Long-term PTSD prevalence and associated adverse psychological, functional, and economic outcomes: a 12-15 year follow-up of adults with suspected serious injury.

Background: An increasing number of longitudinal studies investigates long-term PTSD, related outcomes and potential gender differences herein. However, a knowledge gap exists when it comes to studies following individual civilian trauma beyond a decade post-trauma.Objective: To investigate the long-term PTSD prevalence, associated adverse psychological, functional and economic outcomes related to (suspected) serious injury of 12-15 years ago in Dutch adults, as well as potential gender differences herein.Method: N = 194 trauma-exposed adults (34% women) admitted to an emergency department following suspected serious injury completed a follow-up assessment 12-15 years (M = 14.30, SD = 1.00) post-trauma. Participants completed assessments of clinician-rated PTSD symptom severity, as well as self-report questionnaires on psychological, functional and economic outcomes.Results: Nine participants (4.8%) fulfilled the DSM-5 diagnostic criteria for PTSD related to the index trauma of 12-15 years ago. Results showed that PTSD symptom severity (CAPS-5) was significantly associated with more severe symptoms of anxiety (HADS) and depression (QIDS), lower well-being (WHO-5) and (health-related) quality of life (WHOQOL; EQ-5D-5L), but not with alcohol use (AUDIT), productivity loss at work (iPCQ) and health care use (iMCQ). No significant gender differences in the long-term PTSD prevalence nor in its related psychological, functional and economic outcomes were found.Conclusions: Our findings underscore the long-term presence of PTSD and associated adverse psychological and functional outcomes in a proportion of adults who experienced (suspected) serious injury over a decade ago. PTSD is already widely recognized for its substantial impact in the aftermath of a trauma. The current study emphasizes the potential long-term consequences of individual civilian trauma, highlighting the importance of accurate screening and prevention for PTSD.

We investigated long-term PTSD and associated adverse outcomes 12­15 years post-trauma.4.8% had PTSD 12­15 years following suspected serious injury.Higher PTSD symptoms were associated with adverse psychological and functional outcomes.

Loss of Cognitive Function in Mexican children due to lead exposure and the associated economic costs.

BACKGROUND: Lead exposure reduces the cognitive development and future economic prospects of children. While previous studies in high-income settings have explored productivity losses associated with lead exposure, limited research has focused on low and middle-income countries like Mexico. OBJECTIVES: This study aims to provide a comprehensive assessment of the economic implications of lead exposure on Mexican children using, for the first time, nationally representative Blood lead levels (BLLs) measurements in children aged 1-4, specifically focusing on the costs of forgone lifetime income due to cognitive losses. METHODS: BLLs of children aged 1-4 were extracted from the 2018-2019 National Health and Nutrition Survey (ENSANUT). Estimations of cognitive losses were derived from a log-linear relationship between BLLs and IQ loss. Lost lifetime economic productivity per child was calculated, assuming a 2% reduction in lifetime potential productivity for each IQ point lost due to lead exposure, based on previous literature (Attina and Trasande, 2013; Larsen and Sanchez-Triana, 2023). Productivity data were obtained from representative sources for Mexico. RESULTS: The estimated economic loss amounted to US $33.02 billion, equivalent to 2.76% of Mexico's Gross Domestic Product (GDP) in 2019 (calculated for a 1-year cohort). On a national scale, the long-term loss of cognition for children 1-4 years old is 4.14 IQ points per child due to lead exposure, with significant variability across States (range: 3.26 to 5.26). Lead-poisoned children (≥5 µg/dL) suffered an average loss of 6.42 IQ points (range: 0 to 6.97). In terms of economic impact, some States like Chiapas experienced losses of 7.08% of its GDP, while others had losses as low as 0.67%. Intriguingly, states with lower Human Development Indexes (HDIs) exhibited relatively higher economic losses despite lower average blood lead levels. DISCUSSION: The heterogeneous impact of lead exposure across Mexican states underscores the necessity for tailored regional policies. These findings emphasize the urgency for targeted interventions and informed policy measures to mitigate the socioeconomic consequences of lead exposure on Mexican children.

Estimated economic costs of dental implants among older South Korean adults, 2015-2018.

OBJECTIVE: Dental implants are a considerable financial burden for elderly people and their caregivers. This study aimed to calculate the estimated economic costs of dental implants on the Korean older population. MATERIALS AND METHODS: The economic costs of dental implants for adults aged 75 years and older were estimated from a societal perspective, considering both direct and indirect expenditures. We used data from the Korean National Health Insurance Service for the period 2015-2018 to estimate the medical costs. Noninsured medical costs were estimated from research on medical expenses by the National Health Insurance Review and Assessment Service. Indirect costs related to transportation fees and time loss were obtained. The Cochran Armitage trend test was performed to examine the trend of the economic burden of dental implants. RESULTS: The estimated economic costs showed from 2015 to 2018 (total costs: $26.54-55.66 million, total costs after discount: $17.11-39.56 million). Direct costs, including insured and noninsured medical costs, represented from $25.81 to $47.03 million. Indirect costs, including transportation and time costs, ranged from $0.73 to $1.63 million. The impact of the total dental implant costs was 0.0018%-0.0034% of the Korean annual gross domestic product and 1.03%-1.59% of the annual total costs of dental care benefits. CONCLUSIONS: The estimated economic burden of dental implants significantly increased from 2015 to 2018 in older South Korean adults. These results will provide a foundation and guidance for further health economic studies on the burden of dental implants in the elderly population.

Biological Sex Disparities in the Economic Burden of Tobacco Use: A Comparative Analysis between Men and Women in China.

To examine the impact of tobacco use on the economic costs between biological sex differences, we utilized propensity score matching and human capital methods to analyze the economic costs associated with smoking. Our findings reveal a nuanced pattern in the economic burden: although men who smoke bear a higher overall economic cost, the individual impact on women who smoke is significantly more profound. As a result, there exists a distinct disparity in the distribution of economic consequences stemming from tobacco use between men and women.

The rising global economic costs of invasive Aedes mosquitoes and Aedes-borne diseases.

Invasive Aedes aegypti and Aedes albopictus mosquitoes transmit viruses such as dengue, chikungunya and Zika, posing a huge public health burden as well as having a less well understood economic impact. We present a comprehensive, global-scale synthesis of studies reporting these economic costs, spanning 166 countries and territories over 45 years. The minimum cumulative reported cost estimate expressed in 2022 US$ was 94.7 billion, although this figure reflects considerable underreporting and underestimation. The analysis suggests a 14-fold increase in costs, with an average annual expenditure of US$ 3.1 billion, and a maximum of US$ 20.3 billion in 2013. Damage and losses were an order of magnitude higher than investment in management, with only a modest portion allocated to prevention. Effective control measures are urgently needed to safeguard global health and well-being, and to reduce the economic burden on human societies. This study fills a critical gap by addressing the increasing economic costs of Aedes and Aedes-borne diseases and offers insights to inform evidence-based policy.

The Economic Iceberg of Celiac Disease: More Than the Cost of Gluten-Free Food.

Celiac disease (CeD) is a chronic autoimmune disorder of global relevance, with the potential for acute and long-term complications. However, the economic burden of CeD is rarely considered and largely thought of as limited to the cost of gluten-free food. Fortunately, recent research has shed light on the various societal costs of CeD across the health care continuum. This article summarizes the current evidence on the economic impacts of CeD, which suggest that the societal economic burden of CeD stretches beyond the cost of gluten-free food. This review provides ample evidence of larger but hidden costs related to excess health care use for complications and comorbidities, as well as reduced productivity. Although significant advances are expected in the management of CeD, their effect on the economic burden of CeD remain uncertain. The aim of this review was to inform stakeholders across society and contribute to improved policies to support patients with CeD.

A systematic review of the epidemiology and the public health implications of stroke in Sub-Saharan Africa.

BACKGROUND: With approximately 11 million strokes occurring annually worldwide, and over 6.5 million deaths annually, stroke has made its place as one of the major killers in the world. Although developing countries make up more than 4/5 of the global stroke burden, well-grounded information on stroke epidemiology remains lacking there. AIMS: This systematic review study aimed to provide a synthesis of studies on the incidence and prevalence of stroke among adults in sub-Saharan Africa (SSA), subsequently deduce the associated risk factors and public health implications (mortality rates and economic costs) of the disease on the population of this region. METHODS: A systematic review of studies carried out in the region and published on PUBMED. Eligibility criteria were established using the PEO (Population/Patient, Exposure, Outcome) format. Research articles investigating either (or all) of the following: ischemic or haemorrhagic stroke, incidence, prevalence, and risk factors of stroke in adults (≥ 18 years old), in at least one region of SSA were included. Exclusion criteria comprised studies involving populations younger than 18 years old, research conducted outside the designated research region, and articles inaccessible in full text. The PRISMA guidelines were used for the search strategy. RESULTS: Fifty-two studies were included review. Among them, over 11 studies investigated the prevalence of the disease. Some older studies within the continent (Nigeria, 2011) showed a prevalence of 1.3 per 100 while more recent studies (Zambia, 2021) showed a prevalence of 4.3 per 1000. The highest prevalence noted in this region was in Madagascar (2017) with 48.17 per 100, while the lowest was recorded in (Zimbabwe, 2017) with 0.61 per 100. The study in Tanzania showed a crude incidence of 94·5 per 100 000 (76·0-115·0) while the study in Ghana in 2018 showed an incidence of 14.19 events per 1000 person-years [10.77-18.38]. The identified risk factors included hypertension, diabetes, smoking, alcohol consumption, physical inactivity, poor diets (more salt, less vegetables), dyslipidaemia, HIV/AIDS co-infection, heart disease (cardiomyopathies, cardiac arrhythmias), obesity, previous stroke and/or family history of stroke. Over 21 studies investigated the mortality rates due to stroke in SSA, with most of the studies being in West Africa. These studies revealed mortality rates as high as 43.3% in Ghana, and as low as 10.9% in Cameroon. Few studies reported on the economic costs of stroke in the region; two in Benin, two in Nigeria and one in Tanzania. CONCLUSION: The increasing incidence/prevalence, lifestyle factors and interactions with other diseases, including major communicable diseases, stroke is becoming a pressing public health problem for SSA. Reducing the incidence of stroke in Africa will surely lower mortality, morbidity, disability, and the neurological as well as cognitive aftereffects of stroke, as is clear from the experience of higher-income nations. We recommend a collective intervention involving the governments of nations, international organizations, civil society, and the private sector for greater impact and sustainable outcomes reducing the epidemiology and implications of stroke in SSA.

Loneliness in Pregnancy and Parenthood: Impacts, Outcomes, and Costs.

Background: Becoming a parent has been highlighted as a period associated with increased risks for loneliness, with around one-third of parents reporting feeling lonely often or always. However, as most understanding of loneliness is based on elderly or student cohorts, further insights into the costs of parental loneliness is needed. Method: We conducted a literature review of impacts of loneliness in pregnancy and parenthood and present a synthesis of the health, social, societal, and economic costs. We draw on evidence about impacts and costs of loneliness in other cohorts to help provide a wider context to understand the impacts and costs and how parental loneliness differs from other populations. Results: Similar to literature with elderly cohorts, parental loneliness has impacts on health and wellbeing, such as depression in new parents and increased general practitioner (GP) visits in pregnancy. But also has intergenerational impacts via its association with poor mental health and social competence and increased respiratory tract infections in the child. Physical health impacts widely associated with loneliness in other cohorts have yet to be examined in parents. Loneliness in parents is likely to result in social withdrawal further isolating parents and wider societal and economic costs relating to absence from employment and informal caring roles. Conclusion: Parental loneliness has the potential for negative and pervasive impacts. As parental loneliness has wide ranging and intergenerational impacts it is important that a multi-sectoral perspective is used when examining its costs.

Economic analysis of banana peel and sweet potato vines in diets for rabbits.

This study aimed to evaluate the costs of using banana peel (BP) and sweet potato vine (SPV) in rabbit diets. BP and SPV were chosen to replace maize and alfalfa hay, because, in addition to the ingredients having similar nutritional characteristics, they are among the most expensive ingredients in rabbit diets. Data were obtained through a biological assay carried out in the Cuniculture Laboratory of the Universidade Federal de Santa Maria, Santa Maria, RS, Brazil. Fifty New Zealand white rabbits, weaned at 35 days of age, were fed during the growth phase (35 to 84 days) with increasing levels of BP and SPV, replacing maize and alfalfa hay (T0, T25, T50, T75 and T100% replacement). A diet containing 100% replacement (T100) had the lowest cost per kilogram, which was R$ 1.18/kg, while the controlled diet was 57% more expensive, costing R$ 2.08/kg. The total operating cost to produce a rabbit with control treatment was R$10.93/head and at T100, it was R$6.51/head. The animal income for a live rabbit was R$ 24.08 and R$ 23.95 in treatments T0 and T100, respectively. Regarding the gain margin per animal (GMA), in TO it was R$ 13.16 while in T100 it was R$ 17.44, therefore the GMA was 32.55% higher when using the T100 diet. In conclusion, it is more economical and feasible to feed rabbits with diets containing 100% BP and SPV, replacing maize and alfalfa hay.

Absenteeism, Presenteeism, and the Economic Costs of Alcohol Hangover in The Netherlands.

The alcohol hangover is defined as the combination of negative mental and physical symptoms that can be experienced after a single episode of alcohol consumption, starting when the blood alcohol concentration (BAC) approaches zero. Alcohol hangover symptoms such as fatigue, nausea, and headache can negatively affect daily activities, including work performance. The alcohol hangover can therefore be a cause of both absenteeism (not going to work) and presenteeism (going to work while hungover). An online survey among a convenience sample of n = 347 Dutch adults examined the number of days of absenteeism and presenteeism associated with having a hangover as well as the loss of productivity when going to work when hungover during the year 2019. In the Dutch sample, 8.1% of employees reported one or more days of absenteeism due to hangover in 2019, and 33.4% reported one or more days of presenteeism. The analyses revealed that alcohol hangover was associated with 0.2 days of absenteeism and 8.3 days of presenteeism and a productivity loss of 24.9% on days worked with a hangover. The estimated associated costs for the Dutch economy in 2019 of absenteeism (EUR 234,538,460) and presenteeism (EUR 2,423,603,184) total EUR 2,658,141,644. In conclusion, the alcohol hangover is associated with absenteeism, presenteeism, and reduced performance at work while hungover. As such, the annual costs of the alcohol hangover have a significant impact on the Dutch economy. However, these first findings on the economic costs of the alcohol hangover should be considered a rough estimate. They should be verified in a longitudinal study to minimize recall bias, including a nationally representative sample of sufficient sample size.

Repeated foreign body ingestion as a dynamic game: A case report.

In this case report, we correct the analysis of mitigating intentional foreign body ingestion offered by Sarah J. Diamond and Amnon Sonnenberg. Patients who notoriously swallow foreign objects generate significant economic costs to hospitals. In previous publications, it has been argued that hospitals might reduce the need for endoscopy by offering such patients a paid position to discourage foreign body ingestions. However, the game-theoretical analysis offered in the literature was based on a static game which did not justify the relevant equilibrium. To obtain the actual goal of keeping the patient away from foreign body ingestion, we consider a repeated game with an infinite horizon. We show that there exists a combination of strategies applied by the hospital and the patient that leads to a steady state in which the patient will be discouraged from foreign body ingestion.

Economic Burden of Clostridioides difficile Infection in European Countries.

Clostridioides difficile infection (CDI) remains a considerable challenge to healthcare systems worldwide. Although CDI represents a significant burden on healthcare systems in Europe, few studies have attempted to estimate the consumption of resources associated with CDI in Europe. The reported extra costs attributable to CDI vary widely according to the definitions, design, and methodologies used, making comparisons difficult to perform. In this chapter, the economic burden of healthcare facility-associated CDI in Europe will be assessed, as will other less explored areas such as the economic burden of recurrent CDI, community-acquired CDI, pediatric CDI, and CDI in outbreaks.

The Economic Costs of Informal Care: Estimates from a National Cross-Sectional Survey in The Netherlands.

Faced with an unprecedented demand for long-term care, European health care systems are moving towards mixed care models, where the welfare state and informal caregivers share care responsibilities. While informal care is often viewed as a means of alleviating pressure on public care, it comes with significant economic costs for caregivers, their employers, and society at large. This study uses nationally representative data to estimate the total direct (informal care time and out-of-pocket costs) and indirect (productivity) economic costs of informal care in the Netherlands in 2019. Informal care time costs are estimated using the opportunity cost and the proxy good methods. Indirect costs are estimated using the human capital and friction cost approaches. Our results reveal the considerable annual societal cost of informal care in the Netherlands, ranging between €17.5 billion and €30.1 billion, depending on the valuation approach. These costs are equivalent to 2.15% and 3.71% of Dutch GDP in 2019, comparable to the public expenditure on long-term care in that year. Female caregivers account for slightly more than half (53%-57%) of the total costs. Around 57%-88% of these costs are in the form of informal care time. The main driver of indirect costs is the temporary cessation of work, which comprises 12%-17% of the total costs. Findings corroborate that substantial resources, yet thus far largely disregarded, are spent on informal care even in a country with a relatively generous public long-term care system.

A Retrospective Observational Real-Word Analysis of the Adherence, Healthcare Resource Consumption and Costs in Patients Treated with Bisoprolol/Perindopril as Single-Pill or Free Combination.

INTRODUCTION: The present real-world analysis aims to compare the drug utilization, hospitalizations and direct healthcare costs related to the use of single-pill combination (SPC) or free-equivalent combination (FEC) of perindopril and bisoprolol (PER/BIS) in a large Italian population. METHODS: This observational retrospective analysis was based on administrative databases covering approximately 7 million subjects across Italy. All adult subjects receiving PER/BIS as SPC or FEC between January 2017-June 2020 were included. Subjects were followed for 1 year after the first prescription of PER/BIS as FEC (± 1 month) or SPC. Before comparing the SPC and FEC cohorts, propensity score matching (PSM) was applied to balance the baseline characteristics. Drug utilization was investigated as adherence (defined by the proportion of days covered, PDC) and persistence (evaluated by Kaplan-Meier curves). Hospitalizations and mean annual direct healthcare costs (due to drug prescriptions, hospitalizations and use of outpatient services) were analyzed during follow-up. RESULTS: The original cohort included 11,440 and 6521 patients taking the SPC and FEC PER/BIS combination, respectively. After PSM, two balanced SPC and FEC cohorts of 4688 patients were obtained (mean age 70 years, approximately 50% male, 24% in secondary prevention). The proportion of adherent patients (PDC ≥ 80%) was higher for those on SPC (45.5%) than those on FEC (38.6%), p < 0.001. The PER/BIS combination was discontinued by 35.8% of patients in the SPC cohort and 41.7% in the FEC cohort (p < 0.001). The SPC cohort had fewer cardiovascular (CV) hospitalizations (5.3%) than the free-combination cohort (7.4%), p < 0.001. Mean annual total healthcare costs were lower in the SPC (1999€) than in the FEC (2359€) cohort (p < 0.001). CONCLUSION: In a real-world setting, patients treated with PER/BIS SPC showed higher adherence, lower risk of drug discontinuation, reduced risk of CV hospitalization, and lower healthcare costs than those on FEC of the same drugs.

Patients with cardiovascular conditions often need to take many pills. This may result in patients not taking their pills as prescribed (i.e., low adherence) and compromise the potential benefits derived from prescription of cardiovascular protective drugs. Simplifying treatment by combining drugs into a single pill can improve adherence and, consequently, patient outcomes. In this analysis using data from real clinical practice, we explored whether using a single pill of perindopril and bisoprolol is associated with higher levels of adherence, lower proportion of patients with hospitalizations and lower economic costs than using the same drugs prescribed as free-equivalent combination in a large sample of the Italian population of approximately 7 million people. We identified two groups of patients taking single pill or free-equivalent combination of perindopril and bisoprolol (4688 patients in each cohort). Over 1-year follow-up, patients taking single pill were more likely to be adherent and were less likely to stop taking their treatment. They also had fewer cardiovascular hospitalizations with shorter hospital admission and had lower healthcare direct costs. In conclusion, simplifying treatment by combining perindopril and bisoprolol in a single pill instead of two may have a positive effect on adherence, outcomes and healthcare costs already after 1 year.

Health system cost for providing antiretroviral therapy, family planning, and pregnancy-related services to women living with HIV in public health settings, Mumbai, India.

Background: Integration of HIV care into family planning (FP) services would help in reducing unintended pregnancies among women living with HIV. Objectives: This study focuses on determining the health system cost for providing the linked HIV-FP services per beneficiary for the year 2019-2020. Materials and Methods: Using mixed micro-costing approach costs were collected from two tertiary hospitals in Maharashtra, India. The economic costs collected from gynaecology department and anti-retroviral treatment center were combined and added with package, program, and intervention costs to obtain health-system costs. We conducted probabilistic sensitivity analysis. Results: The unit cost and annual per-capita cost for providing HIV care (without considering cost of drugs and investigations) per beneficiary were INR 1033.8 (USD 13.6) and INR 9304.2 (USD 122.7), respectively. The unit cost was least for the outpatient services INR 197.5 (USD 2.6), followed by inpatient services INR 2735.92 (USD 36.21) and operation theater INR 4410 (USD 58.2). Cost was highest for dual-permanent (INR 13866.8 [USD 182.9]) followed by dual-reversible user (INR 2104.8 [USD 24.8]). It was the least for a person who only used condoms at INR 1674.1 (USD 22.1). In pregnancy-related services, cost for ante-natal services was least (INR 2043.6 [USD 27.96]), followed by vaginal delivery (INR 7120.5 [USD 93.93]), abortion (INR 11530.5 [USD 152.097]), and C-section (INR 18703.8 [USD 246.7]). Conclusion: We found no staggeringly additional costs for providing FP and pregnancy-related services to HIV-affected population, in comparison to general population. The findings could improve programs and insurance with a focus on this vulnerable population.

Economic impacts associated with the health effects of climate change in South America: a scoping review.

This scoping review assesses the current evidence on the health impacts of climate change and associated economic costs in South America. In total, 3281 studies were identified using a systematic search strategy, but only 23 articles met the inclusion criteria and were analysed. The results from these articles indicate that the health effects of climate change will likely be costly for South America; however, evidence is limited to a handful of countries or regional analyses that ignore heterogeneity across and within countries. Most of the analysed studies looking at extreme weather events related to climate change focus on the effects and costs of droughts and fire events. A broader understanding of the topic could be achieved by estimating other extreme weather events' health effects and costs, using appropriate research methods to identify causal impacts, and including a more comprehensive and representative regional population sample. Beyond identifying effects, it is important to investigate demand responses for healthcare services, associated costs, availability and expansion of infrastructure, and cost-effectiveness of policies aimed at coping with and adapting to the health dimension of climate change.

Economic costs of family caregiving for persons with advanced stage cancer: a longitudinal cohort study.

PURPOSE: To form a multifaceted picture of family caregiver economic costs in advanced cancer. METHODS: A multi-site cohort study collected prospective longitudinal data from caregivers of patients with advanced solid tumor cancers. Caregiver survey and out-of-pocket (OOP) receipt data were collected biweekly in-person for up to 24 weeks. Economic cost measures attributed to caregiving were as follows: amount of OOP costs, debt accrual, perceived economic situation, and working for pay. Descriptive analysis illustrates economic outcomes over time. Generalized linear mixed effects models asses the association of objective burden and economic outcomes, controlling for subjective burden and other factors. Objective burden is number of activities and instrumental activities of daily living (ADL/IADL) tasks, all caregiving tasks, and amount of time spent caregiving over 24 h. RESULTS: One hundred ninety-eight caregivers, 41% identifying as Black, were followed for a mean period of 16 weeks. Median 2-week out-of-pocket costs were $111. One-third of caregivers incurred debt to care for the patient and 24% reported being in an adverse economic situation. Whereas 49.5% reported working at study visit 1, 28.6% of caregivers at the last study visit reported working. In adjusted analysis, a higher number of caregiving tasks overall and ADL/IADL tasks specifically were associated with lower out-of-pocket expenses, a lower likelihood of working, and a higher likelihood of incurring debt and reporting an adverse economic situation. CONCLUSIONS: Most caregivers of cancer patients with advanced stage disease experienced direct and indirect economic costs. IMPLICATIONS FOR CANCER SURVIVORS: Results support the need to find solutions to lessen economic costs for caregivers of persons with advanced cancer.

Current investigations on global N2O emissions and reductions: Prospect and outlook.

Global nitrous oxide (N2O) emissions merit scrutiny, because N2O is the third most important greenhouse gas for global warming and the predominant ozone-depleting substance in this century. Here we recapitulate global natural and anthropogenic N2O sources, comprehensively depict global sectoral human-induced N2O emissions by country, thoroughly survey all existing approaches for mitigating human-induced N2O emissions, preview the economic costs and social benefits from abating N2O emissions, and summarize roadblocks for achieving its emission reductions. From 1970 to 2018, the annual global anthropogenic N2O emissions increased by 64%-about 3.6 teragrams (Tg); agricultural sources primarily accounted for 78% of this increment. We find the social benefits from reducing N2O emissions override the economic costs for abatements, only except precision farming for agricultural sources and replacement by Xe for anesthetic, thus justifying the motivation for crafting policies to limit its emissions. Net zero N2O emissions cannot be achieved via applying current technologies and breeding N2O-reducing microbes is a potential method to accrue N2O sinks.

The economic burden of mental disorders: results from the Netherlands mental health survey and incidence study-2.

OBJECTIVE: Currently, there is a paucity of up-to-date estimates of the economic burden caused by mental disorders. Such information could provide vital insight into one of the most serious and costly-yet to some extent preventable-health challenges facing the world today. METHOD: Data from a national psychiatric-epidemiological cohort study (NEMESIS-2, N = 6506) were used to provide reliable, relevant, and up-to-date cost estimates (in 2019 Euro) regarding healthcare costs, productivity losses, and patient and family costs associated with DSM-IV mental disorders both at individual level, but also in the general population and in the workforce of the Netherlands (per 1 million population). RESULTS: In the general population, the costs of mood disorders, specifically depression, are substantial and rank above those from the anxiety disorders, whilst costs of anxiety disorders are more substantial than those stemming from substance use disorders, even when the per-person costs of drug abuse appear highest of all. In the workforce, specific and social phobias are leading causes of excess costs. The workforce has lower healthcare costs but higher productivity costs than general population. DISCUSSION: The findings suggest that (preventive) healthcare interventions targeting the workforce are likely to become cost-effective and underscore the importance for employers to create healthy work environments. Overall, the results highlight the need to strengthen the role of mental health promotion and prevention of mental disorders in the social domain before people require treatment to reduce the staggering and costly burden caused by mental disorders to individuals and society.