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The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/readmissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings.

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Strain-displacement relations for thin shells valid for large displacements are derived. With these as a starting point approximate strain-displacement relations and equilibrium equations are derived by making certain simplifying assumptions. In particular the middle surface strains are assumed small and the rotations are assumed moderately small. The resulting equations are suitable as a basis for stability investigations or other problems in which the effects of deformation on equilibrium cannot be ignored, but in which the rotations are not too large. The linearized forms of several of the sets of equations derived herein coincide with small deflection theories in the literature. Introduction. The literature is not devoid of papers in which some of the effects of finite displacements on the deformation of thin shells are accounted for. This is most obviously the case for papers dealing with the stability of shells, but these have been concerned almost exclusively with cylinders, cones, and spheres. The differential equations governing the phenomenon have been derived specifically for these geometrical shapes. Despite the potential usefulness of a general non-linear theory, the literature on the subject is sparse. It is the purpose of the present paper to derive an exact theory for large deflections of a thin shell with an arbitrary middle surface and then, by making certain simplifying assumptions, to derive from this several approximate theories suitable for applications. Probably the earliest work of some generality is Marguerre's nonlinear theory of shallow shells [1]. Donnell [2] developed an approximate theory specifically for cylinders and suggested its extension for a general middle surface. The result, a theory for what might be termed "quasi-shallow shells", has been worked out by a number of authors, notably Mushtari and Vlosov [3]. The problem of symmetric deformations of shells of revolution has been reduced to the solution of a pair of equations analogous to the Reissner-Meissner equations by E. Reissner [4]. These several problems are adequately formulated but the general problem presents difficulties not found in the special cases. The earliest work of a completely general nature appears to be the paper by Synge and Chien [5] followed by a series of papers by Chien [6, 7]. The intrinsic theory of shells developed by Synge and Chien avoids the use of displacements as unknowns in the equations. The theory of shells is deduced from the three-dimensional theory of elasticity and then, by means of series expansions in powers of a small thickness parameter, approximate theories of thin shells are derived. A large number of problem types is found classified according to the relative orders of magnitude of various parameters. Several authors have discussed and criticized this work [8, 9, 10, 11]. An elegant and general formulation of the problem is to be found in the recent paper by Ericksen and Truesdell [8]. In this paper there is a unified treatment of thin shells and curved rods developed as two-and...