Financial Drain Research Articles

Accelerated Closure of Diabetic Wounds by Efficient Recruitment of Fibroblasts upon Inhibiting a 14-3-3/ROCK Regulatory Axis

Chronic non-healing wounds negatively impact quality of life and are a significant financial drain on health systems. The risk of infection that exacerbates comorbidities in patients necessitates regular application of wound care. Understanding the mechanisms underlying impaired wound healing are therefore a key priority to inform effective new-generation treatments. In this study, we demonstrate that 14-3-3-mediated suppression of signaling through ROCK is a critical mechanism that inhibits the healing of diabetic wounds. Accordingly, pharmacological inhibition of 14-3-3 by topical application of the sphingo-mimetic drug RB-11 to diabetic wounds on a mouse model of type II diabetes accelerated wound closure more than 2-fold than vehicle control, phenocopying our previous observations in 14-3-3ζ-knockout mice. We also demonstrate that accelerated closure of the wounded epidermis by 14-3-3 inhibition causes enhanced signaling through the Rho-ROCK pathway and that the underlying cellular mechanism involves the efficient recruitment of dermal fibroblasts into the wound and the rapid production of extracellular matrix proteins to re-establish the injured dermis. Our observations that the 14-3-3/ROCK inhibitory axis characterizes impaired wound healing and that its suppression facilitates fibroblast recruitment and accelerated re-epithelialization suggest new possibilities for treating diabetic wounds by pharmacologically targeting this axis.

Economic costs of invasive non-native species in urban areas: An underexplored financial drain

Urbanization is an important driver of global change associated with a set of environmental modifications that affect the introduction and distribution of invasive non-native species (species with populations transported by humans beyond their natural biogeographic range that established and are spreading in their introduced range; hereafter, invasive species). These species are recognized as a cause of large ecological and economic losses. Nevertheless, the economic impacts of these species in urban areas are still poorly understood. Here we present a synthesis of the reported economic costs of invasive species in urban areas using the global InvaCost database, and demonstrate that costs are likely underestimated. Sixty-one invasive species have been reported to cause a cumulative cost of US$ 326.7 billion in urban areas between 1965 and 2021 globally (average annual cost of US$ 5.7 billion). Class Insecta was responsible for >99 % of reported costs (US$ 324.4 billion), followed by Aves (US$ 1.4 billion), and Magnoliopsida (US$ 494 million). The reported costs were highly uneven with the sum of the five costliest species representing 80 % of reported costs. Most reported costs were a result of damage (77.3 %), principally impacting public and social welfare (77.9 %) and authorities-stakeholders (20.7 %), and were almost entirely in terrestrial environments (99.9 %). We found costs reported for 24 countries. Yet, there are 73 additional countries with no reported costs, but with occurrences of invasive species that have reported costs in other countries. Although covering a relatively small area of the Earth's surface, urban areas represent about 15 % of the total reported costs attributed to invasive species. These results highlight the conservative nature of the estimates and impacts, revealing important biases present in the evaluation and publication of reported data on costs. We emphasize the urgent need for more focused assessments of invasive species' economic impacts in urban areas.

Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study.

Households in low-resource settings are more vulnerable to events which adversely affect their livelihoods, including shocks e.g. death of family members, droughts and more recently COVID-19. Drug Resistant Tuberculosis (DR-TB) is another shock that inflicts physical, psychological and socioeconomic burden on individuals and households. We describe experiences and coping strategies among people affected by DR-TB and their households in Zimbabwe during the COVID-19 pandemic, 2020-2021. We purposively selected 16 adults who had just completed or were completing treatment for DR-TB for in-depth interviews. We transcribed audio-recordings verbatim and translated the transcripts into English. Data were coded both manually and using NVivo 12 (QSR International), and were analysed thematically. Health seeking from providers outside the public sector, extra-pulmonary TB and health system factors resulted in delayed DR-TB diagnosis and treatment and increased financial drain on households. DR-TB reduced productive capacity and narrowed job opportunities leading to income loss that continued even after completion of treatment. Household livelihood was further adversely affected by lockdowns due to COVID-19, outbreaks of bird flu and cattle disease. Stockouts of DR-TB medicines, common during COVID-19, exacerbated loss of productive time and transport costs as medication had to be accessed from other clinics. Reversible coping strategies included: reducing number of meals; relocating in search of caregivers and/or family support; spending savings; negotiating with school authorities to keep children in school. Some households adopted irreversible coping strategies e.g. selling productive assets and withdrawing children from school. DR-TB combined with COVID-19 and other stressors and pushed households into deeper poverty and vulnerability. Multisectoral approaches that combine health systems and socioeconomic interventions are crucial to mitigate diagnostic delays and suffering, and meaningfully support people with DR-TB and their households to compensate the loss of livelihoods during and post DR-TB treatment.

Are In-Person Trainee Interviews a Relic of the Past?

Are In-Person Trainee Interviews a Relic of the Past?

The influence of religion and socio-economic status on coping with chronic diseases among older adults in Nigeria

ABSTRACT Although still regarded as a demographically young country, the increased life-expectancy in Nigeria has corresponded with increased rates of chronic diseases among older people. There is limited information about the strategies adopted by older people in dealing with chronic diseases. This study explored how religion and social support help older people cope with their chronic disease conditions, while accounting for the prevailing socio-cultural and economic circumstances in Nigeria. This qualitative study was conducted in two state-owned medical institutions, in a city in the North-Central part of Nigeria. In-depth interviews were conducted among 19 purposively selected chronically ill persons aged between 50 years and over, during clinic days, after receiving treatment from the medical doctors. Recurring themes include: ‘God as Bestower and Reliever,’ Disease as Frustration and Disruption,’ ‘Financial Strain and Drain,’ and ‘Times are Hard.’ The study revealed that religion is central to peoples’ understanding and acceptance of their chronic disease conditions as well as adherence to prescriptions. It also explored the dual burden of coping with chronic conditions as well as being financially responsible for themselves and their families. The study also highlighted the centrality of religion in understanding chronic conditions as well as adherence to physicians’ orders/prescriptions.

A Theoretical Assessment of Standardization in the Satellite Upstream Value Chain

A study conducted by Bryce Space and Technology on the quantification and cause-mapping of launch delays of small satellites revealed that all 1,078 small satellites launched commercially in the past five years had suffered launch delays. The study attributed the primary reasons for this delay to schedule slippages of launches and the primary satellite. Such delays are a huge financial drain for the small satellite manufacturers. As a critical step toward addressing such problems by streamlining the supply chain and imparting the elements of interoperability and cross-compatibility, there are renewed calls for extending the scope of standardization of satellites—sizes, interface, and other aspects—from the currently existing CubeSat standards (CDS) to cover larger small satellites up to 500 kg. There are several initiatives such as Launch U by Aerospace Corporation, for example, aiming at addressing this area. In this context, the article tries to assess standardization through several strategic frameworks such as the Transaction asset model, Kraljic matrix, and Project planning model to identify the positive effects of standardization and also the negatives to impress on the need to define a proper extent until which standardization can be allowed to happen.

Assessing the divergence of south-south Nigerian indigenous contractors in international construction environment for national economic recovery

The expansion from the domestic market to the international market has become increasingly important for construction business including that of Nigerian Contractors amidst saturated local market, more patronage to foreign Contractors by the sector, stiff competition, political rivalry, insecurity and dwindling economic situation in the country. These factors have left most Contractors vulnerable for years without contract awards thereby resulting in retrenchments, inability to remit value-added tax (VAT), unsustained company’s profitability, heavy financial risk, practice and technology drain, bankruptcy, merging of companies as well as redundancy. Thus, the aim of the paper is to evaluate sound prospects for economic boost by the involvement of indigenous Contractors in oversea’s projects. The research was built on the foundation of stage growth theory which postulated that countries should modernize and model themselves after wealthier and economical viable ones to climb the upward ladder for development. The paper adopted a survey design method in which a total of 150 questionnaires were administered representing the sample size and 120 copies filled and submitted completely was achieved through a simple random sampling technique from the target population of 240 Federal Government-registered Indigenous Contractors in the South-South geo-political zone of Nigeria. Data analysis was done through simple percentages, frequencies, mean as well as statistics tools-analysis of variance (one-way ANOVA) to test the effect of one variable on another. The results showed that high profit and revenue, expansion of subsidiaries, foreign direct investment (FDI), new technological strength, the local and foreign government supports, amongst others were ranked 1st, 2nd, 3rd, 4th and 5th respectively as key prospects that will be achieved for the economic recovery of the nation. Also, competing in a foreign contract will lower the cost of the project in the country. The paper tested a hypothesis: whether there is value addition on the nation economy via indigenous contractor participation in the foreign project. The alternative hypothesis H1 was accepted since the f-calculated value of 64.24 was greater than the table f-value of 5.29 at 4/20 degree of freedom tested at 0.01 level of significance. It then concluded that Indigenous contractors has not been involved significantly in the overseas project, hence; it recommended an integrated approach, developing external wings, good industry practices, technical and dynamic capabilities, collective championing and depoliticizing construction contract for maximum participation.

The US failure to adopt the metric system: the high cost of teaching the English system

Over twenty years ago, an article by Richard Phelps addressed the benefits of the United States (US) educational system carrying out a complete adoption of the metric system of measurement. Today we find that the US is still in the same position in teaching both measurement systems in schools, which is a financial drain. This study sought to identify the monetary savings that the US would obtain by teaching only the metric system of measurement in today’s schools. A cost–benefit analysis of data, used in economics, provided evidence there is great benefit to the US in only teaching the metric system of measures. Calculations show annual savings due to the elimination of English measures from instruction ranging from $1.603 billion to $2.506 billion per year. Over time the total savings would accumulate to a present discounted value of between $53.4 to $83.5 billion. Such savings are significant and should impact policy decisions related to the US transitioning to a full metric conversion.

Finding a Preservative for Homemade Local Beverages in Northern Ghana: The Case of Sobolo, Tiger Nuts Drink and Zim Kom

In northern Ghana, the most famous and preferred locally made beverages are tiger nuts drink, sobolo and zimkom. The main problem associated with these products however, is their short shelf-life when they are kept at ordinary air/ room temperatures as a result of activities of microorganisms which actions are facilitated by conducive atmosphere of the region. The conducive atmosphere coupled with the ‘doomsolization’ of Ghana’s economy almost every other year during when such beverages are in high demand, further exacerbates the problem of storage losses vendors endear. This has very serious negative financial drain on profits since any unfinished often go waste. Presently large scale production is not possible and therefore these vendors cannot enjoy the economy of scale. To aggravate matters, most vendors lack refrigerators; and even for those who own refrigerators, erratic electricity supplies during the dry periods of the year, encounter significant losses too. It was against this background that this study sought to identify suitable preservative for these homemade local beverages in northern Ghana so that when such a preservative is used the products can be stored under ambient temperatures for an extended period of time. Specifically, the study sought to assess the effects of sodium benzoate on the three beverages; to determine the extent of shelf life extension of the beverages due to the benzoate; to establish which concentration level of the benzoate is most effective; and to determine whether respondents would notice the benzoate in beverages. The research design employed was quasi-experimental involving the treatment and observation of samples under various handling and/ or storage conditions. Sufficient quantities of each beverage were procured and two varying concentrations of sodium benzoate solutions prepared for use in the experiments. The shelf life observation technique employed was direct where, taste, smell, colour and appearance. Samples without preservatives were set aside as experimental controls. A total of four different experiments were conducted for a period of twenty six (26) days. The major finding was that using sodium benzoate 1.0 g/1000 ml in non-refrigerated tiger nut drink’s shelf-life was five (5) days maximum; sobolo lasted 22 days whilst zimkom, 15 days. Sensory evaluations of the samples using untrained consumer panel revealed 100% consumer acceptability. The study recommends a dissemination seminar or workshop to be organised to train the beverage vendors on adopting the use of the sodium benzoate preservative to reduce spoilage losses.

"Post-COVID-19 syndrome:" The New Pandemic Affecting Healthcare Workers and How the Frontline Warriors Are Battling it.

Objectives:“Post-COVID-19 syndrome,” which may be the new pandemic, has affected various domains of quality of life; even among those who have recovered from mild COVID-19 disease. The aim of our study was to explore the health, social and psychological impact on healthcare workers (HCWs) who have recovered from active COVID-19 illness and highlight their needs post-recovery.Materials and Methods:It was a web-based survey study. A total of 163 eligible consenting HCWs participated in this survey. The Institutional Ethical Committee approval was obtained before study recruitment and the study was registered with the Clinical Trial Registry of India. Each participant responded to 25 questions.Results:Among those participated, 51% were doctors, 32% were nurses and others were allied health professionals and students. About 82% had mild COVID-19 illness and 40% required hospitalisation for COVID-19 treatment. In the post-recovery period, 66% experienced health issues and fatigue on mild exertion was the most common symptom (42.94%). It was followed by anosmia and ageusia (21.47%), headache and myalgia (15.34%) and breathlessness (8.59%). About 82% HCW felt the need for a post-COVID-19 recovery health care unit. Potential risk of infecting family members was the most common concern (53.46%) followed by the fear of contracting the virus again (46.54%). About 35% of HCW experienced the fear of developing post-COVID-19 complications. About 78% of HCW did not report any psychological concerns, but one-third were stressed due to the financial impact.Conclusion:Post-COVID-19 syndrome impacts all domains of quality of life. Fatigue, loss of taste and smell, headache, myalgia and breathlessness continue to persist beyond recovery of active illness. Most of the HCWs emphasised the need to set up post-COVID-19 care units. The fear of contracting the virus again and financial drain due to hospital expenses continued to distress HCWs.

Implications of Enuresis in Children and Their Families

Nocturnal enuresis (bedwetting during the night at sleep) is one of the most disturbing and frustrating childhood problems for both parents as well as children (Bulut, 2019). As many as 5 million American children and families are suffering from it (Warzak, 1993). Nocturnal enuresis is one of the most common disorders of childhood (Schulpen, 1997). If it is not treated, it has a significant effect on children’s social and emotional health. Even when they reach adulthood, enuresis can still have a serious effect on their careers, social life and personal relationships (Graff, 1992). Furthermore, enuresis causes a financial drain in both the families and the society as a whole. Continuously having to wash, dry, and buy washing soaps and diapers can cause a significant financial burden on families. Additionally, enuresis can limit the family’s mobility and vacation planning. Therefore, it seems that it has multiple consequences to be considered.

Appraisal of Burden of Caregivers to Chronically Rehabilitated Patients with Spinal Cord Injuries in a Tertiary Neurological Center in Nepal.

The care of a patient with a spinal cord injury is part of healthcare systems. It causes a substantial physical and emotional drain on the caretakers who often are in short supply and thus may lack adequate training, preparation, and support. Long hours of assisting a chronically handicapped patient with activities of daily living and exercises decrease the rehabilitator's quality of life and take a psychological toll that increases a risk of burnout syndrome. The present study found a significant caregiving burden among care providers of chronically dependent patients with spinal cord injuries. Additionally, financial drain escalates the issue in this rather neglected health and quality of life aspect concerning caregivers. For the situation to improve, there must be a paradigm shift in care taking toward the motivative patient's participation in the rehabilitative process. Provisions for social support and educational programs focusing on the patients and their families need to be reappraised.

Variation of cost among anti-malarial drugs available in Indian market

Background: There are numerous brands of antimalarial existent in the market. Expensive drugs could result in financial drain that causes reduced compliance or even non-compliance. Non-adherence to therapy could consequently cause partial treatment that leads to higher morbidity and in certain cases mortality too. Thus this evaluation was conducted to measure the cost disparity of malaria therapy.Methods: The maximum and minimum price of each brand of the drug in Indian rupee rate was noted by using the latest edition of current index of medical specialities. The cost ratio and the percentage cost variation for individual drug brands were calculated.Results: The analysis of data reflected a considerable cost variation among antimalarial drugs. Chloroquine DS 500 mg showed the highest cost ratio and cost variation (cost ratio=15.3 and % cost variation=1434). Overall injectable antimalarials showed considerable cost variation as compared to oral antimalarial agents.Conclusions: The maximum variation shown by oral antimalarial was found to be for chloroquine DS 500 tablet. But there was significant price variation among injectable antimalarial. Injectable antimalarials are often the choice of drug when dealing with critically ill malaria patients specially when suffering from complicated malaria. So, such significant price variation creates burden on poor patients economically which leads to non-compliance and hence increased morbidity and mortality due to incomplete treatment.

Prevalence and financial loss estimation of parasitic diseases detected in slaughtered cattle in Kwara State, North-central Nigeria.

Parasitism is of great concern to the wellbeing, productivity and reproductivity of animals and it causes great financial loss to the economy of any nation. This study was conducted to determine the prevalence and the economic loss from carcass and viscera condemnation due to parasitic diseases in slaughtered cattle in Kwara State, North-central Nigeria. A 16year (2003-2018) record of parasitic diseases detected in cattle slaughtered at the major abattoirs in Ilorin city was retrieved from the Kwara State Veterinary department of the Ministry of Agriculture and Natural Resources. The total prevalence as well as the yearly, monthly and seasonal prevalence of each of the documented parasitic diseases was determined. The financial losses associated with each of the parasitic diseases were estimated in Nigerian Naira (₦) and US Dollar (USD) considering the market price and weight of viscera condemned. Fasciolosis, hydatidosis, dicrocoeliosis, cysticercosis and oesophagostomiasis were the parasitic disease conditions with fasciolosis (6371/832,001) and cysticercosis (134/832,001) been the most and least prevalent disease conditions respectively. The yearly and monthly prevalence of each disease conditions showed an undefined pattern. There was a significantly difference in the prevalence of the detected parasitic conditions within seasons. The total financial loss associated with these disease conditions was 304,133.82 USD (46,161,433 Nigerian Naira). This study showed that parasitic diseases are of great financial drain to the livestock economy of Nigeria and this study will serve as baseline information on the economic losses associated with parasitic diseases of cattle at slaughter in Nigeria.

University Technology Transfer and Laggards: Differential Results and Policy Implications

Universities are unique environments that thrive on the research and curiosity of faculty and students. To disseminate knowledge and potentially derive lucrative sources of funding, universities have vigorously entered the field of technology commercialization and patenting. The passage of the Bayh-Dole Act was instrumental to encourage this activity and the result has been an explosion of university-related patenting. This activity comes at a social cost, however, since patents restrict knowledge transfers and may create deadweight losses. These costs are amplified if technology transfer office (TTO) activity is viewed from a narrow financial or cost-benefit viewpoint. As demonstrated in this study, twenty institutions belong to an elite grouping of leader institutions that have financially sustainable TTO operations. The rest are classified as laggards and consistently operate with losses. This article examines why the leaders excel and why the laggards continue to support TTO activities when they present a financial drain on universities. Transaction cost economics, institutional theory, signaling and expected value theory can all offer insights related to the organization and maintenance of these offices. These theoretical perspectives help to explain why universities engage in technology transfer. An in-depth examination of the highly successful Taxol case at Florida State University, a laggard institution, sheds light on some of the antecedents for a successful, yet rare, technology transfer event. The case reinforces the view that technology transfer should not be viewed narrowly, even among laggard institutions, but rather it should be viewed as a strategic endeavor that involves signaling, the observance of social conventions and investment for broader technological and economic objectives. Two negative consequences have resulted despite the success of Bayh-Dole. These include the increasingly predatory and commercial behavior of universities and the highly skewed distribution of value among TTOs. If left unaddressed, these problematic results may result in legislative reforms that could weaken the ability of universities to practice technology transfer.

Impact of oral health-related behaviors on dental caries among children with special health-care needs in Goa: A cross-sectional study.

Children with special health-care needs (CSHCNs) have high unmet dental needs and are at increased risk of poor oral health. The aim of the present study was to evaluate the relationship between oral health behavior and dental caries experience among CSHCN. The cross-sectional study sample comprised of 223 CSHCNs from special educational schools in Goa. A self-administered parental questionnaire was used to collect data on sociodemographic characteristics and oral health behavior variables. Type III clinical examination for dental caries was done using the World Health Organization criteria. Statistical analysis was done using SPSS version 19.0. The mean age of the study sample was 13.85 ± 7.2 years. Seventy-two percent of the study sample had never visited a dentist. Majority of the study participants (57.4%) brushed their teeth once daily. The caries prevalence was 68.6%. The mean decayed, missing, and filled teeth index for permanent dentition and primary dentition of the study participants was 2.83 ± 3.23 and 0.35 ± 1.00, respectively. Dental caries was significantly associated with frequency of brushing and dental visits. The caries experience was high among children with special needs in Goa. There is a significant association between oral health behavior and dental caries experience. Oral health promotion may lead to reduction in dental caries level, thus reducing the emotional, physical, and financial drain on their caregivers.

Weighing Up the Evidence and Local Experience of Residential Care

Therapeutic residential care is currently seen as an answer to managing the increasing disruption experienced by many young people in care. Yet the history of residential care in Australia is problematic and the international evidence for the efficacy of therapeutic approaches is very poor. The author's own agency's experience of providing residential care also indicates that caution is needed before increasing the numbers of residential ‘beds’. Problems include young people's dislike of residential options and the stressfulness of an environment that involves shift workers and multiple transient relationships. Further, residential care can be a financial drain on child welfare budgets (being tendered to non-government agencies at over seven times the cost of community care), and has the potential danger – when beds are empty – of being used for young people who do not need this level of care. Residential care may appear to be the only option for a handful of adolescents no longer suited to foster care; but before developing therapeutic residential care further, government must be able to guarantee, at a minimum: a safe environment, a nurturing and healing environment, continuity of care, and the capacity to meet young people's developmental and permanency needs. These standards must be met, not just now, but over the long term.

Use of crystal methamphetamine among male adolescents in Cape Town, South Africa: Caregivers' experiences

BackgroundAgainst the background that crystal methamphetamine (colloquially known as “tik”) is extensively used by the emerging working class Coloured youth in Cape Town, South Africa, this exploratory qualitative study was conducted to explore the experience of mothers whose children use methamphetamine.MethodsThe researchers conducted one-to-one semi-structured in-depth interviews with sixteen (16) purposively selected caregivers (mothers) whose sons use methamphetamine. Interviews were recorded and simultaneously translated and transcribed. Thematic analysis was used to identify themes related to the experiences of caregivers of youth with methamphetamine problems.ResultsFindings showed that youth misbehaviour provided a context that led to feelings of shame and embarrassment. Participants also experienced personal challenges which included emotional problems, fear and self-blame. Participants also expressed family disruptions and financial drain as adverse experiences as a results of their sons’ misbehaviour.ConclusionThe study results highlight the psychosocial challenges for caregivers of children who use methamphetamine. These findings underscore the need for effort to be directed at the development of formal support interventions for mothers of youth who are troubled with addiction.

Costs of management of injuries in emergency room patients in Ilorin

Background: Injuries pose a significant economic problem to communities in every society. Studies aimed at estimating the costs of management of injuries are very limited in this environment. Materials and Methods: The patients who presented to the emergency unit of the University Teaching Hospital, Ilorin, Nigeria, with traumatic injuries were recruited. The expenses were classified into various groups. Results: Of the 165 patients recruited, majority were young adult men. The mean direct cost per injury was N4061 ($27.1) with the cost of drugs accounting for the largest share of the costs. The costs incurred were higher with the increasing severity of injury. Conclusion: The direct costs of management of injuries from this study represent a significant economic drain to the low-income population of this environment. Extrapolating these cost estimates of medical treatment to the fatal as well as the even larger non-fatal injury burden in Nigeria exposes the immense financial drain to the individual and community.

Sexually Transmitted Diseases: A Webliography

ABSTRACTSexually transmitted diseases (STDs) are contagious infections spread through intimate sexual contact. Although sexually transmitted diseases are a threat to a person's health, they are preventable. The 2014 Sexually Transmitted Disease Surveillance Report published by the Centers for Disease Control and Prevention (CDC) reported a rise in rates of infections in three major sexually transmitted diseases (CDC “Sexually Transmitted Diseases” 2015). Serious health problems such as pelvic inflammatory disease in women and even death can develop from these diseases. Several different types of medications are available for treating STDs. These diseases are a financial drain on the current health care system. Prevention and education are needed to make a difference in their impact.