Financial Worries Research Articles

When the Bough Breaks: The Financial Burden of Childbirth and Postpartum Care by Insurance Type.

Out-of-pocket (OOP) costs related to childbirth and postpartum care may cause financial hardship, depending on type of insurance and income. We estimated OOP spending on childbirth and postpartum care and financial strain 1 year after birth, comparing Medicaid-insured births with commercially insured births. The Postpartum Assessment of Health Survey followed up with respondents to the Centers for Disease Control and Prevention (CDC) Pregnancy Risk Assessment Monitoring System after a 2020 birth in six states and New York City. The survey included questions on health care costs and financial well-being. Our analytic sample consisted of 4,453 postpartum people, 1,544 with a Medicaid-insured birth and 2,909 with a commercially insured birth. We observe significant financial hardship from childbirth that persists into the postpartum year, with significant differences by insurance and income. We find Medicaid is highly financially protective relative to commercial insurance; 81.4% of Medicaid-insured births were free to the patient, compared with 15.7% of commercially insured births (p < 0.001). Six of ten commercially insured births (59%) cost over $1,000 OOP. Among respondents reporting OOP costs for childbirth, we found that Medicaid enrollees are more likely to have borrowed money from friends or family to pay for childbirth (8% vs. 1%, p < 0.001) and one in five had not made any payments 1 year postpartum (26% vs. 5% of commercially insured births, p < 0.001). Among the commercially insured, those with incomes under 200% of the federal poverty level (FPL) fared worse financially than those above 200% FPL on a number of indicators, including debt in collection (33% vs. 13%, p < 0.001) and financial worry (55% vs. 34%, p < 0.001). The cost of childbirth and postpartum health care results in significant and persistent financial hardship, particularly for families with lower income with commercial insurance. Medicaid offers greater protection for families with low income by offering reduced cost sharing for childbirth and postpartum health care, but even minimal cost sharing in Medicaid causes financial strain.

Academic Performance, Health and Support Needs: Comparing Foster Care Alumni and Peers in Higher Education in Norway

The completion rates of higher education are low among young adults with a history of foster care. Understanding how students from foster care alumni fare is imperative for facilitating attainment and preventing drop-out. The aim of this study was to compare students from foster care alumni and the general student population by examining (1) sociodemographic characteristics, academic functioning and need for special assistance; (2) contextual factors important for student life; and (3) mental and somatic health, loneliness, life satisfaction and use of cannabis and alcohol. Data comprised self-reports from the Norwegian national survey Students’ Health and Well-being Study 2022. Reports from foster care alumni students (n = 508) were compared to those of the general student sample (n = 59,036). Compared to the general sample, twice as many foster care alumni students reported receiving or needing special assistance in their studies. Moreover, they reported substantially higher economic burden than their student peers, by higher frequency of work income, more financial worries, and less parental financial support. Foster care alumni students also reported a higher load of informal care responsibilities, poorer mental and somatic health, more loneliness and lower life satisfaction. Foster care alumni students fare comparably well in terms of grades and study progression despite the reported economic burden and impaired health and well-being. As these are factors shown to impact study completion, policies need to be put in place to ensure that care-experienced students receive adequate support through their young adulthood and specifically in higher education.

Sources of stress and outcomes in carepartners of persons with chronic heart failure

Abstract Background Serving as a carepartner (CP) for someone with chronic heart failure (HF) can be challenging and difficult and may yield adverse psychological outcomes. Sources of HF CP burden and strain may come from physical, informational, and tangential demands. Yet additional life events and sources of stress may be present and compound experiences of HF CPs. Greater understanding of the factors associated with stress sources is needed to direct CP assessment and interventions. Purposes To explore the contributions of CP perceptions of HF care burden and strain, other sources of stress from occupational type and working status, and financial concerns to CP psychological outcomes and to examine the influence of social support in mitigating these outcomes. Methods CPs of persons with chronic HF, defined as providing care for the person with HF at least 4 hours a week, were enrolled. Baseline variables and measures were demographics (age, marital status, education), sources of stress (CP perceived strain and burden [Oberst, STRAIN], caring for others, occupation type, working status, and financial concerns. Psychological outcomes were overall perceived stress (PSS) and depression (CES-D) with social support measured by the Enriched Social Support Inventory (ESSI). Relationships among stress sources and outcomes were assessed using best model subsets regression analysis (Akaike information criterion) comparing the models with and without adjusting for social support. For each model, age, caring for others, CG strain (mental and physical), CG burden (time and difficulty), financial worry, occupation type and status were considered for the model. Results CPs of persons with HF (n=127; 92% women; 58% Black; primarily spouses and adult children) were included. For stress, the best model included age, caring for others, mental strain, occupation and CP burden of difficulty and time (adjusted r2=0.381). After adjusting for social support, occupation type was not significant, and adjusted r2 increased to 0.462. For depression, caring for others and CP burden (difficulty) were included in the best model subset (adjusted r2=0.208). After adjusting for social support, caring for others was not significant, and the adjusted r2 increased to 0.286. Conclusion Sources of stress from higher perceived CP burden of the person with HF, occupation type, and having other caregiving roles contributed to overall stress with social support mitigating the effects of occupation type and caring for others. These findings support further study of comprehensive assessments of sources of stress and their contributions to adverse psychological outcomes for CPs within the context of social support to tailor CP interventions to the CP’s specific needs. The consistent role of social support in attenuating psychological stress warrants study of ways to clinically incorporate social support into interventions to improve outcomes for CPs.

“Tell me what I'm doing wrong”: Criticism of parenting choices and mental health during COVID-19

During the COVID-19 pandemic, parents struggled with high levels of economic insecurity and mental health difficulties. Social cognitive theory suggests that receiving criticism from others contributes to psychological distress. This mixed-methods study explored longitudinal associations between receiving criticism about parenting choices and parental anxiety, depression, and financial worries during COVID-19. Survey data were collected at two time points in April 2020 from a national U.S. sample of 359 parents (70 % White, 67 % female, average age 34 years). Quantitative analyses were conducted using logistic and linear regression, and qualitative responses were coded to elucidate topics of criticism. Criticism at T1 was associated with increased parental anxiety, depression, and financial worries at T2 after controlling for these outcomes at T1. Content coding revealed parents were criticized for lenient parenting styles (20.63 %) or for being too strict with COVID-19 precautions (18.13 %). Being criticized about parenting choices may exacerbate mental health problems. Parents may benefit from receiving positive feedback about their parenting methods, either through social media or from family members.

Impact of low back pain and care-seeking behavior in an Indigenous community in Suriname: a qualitative approach.

Low back pain is a significant global public health issue affecting over half a billion people and contributing to disability worldwide. The impact of disability related to low back pain is growing, particularly in low- and middle-income countries. In contrast with previous research, current evidence shows Indigenous Peoples also experience low back pain's disabling effects. A clinical ethnographic can contribute by attempting to understand the data through the perspective of Indigenous Peoples. A clinical ethnographic study was conducted in Galibi, a Kalinya rural Indigenous village in Suriname, with support of the local traditional authority. The main objective was to explore the impact of low back pain and care-seeking behavior from the perspective of Indigenous Peoples with low back pain. The findings were that low back pain had a significant physical and emotional impact. Despite aggravating their low back pain, participants continued many of their activities of daily life since these were essential for their (economic) survival. Furthermore, participants expressed anxiousness, financial worries, and concerns about the cause and future of their low back pain. To address their low back pain, the Kalinya Indigenous Peoples used both western and traditional care. Visits to western healthcare practitioners were limited due to logistical challenges and travel costs, and the experience was often negative. The study highlights the experiences of Kalinya Indigenous Peoples dealing with low back pain. Low back pain is a burden within Indigenous Peoples of Galibi but accepted as an integral part of their life. When in pain, Indigenous Peoples face many barriers to access western health care and visits to healthcare practitioners were often unhelpful. This contributed to a long-lasting negative impact on the Indigenous people with low back pain. Further research is needed to develop strategies that improve health outcomes related to low back pain while reducing its associated disability in Indigenous Peoples.

A longitudinal study of the psychological predictors of mental health and stress among university students during the COVID-19 pandemic in Germany

AbstractRepeated nationwide lockdowns and contact restrictions during the COVID-19 pandemic in Germany massively affected students’ life.There is a lack of longitudinal studies on the change in students’ mental health problems and the influencing factors across the pandemic phases. The aims of the longitudinal study were to investigate the change in students’ depression, anxiety and stress across a one-and-a-half-year study period of the pandemic in Germany and the association between protective (mindfulness, coping strategies, self-efficacy) and risk factors (financial and academic worries) and students’ mental health issues and stress. A subsample of 911 university students was included in the longitudinal analyses. Students were surveyed at four points during the first and second years of the pandemic. Linear mixed-effects modelling was used to investigate our research questions. The models investigated the protective and risk factors as time-invariant and time-varying covariates. The results showed that depression, anxiety and stress decreased slightly over the pandemic. Further, mindfulness and active coping remained equally important over time for reducing depression, anxiety and stress. However, self-efficacy and acceptance became more critical for reducing mental health issues or stress over time. Although financial worries remained equally important for depression, anxiety and stress throughout the pandemic, academic worries became more important for mental health issues over time.The study provides insights into protective and risk factors throughout the pandemic. The results highlight the importance of investigating time-invariant and time-varying predictors of mental health issues.

The Status and Expectations of the Relatives of Surgery Patients in the Waiting Area of Guilan Academic Hospitals

Background: The situation of the relatives of surgery patients in waiting areas is an important issue, which has not been investigated in Guilan province, so this study was planned. Methods: This cross-sectional descriptive study was conducted in Guilan academic hospitals (Razi-Poorsina-Heshmat-Alzahra–Amir al Momenin) from Feb 2022 to Dec 2022. Relatives of patients who underwent elective surgeries enrolled the survey. A questionnaire containing two parts of demographic data and 12 items assessing relative’s conditions in waiting area was filled out via a direct interview. Results: 318 relatives enrolled the survey. 93.2% of patients’ relatives were first-degree relatives.76.7% had information about the surgery. 41.5% were informed of their patient’s status in operating room. Fear of not emergence from anesthesia 109(34.3%) and death 105(33.0%) were the main causes of anxiety which was reported as 8.23±28.2 from 10 and only 6(1.9%) had financial concern. 86.8% of the responders declared that being informed from their patient’s condition in operating room, was the most effective approach to reduce their anxiety. A positive and highly significant association was observed between the level of education and receiving explanation from surgeon, anesthesiologist and being informed from patients’ status in waiting area (p=0.001). Conclusion: It was found that relatives of surgery patients suffered from high degrees of anxiety mainly due to fear of death and not emergence from anesthesia. They stated that being informed from their patient’s conditions was the most powerful factor in reducing their anxiety.

A scoping review capturing financial experiences of cancer survivors: Are we on the same page?

348 Background: There is great variation in how post-treatment financial consequences have been conceptualized and measured. This scoping review characterized the terms and measures used to capture the financial experiences of post-treatment cancer survivors. Methods: Reported according to PRISMA-ScR, electronic searches for published literature were conducted using Ovid MEDLINE, Embase.com, Web of Science Core Collection, Cochrane Central via Ovid, and ClinicalTrials.gov in March 2024. Eligible articles were U.S.-based empirical studies conducted with adult (≥18 years) cancer survivors (≥ 6 months post-treatment). Studies were managed using Covidence systematic review software. Results: Two coders screened 2452 titles and abstracts; 502 met inclusion criteria. Initial full-text review identified 127 articles for co-investigator assessment. Each article was evaluated for eligibility and quality by two investigators; 84 met criteria. Many terms were used, including financial hardship, burden, toxicity, stress/distress, worry, problems, impact, economic burden, difficulty, strain, and perceived financial security. Financial hardship and burden were most prevalent and often used interchangeably, categorized within material, psychological, and behavioral domains. Financial stress/distress , and financial worry , were consistently conceived as the psychological aspect of financial burden/hardship. Financial problems , strain , difficulty , impact , and economic burden were mainly measured using items pertaining to material/behavioral domains of financial consequences. Financial toxicity typically described the totality of effect of direct and indirect costs of cancer/treatment on one’s quality of life. Terms and definitions likely differed due to wide variation in the measures used; 47 measures were used. The most common tools included items from the Medical Expenditure Panel Survey Experiences with Cancer Survivorship Supplement (N= 20), the Comprehensive Score for Financial Toxicity (N= 13), and the National Health Interview Survey (N= 11). Conclusions: Findings suggest a general lack of consensus regarding the conceptualization and measurement of the financial experiences of cancer survivors. Financial hardship and burden were often used interchangeably, with financial toxicity capturing the greater encompassing effect of financial consequences of cancer. Future work is needed to arrive at a consensus that distinguishes between these critical outcomes.

Assessing the Burden of Atopic Dermatitis in Portugal through Patient-Centered Experiences

Introduction: Adult patients and caregivers of children with atopic dermatitis experience high physical, mental, and financial burden in Portugal. We outline the experience of atopic dermatitis management and how the current medical care model impacts patient-centered concerns such as financial burden, quality of life, disease burden, and treatment satisfaction. Methods: We conducted a survey of 419 Portuguese adults and caregivers of children to capture the experience of managing atopic dermatitis in Portugal. Results: Respondents reported average satisfaction with treatment, with a mean satisfaction rating of 3.15/5.00 (SD = 0.77). Adults reported slightly better control of atopic dermatitis symptoms (mean = 56.6) than pediatric patients (mean = 55.9, caregiver reported). Nearly 34% of adults and 39% of caregivers of children and adolescents indicated that their healthcare providers asked about their priorities at the last medical visit. Additionally, only 40% of adult patients and 32% of caregivers reported that patient training was offered to them. Respondents seeing dermatologists reported higher satisfaction than those seeing other healthcare providers (p = 0.01) but there were no differences in long-term control of symptoms by provider type (p = 0.85) when controlling for severity. Portuguese adult patients scored 0.86/1.00 on the EQ-5D (where 0 = death and 1 = perfect health). Financial concern was high as nearly 80% of patients and caregivers reported using savings, borrowing money, and/or reducing spending to cover atopic dermatitis-related costs.Conclusion: Portuguese patients with atopic dermatitis and caregivers experience financial burden, lower health-related quality of life, higher disease burden, and treatment satisfaction issues with their current medical care. These factors often deteriorate as the disease’s severity increases. Providers, researchers and policymakers should focus on better addressing patient-centered concerns for individuals suffering from atopic dermatitis to improve care and health outcomes.

Enhanced Foreign Exchange Volatility Forecasting Using Ceemdan with Optuna-Optimized Ensemble Deep Learning Model

Foreign Exchange (FX) is the largest financial market in the world, with a daily trading volume that significantly exceeds that of stock and futures markets. The prediction of FX volatility is a critical financial concern that has garnered significant attention from researchers and practitioners due to its far-reaching implications in the financial markets. This paper presents a novel hybrid ensemble forecasting model integrating a decomposition strategy and three deep learning (DL) models: Long Short-Term Memory (LSTM), Bidirectional LSTM (BiLSTM), and Convolutional Neural Network (CNN). This combination addresses individual models' limitations and further improves the accuracy and stability of FX volatility forecasting. The proposed approach utilizes the CEEMDAN technique to decompose volatility into multiple distinct intrinsic mode functions (IMFs) and merges these IMFs with GARCH and EGARCH volatilities to form the input dataset for the DL models. In addition, we employed an attention mechanism to improve the effectiveness of the DL techniques. Furthermore, the hyperparameters for the DL models are optimized using the Optuna algorithm. Finally, a hybrid ensemble model for forecasting exchange rate volatility is developed by combining the predictions of three distinct DL models. The proposed approach is evaluated against various benchmark models using evaluation measures such as MSE, MAE, HMSE, HMAE, RMSE, Q-LIKE, and the model confidence set (MCS) approach. The results demonstrate that our proposed approach provides accurate and reliable forecasts of FX volatility under different forecasting regimes, making it a valuable tool for financial practitioners and researchers.

The Relationship between Financial Inclusion and Women’s Financial Worries: Evidence from Saudi Arabia

Financial inclusion is essential in achieving sustainable development goals in emerging countries. Goal number five of the sustainable development agenda, “Gender equality”, depends on women’s financial empowerment. It enhances women’s ability to make decisions, access resources and income, and control benefits from economic gains and power. The paper investigates the relationship between financial inclusion and women’s financial worries, using the 2021 Global Financial Inclusion Survey recently published by the World Bank for the Kingdom of Saudi Arabia. This paper examines the effects of several aspects of inclusive finance, access, usage, and quality on women’s financial worries. The research implements an ordered probit analysis and contributes to the literature on women’s financial empowerment and inclusion by demonstrating that having access to financial services empowers women to make decisions about their lives, which greatly improves their welfare and sense of security. These findings provide policymakers with different targeted policies and strategic management practices to substantially improve financial inclusion and alleviate financial concerns within the population, especially among women.

Self-Reported Financial Difficulties Among Patients with Multiple Myeloma and Chronic Lymphocytic Leukemia Treated at U.S. Community Oncology Clinics (Alliance A231602CD).

To estimate the proportion and correlates of self-reported financial difficulty among patients with multiple myeloma (MM) or chronic lymphocytic leukemia (CLL). 23 U.S. community and minority oncology practice sites affiliated with the National Cancer Institute Community Oncology Research Program (NCORP). 521 patients (≥18 years) with MM or CLL were consented and 416 responded to a survey (completion rate=79.8%). Respondents had a MM diagnosis (74.0%), an associate degree or higher (53.4%), were White (89.2%), insured (100%) and treated with clinician-administered drugs (68.0%). Observational, prospective, protocol-based survey administered in 2019-2020. Financial difficulty was assessed using a single-item standard measure, the EORTC QLQC30: "Has your physical condition or medical treatment caused you financial difficulties in the past year?" and using an 'any-or-none' composite measure of 22 items assessing financial difficulty, worries and the use of cost-coping strategies. Multivariable logistic regression models assessed the association between financial difficulty, diagnosis, and socioeconomic and treatment characteristics. 16.8% reported experiencing financial difficulty using the single-item measure and 60.3% using the composite measure. Most frequently endorsed items in the composite measure were financial worry about having to pay large medical bills related to cancer and difficulty paying medical bills. Financial difficulty using the single-item measure was associated with having MM versus CLL (adjusted odds ratio [aOR], 0.34; 95% CI, 0.13-0.84; P=.02), having insurance other than Medicare (aOR, 2.53; 95% CI, 1.37-4.66; P=.003), being non-White (aOR, 2.21; 95% CI, 1.04-4.72; P=.04), and having a high school education or below (aOR, 0.36; 95% CI, 0.21-0.64; P=.001). Financial difficulty using the composite measure was associated with having a high school education or below (aOR, 0.62; 95% CI, 0.41-0.94; P=.03). U.S. patients with blood cancer report financial difficulty, especially those with low socio-economic status. Evidence-based and targeted interventions are needed.

Financial Hardship Among Patients With Early-Stage Colorectal Cancer

The degree of cancer patients' financial hardship is dynamic and can change over time. To assess longitudinal changes in financial hardship among patients with early-stage colorectal cancer. In this prospective longitudinal cohort study, English-speaking adult patients with a new diagnosis of stage I to III colorectal cancer being treated with curative intent at National Cancer Institute (NCI) Community Oncology Research Program (NCORP) practices between May 2018 and July 2020 and who had not started chemotherapy and/or radiation were included. Data analysis was conducted from March to December 2023. Patients completed surveys at baseline as well as at 3, 6, 12, and 24 months after enrollment. Cost-related care nonadherence and material hardship, as adopted by Medical Expenditure Panel Survey, were measured. Factors associated with financial hardship were assessed using longitudinal multivariable logistic regression models with time interaction. A total of 451 patients completed baseline questions, with 217 (48.1%) completing the 24-month follow-up. Mean (SD) age was 61.0 (12.0) years (210 [46.6%] female; 33 [7.3%] Black, 380 [84.3%] White, and 33 [7.3%] American Indian or Alaska Native, Asian, multiracial, or Native Hawaiian or Other Pacific Islander individuals or those who did not report race or who had unknown race). Among 217 patients with data at baseline and 24 months, 19 (8.8%) reported cost-related care nonadherence at baseline vs 20 (9.2%) at 24 months (P = .84), and 125 (57.6%) reported material hardship at baseline vs 76 (35.0%) at 24 months (P < .001). In multivariable analysis, lower financial worry (odds ratio [OR], 0.90; 95% CI, 0.87-0.93), higher education (OR, 0.34; 95% CI, 0.15-0.77), and older age (OR, 0.94; 95% CI, 0.91-0.98) were associated with lower nonadherence. Receipt of chemotherapy was associated with higher material hardship (OR, 2.68; 95% CI, 1.15-6.29), while lower financial worry was associated with lower material hardship (OR, 0.83; 95% CI, 0.80-0.96). Over 24 months, female sex was associated with lower nonadherence (OR, 0.90; 95% CI, 0.85-0.96), while higher education was associated with higher nonadherence (OR, 1.09; 95% CI, 1.03-1.17). Being employed was associated with lower material hardship (OR, 0.85; 95% CI, 0.78-0.93), while receipt of care at safety-net hospitals was associated with higher hardship (OR, 1.09; 95% CI, 1.01-1.17). In patients with early-stage colorectal cancer, material hardship was more common than cost-related cancer care nonadherence and decreased over time, while nonadherence remained unchanged. Early and longitudinal financial screening and referral to intervention are recommended to mitigate financial hardship.

Parents’ perceptions of the safe environment for every kid (SEEK) model in the Swedish child health services

BackgroundThe Safe Environment for Every Kid (SEEK) model was developed to address psychosocial risk factors (financial worries, depressive symptoms, major parental stress, alcohol misuse and intimate partner violence) in the pediatric primary care setting but has not been evaluated from the parents’ perspective. To further investigate the usefulness of SEEK, it is important to explore how parents perceive the model.ObjectiveThe aim of the present study was to explore parents’ perceptions of the SEEK model as a part of regular health visits in the Child Health Services in Sweden.Participants and settingEighteen parents (13 women and five men) in two Swedish counties participated in the study.MethodsSemi-structured telephone interviews were conducted, and the resulting data were analyzed using reflective thematic analysis.ResultsThree themes were identified: Acceptance and understanding of the SEEK model in the child health services, The questionnaire as a bridge to a dialogue, and Feeling trust in the system and the child health nurse’s professional competence. Further, an overarching theme was created that encompassed a core meaning of all three themes; SEEK provides a process-oriented framework to receive support in parenting with a focus on child health.ConclusionsThe study showed that parents express both acceptance and understanding of the SEEK model and they perceive that the model provides an avenue for repeated dialogues about the family’s situation during the child’s upbringing and an opportunity to access support if needed.

Validation of the HIV/AIDS-Targeted Quality of Life (HAT-QOL) for Evaluation of Health-related Quality of Life in People Living with HIV/AIDS in Brazil.

HIV/AIDS-Targeted Quality of Life (HAT-QOL) is an instrument for evaluating health-related quality of life (HRQOL) in people living with HIV (PLWHIV). This has been adapted into Brazilian Portuguese, but its dimensional structure has not been analyzed. This study evaluated the psychometric properties of the Brazilian Portuguese version of the HAT-QOL, using a sample of 319 PLWHIV in Salvador, Brazil. The study performed Exploratory Factor Analysis (EFA) to assess the HAT-QOL dimensional structure. The analysis used a polychoric correlation matrix, Robust Diagonally Weighted Least Squares (RDWLS) as an extraction method, Parallel Analysis for factor retention, robust promin as oblique rotation, and Generalized H-index (G-H) for construct replicability of each factor. Model adequacy was assessed using the Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI). Concurrent validity was evaluated with the 36-item Short Form Health Survey, version 2 (SF-36v2). EFA identified a HAT-QOL six-factor solution: Financial Worries, Sexual Function, Medication Concerns, Life Satisfaction, Health Worries, and Overall Function. This solution showed high G-H indexes, concurrent validity, and satisfactory adequacy indexes (X2 = 231.345, df = 291, p < 0,001; RMSEA = 0.001, CFI = 0.999, TLI = 1.028). HIV Mastery, Disclosure Worries, and Provider Trust domains were not retained in EFA and did not have evidence of concurrent validity. This study proposed a HAT-QOL six-factor model for measuring HRQOL in the Brazilian PLWHIV. Future research could help identify another latent construct from not-included domains.

Thermal chemical pretreatment of waste-activated sludge for enhanced solubilization and biogas production: a review

ABSTRACT Waste-activated sludge (WAS) generation is increasing due to the increased generation of wastewater owing to industrialization and urbanization. The disposal of WAS is a significant environmental and financial concern that can be offset by stabilization and valorization via anaerobic digestion (AD). However, the biodegradation is limited due to microbial cells and extracellular polymeric substances (EPS). Physical, chemical, biological, and hybrid pretreatments and the addition of accelerant materials for enhancing direct interspecies electron transfer (DIET) are among the strategies to overcome the poor biodegradation of WAS. Alkaline pretreatment disintegrates the floc structure of WAS by increasing the osmotic pressure, while microwave irradiation has thermal and a-thermal effects and increases the availability of organics for biodegradation. Moreover, the combination of alkaline and thermal pretreatments has synergic effects on solubilization, biogas production, and dewaterability. The disintegration of WAS is recognized by alteration in volatile solid (VS) content, sCOD, BOD/sCOD, turbidity, nutrients solubilization, dewaterability, particle size, specific surface area, change functional group, alteration in microorganism community, microorganism abundance, color, moisture content, lag phase, and biogas production. Higher doses of pretreatment increase COD solubilization but not biodegradable COD. Maximum COD solubilization ranged from 2 to 37% in alkaline, 21 to 260% in the microwave (MW), and 28 to 624% in hybrid pretreatments.

Fairness and Responsibility in Couples' Financial Discussions

This study investigates the role of financial conflict in romantic relationships. Participants (N = 221) first reported on their financial disagreements with their partners and rated a number of relationship attributes. Two days later, they were randomly assigned to recall either fair or responsible financial behaviour from their partner and rate the same relationship attributes again. Both recall tasks were successful at improving perceived financial communication and perceived partner spending but not financial worry or financial satisfaction. In sum, findings showed recalling any positive financial act can benefit the relationship regardless of which financial topics people fight about. The task was no more effective at improving relationship and financial outcomes when the condition matched the pre-existing conflict’s theme. Implications for relationship therapists as well as financial counsellors will be discussed.

Families of austerity: benefit cutbacks and family stress in the UK

Abstract Benefit cutbacks have been prominent after the Great Recession. The Family Economic Stress Model (FESM) theorizes how financial losses such as those spurred by cutbacks might adversely affect parental and child well-being. Yet, few links with policy have been established. We extend current knowledge by comprehensively assessing how benefits cutbacks may affect parents and their adolescent children. We rely on the first ten waves of the UK Household Longitudinal Study (2009–2019) and an event-study approach to examine the aftermath of an exceptional raft of benefit cutbacks. We find that mothers with lower incomes and single mothers accumulated losses equal to 20–30 percent of their household benefit income. Mothers could not fully compensate for such benefit income losses via their extra earnings, despite increased workforce participation. Financial worries, some forms of material hardship, and mental health worsened among mothers with lower incomes and single mothers exposed to cutbacks. Adolescent socio-emotional difficulties also increased in the period. We find little evidence, though, that cutbacks disrupted parenting. Parents thus display more agency than that accorded by the FESM. Nonetheless, findings point to deepening socioeconomic divides in financial and mental well-being, questioning the rationale for cutbacks.

Enterprise Resource Planning Implementation: Challenges and Barriers

The goal of this study is to ascertain how Enterprise Resource Planning (ERP) adoption software is affected in small and medium-sized businesses in Jordan by the problems and barriers represented by (low knowledge of ERP, misperception, lack of resources, financial worries, and employee resistance). The following titles of employees in Jordanian small and medium-sized businesses' departments of information technology made up the study population: (Department Manager, Assistant Department Manager, Head of Department, and Software Officer). To accomplish the goals of the study, the investigator employed a basic random sample of the study population, wherein (160) questionnaires were distributed and (152) were retrieved. The descriptiveanalytic approach was employed in conjunction with various statistical techniques, the most notable of which was the "T" test for one sample (One SampleT–test), and the statistical package program was utilized for statistical analysis and testing of hypotheses. Use SPSS. The study's conclusions include the existence of a statistically significant relationship between Jordanian SMEs' software implementation and their lack of resources, financial concerns, and inadequate ERP understanding. On the other hand, misperception and employee resistance had no statistically significant effect on the implementation of software in Jordanian SMEs. In light of this, the study made several recommendations, the most significant of which is the establishment of an independent committee of senior management experts in information systems and information technology to monitor a variety of data regarding the readiness and effectiveness of the software. As well as involving the user in the ERP implementation from the beginning, because operations management may clearly and effectively benefit from the end-user's assistance in formulating operations that accurately and firmly fulfil daily work needs

Demographic and lifestyle influences on depression, anxiety, and stress among graduate students: An analytical study of mental health outcomes

This study investigates the frequency and intensity of depression, anxiety, and stress in graduate students, with a specific emphasis on demographic and lifestyle variables. A cohort of 385 postgraduate students successfully administered the Depression, Anxiety, and Stress Scale (DASS-21) and furnished their demographic details. The sample was gender-balanced, with 50.1% male and 49.9% female participants. It comprised students from both urban (47.3%) and rural (52.7%) areas. The marital status distribution was as follows: 84.9% were married, 14.3% were single, and 0.8% were separated, divorced, or widowed. The survey participants were accommodated in three different ways: living with family (36%), staying in dorms (31%), or renting separately (33%). SPSS data analysis indicated that a considerable proportion of individuals suffered psychological discomfort. Specifically, 36.5% reported depression, 39.2% reported anxiety, and 27.8% reported stress. The correlation and regression studies revealed substantial relationships between demographic characteristics, lifestyle habits, and mental health outcomes. Significantly, financial worries, academic demands, and absence of work-life equilibrium were major sources of stress. The results emphasize the immediate requirement for customized mental health interventions in educational institutions. Recommended approaches encompass proactive mental health assessments, easily available therapy services, peer support systems, and programs aimed at enhancing resilience. Tackling these psychological obstacles is crucial for improving the welfare, educational achievements, and career growth of postgraduate students.