Cost-benefit of hospitalization compared with outpatient care for pregnant women with pregestational and gestational diabetes or with mild hyperglycemia, in Brazil

CONTEXTO E OBJETIVO: Gestações complicadas pelo diabetes estão associadas com aumento de complicações maternas e neonatais. Os custos hospitalares aumentam de acordo com a assistência prestada. O objetivo foi calcular o custo-benefício e a taxa de rentabilidade social da hospitalização comparada ao atendimento ambulatorial em gestantes com diabetes ou com hiperglicemia leve. DESENHO do ESTUDO: Estudo prospectivo, observacional, quantitativo, realizado em hospital universitário, sendo incluídas todas as gestantes com diabetes pregestacional e gestacional ou com hiperglicemia leve que não desenvolveram intercorrências clínicas na gestação e que tiveram parto no Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (HC-FMB-Unesp). MÉTODOS: Trinta gestantes tratadas com dieta foram acompanhadas em ambulatório e 20 tratadas com dieta e insulina foram abordadas com hospitalizações curtas e frequentes. Foram obtidos custos diretos (pessoal, material e exames) e indiretos (despesas gerais) a partir de dados contidos no prontuário e no sistema de custo por absorção do hospital e posteriormente calculado o custo-benefício. RESULTADOS: O sucesso do tratamento das gestantes diabéticas evitou o gasto de US$ 1.517,97 e US$ 1.127,43 para pacientes hospitalizadas e ambulatoriais, respectivamente. O custo-benefício da atenção hospitalizada foi US$ 143.719,16 e ambulatorial, US$ 253.267,22, com rentabilidade social 1,87 e 5,35 respectivamente. CONCLUSÃO: A análise árvore de decisão confirma que o sucesso dos tratamentos elimina custos no hospital. A relação custo-benefício indicou que o tratamento ambulatorial é economicamente mais vantajoso do que a hospitalização. A rentabilidade social de ambos os tratamentos foi maior que 1, indicando que ambos os tipos de atendimento à gestante diabética têm benefício positivo.

CPITN: time and cost estimates for periodontal prevention and treatment procedures.

The aim of this study was to estimate the necessary time and cost for periodontal prevention and treatment in a working population from sugar and alcohol refineries in Araraquara, SP, Brazil. A stratified sample of 528 employees aged 18-64 from administrative, industrial and agricultural staffs was examined by one examiner, previously trained, according to the community periodontal index of treatment needs (CPITN). The time required for procedures and the cost was extrapolated to the total worker population. The results showed that the estimated time required for periodontal prevention/treatment was 4527 hours. Of this time, 1783 hours were required for oral hygiene instruction, 2531 for scaling, 151 for surgery and 62 for maintenance. The cost would be US $17,655 for hiring a dentist for 8 hours/day to provide oral hygiene instruction, scaling, surgery and maintenance. However, the cost would be US $9,028 for hiring a dentist for 4 hours/day to provide surgery and maintenance and a dental hygienist for 8 hours/day to provide scaling and oral hygiene instruction. Taking into account epidemiologic, technical and economic aspects, the decision relating to manpower should be this second option.

Analysis of the effect of wash water reduction on bleached pulp characteristics

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Transverse cylindrical grinding of a eutectic alloy

We report herein on a comparison of the performance of two different grinding wheels (conventional and CBN) in the transverse cylindrical grinding of a eutectic alloy. Three cutting conditions were tested: rough, semi-finishing and finishing. The parameters of evaluation were the cutting force, roughness and wheel wear. The optimal cutting force and roughness values were obtained when grinding with the conventional wheel, due to the superior dressing operation performed under every cutting condition tested. Although the CBN wheel presented the best G ratio values, they were lower than expected owing to the inappropriate dressing operation applied. Excessive wheel corner wear was detected in both wheels, caused by the grinding kinematics (transverse grinding) employed. In terms of cutting force and roughness, the conventional wheel proved to be the better choice under the conditions tested. However, in terms of the G ratio, a cost analysis is crucial to determine whether the differences between the wheels justify the use of the CBN wheel, in which case the dressing operation requires improvement.

Tamanho de amostra e estimativa de custo em levantamento epidemiológico de cárie dentária

This study aimed to analyze how the prevalence and the distribution of dental caries influence the sample size in epidemiological surveys, and how much are the costs. Secondary data of oral health surveys in 12-year-old schoolchildren from Bauru in 1976, 1984, 1990, 1994, and 2001, and from Piracicaba in 2001 and 2005 were studied. Sample sizes were estimated taking into account the mean DMFT and standard deviation of each survey, establishing sampling errors of 1%, 2%, 5%, and 10%. Costs were estimated considering permanent material, consumption material and human resources. The sample size in both towns needed to be increased, ranging from 119 in 1976 to 1,118 in 2001 in Bauru, and from 954 in 2001 to 1,252 in 2005 in Piracicaba, when a sampling error of 10% was considered. The cost of dental caries surveys was verified considering different sampling errors. This cost depends on how acceptable is the margin of difference between the true mean and the one found in the survey. In conclusion, the reduction in the prevalence of dental caries has determined the need for increase in sample size and in costs for conducting the surveys.

Avaliação de custos das internações de gestantes diabéticas de um Hospital Universitário do interior de São Paulo

This study aimed at identifying the hospitalization costs of pregnant women with Diabetes Mellitus (DM) at a University Hospital. It is an observational, quantitative study with descriptive data analysis. The direct and indirect costs available in the institution were identified in order to determine the hospitalization costs for patients diagnosed with DM during pregnancy and childbirth. By means of descriptive statistics, it was observed that 63.46% of the patients had caesarean delivery; the mean total cost was R$ 362.93 (U$ 218.10)/hospitalization during pregnancy, R$ 2,642.65 (U$ 1,588.13)/hospitalization for caesarean delivery, and R$ 2.319.77 (U$ 1,394.09)/hospitalization for vaginal delivery. It was concluded that the analysis of hospitalization costs for patients with DM is of utmost importance, since they are highcomplexity hospitalizations that require a large number of interventions, increasing thus the service costs.

Haemonchus contortus: A multiple-resistant Brazilian isolate and the costs for its characterization and maintenance for research use

The aim of this work was to determine the resistance level of Haemonchus contortus isolated from the Santa Inês flock of the Embrapa (Brazilian government's Agricultural Research Company), Southeast Livestock Unit (CPPSE), as well as to determine costs of characterizing and maintaining this isolate in host donors. Forty-two male Santa Inês lambs were experimentally infected with 4000 H. contortus infective larvae of the field isolate of CPPSE, called Embrapa2010, and divided into six treatment groups, which received triclorfon, albendazol plus cobalt sulfate, ivermectin, moxidectin, closantel and levamisole phosphate, as well as a negative control group (water). Egg per gram (EPG) counts were performed at 0, 3, 7, 10 and 14. days post treatment when the animals were slaughtered for parasite count. The data were analyzed using the RESO statistical program, considering anthelmintic resistance under 95% of efficacy. EPG and worm count presented a linear and significant relation with 94% determination coefficient. The susceptibility results obtained by RESO through both criteria (EPG and worm count) were equal, except for closantel, showing that the isolate Embrapa2010 is resistant to benzimidazoles, macrocyclic lactones and imidazothiazoles. The need of a control group did not appear to be essential since the result for susceptibility in the analyses with or without this group was the same. Suppression in egg production after treatment did not occur in the ivermectin and moxidectin groups. In the control group, the establishment percentage was just 12.5 because of the low number of third-stage larvae, resistance (innate and infection immunity) of the animals studied plus good nutrition. Drug classes presented similar efficacy between adults and immature stages. The costs for isolate characterization were calculated for 42 animals during 60. days. The total cost based on local market rates was approximately US$ 8000. The precise identification of Brazilian isolates and their establishment in host donors would be useful for laboratorial anthelmintic resistance diagnoses through in vitro tests, which has an annual cost of approximately US$ 2500 for maintenance in host donors. © 2012 Elsevier B.V.

Sistemas de criação para o Acará-bandeira Pterophyllum scalare

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ciclo combinado com gaseificação integrada de biomassa – análise de penalidade exergética de emissão de CO2

Pós-graduação em Engenharia Mecânica - FEG

Comparação de modelos de custo dos produtos gerados em uma central de cogeração

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Metodologia para ensaio de sistemas de direcionamento via satélite em percursos retos e curvos

Pós-graduação em Agronomia (Energia na Agricultura) - FCA

Análise de investimento em confinamento bovino no centro-oeste brasileiro: um estudo de caso.

This study analyzed the economic viability of an investment in feedlot cattle on a farm in the midsize state of Goias. The research identified that different thematic studies whose interests have focused mainly on cost analysis and profitability punctual. Differently, this study used the approaches of the Discounted Cash Flow (DCF) and the Real Options Theory (ROT). The first used the projected cash flow for 10 years and a discount rate determined by CAPM at 8% p.a. for containment of heads 400. The second was modeled by the binomial model of Cox, Ross and Rubinstein (1979) incorporating the option of waiting. This methodology has not been employed in Brazilian cattle industry. The search results pointed to the economic viability of the project when considered possible scenarios for the different price ranges of the ox that state bushel. In addition, the TOR proved to be a more robust tool for investment analysis, by incorporating the flexibility of farmers to wait for the right time to make the confinement.

Sobre as considerações de uma concepção de um projeto de um forno cerâmico

The current competitiveness of the market has generated the need to minimize the cost of production companies in any field of activity, aimed at reducing the cost of production, the cost of purchasing and manufacturing processes interruption of manufacturing processes for possible maintenance. In this sense, companies are seeking methods to improve and streamline their production line. In ceramics industries, cooking the pieces is the portion of the production process that influences the total costs. The oven construction and maintenance represent a large portion embedded in the cost of the final ceramic product. The proposal for a type of oven for baking the parts that takes into account a better burning process, knowledge of the causes of disease and cost analysis of purchasing both of the constituent materials and labor for its construction, can be significant importance to the composition of final product costs or time analysis of ROI. It is proposed a streamlined design of an oven that takes into account the positive characteristics of the furnaces already built and that the experience has endorsed, and also others that are added at the end, lead to a reduction in production cost, the cost income and the number of pathologies arising from wear of the furnace along the lifespan. Therefore, according to the experiences gained over the years in the construction of furnaces and experience of manufacturing of ceramic, it is proposed a project that has an oven improvement over those now being built and that include, among other topics, economy in fuel burning, streamlining the building process

Análise de sistemas de máquinas térmicas em plantas de processos químicos

Pressure drop and energy efficiency of compressors in chemical plants are the focus of this study. Its objective is an analysis of possible sources of energy loss through the study of pressure loss in pipes, calculation of thermodynamic efficiency of the compressors. Important issues are raised for this analysis such as the types of compressors, the operating range of each compressor, compression types, as well as a study of accessories such as filters and valves. After studying these issues was carried out calculations of pressure drop step-bystep and with a software WIPCD. Followed by the calculation of efficiency of compressors and monthly energy cost of each compressor in operation. Finally, the study shows some suggestions for immediate improvements, changes and suggestions for possible future purchases of compressors

The impact of physical activity on mitigation of health care costs related to diabetes mellitus: findings from developed and developing settings Diabetes mellitus and physical exercise

Over the last decades, the prevalence of diabetes mellitus (DM) has been increasing globally such that nowadays the disease constitutes an important outcome related to early mortality among adults. In parallel with the high prevalence, healthcare costs related to DM treatment have increased significantly, exacerbating its burden on modern society. The scientific literature points out that obesity and physical inactivity have a central role in the development of most DM cases. In fact, either physical exercise practice or an increase in the level of physical activity, constitute relevant tools in the guidelines for treatment of the disease. On the other hand, the effect of physical activity on the economic consequences of DM is not completely clear. The identification of the actual burden of lifestyle changes on the reduction of healthcare costs related to DM is relevant, primarily for developing nations, where it could represent a cheaper strategy for treating the disease and its complications than paying for drug treatment, which is commonly related to collateral effects. That being said, the prevention of DM and other diseases and consequently the mitigation of the costs related to these outcomes seem to depend essentially on the promotion of healthy habits. The aim of the present review was therefore to discuss recent evidence on the effects of physical activity/exercise on mitigation of health care cost related to DM.