745 resultados para cost benefit analysis


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PURPOSE: To present fundamental anatomical aspects and technical skills necessary to urethra and urinary bladder catheterization in female mice and rats. METHODS: Urethral and bladder catheterization has been widely utilized for carcinogenesis and cancer research and still remains very useful in several applications: from toxicological purposes as well as inflammatory and infectious conditions to functional aspects as bladder dynamics and vesicoureteral reflux, among many others. RESULTS: Animal models are in the center of translational research and those involving rodents are the most important nowadays due to several advantages including human reproducibility, easy handling and low cost. CONCLUSIONS: Although technical and anatomical pearls for rodent urethral and bladder access are presented as tackles to the advancement of lower urinary tract preclinical investigation in a broaden sight, restriction to female animals hampers the male microenvironment, demanding future advances.

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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.

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Reusable cardboard boxes can be ergonomically designed for internal transportation of dry products in industrial settings. In this study we compared the effects of handling a regular commercial box and two cardboard prototypes on upper limb postures through the evaluation of movements, myoelectrical activity, perceived grip acceptability and capacity for reuse. The ergonomic designs provided a more acceptable grip, safer wrist and elbow movements and lower wrist extensors and biceps activity. Biomechanical disadvantages were observed only for one of the prototypes when handling to high surface. The prototypes were durable and suitable for extensive reuse (more than 2000 handlings) in internal industrial transportation. Despite being slightly more expensive than regular cardboard, the prototypes showed good cost-benefit considering their high durability. Relevance to industry: Cardboard boxes can be efficiently redesigned for allowing safer upper limb movements and lower muscle workload in manual materials handling. New designs can also be extensively reused for internal industrial transportation with good cost-benefit. © 2012 Elsevier B.V.

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Objective: to expand the evaluation of a new ovarian response prediction index (ORPI), which was based on the AMH, AFC and age, and to verify its reability as a predictor of ovarian response to stimulation in assisted reproductive technology (ART) cycles. Methods: A total of 129 patients enrolled in the ICSI programme were included. The ORPI values were calculated by multiplying the AMH level (ng/ml) by the number of antral follicles (2-9 mm), and the result was divided by the age (years) of the patient (ORPI=(AMH × AFC)/Patient age). Results: Spearman's test revealed significant correlations (P<0.0001) between the ORPI and the number of oocytes collected and the number of follicles. Logistic regression revealed that ORPI values were significantly associated with the likelihood of collecting ≥4 oocytes (OR=45.56), ≥4 MII oocytes (OR=6.01) and ≥15 oocytes (OR=6.15; P<0.0001). Based on the ROC curves, the ORPI accurately predicted a low ovarian response (<4 oocytes retrieved; area under the curve (AUC):0.91), collection of ≥4 MII oocytes (AUC:0.85) and an excessive ovarian response (≥15 oocytes retrieved; AUC:0.89). Conclusions: The ORPI exhibited an excellent ability to predict a low ovarian response and a good ability to predict a collection of ≥ 4 MII oocytes, an excessive ovarian response. The ORPI might be used to improve the cost-benefit ratio of ovarian stimulation regimens by guiding the selection of medications and by modulating the doses and regimens according to the actual needs of the patients. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

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The marine environment offers both economic and scientific potential which are relatively untapped from a biotechnological point of view. These environments whilst harsh are ironically fragile and dependent on a harmonious life form balance. Exploitation of natural resources by exhaustive wild harvesting has obvious negative environmental consequences. From a European industry perspective marine organisms are a largely underutilised resource. This is not due to lack of interest but due to a lack of choice the industry faces for cost competitive, sustainable and environmentally conscientious product alternatives. Knowledge of the biotechnological potential of marine organisms together with the development of sustainable systems for their cultivation, processing and utilisation are essential. In 2010, the European Commission recognised this need and funded a collaborative RTD/SME project under the Framework 7-Knowledge Based Bio-Economy (KBBE) Theme 2 Programme 'Sustainable culture of marine microorganisms, algae and/or invertebrates for high value added products'. The scope of that project entitled 'Sustainable Production of Biologically Active Molecules of Marine Based Origin' (BAMMBO) is outlined. Although the Union is a global leader in many technologies, it faces increasing competition from traditional rivals and emerging economies alike and must therefore improve its innovation performance. For this reason innovation is placed at the heart of a European Horizon 2020 Strategy wherein the challenge is to connect economic performance to eco performance. This article provides a synopsis of the research activities of the BAMMBO project as they fit within the wider scope of sustainable environmentally conscientious marine resource exploitation for high-value biomolecules. © 2013 Elsevier B.V.

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This report analyses the agriculture, energy, and health sectors in Trinidad and Tobago to assess the potential economic impacts of climate change on the sectors. The fundamental aim of this report is to assist with the development of strategies to deal with the potential impact of climate change on Trinidad and Tobago. It also has the potential to provide essential input for identifying and preparing policies and strategies to help advance the Caribbean subregion closer to solving problems associated with climate change and attaining individual and regional sustainable development goals. Some of the key anticipated impacts of climate change for the Caribbean include elevated air and sea-surface temperatures, sea-level rise, possible changes in extreme events and a reduction in freshwater resources. The economic impact of climate change on the three sectors was estimated for the A2 and B2 IPCC scenarios until 2050. An exploration of various adaptation strategies was also undertaken for each sector using standard evaluation techniques. The study of the impact of climate change on the agriculture sector focused on root crops, green vegetables and fisheries. For these sectors combined, the cumulative loss under the A2 scenario is calculated as approximately B$2.24 and approximately B$1.72 under the B2 scenario by 2050. This is equivalent to 1.37% and 1.05% of the 2008 GDP under the A2 and B2 scenarios, respectively. Given the potential for significant damage to the agriculture sector a large number of potential adaptation measures were considered. Out of these a short-list of 10 potential options were selected by applying 10 evaluation criteria. All of the adaptation strategies showed positive benefits. The analysis indicate that the options with the highest net benefits are: (1) Building on-farm water storage, (2) Mainstreaming climate change issues into agricultural management and (3) Using drip irrigation. Other attractive options include water harvesting. The policy decisions by governments should include these assessments, the omitted intangible benefits, as well as the provision of other social goals such as employment. The analysis of the energy sector has shown that the economic impact of climate change during 2011-2050 is similar under the A2 (US$142.88 million) and B2 (US$134.83 million) scenarios with A2 scenario having a slightly higher cost (0.737% of 2009 GDP) than the B2 scenario (0.695% of 2009 GDP) for the period. On the supply side, analyses indicate that Trinidad and Tobago’s energy sector will be susceptible to the climate change policies of major energy-importing countries (the United States of America and China), and especially to their renewable energy strategies. Implementation of foreign oil substitution policy by the United States of America will result in a decline in Trinidad and Tobago’s Liquefied Natural Gas (LNG) export (equivalent to 2.2% reduction in 2009 GDP) unless an alternative market is secured for the lost United States of America market. China, with its rapid economic growth and the highest population in the world, offers a potential replacement market for Trinidad and Tobago’s LNG export. In this context the A2 scenario will offer the best option for Trinidad and Tobago’s energy sector. The cost-benefit analysis undertaken on selected adaptation strategies reveal that the benefit-cost ratio of replacing electric water heaters with solar water heaters is the most cost-effective. It was also found that the introduction of Compact Fluorescent Light (CFL) and Variable Refrigerant Volume (VRV) air conditioners surpasses the projected cost of increased electricity consumption due to climate change, and provides an economic rationale for the adoption of these adaptation options even in a situation of increased electricity consumption occasioned by climate change. Finally, the conversion of motor fleets to Compressed Natural Gas (CNG) is a cost-effective adaptation option for the transport sector, although it has a high initial cost of implementation and the highest per capita among the four adaptation options evaluated. To investigate the effect of climate change on the health sector dengue fever, leptospirosis, food borne illnesses, and gastroenteritis were examined. The total number of new dengue cases for the period 2008 to 2050 was 204,786 for BAU, 153,725 for A2 and 131,890 for the B2 scenario. With regard to the results for leptospirosis, A2 and B2 seem to be following a similar path with total number of new cases in the A2 scenario being 9,727 and 9,218 cases under the B2 scenario. Although incidence levels in the BAU scenario coincided with those of A2 and B2 prior to 2020, they are somewhat lower post 2020. A similar picture emerges for the scenarios as they relate to food-borne illnesses and to gastroenteritis. Specifically for food-borne illnesses, the BAU scenario recorded 27,537 cases, the A2 recorded 28,568 cases and the B2 recorded 28,679 cases. The focus on the selected sources of morbidity in the health sector has highlighted the fact that the vulnerability of the country’s health sector to climate change does not depend solely on exogenously derived impacts, but also on the behaviour and practices among the population. It is clear that the vulnerability which became evident in the analysis of the impacts on dengue fever, leptospirosis and food-borne illnesses is not restricted solely to climate or other external factors. The most important adaptation strategy being recommended targets lifestyle, behaviour and attitude changes. The population needs to be encouraged to alter their behaviours and practices so as to minimise their exposure to harmful outcomes as it relates to the incidence of these diseases.

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Water security which is essential to life and livelihood, health and sanitation, is determined not only by the water resource, but also by the quality of water, the ability to store surplus from precipitation and runoff, as well as access to and affordability of supply. All of these measures have financial implications for national budgets. The water sector in the context of the assessment and discussion on the impact of climate change in this paper includes consideration of the existing as well as the projected available water resource and the demand in terms of: quantity and quality of surface and ground water, water supply infrastructure - collection, storage, treatment, distribution, and potential for adaptation. Wastewater management infrastructure is also considered a component of the water sector. Saint Vincent and the Grenadines has two distinct hydrological regimes: mainland St Vincent is one of the wetter islands of the eastern Caribbean whereas the Grenadines have a drier climate than St Vincent. Surface water is the primary source of water supply on St Vincent, whereas the Grenadines depend on man-made catchments, rainwater harvesting, wells, and desalination. The island state is considered already water stressed as marked seasonality in rainfall, inadequate supply infrastructure, and institutional capacity constrains water supply. Economic modelling approaches were implemented to estimate sectoral demand and supply between 2011 and 2050. Residential, tourism and domestic demand were analysed for the A2, B2 and BAU scenarios. In each of the three scenarios – A2, B2 and BAU Saint Vincent and the Grenadines will have a water gap represented by the difference between the two curves during the forecast period of 2011 and 2050. The amount of water required increases steadily between 2011 and 2050 implying an increasing demand on the country‘s resources as reflected by the fact that the water supply that is available cannot respond adequately to the demand. The Global Water Partnership in its 2005 policy brief suggested that the best way for countries to build the capacity to adapt to climate change will be to improve their ability to cope with today‘s climate variability (GWP, 2005). This suggestion is most applicable for St Vincent and the Grenadines, as the variability being experienced has already placed the island nation under water stress. Strategic priorities should therefore be adopted to increase water production, increase efficiency, strengthen the institutional framework, and decrease wastage. Cost benefit analysis was stymied by data availability, but the ―no-regrets approach‖ which intimates that adaptation measures will be beneficial to the land, people and economy of Saint Vincent and the Grenadines with or without climate change should be adopted.

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The Bahamas is at great risk and vulnerability given its geographical features as a low-lying, sea encircled country. If projected sea level rise is reached by 2050, between 10-12% of territory will be lost, especially in coastal zones where the main tourism assets are located. Vulnerability could also be manifested if flight carbon emission taxes are established in the main source markets, representing an economic threat to the tourism sector for the islands. The impact of climate change on main tourism demand variables will cause some losses to the country‟s income and government revenues. This would be acting conjointly with some local threats to tourism assets and trends in future global tourism demand. The second and no less important threat is tropical cyclones, which may be associated with raising sea level. Estimations posited the amount of losses in excess of 2400 million US$ for the four decades under examination. It is to be pointed out that there is still a lack of comparatively accurate data collection and analysis on this subject, a point deserving more attention in order to deepen the understanding of, and to extract better lessons from these extreme events. In the same period, total estimated impacts of progressive climate change are between 17 and 19 billions of B$ with estimated discount rates applied. The Bahamas is a Small Island Developing State with low growth on GHG emissions (second in Latin America), as well as a relative short capacity to lower emissions in the future. The country has a relative delay in the application of renewable energy systems, a solution that, provided documented studies on-site, might turn out to be fundamental in the country‟s efforts to establish mitigation related policies. The Bahamas currently has institutions and organizations that deal with climate change-related issues and an important number of measures and courses of action have been set up by the government. Nevertheless, more coordination among them is needed and should include international institutions. This coordination is essential even for the first steps, i.e. to conduct studies with a bottom-up approach in order to draw more accurate programs on adaptation and mitigation. It is fundamental for tourism to keep track of potential losses in tourist attractions (and to act accordingly), related to correspondent losses in biodiversity, water resources and coastal erosion. Also, actions to fight climate change impacts might improve the islands security standards, quality of living and protect cultural and heritage assets. These elements may definitely shape the future of the country‟s competitiveness as a tourism destination. It is possible and necessary to decide about the options with good cost-benefit ratio and reasonable payback periods, notwithstanding that cost-benefit analysis requires more refined and accurate data to provide precise and locally adapted options.

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This report provides an analysis and evaluation of the likely effects of climate change on the tourism sector in Montserrat. Clayton (2009) identifies three reasons why the Caribbean should be concerned about the potential effects of climate change on tourism: (a) the relatively high dependence on tourism as a source of foreign exchange and employment; (b) the intrinsic vulnerability of small islands and their infrastructure (e.g. hotels and resorts) to sea level rise and extreme climatic events (e.g. hurricanes and floods); and, (c) the high dependence of the regional tourist industry on carbon-based fuels (both to bring tourist to the region as well as to provide support services in the region). The effects of climate change are already being felt on the island. Between 1970 and 2009, there was a rise in the number of relatively hot days experienced on the island. Added to this, there was also a decline in mean precipitation over the period. Besides temperature, there is also the threat of wind speeds. Since the early 20th century, the number of hurricanes passing through the Caribbean has risen from about 5-6 per year to more than 25 in some years of the twenty-first century. In Montserrat, the estimated damage from four windstorms (including hurricanes) affecting the island was US$260 million or almost five times 2009 gross domestic product (GDP). Climate change is also likely to significantly affect coral reefs. Hoegh-Guldberg (2007) estimates that should current concentrations of carbon dioxide in the Earth’s atmosphere rise from 380ppm to 560ppm, decreases in coral calcification and growth by 40% are likely. The report attempted to quantify the likely effects of the changes in the climatic factors mentioned above. As it relates to temperature and other climatic variables, a tourism climatic index that captures the elements of climate that impact on a destination’s experience was constructed. The index was calculated using historical observations as well as those under two likely climate scenarios: A2 and B2. The results suggest that under both scenarios, the island’s key tourism climatic features will likely decline and therefore negatively impact on the destination experience of visitors. Including this tourism climatic index in a tourism demand model suggests that this would translate into losses of around 145% of GDP. As it relates to coral reefs, the value of the damage due to the loss of coral reefs was estimated at 7.6 times GDP, while the damage due to land loss for the tourism industry was 45% of GDP. The total cost of climate change for the tourism industry was therefore projected to be 9.6 times 2009 GDP over a 40-year horizon. Given the potential for significant damage to the industry, a large number of potential adaptation measures were considered. Out of these, a short-list of 9 potential options was selected using 10 evaluation criteria. These included: (a) Increasing recommended design wind speeds for new tourism-related structures; (b) Construction of water storage tanks; (c) Irrigation network that allows for the recycling of waste water; (d) Enhanced reef monitoring systems to provide early warning alerts of bleaching events; (e) Deployment of artificial reefs and fish-aggregating devices; (f) Developing national evacuation and rescue plans; (g) Introduction of alternative attractions; (h) Providing re-training for displaced tourism workers, and; (i) Revised policies related to financing national tourism offices to accommodate the new climatic realities Using cost-benefit analysis, three options were put forward as being financially viable and ready for immediate implementation: (a) Increase recommended design speeds for new tourism-related structures; (b) Enhance reef monitoring systems to provide early warning alerts of bleaching events, and; (c) Deploy artificial reefs or fish-aggregating devices. While these options had positive benefit cost ratios, other options were also recommended based on their non-tangible benefits: an irrigation network that allows for the recycling of waste water, development of national evacuation and rescue plans, providing retraining for displaced tourism workers and the revision of policies related to financing national tourism offices to accommodate the new climatic realities.

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Pós-graduação em Educação - FFC

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The study aimed to identify pharmacoeconomic studies in pharmacovigilance and to observe the economic outcomes in post-marketing surveillance. Therefore, a bibliographic survey was performed in databases Lilacs, PubMed/ Bireme. The search strategy was done by using scientific health descriptors [ "adverse drug reaction reporting systems " OR " medication errors " OR "product surveillance, postmarketing" OR " sentinel surveillance" ] AND [ " cost-benefit analysis" OR "cost efficiency analysis " OR " costs and cost analysis " OR " hospital costs " OR " cost-effectiveness " OR " cost-effectiveness evaluation " OR " drug costs " ]. Manuscripts published in the last 10 years were selected. We chose 13 articles, of which 12 corresponded to cost-benefit analysis and only one to cost-effectiveness assessment. In only one study there was no economy, all the other ones generated savings, ranging from 13.7 to 30% in spending valued service. Surveillance actions were: continuing education; active search through tracking devices and / or implementation of round; teamwork and multidisciplinary deployment; computerized security services management, enabling traceability of information and alerts. The results of the proposed actions have led to the prevention of adverse drug reactions, to decline of risks to the patient, to the reduction of inappropriate prescriptions, as well as the length of hospital stay spending valued service. Surveillance actions were: continuing education; active search through tracking devices and / or implementation of round; teamwork and multidisciplinary deployment; computerized security services management, enabling traceability of information and alerts. The results of the proposed actions have led to the prevention of adverse drug reactions, to decline of risks to the patient, to the reduction of inappropriate prescriptions, as well as the length of hospital stay

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The objective of this paper is to present a benefit-cost ranking of 127 civil transport aircraft; this ranking was determined considering a new data envelopment analysis (DEA) approach, called triple index, which combines three assessment methods: 1) standard frontier, 2) inverted index; 3) cross-multiplicative index. The analysis used the following inputs: a) market price; b) direct operating costs; and as outputs: a) payload, b) cruise speed; c) maximum rate of climb with a single engine. To ensure the homogeneity of the units, the aircrafts were divided according to the propulsion system (jet and turboprop) and size (regional, narrow-body and wide-body); they were also evaluated according to different ranges in order to identify the aircraft with the best cost-benefit relationship for each option.

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The aim of this study was to present the contributions of the systematic review of economic evaluations to the development of a national study on childhood hepatitis A vaccination. A literature review was performed in EMBASE, MEDLINE, WOPEC, HealthSTAR, SciELO and LILACS from 1995 to 2010. Most of the studies (8 of 10) showed favorable cost-effectiveness results. Sensitivity analysis indicated that the most important parameters for the results were cost of the vaccine, hepatitis A incidence, and medical costs of the disease. Variability was observed in methodological characteristics and estimates of key variables among the 10 studies reviewed. It is not possible to generalize results or transfer epidemiological estimates of resource utilization and costs associated with hepatitis A to the local context. Systematic review of economic evaluation studies of hepatitis A vaccine demonstrated the need for a national analysis and provided input for the development of a new decision-making model for Brazil.

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We need a large amount of energy to make our homes pleasantly warm in winter and cool in summer. If we also consider the energy losses that occur through roofs, perimeter walls and windows, it would be more appropriate to speak of waste than consumption. The solution would be to build passive houses, i.e. buildings more efficient and environmentally friendly, able to ensure a drastic reduction of electricity and heating bills. Recently, the increase of public awareness about global warming and environmental pollution problems have “finally” opened wide possibility in the field of sustainable construction by encouraging new renewable methods for heating and cooling space. Shallow geothermal allows to exploit the renewable heat reservoir, present in the soil at depths between 15 and 20 m, for air-conditioning of buildings, using a ground source heat pump. This thesis focuses on the design of an air-conditioning system with geothermal heat pump coupled to energy piles, i.e. piles with internal heat exchangers, for a typical Italian-family building, on the basis of a geological-technical report about a plot of Bologna’s plain provided by Geo-Net s.r.l. The study has involved a preliminary static sizing of the piles in order to calculate their length and number, then the project was completed making the energy sizing, where it has been verified if the building energy needs were met with the static solution obtained. Finally the attention was focused on the technical and economical validity compared to a traditional system (cost-benefit analysis) and on the problem of the uncertainty data design and their effects on the operating and initial costs of the system (sensitivity analysis). To evaluate the performance of the thermal system and the potential use of the piles was also used the PILESIM2 software, designed by Dr. Pahud of the SUPSI’s school.