Assessing chronic disease management in European health systems. Country reports

Many countries are exploring innovative approaches to redesign delivery systems to provide appropriate support to people with long-standing health problems. Central to these efforts to enhance chronic care are approaches that seek to better bridge the boundaries between professions, providers and institutions, but, as this study clearly demonstrates, countries have adopted differing strategies to design and implement such approaches. This book systematically examines experiences of 12 countries in Europe, using an explicit comparative approach and a unified framework for assessment to better understand the diverse range of contexts in which new approaches to chronic care are being implemented, and to evaluate the outcomes of these initiatives. The study focuses in on the content of these new models, which are frequently applied from different disciplinary and professional perspectives and associated with different goals and does so through analyzing approaches to self-management support, service delivery design and decision-support strategies, financing, availability and access. Significantly, it also illustrates the challenges faced by individual patients as they pass through the system. This book complements the earlier published study Assessing Chronic Disease Management in European Health Systems; it builds on the findings of the DISMEVAL project (Developing and validating DISease Management EVALuation methods for European health care systems), led by RAND Europe and funded under the European Union’s (EU) Seventh Framework Programme (FP7) (Agreement no. 223277)

Estimation Of Nonorthogonal Shear Wave Polarizations And Shear Wave Velocities From Four-Component Dipole Logs

Polarizations of split shear waves and flexural borehole waves are most commonly estimated from four-component data using the rotation technique of Alford (1986). This method is limited to the case of the two polarizations being orthogonal to each other. We present a method that is able to handle the case of nonorthogonally polarized waves and, moreover, is computationally more efficient than Alford's technique. Our method is based on the eigenvalue decomposition of an asymmetric matrix and a least-squares minimization of its off-diagonal components. In the case of orthogonally polarized waves, our method will yield exactly the same results as the Alford rotation. We apply our method to a cross-dipole shear-wave logging data set from the Powder River Basin in Wyoming and find that independently rotated source-receiver sets are very consistent with each other in anisotropic sections. After the rotation we compare two methods for estimating the phase velocities of fast and slow waves-a semblance method and homomorphic processing (Ellefsen et al., 1993). We find homomorphic processing to be more reliable due to the dispersive nature of flexural waves.Massachusetts Institute of Technology. Borehole Acoustics and Logging ConsortiumUnited States. Dept. of Energy (Contract DE-FG02-86ER13636

Assessing chronic disease management in European health systems. Concepts and approaches

This book comprises two volumes and builds on the findings of the DISMEVAL project (Developing and validating DISease Management EVALuation methods for European health care systems), funded under the European Union’s (EU) Seventh Framework Programme (FP7) (Agreement no. 223277). DISMEVAL was a three-year European collaborative project conducted between 2009 and 2011. It contributed to developing new research methods and generating the evidence base to inform decision-making in the field of chronic disease management evaluation (www.dismeval.eu). In this book, we report on the findings of the project’s first phase, capturing the diverse range of contexts in which new approaches to chronic care are being implemented and evaluating the outcomes of these initiatives using an explicit comparative approach and a unified assessment framework. In this first volume, we describe the range of approaches to chronic care adopted in 12 European countries. By reflecting on the facilitators and barriers to implementation, we aim to provide policy-makers and practitioners with a portfolio of options to advance chronic care approaches in a given policy context. In volume II (available online at http://www.euro.who.int/en/about-us/ partners/observatory/studies), we present detailed overviews of each of the 12 countries reviewed for this work and which informed the overview presented in the first volume of the book

The Rise of Certificate Transparency and Its Implications on the Internet Ecosystem

In this paper, we analyze the evolution of Certificate Transparency (CT) over time and explore the implications of exposing certificate DNS names from the perspective of security and privacy. We find that certificates in CT logs have seen exponential growth. Website support for CT has also constantly increased, with now 33% of established connections supporting CT. With the increasing deployment of CT, there are also concerns of information leakage due to all certificates being visible in CT logs. To understand this threat, we introduce a CT honeypot and show that data from CT logs is being used to identify targets for scanning campaigns only minutes after certificate issuance. We present and evaluate a methodology to learn and validate new subdomains from the vast number of domains extracted from CT logged certificates.Comment: To be published at ACM IMC 201

Drosophila simulans: a species with improved resolution in evolve and resequence studies

The combination of experimental evolution with high-throughput sequencing of pooled individuals-i.e., evolve and resequence (E&R)-is a powerful approach to study adaptation from standing genetic variation under controlled, replicated conditions. Nevertheless, E&R studies in Drosophila melanogaster have frequently resulted in inordinate numbers of candidate SNPs, particularly for complex traits. Here, we contrast the genomic signature of adaptation following ∼60 generations in a novel hot environment for D. melanogaster and D. simulans For D. simulans, the regions carrying putatively selected loci were far more distinct, and thus harbored fewer false positives, than those in D. melanogaster We propose that species without segregating inversions and higher recombination rates, such as D. simulans, are better suited for E&R studies that aim to characterize the genetic variants underlying the adaptive response.Neda Barghi, Raymond Tobler, Viola Nolte and Christian Schlöttere

Total perfusion-diffusion mismatch detected using resting-state functional MRI

Total perfusion- diffusion mismatch is a well- recognised phenomenon in patients with acute ischaemic stroke. We describe a case of total perfusion- diffusion mismatch detected using an emerging contrast- agent- free perfusion imaging technique in a young patient with acute cerebellar strok