Impact of worksite health-promotion programs in hospital admission costs and medical leaves in a sample of brazilian companies

Programas de saúde e bem-estar têm sido adotados por empresas como forma de melhorar a saúde de empregados, e muitos estudos descrevem retornos econômicos positivos sobre os investimentos envolvidos. Entretanto, estudos mais recentes com metodologia melhor têm demonstrado retornos menores. O objetivo deste estudo foi investigar se características de programas de saúde e bem-estar agem como preditores de custos de internação hospitalar (em Reais correntes) e da proporção de funcionários que têm licença médica, entre Abril de 2014 e Maio de 2015, em uma amostra não-aleatória de empresas no Brasil, através de parceria com uma empresa gestora de ‘big data’ para saúde. Um questionário sobre características de programas de saúde no ambiente de trabalho foi respondida por seis grandes empresas brasileiras. Dados retirados destes seis questionários (presença e idade de programa de saúde, suas características – inclusão de atividades de screening, educação sobre saúde, ligação com outros programas da empresa, integração do programa à estrutura da empresa, e ambientes de trabalho voltado para a saúde – e a adoção de incentivos financeiros para aderência de funcionários ao programa), bem como dados individuais de idade, gênero e categoria de plano de saúde de cada empregado , foram usados para construir um banco de dados com mais de 76.000 indivíduos. Através de um modelo de regressão múltipla e seleção ‘stepwise’ de variáveis, a idade do empregado foi positivamente associada e a idade do programa de saúde e a categoria ‘premium’ de plano de saúde do funcionário foram negativamente associadas aos custos de internação hospitalar (como esperado). Inesperadamente, a inclusão de programas de screening e iniciativas de educação de saúde nos programas de saúde e bem-estar nas empresas foram identificados como preditores positivos significativos para custos de admissão hospitalar. Para evitar a inclusão errônea de licenças-maternidade, apenas os dados de licença médica de pacientes do sexo masculino foram analisados (dados disponíveis apenas para duas entre as companhias incluídas, com um total de 18.957 pacientes do sexo masculino). Analisando estes dados através de um teste Z para comparação de proporções, a empresa com programa de saúde que inclui atividades voltadas a cessação de hábitos ruins (como tabagismo e etilismo), controle de diabetes e hipertensão, e que adota incentivos financeiros para a aderência de funcionários ao programa tem menor proporção de empregados com licençca médica no período analisado, quando comparada com a outra empresa que não tem estas características (também conforme esperado). Entretanto, a companhia com menor proporção de funcionários com licença médica também foi aquela que adota programa de screening entre as atividades de seu programa de saúde. Potenciais fontes de ameaça à validade interna e externa destes resultados são discutidas, bem como possíveis explicações para a associação entre programas de screening e educação médica a piores indicadores de saúde nesta amostra de companhias são discutidas. Novos estudos com melhor desenho, com amostras maiores e randômicas são necessários para validar estes resultados e possivelmente melhorar a validade interna e externa destes resultados.

Bright minds, big rent: gentrification and the rising returns to skill

In 1980, housing prices in the main US cities rose with distance to the city center. By 2010, that relationship had reversed. We propose that this development can be traced to greater labor supply of high-income households through reduced tolerance for commuting. In a tract-level data set covering the 27 largest US cities, years 1980-2010, we employ a city-level Bartik demand shifter for skilled labor and find support for our hypothesis: full-time skilled workers favor proximity to the city center and their increased presence can account for the observed price changes, notably the rising price premium commanded by centrality.

Revamping asset quality to maximize income in office markets

We use a unique dataset of c. 2200 commercial towers located in the city of Sao Paulo from 2005:Q3 to 2014:Q3 to study the relationship between asset quality and potential income in different niches of the office market. Our evidence suggests a rent premium in the market for larger office space (corporate) and that building quality is more relevant in this segment. We hypothesize such difference is due to larger competition and commoditization in the market for smaller office space (office) as income in this segment tends to be insensible to different levels of asset quality when we control for spatial variation. We also find that rent premiums associated with building class are monotonically increasing, but not strictly positive across certain quality thresholds. Thus, landlords and developers should take into consideration the market niche and acceptable target building class levels when designing their investment plans in order to maximize income .

Valuing emerging markets companies : new approaches to determine the effective exposure to country risk

The aim of this paper is to propose new methods to measure the effective exposure to country risk of emerging-market companies. Starting from Damodaran (2003), we propose seven new approaches and a revised CAPM for emerging markets companies. The “Prospective Lambda” represents the effective exposure according to analysts’ estimates of growth. The “Relative Lambda” relies on the firm value estimated through a relative valuation. The “Retrospective Lambda” represents the ex-post effective exposure to country risk. The “Company Effective Risk Premium” is a generalization of the Retrospective Lambda, and expresses the premium effectively requested by investors to invest in that specific company in the past year. “The Actual Lambda” and the “Company Actual Risk Premium” represent, respectively, the actual exposure to country risk of a company and the actual premium requested by investors to invest in that specific company. The “Industry Lambda” reflects the median exposure to country risk of the industry in which the company belongs. We tested our new measures of exposure to country risk on the Latin American emerging markets companies according to the classification of the MSCI Emerging Markets Latin America Index. The results confirm that the new approaches can be effectively applied by financial analysts to stable-growth companies that operate in emerging markets and to mature markets companies that operate in emerging markets, providing with a more reliable estimate of both the premium effectively requested by investors in the past and the actual premium. Applying the new approaches, the cost of equity reflects the effective exposure of a company to country risk without being over- or underestimated, as is the case with other existing approaches.

Influência do número de refundições da liga Ni-Cr-Mo-Ti sobre as propriedades de próteses metalocerâmicas

A frequently encountered difficulty in oral prosthetics is associated with the loss of metallic alloys during the melting stage of the production of metal-ceramic replacement systems. Remelting such materials could impar their use in oral rehabilitation due to loss in esthetics, as well as in the chemical, physical, electrochemical and mechanical properties. Nowadays, the Ni-Cr-Mo-Ti alloy is widely used in metal-ceramic systems. Manufacturers state that this material can be remelted without significant alterations in its behavior, however little has been established as to the changes in the performance of this alloy after successive remelting, which is common practice in oral prosthetics. Therefore, the objective of this study was to evaluate possible changes in the esthetics and associated properties of metalceramic samples consisting of Ni-Cr-Mo-Ti and dental porcelain. Three to five remelting steps were carried out. The results revealed that Ni-Cr-Mo-Ti can be safely used even after three remelting steps. Further remelting significantly affect the characteristics of the alloys and should not be recommended for the manufacture of metal-ceramic systems

Composição nutricional e avaliação de rótulo de rações secas para cães comercializadas em Jaboticabal-SP

Avaliaram-se 49 marcas de rações para cães adultos e filhotes comercializadas em Jaboticabal-SP. Os alimentos foram divididos em três segmentos: econômico, standard e super-premium. Nessa ordem, as rações para cães adultos apresentaram, em média, 16,9%, 20,9% e 27,8% de proteína, 9,7%, 10,5% e 15% de gordura, 6,4%, 2,9% e 1,1% de fibra e 1,9%, 1,9% e 1,4% de Ca. Para filhotes, os produtos standard e super-premium apresentaram, respectivamente, 26,1% e 31,0% de proteína, 10,8% e 15,2% de gordura, 2,6% e 2,4% de fibra, 2,1% e 1,7% de Ca e 1,6% e 1,3% de P. A porcentagem de rações cujos teores nutricionais declarados no rótulo não estavam de acordo com os encontrados nas análises de laboratório foi, para os produtos super-premium para filhotes, 80,0% para o Ca e 60,0% para a gordura; para os produtos standard para filhotes, 28,6% para proteína e 57,2% para o cálcio; para os produtos econômicos para cães adultos, 44,0% para a fibra e 33,0% para a proteína; para os produtos standard para cães adultos de 33,0% para a gordura e 50,0% para o Ca; e para os produtos super-premium para cães adultos, 50,0% para o cálcio e 33,0% para a gordura. Foram encontradas inadequações nutricionais em produtos, como teores insuficientes de proteína e altas concentrações de fibra, cálcio e fósforo.

Avanços metodológicos na seleção do sexo de espermatozóides bovinos para utilização no melhoramento genético e na produção animal

O mercado demanda, desde final da década de 20, uma tecnologia para a sexagem de espermatozóides que possa ser inserida na indústria de produção de sêmen congelado e que tenha as seguintes características: a) não altere a viabilidade espermática; b) seja compatível com a congelação do espermatozóide sexado; c) permita a sexagem de espermatozóides previamente congelados e descongelados; d) permita a produção de várias doses de sêmen sexado congelado por dia, com custo compatível ao mercado. A importância dessa tecnologia para maximizar a produção animal a um custo baixo tem sido um desafio da pesquisa a vários anos. A possibilidade de produzir, em escala comercial, doses de sêmen enriquecidas com espermatozóides X ou Y aumentará os benefícios do uso da inseminação artificial no seu papel de maximizar o progresso genético entre gerações de acordo com os requerimentos de cada programa de melhoramento animal. Diferentes rotas tecnológicas são percorridas na tentativa de selecionar-se o sexo em mamíferos, tanto nas espécies de interesse zootécnico quanto em espécies ameaçadas de extinção, animais de companhia. Neste sentido, existem duas alternativas: a separação de espermatozóides portadores do cromossomo X, daqueles portadores do cromossomo Y; ou a sexagem de embriões pré-implantados. A viabilidade da sexagem de espermatozóides em bovinos é esperada por muitos anos e os desenvolvimentos recentes tornaram essa tecnologia de aplicação commercial. Entretanto, muitas limitações ainda existem, principalmente, referente à taxa de gestação em condições de campo. Isso restringe a utilização dessa tecnologia no melhoramento genético e produção animal. Nessa palestra abordaremos os potenciais sistemas de criação e produção que poderão beneficiar-se com a sexagem de espermatozóides, quando essas limitações forem solucionadas.

Riscos ocupacionais e acidentes de trabalho em um serviço de atendimento móvel de urgência do Rio Grande do Norte

Exploratory, descriptive and quantitative study with prospective data, performed in the Mobile Emergency Care Service in the metropolitan region of Natal/RN, in order to identify the knowledge of the multidisciplinary team about the rules of standard precautions and worker safety, to identify occupational hazards peculiar to the activities of this service; characterize work-related accidents (WRA) and know the procedures adopted after each WRA. The population consisted of 162 professionals and data were collected between the months of November and December 2010. As for personal and professional characteristics, of the 162 professional, 12,96% were physicians; 6,79%, nurses; 33,95%, nursing technicians, 46,29%, conductors; 74,70% were male; 43,21% were between 31 and 40 years old; 69,33% lived in Natal/RN, 50,00% had completed high school; 58,64% were married; 69,75% had children, 46,91% were between 1 and 4 years of training; 61,73% had improvement courses; 59,25% had 3 to 4 years of service; 54,32%, with 1-4 years experience in emergency; 44,44% received 1-2 minimum wages; 78,40% received insalubrity premium; 67,28% worked in Basic Support Unit (BSU); 83,95% had journey on SAMU Metropolitano of 31-40 hours per week; 52,47% had other employments. As for knowledge of rules of standard precautions, safety and occupational hazards, 99,38% knew what it was WRA; 62,96% gave incomplete answers; 74,07% knew the rules of prevent WRA; 46,67% acquired this knowledge in lectures; 53,09% knew Personal Protective Equipment (PPE); 71,60% gave incorrect answers about the importance of standard precautions; 45,06% never received an educational intervention on this issue; 89,51% said that educational interventions in the prevention of WRA are very important; 90,12% pointed out this as a very important issue in the workplace; 27,00% suggested guidance on the topic in the workplace; regarding the physical hazards, 34,57% considered noise as the most important; about chemical hazards, 78,40% chose the gases and smoke; for biological hazards, 48,77% reported contact with the blood; for mechanical hazards, 80,86% said that were transport accidents; about ergonomic risks, 40,12% say it is the tension/stress in the care of critically ill, psychiatric and aggressive patients; and there was an average of 4,5 to the feeling of safety in the workplace. Regarding the data on the WRAs occurred, 31,48% experienced at least one accident event; 72,55% did not notify it; 60,98% answered that there was no routine for notification; 56,86% were performing patient transportation; 49,02% were hurt in the Basic Support Unit/Rescue Unit (BSU/RH); 60,78% occurred during the day; 96,08% of professionals were in normal work schedule (24 hours on duty); 31,37% had contusion; 58.82% had damage to members/pelvic girdle; 43,14% had traffic accidents. About the evolution of the WRA, 62,75% did not have to take time away from work; 76,47% had no sequelae; 88,24% did not require rehabilitation; no professional had a change of occupation. And by means of univariate logistic regression, showed that the nurses and male sex were risk factors for the occurrence of WRA. We conclude that there were gaps in the knowledge of staff regarding WRA, emphasizing the need for continuing education in biosafety in the service.

Desempenho de um veículo flex em bancada dinamométrica de chassi

Flex-fuel vehicles are equipped with Otto Cycle internal combustion engines and have the capability of functioning with more than one type of fuel, mixed at the same tank and burned in the combustion chamber simultaneously. This sort of motorization is a world pattern due to the scarcity of petroleum, the trade of several types of fuels, technology advances and the restriction imposed to gas emissions to the atmosphere. In Brazil, the Flexfuel vehicles are a reality, specially the ones using fuel with 20 to 25% anhydrous alcohol mixed with gasoline and those that use natural gas or original liquid fuel (gasoline or hydrated ethanol). The Brazilian model Fiat Siena, the object of this present scientific investigation, is equipped with a unique electronic central capable of managing the liquid or gaseous fuels. The purpose of this research was to perform a comparative analysis in terms of performance (in terms of both potency and consumption) of a tetra-fuel vehicle - using a chassis dynamometer, operating with different fuels: common gasoline, premium gasoline, Podium gasoline, ethanol or natural gas. It became necessary to develop a bench of tests and trials procedures, as well as to know the functioning of the electronic management of the vehicle under analysis. The experiments were performed at the automotive laboratory in CTGAS-ER (Center of Gas Technologies and Renewable energies) at the light of Brazilian standard ABNT, NBR 7024: Light on-road vehicles - measurement of fuel consumption. The essay results on specific fuel consumption using common gasoline, premium gasoline and Podium gasoline have shown similar results, both for urban and road driving cycles

Maximum inhibitory dilution of mouthwashes containing chlorhexidine and polyhexamethylene biguanide against salivary Staphylococcus aureus

Objective: The aim of the present study was to determine the in vitro maximum inhibitory dilution (MID) of two chlorhexidine-based oral mouthwashes (CHX): Noplak (R), Periogard (R), and one polyhexamethylene biguanide-based mouthwash (PHMB): Sanifill Premium (R) against 28 field Staphylococcus aureus strains using the agar dilution method. Materials and Methods: For each product, decimal dilutions ranging from 1/10 to 1/655,360 were prepared in distilled water and added to Mueller Hinton Agar culture medium. After homogenization, the culture medium was poured onto Petri dishes. Strains were inoculated using a Steers multipoint inoculator and dishes were incubated at 37 degrees C for 24hours. For reading, MID was considered as the maximum dilution of the mouthwash still capable of inhibiting microbial growth. Results: Sanifill Premium (R) inhibited the growth of all strains at 1/40 dilution and of 1 strain at 1/80 dilution. Noplak (R) inhibited the growth of 23 strains at 1/640 dilution and of all 28 strains at 1/320 dilution. Periogard (R) showed inhibited growth of 7 strains at 1/640 dilution and of all 28 strains at 1/320 dilution. Data were submitted to Kruskal-Wallis statistical test, showing significant differences between the mouthwashes evaluated (p<0.05). No significant difference was found between Noplak (R) and Periogard (R) (p>0.05). Sanifill Premium (R) was the least effective (p<0.05). Conclusion: It was concluded that CHX-based mouthwashes present better antimicrobial activity against S. Aureus than the PHMB-based mouthwash.

Isolation and characterization of latent and active polyphenoloxidase in BRS Clara (CNPUV 154-147 x Centennial seedless) and BRS Morena (Marroo seedless x Centennial seedless) seedless table grapes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos de probióticos sobre a digestibilidade, escore fecal e características hematológicas em cães

Avaliaram-se os efeitos da suplementação de dois tipos de probióticos para cães filhotes, que receberam dois tipos de dieta - de alta e de baixa qualidade -, sobre a digestibilidade dos nutrientes, escore fecal e parâmetros sanguíneos. Foram utilizados 18 animais, distribuídos em três tratamentos. No tratamento 1, controle, os cães receberam somente a ração; no tratamento 2, ração com probiótico 1 (Bifidobacterium) e, no tratamento 3, ração com probiótico 2 (Lactobacillus). O experimento foi dividido em duas fases. Verificaram-se que os valores médios do coeficiente de metabolizabilidade da energia bruta (CMEB) na fase 1, caracterizada pela troca da dieta Super Premium para a dieta Standard, apresentaram resultados significativos (P<0,05), sendo os melhores resultados obtidos nos animais que receberam o probiótico 2. Não houve diferenças significativas (P>0,05) para o escore fecal e para as análises hematológicas.

Nutritional support and outcome in hospitalized dogs and cats

This study investigated the effect of assisted nutritional support on the outcome and time of hospitalization (TH) of dogs and cats. The study compared two groups of 400 hospitalized animals. The animals in group 1 did not receive assisted nutritional support because they were hospitalized before the clinical nutrition service was implemented; animals in group 2 were nutritionally managed. Animals in group 1 received a low-cost diet with no consumption control. Group 2 animals had their maintenance energy requirement (MER) calculated, received a high-protein and high-energy super-premium diet, had their caloric intake (CI) monitored, and received enteral and parenteral nutritional support when necessary. The statistical analysis of the results included the standard T test (group 1 versus group 2) and chisquare and Spearman's correlation to evaluate group 2 (CI and outcome, body condition score (BCS) and outcome, BCS and CI). For group 2, favorable outcome (FO), defined as the percent responding to therapy and dis-charged from the hospital, was 83%, and the TH was 8.59 days. These values were lower (P < .001) for group 1 (63.2% FO and TH of 5.7 days). For group 2, 65.5% of the animals received voluntary consumption (93.1% outcome), 14.5% received enterai support (67.9% FO), 6.5% received parenteral support (68% FO), and 6.17% did not eat (38.5% FO), demonstrating an association between the type of nutritional support and outcome (P < .01). Group 2 animals that received 0% to 33% of their MER had 62.9% FO, and those receiving more than 67% had 94.3% FO, which shows that lower mortality rates are associated with higher CI (P < .001). TH was higher for animals with higher CI (P < .001). The BCS did not correlate with Cl (P > .05) but did correlate with outcome (P < .01). FO was 68.7% for animals with low BCS, 85.7% for animals with ideal BCS, and 86.6% for overweight animals. Nutritional support could allow for longer therapies, thus increasing the TH and FO rate.

Digestibilidade de uma dieta caseira e dois alimentos comerciais, econômico e super-prêmio, para cães

They were compared the coefficients of apparent digestibility (CAD) and the fecal quality of dogs fed a home-made diet and two dog foods, standard and super-premium. Six adult dogs were distributed in a double latin square desing (3 × 3), with three treatments and three periods, in a total of six replications per treatment. Tukey's test was used to compare the means. The home-made diet presented the highest CAD, not differing only of the CAD of acid ether extract of the super-premium food. The standard food was the lowest digestive, producting more feces. Fecal dry matter of dogs fed home-made diet was lower than in the standard and super-premium foods, which did not differ among then. Fecal score presented low variability among treatments, remaining in the considered ideal range. Home-made diet can be an alternative in the feeding of dogs.

The Canadian retirement income system

Includes bibliography