasis en la violencia sexual. Los estudios revisados confirman que la violencia en etapas tempranas del desarrollo se asocia con un mayor uso de los servicios de salud y de otros recursos, que suponen una importante inversión pública a tener en cuenta. Estos trabajos presentan limitaciones que derivan de los datos incompletos o poco fiables incluidos respecto a la mortalidad y la morbilidad vinculadas a la violencia contra la infancia y que suponen estimaciones variables de sus costes, que oscilan en España de 17 mil millones de euros para las experiencias adversas en la infancia, a cerca de 1.000 millones de euros para la violencia sexual. Es necesario disponer de datos fiables sobre los costes de la violencia en la infancia para tomar decisiones mejor informadas sobre la inversión económica en su prevención y tratamiento, así como concienciar sobre su escala e impacto.(AU)

The aim of this narrative review is to analyze, through the estimates made in previous studies, the costs of medical, physical, and mental care, productivity losses, costs for the child protection system, and costs for the criminal justice system of violence against children and youth, with special emphasis on sexual violence. The reviewed studies confirm that violence in early stages of development is associated with greater use of health services and other resources, which represent a significant public investment that must be taken into account. These works have limitations that derive from the incomplete or unreliable data included regarding mortality and morbidity related to violence against children and that imply variable estimates of their costs, which in Spain range from 17 billion euros for adverse childhood experiences to around €1 billion for sexual violence. Reliable data on the costs of violence against children is needed to make better-informed decisions about financial investment in its prevention and treatment, as well as to raise awareness of its scale and impact.(AU)

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Plastic waste management is one of the major global challenges at present. Recycling single used plastic waste as partial replacement of natural aggregates in concrete may reduce problems regarding mismanagement of plastic waste and unsustainable utilisation of natural resources as aggregates. This concept has been explored in many studies and positive results are obtained, but it has not been materialized at a large scale due to the uncertainty regarding economic viability. The present study therefore focuses on the economic aspects of using Polyethylene based fine aggregates and Polyethylene Terephthalate based coarse aggregates as partial replacement (10%, 20%, 30% and 40%) of natural fine and coarse aggregates separately and simultaneously, with special emphasis given on environmental and social cost. A material flow diagram using STAN is first developed to calculate plastic waste generation. An industrial survey has been conducted to estimate production cost of plastic aggregates, while social cost as WTP is determined through CVM method. The result shows that the total cost of concrete decreases with increase of replacement percentage and cost reduction varies between 0.65% and 7.58% compare to conventional concrete depending on the percentage and type of replacement without compromising strength. So, alongside being hugely beneficial to environment and society in terms of reduction of leachate and greenhouse gas generation, micro-plastic pollution, requirement of landfill area, mosquito borne diseases, erosion, sedimentation, land loss etc.; the concept of recycling plastic waste as partial replacement of natural aggregates in concrete has been proved to be economically viable and beneficial too.

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The article analyzes the practice of estimating social economic losses of society from drug consumption implemented in Russia and European countries from 2002 to the present time. Purpose of the study is to identify objective indicators and advantages of various calculation methods applied to analyze of foreign and national practice of estimating social and economic losses of society from drug consumption. The analytical method was applied to analyze various approaches to estimating social economic losses of society because of drug consumption in various countries. The sampling of articles was implemented in accordance with the PRISMA guidelines in the PubMed, Google Scholar and eLibrary databases. It is established that in various studies assessing value of social cost of drug consumption, different methodological approaches are applied, which affects the results of assessment. The magnitude of social cost of drug addiction in the studies ranged from 0.00023% to 4.7% of the Gross Domestic (National) Product (GNP). The large part of social cost of drug abuse in GNP is mostly conditioned by estimating number of hidden drug users during the study, as well as by optimal approach in calculating expenditure categories. The assessment of amount of economic losses of society because of drug traffic is needed to make correct management decisions within the framework of implementation of state drug policy at various levels. This approach can help to better use of the public financial resources.

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There is growing interest in green social prescribing and connecting with nature-based activities to promote social cohesion along with improving levels of health, wealth and well-being. The Outdoor Partnership is a third sector organisation based in North Wales offering nature based social prescribing interventions. Individuals experiencing poor mental health and wellbeing are referred from GPs, community mental health services, and third sector organisations to the 'Opening the Doors to the Outdoors' (ODO) programme which is a 12-week outdoor walking and climbing green prescribing intervention. The purpose of the ODO programme is to provide a supportive environment to increase levels of physical activity among participants leading to improvements in overall health and mental wellbeing while promoting socialisation among peers. In this evaluation of a preventative green social prescribing intervention, a mixed method social return on investment (SROI) approach used quantitative and qualitative data from ODO participants. Data collection took place from April 2022-November 2022. Mental wellbeing data was collected at baseline and at 12 weeks using the Short Warwick Edinburgh Mental Wellbeing Scale, a social trust question, an overall health question, and the International Physical Activity Questionnaire- short form. Baseline and follow-up data was available for 52 ODO participants. Results indicate that for every £1 invested in the ODO programme, social values ranging from £4.90 to £5.36 were generated.

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Prompt and appropriate treatment of chronic low back pain (cLBP) is of the utmost importance for preventing relevant disability, high burden of disease, and increasing costs for the healthcare system. Recently, the concept of functional impairment has been associated with any type of chronic pain, and mounting attention has been paid to extending the aims of treatment beyond mere pain remission, including restoration of working capacity, everyday functioning, mobility, and quality of life. Nevertheless, a shared definition of functionality is still lacking. Notably, different specialists involved in the treatment of cLBP such as general practitioners, orthopedists, pain therapists, and physiatrists, and patients themselves have different opinions on what "functional impairment" actually means. On these premises, a qualitative interview study was performed to investigate how the concept of "functionality" is interpreted by different specialists involved in the management of cLBP, and by patients. Overall, all different specialists agreed that functionality should be assessed in clinical practice. However, in spite of several instruments available for evaluating functionality, no homogeneity of behavior is observable.

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Cognitive behavioral therapy (CBT) is effective for pain relief in children and adolescents with functional abdominal pain disorders (FAPDs). However, few studies have focused on the FAPDs specifically and the medium-term or long-term results of CBT. In this meta-analysis, we investigated the efficacy of CBT in pediatric FAPDs and unclassified chronic or recurrent abdominal pain (CAP and RAP, respectively). We searched the PubMed, Embase, and Cochrane Library databases for related randomized controlled trials until August 2021. Eventually, 10 trials with 872 participants were included. The methodological quality of the studies was assessed, and data on two primary and four secondary outcomes of interest were extracted. We used the standardized mean difference (SMD) to measure the same outcome, and precisions of effect sizes were reported as 95% confidence intervals (CIs). We found that CBT had significantly positive effects on reducing pain intensity immediately (SMD: -0.54 [CI: -0.9, -0.19], p = 0.003), 3 months after the intervention (SMD: -0.55; [CI: -1.01, -0.1], p = 0.02) and 12 months after the intervention (SMD: -0.32; [CI: -0.56, -0.08], p = 0.008). CBT also reduced the severity of gastrointestinal symptoms, depression, and solicitousness, improved the quality of life and decreased the total social cost. Future studies should consider uniform interventions in the control group and comparing different CBT delivery methods.

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Facing significant carbon emissions annually, China requires a clear decarbonization strategy to meet its climate targets. This study presents a MESSAGEix-CAEP model to explore Chinese decarbonization pathways and their cost-benefit under two mitigation scenarios by establishing connections between five energy-intensive sectors based on energy and material flows. The results indicated the following: 1) Interaction and feedback between sectors should not be disregarded. The electrification process of the other four sectors was projected to increase electricity production by 206%, resulting in a higher power demand than current forecasts. 2) The marginal abatement cost to achieve carbon neutrality across all five sectors was 2189 CNY/tCO2, notably higher than current Chinese carbon emission trading prices. 3) The cost-benefit analysis indicates that a more ambitious abatement strategy would decrease the marginal abatement cost and result in a higher net carbon abatement benefit. The cumulative net benefit of carbon reduction was 7.8 trillion CNY under ambitious mitigation scenario, 1.3 trillion CNY higher than that under current Chinese mitigation scenario. These findings suggest that policy-makers should focus on the interaction effects of decarbonization pathways between sectors and strengthen their decarbonization efforts to motivate early carbon reduction.

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In the metropolises, it is unlikely to use merely solar and wind energy to pursue zero carbon building design. However, it would become possible if biofuel-driven trigeneration systems (BDTS) are adopted. It is thus essential to assess the application opportunity of BDTS in a holistic way. In this study, BDTS offered definite primary energy saving of up to 15% and carbon emissions reduction of at least 86% in different types of non-residential buildings as compared to the conventional systems. With 24/7 operation for the hotel and hospital buildings, the corresponding BDTS could even achieve zero carbon emissions. All the BDTS primed with compression-ignition internal combustion engine were not economically viable even in running cost due to the high local biodiesel price level. The BDTS primed with spark-ignition engine and fueled by biogas, however, would have economic merit when carbon price was considered for the conventional systems that fully utilize fossil fuels. Adoption of carbon tax and social cost could have the payback ceilings of 8 years and 2 years respectively for most of building types. Consequently, the results could reflect the application potential of BDTS for non-residential buildings, leading the pathway to carbon neutrality for sustainable sub-tropical cities.

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Lead (Pb) pollution has been one of the major environmental problems of worldwide significance. It is a latent factor for several fatal illnesses, whereas the exposure to lead in early childhood causes a lifetime IQ loss. The social cost is the concept to aggregate various adverse effects in a single monetary unit, which is useful in describing the pollution problem and provides foundation for the design of interventions. However, the assessment of the social cost is scarce for developing countries. In this study, we focus on the lead pollution problem of a former mining town, Kabwe, Zambia, where mining wastes abandoned near residential areas has caused a critical pollution problem. We first investigated the social cost of lead pollution that future generations born in 2025-2049 would incur in their lifetime. As the channels of the social cost, we considered the lost income from the IQ loss and the lost lives from lead-related mortality. The results showed that the social cost would amount to 224-593 million USD (discounted to the present value). Our results can be considered conservative, lower bound estimates because we focused only on well-identified effects of lead, but the social cost was still substantial. Then we examined several engineering remediation measures. The results showed that the social cost can be reduced (the benefits of remediations) more than the costs of implementing remediation measures. This study is the first to investigate the social cost of mining-related lead pollution problem in developing countries. Our interdisciplinary approach utilises the micro-level economic, health and pollution data and integrates the techniques in economics, toxicology and engineering.

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A 2-year monitoring campaign was carried out within the Marche Region (Italy) to quantify the potential still edible wasted food (seFW) within the sorted (seFWsorted) and unsorted (seFWunsorted) waste streams. Results were elaborated to estimate the distribution of seFW among the five provinces and the amount per capita. Results in terms of total quantities per inhabitants (seFWindex per capita) depict an important variability between districts but almost constant in years (26-38 kg/inhabitants in 2018 and 26-36 kg/inhabitants in 2019). Scores in Marche were then used to study the national situation, adopting the same percentage factors. Analysis was performed on 2019 data. Gradual colour shade was used to identify the Regions with greater seFW production potential. Worst scores are achieved by Lazio, Lombardia and Sicilia (red), followed by others classified as orange and yellow. More than 1.5 Mt potential seFW was estimated at national level, 29% of which is due to the unsorted fraction. Results at national level were used to assess the potential environmental impact related to seFW in terms of climate change. Carbon footprint indicator was quantified per capita (69 kg equivalent carbon dioxide (CO2e)/inhabitant/year in the case of Marche) and overall (3.5 MtCO2e). In addition, an evaluation of the potential economic implications related to the greenhouse gases emitted was made using the Social Cost of Carbon. Results showed that cost of the tCO2e global damage related to seFW in Italy ranges from 35 to 700 M$.

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A number of investigators have explored the use of value of information (VOI) analysis to evaluate alternative information collection procedures in diverse decision-making contexts. This paper presents an analytic framework for determining the value of toxicity information used in risk-based decision making. The framework is specifically designed to explore the trade-offs between cost, timeliness, and uncertainty reduction associated with different toxicity-testing methodologies. The use of the proposed framework is demonstrated by two illustrative applications which, although based on simplified assumptions, show the insights that can be obtained through the use of VOI analysis. Specifically, these results suggest that timeliness of information collection has a significant impact on estimates of the VOI of chemical toxicity tests, even in the presence of smaller reductions in uncertainty. The framework introduces the concept of the expected value of delayed sample information, as an extension to the usual expected value of sample information, to accommodate the reductions in value resulting from delayed decision making. Our analysis also suggests that lower cost and higher throughput testing also may be beneficial in terms of public health benefits by increasing the number of substances that can be evaluated within a given budget. When the relative value is expressed in terms of return-on-investment per testing strategy, the differences can be substantial.

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Population forecasts are used by governments and the private sector for planning, with horizons up to about three generations (around 2100) for different purposes. The traditional methods are deterministic using scenarios, but probabilistic forecasts are desired to get an idea of accuracy, assess changes, and make decisions involving risks. In a significant breakthrough, since 2015, the United Nations has issued probabilistic population forecasts for all countries using a Bayesian methodology that we review here. Assessment of the social cost of carbon relies on long-term forecasts of carbon emissions, which in turn depend on even longer-range population and economic forecasts, to 2300. We extend the UN method to very-long range population forecasts by combining the statistical approach with expert review and elicitation. While the world population is projected to grow for the rest of this century, it will likely stabilize in the 22nd century and decline in the 23rd century.

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Objectives: Palliative care involves providing symptomatic relief from the pain and stress of a severe illness to markedly improve the quality of life for both the patients and their families. It imposes high indirect costs on the patients. The study was conducted at SGPGIMS, which caters to 500 head-and-neck cancer patients annually. Out of these, 30-40% of cases require dedicated palliative care. Unfortunately, often, when patients reach the stage of palliative care, they have exhausted their all financial reserves. Therefore, a cost analysis of total cost incurred (including out-of-pocket expenditure and social cost) during palliative care in cases of head-and-neck cancer at a Government Regional Cancer Centre was undertaken. Material and Methods: The study is a descriptive study and the study sample consisted of (a) patients who had undergone surgery, chemotherapy, or radiotherapy and had recurred/relapsed and were now candidates for palliative care and (b) patients who presented de novo to the Regional Cancer Centre, SGPGIMS with advanced-stage disease, where the cure was not possible. The expenditure incurred was obtained retrospectively and prospectively from the study samples. Results: The out-of-pocket expenditure per patient per day was INR 2044.21. The social cost per patient per day was INR 518.21. Out of the total expenditure of INR 2562.42/patient/day, 80% of the cost was out-of-pocket expenditure and the remaining 20% was social cost borne by the patient. Conclusion: The study thus added to perspective on the average expenditure on out-of-pocket expenses and social costs being incurred as of date, while getting palliative care for head-and-neck cancer at a Regional Cancer Centre.