ECHOES OF HONOR: A COMPARATIVE ANALYSIS OF BLOOD, HONOR, AND REVENGE FROM SPANISH AND JAPANESE DRAMA TO THE DIGITAL AGE

Linda Hutcheon famously stated that with adaptations, audiences seem to “desire the repetition as much as the change”, and she notes that the relationship between an adaptation and its originating text is one which remains contentious. Although previous literary and historical scholars have documented the enduring popularity of adaptations through archival methods, the literature to date lacks a robust comparative textual approach. I use national plays such as Fuenteovejuna (1612-1614), El burlador de Sevilla y convidado de piedra (1630), The Treasury of Loyal Retainers (Kanadehon Chūshingura 仮名手本忠臣蔵 c1748), and “Yotsuya Ghost Stories” (Tōkaidō Yotsuya Kaidan東海道四谷怪談1825) as models of classical Spanish and Japanese national media that foreground and debate the honor theme. Through this theme, I argue that comparative examinations of the motifs of spectacle, gender, and honor among media adaptations of the popular dramatic theatre of Golden Age (1492-1681) Spain and Edo Period (1603-1868) Japan can help to delineate current adaptation paradigms. The promotion and maintenance of a complex system of “honor” in both Japan and Spain is a major point of contention through the plot and exposition of these dramatic works. In this context, my use of the term national play encompasses what J. Tompkins refers to as the heterotopias of theater, and is a designation to denote plays which appear to be part of a canon of works deemed representative of their respective countries on and off stage. Despite these shifts and movements to new formats, these plays and their “echoes” continue to captivate audiences around the world and reinforce conversations related to modern motifs related to honor, society, and the human condition. While the motivations behind the actions of the characters, especially those who are marginalized, are repurposed and remain a source of contention, the effects of their iconic debates continue to live on in an increasingly global and technically expansive imagination.Doctor of Philosoph

A focused telephonic nursing intervention delivers improved adherence to A1c testing

Compliance with hemoglobin A1c (A1c) testing is suboptimal despite the clear national recommendations and guidelines established for care of patients with diabetes. Recent studies have demonstrated a relationship between participation in a diabetes disease management (DM) program and improved adherence to A1c testing. A focused intervention study was initiated to investigate the ability of a DM program to drive improvement in A1c testing. A cohort of 36,327 members experienced a statistically significant increase (29%) in A1c testing while participating in the 6-month focused intervention. This finding demonstrated that a focused DM intervention is able to deliver improvement in a clinical process metric critical for managing patients with diabetes, thereby reducing their risk of disease exacerbation

Association between frequency of telephonic contact and clinical testing for a large, geographically diverse diabetes disease management population

Diabetes disease management (DM) programs strive to promote healthy behaviors, including obtaining hemoglobin A1c (A1c) and low-density lipoprotein (LDL) tests as part of standards of care. The purpose of this study was to examine the relationship between frequency of telephonic contact and A1c and LDL testing rates. A total of 245,668 members continuously enrolled in diabetes DM programs were evaluated for performance of an A1c or LDL test during their first 12 months in the programs. The association between the number of calls a member received and clinical testing rates was examined. Members who received four calls demonstrated a 24.1% and 21.5% relative increase in A1c and LDL testing rates, respectively, compared to members who received DM mailings alone. Response to the telephonic intervention as part of the diabetes DM programs was influenced by member characteristics including gender, age, and disease burden. For example, females who received four calls achieved a 27.7% and 23.6% increase in A1c and LDL testing, respectively, compared to females who received mailings alone; by comparison, males who were called achieved 21.2% and 19.9% relative increase in A1c and LDL testing, respectively, compared to those who received mailings alone. This study demonstrates a positive association between frequency of telephonic contact and increased performance of an A1c or LDL test in a large, diverse diabetes population participating in DM programs. The impact of member characteristics on the responsiveness to these programs provides DM program designers with knowledge for developing strategies to promote healthy behaviors and improve diabetes outcomes

Remote physiological monitoring: Clinical, financial, and behavioral outcomes in a heart failure population

This article reports on the outcomes associated with remote physiological monitoring (RPM) conducted as part of a heart failure disease management program. Claims data, medical records, data transmission records, and survey results for 91 individuals ages 50–92 (mean 74 years) successfully completing a heart failure RPM program were analyzed for time periods before, during, and after the monitoring intervention. The program was associated with significant reductions in per member per month costs and emergency room and hospital utilization. More detailed analyses were performed for specific gender and age subgroups. Participant surveys indicated high levels of satisfaction, and improvements in self-perceived health status, self-efficacy, and self-management behaviors. This study is the first to assess the impact of a RPM program following removal of the monitoring equipment. The results indicate that RPM, as a component of a traditional disease management program, has a sustained, beneficial effect on participants’ lifestyles after the monitoring period has ended

Early role of vascular dysregulation on late-onset Alzheimer's disease based on multifactorial data-driven analysis

Multifactorial mechanisms underlying late-onset Alzheimer's disease (LOAD) are poorly characterized from an integrative perspective. Here spatiotemporal alterations in brain amyloid-β deposition, metabolism, vascular, functional activity at rest, structural properties, cognitive integrity and peripheral proteins levels are characterized in relation to LOAD progression. We analyse over 7,700 brain images and tens of plasma and cerebrospinal fluid biomarkers from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Through a multifactorial data-driven analysis, we obtain dynamic LOAD–abnormality indices for all biomarkers, and a tentative temporal ordering of disease progression. Imaging results suggest that intra-brain vascular dysregulation is an early pathological event during disease development. Cognitive decline is noticeable from initial LOAD stages, suggesting early memory deficit associated with the primary disease factors. High abnormality levels are also observed for specific proteins associated with the vascular system's integrity. Although still subjected to the sensitivity of the algorithms and biomarkers employed, our results might contribute to the development of preventive therapeutic interventions

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

The relationship of body image, body mass index and self-esteem to eating attitudes in a normal sample

The purpose of this study was to examine how body image, Body Mass Index (BMI), self-esteem and eating attitudes were related in a non-clinical sample of New Zealand women. The sample consisted of 36 women ranging in age from 17 to 55 years of age. Body image was assessed using the Body Shape Questionnaire, BMI was calculated based on measures of height and weight; eating attitudes was assessed with the Eating Concern subscale of the Eating Disorders Examination and self-esteem was assessed using the Rosenberg Self-Esteem Scale. The results of this study conclude that elevated BMI is associated with higher dissatisfaction with body image, and there is a positive correlation between body image and eating attitudes. Self-esteem and eating attitudes were significantly correlated with lower self-esteem being associated with increased disturbance in eating attitudes. Self-esteem and BMI were found to significantly contribute to eating attitudes on their own as well as together. Body image on its own also made a significant contribution to eating attitudes. Previous research informs us of the negative implications of dissatisfaction with body image, elevated BMI, disturbed eating attitudes and low-self-esteem and this study examines the links between these variables in order to add further information to what contributes to each of the variables. These findings were discussed in light of sociocultural theories of eating disorders and their implications to women from nonclinical populations