America's Policy towards Iraq

2002 ◽  
Vol 58 (2) ◽  
pp. 1-14
Author(s):  
K.P. Fabian
Keyword(s):  
Economic Sanctions ◽  
Direct Consequence ◽  
Morbidity And Mortality ◽  
Definition Of

“I had been instructed to implement a policy that satisfies the definition of genocide, a deliberate policy that has effectively killed well over a million individuals, children and adults.” (Dennis Halliday, UN Humanitarian Coordinator in Iraq, 1997–98). “More than one million Iraqis have died −500,000 of them children as a direct consequence of economic sanctions. As many as 12% of the children surveyed in Baghdad are wasted, 28% stunted, and 29% underweight”. (Morbidity and Mortality among Iraqi Children, 1990–98, FAO, December 1999).

Merit-based Claim Adjudication for Cancer Treatment Toxicities – Policy Trends that Lower Downstream Costs

2018 ◽  
Vol 47 (4) ◽  
pp. 236-248
Author(s):  
Ricky McCullough
Keyword(s):  
Cancer Treatment ◽  
Medical Condition ◽  
Therapeutic Option ◽  
Health Benefit ◽  
Direct Consequence ◽  
Economic Benefits ◽  
Morbidity And Mortality ◽  
Patient Morbidity ◽  
Policy Trend ◽  
Definition Of

Background.—Due largely to the lack of effective therapeutic options, between 1973-2013, chemoradiation toxic mucositis (CRTM) has remained an uncapped expenditure for 40 years, with incremental costs of $17,000-$40,000 per patient per episode. Costs in patient morbidity and mortality have continued as well. A recent therapeutic option associated with complete prevention and/or rapid sustained elimination (high potency polymerized cross-linked sucralfate, HPPCLS) delivers value by eliminating downstream costs CRTM experienced in the first 12 months. While many insurers carry the therapy as a specialty pharmacy support drug, few are familiar with the associated health economic benefits and the statutory requirements driving its coverage. Purpose.—To present the rationale behind early policy trends that frame CRTM as an emergent/urgent medical condition mandated coverage as an essential health benefit. Rather than problematic for costs, this coverage trend appears to be value-based. Methods.—Discuss early adverse claim experience of HPPCLS. Present the costs, tenets and statutes driving policy trend toward obligatory coverage of CRTM. Review the ethical (fiduciary) and statutory requirements for CRTM coverage. Results.—CRTM coverage is ethically responsible since it is a direct consequence of authorized cancer treatment. The symptom/signs complex of CRTM meets the ‘prudent layperson’ statutory definition of emergency medical condition. All previously uncapped downstream costs of CRTM can be reduced to the cost of therapy, saving $15-$30K per patient per CRTM episode. Conclusions.—Policy trend of CRTM coverage as an emergent/urgent medical condition is a value-based approach of toxicity management, conserving resources, cutting costs and eliminating patient morbidity and mortality.

scholarly journals An Investigation of Economic Sanctions and Its Implications for Africa

2018 ◽  
Vol 11 (3) ◽  
pp. 74
Author(s):  
Frederick Appiah Afriyie ◽  
Jisong Jian
Keyword(s):  
Civil Wars ◽  
Economic Sanctions ◽  
The United States ◽  
West African ◽  
African Continent ◽  
The European Union ◽  
Negative Effects ◽  
Policy Tool ◽  
The Us ◽  
Definition Of

Economic sanctions are not only applied to countries in Africa by the United Nations (UN), the European Union (EU) and the United States (US) but also by the African Union (AU) and the Economic Community of West African States (ECOWAS) as well. The African continent is considered to be the most affected in terms of the influences of more economic sanctions from the UN, EU, and the U.S than any other continent across the globe and these sanctions normally comes into force as a result of conflicts, civil wars and also unconstitutional overthrow of a constitutionally elected government. Also these sanctions come to serve as a punishment and a deterrent to those who deviate from or go against internationally agreed laws.Undeniably, in recent years economic sanctions have become more effective and an efficient known foreign policy tool used as the number one alternative to halt wars or military takeovers.Despite economic sanctions being widely accepted by the international community as the most effective panacea and also a preferred choice, when it is imposed on a state, it has serious repercussions on the innocent citizens while the initiators or the main officials in various positions for whom these sanctions were intended for are always left off the hook.This paper therefore investigates the merits and the demerits that are associated with economic sanctions both within some countries on the African continent and the non-African continent. In addition, we will elaborate on the implications of such sanctions relative to the Africa Continent. The paper is divided into four sections. The first section of this paper elaborates on the introduction, the importance of economic sanctions and the types of sanctions. The second section deals with the definition of economic sanction, explains the sanction process at EU, AU, UN and the US and the final part looks at both the positive and negative effects of economic sanctions.

scholarly journals Trauma-Induced Coagulopathy

2019 ◽  
Vol 39 (01) ◽  
pp. 020-027 ◽  
Author(s):  
Sirak Petros
Keyword(s):  
Protein C ◽  
Damage Control ◽  
Activated Protein C ◽  
Underlying Disease ◽  
Morbidity And Mortality ◽  
Short Discussion ◽  
Trauma Induced Coagulopathy ◽  
Therapeutic Principles ◽  
Definition Of ◽  
Later Phase

AbstractTrauma-induced coagulopathy (TIC) is a heterogeneous entity that contributes to a significant morbidity and mortality following trauma. The activated protein C system, endotheliopathy and platelet dysfunction have been implicated in the pathogenesis of TIC, although there are still controversies on the exact pathogenesis. TIC can be modified by hypoperfusion, acidosis, hypothermia, haemodilution, underlying disease conditions, pre-injury medications as well as genetic predispositions. Current definition of this syndrome is based on laboratory abnormalities that do not easily allow a distinction between adaptive and maladaptive changes of the haemostatic system. The management of the coagulopathy in the early phase of trauma focuses on the treatment of bleeding. The improving quality in the early damage control following trauma has led to a marked reduction in morbidity and mortality. In the later phase, hypercoagulopathy and inflammation contribute to organ dysfunction, venous thromboembolism and poor outcome. Despite considerable advances in trauma management, TIC remains a diagnostic and therapeutic challenge both in the early and late phases of trauma. This review mainly focuses on the pathogenesis of TIC, with a very short discussion on diagnostic and therapeutic principles.

Should Vasopressors Be Started Early in Septic Shock?

2021 ◽  
Vol 42 (05) ◽  
pp. 683-688
Author(s):  
Luca Cioccari ◽  
Stephan M. Jakob ◽  
Jukka Takala
Keyword(s):  
Septic Shock ◽  
Tissue Perfusion ◽  
Conclusive Evidence ◽  
Morbidity And Mortality ◽  
Blood Pressure Targets ◽  
Source Of Infection ◽  
Increased Risk ◽  
Resuscitation Strategy ◽  
Definition Of ◽  
Persistent Hypotension

AbstractSepsis can influence blood volume, its distribution, vascular tone, and cardiac function. Persistent hypotension or the need for vasopressors after volume resuscitation is part of the definition of septic shock. Since increased positive fluid balance has been associated with increased morbidity and mortality in sepsis, timing of vasopressors in the treatment of septic shock seems crucial. However, conclusive evidence on timing and sequence of interventions with the goal to restore tissue perfusion is lacking. The aim of this narrative review is to depict the pathophysiology of hypotension in sepsis, evaluate how common interventions to treat hypotension interfere with physiology, and to give a resume of the results from clinical studies focusing on targets and timing of vasopressor in sepsis. The majority of studies comparing early versus late administration of vasopressors in septic shock are rather small, single-center, and retrospective. The range of “early” is between 1 and 12 hours. The available studies suggest a mean arterial pressure of 60 to 65 mm Hg as a threshold for increased risk of morbidity and mortality, whereas higher blood pressure targets do not seem to add further benefits. The data, albeit mostly from observational studies, speak for combining vasopressors with fluids rather “early” in the treatment of septic shock (within a 0–3-hour window). Nevertheless, the optimal resuscitation strategy should take into account the source of infection, the pathophysiology, the time and clinical course preceding the diagnosis of sepsis, and also comorbidities and sepsis-induced organ dysfunction.

scholarly journals Generalized solutions to bounded-confidence models

2021 ◽  
pp. 1-40
Author(s):  
Benedetto Piccoli ◽  
Francesco Rossi
Keyword(s):  
Differential Equations ◽  
Social Dynamics ◽  
Initial Conditions ◽  
Direct Consequence ◽  
Point Of View ◽  
Generalized Solutions ◽  
Multi Agent Systems ◽  
Bounded Confidence ◽  
Analytical Point ◽  
Definition Of

Bounded-confidence models in social dynamics describe multi-agent systems, where each individual interacts only locally with others. Several models are written as systems of ordinary differential equations (ODEs) with discontinuous right-hand side: this is a direct consequence of restricting interactions to a bounded region with non-vanishing strength at the boundary. Various works in the literature analyzed properties of solutions, such as barycenter invariance and clustering. On the other side, the problem of giving a precise definition of solution, from an analytical point of view, was often overlooked. However, a rich literature proposing different concepts of solution to discontinuous differential equations is available. Using several concepts of solution, we show how existence is granted under general assumptions, while uniqueness may fail even in dimension one, but holds for almost every initial conditions. Consequently, various properties of solutions depend on the useddefinition and initial conditions.

scholarly journals Approximate Reciprocal Relationship Between Two Cause-Specific Hazard Ratios in COVID-19 Data With Mutually Exclusive Events

2021 ◽  
Author(s):  
Sirin Cetin ◽  
Ayse Ulgen ◽  
Hakan Sivgin ◽  
Wentian Li
Keyword(s):  
Survival Data ◽  
Direct Consequence ◽  
Reciprocal Relationship ◽  
Quantitative Relation ◽  
Reciprocal Relation ◽  
Time To Event ◽  
Slow Recovery ◽  
Special Situation ◽  
Hazard Ratios ◽  
Definition Of

ABSTRACTCOVID-19 survival data presents a special situation where not only the time-to-event period is short, but also the two events or outcome types, death and release from hospital, are mutually exclusive, leading to two cause-specific hazard ratios (csHRd and csHRr). The eventual mortality/release outcome can also be analyzed by logistic regression to obtain odds-ratio (OR). We have the following three empirical observations concerning csHRd, csHRr and OR: (1) The magnitude of OR is an upper limit of the csHRd: | log(OR) | ≥ | log(csHRd)|. This relationship between OR and HR might be understood from the definition of the two quantities; (2) csHRd and csHRr point in opposite directions: log(csHRd)· log(csHRr) < 0; This relation is a direct consequence of the nature of the two events; and (3) there is a tendency for a reciprocal relation between csHRd and csHRr: csHRd ∼ 1/csHRr. Though an approximate reciprocal trend between the two hazard ratios is in indication that the same factor causing faster death also lead to slow recovery by a similar mechanism, and vice versa, a quantitative relation between csHRd and csHRr in this context is not obvious. These resutls may help future analyses of COVID-19 data, in particular if the deceased samples are lacking.

Application of diffraction instrumental monitoring to the analysis of diffraction patterns from a Round Robin project on KCl

2001 ◽  
Vol 16 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Giovanni Berti
Keyword(s):  
Cell Parameter ◽  
Direct Consequence ◽  
Lattice Parameter ◽  
Round Robin ◽  
X Ray Diffraction ◽  
X Ray ◽  
Standard Values ◽  
Instrumental Monitoring ◽  
Diffraction Patterns ◽  
Definition Of

The outcome of the analysis of data from a Round Robin on a KCl sample is reported. The research project has led to a definition of a working protocol for the treatment of X-ray diffraction data from powders (XRPD). The protocol is based on the method of “Diffraction Instrumental Monitoring” (DIM), whose main characteristics are briefly illustrated. When experimental data are referred to the expected standard values of the lattice parameter, the method enables comparison with data obtained from differing instrumentation found in different laboratories. Application of DIM to the KCl Round Robin demonstrates the ability of DIM to effectively evaluate systematic contribution. Accuracy on the cell parameter is obtained as a direct consequence; in this application, where the knowledge of the KCl d-spacing was not a problem, the accuracy of lattice parameter is a feedback for constraining the evaluation of the effective values of the experiment-related parameters.

scholarly journals Skipping Breakfast and the Risk of Cardiovascular Disease and Death: A Systematic Review of Prospective Cohort Studies in Primary Prevention Settings

2019 ◽  
Vol 6 (3) ◽  
pp. 30 ◽  
Author(s):  
Richard Ofori-Asenso ◽  
Alice J. Owen ◽  
Danny Liew
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Prospective Cohort Studies ◽  
Cardiovascular Morbidity And Mortality ◽  
Different Populations ◽  
Definition Of ◽  
Skipping Breakfast

Several studies have associated skipping (not having) breakfast with cardiometabolic risk factors such as obesity, high blood pressure, unfavorable lipid profiles, diabetes, and metabolic syndrome. We examined the available evidence regarding the effect of skipping breakfast on cardiovascular morbidity and mortality, as well as all-cause mortality. Medline, Embase, and Web of Science were searched from inception until May 2019 to identify prospective cohort studies that examined the association between skipping breakfast and the risk of cardiovascular morbidity and mortality and all-cause death. Electronic searches were supplemented by manual screening of the references of retrieved studies. Out of 456 citations identified, four studies (from Japan and the US) were included. The included studies involved a total of 199,634 adults (aged ≥40 years; 48.5% female) without known cardiovascular disease (CVD) at baseline followed over a median duration of 17.4 years. The pooled data suggested that people who regularly skipped breakfast were about 21% more likely (hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.08–1.35; I2 = 17.3%, p = 0.304) to experience incident CVD or die from it than people who regularly consumed breakfast. Also, the risk of all-cause death was 32% higher (HR 1.32, 95% CI 1.17–1.48; I2 = 7.6%, p = 0.339) in people who regularly skipped breakfast than in people who regularly consumed breakfast. However, the definition of skipping breakfast was heterogenous and adjustment for confounders varied significantly. Therefore, residual confounding could not be ruled out and caution is required in the interpretation of the findings. Hence, large prospective studies with a consistent definition of skipping breakfast, and conducted across different populations, are needed to provide more robust evidence of the health effects of skipping breakfast.

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