Measuring the burden of treatment for chronic disease: implications of a scoping review of the literature

Background: Although there has been growing research on the burden of treatment, the current state of evidence on measuring this concept is unknown. This scoping review aimed to provide an overview of the current state of knowledge as well as clear recommendations for future research, within the context of chronic disease. Methods: Four health-based databases, Scopus, CINAHL, Medline, and PsychInfo, were comprehensively searched for peer-reviewed articles published between the periods of 2000–2016. Titles and abstracts were independently read by two authors. All discrepancies between the authors were resolved by a third author. Data was extracted using a standardized proforma and a comparison analysis was used in order to explore the key treatment burden measures and categorize them into three groups. Results: Database searching identified 1458 potential papers. After removal of duplications, and irrelevant articles by title, 1102 abstracts remained. An additional 22 papers were added via snowball searching. In the end, 101 full papers were included in the review. A large number of the studies involved quantitative measures and conceptualizations of treatment burden (n = 64; 63.4%), and were conducted in North America (n = 49; 48.5%). There was significant variation in how the treatment burden experienced by those with chronic disease was operationalized and measured. Conclusion: Despite significant work, there is still much ground to cover to comprehensively measure treatment burden for chronic disease. Greater qualitative focus, more research with cultural and minority populations, a larger emphasis on longitudinal studies and the consideration of the potential effects of “identity” on treatment burden, should be considered

Politics and War in Historical and Theoretical Perspective. With EU Case Study

The aim of this paper is to shed light on the dominant theoretical paradigms and show their sustainability in the last 150 years, following the historical context of the interrelationship between politics and war. Starting from Clausewitz’s thesis on war as a continuation of politics by other, violent means, the paper thematizes the dominant wars in the twentieth century, World War I and II, their causes and connection with politics, which proves to be an essential element of every war. Namely, war has always been the consequence of political decisions and as such a significant political tool for achieving a certain goal. In this context, the Cold War period unequivocally confirms Clausewitz’s realist thesis, showing that war is not necessarily an armed conflict, but that it is nonetheless a political matter. After the collapse of the Soviet Union and the end of the Cold War, realism and liberalism regained prominence and emerged as significant theories on war and security. Both theories have their roots in the twentieth century, and therefore their paradigm becomes insufficient to answer the new questions posed by the nature of interdependent world. Nevertheless, these theories, especially liberalism, show their practical application and stand at the core of the ideological basis for the formation of the European Union. In this sense, Europe, after centuries of wars fought on its soil, displays the possibility of successful cooperation. As a result, war appears not only as a continuation of politics by violent means, but as a constituent element of systems and states in the modern world.El objetivo de este trabajo es arrojar luz sobre los paradigmas teóricos dominantes y mostrar su sostenibilidad en los últimos 150 años, siguiendo el contexto histórico de la interrelación entre política y guerra. Partiendo de la tesis de Clausewitz sobre la guerra como continuación de la política por otros medios violentos, este artículo analiza las guerras dominantes en el siglo xx, la Primera y la Segunda Guerra Mundial, sus causas y su conexión con la política, que resulta ser un elemento esencial de toda guerra. En concreto, la guerra siempre ha sido la consecuencia de decisiones políticas y, como tal, una importante herramienta política para conseguir un determinado objetivo. En este contexto, el periodo de la Guerra Fría confirma inequívocamente la tesis realista de Clausewitz, demostrando que la guerra no es necesariamente un conflicto armado, pero que no deja de ser una cuestión política. Tras el colapso de la Unión Soviética y el fin de la Guerra Fría, el realismo y el liberalismo recuperaron protagonismo y surgieron como teorías significativas sobre la guerra y la seguridad. Ambas teorías hunden sus raíces en el siglo xx, por lo que su paradigma resulta insuficiente para responder a las nuevas cuestiones que plantea la naturaleza del mundo interdependiente. Sin embargo, estas teorías, especialmente el liberalismo, muestran su aplicación práctica y se sitúan en el núcleo de la base ideológica para la formación de la Unión Europea. En este sentido, Europa, tras siglos de guerras libradas en su territorio, muestra la posibilidad de una cooperación exitosa. En consecuencia, la guerra aparece no sólo como una continuación de la política por medios violentos, sino como un elemento constitutivo de los sistemas y estados del mundo moderno

On a high performance image compression technique

We introduce an optimal approach to colour image compression using a new scan method. We propose efficient methods to increase the compression ratio for colour images by dividing the colour image into non-overlapping blocks and applying a different compression ratio for these blocks depending on the classification of blocks into edge and non-edge blocks. In an edge block (a region that contains important information) the compression ratio is reduced to prevent loss of information, while in a non-edge block (a smooth region which does not have important information), a high compression ratio is used. The new proposed scan is used instead of the zigzag scan. A particular implementation of this approach was tested, and its performance was quantified using the peak signal-to-noise ratio. Numerical results indicated general improvements in visual quality for colour image coding

Λr -sets and separation axioms

Separation axioms are among the most common and important and interesting concepts in topology as well as in bitopologies. In this paper, we introduce Λr-sets and some weak separation axioms using Λr -open sets and Λr -closure operator

Severe malaria - a case of fatal Plasmodium knowlesi infection with post-mortem findings: a case report.

BACKGROUND: Zoonotic malaria caused by Plasmodium knowlesi is an important, but newly recognized, human pathogen. For the first time, post-mortem findings from a fatal case of knowlesi malaria are reported here. CASE PRESENTATION: A formerly healthy 40 year-old male became symptomatic 10 days after spending time in the jungle of North Borneo. Four days later, he presented to hospital in a state of collapse and died within two hours. He was hyponatraemic and had elevated blood urea, potassium, lactate dehydrogenase and amino transferase values; he was also thrombocytopenic and eosinophilic. Dengue haemorrhagic shock was suspected and a post-mortem examination performed. Investigations for dengue virus were negative. Blood for malaria parasites indicated hyperparasitaemia and single species P. knowlesi infection was confirmed by nested-PCR. Macroscopic pathology of the brain and endocardium showed multiple petechial haemorrhages, the liver and spleen were enlarged and lungs had features consistent with ARDS. Microscopic pathology showed sequestration of pigmented parasitized red blood cells in the vessels of the cerebrum, cerebellum, heart and kidney without evidence of chronic inflammatory reaction in the brain or any other organ examined. Brain sections were negative for intracellular adhesion molecule-1. The spleen and liver had abundant pigment containing macrophages and parasitized red blood cells. The kidney had evidence of acute tubular necrosis and endothelial cells in heart sections were prominent. CONCLUSIONS: The overall picture in this case was one of systemic malaria infection that fit the WHO classification for severe malaria. Post-mortem findings in this case were unexpectedly similar to those that define fatal falciparum malaria, including cerebral pathology. There were important differences including the absence of coma despite petechial haemorrhages and parasite sequestration in the brain. These results suggest that further study of knowlesi malaria will aid the interpretation of, often conflicting, information on malaria pathophysiology in humans

Effect of heat and mass transfer and rotation on peristaltic flow through a porous medium with compliant walls

Purpose: The purpose of this paper is to investigate the peristaltic flow of an incompressible Newtonian fluid in a channel with compliant walls. The effects of rotation and heat and mass transfer are also taken into account. The governing equations of two dimensional fluid have been simplified under long wavelength and low Reynolds number approximation. An exact solutions is presented for the stream function, temperature, concentration field, velocity and heat transfer coefficient. Design/methodology/approach: The effect of the concentration distribution, heat and mass transfer and rotation on the wave frame are analyzed theoretically and computed numerically. Numerical results are given and illustrated graphically in each case considered. Comparison was made with the results obtained in the presence and absence of rotation and heat and mass transfer. Findings: The results indicate that the effect of the permeability and rotation are very pronounced in the phenomena. Originality/value: The objective of the present analysis is to analyze the effects of rotation, heat and mass transfer and compliant walls on the peristaltic flow of a viscous fluid