The marginal costs of climate changing emissions

This paper presents the marginal costs of the emissions of a selected number of radiatively-active gases, three uniformly-mixed gases – carbon dioxide, methane, nitrous oxide – and two region-specific gases – nitrogen (from aircraft) and sulphur, which influence ozone and sulphate aerosol concentrations, respectively. The paper complements earlier research by adding a third model (FUND2.0), adding region-specific gases, and by presenting an alternative accounting framework. The discounting and valuation procedures for marginal cost estimation were refined, but the estimates for the three greenhouse gases do not substantially differ from those in earlier research. It should be noted that with the inclusion of new insights into the impacts of climate change, it can no longer be excluded that marginal costs are negative, particularly for methane. The sign of the costs is model and region dependent. Despite their short life-time, the marginal costs of nitrogen and sulphur emissions are relatively large, primarily because they are not much discounted. The results presented should not be taken as final estimates. The impacts covered by the models used are only a fraction (of unknown size) of all climate change impacts. Particularly, large scale disruptions, such as a breakdown of North Atlantic Deep Water formation or a collapse of the West-Antarctic Ice Sheet, are excluded from the analysis

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Societal Vulnerability to Climate Change and Variability

societal adaptation, globalisation, institutional capacity, resilience, uncertainty, vulnerability,