Life-saving post-ER suicide prevention strategies are cost effective


Three interventions designed for follow up of patients who are identified with suicide risk in hospital emergency departments save lives and are cost effective relative to usual care. A study has modeled the use of the approaches in emergency departments and found that all three interventions compare favorably with a standard benchmark of cost-effectiveness used in evaluating healthcare costs.

Algal blooms cost Ohio homeowners $152 million over six years


Algal blooms at two Ohio lakes cost Ohio homeowners $152 million in lost property value over six years, researchers estimate. Meanwhile, a related study suggests that algae is driving anglers away from Lake Erie, causing fishing license sales to drop at least 10 percent every time a bloom reaches a moderate level of health risk.

Snakebites cost Sri Lanka more than $10 million annually — ScienceDaily

Snakebites are a major public health problem in many rural communities around the world, often requiring medical care and affecting victims’ ability to work. Every year, snakebites cost the Sri Lankan government more than 10 million USD, and lead to economic loss of nearly 4 million USD for individuals, according to a new study in PLOS Neglected Tropical Diseases.

The victims of snakebites in poor rural communities in Asia, Africa, and Latin America are often young individuals who are earning a wage and have a considerable remaining life expectancy. Moreover, they often work in farming or other labor intensive jobs that they must take time off from in order to recover from a bite.

In the new work, David Lalloo, of the Liverpool School of Tropical Medicine, UK, and colleagues from the University of Kelaniya used data from a nation-wide household survey conducted in Sri Lanka in 2013 and 2013 to estimate the number of snake bites and deaths from snake bites annually. To estimate the costs of the bites, they used additional household questionnaires and information gathered from hospital cost accounting systems.

79% of victims, the study found, suffered economic loss after a snake bite, with a median out of pocket cost of $11.82 and a median loss of income of $28.57 for those employed and $33.21 for those self-employed. To put this in context, the mean per capita income per month for people living in the rural areas studied was only $74 USD. The total annual economic burden on households was $3.8 USD. In addition, each year, the bites cost the national healthcare system $10.3 million USD — which is 0.7% of the country’s total healthcare costs — and lead to more than 11,000 years’ worth of disability time, the researchers calculated. The numbers were comparable to Sri Lanka’s annual spending on meningitis and dengue.

“It is unlikely that these costs will reduce in the near future as there is no indication that the high incidence of bites is declining,” the researchers say. “Even more concerning is the economic burden that snakebite places on victims and their households… It is highly likely in Sri Lanka that snakebite drives the same catastrophic costs for the poor as many other diseases.”

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Materials provided by PLOS. Note: Content may be edited for style and length.

Bullying and bias can cost schools millions in lost funding — ScienceDaily

When children avoid school to avoid bullying, many states can lose tens of millions of dollars in lost funding, and California alone loses an estimated $276 million each year because children feel unsafe.

New research from The University of Texas at Austin published in School Psychology Quarterly highlights the hidden cost to communities in states that use daily attendance numbers to calculate public school funding. When children are afraid to go to school because classmates target them because of bias against their race, gender, religion, disability or sexual orientation, schools lose tens of millions of dollars each year linked to this absenteeism.

“Bullying is a big social problem that not only creates an unhealthy climate for individuals but also undermines schools and communities,” says Stephen Russell, professor and chair of human development and family sciences at UT Austin. “We are interested in the economics of bullying and how it can affect a whole school system.”

In the United States, some states including Texas, Illinois and California, use a formula known as average daily attendance to allocate certain school funds. Schools that receive funding based on children’s presence rather than based on total enrollment will have lower revenue when children miss school for any reason.

The research used data from the 2011-2013 California Healthy Kids Survey and information from the state’s Department of Education. Russell and colleagues analyzed surveys of the seventh-, ninth- and 11th-grade students from nearly half of the schools across the state. The team also calculated the average amount of money allocated for each student each day based on average daily attendance funding (about $50).

Analyses showed that 10.4 percent of students reported they missed at least one day of school in the past month because of feeling unsafe. This extrapolates to an estimated 301,000 students missing school because of feeling unsafe and $276 million in lost revenue each year in California public schools.

Biased-based bullying is also costly. Nearly half of the absent students — 45 percent — reported that they missed school and felt unsafe because of being targeted for bias. When Russell and colleagues calculated the lost revenue to California schools each year, it was up to $78 million for bullying due to race/ethnicity bias, as much as $54 million based on a religion bias, up to $54 million for gender bias, as high as $62 million for bias related to sexual orientation and as much as $49 million for disability-related bias. Many children reported they were bullied in more than one of these categories.

“We found a strong link between all types of bullying and school absence,” says first author Laura Baams, also of UT Austin. “Once school districts and boards realize how much funding is lost — especially in those districts that are struggling for funds — we see that it is worth the investment to do something about bullying.”

Not all students subject to bullying miss school. About 19 percent of students experienced biased-based bullying but did not miss school. Still, Russell explains, other effects can occur such as depression, anxiety, poorer academic achievement and health complaints.

“Discriminatory bullying occurs because of who you are or because of who someone assumes you are,” says Russell. “There are clear steps that schools can take to create a safe environment. Professional anti-bullying training and decreasing racism are not only cheaper than leaving the system as it is, but would also promote an inclusive climate for everyone.”

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Materials provided by University of Texas at Austin. Note: Content may be edited for style and length.

Putting others first can cost lives in emergencies — ScienceDaily

Selfless heroism isn’t the best strategy in life-and-death disaster situations involving groups of people, a new study from the University of Waterloo suggests.

The study, which used computer modeling of a flooded subway station, found overall survival rates were substantially higher when strong people in a 30-member group reached safety themselves before trying to help weaker people.

“Foolhardiness is not a good strategy for rescuing,” said Eishiro Higo, a civil engineering PhD candidate at Waterloo who led the research. “In very critical situations, we have to be kind of selfish, but we can still help others if we have proper equipment and proper strategies.”

In effect, he said, the study showed that when strong members try to help weak members before they are secure themselves, both are dragged down and the group as a whole suffers.

Higo and colleagues built a two-dimensional computer model of an actual three-level underground space in Kyoto, Japan that consists of a subway platform, a parking garage and a shopping mall.

The model simulates severe flooding from a nearby river, with a mix of adults and senior citizens who must reach safety via staircases from the subway platform level to the surface.

Higo repeatedly ran the model using three different evacuation strategies: one in which people only worried about themselves; one in which people immediately worked together as a group; and one in which those capable of saving themselves reached a safe place before trying to save others using a rope.

In most life-and-death scenarios when variables such as the ratio of adults to seniors were adjusted, the rope strategy resulted in the highest overall survival rate.

In a typical scenario that assumed evacuation efforts beginning at a particular point in time, for example, 12 of 30 people survived using the rope strategy, while there were just five survivors using either of the other two strategies.

“We have to identify what is brave and what is reckless,” said Higo. “Helping people from a safe location is still good behaviour and the result is actually much better.”

Crucial to the success of the rope strategy, however, was the availability of simple tools for use by rescuers. Design features including handrails and raised areas on stairs for evacuees to brace themselves or rest also markedly increased the chances of survival.

An extension of work he did for his master’s degree at Kyoto University before coming to Waterloo, his research was motivated in large part by the earthquake and tsunami that devastated east Japan in 2011.

Higo hopes his findings stimulate discussion and lead to the inclusion of relatively inexpensive disaster preparedness features such as ropes and resting areas in public spaces.

Details of the research were recently published in the journal Expert Systems with Applications.

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Materials provided by University of Waterloo. Note: Content may be edited for style and length.