246 research outputs found
The time resolution of the St. Petersburg paradox
A resolution of the St. Petersburg paradox is presented. In contrast to the
standard resolution, utility is not required. Instead, the time-average
performance of the lottery is computed. The final result can be phrased
mathematically identically to Daniel Bernoulli's resolution, which uses
logarithmic utility, but is derived using a conceptually different argument.
The advantage of the time resolution is the elimination of arbitrary utility
functions.Comment: 20 pages, 1 figur
Infrared spectroscopy of diatomic molecules - a fractional calculus approach
The eigenvalue spectrum of the fractional quantum harmonic oscillator is
calculated numerically solving the fractional Schr\"odinger equation based on
the Riemann and Caputo definition of a fractional derivative. The fractional
approach allows a smooth transition between vibrational and rotational type
spectra, which is shown to be an appropriate tool to analyze IR spectra of
diatomic molecules.Comment: revised + extended version, 9 pages, 6 figure
Cost-Effectiveness of Including a Nurse Specialist in the Treatment of Urinary Incontinence in Primary Care in the Netherlands.
#### Objective
Incontinence is an important health problem. Effectively treating incontinence could lead to
important health gains in patients and caregivers. Management of incontinence is currently
suboptimal, especially in elderly patients. To optimise the provision of incontinence care a
global optimum continence service specification (OCSS) was developed. The current study
evaluates the costs and effects of implementing this OCSS for community-dwelling patients
older than 65 years with four or more chronic diseases in the Netherlands.
#### Method
A decision analytic model was developed comparing the current care pathway for urinary
incontinence in the Netherlands with the pathway as described in the OCSS. The new care
strategy was operationalised as the appointment of a continence nurse specialist (NS)
located with the general practitioner (GP). This was assumed to increase case detection
and to include initial assessment and treatment by the NS. The analysis used a societal perspective,
including medical costs, containment products (out-of-pocket and paid by insurer),
home care, informal care, and implementation costs.
#### Results
With the new care strategy a QALY gain of 0.005 per patient is achieved while saving âŹ402
per patient over a 3 year period from a societal perspective. In interpreting these findings it
is important to realise that many patients are undetected, even in the new care situation
(36%), or receive care for containment only. In both of these groups no health gains were
achieved.
#### Conclusion
Implementing the OCSS in the Netherlands by locating a NS in the GP practice is likely to
reduce incontinence, improve quality of life, and reduce costs. Furth
Relationships between various characterisations of wave tails
One can define several properties of wave equations that correspond to the
absence of tails in their solutions, the most common one by far being Huygens'
principle. Not all of these definitions are equivalent, although they are
sometimes assumed to be. We analyse this issue in detail for linear scalar
waves, establishing some relationships between the various properties. Huygens'
principle is almost always equivalent to the characteristic propagation
property, and in two spacetime dimensions the latter is equivalent to the
zeroth order progressing wave propagation property. Higher order progressing
waves in general do have tails, and do not seem to admit a simple physical
characterisation, but they are nevertheless useful because of their close
association with exactly solvable two-dimensional equations.Comment: Plain TeX, 26 page
Critical raw materials and the circular economy
This report is a background document used by several European Commission services to prepare the EC report on critical raw materials and the circular economy, a commitment of the European Commission made in its Communication âEU action plan for the Circular Economyâ. It represents a JRC contribution to the Raw Material Initiative and to the EU Circular Economy Action Plan. It combines the results of several research programmes and activities of the JRC on critical raw materials in a context of circular economy, for which a large team has contributed in terms of data and knowledge developments. Circular use of critical raw materials in the EU is analysed, also taking a sectorial perspective. The following sectors are analysed in more detail: extractive waste, landfills, electric and electronic equipment, batteries, automotive, renewable energy, defence and chemicals and fertilisers. Conclusions and opportunities for further work are also presented
Emergent global oscillations in heterogeneous excitable media: The example of pancreatic beta cells
Using the standard van der Pol-FitzHugh-Nagumo excitable medium model I
demonstrate a novel generic mechanism, diversity, that provokes the emergence
of global oscillations from individually quiescent elements in heterogeneous
excitable media. This mechanism may be operating in the mammalian pancreas,
where excitable beta cells, quiescent when isolated, are found to oscillate
when coupled despite the absence of a pacemaker region.Comment: See home page http://lec.ugr.es/~julya
Young women's use of a microbicide surrogate: The complex influence of relationship characteristics and perceived male partners' evaluations
This is the post-print version of the article. The official published version can be found at the link below.Currently in clinical trials, vaginal microbicides are proposed as a female-initiated method of sexually transmitted infection prevention. Much of microbicide acceptability research has been conducted outside of the United States and frequently without consideration of the social interaction between sex partners, ignoring the complex gender and power structures often inherent in young womenâs (heterosexual) relationships. Accordingly, the purpose of this study was to build on existing microbicide research by exploring the role of male partners and relationship characteristics on young womenâs use of a microbicide surrogate, an inert vaginal moisturizer (VM), in a large city in the United States. Individual semi-structured interviews were conducted with 40 young women (18â23 years old; 85% African American; 47.5% mothers) following use of the VM during coital events for a 4 week period. Overall, the results indicated that relationship dynamics and perceptions of male partners influenced VM evaluation. These two factors suggest that relationship context will need to be considered in the promotion of vaginal microbicides. The findings offer insights into how future acceptability and use of microbicides will be influenced by gendered power dynamics. The results also underscore the importance of incorporating men into microbicide promotion efforts while encouraging a dialogue that focuses attention on power inequities that can exist in heterosexual relationships. Detailed understanding of these issues is essential for successful microbicide acceptability, social marketing, education, and use.This study was funded by a grant from National Institutes of Health (NIHU19AI 31494) as well as research awards to the first author: Friends of the Kinsey Institute Research Grant Award, Indiana Universityâs School of HPER Graduate Student Grant-in-Aid of Research Award, William L. Yarber Sexual Health Fellowship, and the Indiana University Graduate and Professional Student Organization Research Grant
Ten Misconceptions from the History of Analysis and Their Debunking
The widespread idea that infinitesimals were "eliminated" by the "great
triumvirate" of Cantor, Dedekind, and Weierstrass is refuted by an
uninterrupted chain of work on infinitesimal-enriched number systems. The
elimination claim is an oversimplification created by triumvirate followers,
who tend to view the history of analysis as a pre-ordained march toward the
radiant future of Weierstrassian epsilontics. In the present text, we document
distortions of the history of analysis stemming from the triumvirate ideology
of ontological minimalism, which identified the continuum with a single number
system. Such anachronistic distortions characterize the received interpretation
of Stevin, Leibniz, d'Alembert, Cauchy, and others.Comment: 46 pages, 4 figures; Foundations of Science (2012). arXiv admin note:
text overlap with arXiv:1108.2885 and arXiv:1110.545
Expectations and needs of patients with a chronic disease toward self-management and eHealth for self-management purposes
Background:
Self-management is considered as an essential component of chronic care by primary care professionals. eHealth is expected to play an important role in supporting patients in their self-management. For effective implementation of eHealth it is important to investigate patientsâ expectations and needs regarding self-management and eHealth. The objectives of this study are to investigate expectations and needs of people with a chronic condition regarding self-management and eHealth for self-management purposes, their willingness to use eHealth, and possible differences between patient groups regarding these topics.
Methods:
Five focus groups with people with diabetes (nâ=â14), COPD (nâ=â9), and a cardiovascular condition (nâ=â7) were conducted in this qualitative research. Separate focus groups were organized based on patientsâ chronic condition. The following themes were discussed: 1) the impact of the chronic disease on patientsâ daily life; 2) their opinions and needs regarding self-management; and 3) their expectations and needs regarding, and willingness to use, eHealth for self-management purposes. A conventional content analysis approach was used for coding.
Results:
Patient groups seem to differ in expectations and needs regarding self-management and eHealth for self-management purposes. People with diabetes reported most needs and benefits regarding self-management and were most willing to use eHealth, followed by the COPD group. People with a cardiovascular condition mentioned having fewer needs for self-management support, because their disease had little impact on their life. In all patient groups it was reported that the patient, not the care professional, should choose whether or not to use eHealth. Moreover, participants reported that eHealth should not replace, but complement personal care. Many participants reported expecting feelings of anxiety by doing measurement themselves and uncertainty about follow-up of deviant data of measurements. In addition, many participants worried about the implementation of eHealth being a consequence of budget cuts in care.
Conclusion:
This study suggests that aspects of eHealth, and the way in which it should be implemented, should be tailored to the patient. Patientsâ expected benefits of using eHealth to support self-management and their perceived controllability over their disease seem to play an important role in patientsâ willingness to use eHealth for self-management purposes
Being Transparent About Brilliant Failures:An Attempt to Use Real-World Data in a Disease Model for Patients with Castration-Resistant Prostate Cancer
Background: Real-world disease models spanning multiple treatment lines can provide insight into the (cost) effectiveness of treatment sequences in clinical practice. Objective: Our objective was to explore whether a disease model based solely on real-world data (RWD) could be used to estimate the effectiveness of treatments for patients with castration-resistant prostate cancer (CRPC) that could then be suitably used in a cost-effectiveness analysis. Methods: We developed a patient-level simulation model using patient-level data from the Dutch CAPRI registry as input parameters. Time to event (TTE) and overall survival (OS) were estimated with multivariate regression models, and type of event (i.e., next treatment or death) was estimated with multivariate logistic regression models. To test internal validity, TTE and OS from the simulation model were compared with the observed outcomes in the registry. Results: Although patient characteristics and survival outcomes of the simulated data were comparable to those in the observed data (median OS 20.6 vs. 19.8 months, respectively), the disease model was less accurate in estimating differences between treatments (median OS simulated vs. observed population: 18.6 vs. 17.9 [abiraterone acetate plus prednisone], 24.0 vs. 25.0 [enzalutamide], 20.2 vs. 18.7 [docetaxel], and 20.0 vs. 23.8 months [radium-223]). Conclusions: Overall, the disease model accurately approximated the observed data in the total CRPC population. However, the disease model was unable to predict differences in survival between treatments due to unobserved differences. Therefore, the model is not suitable for cost-effectiveness analysis of CRPC treatment. Using a combination of RWD and data from randomised controlled trials to estimate treatment effectiveness may improve the model
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