The Impact of Mesh Implantation on Vaginal Smooth Muscle Innervation and Contraction

2013 ◽  
Author(s):  
Zegbeh C. Jallah ◽  
Pamela Moalli ◽  
Andrew Feola ◽  
William Barone ◽  
Stacy Palcsey ◽  
...  
Keyword(s):  
Structural Integrity ◽  
Surgical Repair ◽  
The United States ◽  
Pelvic Organ ◽  
Muscle Innervation ◽  
Vaginal Canal ◽  
The Cost ◽  
Vaginal Smooth Muscle ◽  
The Impact

Pelvic organ prolapse (POP) is a multifactorial disorder characterized by the descent of the pelvic organs into the vaginal canal. This disorder is associated with decreased quality of life, and even depression, yet 50% of women over the age of fifty are living with POP. The cost associated with the repair of POP exceeds one billion dollars annually, in the United States alone. This rather exorbitant figure includes the cost of surgery performed for symptom management, but does not include strategies which address the underlying cause of the disorder for which there are none. Because failure rates of native tissue repairs are as high as 30%, vaginal mesh is increasingly used in the surgical repair of POP. The procedure aims to reinforce the fibromuscular layer of the vagina and the paravaginal attachments, thus providing structural integrity to the weakened native tissues. However, the use of mesh is limited by mesh-related complications including exposure, erosion, pain contraction and infection.

Maternal Childbirth Injury Alters Vaginal Smooth Muscle Contractility

2011 ◽  
Author(s):  
Zegbeh C. Jallah ◽  
Laura Skoczylas ◽  
Suzan Stein ◽  
Naoki Yoshimura ◽  
Pamela Moalli ◽  
...  
Keyword(s):  
The United States ◽  
Pelvic Organ ◽  
Muscle Contractility ◽  
Smooth Muscle Contractility ◽  
Pelvic Organs ◽  
Vaginal Canal ◽  
Second Procedure ◽  
The Cost ◽  
Vaginal Smooth Muscle

Pelvic organ prolapse (POP) is a multifactorial disorder, characterized by the descent of the pelvic organs into the vaginal canal. POP is associated with decreased quality of life, and even depression, yet 50% of women over the age of fifty are living with this disorder. The estimated direct cost for POP surgeries is over one billion dollars annually, in the United States alone. This rather exorbitant figure includes the cost of surgery performed for symptom management, but does not include strategies which address the underlying cause of the disorder. It is not surprising then, that within a few years over 10% of repairs will require a second procedure. Thus, more studies are needed to understand the pathophysiology of POP.

scholarly journals Why Doulas Need to be the Norm, Not the Exception

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Rating Scales ◽  
Scientific Evidence ◽  
The United States ◽  
Level Of Evidence ◽  
Surgical Interventions ◽  
Search Terms ◽  
Evidence Rating ◽  
The Cost ◽  
The Impact

The rate of cesarean sections is increasing in many countries. The cesarean rate within the United States was reported at 32% in 2015. The risk to mother and baby and the cost of the surgical interventions can burden the healthcare system. Doula support for laboring women has been increasing since the term was first used in 1976. What is the impact of doula support for women during labor? An electronic literature search was conducted utilizing PubMed, CINAHL Plus, and PsychINFO for the search terms “doula”, “birth companion”, and “continuous labor support” published between January 2012 and June 2017. A total of 10 papers were selected for the review based on the inclusion criteria. The 10 studies were reviewed and categorized according to level of evidence and the quality of scientific evidence based on Johns Hopkins Evidence Rating Scales. Findings suggest that there are numerous benefits and no harms identified to providing doula support.

Demonstrating Nutrient Cost Gradients: A Brooklyn Case Study

2014 ◽  
Vol 84 (5-6) ◽  
pp. 244-251 ◽  
Author(s):  
Robert J. Karp ◽  
Gary Wong ◽  
Marguerite Orsi
Keyword(s):  
Low Income ◽  
Energy Content ◽  
Food Selection ◽  
The United States ◽  
United States Department ◽  
Micronutrient Deficiencies ◽  
Caloric Density ◽  
Low Income Families ◽  
The Cost ◽  
The Impact

Abstract. Introduction: Foods dense in micronutrients are generally more expensive than those with higher energy content. These cost-differentials may put low-income families at risk of diminished micronutrient intake. Objectives: We sought to determine differences in the cost for iron, folate, and choline in foods available for purchase in a low-income community when assessed for energy content and serving size. Methods: Sixty-nine foods listed in the menu plans provided by the United States Department of Agriculture (USDA) for low-income families were considered, in 10 domains. The cost and micronutrient content for-energy and per-serving of these foods were determined for the three micronutrients. Exact Kruskal-Wallis tests were used for comparisons of energy costs; Spearman rho tests for comparisons of micronutrient content. Ninety families were interviewed in a pediatric clinic to assess the impact of food cost on food selection. Results: Significant differences between domains were shown for energy density with both cost-for-energy (p < 0.001) and cost-per-serving (p < 0.05) comparisons. All three micronutrient contents were significantly correlated with cost-for-energy (p < 0.01). Both iron and choline contents were significantly correlated with cost-per-serving (p < 0.05). Of the 90 families, 38 (42 %) worried about food costs; 40 (44 %) had chosen foods of high caloric density in response to that fear, and 29 of 40 families experiencing both worry and making such food selection. Conclusion: Adjustments to USDA meal plans using cost-for-energy analysis showed differentials for both energy and micronutrients. These differentials were reduced using cost-per-serving analysis, but were not eliminated. A substantial proportion of low-income families are vulnerable to micronutrient deficiencies.

Return on Invesment (ROI) of Software Product: A Systematic Literature Review

2015 ◽  
Vol 6 (1) ◽  
pp. 50-57
Author(s):  
Rizqa Raaiqa Bintana ◽  
Putri Aisyiyah Rakhma Devi ◽  
Umi Laili Yuhana
Keyword(s):  
Return On Investment ◽  
Assessment Criteria ◽  
Software Product ◽  
And Performance ◽  
Rational Consideration ◽  
Actual Return ◽  
The Cost ◽  
Investment Models ◽  
The Impact

The quality of the software can be measured by its return on investment. Factors which may affect the return on investment (ROI) is the tangible factors (such as the cost) dan intangible factors (such as the impact of software to the users or stakeholder). The factor of the software itself are assessed through reviewing, testing, process audit, and performance of software. This paper discusses the consideration of return on investment (ROI) assessment criteria derived from the software and its users. These criteria indicate that the approach may support a rational consideration of all relevant criteria when evaluating software, and shows examples of actual return on investment models. Conducted an analysis of the assessment criteria that affect the return on investment if these criteria have a disproportionate effort that resulted in a return on investment of a software decreased. Index Terms - Assessment criteria, Quality assurance, Return on Investment, Software product

scholarly journals Autism Tsunami: the Impact of Rising Prevalence on the Societal Cost of Autism in the United States

2021 ◽  
Author(s):  
Mark Blaxill ◽  
Toby Rogers ◽  
Cynthia Nevison
Keyword(s):  
Forecast Model ◽  
The United States ◽  
Population Projections ◽  
Base Case ◽  
Prevention Strategies ◽  
Total Base ◽  
Cost Categories ◽  
The Cost ◽  
The Impact ◽  
First Time

AbstractThe cost of ASD in the U.S. is estimated using a forecast model that for the first time accounts for the true historical increase in ASD. Model inputs include ASD prevalence, census population projections, six cost categories, ten age brackets, inflation projections, and three future prevalence scenarios. Future ASD costs increase dramatically: total base-case costs of $223 (175–271) billion/year are estimated in 2020; $589 billion/year in 2030, $1.36 trillion/year in 2040, and $5.54 (4.29–6.78) trillion/year by 2060, with substantial potential savings through ASD prevention. Rising prevalence, the shift from child to adult-dominated costs, the transfer of costs from parents onto government, and the soaring total costs raise pressing policy questions and demand an urgent focus on prevention strategies.

scholarly journals Understanding the Link between Family Caregiver Quality of Life and the Care Provided to Older People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Well Being ◽  
The United States ◽  
People With Dementia ◽  
The Impact

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.

scholarly journals Are Multi-Language Design Smells Fault-Prone? An Empirical Study

2021 ◽  
Vol 30 (3) ◽  
pp. 1-56
Author(s):  
Mouna Abidi ◽  
Md Saidur Rahman ◽  
Moses Openja ◽  
Foutse Khomh
Keyword(s):  
Programming Languages ◽  
Language Design ◽  
Functional Requirements ◽  
Code Smells ◽  
Design And Implementation ◽  
Design Smells ◽  
The Cost ◽  
The Impact ◽  
Fault Proneness

Nowadays, modern applications are developed using components written in different programming languages and technologies. The cost benefits of reuse and the advantages of each programming language are two main incentives behind the proliferation of such systems. However, as the number of languages increases, so do the challenges related to the development and maintenance of these systems. In such situations, developers may introduce design smells (i.e., anti-patterns and code smells) which are symptoms of poor design and implementation choices. Design smells are defined as poor design and coding choices that can negatively impact the quality of a software program despite satisfying functional requirements. Studies on mono-language systems suggest that the presence of design smells may indicate a higher risk of future bugs and affects code comprehension, thus making systems harder to maintain. However, the impact of multi-language design smells on software quality such as fault-proneness is yet to be investigated. In this article, we present an approach to detect multi-language design smells in the context of JNI systems. We then investigate the prevalence of those design smells and their impacts on fault-proneness. Specifically, we detect 15 design smells in 98 releases of 9 open-source JNI projects. Our results show that the design smells are prevalent in the selected projects and persist throughout the releases of the systems. We observe that, in the analyzed systems, 33.95% of the files involving communications between Java and C/C++ contain occurrences of multi-language design smells. Some kinds of smells are more prevalent than others, e.g., Unused Parameters , Too Much Scattering , and Unused Method Declaration . Our results suggest that files with multi-language design smells can often be more associated with bugs than files without these smells, and that specific smells are more correlated to fault-proneness than others. From analyzing fault-inducing commit messages, we also extracted activities that are more likely to introduce bugs in smelly files. We believe that our findings are important for practitioners as it can help them prioritize design smells during the maintenance of multi-language systems.

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