Swiss DRGs : patient heterogeneity and hospital payments

In this paper, we analyze the prospective method of paying hospitals when the within-DRG variance is high. To avoid patients dumping, an outlier payment system is implemented. In the APDRG Swiss System, it consists in a mixture of fully prospective payments for low costs patients and partially cost-based system for high cost patients. We show how the optimal policy depends on the degree to which hospitals take patients' interest into account. A fixed-price policy is optimal when the hospital is sufficiently benevolent. When the hospital is weakly benevolent, a mixed policy solving a trade-off between rent extraction, efficiency and dumping deterrence must be preferred. Following Mougeot and Naegelen (2008), we show how the optimal combination of fixed price and partially costbased payment depends on the degree of benevolence of the hospital, the social cost of public funds and the distribution of patients severity. [Authors]

Peso para recuperação da atividade ovariana luteal cíclica em vacas leiteiras mestiças em anestro

Procurou-se conhecer o ganho de peso necessário e o peso mínimo para restabelecimento da atividade ovariana luteal cíclica (AOLC) em vacas adultas, mestiças Holandês x Zebu, não-lactantes, magras e com ovários inativos, anestro adquirido após longo período de restrição alimentar. Seis animais, com peso médio de 322,0 ± 27,0 kg, receberam dieta de mantença para o baixo peso apresentado (grupo I) e 12 animais, com peso médio de 315,0 ± 29,4 kg, foram alimentados para ganho de peso até a recuperação da AOLC (grupo II). O sangue foi coletado (dosagem de progesterona-RIA), e os animais, pesados semanalmente. A AOLC foi avaliada pela concentração de progesterona no sangue, exame dos ovários por palpação retal a cada 12 dias e observação visual do estro três vezes ao dia. O reinício da AOLC ocorreu nos animais do grupo II quando pesaram em média 392,7 ± 29,4 kg. A média do ganho de peso total nesse grupo foi de 77,7 ± 11,2 kg, correspondendo a 24,7 ± 4,5% do peso desses animais em anestro, ou 37,7% dos 206,2 kg perdidos na fase de restrição alimentar para adquirir anestro. Os seis animais do grupo I permaneceram em anestro. Os resultados mostram a influência do nível alimentar sobre a função luteal ovariana e a necessidade de ganho de peso para o restabelecimento do ciclo estral em vacas mestiças leiteiras, magras e em anestro.

Sobre la fundamentación de la definición Aristotélica del tiempo en la del movimiento

El estudio aristotélico del tiempo (Phys. IV, 10-14), centrado en su definición del mismo como "número del movimiento según el antes y el después", presenta una sorprendente ausencia: en él no halla aplicación, como cabría esperar, la definición previamente dada del movimiento como "acto de la potencia en cuianto tal". Sin embargo, se muestra que la epistemología aristotélica permitiría esperar una (al aplicación. Asimismo, para mostrar quedicha aplicación sería posible, se ofrece una prueba, partiendo de la definición de movimiento, del teorema "lo que se mueve, se mueve de algo a algo", básico para la defiinición del tiempo como número del movimiento.

La justicia como reciprocidad entre individuos (Epicuro) frente a la justicia como finalidad común (Aristóteles)

El presente artículo sostiene, por debajo de la contraposición entre los conceptos dejusticia epicúreo y aristotélico, la existencia de un común denominador a ambos, a saber, la prioridad de un concepto social-natural (no meramente social ni meramente natural) de justicia, previo a todo cálculo de conveniencia, pero no por ello de naturaleza metafísica.En el caso de Epicuro, se trata de un concepto de mínimo al que debe ajustarse el florecimiento individual: el reconocimiento mutuo. En el caso de Aristóteles, de un máximo en la búsqueda del bien común como condición del bien de cada individuo: la pólis gobernada en beneficio de todos los ciudadanos.

Characterization of thirteen microsatellite markers in river and brook lampreys (Lampetra fluviatilis and L-planeri)

We describe the development based on 454 pyrosequencing technology of thirteen microsatellite markers for two closely related species of lamprey: Lampetra fluviatilis and L. planeri. The number of alleles per locus ranged from 2 to 5 in L. fluviatilis and from 2 to 6 in L. planeri. Gene diversity ranged from 0.062 to 0.718 in L. fluviatilis and from 0.322 to 0.677 in L. planeri. These markers will be helpful to study population genetic structure of both species and resolve their taxonomic status as separate species or ecotypes of a single species.

Stable O and H isotopic composition of hydrous minerals as proxies for paleoclimate and -topography : application to the European Alps

The isotopie composition of clay minerals can be used to gain information on paleoaltitude, -topography and -climate during the time of their formation, as they form in isotopie equilibrium with ambient water, which has an isotopie composition that is determined by previous rain-out. In this thesis, the usability of this approach is evaluated for sample material from both the North Alpine Foreland Basin and internal parts of the European Alps. The isotopie composition of precipitation is determined by the air temperature and the extent of previous rain-out, which in turn is affected by the distance to the point of origin of the water vapor and the condensation conditions. An orographic barrier leads to uplift and adiabatic cooling of air masses and thereby enhances rainfall with a characteristic depletion in heavy 0 and H isotopes. Processes such as evaporation and mixing of water with different origin affect the isotopie composition further on the surface. Clay minerals are hydrous phyllosilicates that can form during weathering or pedogenesis in isotopie equilibrium with the present water and inherit its isotopie composition with a characteristic fractionation. If their isotopie composition was preserved after formation and the necessary parameters are known, it is possible to calculate the isotopie composition of the ambient water and thereby reconstruct climatic and topographic conditions during their formation. Due to the hygroscopic behavior of the sample material, analytical procedures needed to be modified to allow an analysis of the oxygen and hydrogen isotopie composition of the hydroxyl water built into their crystal structure and not the one of recently adsorbed water. In order to determine typical 5lsO and 8D values of meteoric water and minerals in the weathering environment in high Alpine regions, samples of surface water and soils from the valley of Visp in the Swiss Alps were studied that were collected along a transect with varying altitudes and host rock lithologies. The actual aim to attempt the reconstruction of Alpine paleoelevations was addressed by the analysis of sediments deposited under marine and terrestrial conditions during the Miocene and Oligocene, which were sampled from different locations in Switzerland, Germany and Austria. Further bentonite and fault gouge clay samples were used as reference material from low and high elevations. Results show that the isotopie composition of clay minerals can be influenced by several factors, such as the mode and site of their formation, possible isotope exchange (which is evident for 8D values), the samples' mineral composition (such as the presence of detrital material) and the deposition environment. With a consideration of these parameters and limitation to certain sample material, conclusions are drawn on the isotopie composition of the water from which the clay minerals formed. Most of the obtained values lie in the same range as has been reported in literature for foreland precipitation. The reconstruction of paleoelevation might be possible for selected sites with a geographical setting close to the Alpine chain or for intramontane basins. - La composition isotopique des argiles, qui se forment typiquement en contact avec des eaux superficielles, peut être utilisée pour obtenir des informations sur la paléoaltitude, la paléotopographie et le paléoclimat pendant leur création. La composition en isotopes stable (oxygène et hydrogène) des eaux de pluie est déterminée par l'altitude, la température, la distance depuis le lieu d'évaporation et par le taux de précipitation. Certains processus comme l'évaporation, l'interaction avec des minéraux et le mélange d'eaux d'origines variées peuvent aussi changer la composition des eaux de surface. Les argiles sont des pliyllosilicates hydratés qui sont crées par l'altération des roches au contact de ces eaux de surface et ils acquièrent une composition isotopique qui est soumise à un certain fractionnement. L'objectif de cette thèse est d'évaluer si l'effet de l'altitude des Alpes, est détectable dans la composition isotopique des sédiments du bassin d'avant-pavs pendant le Miocène. Après avoir établi la procédure analytique, des compositions isotopiques typiques de régions de hautes altitudes ont été determine sur les eaux de surfaces (rivières) et sur des échantillons de sols, le long d'une coupe dans la valée de Visp, dans les Alpes Suisses. Une reconstruction des paléoaltitudes Miocènes Alpines a ensuite été mené par l'analyse de sédiments marins et terrestres en utilisant des échantillons d'âges variés et provenant de Suisse, d'Allemagne et d'Autriche. Les résultats montrent que la composition isotopique des échantillons est impactée par de multiples facteurs, tels que le mode de et le lieu de formation. un possible échange isotopique tardif (surtout pour 5D). leur composition minéralogique et l'environnement de leur sédimentation. Après un examen prudent de ces paramètres, et en se limitant à un certain assortiment d'échatillons, on peut tirer des conclusions sur la composition isotopique des eaux originelles pour en déduire l'effet du climat et de la topographie.

Análise econômica de sistemas de produção de grãos com pastagens anuais de inverno, em sistema plantio direto

Durante seis anos (1990 a 1995), foram avaliados, no CEPAGRO-Centro de Extensão e Pesquisa Agronômica, da Faculdade de Agronomia da Universidade de Passo Fundo (UPF), em Passo Fundo, RS, quatro sistemas de produção de grãos com pastagens anuais de inverno. Os sistemas foram constituídos por: sistema I (trigo/soja, aveia-preta pastejada/soja e aveia-preta pastejada/soja); sistema II (trigo/soja e aveia-preta + ervilhaca pastejadas/milho); sistema III (trigo/soja, aveia-preta + ervilhaca pastejadas/soja e aveia-preta + ervilhaca pastejadas/milho); e sistema IV (trigo/soja, aveia-branca/soja e aveia-branca/soja). O delineamento experimental foi em blocos ao acaso, com três repetições, e parcelas totalizando 500 m². Na média dos seis anos, o sistema II mostrou maior receita líquida (R$ 432,71/ha) do que o sistema IV (R$ 322,93/ha). Por sua vez, o sistema II não diferiu significativamente dos sistemas I (R$ 377,93/ha) e III (R$ 400,27/ha). A integração lavoura pecuária sob sistema de cultivo plantio direto foi viável tanto para as culturas de inverno e de verão como para a engorda de bovinos no período invernal.

Polyphenol-rich foods in the Mediterranean diet are associated with better cognitive function in elderly subjects at high cardiovascular risk

Brain oxidative processes play a major role in age-related cognitive decline, thus consumption of antioxidant-rich foods might help preserve cognition. Our aim was to assess whether consumption of antioxidant-rich foods in the Mediterranean diet relates to cognitive function in the elderly. In asymptomatic subjects at high cardiovascular risk (n = 447; 52% women; age 5580 y) enrolled in the PREDIMED study, a primary prevention dietary-intervention trial, we assessed food intake and cardiovascular risk profile, determined apolipoprotein E genotype, and used neuropsychological tests to evaluate cognitive function.We also measured urinary polyphenols as an objective biomarker of intake. Associations between energy-adjusted food consumption, urinary polyphenols, and cognitive scores were assessed by multiple linear regression models adjusted for potential confounders. Consumption of some foods was independently related to better cognitive function. The specific associations [regression coefficients (95% confidence intervals)] were: total olive oil with immediate verbal memory [0.755 (0.1511.358)]; virgin olive oil and coffee with delayed verbal memory [0.163 (0.0100.316) and 0.294 (0.0550.534), respectively];walnuts with working memory [1.191 (0.0612.322)]; and wine with Mini-Mental State Examination scores [0.252 (0.0060.496)]. Urinary polyphenols were associated with better scores in immediate verbal memory [1.208 (0.2362.180)]. Increased consumption of antioxidant-rich foods in general and of polyphenols in particular is associated with better cognitive performance in elderly subjects at high cardiovascular risk. The results reinforce the notion that Mediterranean diet components might counteract age-related cognitive decline.

Adubação de aveia em dois sistemas de plantio

O objetivo deste trabalho foi determinar as doses de N, P e K necessárias para a obtenção da máxima produção econômica de forragem de aveia, linhagem UPF 87111, nos sistemas de plantio convencional e com cobertura morta, num Latossolo Vermelho distrófico típico. Utilizou-se como esquema experimental um fatorial fracionado (1/2)4³ com dois blocos ao acaso, total de 32 parcelas, sem repetição. Os tratamentos constituíram-se de quatro doses de N e de K2O (0, 70, 140 e 210 kg ha-1), como uréia e cloreto de potássio, respectivamente, e quatro doses de P2O5 (0, 60, 120, 180 kg ha-1), como superfosfato triplo. As doses de N, P e K para produção de forragem de aveia com máxima receita líquida, foram, em kg ha-1, 165 (N), 50 (P2O5), 53 (K2O), no plantio convencional, e 210 (N), 90 (P2O5) no plantio com cobertura morta, com produções de matéria seca de, respectivamente, 6.641 kg ha-1 e 7.322 kg ha-1. Nos dois sistemas de plantio houve resposta somente em relação ao N, e o seu uso resultou maior produção de forragem por unidade de nutriente aplicado.

Como fidelizar a la comunidad educativa en la cultura de seguridad y defensa

Las reflexiones que se recogen en este trabajo son una primera aproximación metodológica acerca de las estrategias de investigación, estudio y desarrollo e innovación relativas a la Cultura de Seguridad y Defensa en España. En sucesivas entregas iremos analizando diferentes aportaciones que nos permitan contribuir a la mejora del conocimiento de la cultura de seguridad y defensa en España. También abordaremos el tema de la puesta en valor de los estudios y programas desarrollados por los militares españoles, y su transferencia en la sociedad civil. En este sentido, esta primera entrega se estructura en dos partes: Marco Metodológico Inicial y Metaestudio acerca de las Tesis Doctorales defendidas en España y compiladas en la Base de Datos Teseo.