Sit down at the ball game: how trade barriers make the world less food secure

This paper analyses the impacts of trade policy responses to rising world food prices by carrying out a series of stylised experiments in the wheat market using a world trade model, GTAP. The sequence of events that is modelled comprises a negative wheat supply shock and subsequent implementation of an export tax by a major net exporter and a reduction in import tariffs by a small importer. The effects of trade policy responses are contrasted with those of full liberalisation of the wheat market. At the core are the (opposite) effects on producers and consumers, as well as the terms-of-trade and trade tax revenue effects. Food security is shown to depend crucially on changes in prices but also in incomes that are associated with changes in factor returns. The results reveal that major net exporters are generally better off when implementing export taxes for food security purposes. Large exporting countries export price instability causing world food prices to rise further. Net importing countries lose out and have limited leeway to reduce tariffs or subsidise imports. Liberalising wheat trade mitigates rising prices and contributes to food security, but to the detriment of production in Africa and Asia, making them more dependent on and vulnerable to changes in the world market. Concerted action at the WTO forum is required, notably clarifying and sharpening the rules regarding export measures.food security; world food crisis; international grain trade; trade measures; trade liberalisation; CGE modelling

Consumers discard a lot more food than widely believed : Estimates of global food waste using an energy gap approach and affluence elasticity of food waste

This work provides an internationally comparable consumer food waste dataset based on food availability, energy gap and consumer affluence. Such data can be used for constructing meaningful and internationally comparable metrics on food waste, such as those for Sustainable Development Goal 12. The data suggests that consumer food waste follows a linear-log relationship with consumer affluence and starts to emerge when consumers reach a threshold of approximately $6.70/day/capita level of expenditure. These findings also imply that most empirical models overestimate consumption by not accounting for the possibility of food waste in their analysis. The results also show that the most widely cited global estimate of food waste is underestimated by a factor greater than 2 (214 Kcal/day/capita versus 527 Kcal/day/capita). Comparison with estimates of US consumer food waste based on national survey data shows this approach can reasonably reproduce the results without needing extensive data from national surveys.</p

Consumers discard a lot more food than widely believed: Estimates of global food waste using an energy gap approach and affluence elasticity of food waste

This work provides an internationally comparable consumer food waste dataset based on food availability, energy gap and consumer affluence. Such data can be used for constructing meaningful and internationally comparable metrics on food waste, such as those for Sustainable Development Goal 12. The data suggests that consumer food waste follows a linear-log relationship with consumer affluence and starts to emerge when consumers reach a threshold of approximately $6.70/day/capita level of expenditure. These findings also imply that most empirical models overestimate consumption by not accounting for the possibility of food waste in their analysis. The results also show that the most widely cited global estimate of food waste is underestimated by a factor greater than 2 (214 Kcal/day/capita versus 527 Kcal/day/capita). Comparison with estimates of US consumer food waste based on national survey data shows this approach can reasonably reproduce the results without needing extensive data from national surveys

Sit down at the ball game: how trade barriers make the world less food secure

This paper analyses the impacts of trade policy responses to rising world food prices by carrying out a series of stylised experiments in the wheat market using a world trade model, GTAP. The sequence of events that is modelled comprises a negative wheat supply shock and subsequent implementation of an export tax by a major net exporter and a reduction in import tariffs by a small importer. The effects of trade policy responses are contrasted with those of full liberalisation of the wheat market. At the core are the (opposite) effects on producers and consumers, as well as the terms-of-trade and trade tax revenue effects. Food security is shown to depend crucially on changes in prices but also in incomes that are associated with changes in factor returns. The results reveal that major net exporters are generally better off when implementing export taxes for food security purposes. Large exporting countries export price instability causing world food prices to rise further. Net importing countries lose out and have limited leeway to reduce tariffs or subsidise imports. Liberalising wheat trade mitigates rising prices and contributes to food security, but to the detriment of production in Africa and Asia, making them more dependent on and vulnerable to changes in the world market. Concerted action at the WTO forum is required, notably clarifying and sharpening the rules regarding export measures

Self-report versus care provider registration of healthcare utilization: impact on cost and cost-utility

OBJECTIVES: This study aims to compare the impact of two different sources of resource use, self-report versus care provider registrations, on cost and cost utility. METHODS: Data were gathered for a cost-effectiveness study performed alongside a 2-year randomized controlled trial evaluating the effect of an INTERdisciplinary COMmunity-based management program (INTERCOM) for patients with chronic obstructive pulmonary disease (COPD). The program was offered by physiotherapists, dieticians and respiratory nurses. During the 2-year period, patients reported all resource use in a cost booklet. In addition, data on hospital admissions and outpatient visits, visits to the physiotherapist, dietician or respiratory nurse, diet nutrition, and outpatient medication were obtained from administrative records. The cost per quality-adjusted life-year (QALY) was calculated in two ways, using data from the cost booklet or registrations. RESULTS: In total, 175 patients were included in the study. Agreement between self-report and registrations was almost perfect for hospitalizations (rho = 0.93) and physiotherapist visits (rho = 0.86), but above 0.55, moderate, for all other types of care. The total cost difference between the registrations and the cost booklet was 464 euros with the highest difference for hospitalizations 386 euro. Based on the cost booklet the cost difference between the treatment group and usual care was 2,444 euros (95 percent confidence interval [CI], -819 to 5,950), which resulted in a cost-utility of 29,100 euro/QALY. For the registrations, the results were 2,498 euros (95 percent CI, -88 to 6,084) and 29,390 euro/QALY, respectively. CONCLUSIONS: This study showed that the use of self-reported data or data from registrations effected within-group costs, but not between-group costs or the cost utility

Short- and long-term efficacy of a community-based COPD management programme in less advanced COPD: a randomised controlled trial

BACKGROUND: The effectiveness of pulmonary rehabilitation in advanced COPD is well established, but few data are available in less advanced disease. METHODS: In a 2 year randomised controlled trial, 199 patients with an average moderate airflow obstruction but impaired exercise capacity (mean (SD) forced expiratory volume in 1 s (FEV(1)) 60 (16)%, peak work load (Wmax) <70%) were randomised to the INTERdisciplinary COMmunity-based COPD management programme (INTERCOM) or usual care. Intervention consisted of 4 months multidisciplinary rehabilitation followed by a 20-month maintenance phase. Outcomes (4, 12, 24 months): health-related quality of life (St George's Respiratory Questionnaire (SGRQ)), exacerbation frequency, MRC dyspnoea score, cycle endurance time (CET), 6-minute walking distance (6MWD), skeletal muscle strength and patients' and caregivers' perceived effectiveness. RESULTS: Between-group comparison after 4 months revealed the following mean (SE) significant differences in favour of INTERCOM: SGRQ total score 4.06 (1.39), p = 0.004; activity and impact subscores, p<0.01; MRC score 0.33 (0.13), p = 0.01; Wmax 6.0 (2.3) Watt, p = 0.02; CET 221 (104) s, p = 0.04; 6MWD 13 (6) m, p = 0.02; hand grip force 4.3 (1.5) lb, p<0.01; and fat-free mass index 0.34 (0.13) kg/m(2), p = 0.01. Between-group differences over 2 years were as follows: SGRQ 2.60 (1.3), p = 0.04; MRC score 0.21 (0.10), p = 0.048; CET 253 (104) s, p = 0.0156; 6MWD 18 (8) m, p = 0.0155. Exacerbation frequency was not different (RR 1.29 (95% CI 0.89 to 1.87)). Patients' and caregivers' perceived effectiveness significantly favoured the INTERCOM programme (p<0.01). CONCLUSIONS: This study shows that a mu

How to Address Uncertainty in Health Economic Discrete-Event Simulation Models

__Background__. Evaluation of personalized treatment options requires health economic models that include multiple patient characteristics. Patient-level discrete-event simulation (DES) models are deemed appropriate because of their ability to simulate a variety of characteristics and treatment pathways. However, DES models are scarce in the literature, and details about their methods are often missing. __Methods__. We describe 4 challenges associated with modeling heterogeneity and structural, stochastic, and parameter uncertainty that can be encountered during the development of DES models. We explain why these are important and how to correctly implement them. To illustrate the impact of the modeling choices discussed, we use (results of) a model for chronic obstructive pulmonary disease (COPD) as a case study. __Results__. The results from the case study showed that, under a correct implementation of the uncertainty in the model, a hypothetical intervention can be deemed as cost-effective. The consequences of incorrect modeling uncertainty included an increase in the incremental cost-effectiveness ratio ranging from 50% to almost a factor of 14, an extended life expectancy of approximately 1.4 years, and an enormously increased uncertainty around the model outcomes. Thus, modeling uncertainty incorrectly can have substantial implications for decision making. __Conclusions__. This article provides guidance on the implementation of uncertainty in DES models and improves the transparency of reporting uncertainty methods. The COPD case study illustrates the issues described in the article and helps understanding them better. The model R code shows how the uncertainty was implemented. For readers not familiar with R, the model’s pseudo-code can be used to understand how the model works. By doing this, we can help other developers, who are likely to face similar challenges to those described here

Systemic impairment in relation to disease burden in patients with moderate COPD eligible for a lifestyle program. Findings from the INTERCOM trial

Carel R van Wetering1, Floortje E van Nooten2, Stijn J M Mol3, Martine Hoogendoorn2, Maureen P M H Rutten-van M&amp;ouml;lken2, Annemie M Schols41Department of Physiotherapy, M&amp;aacute;xima Medical Centre, Veldhoven, The Netherlands; 2Institute for Medical Technology Assessment, Erasmus Medical Centre, Rotterdam, The Netherlands; 3Department of Respiratory Medicine, M&amp;aacute;xima Medical Centre, Veldhoven, The Netherlands; 4Department of Respiratory Medicine, Maastricht University, Maastricht, The NetherlandsIntroduction: In contrast with the frequency distribution of chronic obstructive pulmonary disease (COPD) stages in the population, in which the majority of the patients is classified as GOLD 2, much less information is available on the prevalence and implications of systemic manifestations in less severe patients relative to GOLD 3 and 4.Aim: To characterize local and systemic impairment in relation to disease burden in a group of GOLD 2 COPD patients (n = 127, forced expiratory volume in one second (SD): 67 (11)% pred) that were eligible for the Interdisciplinary Community-based COPD management (INTERCOM) trial.Methods: Patients were included for this lifestyle program based on a peak exercise capacity (Wmax) &amp;lt;70% of predicted. Metabolic and ventilatory response to incremental cycle ergometry, 6 minute walking distance (6MWD), constant work rate test (CWR), lung function, maximal inspiratory pressure (Pimax), quadriceps force (QF), quadriceps average power (QP) (isokinetic dynamometry), handgrip force (HGF) and body composition were measured. Quality of life (QoL) was assessed by the St. George&amp;rsquo;s Respiratory Questionnaire (SGRQ) and dyspnea by the modified Medical Research Council (MRC) dyspnea scale. Exacerbations and COPD-associated hospital admissions in 12 months prior to the start of the study were recorded. Burden of disease was defined in terms of exercise capacity, QoL, hospitalization, and exacerbation frequency. GOLD 2 patients were compared with reference values and with GOLD 3 patients who were also included in the trial.Results: HGF (77.7 (18.8) % pred) and Pimax (67.1 (22.5)% pred) were impaired in GOLD 2, while QF (93.5 (22.5)% pred) was only modestly decreased. Depletion of FFM was present in 15% of weight stable GOLD 2 patients while only 2% had experienced recent involuntary weight loss. In contrast to Wmax, submaximal exercise capacity, muscle function, and body composition were not significantly different between GOLD 2 and 3 subgroups. Body mass index and fat-free mass index were significantly lower in smokers compared to ex-smokers. In multivariate analysis, QF and diffusing capacity (DLco) were independently associated with Wmax and 6 MWD in GOLD 2 while only 6 MWD was identified as an independent determinant of health-related QoL. HGF was an independent predictor of hospitalization.Conclusions: This study shows that also in patients with moderate COPD, eligible for a lifestyle program based on a decreased exercise capacity, systemic impairment is an important determinant of disease burden and that smoking affects body composition.Keywords: COPD, systemic impairment, lifestyle, pulmonary rehabilitatio

The Proper Motion of the Globular Cluster NGC 6553 and of Bulge Stars with HST

WFPC2 images obtained with the Hubble Space telescope 4.16 years apart have allowed us to measure the proper motion of the metal rich globular cluster NGC 6553 with respect to the background bulge stars. With a space velocity of (${\Pi}, {\Theta}, W$) = (-3.5, 230, -3) km s$^{-1}$, NGC 6553 follows the mean rotation of both disk and bulge stars at a Galactocentric distance of 2.7 kpc. While the kinematics of the cluster is consistent with either a bulge or a disk membership, the virtual identity of its stellar population with that of the bulge cluster NGC6528 makes its bulge membership more likely. The astrometric accuracy is high enough for providing a measure of the bulge proper motion dispersion and confirming its rotation. A selection of stars based on the proper motions produced an extremely well defined cluster color-magnitude diagram (CMD), essencially free of bulge stars. The improved turnoff definition in the decontaminated CMD confirms an old age for the cluster (~13 Gyr) indicating that the bulge underwent a rapid chemical enrichment while being built up at in the early Universe. An additional interesting feature of the cluster color-magnitude diagram is a significant number of blue stragglers stars, whose membership in the cluster is firmly established from their proper motions.Comment: version with full-page figure

Soda Bottle Science—Citizen Science Monsoon Precipitation Monitoring in Nepal

Citizen science, as a complement to ground-based and remotely-sensed precipitation measurements, is a promising approach for improving precipitation observations. During the 2018 monsoon (May to September), SmartPhones4Water (S4W) Nepal—a young researcher-led water monitoring network—partnered with 154 citizen scientists to generate 6,656 precipitation measurements in Nepal with low-cost (&lt;1 USD) S4W gauges constructed from repurposed soda bottles, concrete, and rulers. Measurements were recorded with Android-based smartphones using Open Data Kit Collect and included GPS-generated coordinates, observation date and time, photographs, and observer-reported readings. A year-long S4W gauge intercomparison revealed a −2.9% error compared to the standard 203 mm (8-inch) gauge used by the Department of Hydrology and Meteorology (DHM), Nepal. We analyzed three sources of S4W gauge errors: evaporation, concrete soaking, and condensation, which were 0.5 mm day−1 (n = 33), 0.8 mm (n = 99), and 0.3 mm (n = 49), respectively. We recruited citizen scientists by leveraging personal relationships, outreach programs at schools/colleges, social media, and random site visits. We motivated ongoing participation with personal follow-ups via SMS, phone, and site visit; bulk SMS; educational workshops; opportunities to use data; lucky draws; certificates of involvement; and in certain cases, payment. The average citizen scientist took 42 measurements (min = 1, max = 148, stdev = 39). Paid citizen scientists (n = 37) took significantly more measurements per week (i.e., 54) than volunteers (i.e., 39; alpha level = 0.01). By comparing actual values (determined by photographs) with citizen science observations, we identified three categories of observational errors (n = 592; 9% of total measurements): unit (n = 50; 8% of errors; readings in centimeters instead of millimeters); meniscus (n = 346; 58% of errors; readings of capillary rise), and unknown (n = 196; 33% of errors). A cost per observation analysis revealed that measurements could be performed for as little as 0.07 and 0.30 USD for volunteers and paid citizen scientists, respectively. Our results confirm that citizen science precipitation monitoring with low-cost gauges can help fill precipitation data gaps in Nepal and other data scarce regions