Multiple Conditions

“Multiple chronic conditions,” also known as multimorbidity, is a special situation frequently encountered by global healthcare professionals, especially internists/primary care physicians, neurologists, respiratory/pulmonologists, pain specialists, and oncologists, who spend more than three-quarters of their time in the treatment of chronic diseases and direct patient care. Thus, the increasing need for multidisciplinary approaches in the management of multiple chronic medical problems, rather than focusing on individual diseases, should be borne in mind by global healthcare professionals, public health professionals, healthcare providers, health policymakers, and pharmaceutical industries. This book is an up-to-date source of information for physicians, residents, and advanced medical students seeking a broader understanding of managing chronic disease clusters.

The objective of this conference was to foster a healthy exchange of ideas and experience in the domain of multiple criteria problem solving. This conference was an outgrowth of an earlier conference I organized with Herve Thiriez at CESA, Jouy-en-Josas, France in 1975 during my stay at the European Institute in Brussels. When I re joined the State University of New York at Buffalo that year, I be gan to search for potential sponsors for this conference. Approxi mately one year later when the prospects began to look promising, I contacted several individuals to act as an informal coordinating committee for the conference. I wanted to avoid biasing the con ference completely to my way of thinking! The members of this committee were Jim Dyer, Peter Fishburn, Ralph Kee. ney, Bernard Roy (Universite de Paris IX Dauphine who was unable to participate in the conference), and Milan Zeleny. Though the committee did not meet, per se, their inputs regarding format, possible participants, number of participants, length of the conference, and so on were of great value to me in planning and organizing the conference. I wish to acknowledge the contributions of this group. We were most fortunate in obtaining the financial support of the European Institute for Advanced Studies in Management, Brussels ·(one of the sponsors of the Jouy-en-Josas conference), the Office of Naval Research, and the State University of New York at Buffalo.

With the progress of population aging, development of medical technology, increase in life expectancy, changes in life habits, etc., the prevalence of chronic conditions is rising and their burden on individuals and society is growing rapidly(WHO,2011)1). According to a report from OECD (2010), chronic diseases are the main causes for disabilities and deaths throughout the world, as 60% of the global population is estimated to die from chronic diseases. Recently, the concern over prevalence and management of multiple chronic conditions, along with the increase in chronic conditions, is rising (Lenhert et al., 2011). Results from various studies indicate that prevalence of multiple chronic conditions occurs in more than 65% of the elderly aged 65 years or older (Lenhert et al., 2011). In Korea, 68.7% of people in their 50s have at least one chronic disease, and the ratio grows to 83.7% and 91.3% among those in their 60s and 70s, respectively (Young-Ho Jung et al., 2011)2). Among patients who have multiple chronic conditions, those in their 50s have an average of two chronic conditions, whereas those in their 60s have an average of three conditions and those in their 70s have an average of 3.5 chronic conditions (Young-Ho Jung, 2012)3). We can see that the ratios of people who have chronic conditions and multiple chronic conditions rise as they get older, and thus, management of chronic diseases is one of the key policy issues in today's society where population aging is swiftly occurring. However, there has been insufficient research on multiple chronic conditions compared to that on chronic conditions in general. Therefore, it is necessary to facilitate research on and policy attention to multiple chronic conditions. Based on this necessity, the study attempts to promote the understanding of multiple chronic conditions by analyzing the types and distribution of these conditions among the elderly patients who have multiple chronic conditions. Following chapter 1, which provides the introduction, chapter 2 presents the classification of chronic diseases and the concept of multiple chronic conditions. Chapter 3 deals with the distribution of comorbidity of major chronic conditions and use of medical care; in more concrete terms, analysis was made on the comorbidity of hypertension and heart disease, comorbidity of diabetes and heart disease, and comorbidity of hypertension and diabetes. In chapter 4, types and constitution of multiple chronic diseases among the elderly aged 65 or older and their risks were analyzed. In the study, the Health Insurance Review and Assessment Service's patient sample for 2011 was used for the analysis of multiple chronic conditions, and logistic regression was applied for the risk analysis. The final chapter provides the discussion and conclusion of the study. Contents CHAPTER 1 IntroductionCHAPTER 2 Classification of chronic conditions and concept of multiple chronic conditionsA. Classification of chronic conditionsB. Concept of multiple chronic conditionsCHAPTER 3 Distribution of comorbidity of major chronic conditions and use of medical careA. Comorbidity of hypertension and heart diseaseB. Comorbidity of diabetes and heart diseaseC. Distribution of hypertension and diabetesCHAPTER 4 Types of multiple chronic conditions of the elderlyA. Distribution of chronic conditions among the elderly 65 years of age or olderB. Types and distribution of multiple chronic conditions among the elderly aged or olderC. Analysis of the risks of multiple chronic conditions for the elderlyCHAPTER 5 Discussion and conclusion

The field of multiple criteria decision analysis (MCDA), also termed multiple criteria decision aid, or multiple criteria decision making (MCDM), has developed rapidly over the past quarter century and in the process a number of divergent schools of thought have emerged. This can make it difficult for a new entrant into the field to develop a comprehensive appreciation of the range of tools and approaches which are available to assist decision makers in dealing with the ever-present difficulties of seeking compromise or consensus between conflicting inter ests and goals, i.e. the "multiple criteria". The diversity of philosophies and models makes it equally difficult for potential users of MCDA, i.e. management scientists and/or decision makers facing problems involving conflicting goals, to gain a clear understanding of which methodologies are appropriate to their particular context. Our intention in writing this book has been to provide a compre hensive yet widely accessible overview of the main streams of thought within MCDA. We aim to provide readers with sufficient awareness of the underlying philosophies and theories, understanding of the practi cal details of the methods, and insight into practice to enable them to implement any of the approaches in an informed manner. As the title of the book indicates, our emphasis is on developing an integrated view of MCDA, which we perceive to incorporate both integration of differ ent schools of thought within MCDA, and integration of MCDA with broader management theory, science and practice.

The literature on cytokine genetics is vast, so vast that it is now practically beyond the time or logistical constraints of most scientists to successfully keep pace with it. A compilation of the latest research, Cytokine Gene Polymorphisms in Multifactorial Conditions brings together, reviews, and structures up-to-date information on polymorphisms in cytokine genes. It discusses haplotype structures and linkage disequilibrium patterns in cytokine gene loci; functional biological effects of polymorphisms; and genetic associations with disease. The book documents polymorphisms in the most important cytokine genes, or gene clusters, and their biological and genetic effects in a multitude of distinct multifactorial conditions. Unique to this book are the "disease-centered" chapters examining the role of cytokine gene polymorphisms in a multitude of multifactorial conditions. The conditions include autoimmune or chronic inflammatory diseases, cardiovascular disease, infectious diseases, and longevity. "This section is a real tour de force" (Grant Gallagher and Michael F. Seldin, March 2006). Broadening the understanding of the effect of genetic variations on human immune responses, the organization, scope, and content of this book make it a valuable and easily accessible resource. The book integrates genetic, immunological, and clinical information and will serve as a reference for novice and expert geneticists, immunologists, cell biologists and clinicians. It is a must for everyone involved in, or planning, cytokine genetics or immunogenetics studies.

This book constitutes the revised selected papers of the combined workshops on Web Information Systems Engineering, WISE 2011 and WISE 2012, held in Sydney, Australia, in October 2011 and in Paphos, Cyprus, in November 2012. The seven workshops of WISE 2011-2012 have reported the recent developments and advances in the contemporary topics in the related fields of: Advanced Reasoning Technology for e-Science (ART 2012), Cloud-Enabled Business Process Management (CeBPM 2012), Engineering in the Semantic Enterprise (ESE 2012), Social Web Analysis for Trend Detection (SoWeTrend 2012), Big Data and Cloud (BDC 2012), Personalization in Cloud and Service Computing (PC-S 2011), and User-Focused Service Engineering, Consumption and Aggregation (USECA 2011).

Database Management Systems: Understanding and Applying Database Technology focuses on the processes, methodologies, techniques, and approaches involved in database management systems (DBMSs). The book first takes a look at ANSI database standards and DBMS applications and components. Discussion focus on application components and DBMS components, implementing the dynamic relationship application, problems and benefits of dynamic relationship DBMSs, nature of a dynamic relationship application, ANSI/NDL, and DBMS standards. The manuscript then ponders on logical database, interrogation, and physical database. Topics include choosing the right interrogation language, procedure-oriented language, system control capabilities, DBMSs and language orientation, logical database components, and data definition language. The publication examines system control, including system control components, audit trails, reorganization, concurrent operations, multiple database processing, security and privacy, system control static and dynamic differences, and installation and maintenance. The text is a valuable source of information for computer engineers and researchers interested in exploring the applications of database technology.