Basic Model of Health Care Systems

The first version of a mathematical health care system model by IIASA's Bio-Medical Project consisted of a population block and elements for patient treatment and population screening. One of the goals of this model was to examine the possibility of redistributing health care resources between treatment and screening. The model was constructed in somewhat general terms and lacked the elaboration of its "fine structure" to become an operating model. The work presented here is a natural continuation of the modeling work commenced earlier

On a Method for Analyzing Interconnections Within Complex Systems

One of the problems that usually arises in dealing with complex systems is what to do in a complicated network of informational, organizational, and other interconnections among the elements of these systems. This paper describes a methodology that may be helpful in analyzing problems in various research areas concerning, e.g.: (a) migration flows among different geographic regions; (b) energy exchange among subsystems of large electric power networks; (c) flows of production and trade on the global or regional scale; (d) information flows among a variety of directions in scientific research, and especially links among individual scientists; (e) scheduling sections and participant lists for conferences and workshops; and (f) the psychology of grouping individual relations. Of course this list could be expanded. The author imagines that this methodology could prove useful at IIASA within the matrix framework of its research areas

Time for a Paradigm Shift: Recognizing the Critical Role of Pictures Within Literacy Learning

Broadens the definition of literacy with the help of children’s drawings and conversations. The author shows how the social practices of literacy are enacted in and through the visual

The Effects of Musical Expertise on Sensory Processing

The goal of this thesis was to assess sensorimotor musical experience and its impact on the way that individuals perceive and interact with real-world musical stimuli. Experiment #1 investigated multisensory integration in 14 musicians and 10 non-musicians using a two alternative forced-choice (2AFC) discrimination task, and was designed to examine whether musical expertise augmented multisensory enhancement. Musical experience did not alter the outcomes of multisensory integration, but there may be asymmetries between musicians and non-musicians in their use of auditory cues. Experiment #2 was a neuroimaging case study investigating the influence of musical familiarity on the kinesthetic motor imagery of dance accompanied by music in expert dancers. Familiarity resulted in increased hemodynamic responses in the supplementary motor area (SMA) and decreased responses in Heschls gyrus (HG). These findings provide new evidence regarding the influence of musical expertise on sensory processing using real-world complex stimuli. This thesis suggests that expert practice shapes the way experts perceive and interact with their environments, and emphasizes the need for, and challenges of using naturalistic stimuli

Implantable cardioverter defibrillators: Uses, abuses, gains and complications

Sudden cardiac death (SCD) due to a ventricular arrhythmia is one of the most common causes of death, yet its management continues to be a challenge. Controlled clinical trials have provided evidence that implantable cardioverter defibrillators (ICDs) are effective in reducing the risk of SCD in selected patients with ischaemic or non-ischaemic cardiomyopathy and/or ventricular arrhythmias. As increasing numbers of patients become eligible for ICDs, deciding whom should receive these becomes more complex, especially in patients with borderline risk factors and those with co-morbidities in whom the risk of death from nonarrhythmic cardiovascular cause is higher. What type of ICD a patient should receive remains a challenge. While ICD shocks themselves can affect outcomes adversely, no other therapy has proven more effective to date. Risks of implantation include infection, lead dislodgement and perforation. An ongoing challenge which also needs to be addressed includes whom will be footing the bill for device implants. More data is required to determine which patient population will benefit the most from ICD implants

Resting Sinus Heart Rate and First Degree AV block: Modifiable Risk Predictors or Epiphenomena?

Simple and cost-effective tools that identify patients at increased risk for adverse cardiovascular events are actively sought. High resting sinus heart rate and first degree AV block are easily recognized and commonly encountered findings in a cardiology practice. A growing body of epidemiological and clinical evidence has been shown them to be independent predictors of all-cause and cardiovascular mortality, both in the general population and in patients with structural heart disease. This paper reviews the important role of heart rate and first degree AV block in predicting cardiovascular outcomes, examines the pathophysiological mechanisms underlying this increased risk, and discusses the effectiveness of available therapies to favorably modify these risk factors

Third-Person Perceptions and Calls for Censorship of Flat Earth Videos on YouTube

Calls for censorship have been made in response to the proliferation of flat Earth videos on YouTube, but these videos are likely convincing to very few. Instead, people may worry these videos are brainwashing others. That individuals believe other people will be more influenced by media messages than themselves is called third-person perception (TPP), and the consequences from those perceptions, such as calls for censorship, are called third-person effects (TPE). Here, we conduct three studies that examine the flat Earth phenomenon using TPP and TPE as a theoretical framework. We first measured participants’ own perceptions of the convincingness of flat Earth arguments presented in YouTube videos and compared these to participants’ perceptions of how convincing others might find the arguments. Instead of merely looking at ratings of one’s self vs. a general ‘other,’ however, we asked people to consider a variety of identity groups who differ based on political party, religiosity, educational attainment, and area of residence (e.g., rural, urban). We found that participants’ religiosity and political party were the strongest predictors of TPP across the different identity groups. In our second and third pre-registered studies, we found support for our first study’s conclusions, and we found mixed evidence for whether TPP predict support for censoring YouTube among the public

Advances in the management of atrial fibrillation in congestive heart failure

Atrial fibrillation, a common problem in patients with heart failure, is associated with increased mortality and morbidity. Pharmacological as well as invasive management and the endpoints of such management are complex. Recent randomized trials indicate that a rate-control strategy, along with anticoagulation treatment with warfarin, when appropriate, has a similar outcome in terms of mortality and morbidity as rhythm control, and could, therefore, be considered as the primary management strategy for atrial fibrillation in patients with heart failure