Regulatory ambivalence and the limitations of pharmaceutical policy in Spain

Broadly speaking, pharmaceutical policy in Spain has been unable to control either the price or thevolume of drugs prescribed. Limited attempts have been made to bring together the regulation of thepharmaceutical market and policies, in pursuit of the desired goals of efficiency and quality. Thispaper assesses the regulation of the Spanish pharmaceutical market over the last two decades byexamining regulation and policy and the available empirical evidence on their appreciable effects,and presents recommendations for policy design. Our findings suggest that policies aiming to improveefficiency and quality have not managed to contain costs, while cost-effectiveness is still overlooked.We argue that future policies should encourage broader participation in the decision-making processesand promote a higher degree of competition, especially from generic drugs.

Supply chain management: An opportunity for metaheuristics

In today s highly competitive and global marketplace the pressure onorganizations to find new ways to create and deliver value to customersgrows ever stronger. In the last two decades, logistics and supply chainhas moved to the center stage. There has been a growing recognition thatit is through an effective management of the logistics function and thesupply chain that the goal of cost reduction and service enhancement canbe achieved. The key to success in Supply Chain Management (SCM) requireheavy emphasis on integration of activities, cooperation, coordination andinformation sharing throughout the entire supply chain, from suppliers tocustomers. To be able to respond to the challenge of integration there isthe need of sophisticated decision support systems based on powerfulmathematical models and solution techniques, together with the advancesin information and communication technologies. The industry and the academiahave become increasingly interested in SCM to be able to respond to theproblems and issues posed by the changes in the logistics and supply chain.We present a brief discussion on the important issues in SCM. We then arguethat metaheuristics can play an important role in solving complex supplychain related problems derived by the importance of designing and managingthe entire supply chain as a single entity. We will focus specially on theIterated Local Search, Tabu Search and Scatter Search as the ones, but notlimited to, with great potential to be used on solving the SCM relatedproblems. We will present briefly some successful applications.

Stochastic uncoupled dynamics and Nash equilibrium

In this paper we consider dynamic processes, in repeated games, that are subject to the natural informational restriction of uncoupledness. We study the almost sure convergence to Nash equilibria, and present a number of possibility and impossibility results. Basically, we show that if in addition to random moves some recall is introduced, then successful search procedures that are uncoupled can be devised. In particular, to get almost sure convergence to pure Nash equilibria when these exist, it su±ces to recall the last two periods of play.

Diversity and regional inequalities: Assessing the outcomes of the Spanish 'System of Health Care Services'

The consolidation of a universal health system coupled with a process of regionaldevolution characterise the institutional reforms of the National Health System(NHS) in Spain in the last two decades. However, scarce empirical evidence hasbeen reported on the effects of both changes in health inputs, outputs andoutcomes, both at the country and at the regional level. This paper examinesthe empirical evidence on regional diversity, efficiency and inequality ofthese changes in the Spanish NHS using cross-correlation, panel data andexpenditure decomposition analysis. Results suggest that besides significantheterogeneity, once we take into account region-specific needs there is evidenceof efficiency improvements whilst inequalities in inputs and outcomes, althoughmore visible , do not appear to have increased in the last decade. Therefore,the devolution process in the Spanish Health System offers an interesting casefor the experimentation of health reforms related to regional diversity butcompatible with the nature of a public NHS, with no sizeable regionalinequalitiest.

Trends in prevalence, awareness, treatment and control of hypertension in the Republic of Seychelles (African region) between 1989 and 2013 [Poster]

Background: Few data exist on secular trends of high blood pressure (HBP) detection and control in low and middle income countries, particularly in the African region. This study examines trends of HBP over 25 years based on 4 independent population surveys. In the Seychelles, heath care is free to all inhabitants within a national health system, inclusive all HBP medications. Previous studies have shown a transition from traditional to cardiometabolic cardiovascular risk factors in Seychelles. Age adjusted cardiovascular disease mortality rates is high but decreasing over the last two decades.

TCR signaling requirements for activating T cells and for generating memory.

Over the last two decades the molecular and cellular mechanisms underlying T cell activation, expansion, differentiation, and memory formation have been intensively investigated. These studies revealed that the generation of memory T cells is critically impacted by a number of factors, including the magnitude of the inflammatory response and cytokine production, the type of dendritic cell [DC] that presents the pathogen derived antigen, their maturation status, and the concomitant provision of costimulation. Nevertheless, the primary stimulus leading to T cell activation is generated through the T cell receptor [TCR] following its engagement with a peptide MHC ligand [pMHC]. The purpose of this review is to highlight classical and recent findings on how antigen recognition, the degree of TCR stimulation, and intracellular signal transduction pathways impact the formation of effector and memory T cells.

O Impacto dos Impostos no Orçamento das Câmaras Municipais: o Caso do Município do Tarrafal de Santiago

O objectivo deste trabalho é desenvolver uma breve contextualização sobre o impacto dos impostos nos orçamentos das Autarquias Locais em Cabo Verde e a forma como as receitas recebidas pelo Estado central são depois distribuídas aos municípios. Convém ainda salientar que este trabalho visa analisar as políticas fiscais e os impostos em particular. Nele ir-se-á demonstrar e comprovar a contribuição das autarquias locais no desenvolvimento de Cabo Verde e a necessidade de serem transferidos mais recursos às câmaras municipais, visando maior e melhor desenvolvimento do país, tendo em conta a experiência acumulada durante as duas últimas décadas. Por outro lado, o presente estudo tem a finalidade de diagnosticar os principais problemas financeiros com que as autarquias locais se debatem, o que sugere a adopção de um conjunto de alterações nos actuais instrumentos financeiros. Algumas medidas aqui previstas, podem e devem ser adoptadas de imediato pelas autarquias locais. Desde logo, o estudo do Sistema Tributário visa promover a difusão de procedimentos amparados por lei com a finalidade de auxiliar os profissionais e ajudá-los a ampliar a sua participação individual na consolidação da autonomia financeira dos municípios. Há claramente avanços em matéria legislativa, mas é preciso aprovar um novo modelo, cuja aplicação irá trazer, seguramente, maiores benefícios para o país, porquanto reclama por um desenvolvimento mais equilibrado e promoverá uma equidade inter-geracional muito mais ampla.

Hidraulica Agricola e Desenvolvimento Rural - Estudos e Projetos - Relatorio Detalhado Integrador e Critico da Actividades Profissional

on agricultural hydraulics and rural development has been the main activity of the author in the last two decades. A large part of the professional career was devoted to studies and design of hydraulic infrastructures for the establishment of irrigation in Portugal. The recent years of his professional career focused on the internationalization of consulting services by drafting general plans, technical advises, design projects, training and specialized technical assistance to farmers and technicians. Angola and Cape Verde have been the stage of action. The present document was written with two main objectives: to obtain a Master of Science degree and to share with the community some relevant aspects of author’s work experience. The document was structured to emphasize three major units: the agricultural hydraulics, rural development and studies and projects. For these units were selected groups of activities considered relevant to the author's career: Alqueva Multi-Purpose Scheme, Rehabilitation and Modernization of Hydro-agricultural Schemes, Other Studies and Projects, Master Plans and Reports and Agriculture and Rural Development. In every activity is highlighted the aspects considered most important and which reflect the author's experience.

Novas Pragas Agrícolas na Ilha de São Nicolau - Cabo Verde - Tuta absoluta (Meyrick) (Lep - Gelechiidae) e Bactrocera invadens (Drew, Tsuruta & White) (Dipt - Tephritidae)

Em algumas das ilhas do Arquipélago de Cabo Verde entraram, nos últimos dois anos, espécies invasoras que constituem pragas de culturas agrícolas e que têm apresentado elevada repercussão económica. Entre elas contam-se a traça do tomateiro, Tuta absoluta (Meyrick) (Lepidoptera: Gelechidae) e Bactrocera invadens (Drew, Tsuruta & White) (Diptera: Tephritidae). Com o objectivo de avaliar a presença destas pragas na ilha de São Nicolau, foram instaladas armadilhas com atractivos em quatro zonas com bananeiras (Ribeira Prata, Fajã, Maiama e Campo de Preguiça) para a monitorização da mosca da fruta. Foram também instaladas ensaios em seis parcelas de tomateiro para a comparação de estratégias de protecção contra T. absoluta, armadilha com feromona sexual para captura em massa em conjunto com Bacillus thuringiensis e tratamento com deltametrina. Das quatro zonas monitorizadas, B. invadens só foi encontrada no Vale da Fajã. No que diz respeito a T. absoluta, fez-se a comparação entre a população presente em três estratos do tomateiro e não se encontraram diferenças significativas. As estratégias de protecção contra T. absoluta também não diferiram significativamente no que se refere ao número de minas nas folhas e frutos furados. Nesidiocoris tenuis foi identificado como inimigo natural de T. absoluta presente na ilha.

Social spending and demographics: The role of public policies in the intergenerational redistribution of income. Empirical evidence from Spain and Catalonia

The demographic shift underway in Southern Europe requires a revision of some of thefundamental principles of the traditional welfare state. We analyze the evolution of several aspects of welfare and social expenditure over the last two decades. We find that in the context of the present demographic changes and real estate boom current social and pension policy leads to a new distribution of benefits and burdens which is highly intergenerationally unequal. We argue for a revised definition of public policy based on Musgrave's proposition as a possible rule for an intergenerationally fair distribution.

Essays on the history of Brazilian dipterology: II. notices about Brazilian Diptera (17th century)

Essays on the history of Brazilian dipterology. II. Notices about Brazilian Diptera (17th century). Notices from the Brazilian Diptera from the 17th century come mainly from two foreign invasions occurred in Brazil, the first one by the French in Maranhão and the second by the Dutch in northeastern Brazil. This paper includes reports of Fathers Claude d'Abbeville and Yves d'Evreux and from Piso and Marcgrave, the last two presenting the first illustrations of Brazilian Diptera. The paper also includes reports of Friar Laureano de la Cruz, Father João de Sotto Mayor and Maurício de Heriarte.

A morphological reappraisal of the immature stages and life history of Elachista synethes Meyrick (Lepidoptera, Elachistidae), an Australian leaf miner alien to Chile

ABSTRACT Elachista synethes was recently recognized as an alien species in northern Chile, where its larvae mine the rescue grass Bromus catharticus (Poaceae). In order to provide the necessary information to allow field detection of E. synethes during early ontogeny, we conducted a morphological reappraisal of the immature stages of this leaf-miner moth, based on light and scanning electron microscopy, including the first descriptions of the egg and the first-instar larva. This is the first report of the existence of an apodal early larva for a species of Elachista Treitschke. The legs and prolegs are absent in the first two instars, but are well developed in the last two. Additional observations on the life history are also provided, including a description of the mine.

Immature stages of Hamadryas fornax fornax (Hübner) (Lepidoptera: Nymphalidae: Biblidinae)

ABSTRACT The external morphology and biology of the immature stages of Hamadryas fornax fornax (Hübner, [1823]) (Lepidoptera, Nymphalidae, Biblidinae) recorded on Dalechampia triphylla (Euphorbiaceae) in Curitiba, Paraná, Brazil are described. Morphological characters are illustrated and described, as a result of observations in scanning electron, stereoscope and optical microscopes, the last two attached to a camera lucida. Results are compared and discussed with immature stages of other species of Biblidinae.

Reconstructing mid-to-recent Holocene paleoenvironments in the vicinity of ancient Amarynthos (Euboea, Greece).

This article examines the shoreline evolution and human occupation in the vicinity of the important archeological site of Amarynthos (Euboea Island, Greece) over the last six millennia. Archeological evidence indicates a continuous occupation of the site from the Bronze Age to the Roman period and the site is well-known, thanks to the existence of a sanctuary dedicated to the goddess Artemis. Based on the study of four boreholes, a paleogeographic reconstruction of the coastal landscape is proposed. Facies were determined based on mollusc identification, and sedimentology based on grain-size measurements (hand sieving for the fraction above 2 mm and LASER technique for particles below 2 mm) and loss-on-ignition. In addition, a series of 12 AMS radiocarbon dates define a reliable chronostratigraphy. Results suggest the presence of a fully marine environment from the early Holocene to ca. 2600-2400 cal. BC, which developed into a brackish environment from ca. 2600-2400 cal. BC to ca. 750 cal. BC due to the deltaic progradation of the nearby stream (Sarandapotamos River). From ca. 750 cal. BC onward, coastal swamps prevailed in the study area. Human-environmental interaction is discussed and particular attention is paid to the paleolandscape configuration of Amarynthos.

Predicting species distribution: offering more than simple habitat models

n the last two decades, interest in species distribution models (SDMs) of plants and animals has grown dramatically. Recent advances in SDMs allow us to potentially forecast anthropogenic effects on patterns of biodiversity at different spatial scales. However, some limitations still preclude the use of SDMs in many theoretical and practical applications. Here, we provide an overview of recent advances in this field, discuss the ecological principles and assumptions underpinning SDMs, and highlight critical limitations and decisions inherent in the construction and evaluation of SDMs. Particular emphasis is given to the use of SDMs for the assessment of climate change impacts and conservation management issues. We suggest new avenues for incorporating species migration, population dynamics, biotic interactions and community ecology into SDMs at multiple spatial scales. Addressing all these issues requires a better integration of SDMs with ecological theory.