The Global Burden of Animal Diseases (GBADs) programme follows a multistage process to produce disease burden estimates in livestock and farmed aquatic animal production systems. The GBADs programme has broad goals of inclusivity, transparency and rigour. Meeting those goals means providing users of all levels of technical expertise with a clear explanation of the programme\'s output. In this way, the meaning and limitations of those results are clearly communicated, minimising the risk of misinterpretation. The first published estimates of disease burden have been calculated at farm level using a new metric called the Animal Health Loss Envelope. This metric estimates the cost of lost productivity and expenditure on disease control for profit-maximising producers by comparing current system performance to a hypothetical ‘ideal health\'scenario. This ideal is a farm-specific concept and is critically different from an ideal health state when physiologically defined. The metric and its key concepts are described in this article.
Le programme \" Impact mondial des maladies animales \" (GBADs) procède par analyses successives pour générer des estimations de l\'impact des maladies dans les systèmes de production d\'animaux terrestres et aquatiques. Le programme GBADs s\'est fixé des objectifs ambitieux d\'inclusivité, de transparence et de rigueur. Pour que ces objectifs soient tenus, tous les utilisateurs du programme, quel que soit leur niveau de compétences techniques, doivent y trouver une explication claire des résultats produits. La signification et les limites de ces résultats sont ainsi clairement exposées, ce qui minimise les risques d\'erreurs d\'interprétation. Les premières estimations publiées de l\'impact des maladies ont été calculées à l\'échelle des élevages, en faisant appel à un nouvel indicateur dénommé \" enveloppe des pertes sanitaires animales \". Cet indicateur estime le coût des pertes de productivité et les dépenses liées au contrôle des maladies chez des éleveurs cherchant une maximisation des profits, en comparant les performances du système actuel avec ceux d\'un scénario hypothétique de \" santé idéale \". Cet idéal est un concept forgé spécifiquement pour chaque exploitation et diffère donc radicalement de la situation sanitaire idéale définie par des critères physiologiques. L\'auteur décrit l\'indicateur et ses concepts essentiels.
El programa sobre el Impacto Global de las Enfermedades Animales (GBADs) sigue un proceso de varias etapas para elaborar estimaciones del impacto de las enfermedades en los sistemas de producción ganadera y de animales acuáticos. El programa GBADs tiene como objetivos generales la inclusión, la transparencia y el rigor. Cumplir dichos objetivos implica proporcionar a los usuarios, independientemente de su nivel de conocimientos técnicos, una explicación clara de los resultados del programa. De esta manera, el significado y las limitaciones de dichos resultados se comunican con claridad, lo que minimiza el riesgo de interpretaciones erróneas. Las primeras estimaciones publicadas sobre el impacto de las enfermedades se han calculado a nivel de explotación utilizando una medida denominada \"cartera de pérdidas en sanidad animal\". Dicha medida calcula los costos de la pérdida de productividad y los gastos en control de enfermedades para los productores que buscan la maximización de los beneficios comparando el desempeño actual del sistema con un escenario hipotético de \"sanidad ideal\". Este ideal es un concepto específico de cada explotación y difiere mucho del estado de sanidad ideal en términos fisiológicos. En este artículo se describen tanto la medida como sus conceptos clave.

BACKGROUND: Gambling and its harmful effects on human health and well-being represent a significant public health concern in many countries, with electronic gambling machines (EGMs) recognized as one of the most detrimental forms of gambling. Previous research has established an association between EGM accessibility, expenditure, gambling harm, and the socioeconomic status (SES) of neighborhoods. However, there is limited understanding of the direct impact of SES and EGM accessibility on individual player expenditures. Prior estimations of expenditure often rely on self-reported data or venue-level revenue statistics. This study uses high spatial resolution socioeconomic data together with individual-level account-based location and expenditure (point of sales) data (71,669 players, 745 EGM venues) to explore the association between EGM accessibility and neighborhood SES and to examine whether the EGM expenditure of neighborhood residents is associated with EGM accessibility and neighborhood SES.
METHODS: Player account data include information on the home location and expenditure of the entire EGM gambling population across every EGM venue located in the Helsinki region, Finland. High-resolution (250 × 250 m) grid-level data on socioeconomic variables were used to obtain the local socioeconomic conditions of the players. EGM accessibility was estimated for every grid cell using a calibrated gravity model derived from the player account data. Statistical analyses included correlation analysis, spatial autocorrelation analysis, and regression models.
RESULTS: First, significantly higher levels of EGM accessibility were found in areas with lower local SES. Second, regression analysis revealed that both higher EGM accessibility and lower local SES were associated with higher annual losses per adult. These results, in combination with visual and spatial autocorrelation analyses, revealed that accessibility to EGM gambling is highly concentrated, especially in lower socioeconomic neighborhoods with higher levels of EGM expenditure.
CONCLUSIONS: The results lay the groundwork for future spatial research on gambling harm, expenditure, accessibility, and SES utilizing detailed account data on the interaction between players and venues. The results underscore the importance of spatial restrictions when regulating EGM accessibility, particularly in areas with vulnerable populations, as a crucial measure for public health and harm prevention. The results also enable targeted gambling harm prevention actions at the local level.

OBJECTIVE: Australians spend more per capita on gambling than any other country in the world. Electronic gaming machines (EGM) expenditure accounts for almost 90% of this expenditure. No study to date has conducted a rigorous longitudinal analysis of the relationship between gambling expenditure and crime. This study aimed to estimate the short- and long-run relationship between gambling expenditure and crime.
METHODS: Longitudinal analysis using panel autoregressive distributed lag (ARDL) modelling.
METHODS: Recorded property and violent crimes committed in New South Wales (NSW), Australia, between 28 December 2015 and 5 January 2020.
METHODS: Monthly gross EGM expenditure profit, broken down by Local Government Area (LGA). Monthly recorded rates of assault, break enter and steal (dwelling), break enter and steal (non-dwelling), break enter and steal (total), motor vehicle theft, stealing from a motor vehicle, stealing from a retail store, stealing from the person, stealing (total) and fraud.
RESULTS: Each 10% increase in gambling expenditure in NSW is associated with annual: 7.4% increase in assaults, 10.5% increase in break and enter (dwelling) offences; 10.3% increase in break and enter (non-dwelling) offences; 11% increase in motor vehicle theft offences; 8.2% increase in stealing from motor vehicle offences; and 7.4% increase in fraud offences.
CONCLUSIONS: Electronic gaming expenditure appears to be positively associated with property and violent crime in New South Wales, Australia.

BACKGROUND: Understanding healthcare-seeking behavior and examining health expenditures can help determine possible barriers to accessing healthcare and direct more effective and inclusive healthcare systems. This study aimed to evaluate healthcare-seeking behavior and out-of-pocket healthcare expenditure in a sample of the population in Erbil, Iraq.
METHODS: We conducted this cross-sectional study in Erbil, Kurdistan Region of Iraq, from October to December 2023. A convenience sample of 414 adults completed a self-administered online survey. The following data were collected: recent illness, sociodemographic characteristics, type of healthcare received, and cost of healthcare.
RESULTS: The most common health conditions reported were communicable diseases (16.3%), musculoskeletal problems (13.1%), and noncommunicable diseases (12.7%). Approximately 85% of patients with health conditions requiring care sought healthcare; most visited private clinics (46.3%) and private hospitals (18.6%). The median total out-of-pocket healthcare expenditure in US dollars was 117.3 (interquartile range (IQR) = 45.6-410.0). The median total cost was much greater for participants who first visited a private health facility (USD 135.5, IQR = 57.3-405.6) than those who first visited a public facility (USD 76.8, IQR = 16.1-459.7). Participants ≥ 60 years spent significantly more than those < 14 years (USD 332, 95% CI = 211-453, p < 0.001). Evermarried participants spent significantly more than unmarried (USD 97, 95% CI = 1 to 192, p = 0.047). Health expenditures were significantly greater for noncommunicable diseases than infectious diseases (USD 232, 95% CI = 96-368, p = 0.001). After adjusting for covariates, age ≥ 60 years was independently associated with higher spending (USD 305, 95% CI = 153-457, p < 0.001).
CONCLUSIONS: Most participants sought care from formal health services, preferring the private sector. Seeking care from private facilities incurred significantly higher costs than seeking care from public ones, which suggests potential barriers to accessing healthcare, particularly affordability. The findings underscore the importance of evaluating existing healthcare policies to enhance effectiveness and identify areas for improvement. This study can help policymakers and healthcare providers design effective interventions, allocate resources efficiently, and improve healthcare delivery.

OBJECTIVE: Much of the cost data from India is restricted to patients recruited purely from healthcare institutions and do not explore determinants. Therefore, the out of pocket expenditure for ambulatory diabetes care was evaluated in Delhi.
METHODS: The DEDICOM-II survey used a two-stage probability-proportionate-to-size(systematic) cluster design. Thirty clusters were chosen to recruit 25 to 30 subjects per area. We used questionnaires to estimate the direct out-of-pocket expenditure (OOPE) on drugs, investigations, consultation and travel, excluding hospitalization, and then analysed its determinants and impact on quality of care.
RESULTS: We enrolled 843 subjects with a mean age of 53.1 years. The annual direct OOPE on ambulatory care of diabetes was US$ 116.3 (95 % CI 93.8-138.9) or INR 8074.8 (95 % CI 6512.9-9636.7), corresponding to 3.6 %(95 % CI 2.9-4.3) of the yearly family income. The burden of expenses was disproportionately higher for those visiting private providers from lower-income groups(19.1 %). Duration of disease and treatment with insulin predicted higher annual OOPE while care at public facilities was less expensive. Cost was higher for those adhering to the recommended processes of care. Quality of care was better for institutional care and worse for alternative medicine or self-care.
CONCLUSIONS: The study provides representative estimates of the high cost of diabetes management in Delhi across the socio-economic and care provider spectra. Poorer patients suffer a high financial burden from diabetes, highlighting the need for enhancing equity in diabetes care.

We discuss the ramifications of the Commonwealth of Australia Budget allocations for mental healthcare for 2024-2025. There is funding for population-based mental health initiatives for milder anxiety and depression but no direct funding of services for the most severe and disabling forms of mental illness, other than pre-existing state/territory disbursements from the Commonwealth for state-based health services. There are substantial concerns that the Commonwealth funding has potentially been misallocated to ineffective interventions that are unlikely to reduce the population prevalence of mild anxiety and depression in Australia. Funds may have been better allocated to provide effective care for those with the most severe and disabling illnesses including schizophrenia, bipolar disorder and severe depression.

OBJECTIVE: Breast cancer is the most frequently diagnosed cancer among women worldwide. Mortality-to-incidence ratio (MIR) is a marker that reflects the efficacy and availability of screening interventions and treatment outcomes. MIR can be used to influence public health strategy. The association between the MIRs for breast cancer among countries with different economic statuses and health expenditure is important yet has been investigated. This study was aimed to elucidate the association between the breast cancer MIRs and the human development and health expenditure among different countries.
METHODS: Cancer incidence and mortality rates were obtained from the GLOBOCAN database. The MIRs were calculated by dividing the crude rate of mortality to the incidence. Associations among the MIR and variants of human development index (HDI) and current health expenditure (CHE) in 50 countries were estimated via linear regression.
RESULTS: Breast cancer had a higher incidence rate, but lower mortality rate, in developed countries (high HDI, CHE per capita, CHE/GDP), as compared with developing countries. Favorable MIRs were associated with a high HDI and high health expenditure countries (presented by high CHE per capita, and CHE/GDP) (both p < 0.001) CONCLUSION: The MIR for breast cancer is reversely correlated with the development and healthcare disparities among different countries. This implies that allocating more resources to healthcare systems for breast cancer screening and treatment can improve disease outcomes. Our report may be helpful for public health policy making.

Science, technology, and innovation (STI) play a vital role in driving economic growth and social development. STI measurement, including the measurement of Research and Development (R&D) investment, is crucial in providing evidence for policy and decision-making to support STI in a country. In South Africa, the Human Sciences Research Council\'s Centre for Science, Technology and Innovation Indicators (CeSTII), has, on behalf of the Department of Science and Innovation (DSI), conducted the annual national R&D Survey over the past two decades. As part of this, CeSTII has maintained an extensive database of historic unit-level survey responses. To date, the centre has a rich repository of curated R&D survey data series. These datasets are key tools for enhancing the system of STI indicators for evidence-based policy-making within the National System of Innovation (NSI). In this survey, CeSTII annually collects and reports on the country\'s R&D expenditure and personnel data across five sectors: business, not-for-profit organisations, government, science councils, and higher education institutions. Recently, these individual datasets have been merged to establish a coherent time series dataset to mitigate the challenge of repeatedly seeking historical data, which may be cumbersome and time-intensive process. The R&D indicators statistics are used by the government to inform STI policy on R&D for national priorities and required R&D funding levels and for monitoring and benchmarking purposes.

UNASSIGNED: This study forecasts the income and expenditures of the long-term care insurance fund, provides a basis for formulating the raising standard of the long-term care insurance fund, and explores the measures to improve the pilot work of long-term care insurance.
UNASSIGNED: By using the exponential smoothing and ARIMA models to forecast the income and expenditure of the old-age care insurance fund in 2022, the problems existing in the operation of the long-term care insurance fund are discussed.
UNASSIGNED: In 2022, the income of the old-age insurance fund was 28.8934 million yuan, and the fund compensation expenditure was 28.4070 million yuan, with a slight balance of the fund. The highest relative errors of income and expenditure forecast models are -2.03% and - 2.76%, respectively. According to the results of fund expenditure, the annual financing standard should be 132.93 yuan/person, and the individual financing standard should be 66.47 yuan/person.
UNASSIGNED: Through the integration of personal payment, welfare, sports lottery public welfare income, social donations, and other ways, we can gradually establish a multi-channel risk-sharing financing. We will appropriately raise the standard for individual financing and the annual contribution standard for individuals from 50 yuan to 66.47 yuan. This will promote sustainable development of long-term insurance system.

BACKGROUND: The Apple Watch (AW) Series 1 provides energy expenditure (EE) for wheelchair users but was found to be inaccurate with an error of approximately 30%, and the corresponding error for heart rate (HR) provided by the Fitbit Charge 2 was approximately 10% to 20%. Improved accuracy of estimated EE and HR is expected with newer editions of these smart watches (SWs).
OBJECTIVE: This study aims to assess the accuracy of the AW Series 4 (wheelchair-specific setting) and the Fitbit Versa (treadmill running mode) for estimating EE and HR during wheelchair propulsion at different intensities.
METHODS: Data from 20 manual wheelchair users (male: n=11, female: n=9; body mass: mean 75, SD 19 kg) and 20 people without a disability (male: n=11, female: n=9; body mass: mean 75, SD 11 kg) were included. Three 4-minute wheelchair propulsion stages at increasing speed were performed on 3 separate test days (0.5%, 2.5%, or 5% incline), while EE and HR were collected by criterion devices and the AW or Fitbit. The mean absolute percentage error (MAPE) was used to indicate the absolute agreement between the criterion device and SWs for EE and HR. Additionally, linear mixed model analyses assessed the effect of exercise intensity, sex, and group on the SW error. Interclass correlation coefficients were used to assess relative agreement between criterion devices and SWs.
RESULTS: The AW underestimated EE with MAPEs of 29.2% (SD 22%) in wheelchair users and 30% (SD 12%) in people without a disability. The Fitbit overestimated EE with MAPEs of 73.9% (SD 7%) in wheelchair users and 44.7% (SD 38%) in people without a disability. Both SWs underestimated HR. The device error for EE and HR increased with intensity for both SWs (all comparisons: P<.001), and the only significant difference between groups was found for HR in the AW (-5.27 beats/min for wheelchair users; P=.02). There was a significant effect of sex on the estimation error in EE, with worse accuracy for the AW (-0.69 kcal/min; P<.001) and better accuracy for the Fitbit (-2.08 kcal/min; P<.001) in female participants. For HR, sex differences were found only for the AW, with a smaller error in female participants (5.23 beats/min; P=.02). Interclass correlation coefficients showed poor to moderate relative agreement for both SWs apart from 2 stage-incline combinations (AW: 0.12-0.57 for EE and 0.11-0.86 for HR; Fitbit: 0.06-0.85 for EE and 0.03-0.29 for HR).
CONCLUSIONS: Neither the AW nor Fitbit were sufficiently accurate for estimating EE or HR during wheelchair propulsion. The AW underestimated EE and the Fitbit overestimated EE, and both SWs underestimated HR. Caution is hence required when using SWs as a tool for training intensity regulation and energy balance or imbalance in wheelchair users.