Monday, April 15, 2024

 

Rogue Waves are Much More Common Than Anyone Thought

Ocean surface during a storm somewhere in the Southern Ocean. Alessandro Toffoli
Ocean surface during a storm somewhere in the Southern Ocean. Alessandro Toffoli

PUBLISHED APR 14, 2024 5:27 PM BY THE CONVERSATION

 

 

[By Alessandro Toffoli]

Rogue waves are giant colossi of the sea – twice as high as neighboring waves – that appear seemingly out of nowhere. Stories of unimaginable mountains of water as tall as ten-storey buildings have populated maritime folklore and literature for centuries.

Recent technology has allowed scientists to spot rogue waves out at sea, making legend become reality. The first and most famous measurement was of the Draupner wave, a 25.6-meter monster recorded in the North Sea on January 1, 1995.

Despite observations, we still don’t know how often rogue waves occur, or if we can predict them. A record of a rogue wave doesn’t include specific features that distinguish the sea around it, so we can’t make comparisons or predict the conditions needed.

Our team set sail on the South African icebreaker S.A. Agulhas-II to chase rogue waves across the Southern Ocean, where mighty winds shape Earth’s fiercest waves.


 

What creates rogue waves?

In the random environment of ocean waves, several mechanisms give rise to rogue ones. One primary source involves the overlap of multiple waves at the same location and time. This results in concentrated energy, leading to tall waves.

Under consistent ocean conditions, rogue waves generated this way may occur once every two days at a set location. But the ocean is dynamic, so conditions are rarely consistent for long – making it less likely for rogue waves to occur. The overlap of waves may be minimal or non-existent even during prolonged and intense storms.

Numerical and laboratory studies suggest strong winds also contribute to the development of rogue waves, because they push harder on some already tall waveforms. But wind has seldom been considered in rogue wave analysis.

A simplified anatomy of ocean waves. NOAA

Wind prompts ocean waves to grow progressively higher, longer and faster. During this stage, waves are “young” and hungry for wind input. When waves go faster than wind, they stop being accelerated by it and reach a “mature” stage of full development.

Through this process, the wind creates a chaotic situation where waves of different dimensions and directions coexist.

Our recent observations show that unique sea conditions with rogue waves can arise during the “young” stage – when waves are particularly responsive to the wind. This suggests wind parameters could be the missing link. However, there’s even more to consider.

Powerful waves amplify each other

Ocean waves are one of the most powerful natural forces on Earth and could become even more powerful in the future due to climate change. If the wave field possesses an extreme amount of energy – when waves are steep and most of them have a similar amplitude, length and direction – another mechanism can trigger the formation of rogue waves.

This mechanism involves an exchange of energy between waves that produces a “self-amplification”, where one wave grows disproportionately at the expense of its neighbors. Theoretically, studies show this could increase the likelihood of rogue waves ten-fold.

While self-amplification manifests as whitecaps – frothy, aerated crests of choppy waves – until now there has been no evidence it can make rogue waves more likely in the ocean.

Recent experiments suggest wind can make extreme events like rogue waves more common. But this aspect has not been thoroughly explored.

What did we find in the Southern Ocean?

We used a new three-dimensional imaging method for scanning the ocean surface throughout the expedition. It mimics human vision: closely located sensors record sequences of simultaneous images. Computer algorithms then match pairs of them to reconstruct the three-dimensional depths – the wavy surface.

Example of the three-dimensional ocean surface reconstructed from synchronized images. Hans Clarke

As our ship passed through several storms, the sensors captured data during various phases of wave growth – from the early stages of young waves fuelled by the wind, to mature waves that aren’t influenced by it.

Our results show young waves display signs of self-amplification and an increased likelihood of rogue waves. We recorded waves twice as high as their neighbors once every six hours.

This mirrors what lab models have reported: sea conditions theoretically more prone to self-amplification would produce more rogue waves.

In contrast, mature seas don’t show an increased probability of rogue waves. We detected none under those conditions.

Our findings challenge previous thinking: that self-amplification doesn’t change the likelihood of rogue waves in the ocean. We have also shown that when developing tools for predicting rogue waves, we need to take wind into thorough consideration. After all, it’s a natural feature of the open sea.

Alessandro Toffoli is a Professor in Ocean Engineering, The University of Melbourne.

This article appears courtesy of The Conversation and may be found in its original form here

The Conversation

The opinions expressed herein are the author's and not necessarily those of The Maritime Executive.

 

Pirates Release Bulker Abdullah in Exchange for $5M Ransom

Somali pirates
File image

PUBLISHED APR 14, 2024 10:57 PM BY THE MARITIME EXECUTIVE

 

 

The Somali pirate crew that hijacked the Bangladeshi-flagged bulker Abdullah have received their ransom payout and have departed the ship, releasing the vessel and its 23 crewmembers. 

Abdullah was hijacked off the coast of Puntland last month while on a voyage from Mozambique to the UAE with a load of coal. 

The pirates told Reuters that they were paid $5 million in ransom, or about $220,000 per crewmember. They divided the loot amongst themselves and departed in smaller groups. 

The shipowner, SR Shipping, confirmed to AFP that a "deal" had been reached with the pirates. 

The payout suggests that piracy is still among the most lucrative criminal enterprises available along the coast of Somalia. In the heyday of maritime crime in the region, from 2005-2012, pirates netted about $400 million, according to World Bank estimates. 

It is not clear whether the pirates escaped to benefit from their ill-gotten gains. An officer with the Puntland Police Force told local Somali outlet Garowe that eight members of the gang were apprehended right after leaving the ship. However, the status of the ransom money is unclear. 

Pirate sightings and approaches have been observed much more frequently in the Indian Ocean since the beginning of Houthi attacks in the Red Sea late last year. As Western navies repositioned to counter anti-ship drones and missiles from Houthi forces in Yemen, counter-piracy operations took a back seat, leaving an opening for Somali gangs to roam at sea once more.

The Indian Navy has stepped up to fill the gap. Last month, Indian Navy forces captured a large gang of 35 pirates aboard the bulker Ruen. The suspects have been returned to India for trial.

ALTERNATE FUEL

Viking Line Sees Improved Supplies of Bio-LNG on the Market

Viking Grace
Viking Grace (Courtesy Viking)

PUBLISHED APR 14, 2024 11:18 PM BY THE MARITIME EXECUTIVE

 

Finnish ro/pax operator Viking Line began offering passengers the opportunity to pay for bio-LNG on its voyages last year, and the possibilities for using this sustainable fuel have been growing, the company reported last week. 

"We made sure that Viking Glory, which was completed in 2021, and Viking Grace, which was completed in 2013, were built with the technological readiness to use biogas and synthetic fuels produced from renewable energy," said Viking Line’s Sustainability Manager, Dani Lindberg. "There is now enough biogas being produced in the market so that we can start to use this fuel together with liquefied natural gas for these two climate-smart vessels."

Under Viking's low-carbon pricing program, passengers on the Turku route are offered the option of buying biofuel to cover their journey. This adds a manageable fee of up to €5 in addition to the fare, which ranges between €45-55. The price is based on the typical fuel usage per passenger, and effectively reduces the passenger’s carbon footprint by up to 90 percent. The two passenger ferries make two sailings each day on the same route, and the voyage takes eight to 12 hours depending on the vessel. 

Last year, Lindberg said that the local supply of bio-LNG was limited, constraining the amount that Viking could access. Subsidies may be required to expand production, according to the International Council on Clean Transportion (ICCT); with the right policies, 98 billion cubic meters (bcm) of biomethane could be produced in Europe by 2050, according to an industry-backed study for Gas for Climate. This would be enough to replace about 30 percent of current European demand for pipeline gas. 

Viking also uses electricity from renewable energy at all of the ports where it uses shore power, which reduces the company’s annual greenhouse gas emissions by about 780 tonnes. Last year it also sold its largest and most emissions-intensive vessel, the M/S Rosella. 

For the second time, Viking Line was named the most sustainable company in maritime transport service between Finland and Sweden last year, based on a passenger survey.


Methanol-Fuelled MAN 21/31DF-M GenSet Secures First Propulsion Order

MAN Energy Solutions
Three MAN 21/31DF-M units are bound for a chemical tanker

PUBLISHED APR 15, 2024 9:38 AM BY THE MARITIME EXECUTIVE

 

[By: MAN Energy Solutions]

MAN Energy Solutions has received an order for 3 × MAN 6L21/31DF-M (Dual Fuel-Methanol) GenSets capable of running on methanol in connection with the construction of a 7,990 dwt IMO Type II chemical bunker tanker.

The dual-fuel engines will form part of a diesel-electric propulsion system on board the vessel with electrical motors driving twin fixed-pitch propellers via gearboxes; an onboard battery-storage system will optimise the use of the dual-fuelled generators. MAN Energy Solutions’ licensee, CMP – an engine-manufacturing division of Chinese State Shipbuilding Corporation (CSSC) – will build the engines in China and the vessel is scheduled for delivery during Q4, 2025.

The newbuild will operate at the port of Singapore under charter to deliver marine fuels. The port itself is reported as laying plans for the steady supply of methanol from 2025 onwards in order to meet future, anticipated bunkering requirements for methanol-fuelled vessels. 

Bjarne Foldager – Country Manager, Denmark – MAN Energy Solutions, said: “Seeing our trusted MAN L21/31 GenSets go into these ships as a methanol-fuelled version shows that maritime decarbonisation is a prominent consideration for shipowners in all vessel segments and sizes. It also clearly illustrates, regardless of the market one serves as shipowner, that our broad, dual-fuel portfolio enables everyone to take part in the green transition.”

Thomas S. Hansen – Head of Sales and Promotion – MAN Energy Solutions, said: “The MAN L21/31 engine is well-established in the market having racked up some 2,750 sales. The reliability of its cost-effective, port fuel-injection concept now prominently positions the 21/31DF-M as the preferred, medium-speed, small-bore engine for GenSet and diesel-electric propulsion solutions, while also meeting market demands to balance both CAPEX and OPEX. With the shipping market currently experiencing an increased interest in methanol as marine fuel, and orders for methanol-fuelled ships steadily growing as part of many companies’ decarbonisation strategy, we feel that the introduction of this dual-fuel engine is timely.”

The products and services herein described in this press release are not endorsed by The Maritime Executive.

Thinking outside the doctor’s office: Poll looks at older US adults’ use of urgent care, retail clinics and more



Majority have gotten health care at an “alternative” site in the past two years, but survey of people ages 50 to 80 shows variations in use, motivations and attitudes



Reports and Proceedings

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN



When today’s older adults were growing up, urgent care centers and clinics inside retail stores didn’t exist. But most of them have now embraced these non-traditional sites for getting medical care, a new national poll finds.

 

In the past two years, 60% of people age 50 to 80 have visited an urgent care clinic, or a clinic based in a retail store, workplace or vehicle, according to new findings from the University of Michigan National Poll on Healthy Aging.

 

Urgent care clinics were the most common alternative source of care, with 47% of adults age 50-80 visiting one at least once, and 23% going more than once, in the past two years.

 

Many of those who went to any alternative site said they did so to avoid going to the emergency room (44%) or to get a vaccine, a test or an exam (35%). They went for a variety of health reasons, including getting immediate attention for symptoms and injuries, getting vaccinated, and receiving tests or treatments for COVID-19 infections.

 

And 75% of those who have gone to such a site recently say they’re likely to go again in the next two years.

 

But even as they sought care at these sites, most older adults who also have a primary care provider preferred the quality of care and sense of connection at their regular clinic. Among those who say they’re not likely to go to an alternative site for care in the future, 74% said it’s because they prefer to go to their regular provider.

 

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, U-M’s academic medical center. Two members of AARP’s Public Policy Institute worked with the poll team on the poll questions and report.

 

“The rapid rise in availability of these kinds of clinics, which typically offer walk-in convenience, expanded hours, and self-scheduling of appointments in locations close to home, work or shopping, has transformed the American health care landscape in less than two decades,” said poll director Jeffrey Kullgren, M.D., M.P.H., M.S. “With the nationwide shortage of primary care providers, it’s important to understand how this age group, with generally higher medical needs, views and uses this type of care.”

 

Kullgren is a primary care physician at the VA Ann Arbor Healthcare System and associate professor of internal medicine at U-M.

 

“Access to timely and convenient care was critical for older adults during the pandemic, and our research shows alternative care options will continue to be in demand for the long-term,” said Susan Reinhard, senior vice president and director of AARP Public Policy Institute. “Policymakers and clinicians must ensure that patients receive high quality care at sites like urgent care clinics that is well-coordinated with their usual health care provider.”

 

Other key findings from the poll:

 

  • The percentage of older adults who had gone to a retail clinic was half that of the proportion who had gone to an urgent care center, at 28% vs 47%. Only 9% had gone to a clinic at their worksite, and 5% had gotten care from a traveling provider based in a bus or van.
  • Those in their 50s and early 60s were more likely than those age 65 to 80 to have sought care from one of these types of alternative care sites, at 64% vs. 55%.
  • Women were more likely than men to have gone to an alternative site for care in the last two years, at 63% vs. 57%.
  • Older adults who live in urban or suburban areas with populations over 50,000 were more likely than those in less-populated areas to have gone to an alternative site for care, at 62% vs 52%.
  • 61% of those who said they have a primary care provider said they visited an urgent care clinic, retail clinic or other alternative site in the past two years. The majority (64%) had let that regular provider know they had gone to an alternative site.
  • Asked to compare the two, 43% of those who had gone to an alternative site for care said the alternative site was more convenient than their usual provider. But 52% said the quality of care was better at their usual provider’s clinic, and 67% said they felt more connection to their provider at their usual clinic.
  • Cost does not seem to be a main driver for seeking care at a non-traditional site, with only 9% of alternative site users citing it as a reason. And 19% of those who had gone to an alternate care site said their alternative site was better on cost. Also, 23% of those who said they weren’t likely to go to an alternative site for care in the next two years said that they were concerned about cost or lack of insurance coverage for such care.
  • 43% of those who haven’t gotten care at an alternative care site in the past two years say they are likely to do so in the next two years. 

 

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in July and August 2023 among 2,657 adults aged 50 to 80. The sample was subsequently weighted to reflect the U.S. population. Read past National Poll on Healthy Aging reports and about the poll methodology.

 

Experiencing racial discrimination impacts the mental health of teens in the U.S. (IN) justice system



Interventions need to consider adolescents' exposure to interpersonal racial discrimination alongside other forms of violence when providing care



SOUTHERN METHODIST UNIVERSITY





DALLAS (SMU) – A new study by SMU psychologists shows interpersonal racial discrimination and other forms of violence can impact the mental health of adolescents in the justice system.

The research advocates for a more holistic approach to mental health intervention, emphasizing the importance of considering adolescents' experiences of interpersonal racial discrimination alongside other more recognized forms of violence. By acknowledging and addressing these intersecting factors, stakeholders can better tailor support systems to meet the unique needs of adolescents of color in the justice system.

Published in the Journal of Interpersonal Violence, the study involves 118 adolescents of color, ages 14 to 17, and their mothers, comparing the effects of interpersonal racial discrimination together with experiences of harsh parenting, teen dating violence, and exposure to parental partner violence. The authors note that while interpersonal racial discrimination can be conceptualized as a type of interpersonal violence, it is seldom considered as such.

This can be a problem when trying to understand how a teen’s exposure to interpersonal violence, in various forms, relates to their mental health symptoms and subsequent acts of delinquency. The authors note that adolescents of color are disproportionately represented in the U.S. justice system, a disparity that previous studies have tied to racism and interpersonal racial discrimination.

“It is common for researchers to look at common adverse childhood experiences related to violence, but often racial discrimination is left out of the equation,” said lead author Ernest Jouriles, professor and director of clinical training in SMU’s Department of Psychology. “We found that experiencing interpersonal racial discrimination is as harmful, if not more harmful, than other commonly studied traumatic events.”

The research used 3-month, longitudinal data from a larger study that looked at how mother-adolescent communication about dating relationships is linked to adolescent dating violence and victimization. Participants in that study were recruited with flyers distributed at truancy courts, by probation offices, and through victim services offices.

Half of the teenagers reported experiencing violence from their parents, and more than half said they had experienced violence in their dating relationships. Some also reported they had seen their parents being physically violent with each other. About half noted they themselves had been mistreated because of their race. Many believed the unfair treatment stemmed from people perceiving the teens as lacking intelligence.

“Historically, this research has been very siloed, with racial discrimination in one area of research and interpersonal violence in another, but our results suggest they should be examined together,” said Melissa Sitton, a doctoral student in the SMU Clinical Psychology program and one of the paper’s authors. “Researchers, clinicians and others providing services must assess situations more broadly to provide more effective assistance.”

Sitton will present the research at the upcoming Society for Research in Child Development Anti-Racist Developmental Science Summit: Transforming Research, Practices, and Policies Summit, scheduled for May 15-17 in Panama City, Panama.

Additional research team members include SMU professors David Rosenfield and Renee McDonald and Pricilla Lui from the University of Washington. Research reported in this press release was supported by the Centers for Disease Control and Prevention under Award Number R01CE001432.

About SMU

SMU is the nationally ranked global research university in the dynamic city of Dallas. SMU’s alumni, faculty and more than 12,000 students in eight degree-granting schools demonstrate an entrepreneurial spirit as they lead change in their professions, communities and the world.

 

Mental health disparities growing among transgender adults



AMERICAN PUBLIC HEALTH ASSOCIATION




In the U.S., transgender and gender non-conforming (TGNC) individuals represent a historically marginalized segment of society. They often report unfavorable outcomes in terms of both physical and mental health compared to their cisgender counterparts. Despite advancement in psychological and physical healthcare provisions for TGNC individuals over the years, they face significant barriers that hinder access to crucial services, including but not limited to, lengthy waiting lists, inconvenient travel requirements and a lack of insurance coverage.

In a recent study published in the May 2024 issue of the American Journal of Public Health, researchers examined changes in self-reported mental health from 2014 to 2021 among a nationally representative adult population. By analyzing data from the U.S. Behavioral Risk Factor Surveillance System Survey, researchers Donn Feir of the University of Victoria and Samuel Mann of the RAND Corporation found that mental health distress increased disproportionately among TGNC adults over this period, compared to cisgender adults.

The number of self-reported “poor mental health days” per month serves as a reliable indicator of mental health, correlating with other psychological and physical health indicators. While TGNC individuals reported more poor mental health days in 2014, the statistics worsened significantly over the next seven years. 

“In 2014, cisgender individuals reported a mean average of 3.68 poor mental health days, compared with a mean average of 5.42 poor mental health days among transgender respondents. The size of this disparity adjusted by differences in observable characteristics increased by 2.75 days over the sample period,” explained Mann.

Researchers also uncovered a disproportionate rise in the frequency of mental health distress reported by TGNC individuals during the seven-year study period. “In 2014, 11.4% of cisgender adults reported frequent mental distress compared with 18.9% of transgender adults. By 2021, [those numbers rose to] 14.6% of cisgender adults and 32.9% of transgender adults report[ing] frequent mental distress,” Feir noted.

The observed trend of rapidly increasing mental distress among TGNC adults indicates potential worsening of socioeconomic and other disparities, as well as an increase in the barriers that prevent them from accessing the support services they need. This increase in mental distress within the TGNC population could also stem from factors such as societal discrimination or lack of access to gender-affirming and mental health care resources.

The alarming increase in the frequency of self-reported mental distress among transgender individuals suggests an urgent need to recalibrate country-wide initiatives supporting TGNC individuals across the U.S. Resource allocation that enhances access to gender-affirming and mental health services may also be a crucial step in mitigating disparities in mental health between TGNC and cisgender people.

Finally, policy changes that promote overall well-being and inclusivity for TGNC individuals may help improve mental health outcomes for this underserved community in the long run. “Policies are needed to address the worsening mental health of transgender and gender-nonconforming people in the United States,” Mann concluded.
 

EMOTIONAL PLAGUE

Economic burden of childhood verbal abuse by adults estimated at $300 billion globally




UNIVERSITY COLLEGE LONDON




Childhood verbal abuse by adults costs society an estimated $300 billion (£239 billion) a year globally, show findings presented at the first international conference on childhood verbal abuse, hosted by UCL, Words Matter and the World Health Organization (WHO).

The Words Matter: Impact and Prevention of Childhood Verbal Abuse conference marks the first time that experts from around the world have come together to focus attention on the lifetime damage of childhood verbal abuse and the need to develop solutions.

Childhood verbal abuse involves behaviours that can be detrimental to a child’s wellbeing, such as belittling, shouting and threatening language.

The new study, led by Professor Xiangming Fang (China Agricultural University and Georgia State University) used data from the US Centers for Disease Control and Prevention’s Violence Against Children Surveys, in four countries: Cambodia (1212 participants), Kenya (1099 participants), Colombia (1415 participants) and Moldova (906 participants), to analyse the effects of childhood verbal abuse on selected health outcomes, including mental distress, self-harm, drug use and problem drinking.

The study then estimated the Disability-Adjusted Life Years (DALY) lost (the total amount of healthy life years lost due to people dying prematurely or living with a disability caused by a common disease or health problem in the community) due to health outcomes attributed to childhood verbal abuse to estimate its economic burden.

These DALY losses were then converted into monetary value – assuming that one DALY was equal to the country’s per-capita Gross Domestic Product (GDP).

The mean economic burden of childhood verbal abuse across the four countries was found to be 0.34% of GDP. When this figure was applied to global GDP, it equated to approximately $300 billion every year.

Meanwhile, the DALY losses for outcomes attributed to childhood verbal abuse were significantly great than corresponding estimates for breast cancer and liver cancer in the four countries studied, and similar to the Disability-Adjusted Life Years lost to hypertensive heart disease.

Conference Chair, Professor Peter Fonagy (UCL Psychology & Language Sciences), said: “Verbal abuse of children by adults is all too common, but is one of the most significant modifiable causes of life-long mental health disorders.

“Tackling it gives us a powerful lever to prevent mental health disorders and their enormous cost to both the UK and global economy.

“I am delighted that with the Words Matter charity, we have an organisation finally focusing on this problem. Bringing greater awareness to childhood verbal abuse has the potential to dramatically reduce the economic and psychological burden of psychiatric disorders.”

Previous research from experts at UCL and Wingate University* found that childhood verbal abuse can be as harmful as other forms of abuse and have significant adverse impacts on children’s mental and physical health and development – leading to anxiety, depression, eating disorders, self-harm, substance abuse and even suicide.

Professor Xiangming Fang said: “The economic burden of childhood verbal abuse by adults that we have quantified clearly highlights the shocking hidden cost of the damage it causes to children throughout their lifetime. However, this is likely a considerable underestimate given the impact of childhood verbal abuse on several outcomes including healthcare utilisation costs and legal system expenses, which were not included in the analysis due to data unavailability.

“There is clearly a significant opportunity for economic growth by ending childhood verbal abuse, and by revealing these figures, we hope this form of childhood maltreatment will be given the attention it deserves. Vital now is undertaking more research and devoting funds and resources to preventing it, so the cost to society can be reduced.”

Jessica Bondy, Founder of Words Matter, said: “For too long, childhood verbal abuse by adults has gone under the radar, yet it is all around us. We hope this conference helps put the issue firmly on the map and galvanises action. It is possible to bring an end to childhood verbal abuse with greater awareness, understanding and collaboration across the globe to devise solutions. We must act now, given the lifelong impact on children’s mental and physical health and wellbeing and the monumental cost to society. Let’s build children up, not knock them down, and create a better future for children.”

Tim Loughton MP, Chair of the All-Party Parliamentary Group for Children and former Children’s Minister said: “By convening this conference, the work of Words Matter and its expert advisers is filling a gap in understanding the harms that can be inflicted on children from the way adults communicate with them and the routes for prevention. Whilst we are all too familiar with the damage done to children as a result of physical violence, verbal abuse is more insidious and pervasive, impacting so many whose mental health has already been deeply affected due to the Covid pandemic.

“We all have a duty of care to treat children with respect and that includes the words and language we use with them. This conference highlights how much words really do matter and how if used poorly, they can have lasting implications for children and our economy.”

Former Health Minister and Chief Executive of the NHS Confederation and currently Opposition Whip, Lord Philip Hunt of Kings Heath said: “All children deserve to grow up happy and healthy, but millions are suffering verbal abuse by adults which has for far too long been hidden in the shadows. Thanks to the work of Words Matter, we now know that this is not only impacting children's mental health and development but is also, as this new study shows, having a huge cost on society as a whole. We all want children to develop armed with the tools to lead confident and productive adult lives and the words they hear from adults are so important in building self-esteem and confidence. By shining a light on this abuse, lives can and will be changed.”

Study limitations

The $300 billion is likely a considerable underestimate given the impact of childhood verbal abuse on several outcomes, including healthcare utilisation costs and legal system expenses, which were not included in the analysis, due to data unavailability.

Additionally, costs associated with chronic illnesses such as diabetes, heart disease, and cancer were not taken into account.

Multiple risk factors can contribute to the occurrence of any disease. When attributing a disease to these factors the maximum attribution is capped at 100%. However, if multiple risk factors are involved and overlap, the sum of DALY estimates for all risk factors may exceed 100%. Failure to fully account for these inter-correlations could potentially result in overestimation of the figures instead.

The field lacks reliable longitudinal data to assess the long-term repercussions of childhood verbal abuse. 

The absence of high-quality cohort studies that adopt a lifetime perspective in economic data estimation may lead to a substantial underestimation of the economic impact of childhood verbal abuse. 

Prioritising the collection of longitudinal data on the consequences of childhood verbal abuse should be a primary focus of future efforts.