Suchergebnisse

This paper examines the problem of "charity hazard", which is the crowding out of private insurance demand by government compensation. In the context of flood insurance and disaster financing, charity hazard is particularly worrisome given current trends of increasing flood risks as a result of climate change and more people choosing to locate in high-risk areas. We conduct an experimental analysis of the influence on flood insurance demand of risk and ambiguity preferences and the availability of different forms of government compensation for disaster damage. Certain and risky government compensation crowd out demand, confirming charity hazard, but this is not observed for ambiguous compensation. Ambiguity averse subjects have higher insurance demand when government compensation is ambiguous relative to risky. Policy recommendations are discussed to overcome charity hazard

Cropland ammonia (NH3) emission is a critical driver triggering haze pollution. Many agricultural policies were enforced in past four decades to improve nitrogen (N) use efficiency while maintaining crop yield. Inadvertant reductions of NH3 emissions, which may be induced by such policies, are not well evaluated. Here, we quantify the China's cropland-NH3 emission change from 1980 to 2050 and its response to policy interventions, using a data-driven model and a survey-based dataset of the fertilization scheme. Cropland-NH3 emission in China doubled from 1.93 to 4.02 Tg NH3-N in period 1980-1996, and then decreased to 3.50 Tg NH3-N in 2017. The prevalence of four agricultural policies may avoid ~3.0 Tg NH3-N in 2017, mainly located in highly-fertilized areas. Optimization of fertilizer management and food consumption could mitigate three quarters of NH3 emission in 2050 and lower NH3 emission intensity (emission divided by crop production) close to the European Union and the United States. Our findings provide an evidence on the decoupling of cropland-NH3 from crop production in China, and suggest the need to achieve cropland-NH3 mitigation while sustaining crop yields in other developing economies.

Cropland ammonia (NH3) emission is a critical driver triggering haze pollution. Many agricultural policies were enforced in past four decades to improve nitrogen (N) use efficiency while maintaining crop yield. Inadvertant reductions of NH3 emissions, which may be induced by such policies, are not well evaluated. Here, we quantify the China's cropland-NH3 emission change from 1980 to 2050 and its response to policy interventions, using a data-driven model and a survey-based dataset of the fertilization scheme. Cropland-NH3 emission in China doubled from 1.93 to 4.02 Tg NH3-N in period 1980-1996, and then decreased to 3.50 Tg NH3-N in 2017. The prevalence of four agricultural policies may avoid ~3.0 Tg NH3-N in 2017, mainly located in highly-fertilized areas. Optimization of fertilizer management and food consumption could mitigate three quarters of NH3 emission in 2050 and lower NH3 emission intensity (emission divided by crop production) close to the European Union and the United States. Our findings provide an evidence on the decoupling of cropland-NH3 from crop production in China, and suggest the need to achieve cropland-NH3 mitigation while sustaining crop yields in other developing economies.

Natural disasters cause considerable losses to people's lives and property. Satellite images can provide crucial information of the affected areas for the first time, conducive to relieving the people in disaster and reducing the economic loss. However, the traditional satellite image analysis method based on manual processing drains workforce and material resources, which slowed the government's response to the disaster. Aiming at the natural disasters like floods and earthquakes that often happen in the south of China, we propose a dual-stage damage assessment method based on LEDNet and ResNet. Our method detects the changes between the satellite images captured before and after a disaster of the same area, segments the buildings, and evaluates the damage level of affected buildings. In addition, we calculate influence maps based on the damage scale to the building and estimate the damage situation for electrical facilities. We used images related to earthquakes and floods in the xBD dataset to train the network model. Moreover, qualitative and quantitative evaluations demonstrated that our method has higher accuracy than the xBD baseline.

Background: The Chinese government has provided health services to those infected by the human immunodeficiency virus (HIV) under the acquired immunodeficiency syndrome (AIDS) care policy since 2003. Detailed research on the actual expenditures and costs for providing care to patients with AIDS is needed for future financial planning of AIDS health care services and possible reform of HIV/AIDS-related policy. The purpose of the current study was to determine the actual expenditures and factors influencing costs for untreated AIDS patients in a rural area of China after initiating highly active antiretroviral therapy (HAART) under the national Free Care Program (China CARES).Methods: A retrospective cohort study was conducted in Yunnan and Shanxi Provinces, where HAART and all medical care are provided free to HIV-positive patients. Health expenditures and costs in the first treatment year were collected from medical records and prescriptions at local hospitals between January and June 2007. Multivariate linear regression was used to determine the factors associated with the actual expenditures in the first antiretroviral (ARV) treatment year.Results: Five ARV regimens are commonly used in China CARES: zidovudine (AZT) + lamivudine (3TC) + nevirapine (NVP), stavudine (D4T) + 3TC + efavirenz (EFV), D4T + 3TC + NVP, didanosine (DDI) + 3TC + NVP and combivir + EFV. The mean annual expenditure per person for ARV medications was US$2,242 (US$1 = 7 Chinese Yuan (CNY)) among 276 participants. The total costs for treating all adverse drug events (ADEs) and opportunistic infections (OIs) were US$29,703 and US$23,031, respectively. The expenses for treatment of peripheral neuritis and cytomegalovirus (CMV) infections were the highest among those patients with ADEs and OIs, respectively. On the basis of multivariate linear regression, CD4 cell counts (100-199 cells/μL versus <100 cells/μL, P = 0.02; and ≥200 cells/μL versus <100 cells/μL, P < 0.004), residence in Mangshi County (P < 0.0001), ADEs (P = 0.04) and OIs (P = 0.02) were significantly associated with total expenditures in the first ARV treatment year.Conclusions: This is the first study to determine the actual costs of HIV treatment in rural areas of China. Costs for ARV drugs represented the major portion of HIV medical expenditures. Initiating HAART in patients with higher CD4 cell count levels is likely to reduce treatment expenses for ADEs and OIs in patients with AIDS. © 2011 Zhou et al; licensee BioMed Central Ltd.

In the past 200 years, vaccines have had unmistakable impacts on public health including declines in morbidity and mortality, most markedly in economically-developed countries. Highly engineered vaccines including vaccines for conditions other than infectious diseases are expected to dominate future vaccine development. We examine immunization vaccine policy as a driver of vaccine innovation and development. The pathways to recommendation for use of licensed vaccines in the US, UK, Canada and Australia have been similar, including: expert review of disease epidemiology, disease burden and severity; vaccine immunogenicity, efficacy and safety; programmatic feasibility; public demand; and increasingly cost-effectiveness. Other attributes particularly important in development of future vaccines are likely to include: duration of immunity for improved vaccines such as pertussis; a greater emphasis on optimizing community protection rather than direct protection only; programmatic implementation, feasibility, improvements (as in the case of development of a universal influenza vaccine); public concerns/confidence/fears related to outbreak pathogens like Ebola and Zika virus; and major societal burden for combating hard to treat diseases like HIV and antimicrobial resistant pathogens. Driving innovation and production of future vaccines faces enormous economic hurdles as available approaches, technologies and regulatory pathways become more complex. As such, cost-mitigating strategies and focused, aligned efforts (by governments, private organizations, and private-public partnerships) will likely be needed to continue to spur major advances in vaccine technologies and development.

BACKGROUND: Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, which are typically transmitted via respiratory droplets, are leading causes of invasive diseases, including bacteraemic pneumonia and meningitis, and of secondary infections subsequent to post-viral respiratory disease. The aim of this study was to investigate the incidence of invasive disease due to these pathogens during the early months of the COVID-19 pandemic. METHODS: In this prospective analysis of surveillance data, laboratories in 26 countries and territories across six continents submitted data on cases of invasive disease due to S pneumoniae, H influenzae, and N meningitidis from Jan 1, 2018, to May, 31, 2020, as part of the Invasive Respiratory Infection Surveillance (IRIS) Initiative. Numbers of weekly cases in 2020 were compared with corresponding data for 2018 and 2019. Data for invasive disease due to Streptococcus agalactiae, a non-respiratory pathogen, were collected from nine laboratories for comparison. The stringency of COVID-19 containment measures was quantified using the Oxford COVID-19 Government Response Tracker. Changes in population movements were assessed using Google COVID-19 Community Mobility Reports. Interrupted time-series modelling quantified changes in the incidence of invasive disease due to S pneumoniae, H influenzae, and N meningitidis in 2020 relative to when containment measures were imposed. FINDINGS: 27 laboratories from 26 countries and territories submitted data to the IRIS Initiative for S pneumoniae (62 837 total cases), 24 laboratories from 24 countries submitted data for H influenzae (7796 total cases), and 21 laboratories from 21 countries submitted data for N meningitidis (5877 total cases). All countries and territories had experienced a significant and sustained reduction in invasive diseases due to S pneumoniae, H influenzae, and N meningitidis in early 2020 (Jan 1 to May 31, 2020), coinciding with the introduction of COVID-19 containment measures in each country. By contrast, no significant changes in the incidence of invasive S agalactiae infections were observed. Similar trends were observed across most countries and territories despite differing stringency in COVID-19 control policies. The incidence of reported S pneumoniae infections decreased by 68% at 4 weeks (incidence rate ratio 0·32 [95% CI 0·27-0·37]) and 82% at 8 weeks (0·18 [0·14-0·23]) following the week in which significant changes in population movements were recorded. INTERPRETATION: The introduction of COVID-19 containment policies and public information campaigns likely reduced transmission of S pneumoniae, H influenzae, and N meningitidis, leading to a significant reduction in life-threatening invasive diseases in many countries worldwide. FUNDING: Wellcome Trust (UK), Robert Koch Institute (Germany), Federal Ministry of Health (Germany), Pfizer, Merck, Health Protection Surveillance Centre (Ireland), SpID-Net project (Ireland), European Centre for Disease Prevention and Control (European Union), Horizon 2020 (European Commission), Ministry of Health (Poland), National Programme of Antibiotic Protection (Poland), Ministry of Science and Higher Education (Poland), Agencia de Salut Pública de Catalunya (Spain), Sant Joan de Deu Foundation (Spain), Knut and Alice Wallenberg Foundation (Sweden), Swedish Research Council (Sweden), Region Stockholm (Sweden), Federal Office of Public Health of Switzerland (Switzerland), and French Public Health Agency (France).