Adolescent idiopathic scoliosis can progress and affect the health related quality of life of the patients. Research shows that screening is effective in early detection, which allows for bracing and reduced surgical rates, and may save costs, but is still controversial from a health economic perspective. Model based cost minimisation analysis using hospital’s costs, administrative data, and market prices to estimate costs in screening, bracing and surgical treatment. Uncertainty was characterised by deterministic and probabilistic sensitivity analyses. Time horizon was 6 years from first screening at 11 years of age. To compare estimated costs in screening and non-screening scenarios (reduced treatment rates of 90%, 80%, 70% of screening, and non-screening Norway 2012). Data was based on screening and treatment costs in primary health care and in hospital care settings. Participants were 4000, 12-year old children screened in Norway, 115190 children screened in Hong Kong and 112 children treated for scoliosis in Norway in 2012. We assumed equivalent outcome of health related quality of life, and compared only relative costs in screening and non-screening settings. Incremental cost was defined as positive when a non-screening scenario was more expensive relative to screening. Screening per child was € 8.4 (95% CrI 6.6 to10.6), € 10350 (8690 to 12180) per patient braced, and € 45880 (39040 to 55400) per child operated. Incremental cost per child in non-screening scenario of 90% treatment rate was € 13.3 (1 to 27), increasing from € 1.3 (−8 to 11) to € 27.6 (14 to 44) as surgical rates relative to bracing increased from 40% to 80%. For the 80% treatment rate non-screening scenario, incremental cost was € 5.5 (−6 to 18) when screening all, and € 11.3 (2 to 22) when screening girls only. For the non-screening Norwegian scenario, incremental cost per child was € -0.1(−14 to 16). Bracing and surgery were the main cost drivers and contributed most to uncertainty. With the assumptions applied in the present study, screening is cost saving when performed in girls only, and when it leads to reduced treatment rates. Cost of surgery was dominating in non-screening whilst cost of bracing was dominating in screening. The economic gain of screening increases when it leads to higher rates of bracing and reduced surgical rates.

The disappearance of intangible cultural heritages (ICHs) together with associated symbols and meanings in sub-Saharan Africa (SSA) undermines 2003 UN Convention for Safeguarding of the Intangible Cultural Heritage. To contribute to reversing this trend, the present study estimates the economic value of preserving traditional kente weaving and interpretation of kente symbols by establishing national demonstration centers in Ghana. Contingent valuation (CV) surveys of both the public and kente weavers are used to elicit their preferences for these national centers. As CV surveys of cultural heritage have often been criticized for lacking both policy and payment consequentiality, we have used a specific preservation measure and a non-voluntary payment vehicle to make the decision context realistic and consequential. Households show significant, positive mean willingness-to-pay (WTP) for establishing national centers to preserve both the kente weaving technique and the interpretation of kente symbols. Furthermore, we find no distance decay in WTP for preservation of this ICH; indicating that people have strong preferences for preserving this ICH independent of how far they live from the center of kente weaving activities. This leads to larger aggregated benefits of preservation compared to built cultural heritage and local environmental goods, for example, where strong distance decay occurs in many cases. This makes the net present value of centers for demonstration of kente weaving and interpretation of kente symbols positive and an economically worthwhile investment. The policy implication of these results is that higher investments in preserving ICHs can be justified not only from a cultural heritage perspective, but also from an economic point of view.

A collective understanding of economic impacts and in particular of monetary costs of biological invasions is lacking for the Nordic region. This paper synthesizes findings from the literature on costs of invasions in the Nordic countries together with expert elicitation. The analysis of cost data has been made possible through the InvaCost database, a globally open repository of monetary costs that allows for the use of temporal, spatial, and taxonomic descriptors facilitating a better understanding of how costs are distributed. The total reported costs of invasive species across the Nordic countries were estimated at $8.35 billion (in 2017 US$ values) with damage costs significantly outweighing management costs. Norway incurred the highest costs ($3.23 billion), followed by Denmark ($2.20 billion), Sweden ($1.45 billion), Finland ($1.11 billion) and Iceland ($25.45 million). Costs from invasions in the Nordics appear to be largely underestimated. We conclude by highlighting such knowledge gaps, including gaps in policies and regulation stemming from expert judgment as well as avenues for an improved understanding of invasion costs and needs for future research.