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If you are headed to Istria, the largest Croatian peninsula, by a car you may turn off the GPS device after you cross the Slovenian border. Once you get off the highway in any randomly selected exit and drive along the coast, you may see some of the towns that you previously believed to exist only on postcards. One after the other, Umag, Novigrad, Porec, Vrsar, Rovinj, Pula... History in its original form is preserved on the walls of these cities, churches, and houses. Pula forum arena or Basilica of Eupharasius are just some of the sights that you will still talk about long after you see them.
Do not turn on the GPS and take a look around – the beautiful coastal landscapes with vineyards and olive groves behind which you may see the clear blue see, landscaped urban complexes with attractive villas, distinctive Istrian houses and numerous hotels, camps and other accommodation facilities. Get out of the car, get some rest…get some color and refresh in the clean sea on some of the hundreds of well-known beaches. Take the time to visit some of the world famous sporting and cultural events such as the Pula Film Festival or the ATP tournament in Umag. You can sail to the Brijuni islands where you have the opportunity to discover the amazing fascinating National Park, or enjoy the outdoor theatre.
If, out of curiosity, you decide to go the other way, and turn towards the interior of the peninsula, you will immediately realize that the sea is not the only natural beauty of Istria. Near the traditional stone houses you will notice vineyards on three different types of clay that will make you want to taste the local wine in one of the famous Istrian “konoba.” To avoid drinking on an empty stomach, under palate will suddenly create the world’s famous ham. Travel and fascination with indigenous houses will have to briefly be interrupted in Groznjan, where you will take a break and listen to a jazz concert while wondering which fairy tale did this pearl of Istrian inland come out of. You will continue through Oprtalj and Livade truffle roads until the river Mirna valley. In Motovun you will experience the unique atmosphere of the local film festival, then go through Buzet to Roc, where through the glagolitic Alley you will arrive to the smallest town in the world – Hum.
Just when you think that you cannot be fascinated anymore, you will reach the other shore of Istria and the gazebo in the middle of the unique landscape where you can see the unique Adriatic Sea from a completely different perspective. Labin, Rabac, Icici, Opatija…You will want to stay there forever.
Results
Sample Characteristics
Sample characteristics are summarized in Table 1. Participants were largely Anglo-American (n = 145, 92%) and well educated, with 73% (n = 115) having more than a high-school education. Their mean age was 61.89 years (SD = 11.49, range 24–89). The majority had metastatic disease (n = 151, 96%) but still largely maintained good performance status, (median AKPS = 80, range 50–100). The total BQ-II score (N = 157) was M (mean) = 1.83 (SD = 0.77). Subscale scores, from highest to lowest, were harmful effects M = 2.50 (0.98), physiologic effects M = 2.17 (SD = 0.97), fatalism M = 1.11 (0.83), and communication M = 0.89 (0.98).
Forty-six participants (29%) reported never having pain because of their present disease. Among those participants who reported experiencing pain and/or using pain medications in the past week (n = 97, Table 2), the mean worst pain severity was 5.75 (SD = 2.55). Forty-one percent reported worst pain in the "severe" range and 39% reported using strong analgesics. More than half (n = 56, 58%) demonstrated adequate use of analgesics for the level of pain severity experienced. On average, participants reported mild-to-moderate pain interference with daily life (M = 3.87, SD = 2.54).
Change in Patient-related Barriers to Pain Management
We identified a total of 7 study reports that met criteria and provided data for one or more of the planned analyses (Table 3). The samples from these studies were similar to the current sample with respect to the inclusion criteria (adults, with cancer diagnosis, experiencing pain) and observed demographic and clinical characteristics. All samples included persons of both sexes, with reported mean ages of 55 to 61 years old, and a majority of the sample being Anglo-American race and having some education beyond high school. The samples were commonly comprised of a mix of persons with breast, lung, gastrointestinal, genitourinary, and gynecologic cancers.
Findings were analyzed by the publication year because most did not report the dates of recruitment and data collection. A total of 5 previous studies reported scores on the harmful effects BQ-II subscale for comparison with the current study.[4,15,23,29,40] A significant linear relationship was found between year of publication and harmful effects subscale score (B = 0.0350, R2 = 0.0347, F1,637 = 23.19, P < 0.0001). Belief that analgesics have harmful (addictive) effects increased by approximately 0.035 points per year, and a total of 0.63 points on the 0 to 5 scale since 2002. A total of 6 previous studies reported total BQ-II scores.[4,15,23,27,41,44] A significant linear relationship was found between year of publication and the BQ-II total score (B = 0.039, R 2 = 0.065, F1,923 = 73.79, P < 0.0001). Total BQ-II mean scores increased by approximately 0.039 points per year; over the 18-year span of publications, mean scores increased by 0.70 points on the 0 to 5 scale.
Relationship Between Barriers and Adequacy of Pain Management
Two of the identified studies reported the association between barriers and pain severity, one reporting correlations with the harmful effects subscale score,[29] and another reporting correlations with the total BQ-II score[15] (Table 4). Correlations between harmful effects and pain severity observed in the current sample (r = 0.13–0.22) did not differ from scores reported in 2009 (consistent pain r = 0.03–0.28; breakthrough pain r = −0.02 = 0.16).[29] Correlations between total BQ-II and pain severity (r = 0.10–0.19) and between total BQ-II and pain interference with daily life (r = 0.13) observed in the current sample did not differ from those reported in 2002 (pain severity r = 0.10–0.16; pain interference r = 0.16).[15]
One previous study described harmful effects and total BQ-II scores by the PMI category (adequate vs inadequate analgesic use).[15] In comparison with the current findings, there were no significant differences in mean score differences on the harmful effects subscale or the total BQ-II score by the PMI category (Table 5).
Two previous studies reported PMI scores for their participants.[15,44] Logistic regression analysis did not identify any change in the proportions of people in the adequate vs inadequate analgesic use categories by the year of publication (Table 6).
Pain. 2021;162(6):1840-1847. © 2021 Lippincott Williams & WilkinsGoogle Maps is, by far, the most popular navigation app on the planet, with a vast majority of global users using it almost daily. This is true even in the U.S., where Google Maps logged more than 25 million downloads in 2021. However, unlike most other countries where Google Maps is the dominant navigation app by a fair margin, the service does face stiff competition from Waze Maps.
According to Statista, Waze Maps logged more than 13 million downloads in 2021, making it clear that people in the U.S. seem to have a particular liking for Waze. The primary reason for the popularity is the app's focus on providing drivers with real-time crowdsourced information intended to help them reach their destinations as fast as possible. Given the larger number of users it has in the U.S., crowdsourced data on Waze may be more accurate than Google Maps at times.
While all this might make it sound like Waze is a significant competitor to Google Maps, the truth is that Waze is a fully-owned subsidiary of Alphabet — the company that also owns Google Maps. Waze was, in fact, acquired by Google almost a decade ago for $1.1 billion. However, Waze and its 500-odd employees were allowed to operate the service independently despite the acquisition. This status quo is about to change if we are to believe a new WSJ report. Google has reportedly made plans to merge the entirety of Waze's existing team under the team that also oversees Google Maps.
A cost-cutting measure?
The move to merge the Waze team with the Google Maps team is largely seen as a move to improve Google's efficiency. Like most other tech companies, Google has faced serious headwinds owing to the global slowdown, following which Google CEO Sundar Pichai set out on a plan to make the company more productive (via CNBC). A crucial part of Pichai's plan