987 resultados para Budget 2013


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Cost-effectiveness and budget impact of saxagliptine as additional therapy to metformin for the treatment of diabetes mellitus type 2 in the Brazilian private health system Objectives: To compare costs and clinical benefits of three additional therapies to metformin (MF) for patients with diabetes mellitus type 2 (DM2). Methods: A discrete event simulation model seas built to estimate the cost-utility ratio (cost per quality-adjusted life years [QALY)) of saxagliptine as an additional therapy to MF when compared to rosiglitazone or pioglitazone. A budget impact model (BIM) was built to simulate the economic impact of saxagliptine use in the context of the Brazilian private health system. Results: The acquiring medication costs for the hypothetical patient group analyzed in a time frame of three years, were R$ 10,850,185, R$ 14,836,265 and R$ 14,679,099 for saxagliptine, pioglitazone and rosiglitazone, respectively. Saxagliptine showed lower costs and greater effectiveness in both comparisons, with projected savings for the first three years of R$ 3,874 and R$ 3,996, respectively. The BIM estimated cumulative savings of R$ 417,958 with the repayment of saxagliptine in three years from the perspective of a health plan with 1,000,000 covered individuals. Conclusion: From the perspective of private paying source, the projection is that adding saxagliptine with MF save costs when compared with the addition of rosiglitazone or pioglitazone in patients with DM2 that have not reached the HbA1c goal with metformin monotherapy. The BIM of including saxagliptine in the reimbursement lists of health plans indicated significant savings on the three-year horizon.

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A field study of thermal circulation over very gentle slope is described for a specific day characterised by weak synoptic conditions. The emphasis was on morning and evening transitions, but measurements cover the entire day; therefore a brief analysis is performed to represent the general thermal circulation pattern. Both transition periods are characterised by complex dynamic behaviours. During evening transition, the upslope flow has got through a stagnation condition characterised by wind velocity U<0:5 m=s. Only when the stagnating air has become negative buoyant, the flow is allowed to pour downslope like a slab. Some features of front formation has been found during the transition development, such as delay time of downslope flow start up along the slope, and the presence of positive turbulent kinetic energy at the onset of the motion. Eventually the observed evening transition has followed a mixed mechanisms, with features from different models. Therefore the Rayleigh number seems not to be a good criterion by which parametrise evening transition itself. Morning transition is characterised by destruction of nocturnal temperature inversion and the onset of upslope flow. Inversion destruction can be described in terms of CBL growth at surface and inversion decent from the top of the layer. KH has found to be a good indicator of inversion breakup, if used as parameter to study the inversion breakup in terms of temperature reversal. After the inversion breakup, buoyancy and mechanical productions supply the flow with the necessary energy to start the upslope wind. More quantitative analysis are provided by the study of stability parameters and turbulent kinetic energy budgets. Gradient Richardson number has been used in this terms, finding that a mixed SBL-CBL behaviour dominates the most of the observed layers. Tke budget has shown high turbulent behaviour during morning transition while the evening transition has developed entirely in laminar condition, apart from short intermittent turbulent events.

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The seasonal dynamics of molybdenum (Mo) were studied in the water column of two tidal basins of the German Wadden Sea (Sylt-Rømø and Spiekeroog) between 2007 and 2011. In contrast to its conservative behaviour in the open ocean, both, losses of more than 50% of the usual concentration level of Mo in seawater and enrichments up to 20% were observed repeatedly in the water column of the study areas. During early summer, Mo removal by adsorption on algae-derived organic matter (e.g. after Phaeocystis blooms) is postulated to be a possible mechanism. Mo bound to organic aggregates is likely transferred to the surface sediment where microbial decomposition enriches Mo in the pore water. First δ98/95Mo data of the study area disclose residual Mo in the open water column being isotopically heavier than MOMo (Mean Ocean Molybdenum) during a negative Mo concentration anomaly, whereas suspended particulate matter shows distinctly lighter values. Based on field observations a Mo isotope enrichment factor of ε = −0.3‰ has been determined which was used to argue against sorption on metal oxide surfaces. It is suggested here that isotope fractionation is caused by biological activity and association to organic matter. Pelagic Mo concentration anomalies exceeding the theoretical salinity-based concentration level, on the other hand, cannot be explained by replenishment via North Sea waters alone and require a supply of excess Mo. Laboratory experiments with natural anoxic tidal flat sediments and modelled sediment displacement during storm events suggest fast and effective Mo release during the resuspension of anoxic sediments in oxic seawater as an important process for a recycling of sedimentary sulphide bound Mo into the water column.

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Accurate assessments of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere is important to better understand the global carbon cycle, support the climate policy process, and project future climate change. Present-day analysis requires the combination of a range of data, algorithms, statistics and model estimates and their interpretation by a broad scientific community. Here we describe datasets and a methodology developed by the global carbon cycle science community to quantify all major components of the global carbon budget, including their uncertainties. We discuss changes compared to previous estimates, consistency within and among components, and methodology and data limitations. CO2 emissions from fossil fuel combustion and cement production (EFF) are based on energy statistics, while emissions from Land-Use Change (ELUC), including deforestation, are based on combined evidence from land cover change data, fire activity in regions undergoing deforestation, and models. The global atmospheric CO2 concentration is measured directly and its rate of growth (GATM) is computed from the concentration. The mean ocean CO2 sink (SOCEAN) is based on observations from the 1990s, while the annual anomalies and trends are estimated with ocean models. Finally, the global residual terrestrial CO2 sink (SLAND) is estimated by the difference of the other terms. For the last decade available (2002–2011), EFF was 8.3 ± 0.4 PgC yr−1, ELUC 1.0 ± 0.5 PgC yr−1, GATM 4.3 ± 0.1 PgC yr−1, SOCEAN 2.5 ± 0.5 PgC yr−1, and SLAND 2.6 ± 0.8 PgC yr−1. For year 2011 alone, EFF was 9.5 ± 0.5 PgC yr−1, 3.0 percent above 2010, reflecting a continued trend in these emissions; ELUC was 0.9 ± 0.5 PgC yr−1, approximately constant throughout the decade; GATM was 3.6 ± 0.2 PgC yr−1, SOCEAN was 2.7 ± 0.5 PgC yr−1, and SLAND was 4.1 ± 0.9 PgC yr−1. GATM was low in 2011 compared to the 2002–2011 average because of a high uptake by the land probably in response to natural climate variability associated to La Niña conditions in the Pacific Ocean. The global atmospheric CO2 concentration reached 391.31 ± 0.13 ppm at the end of year 2011. We estimate that EFF will have increased by 2.6% (1.9–3.5%) in 2012 based on projections of gross world product and recent changes in the carbon intensity of the economy. All uncertainties are reported as ±1 sigma (68% confidence assuming Gaussian error distributions that the real value lies within the given interval), reflecting the current capacity to characterise the annual estimates of each component of the global carbon budget. This paper is intended to provide a baseline to keep track of annual carbon budgets in the future.

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Ice shelves strongly interact with coastal Antarctic sea ice and the associated ecosystem by creating conditions favourable to the formation of a sub-ice platelet layer. The close investigation of this phenomenon and its seasonal evolution remain a challenge due to logistical constraints and a lack of suitable methodology. In this study, we characterize the seasonal cycle of Antarctic fast ice adjacent to the Ekström Ice Shelf in the eastern Weddell Sea. We used a thermistor chain with the additional ability to record the temperature response induced by cyclic heating of resistors embedded in the chain. Vertical sea-ice temperature and heating profiles obtained daily between November 2012 and February 2014 were analyzed to determine sea-ice and snow evolution, and to calculate the basal energy budget. The residual heat flux translated into an ice-volume fraction in the platelet layer of 0.18 ± 0.09, which we reproduced by a independent model simulation and agrees with earlier results. Manual drillings revealed an average annual platelet-layer thickness increase of at least 4m, and an annual maximum thickness of 10m beneath second-year sea ice. The oceanic contribution dominated the total sea-ice production during the study, effectively accounting for up to 70% of second-year sea-ice growth. In summer, an oceanic heat flux of 21 W/m**2 led to a partial thinning of the platelet layer. Our results further show that the active heating method, in contrast to the acoustic sounding approach, is well suited to derive the fast-ice mass balance in regions influenced by ocean/ice-shelf interaction, as it allows sub-diurnal monitoring of the platelet-layer thickness.

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Competitiveness adjustment in struggling southern euro-area members requires persistently lower inflation than in major trading partners, but low inflation worsens public debt sustainability. When average euro-area inflation undershoots the two percent target, the conflict between intra-euro relative price adjustment and debt sustainability is more severe. In our baseline scenario, the projected public debt ratio reduction in Italy and Spain is too slow and does not meet the European fiscal rule. Debt projections are very sensitive to underlying assumptions and even small negative deviations from GDP growth, inflation and budget surplus assumptions can easily result in a runaway debt trajectory. The case for a greater than five percent of GDP primary budget surplus is very weak. Beyond vitally important structural reforms, the top priority is to ensure that euro area inflation does not undershoot the two percent target, which requires national policy actions and more accommodative monetary policy. The latter would weaken the euro exchange rate, thereby facilitating further intra-euro adjustment. More effective policies are needed to foster growth. But if all else fails, the European Central Bank’s Outright Monetary Transactions could reduce borrowing costs.

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Many studies suggest that balanced budget rules can restrain sovereign debt and lower sovereign borrowing costs, even if those rules are never enforced in court. Typically, this is explained as a result of a legal deterrence logic, in which the threat of judicial enforcement deters sovereigns from violating the rules. By contrast, we argue that balanced budget rules work by coordinating decentralized punishment of sovereigns by bond markets, rather than by posing a credible threat of judicial enforcement. Therefore, the clarity of the focal point provided by the rule, rather than the strength of its judicial enforcement mechanisms, determines its effectiveness. We develop a formal model that captures the logic of our argument, and we assess this model using data on US states. We then consider implications of our argument for the impact of the balanced budget rules recently imposed on eurozone states in the Fiscal Compact Treaty.

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The European Council meeting on 7 and 8 February 2013 attracted an unusual level of attention from media and citizens. For a couple of days, Europe played a more important role in national politics and news. Sensation-frenzied media and excited politicians spouted notions of ‘a battle’, ‘winners’, ‘losers’ or ‘striking deals’, as if Europe had gone back to the time when its military powers still conflicted. After more than 24 hours of intense negotiations, the respective Member States leaders left Brussels with ‘good news’ for their citizens. However, those with more Euro-federalist feelings were left with a sense of non-accomplishment and missed opportunities, not only because the EU budget for the first time in history was set for a net decrease, but also because the European Council’s conclusions did not contain any ground-breaking changes to this system. Nevertheless, the European Parliament (EP) immediately reminded Europe about its role and outlined its conditions for further negotiations. Thus, the supporters of a modern and stronger EU budget still see a chance in the consent procedure and hope to shift the focus of the debate from the juste retour spirit to the consideration of the European common good. Is there still a chance for such a shift? What issues are at stake?

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A guide to information sources on the European Union’s budget, with hyperlinks to further sources of information within European Sources Online and on external websites

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Shipping list no.: 2012-0266-P (pt. 1A), 2012-0262-P (pt. 1B), 2012-0267-P (pt. 1C), 2012-0317-P (pt. 2), 2013-0006 (pt. 3), 2013-0008-P (pt. 4), 2013-0027-P (pt. 5), 2013-0033-P (pt. 6), 2013-0042-P (pt. 7), 2013-0038-P (pt. 9).

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Shipping list no. 2012-0243-P (pt. 1, 4), 2012-0266-P (pt. 2A), 2012-0267-P (pt. 2B), 2012-0250-P (pt. 3), 2013-0038 (pt. 5), 2013-0040-P (pt. 6), 2012-0298-P (pt. 7).

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Recent studies suggest that coastal ecosystems can bury significantly more C than tropical forests, indicating that continued coastal development and exposure to sea level rise and storms will have global biogeochemical consequences. The Florida Coastal Everglades Long Term Ecological Research (FCE LTER) site provides an excellent subtropical system for examining carbon (C) balance because of its exposure to historical changes in freshwater distribution and sea level rise and its history of significant long-term carbon-cycling studies. FCE LTER scientists used net ecosystem C balance and net ecosystem exchange data to estimate C budgets for riverine mangrove, freshwater marsh, and seagrass meadows, providing insights into the magnitude of C accumulation and lateral aquatic C transport. Rates of net C production in the riverine mangrove forest exceeded those reported for many tropical systems, including terrestrial forests, but there are considerable uncertainties around those estimates due to the high potential for gain and loss of C through aquatic fluxes. C production was approximately balanced between gain and loss in Everglades marshes; however, the contribution of periphyton increases uncertainty in these estimates. Moreover, while the approaches used for these initial estimates were informative, a resolved approach for addressing areas of uncertainty is critically needed for coastal wetland ecosystems. Once resolved, these C balance estimates, in conjunction with an understanding of drivers and key ecosystem feedbacks, can inform cross-system studies of ecosystem response to long-term changes in climate, hydrologic management, and other land use along coastlines.

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In addition to enhance agricultural productivity, synthetic nitrogen (N) and phosphorous (P) fertilizer application in croplands dramatically altered global nutrient budget, water quality, greenhouse gas balance, and their feedbacks to the climate system. However, due to the lack of geospatial fertilizer input data, current Earth system/land surface modeling studies have to ignore or use over-simplified data (e.g., static, spatially uniform fertilizer use) to characterize agricultural N and P input over decadal or century-long period. We therefore develop a global time-series gridded data of annual synthetic N and P fertilizer use rate in croplands, matched with HYDE 3,2 historical land use maps, at a resolution of 0.5º latitude by longitude during 1900-2013. Our data indicate N and P fertilizer use rates increased by approximately 8 times and 3 times, respectively, since the year 1961, when IFA (International Fertilizer Industry Association) and FAO (Food and Agricultural Organization) survey of country-level fertilizer input were available. Considering cropland expansion, increase of total fertilizer consumption amount is even larger. Hotspots of agricultural N fertilizer use shifted from the U.S. and Western Europe in the 1960s to East Asia in the early 21st century. P fertilizer input show the similar pattern with additional hotspot in Brazil. We find a global increase of fertilizer N/P ratio by 0.8 g N/g P per decade (p< 0.05) during 1961-2013, which may have important global implication of human impacts on agroecosystem functions in the long run. Our data can serve as one of critical input drivers for regional and global assessment on agricultural productivity, crop yield, agriculture-derived greenhouse gas balance, global nutrient budget, land-to-aquatic nutrient loss, and ecosystem feedback to the climate system.