Contextual factors related to vector-control interventions for malaria: a scoping review and evidence and gap map protocol.

Objective: This scoping review will identify existing literature regarding contextual factors relevant to vector-control interventions to prevent malaria. We will use the findings of the scoping review to produce an interactive evidence and gap map. The map will assist in the priority setting, development, and conduct of targeted systematic reviews. These systematic reviews seek to assist the Vector Control and Insecticide Resistance Unit of the World Health Organization's Global Malaria Programme by informing recommendation development by their Guidelines Development Group. Introduction: Malaria contributes substantially to the global burden of disease, with an estimated 247 million cases and 619,000 deaths in 2021. Vector-control is key in reducing malaria transmission. Vector-control interventions directly target the mosquito, reducing the potential for parasite infections. These interventions commonly include insecticides used in indoor residual spraying or insecticide-treated nets and larval source management. Several new vector-control interventions are under evaluation to complement these. In addition to estimating the effects of interventions on health outcomes, it is critical to understand how populations at risk of malaria consider them in terms of their feasibility, acceptability, and values. Inclusion Criteria: Eligible studies will have assessed the contextual factors of feasibility or acceptability of the interventions of interest, or the valuation of the outcomes of interests. These assessments will be from the perspective of people who receive (residents) or deliver (workers or technicians) the vector-control intervention for the purpose of preventing malaria. Methods: We will conduct this scoping review in accordance with the JBI methodology for scoping reviews and report in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR). We will construct the evidence and gap map following guidance from the Campbell Collaboration.

Cost-benefit analysis of haemodialysis in patients with end-stage kidney disease in Abuja, Nigeria.

BACKGROUND: Significant gaps in scholarship on the cost-benefit analysis of haemodialysis exist in low-middle-income countries, including Nigeria. The study, therefore, assessed the cost-benefit of haemodialysis compared with comprehensive conservative care (CCC) to determine if haemodialysis is socially worthwhile and justifies public funding in Nigeria. METHODS: The study setting is Abuja, Nigeria. The study used a mixed-method design involving primary data collection and analysis of secondary data from previous studies. We adopted an ingredient-based costing approach. The mean costs and benefits of haemodialysis were derived from previous studies. The mean costs and benefits of CCC were obtained from a primary cross-sectional survey. We estimated the benefit-cost ratios (BCR) and net benefits to determine the social value of the two interventions. RESULTS: The net benefit of haemodialysis (2,251.30) was positive, while that of CCC was negative (-1,197.19). The benefit-cost ratio of haemodialysis was 1.09, while that of CCC was 0.66. The probabilistic and one-way sensitivity analyses results demonstrate that haemodialysis was more cost-beneficial than CCC, and the BCRs of haemodialysis remained above one in most scenarios, unlike CCC's BCR. CONCLUSION: The benefit of haemodialysis outweighs its cost, making it cost-beneficial to society and justifying public funding. However, the National Health Insurance Authority requires additional studies, such as budget impact analysis, to establish the affordability of full coverage of haemodialysis.

Effects of acute stress on reward processing: A comprehensive meta-analysis of rodent and human studies.

Stressors can initiate a cascade of central and peripheral changes that modulate mesocorticolimbic dopaminergic circuits and, ultimately, behavioral response to rewards. Driven by the absence of conclusive evidence on this topic and the Research Domain Criteria framework, random-effects meta-analyses were adopted to quantify the effects of acute stressors on reward responsiveness, valuation, and learning in rodent and human subjects. In rodents, acute stress reduced reward responsiveness (g = -1.43) and valuation (g = -0.32), while amplifying reward learning (g = 1.17). In humans, acute stress had marginal effects on valuation (g = 0.25), without affecting responsiveness and learning. Moderation analyses suggest that acute stress neither has unitary effects on reward processing in rodents nor in humans and that the duration of the stressor and specificity of reward experience (i.e., food vs drugs) may produce qualitatively and quantitatively different behavioral endpoints. Subgroup analyses failed to reduce heterogeneity, which, together with the presence of publication bias, pose caution on the conclusions that can be drawn and point to the need of guidelines for the conduction of future studies in the field.

Does Willingness to Pay differ for mental and physical health?

OBJECTIVES: The urban environment can have a significant impact on mental and physical health. Health impact appraisal of new developments should address these issues. However, transferable economic valuation evidence for urban planners in the UK is thin, especially around mental health, making it harder to estimate the cost-efficiency of public health interventions to address these conditions. A further complication is that mental health may be perceived differently from physical health. This study examines Willingness to Pay (WTP) to avoid depression and lower back pain. METHODS: WTP estimates were obtained by applying contingent valuation tasks in an online survey with a representative sample in the UK (n=1553). Interval regression models were used to estimate the effects of disease severity, payment frequency, and respondent characteristics on WTP. RESULTS: Respondents' WTP to avoid both conditions was relatively high (around 5-6% of stated income to return to current health state). Depression was rated as being twice as burdensome on quality of life than Pain, and bids to avoid Depression were 20-30% more than Pain. Analysis of motivation responses suggests mental health treatment is perceived as less easy to access and less effective than the equivalent for pain, and respondents expect a larger burden on their family and relationships as they try to manage their condition themselves. CONCLUSIONS: Results suggest that depression bids may be affected by uncertainty around access to effective treatment in the health care system. This has implications for how mental illness may be prioritised in resource allocation towards public health interventions.

Statistical and cross-sectional analysis of factors effecting the prevalence of pressure ulcer in hospital admitted stroke patients.

Every year, millions of people around the world are disabled by stroke, it is well recognized that complications aftera stroke extend hospital stays and pressure ulcers, a stroke consequence, which can be prevented by educating the caregiver. The primary focus of this research is not only to investigate the prevalence of pressure ulcers (PU) among stroke patients, but this study also introduced a variety of factors which influence the formation of PU, such as restricted mobility, gender, duration of stroke, hypertension, diabetes, hygiene, type of mattress, malnutrition, awareness, etc. In addition, this research provides a comparative and statistical analysis, a cause of the catastrophic disabilities influenced by a variety of factors. Moreover, the proposed research also provides a room for the pertinent treatment of stroke patient to curtail the formation of pressure ulcer. In this research, a total of 120 stroke patients were initially included to monitor the frequency of pressure ulcers at incipient stage. Out of the total patients, the number of patients with ischemic stroke were 78.5 % while 8.3 % were of haemorrhagic type. In the results, the demographic characteristics and the factors which influence the formation of PU of the patients were examined with their cross-sectional impact on each other through comparative and statistical analysis. It was discovered that among all the stroke patients, 8.3 % were found with a PUs and the most frequent localization was sacrum and no new PU was observed for the participants under the observation.

Willingness to pay for chronic disease management services provided by primary care nurses.

BACKGROUND: Due to the rapid increase in chronic diseases in South Korea, the Korean government has expanded chronic disease management to primary care. Thus, the role of primary care nurses is critical. However, the fee for chronic disease management services provided by primary care nurses has not been set, and few studies have evaluated the value of nursing services. This study aimed to estimate the willingness to pay (WTP) for chronic disease management services provided by primary care nurses and to identify the factors that affect WTP. METHODS: This study adopted a descriptive research design and conducted a cross-sectional online survey from January 16 to 18, 2023. The inclusion criteria were community residents aged ≥ 20 years living in South Korea and capable of participating in online surveys. A total of 520 people participated in this study. A contingent valuation method (CVM) was used with double-bound dichotomous choice questions along with open-ended questions. The mean WTP was calculated using a Tobit model. RESULTS: The mean WTP of the 520 study participants for one chronic disease management service provided by primary care nurses was 15,390.71 Korean won ($11.90). Factors affecting WTP were having a chronic disease, recognition of primary care nurses, and the first-bid price. Community residents with fewer chronic diseases, high awareness of primary care nurses, and a higher first-bid price showed higher WTP for chronic disease management services provided by primary care nurses. CONCLUSIONS: Primary care is important worldwide due to the increasing number of chronic diseases, and Korea is no exception. However, payment for services by primary care nurses is undervalued compared to their critical role and skills. This has led to problems such as a primary care nurse shortage and burnout. This study estimated individuals' WTP for chronic disease management services provided by primary care nurses. The results can be used as a basic resource for setting the fee for services provided by primary care nurses. It is also a good starting point to understand the benefits of primary care nurse services.

The impact of China's urbanization on ecosystem service value from the perspective of gross ecosystem product: a case study of Beijing-Tianjin-Hebei region.

Gross ecosystem product (GEP) is an aggregate measure of the monetary value of final ecosystem services, or the direct benefits that people derive from nature. GEP can provide decision makers with clear and competing evidence of the monetary value of ecosystem services. However, the relationship between GEP and urbanization has not been clarified which is not conducive to the decision-making role of GEP in the process of urban sustainable development. This work focused on the 'Beijing-Tianjin-Hebei' (BTH) urban agglomeration as a case study of the dynamics of ecological production amidst rapid economic and urban development, and coupled a spatial-temporal analysis of regional ecological change based on GIS (Geographic Information System) with economic valuation methods using official statistics and survey data. Results showed that from 2000 to 2020, the GEP increased from 1.55 trillion to 2.36 trillion, the value of provisioning services and cultural services increased from 0.51 to 0.71 trillion to 0.10-0.65 trillion. The value of regulation services showed an upward and downward trend (0.94-1.03-0.98) due to the rapid economic development in the Beijing-Tianjin-Hebei region. There were obvious spatial differences in the distribution of the GEP, in which Beijing, Tianjin, Tangshan, Cangzhou GEP accounted for 15%, 14%, 16% and 11%, respectively. During 2000-2020, there is a significant correlation between urbanization index (UI) and GEP in BTH, but the correlation between GEP and UI shows a trend of first increasing and then decreasing. The correlation between UI and EPS and ERS gradually decreases, and the impact of UI on ETS shows a significant positive correlation. In the future, it can be foreseen that urbanization will suppress the increase of GEP.

Valuation of knowledge, attitude, practices of tuberculosis among the health care workers from Islamabad Pakistan.

BACKGROUND: Tuberculosis (TB) as a foremost infectious disease adds massive burden to morbidity and mortality rate, despite of well-structured TB control programs around the globe. Inappropriate health care management system and poor implementation on standard in relevance to TB, remain some reasons causative to TB prevalence and its rising antimicrobial resistance. Health Care Workers (HCWs) laboring as a part of TB control system, are the vital warriors in achieving the goals of TB End Strategy by 2035. Their performance is influenced by their knowledge, attitude, and practices (KAP) toward this infectious disease. This study aimed to signify the role of KAP score of health care Workers in the better control and prevention of TB in the Islamabad Capital Territory (ICT), Pakistan. METHODS: A cross-sectional study on Knowledge, Attitude and Practice study of Tuberculosis (TB) among health care Workers, was done in ICT, which is the capital of Pakistan. The KAP of TB was collected for the 306 Health Care Workers from all the Islamabad TB referring health facilities which refer the TB patients for testing to the National Reference Laboratory, Islamabad Pakistan. Eligible health care workers were requested to respond on KAP questionnaire after informed consent. KAP questionnaire comprised of knowledge, attitude, and practices section including demographic information. All the data was analyzed using IBM SPSS statistics 21. One Way Analysis of Variance (ANOVA) was applied to calculate KAP mean score against different variables. On the significant data sets of ANOVA output, Tukey's Multiple Comparison Test was applied for pairwise comparison. Pearson correlation coefficient was utilized to explore the association between two qualitative variables. The non-parametric tests were applied to evaluate difference of KAP score in relation to demographic covariates individually. RESULTS: From June to July 2023, we conducted TB KAP study among Health Care Workers of ICT, Pakistan. The average age was 33 years (range 26-30 years). Majority of the recruited subjects were not being trained for dealing with TB infection. The results demonstrated that Health Care Workers working were lacking their knowledge about mode of TB transmission, best diagnostic technique, and contraction of TB infections. The mean knowledge, attitude and practices mean scores were 15.05 (SD = 3.96), 83.68 (SD = 15.74) and 6.31 (SD = 2.21), respectively. Mean knowledge score of Health Care Workers were significantly related to their educational level and occupation while no significant association was declared with working experience as TB staff. Pearson coefficient of attitude score with knowledge of Health Care Workers was of weak level (0.28). Practice mean score was correlated to knowledge mean score at a moderate level (r = 0.40). On the other hand, practice score was r = 0.29 with attitude mean score had shown weak level correlation. A number of demographic factors were strongly linked to each of the mean score of knowledge, attitude, and practices. CONCLUSION: These findings highlighted the significant involvement of education, profession, and professional trainings in the better knowledge, attitude, and practices of the TB related health care Workers. For a better management system of infectious diseases like TB, a well-trained and professionally competent staff of Health Care Workers is important so as to achieve the goal of TB-End strategy by 2035 from Pakistan, which is the 5th highest burden country for TB.

Assessing changes in the ecosystem service value in response to land use and land cover dynamics in Malawi.

Land use and land cover (LULC) changes are inevitable outcomes of socioeconomic changes and greatly affect ecosystem services. Our study addresses the critical gap in the existing literature by providing the first comprehensive national analysis of LULC changes and their impacts on ecosystem service values (ESVs) in Malawi. We assessed changes in ecosystem service values (ESVs) in response to LULC changes using the benefit transfer method in ArcGIS 10.6 software. Our findings revealed a significant increase in grasslands, croplands, and urban areas and a notable decline in forests, shrubs, wetlands, and water bodies. Grassland, cropland, and built-up areas expanded by 52%, 1%, and 23.2%, respectively. In contrast, permanent wetlands, barren land, and water bodies declined by 27.6%, 34.3%, and 1%, respectively. The ESV declined from US$90.87 billion in 2001 to US$85.60 billion in 2022, marking a 5.8% reduction. Provisioning services increased by 0.5% while regulating, supporting, and cultural ecosystem service functions declined by 12.2%, 3.16%, and 3.22%, respectively. The increase in provisioning services was due to the expansion of cropland. However, the loss of regulating, supporting, and cultural services was mainly due to the loss of natural ecosystems. Thus, environmental policy should prioritise the conservation and restoration of natural ecosystems to enhance the ESV of Malawi.

Reducing discrepancies between actual and ideal affect across adulthood: the roles of activity flow conduciveness, pleasantness, and familiarity.

Previous findings demonstrate that people often do not feel how they want to feel, supporting the distinction between "actual affect" and "ideal affect." But are there certain activities that reduce the discrepancy between actual and ideal affect? Based on flow theory and socioemotional selectivity theory, we examined whether the discrepancy between people's actual and ideal positive affect would be smaller during activities that were more conducive to flow (a state of intense absorption and concentration), pleasant, and familiar. In Study 1, U.S. participants aged 17-79 (N = 393) reported their ideal affect and how they felt during activities with varying degrees of challenges and skills. For both low-arousal positive affect (LAP) and high-arousal positive affect (HAP), participants reported smaller actual-ideal affect discrepancies during flow-conducive activities (when skills matched challenges). Study 2 was a 14-day experience sampling study, in which Hong Kong participants aged 18-83 (Nindividual = 109) reported their momentary actual and ideal affect, and how pleasant and familiar their activities were (Nexperience = 3,815). Greater activity familiarity was associated with smaller discrepancies in actual-ideal LAP, while greater activity pleasantness was associated with smaller discrepancies in actual-ideal HAP. These findings provide insights on the activities that help people achieve their ideal affect more easily.

Americans' willingness to give to global immunization programs: Political heterogeneity in preferences for program management and response to priming communications.

To develop effective private donation campaigns that support vaccine distribution in low- and middle-income countries (LMICs), one must understand donors' willingness to give, response to stimuli, and preferences for program management. We use a contingent valuation method to estimate United States citizens' willingness to give to nongovernmental COVID-19 immunization programs in LMICs during the emergency phase of the pandemic. Using split-sample treatments, we evaluate the impact of the immunization program administrator (generic NGO or COVAX) and the role of priming communications on inequality in income and vaccination rates between the US and recipient countries. Results show that the median American would donate $42 towards global immunization programs. Preferences for program management and responses to priming communications are heterogeneous across political affiliations, after controlling for altruistic motives, experiences with COVID, giving behaviors, and sociodemographic characteristics. Specifically, Democrats and Independents are more likely to donate to the COVAX-administered fund, and more responsive to priming statements regarding vaccine-gaps. Policy implications are discussed.

Scale and rate heterogeneity in the EQ-5D-5L valuation.

OBJECTIVES: To estimate values on a quality-adjusted life year (QALY) scale using individual preference evidence, choice analyses typically include ancillary parameters, such as scale factors and discount rates. These parameters potentially differ among respondents. In this study, we investigated how allowing heterogeneity in scale and rate affects the estimation of EQ-5D-5L values. METHODS: Using the first wave of the 2016 EQ-5D-5L valuation study (N = 1017), we estimated a conditional logit (CL) model and three mixed logit models: random scale, random rate, and bivariate. Prior to the exploratory study, we hypothesized that scale and rate are correlated and that allowing heterogeneity in both parameters decreases the number of insignificant incremental effects. We confirmed the exploratory findings by re-estimating these models using paired comparison responses from a second wave (N = 1229). RESULTS: Scale and rate exhibited significant heterogeneity and were positively correlated. As hypothesized, allowing this heterogeneity improved the face validity of the EQ-5D-5L value set by reducing the number of insignificant incremental effects (from 6 to 2 p-values > 0.05; out of 20). Nevertheless, the CL and bivariate mixed logit estimates are highly correlated and concordant (Pearson correlation coefficient of 0.897, Spearman correlation coefficient of 0.888, Lin's concordance coefficient of 0.763). CONCLUSIONS: Allowing this heterogeneity adds three parameters to the estimation (two variances and a correlation) and improves the face validity of the EQ-5D-5L values. This finding may influence experimental design and choice analysis in health valuation more generally.

[Market research of russian medical construction facilities: cost estimation and investments in construction programs].

Within the framework of the study, conditions are analyzed, cost estimates and other characteristics of large construction projects in the medical field are presented. The article analyzes investment projects of construction medical facilities in the Russian Federation. Plans for the development of some large medical networks are also briefly highlighted. A review of literature sources on health development programs of the subjects of the Russian Federation was conducted, federal target programs were considered, investment projects for the construction of medical facilities planned for completion in 2023-2025 were studied. Some analytical results of monitoring for 2020-2023 on the activity of the investment market in the direction of the Russian strategic and institutional design of the construction of medical facilities in the Russian Federation are presented.

Putting a Dollar Value on Informal Care Time Provided to People Living With Dementia: A Discrete Choice Experiment.

OBJECTIVES: Informal care represents a significant cost driver in dementia but monetizing informal care hours to inform cost-of-illness or economic evaluation studies remains a challenge. This study aimed to use a discrete choice experiment to estimate the value of informal care time provided to people with dementia in Australia accounting for positive and negative impacts of caregiving. METHODS: Attributes and levels were derived from a literature review, interviews with carers, and advice received from an advisory group. Attributes included 4 positive and negative caregiving experiences, in addition to "hours of care provided" and the "monetary compensation from the government." A D-efficient design was constructed with 2 generic alternatives that represented hypothetical informal caregiving situations. The discrete choice experiment survey was administered online to a representative sample of the Australian general population and a group of informal carers of people with dementia. The willingness to accept estimates were calculated for the 2 samples separately using the mixed logit model in the willingness to pay space. RESULTS: Based on 700 respondents included in the analysis (n = 488 general public, n = 212 informal carers), the mean willingness to accept for an additional hour of informal care, corrected for the positive and negative impacts of informal care, was $21 (95% CI 18-23) for the general public and $20 (95% CI 16-25) for the informal carers sample. CONCLUSION: The estimates generated in this study can be used to inform future cost-of-illness studies and economic evaluations, ensuring that informal care time is considered in future policy and funding decisions.

Difficulty sensitivity replaces reward sensitivity during adolescence: Task-related fMRI and functional connectivity during self-regulative learning choices.

AIM: We examined age-related differences in valuation and cognitive control circuits during value-based decision-making. METHODS: 13-year-olds (N = 25) and 17-year-olds (N = 22) made a metacognitive choice to be tested or not on an upcoming learning task, based on reward and difficulty associated with word-pairs. To investigate whether these determinants of subjective value are differently processed at different ages, we performed region-of-interest(ROI)-based analyses of task-related and functional connectivity data. RESULTS: We observed age-related differences in responsiveness of valuation structures (amygdala, ventral striatum, ventromedial prefrontal cortex) and caudate nucleus, with activity modulated by reward in 13-year-olds, while in 17-year-olds activity being responsive to difficulty. These accompanied age-related differences in functional connectivity between medial prefrontal and striatal/amygdala seeds. DISCUSSION: These results are in line with current views that sensitivity changes for reward and difficulty during adolescence are the result of a maturational switch in effort-related signalling in the cognitive control circuit, which increasingly regulates value-signalling structures.

Is anchoring at 'dead' a theoretical requirement for health state valuation?

Values that accompany generic health measures are typically anchored at 1 = full health and 0 = dead. Some health states may then be considered 'worse than dead' (WTD) and assigned negative values, which causes fundamental measurement problems. In this paper, we challenge the assumption that anchoring values at 'dead = 0' is necessary for quality-adjusted life year (QALY) estimation. We summarise the role of 'dead' in health state valuation and consider three critical questions: (i) whether the measurement properties of health state values require 'dead'; (ii) whether 'dead' needs to be valued relative to health states; and (iii) whether values for states WTD are meaningful or useful. We conclude that anchoring 0 at dead is not a requirement of health status measurement or cost-effectiveness analysis. This results from reframing QALYs as the relevant unit of measurement and reframing values as being derived from QALYs rather than the reverse.

Redefining dominance calculation: Increased competition flattens the dominance hierarchy in dairy cows.

Dominance hierarchies are known for mitigating conflicts and guiding priority of access to limited resources in gregarious animals. The dominance hierarchy of dairy cows is typically investigated using agonistic interactions, often monitored at the feed bunk right after fresh feed delivery when competition is high resulting in frequent interactions. Yet, the outcome of agonistic interactions during times of high competition may be more influenced by cows' high valuation of fresh feed than their intrinsic attributes, such that the dominance hierarchy constructed using agonistic interactions under high versus low competition times might differ. We tested how the structure of the dominance hierarchy changes in relation to different levels of competition in a dynamic group of 48 lactating dairy cows over 10 mo, with 6 cows exchanged every 16 d for a total of 159 cows. Using a validated algorithm we continuously detected the actor and reactor of replacement behaviors in 30 feed bins as cows competed for feed. We also calculated the percentage of occupied feed bins to characterize competition at the moment of each replacement. These data were combined to create hierarchies using Elo ratings, separately for 25 occupancy levels ranging from 13% to 100%. For each 1% rise in feeder occupancy, hierarchy steepness fell by 2.41 × 10-3 ± 9.71 × 10-5 (SE), and the percentage of dyads where both cows replaced each other rose by 0.13% ± 0.01%. At the highest feeder occupancy level in comparison to the lowest one, we observed 7.57% more dyads in which the dominant individual (those won more interactions at the lowest feeder occupancy) started to lose proportionally more. The magnitude of decrease in the winning rate of the dominant individual in those dyads also got amplified by 1.06 × 10-3% ± 1.37 × 10-4% (SE) for each 1% increase in feeder occupancy. These findings illustrate how inferred hierarchies vary with competition, with high competition flattening the hierarchy due to increased success of subordinate animals. We suggest that during heightened competition, increased valuation of resources can affect competitive success more than the individual's intrinsic dominance attributes. We recommend against calculating dominance hierarchies based on agonistic interactions during periods of high competition alone, and more generally urge researchers to differentiate agonistic interactions based on context when constructing dominance hierarchies.

Analysis, modelling, and financial perspectives of reverse mortgage implementation in Colombia.

Purpose: Increased life expectancy in recent years, together with the downward trend in fertility rates, will accelerate the aging of the Latin American population (Flamini and et al., 2018) [1]. This demographic change represents a problem for pension systems as the economic capacity to finance the retirement of the population could be insufficient in the future. This creates a favorable scenario for new financial products, including reverse mortgages. This study determines, from the supply approach, the potential of reverse mortgages in the main cities of Colombia as a complement to the financing of old age according to the guidelines of Benavides et al. (Benavides Franco et al., Jan. 2021) [2]. Methodology: The following variables were used: housing prices, interest rates, mortality rates, and the consumer price index. The econometric testing simulates the possible paths of these variables, estimates the probability of occurrence of the paths, and calculates the expected losses of bidding banks. Findings: The results show that reverse mortgages are a good complement to Colombia's pension system and confirm the feasibility of implementation at city level. It is recommended that the State stimulate the growth of this market and improve the corresponding regulatory framework. Originality: This study confirms the hypothesis that the reverse mortgages are a good complement to the pension system with city-level data. Specifically, it uses housing prices and mortality records from the main cities of the country (Bogotá, Cali, and Medellín) to capture their idiosyncrasies.

A social-ecological approach for identifying and mapping ecosystem service trade-offs and conservation priorities in peri-urban areas.

Considering both ecological and social dimensions in the assessment of ecosystem services (ESs) can facilitate acceptable and inclusive management strategies, especially in peri-urban areas characterized by intricate human-ecosystem interactions. A limited body of research, however, has mapped the plural values of ESs and their different types of trade-offs in such areas. This research aimed to execute an interdisciplinary analysis of the biophysical and social values of ESs in peri-urban Shanghai, China, through a social-ecological approach that integrates spatial biophysical assessment with participatory mapping. Trade-off analysis in both ES types and ES valuations were then conducted, and multicriteria decision-making was applied for conservation. Our results reveal that trade-off intensities were lower within the social values compared to the biophysical values. Within both value dimensions, relatively stronger trade-offs were found between food production and other ESs. Areas with both high biophysical and social values were infrequently observed across ESs. Based on the characteristics of diverse values, our study identified priority conservation areas and provided management implications. We argue that adopting the integrated social-ecological perspective in sustainable environmental management contributes to the realization of harmonious coexistence between people and nature in peri-urban areas.

Stability of Willingness to Pay: Does Time and Treatment Allocation in a Randomized Controlled Trial Influence Willingness to Pay?

BACKGROUND: Willingness-to-pay (WTP) estimates are useful to policy makers only if they are generalizable beyond the moment when they are collected. To understand the "shelf life" of preference estimates, preference stability needs be tested over substantial periods of time. METHODS: We tested the stability of WTP for preventative dental care (scale and polish) using a payment-card contingent valuation question administered to 909 randomized controlled trial participants at 4 time points: baseline (prerandomization) and at annual intervals for 3 years. Trial participants were regular attenders at National Health Service dental practices. Participants were randomly offered different frequencies (intensities) of scale polish (no scale and polish, 1 scale and polish per year, 2 scale and polishes per year). We also examined whether treatment allocation to these different treatment intensities influenced the stability of WTP. Interval regression methods were used to test for changes in WTP over time while controlling for changes in 2 determinants of WTP. Individual-level changes were also examined as well as the WTP function over time. RESULTS: We found that at the aggregate level, mean WTP values were stable over time. The results were similar by trial arm. Individuals allocated to the arm with the highest scale and polish intensity (2 per year) had a slight increase in WTP toward the latter part of the trial. There was considerable variation at the individual level. The WTP function was stable over time. CONCLUSIONS: The payment-card contingent valuation method can produce stable WTP values in health over time. Future research should explore the generalizability of these results in other populations, for less familiar health care services, and using alternative elicitation methods. HIGHLIGHTS: Stated preferences are commonly used to value health care.Willingness-to-pay (WTP) estimates are useful only if they have a "shelf life."Little is known about the stability of WTP for health care.We test the stability of WTP for dental care over 3 y.Our results show that the contingent valuation method can produce stable WTP values.