Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness

<b>Background</b> In this article we outline Burden of Treatment Theory, a new model of the relationship between sick people, their social networks, and healthcare services. Health services face the challenge of growing populations with long-term and life-limiting conditions, they have responded to this by delegating to sick people and their networks routine work aimed at managing symptoms, and at retarding - and sometimes preventing - disease progression. This is the new proactive work of patient-hood for which patients are increasingly accountable: founded on ideas about self-care, self-empowerment, and self-actualization, and on new technologies and treatment modalities which can be shifted from the clinic into the community. These place new demands on sick people, which they may experience as burdens of treatment.<p></p> <b>Discussion</b> As the burdens accumulate some patients are overwhelmed, and the consequences are likely to be poor healthcare outcomes for individual patients, increasing strain on caregivers, and rising demand and costs of healthcare services. In the face of these challenges we need to better understand the resources that patients draw upon as they respond to the demands of both burdens of illness and burdens of treatment, and the ways that resources interact with healthcare utilization.<p></p> <b>Summary</b> Burden of Treatment Theory is oriented to understanding how capacity for action interacts with the work that stems from healthcare. Burden of Treatment Theory is a structural model that focuses on the work that patients and their networks do. It thus helps us understand variations in healthcare utilization and adherence in different healthcare settings and clinical contexts

Characteristics of Vehicular Traffic Flow at a Roundabout

We construct a stochastic cellular automata model for the description of vehicular traffic at a roundabout designed at the intersection of two perpendicular streets. The vehicular traffic is controlled by a self-organized scheme in which traffic lights are absent. This controlling method incorporates a yield-at-entry strategy for the approaching vehicles to the circulating traffic flow in the roundabout. Vehicular dynamics is simulated within the framework of the probabilistic cellular automata and the delay experienced by the traffic at each individual street is evaluated for specified time intervals. We discuss the impact of the geometrical properties of the roundabout on the total delay. We compare our results with traffic-light signalisation schemes, and obtain the critical traffic volume over which the intersection is optimally controlled through traffic light signalisation schemes.Comment: 10 pages, 17 eps figures. arXiv admin note: text overlap with arXiv:cond-mat/040107

Relativistic Quantum Thermodynamics of Ideal Gases in 2 Dimensions

In this work we study the behavior of relativistic ideal Bose and Fermi gases in two space dimensions. Making use of polylogarithm functions we derive a closed and unified expression for their densities. It is shown that both type of gases are essentially inequivalent, and only in the non-relativistic limit the spinless and equal mass Bose and Fermi gases are equivalent as known in the literature.Comment: 6 pages, 1 figur

Influence of local carrying capacity restrictions on stochastic predator-prey models

We study a stochastic lattice predator-prey system by means of Monte Carlo simulations that do not impose any restrictions on the number of particles per site, and discuss the similarities and differences of our results with those obtained for site-restricted model variants. In accord with the classic Lotka-Volterra mean-field description, both species always coexist in two dimensions. Yet competing activity fronts generate complex, correlated spatio-temporal structures. As a consequence, finite systems display transient erratic population oscillations with characteristic frequencies that are renormalized by fluctuations. For large reaction rates, when the processes are rendered more local, these oscillations are suppressed. In contrast with site-restricted predator-prey model, we observe species coexistence also in one dimension. In addition, we report results on the steady-state prey age distribution.Comment: Latex, IOP style, 17 pages, 9 figures included, related movies available at http://www.phys.vt.edu/~tauber/PredatorPrey/movies

Density dependent hadron field theory for hypernuclei

The Density Dependent Relativistic Hadron Field (DDRH) theory, previously introduced and applied to isospin nuclei, is extended to hypernuclei by including the octet hyperons. Infinite matter Dirac-Brueckner theory for octet baryons and the derivation of in-medium DDRH baryon-meson vertices is discussed. From the properties of Dirac-Brueckner interactions it is found that hyperon and nucleon self-energies and vertices are related by the ratios of free space coupling constants. This leads to simple scaling laws for the in-medium hyperon and nucleon vertices. The model is applied in relativistic DDRH mean-field calculations to singl$\Lambda nuclei. Free space N-Lambda T-matrix results are used for the scalar vertex. As the only free parameter the hyperon vector vertex scaling factor is adjusted to a selected set of hypernuclear data. Spectroscopic data of single Lambda hypernuclei over the full mass range are well described. The reduced Lambda spin-orbit splitting is reproduced and found to be related closely the medium dependence of scalar and vector interactions.Comment: 38 pages, 9 figure

L∞L_\infty-Algebras, the BV Formalism, and Classical Fields

We summarise some of our recent works on $L_\infty$-algebras and quasi-groups with regard to higher principal bundles and their applications in twistor theory and gauge theory. In particular, after a lightning review of $L_\infty$-algebras, we discuss their Maurer-Cartan theory and explain that any classical field theory admitting an action can be reformulated in this context with the help of the Batalin-Vilkovisky formalism. As examples, we explore higher Chern-Simons theory and Yang-Mills theory. We also explain how these ideas can be combined with those of twistor theory to formulate maximally superconformal gauge theories in four and six dimensions by means of $L_\infty$-quasi-isomorphisms, and we propose a twistor space action.Comment: 19 pages, Contribution to Proceedings of LMS/EPSRC Durham Symposium Higher Structures in M-Theory, August 201

Twisted topological structures related to M-branes

Studying the M-branes leads us naturally to new structures that we call Membrane-, Membrane^c-, String^K(Z,3)- and Fivebrane^K(Z,4)-structures, which we show can also have twisted counterparts. We study some of their basic properties, highlight analogies with structures associated with lower levels of the Whitehead tower of the orthogonal group, and demonstrate the relations to M-branes.Comment: 17 pages, title changed on referee's request, minor changes to improve presentation, typos correcte

A Phase-Space Approach to Collisionless Stellar Systems Using a Particle Method

A particle method for reproducing the phase space of collisionless stellar systems is described. The key idea originates in Liouville's theorem which states that the distribution function (DF) at time t can be derived from tracing necessary orbits back to t=0. To make this procedure feasible, a self-consistent field (SCF) method for solving Poisson's equation is adopted to compute the orbits of arbitrary stars. As an example, for the violent relaxation of a uniform-density sphere, the phase-space evolution which the current method generates is compared to that obtained with a phase-space method for integrating the collisionless Boltzmann equation, on the assumption of spherical symmetry. Then, excellent agreement is found between the two methods if an optimal basis set for the SCF technique is chosen. Since this reproduction method requires only the functional form of initial DFs but needs no assumptions about symmetry of the system, the success in reproducing the phase-space evolution implies that there would be no need of directly solving the collisionless Boltzmann equation in order to access phase space even for systems without any special symmetries. The effects of basis sets used in SCF simulations on the reproduced phase space are also discussed.Comment: 16 pages w/4 embedded PS figures. Uses aaspp4.sty (AASLaTeX v4.0). To be published in ApJ, Oct. 1, 1997. This preprint is also available at http://www.sue.shiga-u.ac.jp/WWW/prof/hozumi/papers.htm

A Vehicular Traffic Flow Model Based on a Stochastic Acceleration Process

A new vehicular traffic flow model based on a stochastic jump process in vehicle acceleration and braking is introduced. It is based on a master equation for the single car probability density in space, velocity and acceleration with an additional vehicular chaos assumption and is derived via a Markovian ansatz for car pairs. This equation is analyzed using simple driver interaction models in the spatial homogeneous case. Velocity distributions in stochastic equilibrium, together with the car density dependence of their moments, i.e. mean velocity and scattering and the fundamental diagram are presented.Comment: 27 pages, 6 figure

HIFI spectroscopy of low-level water transitions in M82

We present observations of the rotational ortho-water ground transition, the two lowest para-water transitions, and the ground transition of ionised ortho-water in the archetypal starburst galaxy M82, performed with the HIFI instrument on the Herschel Space Observatory. These observations are the first detections of the para-H2O(111-000) (1113\,GHz) and ortho-H2O+(111-000) (1115\,GHz) lines in an extragalactic source. All three water lines show different spectral line profiles, underlining the need for high spectral resolution in interpreting line formation processes. Using the line shape of the para-H2O(111-000) and ortho-H2O+(111-000) absorption profile in conjunction with high spatial resolution CO observations, we show that the (ionised) water absorption arises from a ~2000 pc^2 region within the HIFI beam located about ~50 pc east of the dynamical centre of the galaxy. This region does not coincide with any of the known line emission peaks that have been identified in other molecular tracers, with the exception of HCO. Our data suggest that water and ionised water within this region have high (up to 75%) area-covering factors of the underlying continuum. This indicates that water is not associated with small, dense cores within the ISM of M82 but arises from a more widespread diffuse gas component.Comment: 5 pages, 4 figures. Accepted for publication in A&