The epidemiology, healthcare and societal burden and costs of asthma in the UK and its member nations: analyses of standalone and linked national databases

Background: There are a lack of reliable data on the epidemiology and associated burden and costs of asthma. We sought to provide the first UK-wide estimates of the epidemiology, healthcare utilisation and costs of asthma. 

Methods: We obtained and analysed asthma-relevant data from 27 datasets: these comprised national health surveys for 2010-11, and routine administrative, health and social care datasets for 2011-12; 2011-12 costs were estimated in pounds sterling using economic modelling. 

Results: The prevalence of asthma depended on the definition and data source used. The UK lifetime prevalence of patient-reported symptoms suggestive of asthma was 29.5 % (95 % CI, 27.7-31.3; n = 18.5 million (m) people) and 15.6 % (14.3-16.9, n = 9.8 m) for patient-reported clinician-diagnosed asthma. The annual prevalence of patient-reported clinician-diagnosed-and-treated asthma was 9.6 % (8.9-10.3, n = 6.0 m) and of clinician-reported, diagnosed-and-treated asthma 5.7 % (5.7-5.7; n = 3.6 m). Asthma resulted in at least 6.3 m primary care consultations, 93,000 hospital in-patient episodes, 1800 intensive-care unit episodes and 36,800 disability living allowance claims. The costs of asthma were estimated at least £1.1 billion: 74 % of these costs were for provision of primary care services (60 % prescribing, 14 % consultations), 13 % for disability claims, and 12 % for hospital care. There were 1160 asthma deaths. 

Conclusions: Asthma is very common and is responsible for considerable morbidity, healthcare utilisation and financial costs to the UK public sector. Greater policy focus on primary care provision is needed to reduce the risk of asthma exacerbations, hospitalisations and deaths, and reduce costs.

‘Abuse of Rights’ in Belgian and French Patent Law – A Case Law Analysis

This paper examines what types of actions undertaken by patent holders have been considered as abusive in the framework of French and Belgian patent litigation. Particular attention is given to the principle of the prohibition of “abuse of rights” (AoR). In the jurisdictions under scrutiny, the principle of AoR is essentially a jurisprudential construction in cases where judges faced a particular set of circumstances for which no codified rules were available. To investigate how judges deal with the prohibition of AoR in patent litigation and taking into account the jurisprudential nature of the principle, an in-depth and comparative case law analysis has been conducted. Although the number of cases in which patent holders have been sanctioned for such abuses is not overabundant, they do provide sufficient leads on what is understood by Belgian and French courts to constitute an abuse of patent rights. From this comparative analysis, useful lessons can be learned for the interpretation of the ambiguous notion of ‘abuse’ from a broader perspective.

Do Individuals or Firms Matter More? The Case of Patent Generation

This paper studies the relative importance of individual inventors’ human capital and firms’ organizational capital in promoting a firm’s innovation output. We decompose the variation in innovation output into inventor- and firm-specific components. Inventors’ human capital is about 13 times as important as firms’ organizational capital in explaining a firm’s innovation performance in terms of patent counts and citations, while inventors’ human capital is only about the same as important when explaining the firm’s innovation styles in terms of patent exploratory and exploitive scores. In the cross section, inventors contribute more to innovation output when they are better networked, in firms with higher inventor mobility, in industries in which innovation is more difficult to achieve, and in publicly traded firms. Additional tests suggest that our main findings continue to hold after accounting for inventors’ endogenous moving. This paper highlights the importance of individual inventors in enhancing firm innovation and sheds new light on the theory of the firm.

Standard Essential Patent in Telecommunication Standard: United States and China Comparison

Thesis (Ph.D.)--University of Washington, 2016-08

Mothers’ perception of recovery and satisfaction with patent medicine dealers’ treatment of childhood febrile conditions in rural communities

Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend. Methods Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05. Results Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727). Conclusions Mothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.

Modulation of sea surface temperature warming in the Bay of Biscay by Loire and Gironde Rivers

The influence of Loire and Gironde River discharges over the sea surface temperature (SST) in the eastern Bay of Biscay (0.6º–36.6ºW, 44.2º–47.8ºW) was analyzed by means of two complementary databases (MODIS and OISST1/4). The area influenced by river plume showed a different SST when compared with the adjacent oceanic area for the months when the plume attains its highest extension (December, January, and February). Ocean was observed to warm at a rate of approximately 0.3ºC dec−1 while temperature at the area influenced by the rivers cooled at a rate of −0.15ºC dec−1 over the period 1982–2014. The mere presence of a freshwater layer is able to modulate the warming observed at adjacent ocean locations since the coastal area is isolated from the rest of the Bay. This nearshore strip is the only part of the Bay where changes in SST depend on North Atlantic Oscillation (NAO) but not on North Atlantic SST represented by the Atlantic Multidecadal Oscillation (AMO). These different cooling-warming trends are even more patent over the last years (2002–2014) under atmospheric favorable conditions for plume enhancement. River runoff increased at a rate on the order of 120 m3s−1dec−1 over that period and southwesterly winds, which favor the confinement of the plume, showed a positive and significant trend both in duration and intensity. Thus, the coastal strip has been observed to cool at a rate of −0.5°C dec−1.

Protecting databases from schema disclosure: a CRUD-based protection model

Database schemas, in many organizations, are considered one of the critical assets to be protected. From database schemas, it is not only possible to infer the information being collected but also the way organizations manage their businesses and/or activities. One of the ways to disclose database schemas is through the Create, Read, Update and Delete (CRUD) expressions. In fact, their use can follow strict security rules or be unregulated by malicious users. In the first case, users are required to master database schemas. This can be critical when applications that access the database directly, which we call database interface applications (DIA), are developed by third party organizations via outsourcing. In the second case, users can disclose partially or totally database schemas following malicious algorithms based on CRUD expressions. To overcome this vulnerability, we propose a new technique where CRUD expressions cannot be directly manipulated by DIAs any more. Whenever a DIA starts-up, the associated database server generates a random codified token for each CRUD expression and sends it to the DIA that the database servers can use to execute the correspondent CRUD expression. In order to validate our proposal, we present a conceptual architectural model and a proof of concept.

Topographical map of Jersey City, Hoboken, and the adjacent country : describing minutely the courses of rivers and brooks, the township and original patent lines, railways, turnpike, carriage and bridle roads, the present farm boundaries with the names of their proprietors : a correct plan of public grounds and gentlemen's country seats, the position of farm houses, forests, swamps, and marshes, showing a complete view of the face of the country /

Shows cadastral and topographic data (land tracts with proprietors' names) in unurbanized areas.

Information Analysis and Databases

Means to automate the fact replace the man in their job functions for a man and machines automatic mechanism, ie documentary specialists in computer and computers are the cornerstone of any modern system of documentation and information. From this point of view immediately raises the problem of deciding what resources should be applied to solve the specific problem in each specific case. We will not let alone to propose quick fixes or recipes in order to decide what to do in any case. The solution depends on repeat for each particular problem. What we want is to move some points that can serve as a basis for reflection to help find the best solution possible, once the problem is defined correctly. The first thing to do before starting any automated system project is to define exactly the domain you want to cover and assess with greater precision possible importance.

TRIPS and Special & Differential Treatment – Revisiting the Case for Derogations in Applying Patent Protection for Pharmaceuticals in Developing Count

In this paper we apply an implicit threshold approach, malleable to the principle of graduation, to identify countries that should benefit from derogations from WTO TRIPS commitments for pharmaceutical patents under the tenets of Special and Differential Treatment. This is based on the identification of four broad constraints loosely classified as; economic constraints; access topharmaceuticals; capacity constraints; and incidence of health outcomes. We identify these by means of analytical criteria and create a composite index that ranks countries according to the observed constraints which delimit the capabilities and desirability of implementing TRIPs disciplines. We discuss the use of negotiated weights and thresholds in determining participation and graduation into general provisions of the agreement. It follows that countries below the chosen threshold should be exempt from these hence receiving Special and Differential Treatment.

Is there a case to be made for a global patent system? The example of plant biotechnology

The assessment of patterns of patentability in plant biotechnology on the basis of existing statistics shows a considerable concentration of patents to a few countries, in particular the United States, Australia, Japan, China, Mexico, Brazil, Germany, Canada, New Zealand, South Korea, India, Spain and Hungary. These patterns suggest that there is a clear relationship between the choice of patent jurisdictions and the biotechnology regulatory framework. This observation of the geographic distribution of biotechnology patents lends credence to maintaining a system of territorial rights that allow for regulatory competition, but continuing the process of substantive patent law harmonization which potentially minimize trade barriers.

High-Dose Oral Ibuprofen in Treatment of Patent Ductus Arteriosus in Full-Term Neonates

Background: Patent ductus arteriosus (PDA) is an important risk for heart failure due to left to right shunt in term neonates. Objectives: In this study, we evaluated the effect of high dose ibuprofen in closure of PDA in term neonates. Patients and Methods: We used double dose ibuprofen (20 mg/kg, 10 mg/kg, and 10 mg/kg) for 3 - 30 day old term neonates with PDA who were admitted in the neonatal wards of Shiraz University of Medical Sciences. The results of this study were compared to the data of the previous study in our center which used the low dose of ibuprofen (10 mg/kg, 5 mg/kg, and 5 mg/kg). Results: 29 full term neonates received high-dose ibuprofen, in 18 neonates, PDA was closed after 4 days (62.1% versus 43.3% for the standard dose and 4.7% for the control group in the previous study) (P = 0.001). The results showed no significant correlation between the closure rate and gestational age, postnatal age, sex, and weight. In the 4th day of treatment, size of the pulmonic end of ductus arteriosus decreased from 2.09 mm to 0.77 mm compared to 1.68 mm to 0.81 mm in the standard dose of oral ibuprofen and 2.1 mm to 1.4 mm in the control group (P = 0.046). Conclusions: This study indicated that high-dose oral ibuprofen was more effective in closing or decreasing the size of PDA.

An investigation of imputation methods for discrete databases and multi-variate time series

When it comes to information sets in real life, often pieces of the whole set may not be available. This problem can find its origin in various reasons, describing therefore different patterns. In the literature, this problem is known as Missing Data. This issue can be fixed in various ways, from not taking into consideration incomplete observations, to guessing what those values originally were, or just ignoring the fact that some values are missing. The methods used to estimate missing data are called Imputation Methods. The work presented in this thesis has two main goals. The first one is to determine whether any kind of interactions exists between Missing Data, Imputation Methods and Supervised Classification algorithms, when they are applied together. For this first problem we consider a scenario in which the databases used are discrete, understanding discrete as that it is assumed that there is no relation between observations. These datasets underwent processes involving different combina- tions of the three components mentioned. The outcome showed that the missing data pattern strongly influences the outcome produced by a classifier. Also, in some of the cases, the complex imputation techniques investigated in the thesis were able to obtain better results than simple ones. The second goal of this work is to propose a new imputation strategy, but this time we constrain the specifications of the previous problem to a special kind of datasets, the multivariate Time Series. We designed new imputation techniques for this particular domain, and combined them with some of the contrasted strategies tested in the pre- vious chapter of this thesis. The time series also were subjected to processes involving missing data and imputation to finally propose an overall better imputation method. In the final chapter of this work, a real-world example is presented, describing a wa- ter quality prediction problem. The databases that characterized this problem had their own original latent values, which provides a real-world benchmark to test the algorithms developed in this thesis.

Databases for quantitative history

This paper will propose that, rather than sitting on silos of data, historians that utilise quantitative methods should endeavour to make their data accessible through databases, and treat this as a new form of bibliographic entry. Of course in many instances historical data does not lend itself easily to the creation of such data sets. With this in mind some of the issues regarding normalising raw historical data will be looked at with reference to current work on nineteenth century Irish trade. These issues encompass (but are not limited to) measurement systems, geographic locations, and potential problems that may arise in attempting to unify disaggregated sources. It will discuss the need for a concerted effort by historians to define what is required from digital resources for them to be considered accurate, and to what extent the normalisation requirements for database systems may conflict with the desire for accuracy. Many of the issues that the historian may encounter engaging with databases will be common to all historians, and there would be merit in having defined standards for referencing items, such as people, places, locations, and measurements.