Financial Pressures Research Articles

Releasing financial pressure through released time religious education: the fiscal impact of one released time programme on a state’s funding for public education

ABSTRACT We sought to quantify the fiscal impact of the Church of Jesus Christ of Latter-day Saints’ released time programme in the state of Utah, in the United States of America, on funding for American public education. The guiding research question for this study was: How much money does the Church of Jesus Christ of Latter-day Saints’ seminary programme save public education in the state of Utah? We collected data from one school district in Utah and then extrapolated those findings, on a per pupil basis, to the entire state. Findings are reported in three approximates of the actual fiscal impact of the Church’s seminary programme in Utah: high, medium, and low. Our conclusion is that the actual fiscal impact of seminary on funding for public education lies within this reported range. We report that the Church’s seminary programme saves the state of Utah between $45,000,000 and $64,000,000 annually. While these figures only constitute 0.6% to 0.8% of the total funding for public education, this released time programme provides district officials with financial and scheduling flexibility. In addition, there are indirect fiscal benefits associated with seminary as well as direct and indirect costs.

Financial toxicity of total cancer care immunotherapy patients and caregivers: impacts of COVID-19 pandemic and inflation.

Financial toxicity, cancer-treatment-related financial harm, is associated with expensive treatments like immunotherapy. The purpose of this study was to explore financial toxicity among advanced cancer patients receiving immunotherapies and their caregivers and, secondarily, to study how recent inflation and the COVID-19 pandemic impacted these experiences. Advanced cancer patients receiving immunotherapies and their caregivers were recruited to participate in semi-structured interviews about supportive care needs from 2022 to 2023. The Comprehensive Score for Financial Toxicity was collected. Guided by Jones et al.'s cancer financial toxicity model, the content analysis was conducted by two trained coders using NVIVO R1. Sixteen patients and 10 caregivers (including 7 dyads) across 5 states participated in interviews in 2022-2023. Participants averaged 63.43years (SD = 12.75), and patients received an average of 14.6months of immunotherapy (SD = 9.415). The majority lived in non-metropolitan areas (67%) and were white (95%). Three theory-driven themes were developed: (1) Sources of Financial Toxicity, (2) Buffers of Financial Toxicity, and (3) Consequences of Financial Toxicity. Inflation was added to financial toxicity for non-metropolitan dwelling participants due to increased prices of gas and accommodation. Social support systems buffered the impact of financial toxicity. Material and psychological impacts of financial toxicity disproportionately affected younger and privately insured participants. While immunotherapy patients face high medical costs of treatment, the burdens of accessing treatment for people living at a distance from the cancer center can exacerbate financial toxicity. Clinicians and researchers should also consider external financial pressures such as national economic impacts that compound the financial toxicity of treatment.

Training the Next Generation of Pediatric Clinical Pharmacologists: Insights and Trainee Perspectives Over 10 Years.

The limited number of researchers with expertise necessary toaddress treatment gaps for children presents an ongoing challenge. The NationalInstitutes of Health established a national Pediatric Clinical Pharmacology T32Training Program in 2012 to train a multidisciplinary, collaborative pediatricclinical pharmacology workforce. We surveyed all current T32 trainees andgraduates since inception to identify strengths and opportunities to enhanceworkforce development. A total of 85 out of 155 (55%) responded, with themajority of respondents being female gender (61%), white race (75%), andworking in academia (75%). Nearly all (97%) reported using clinicalpharmacology in their current position, with 88% planning to remain in clinicalpharmacology in the long term, reinforcing current training efforts. Lifestylefactors and student debt appeared to influence career decisions. Mentors werecritical for introduction and future success in the field. Time and fundinglimitations were perceived as barriers to successful training. There was also apressing need to improve diversity. For workforce development, we suggestsupporting: (1) trainees' lifestyle, by offsetting financial pressures ofresearch training and expanding the geographic footprint of pediatric clinicalpharmacology training; (2) mentorship, by identifying mentors in the field andproviding dedicated support for mentorship; (3) efficiency, by evaluatingcurrent training activities and focusing on activities that maximizeopportunities for future funding; and (4) diversity, by examining barriers todiversity in the workforce in general and expanding early enrichmentopportunities.

Data-Driven Revenue Cycle Management: Optimizing claims denial resolution and under payment for healthcare providers through SaaS Solution

The healthcare industry is increasingly under financial pressure due to high rates of claims denials, leading to substantial revenue loss and operational inefficiencies. Claims denials result from various factors, including coding errors, incomplete documentation, and regulatory non-compliance, all of which contribute to revenue leakage that often reaches 5–10% annually for healthcare providers. This paper explores a proprietary Software-as-a-Service (SaaS) solution that leverages data analytics, machine learning, and real-time reporting to enhance the claims denial management process. Through predictive and prescriptive analytics, the proposed solution enables healthcare providers to identify denial trends, reduce denial rates, optimize claims resolution, and increase revenue retention. The paper includes system architecture, data security protocols, pilot implementation findings, and a comparative analysis of performance metrics. The paper concludes with a discussion on future developments, including real- time denial prediction, automated appeals generation, and enhanced integration capabilities with existing Electronic Health Record (EHR) systems. Keywords: Revenue Cycle Management, healthcare claims denial, claim under payment, SaaS, data analytics, machine learning, real-time reporting, financial sustainability, healthcare providers

How community-based health workers fulfil their roles in epidemic disease surveillance: a case study from Burkina Faso

BackgroundIn 2016, Burkina Faso adopted a new community-based model for disease surveillance, appointing two community-based health workers (CBHWs) per village. The CBHWs play a crucial yet under-researched role in Burkina Faso’s health system. This study aimed to analyze the factors influencing their practices in relation to their official roles in epidemic disease surveillance.MethodsConducted in the Dandé Health District in southwestern Burkina Faso, this qualitative study collected data through semi-structured interviews with 15 CBHWs and 25 health professionals, supplemented by observations of the CBHWs’ working conditions. Data analysis employed a qualitative content analysis.ResultsAnalysis showed major challenges in the current community health strategy, particularly in capacity building and the working conditions of CBHWs (e.g., lack of monthly report sheets and financial incentives). Recognition from the community was the key motivation for volunteering as a CBHW in Dandé Health District where rural populations are under great financial pressure. Consequently, financial incentives (monthly remuneration and extra incentives) and non-financial rewards in terms of status and prestige, play a crucial role in sustaining volunteer enegagment and effectiveness.ConclusionsThis study underscores the necessity of establishing a clear policy on compensation and protection for CBHWs to motivate and optimize their work. Such policies are essential for enhancing their contribution to a robust national community surveillance system, ultimately improving public health outcomes in Burkina Faso.

Impact of family financial pressure on voluntary work performances OCB & CWBs: Mediating role of family motivation and self-control

This study aims to highlight the determinants and pathways that trigger employee functional and detrimental voluntary work performances i.e. OCB & CWBs. It is unclear whether family financial pressure is functional or nonfunctional for generating voluntary work behaviors. This study spotlights the paradoxical nature of family financial pressure. We theorize that family financial pressure is a double-edged sword that can produce positive OCB and negative CWBs employee voluntary work behaviors. We have collected data from manufacturing and service sector employees working in different organizations in Pakistan. This study found that family financial pressure is the salient determinant that can generate both functional voluntary work performance OCB and counterproductive voluntary work performance CWBs through unique pathways i.e. family motivation, state self-control failure. Family motivation acts as a partial mediator between family financial pressure and OCB and state self-control failure also partially mediated the link between family financial pressure and CWBs. The practical and theoretical implications are also discussed in this study.

Contexts and complexities: a realist evaluation of integrated care system leadership.

This paper presents a realist evaluation of leadership within an integrated care system (ICS) in England. This paper aims to examine which aspects of leadership are effective, for whom, how and under what circumstances. Realist evaluation methodology was used, adopting prior realist review findings as the theoretical framework to refine explanations of how and why leadership within an ICS is effective. Between January and November 2023, 23 interviews with ICS leaders took place, alongside 7 meeting observations and documentary analysis. The Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) guidance informed the study design, conduct and reporting. The findings highlight two overarching infrastructural contexts influencing leadership in ICSs: the impact of the post-COVID-19 pandemic legacy and the differences between health and social care regulatory and financial environments. Findings demonstrate that ICS leaders identified a strong sense of purpose as crucial for guiding decisions and creating a psychologically safe environment for open, honest discussions, fostering calculated risk-taking. Whilst a shared vision directed priority setting, financial pressures led to siloed thinking. Leadership visibility was linked to workforce morale, with supportive leadership boosting morale amidst evolving ICS landscapes and confidence in data-driven decisions supported prevention activities. However, financial constraints hindered responsiveness and innovation in addressing health inequalities. By examining ICS leadership post-COVID-19 pandemic and amidst varying regulatory and financial environments, this study contributes to the emerging literature on systems leadership and offers practical guidance for leaders navigating the complexities of integrated care.

Sustainable supply chain management operations: does sustainable environmental disclosure matter for banks’ financial performance in Nigeria?

In recent years, banks have incorporated sustainable development strategies to achieve competitiveness in the financial market. However, the primary concern for banks is the financial pressure to implement sustainable environmental practices. In addition, banks are obliged by different regulators to maintain standards in conducting their business and allocating funds. Previous studies examined the relationship between sustainability reporting, corporate social responsibility (CSR), and firms’ financial performance. Few empirical studies examined the impact of sustainable supply chain management (SSCM) operations on firm financial outcomes, yet the banking sector has been ignored in the analyses. To bridge this gap, we examine the dynamic effect of SSCM operations on deposit money banks’ (DMBs) financial performance. We selected seven banks in Nigeria with national, regional and international authorization and data spanning from 2005 to 2023. Based on the panel co-integration test and the Cross-sectional Dependence Autoregressive Distributed Lag model (CS-ARDL) model, we found that SSCM operations have a significant influence on the financial performance (market value and profitability) of the banks. Impliedly, banks’ SSCM operations and environmental consideration in the allocation of funds drive their corporate image and value. Integration of SSCM strategies for a sustainable environment can help enterprises/companies bridge information asymmetry among diverse stakeholders. We offer some policy suggestions in line with the empirical findings.

Innovative approaches to reforming the pension insurance system of Ukraine: background of foreign countries

One of the most important tasks for any civilized state is to care for the elderly. The collection of various forms of financial support for individuals who have reached the retirement age set by law or have lost their ability to work through centralized insurance or budgetary funds has existed for a long time. This led to the creation of a pension insurance system covering all citizens. The primary goal of such a system is to prevent poverty due to the loss of working ability due to age. Reforming the domestic pension system has been ongoing for more than 20 years. However, it has not yet ensured the implementation of a three-pillar pension system in Ukraine. This requires a more detailed study of the successful experiences of other countries in this field. This is of particular importance in light of the upcoming post-war reconstruction of our country. All sectors of the economy will undergo reconstruction, and it seems entirely likely that radically new paths for rebuilding will be considered, especially for the population’s social insurance system. Modern pension insurance systems operating in different countries are not alike [1]. They differ in principles and organizational foundations of functioning, coverage of participants, taxation methods and rules governing pension contributions and payments. Each pension system depends on the level and stability of the country’s economic development, traditions, social security experience, labor motivation system, tax, and labor legislation. The article is dedicated to analyzing pension systems in industrially developed countries. Studying the experience of such countries is important for Ukraine due to the necessity of creating an efficient national pension system. The article explores the current challenges and opportunities for reforming Ukraine’s pension insurance system using innovative approaches. Particular attention is paid to analyzing the experiences of foreign countries that have successfully reformed their pension systems and introduced modern pension management methods. In light of rapid demographic aging and increasing financial pressure on pension funds, the article justifies the need to transition to a multi-tiered pension insurance system.

Faktor Determinan Tekanan Finansial Pada Generasi Z Di Kota Tasikmalaya

This research aims to measure the factors that cause financial pressure on Gen Z in Tasikmalaya City. The research used quantitative methods with structural equation modeling approach. The results show that financial literacy and financial behavior hurt financial stress. This means that the higher the financial literacy and behavior index, the lower the financial pressure. However, lifestyle has a direct effect on financial stress. The higher the lifestyle, the higher the financial pressure that Gen Z receives.

Online and Offline Fault Detection and Diagnostics in a Nuclear Power Plant Condenser

Nuclear power plants (NPPs) face significant financial pressures due to operational and maintenance costs. This research investigates Fault Detection and Diagnostics (FDD) techniques to optimize maintenance schedules and reduce expenses. The NPP condenser plays a critical role in converting turbine exhaust steam back into water for reuse. Condenser tube fouling, a prevalent fault mode, impedes heat transfer efficiency and can lead to decreased plant efficiency and safety risks. This study proposes an FDD framework that leverages raw signal analyses from temperature and pressure monitoring to detect and diagnose condenser tube fouling in both online and offline settings. The online approach facilitates close-to-real-time predictions, enabling proactive maintenance strategies. Additionally, the framework explores incorporating a condenser’s maintenance history for enhanced diagnostics. We employ a dataset obtained from a simulated nuclear power plant condenser using the Asherah Nuclear Power Plant Simulator (ANS). ANS replicates the operational dynamics of a pressurized water reactor (PWR) type NPP. The proposed methodology utilizes an encoder-decoder (E-D) structured 1DCNN model to analyze the raw signals. The research demonstrates consistent and accurate fault detection and diagnostics for condenser tube fouling in both online and offline scenarios. A high potential for generalization to unseen conditions was observed. However, online detection using small data windows necessitates caution due to potential false alarms around the transition points. Our findings pave the way for further exploration of robust diagnostics by accommodating a wider spectrum of fouling rates within degradation classes using ANS. This combined online and offline FDD approach offers a promising solution for promoting operational safety, efficiency, and cost-effectiveness in NPP condensers.

Navigating identity shifts and well-being in the entrepreneurial exit process: A comparative study of entrepreneurs nearing retirement

Entrepreneurs in their 50s and beyond face significant identity shifts and well-being challenges as they transition out of the businesses they have built. Grounded in Super’s career-development framework and utilizing the Eisenhardt Method for case study analysis, this research explores the entrepreneurial exit process during the maturity and decline stages. With an average business tenure of 11 years, these entrepreneurs encounter emotional and practical hurdles, such as health concerns, financial pressures, and shifting priorities. The study highlights valuing identity diversification and social support in easing the transition, revealing that financial success alone does not guarantee positive post-exit well-being. Gender differences show women prioritize sustainability and family, while men focus on growth and professional identity. These insights underscore the need for early exit planning and holistic support for successful entrepreneurial succession and retirement strategies. JEL CLASSIFICATION: L26: Entrepreneurship; D91: Intertemporal Household Choice; Life Cycle Models and Saving; M14: Corporate Culture; Diversity; Social Responsibility; J14: Economics of the Elderly; Economics of the Handicapped; Non-labor Market Discrimination; I31: General Welfare, Well-being

Threat Modeling for Enhanced Security in the Healthcare Industry with a Focus on Mobile Health and IoT

The advancement of mobile health and the Internet of Things (IoT) promises to enhance healthcare quality while reducing costs, particularly with the transition from inpatient to home and ambulatory care. This shift, driven by an aging population, financial pressures, and a shortage of skilled healthcare professionals, presents significant opportunities and challenges. While mobile health improves access and encourages self-management, it also raises serious concerns regarding security and interoperability, especially with wearable devices equipped with sensors in a patient's Body Area Network (BAN). This paper critically analyzes the security and interoperability risks associated with these technologies, emphasizing the need for robust measures such as configuration and asset management. Utilizing recommendations from ENISA (2016) and conducting a risk and vulnerability assessment, this study develops a comprehensive security model tailored for healthcare architectures. Additionally, it applies the STRIDE threat modeling approach to identify and mitigate potential threats, providing valuable insights for securing healthcare systems and prioritizing critical assets vital to organizational operations.

Credit Cost Management and Financial Performance of Hotel Businesses in Kenya

This study explores the impact of credit cost management on the financial performance of businesses in Kenya's hospitality sector. Specifically, it examines how interest rates, loan collateral, and loan repayment terms influence the profitability and financial stability of small and medium-sized enterprises (SMEs) in the industry. The study is supported by Loanable funds theory, Credit scorecards theory and Tradeoff theory. Through a desk review of existing literature, the study identifies that high interest rates increase the cost of borrowing, creating financial pressure on businesses, while lower rates support profitability. Loan collateral is found to be a major determinant of access to credit, with businesses that provide sufficient collateral securing loans more easily. Flexible loan repayment terms contribute to better cash flow management and liquidity, improving overall financial performance. The study concludes that effective credit cost management is critical for the success of hospitality businesses and recommends that financial institutions and policymakers collaborate to provide more favorable credit terms, including lower interest rates, reduced collateral requirements, and more flexible repayment options. Increased transparency in loan agreements and government interventions to support SMEs are also essential for fostering financial growth in the sector.

“Unachievable adulthood?!” – exploring family formation journeys of care leavers in China

ABSTRACT This study examines the family formation journeys of care leavers in China, focusing on how they plan, navigate, and face challenges during this process. Using convenience and snowball sampling, 19 participants (16 care leavers, 3 care stayers) were interviewed. Thematic analysis identified three family pathways: (i) acquaintance-matched, (ii) self-matched, and (iii) marriage “on the way”. The findings reveal ongoing social exclusion and obstacles to family formation, particularly for male care leavers, due to financial pressures, discrimination, and trauma. The study highlights the need for targeted support and social change to improve outcomes for care leavers in China.

Reform of Budget Performance Management and Local Financial Pressure in China

As the situation of tight fiscal balance among local governments in China continues to intensify, research on how to release local fiscal pressure has attracted much attention. At the national level, the reform of budget performance management has significantly reduced the financial pressure on local governments; Mechanism analysis shows that reform can alleviate local fiscal pressure through two channels: improving fiscal expenditure performance and optimizing regional institutional environment; The analysis of regional heterogeneity shows that the reform only reduced the local fiscal pressure in the eastern region, while the fiscal pressure in non eastern regions did not decrease but instead increased. Finally, this article proposes suggestions for addressing the issues of unbalanced and insufficient reforms, which provide policy insights for China's subsequent efforts to improve the quality and efficiency of budget performance management.

From Tourism to Propaganda Tactics: Unveiling the PRC’s Influence on Palau’s Electoral Landscape

This article argues that the People’s Republic of China (PRC) is leveraging a combination of economic influence, political coercion, and disinformation tactics to sway the outcome of Palau’s 2024 presidential election. With the currently favored candidate reportedly being tied to Chinese Communist Party (CCP)-linked individuals and publicly promoting PRC narratives, it is critical to highlight the PRC’s influence tactics—such as propaganda, censorship, international partnerships, and financial pressures—that are being employed to achieve its goals. The article first offers a brief overview of the PRC’s actions and aims in the Indo-Pacific region, highlighting Palau’s significance to the PRC and the United States. Next, the author summarizes the PRC’s multiple forms of economic influence in the region, such as monopolizing tourism, buying land, engaging in bribery, encouraging illegal activities, and exploiting U.S. missteps. Then, after introducing Palau’s presidential candidates, the article delves into PRC information operations and tactics. It also examines key findings of PRC interference in other recent regional elections, such as in Taiwan and the Philippines, and analyzes what tactics were used, if they were effective, and how these tactics could be adapted to be successfully implemented in Palau. The article concludes with predictive analysis of the PRC’s potential actions in Palau, such as information operations, including amplifying local conflicts, using local media as proxies, and creating artificial intelligence (AI)-generated content, as well as listing potential countermeasures that could be implemented in Palau to combat PRC information advances, such as education programs for students and journalists, misinformation debunking campaigns, and implementing legislation to counter misinformation campaigns.

Peer support groups and care burden in hemodialysis caregivers: a RCT in an Iranian healthcare setting

BackgroundChronic renal failure poses a significant global health challenge, exerting a substantial burden on both patients and their caregivers. Hemodialysis, a common treatment for end-stage renal disease, imposes extensive physical, emotional, and financial pressures on caregivers, often leading to a high care burden. This study uniquely examines the impact of peer support groups on reducing the care burden among caregivers of patients receiving hemodialysis in an Iranian healthcare setting, an aspect that has not been extensively explored before.MethodsA parallel-controlled clinical trial was conducted involving 60 caregivers, divided into intervention and control groups. The intervention group participated in an 8-session peer support program tailored to their identified needs, including coping with stress, social isolation, and financial challenges. The Zarit Care Burden Interview Scale was used to measure care burden before and after the intervention.ResultsThe study revealed statistically significant reductions in care burden, particularly in physical, social, and emotional dimensions, among caregivers in the intervention group compared to the control group. The total care burden score showed a marked decrease, indicating the effectiveness of the peer support intervention. While economic challenges remained a concern, the intervention had a limited impact in this domain.ConclusionThis study demonstrates that peer support groups significantly alleviate the care burden experienced by caregivers of patients receiving hemodialysis, improving their well-being across several dimensions. The findings highlight the importance of integrating peer support strategies into healthcare programs for chronic disease management and underscore the need for supplementary economic support measures to comprehensively address caregivers’ needs. Future research should explore the scalability and long-term sustainability of such interventions and address the unique economic challenges faced by these caregivers.Trial registrationThis study was registered in the Iranian Registry of Clinical Trials (IRCT) under the registration number IRCT20220724055540N1 on 11/08/2022.

The Austrian Political Advertisement Scandal: Patterns of “Journalism for Sale”

Mounting concern surrounds the influence of political actors on journalism, especially as media outlets face increasing financial pressures. These circumstances can give rise to instances of media capture, a mutually corrupting relationship between political actors and media organizations. However, empirical evidence substantiating such mechanisms and their consequences remains limited, particularly in the context of Western democracies. This chapter investigates a recent case in which a former Austrian chancellor allegedly colluded with a tabloid newspaper to receive better news coverage in exchange for increased ad placements by government institutions. We employ automated content analysis to investigate political news articles from seventeen prominent Austrian news outlets spanning 2012–2021 ( n = 222,659). Adopting a difference-in-differences approach, we find a substantial increase in media visibility of the former Austrian chancellor within the news outlet that is alleged to have received bribes, as well as a decrease in favorability for challenger candidates. Although this study does not aim to prove or disprove the involvement of specific political actors or media organizations in unethical or illegal activities, it introduces an innovative method for detecting unusual patterns in media reporting. Findings are discussed in the context of current threats to media independence and underscore the crucial need to protect journalistic integrity and ensure unbiased information for the public.

Literature Review: Financial Management in Hospitals Using Process Improvement Methods

Financial management in hospitals faces significant challenges due to increasing healthcare costs and the demand to maintain high-quality patient care. Process Improvement methods such as Lean and Continuous Improvement have been adopted by hospitals to address these challenges. This study aims to review the literature regarding the impact of implementing Lean and Continuous Improvement methodologies on hospital financial management. The research methodology employed a systematic approach, analyzing studies published between 2018 and 2023. The results of the review showed that the implementation of Lean and Continuous Improvement methods significantly improved operational efficiency, leading to cost reductions of up to 30%, while simultaneously enhancing patient care quality and staff satisfaction. In conclusion, these methodologies offer a sustainable approach for hospitals to manage financial pressures without compromising the quality of care. Hospitals are encouraged to adopt these strategies to achieve long-term financial stability and operational excellence.