Cost of schizophrenia: direct costs and use of resources in the State of São Paulo

OBJECTIVE: To estimate the direct costs of schizophrenia for the public sector. METHODS: A study was carried out in the state of São Paulo, Brazil, during 1998. Data from the medical literature and governmental research bodies were gathered for estimating the total number of schizophrenia patients covered by the Brazilian Unified Health System. A decision tree was built based on an estimated distribution of patients under different types of psychiatric care. Medical charts from public hospitals and outpatient services were used to estimate the resources used over a one-year period. Direct costs were calculated by attributing monetary values for each resource used. RESULTS: Of all patients, 81.5% were covered by the public sector and distributed as follows: 6.0% in psychiatric hospital admissions, 23.0% in outpatient care, and 71.0% without regular treatment. The total direct cost of schizophrenia was US$191,781,327 (2.2% of the total health care expenditure in the state). Of this total, 11.0% was spent on outpatient care and 79.2% went for inpatient care. CONCLUSIONS: Most schizophrenia patients in the state of São Paulo receive no regular treatment. The study findings point out to the importance of investing in research aimed at improving the resource allocation for the treatment of mental disorders in Brazil.

Lipid content of frozen fish: comparison of different extraction methods and variability during freezing storage

In this work, a microwave-assisted extraction (MAE) methodology was compared with several conventional extraction methods (Soxhlet, Bligh & Dyer, modified Bligh & Dyer, Folch, modified Folch, Hara & Radin, Roese-Gottlieb) for quantification of total lipid content of three fish species: horse mackerel (Trachurus trachurus), chub mackerel (Scomber japonicus), and sardine (Sardina pilchardus). The influence of species, extraction method and frozen storage time (varying from fresh to 9 months of freezing) on total lipid content was analysed in detail. The efficiencies of methods MAE, Bligh & Dyer, Folch, modified Folch and Hara & Radin were the highest and although they were not statistically different, differences existed in terms of variability, with MAE showing the highest repeatability (CV = 0.034). Roese-Gottlieb, Soxhlet, and modified Bligh & Dyer methods were very poor in terms of efficiency as well as repeatability (CV between 0.13 and 0.18).

Gaseificação de resíduos: uma alternativa de gestão de resíduos sólidos urbanos na Região Autónoma dos Açores

Dissertação de Mestrado, Ambiente, Saúde e Segurança, 18 de Fevereiro de 2011, Universidade dos Açores.

Concepção de uma instalação frigorífica com atmosfera controlada para a conservação de uvas de mesa

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

Produção de hidrogénio por fotoeletrólise da água – aproveitamento do subproduto oxigénio

A noção de Economia relativa ao Hidrogénio no vocabulário dos líderes políticos e empresariais tem vindo a mudar sobretudo pela preocupação da poluição global, segurança energética e mudanças climáticas, para além do crescente domínio técnico dos cientistas e engenheiros. O interesse neste composto, que é o elemento mais simples e abundante no universo, está a crescer, devido aos avanços tecnológicos das células de combustível – as potenciais sucessoras das baterias dos aparelhos portáteis eletrónicos, centrais elétricas e motores de combustão interna. Existem métodos já bem desenvolvidos para produzir o hidrogénio. Contudo, destacase a eletrólise da água, não só por ser um método simples mas porque pode utilizar recursos energéticos renováveis, tais como, o vento ou os painéis fotovoltaicos, e aumentar a sua eficiência. Os desafios para melhorar a utilização deste método consistem em reduzir o consumo, a manutenção e os custos energéticos e aumentar a confiança, a durabilidade e a segurança. Mais ainda, consistem em rentabilizar o subproduto oxigénio pois é um gás industrial e medicinal muito importante. Neste trabalho, estudou-se a viabilidade económica da instalação de uma unidade de produção de hidrogénio e oxigénio puros por eletrólise da água, utilizando como fonte energética a energia solar, na empresa Gasoxmed – Gases Medicinais S.A., pretendendo num futuro próximo, comercializar o hidrogénio como fonte de energia, e por outro lado, aproveitar o subproduto oxigénio para utilização industrial. Projetou-se assim uma unidade utilizando um eletrolisador da marca Proton, modelo C30, com capacidade de produção gasosa de 3 kg/h (30 m3/h) de hidrogénio e 20 kg/h (15 m3/h) de oxigénio. Os gases produzidos são comprimidos num compressor da marca RIX a 200 bares para posterior armazenamento em cilindros pressurizados. Dimensionou-se ainda um sistema de miniprodução fotovoltaico com potência 250 kW para alimentar eletricamente a instalação. A realização do projeto na nova área de produção necessitará de 1.713.963€, os quais serão adquiridos por empréstimo bancário. Definiram-se todos os custos fixos associados ao projeto que perfazem um total de 62.554€/mês para os primeiros 5 anos (duração do crédito bancário) findo o qual diminuirão para 21.204€/mês. Da comercialização do hidrogénio, do oxigénio industrial e da eletricidade produzida no sistema de miniprodução de 250 kW, prevê-se um lucro mensal de 117.925€, perfazendo assim um total líquido mensal positivo de 55.371€ durante os primeiros 5 anos e a partir daí de 96.721€/mês, resultando uma amortização do investimento inicial no final do 3º ano.

Utilização de materiais anti-vibráteis e de isolamento acústico na via férrea

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Vias de Comunicação e Transportes

Direct medical costs associated with schizophrenia relapses in health care services in the city of São Paulo

OBJECTIVE: To assess direct medical costs associated with schizophrenia relapses in mental health services. METHODS: The study was conducted in three health facilities in the city of São Paulo: a public state hospital; a Brazilian National Health System (SUS)-contracted hospital; and a community mental health center. Medical records of 90 patients with schizophrenia who received care in 2006 were reviewed. Information on inpatient expenditures was collected and used for cost estimates. RESULTS: Mean direct medical cost of schizophrenia relapses per patient was US$ 4,083.50 (R$ 8,167.58) in the public state hospital; US$ 2,302.76 (R$ 4,605.46) in the community mental health center; and US$ 1,198.50 (R$ 2,397.74) in the SUS-affiliated hospital. The main component was daily inpatient room rates (87% - 98%). Medication costs varied depending on the use of typical or atypical antipsychotic drugs. Atypical antipsychotic drugs were more often used in the community mental health center. CONCLUSIONS: Costs associated with schizophrenia relapses support investments in antipsychotic drugs and strategies to reduce disease relapse and the need for mental health inpatient services. Treating patients in a community mental health center was associated with medium costs and added the benefit of not depriving these patients from family life.

Planeamento de curto prazo de sistemas de energia solar usando técnicas de otimização robusta

Dissertação para obtenção do grau de Mestre em Engenharia Electrotécnica

Integration of an automatic storage and retrieval system (ASRS) in a discrete-part automation system

This technical report describes the work carried out in a project within the ERASMUS programme. The objective of this project was the Integration of an Automatic Warehouse in a Discrete-Part Automation System. The discrete-part automation system located at the LASCRI (Critical Systems) laboratory at ISEP was extended with automatic storage and retrieval of the manufacturing parts, through the integration of an automatic warehouse and an automatic guided vehicle (AGV).

Energy storage systems (sistemas de armazenamento de energia)

O armazenamento de energia pode ser efetuado sobre cinco categorias, designadamente, elétrica, eletromecânica, mecânica, térmica e química. Contudo, o assunto aqui debatido é sobre meios de armazenamento de energia elétrica, sendo que o armazenamento de eletricidade é usualmente efetuado recorrendo a outros géneros de energia, tais como, química, mecânica, térmica ou, até, em energia potencial. [1]. Há nos dias de hoje uma crescente preocupação na forma como é gerido o setor elétrico, uma vez que este implica um elevado impacto ambiental. Neste sentido tem havido algumas alterações, nomeadamente, no que diz respeito à produção de energia elétrica. A utilização de energias renováveis estão cada vez mais presentes na produção de eletricidade (Figura 1), pois permitem diminuir de forma indireta a utilização dos combustíveis fósseis, sendo esta a principal vantagem face às centrais de produção convencionais.

Projeto de uma instalação frigorífica

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

Direct treatment costs of HIV/AIDS in Portugal

OBJECTIVE To analyze the direct medical costs of HIV/AIDS in Portugal from the perspective of the National Health Service. METHODS A retrospective analysis of medical records was conducted for 150 patients from five specialized centers in Portugal in 2008. Data on utilization of medical resources during 12 months and patients’ characteristics were collected. A unit cost was applied to each care component using official sources and accounting data from National Health Service hospitals. RESULTS The average cost of treatment was 14,277 €/patient/year. The main cost-driver was antiretroviral treatment (€ 9,598), followed by hospitalization costs (€ 1,323). Treatment costs increased with the severity of disease from € 11,901 (> 500 CD4 cells/µl) to € 23,351 (CD4 count ≤ 50 cells/ µl). Cost progression was mainly due to the increase in hospitalization costs, while antiretroviral treatment costs remained stable over disease stages. CONCLUSIONS The high burden related to antiretroviral treatment is counterbalanced by relatively low hospitalization costs, which, however, increase with severity of disease. The relatively modest progression of total costs highlights that alternative public health strategies that do not affect transmission of disease may only have a limited impact on expenditure, since treatment costs are largely dominated by constant antiretroviral treatment costs.

Lifestyle factors, direct and indirect costs for a Brazilian airline company

OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

Impact of a price-maker pumped storage hydro unit on the integration of wind energy in power systems

The increasing integration of larger amounts of wind energy into power systems raises important operational issues, such as the balance between power generation and demand. The pumped storage hydro (PSH) units are one possible solution to mitigate this problem, once they can store the excess of energy in the periods of higher generation and lower demand. However, the behaviour of a PSH unit may differ considerably from the expected in terms of wind power integration when it operates in a liberalized electricity market under a price-maker context. In this regard, this paper models and computes the optimal PSH weekly scheduling in a price-taker and price-maker scenarios, either when the PSH unit operates in standalone and integrated in a portfolio of other generation assets. Results show that the price-maker standalone PSH will integrate less wind power in comparison with the price-taker situation. Moreover, when the PSH unit is integrated in a portfolio with a base load power plant, the role of the price elasticity of demand may completely change the operational profile of the PSH unit. (C) 2014 Elsevier Ltd. All rights reserved.

Polio inactivated vaccine costs into routine childhood immunization in Brazil

OBJECTIVE To analyze the costs of vaccination regimens for introducing inactivated polio vaccine in routine immunization in Brazil.METHODS A cost analysis was conducted for vaccines in five vaccination regimens, including inactivated polio vaccine, compared with the oral polio vaccine-only regimen. The costs of the vaccines were estimated for routine use and for the “National Immunization Days”, during when the oral polio vaccine is administered to children aged less than five years, independent of their vaccine status, and the strategic stock of inactivated polio vaccine. The presented estimated costs are of 2011.RESULTS The annual costs of the oral vaccine-only program (routine and two National Immunization Days) were estimated at US$19,873,170. The incremental costs of inclusion of the inactivated vaccine depended on the number of vaccine doses, presentation of the vaccine (bottles with single dose or ten doses), and number of “National Immunization Days” carried out. The cost of the regimen adopted with two doses of inactivated vaccine followed by three doses of oral vaccine and one “National Immunization Day” was estimated at US$29,653,539. The concomitant replacement of the DTPw/Hib and HepB vaccines with the pentavalent vaccine enabled the introduction of the inactivated polio without increasing the number of injections or number of visits needed to complete the vaccination.CONCLUSIONS The introduction of the inactivated vaccine increased the annual costs of the polio vaccines by 49.2% compared with the oral vaccine-only regimen. This increase represented 1.13% of the expenditure of the National Immunization Program on the purchase of vaccines in 2011.