Estimativa do custo da asma em tratamento ambulatorial especializado em unidade universitária no Sistema Único de Saúde

A asma é considerada um problema de saúde pública mundial. É necessário expandir o conhecimento sobre seus custos associados em diferentes regiões. O principal objetivo foi estimar os custos do tratamento da asma em uma população de asmáticos com diferentes níveis de gravidade, sob tratamento ambulatorial especializado. Os objetivos secundários foram analisar as características clínicas e sócio-econômicas da população e o custo incremental da associação com a rinite e infecções respiratórias (IR). Asmáticos ≥ 6 anos de idade com asma persistente foram incluídos consecutivamente de março de 2011 a setembro de 2012. Todos realizaram visitas clínicas de rotina com intervalos de 3-4 meses e 2 entrevistas com intervalos de 6 meses para coleta dados. Variáveis clínicas e dados primários sobre os custos da asma, rinite e infecções respiratórias (IR) foram coletados diretamente dos pacientes ou responsáveis (< 18 anos), sob uma perspectiva da sociedade. Os custos em reais foram convertidos em dólares usando a paridade do poder de compra em 2012 (US$ 1,00 = R$ 1,71). Cento e oito pacientes completaram o estudo, sendo 73,8% mulheres. A maioria (75,0%) reside no município do RJ, sendo que 60,1% destes moram longe da unidade de saúde. Rinite crônica estava presente em 83,3%, e mais da metade tinha sobrepeso ou obesidade, nos quais a prevalência de asma grave foi maior (p = 0,001). Metade ou mais dos trabalhadores e estudantes faltaram as suas atividades em decorrência da asma. A renda familiar mensal (RFM) média foi de US$ 915,90 (DP=879,12). O custo médio estimado da asma/rinite/IR foi de US$ 1.276,72 por paciente-ano (DP=764,14) e o custo médio específico da asma foi de US$ 1.140,94 (DP=760,87). Asmáticos obesos, graves ou não controlados tiveram maiores custos em comparação aos não obesos, moderados/leves e controlados (p <0,05 em todas as comparações). A população estudada tem nível sócio-econômico médio/baixo, alta prevalência de rinite crônica e de sobrepeso/obesidade. Maior peso e menor RFM foram mais frequentes entre os graves e não controlados, respectivamente. Asmáticos obesos, graves ou não controlados tiveram maiores custos. O custo incremental da rinite e IR foi de 12%. O custo médio da asma foi equivalente à metade do relatado na União Européia e nos Estados Unidos da América, e foi maior do que a média na região Ásia-Pacífico. Num cenário ideal, onde todos os asmáticos brasileiros recebessem tratamento no Sistema Único de Saúde de acordo com a Iniciativa Global para Asma, o custo total da asma seria equivalente a 3,4-4,5% e 0,4-0,6% do Produto Interno Bruto (PIB) da saúde e do PIB brasileiro, respectivamente. Estratégias de saúde pública com programas estruturados que facilitem o melhor controle da asma e estimulem a redução de peso poderão contribuir para reduzir os custos da doença, o que poderia tornar a oferta de tratamento medicamentoso gratuito para todos os asmáticos persistentes no SUS uma meta alcançável. Recomendamos estender este estudo de custo da asma para diferentes regiões do país.

Year 1 operational report: Improving employment and income through development of Egypt’s aquaculture sector(IEIDEAS) project

Implementation of the SDC funded project ‘Improving Employment and Income through Development of Egypt’s Aquaculture Sector’ commenced on 1st December 2011 and will continue until late 2014. This report summarizes the results of the first 10 months until 30th September 2012. The project was based on a value chain analysis carried out by WorldFish in September 2011. The information in the VCA acts as the baseline for the main project parameters. It established that the aquaculture value chain is a significant employer (14 FTE per 100 tonnes of annual production), particularly in rural areas and there was scope to increase employment of youth and women.

Determinants of small-scale fishermen's income on Oman's Batinah Coast

The small-scale fishing industry of Oman is responsible for almost 90 percent of the total marine fishery production. It is also the main supplier of fish for Omani households. This study analyzes the factors that determine small-scale fishermen’s income on Oman’s Batinah Coast, which has almost 30 percent of Oman’s population and more than one-third of the small-scale fishermen. We find that fishermen’s income here can be explained broadly under four major blocks of variables: geographical region, fishing inputs and catch, socioeconomic and demographic characteristics, and the nature of the relationship with fisheries extension services. In general, the Wilayat (local administrative units) failed to make any significant impact on fishermen’s income. The variable “Fishing inputs and catch,” such as increases in engine power, boat length, weekly catch, and number of weekly trips, positively impacted fishermen’s income while increases in weekly fishing costs, number of crew members, and difficulty in getting ice had a significantly negative effect on the income. Furthermore, socioeconomic and demographic characteristics also contributed significantly in determining the fishermen’s income level. The other important findings were related to extension services. The variables “Fishermen’s exchange of information and cooperation with the ministry” and “Fishermen’s involvement in the extension activities” were found to have positive effects on fishermen’s income levels. Capitalizing on these findings could improve fishermen’s incomes and their lives across the region, as well as nationally.

Informal fish retailing in rural Egypt: Opportunities to enhance income and work conditions for women and men

Poor rural consumers benefit from Egypt’s aquaculture sector through access to small and medium-sized farmed tilapia sold by informal fish retailers, many of whom are women. In fact, informal fish retail is the main, if not only, segment of the farmed fish value chain where women are found. This report aims to inform current and future strategies to improve conditions in informal fish retail by understanding in more depth the similarities and differences in employment quality and outcomes across different fish retailers. It is particularly focused on identifying whether and how gender inequality influences different dimensions of the work, and whether women and men have similar outcomes and employment conditions. This knowledge will help to design interventions to overcome gender-based constraints, as well as approaches that address shared obstacles and include both women and men in gender-responsive ways to ensure that all of those involved in the sector benefit.

Increasing farm income by introducing fish culture in deepwater rice environment

Fish culture in deep-water-rice (DWR) environment using net pen and polder systems was evaluated. In net pen rohu and Thai silver barb were cultured, whereas a 5-species combination (rohu, mrigal, common carp, grass carp and Thai silver barb) were cultured with BR3 rice variety and DWR. Boro-fish production system produced 2.8 t/ha of fish and 7.33 t/ha of rice in polder system with 5-species combinations.

Diversity of wetland fish and its impact on the income of fishermen community of Assam.

A survey was conducted in 3000 fishermen households surrounding 54 wetlands (Beels) of Assam. The fish diversity of the wetlands has been decreasing during the last few years due to some extrinsic and intrinsic factors. The total number of fish species recorded so far during the present study is 67 belonging to 21 families. Cyprinidae is the most dominant family represented by major group species (8), intermediate group species (3) and minor group species (12) of high commercial value. Among these three groups, the diversity of fish species is higher in the minor group fish. The present paper deals with the economic condition of the fishermen who mainly fish in the wetlands. The economic condition of the fishermen community is found very poor. The income of fishermen varies from Rs. 4.478 to Rs.7,484 per annum. A regression analysis shows that the income of fishermen is not dependent alone on the fish production but it is exclusively dependent on the value of the fish catch. All the three groups (in terms of value) have significant influence at 10.00% confidence level. But analysis of β shows that the intermediate fish group exhibits the highest influence on the variation of the fishermen income followed by minor and major group respectively.

Input-output relationship and economics of pangas monoculture and carp-pangas polyculture in two districts of Bangladesh

An attempt was made to study the input-output relationships and economics of pangas monoculture and carp-pangas polyculture in Bangladesh. By analyzing the data collected from 50 pangas farms and 55 carp-pangas farms, the study has investigated the production systems of two technologies and the effects of fingerling stocking and applications of feed and fertilizer on fisheries income. The data were collected from the fishermen of Trishal and Bhaluka of Mymensingh district, and Kahaloo and Adamdighee of Bogra district during 2001-02. For pangas monoculture, the stocking density was 31,561 per ha while it was 55,017 per ha in carp-pangas polyculture. Most of the farmers used urea, TSP and lime before stocking. Rice and wheat bran happened to be the most common feed ingredients for both types of culture in general. Other important ingredients used were mustard oil-cakes, rice polish, wheat flour, fish meal, bone meal, soybean meal and poultry litter. In terms of quantities, rice bran and wheat bran dominated the farmers list. Rice and wheat bran together constituted about 60% of all studied feeds. Feed cost constituted 59.13% of total costs for pangas monoculture and 67.44% for carp-pangas polyculture. Per ha productions of pangas and carp-pangas in a single culture cycle were 15,508 kg and 19,745 kg, respectively. Per ha gross profits were estimated to be Tk 310,311 and Tk 464,418 for pangas monoculture and carp-pangas polyculture, respectively. Net profit appeared to be Tk 264,216 per ha for pangas monoculture and Tk 416,509 per ha for carp-pangas polyculture. The BCRs calculated were 1.46 and 1.68 for monoculture and polyculture, respectively. The break-even costs per kg of fish were estimated at Tk 36.93 for pangas and Tk 30.93 for mixed species which was much lower than the prices the producers received. Break-even productions were estimated at 10,702 kg per ha for pangas monoculture and 11,784 kg per ha for carp-pangas polyculture. Fingerling and feed cost, and pond size significantly explained the variation of income from pangas monoculture. These factors have significantly influenced the income from the crop. Functional analysis shows that 1% increase in the feed cost might increase 0.51% of pangas income and 0.41% in carp-pangas income. No other inputs had shown this much of responses to increasing income from a fish.

Gross clinical signs and haematological changes associated with artifical infection of Edwardsiella tarda in Koi Carp

The occurrence of diseases is a significant setback for successful aquafarming. One of the common fish bacterial disease syndromes, Edwardsiellosis is caused by Edwardsiella tarda, a gram-negative, rod shaped bacterium associated with several diseases of marine and fresh water fish. In this study, an attempt was made to observe and analyze the onset of clinical symptoms and certain haematological parameters in Koi Carp, Cyprinus carpio L., following artificial infection with Edwardsiella tarda. The disease progress was observed and the clinical symptoms were monitored over a period of 15 days following infection. Fish were sampled at three day intervals to analyse the haematological parameters: total erythrocyte counts (RBC), total leucocyte counts (WBC), haemoglobin content and differential leucocyte count. Clinical symptoms observed included: erratic swimming behaviour, loss of appetite, haemorrhages, dropsy and exophthalmia. There was a significant decrease in the total RBC and haemoglobin levels by the 3rd and 6th day post infection, and an increase thereafter. WBC counts were higher in all infected groups in comparison to the control group. A significant increase in the number of neutrophils was found in the infected group up to the 9th day and a decrease thereafter. The lymphocyte number was significantly less up to the 12th day while the monocyte counts were significantly higher up to the 12th day post infection. The results showed that the bacterium, E. tarda, is pathogenic to Koi Carp. The hematological changes and clinical signs in infected fish reported in this paper will be helpful in the identification and the control of this infection.

基于InCoME的软件成本估算方法及支撑工具

软件成本估算领域经过四十余年的发展，涌现出一大批估算理论与方法，但都没有在现实环境中的软件企业中得到广泛应用，在项目早期进行软件成本估算仍旧是一件非常难的任务。由于估算模型的复杂性，缺乏相关的自动化的支撑工具及在现实软件企业中进行成本估算的应用研究是造成这一局面的一个重要原因。 本文从解决现实估算问题出发，提出了基于支撑工具的软件成本估算应用的具体框架。使用专家知识初始化模型，收集历史数据进行模型校准，并使用jack-knife交叉验证对模型进行精度分析。在建立可接受的模型后，收集待估算项目规模和成本因子数据，基于集成成本建模与估算（InCoME）方法，提供COCOMO、类比、回归等多种估算方法的支持。估算结果结合不确定性分析和风险分析，给项目计划和决策提供参考。成本估算应用框架形成一套完整和规范的流程，是一个现实可行的软件成本估算的解决方案。本文的另一贡献在于定制开发此应用框架的支撑工具，即集成成本建模与估算工具。在分析调研主流的软件成本估算工具的基础上，为配合估算应用框架，使用eclipse RCP和关系数据库，开发出层次清晰、可扩展性强、可维护性高、易升级易部署、界面友好的支撑工具。我们将基于支撑工具的软件成本估算应用框架应用于现实中的软件企业进行经验研究，经验研究结果表明，企业的软件成本估算得到了明显改善，支撑工具也被很好的接受。

InCoME软件成本估算工具

针对现行的成本估算软件存在算法支持不够、算法不公开、对建模支持不够等问题,提出了一种基于最优加权算法的集成软件成本估算方法InCoME,并且在此基础上采用Eclipse RCP框架、Java开发语言、HSQLDB关系数据库开发出了In-CoME成本估算软件。该软件不仅实现了驱动因子管理、集成模型支持、模型校准、模型精度分析等模块,而且还实现了基于不确定性的成本估算和风险分析功能,解决了国内一些企业急需成本估算软件等问题。

A data-model fusion approach for upscaling gross ecosystem productivity to the landscape scale based on remote sensing and flux footprint modelling

Chinese Academy of Sciences ; National Science Foundation of China [41071059]; National Key Technology R&D Program of China [2008BAK50B06-02]; National Basic Research Program of China [2010CB950900, 2010CB950704]; Natural Sciences and Engineering Research Council of Canada