O papel da análise custo-efetividade no processo decisório em saúde: o caso do sub-programa de controle da hanseníase

A introdução da Análise Custo-Efetividade na área da Saúde decorre desta preocupação de aperfeiçoamento dos métodos gerenciais em geral, e de escolha de alternativas de ação que levem ao melhor resultado em relação ao custo. Derivada das técnicas econômicas de análise de investimentos em uso no setor empresarial, a ACE pode ser de grande utilidade na montagem de programas e planos de saúde, na escolha entre diversos programas alternativos, e na sua avaliação. Consiste basicamente em confrontar os custos (esperados ou realizados a) de um programa, com seus resultados ou impactos (esperados ou realizados). A aplicação da Análise Custo-Efetividade é ainda recente, e restringe-se aos Estados Unidos e a alguns países europeus. No Brasil, embora comece a ser divulgada, ainda não foi utilizada em programas reais. Seus princípios e sua metodologia são relativamente simples, mas sua utilização em casos concretos esbarra em algumas dificuldades. Assim, a aplicação da análise a um dos programas desenvolvidos na Secretaria da Saúde poderá, além de divulgar a ACE na instituição, estabelecer claramente seu potencial e suas limitações no contexto da saúde pública brasileira. Um dos programas mais problemáticos da Secretaria é o Sub-programa de Controle da Hanseníase. Em vigência há vários anos, seus resultados estão aquém do esperado, em que pesem as características de uma doença endêmica e complexa e as falhas do próprio sub-programa. O interesse em se avaliar um programa cujos resultados são reconhecidamente insatisfatórios, e nosso conhecimento e experiência pessoal na área da hanseníase, justificam a escolha deste Sub-programa para a aplicação da Análise Custo-Efetividade.

Efeito do dispositivo intra-uterino de cobre (TCU 380A) na vascularização sub-endometrial e nos índices de resistência e pulsatilidade das artérias uterinas

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Análise da sobre-reação e sub-reação nos ativos de primeira e segunda lina do mercado acionário brasileiro

The Behavioral Finance develop as it is perceived anomalies in these markets efficient. This fields of study can be grouped into three major groups: heuristic bias, tying the shape and inefficient markets. The present study focuses on issues concerning the heuristics of representativeness and anchoring. This study aimed to identify the then under-reaction and over-reaction, as well as the existence of symmetry in the active first and second line of the Brazilian stock market. For this, it will be use the Fuzzy Logic and the indicators that classify groups studied from the Discriminant Analysis. The highest present, indicator in the period studied, was the Liabilities / Equity, demonstrating the importance of the moment to discriminate the assets to be considered "winners" and "losers." Note that in the MLCX biases over-reaction is concentrated in the period of financial crisis, and in the remaining periods of statistically significant biases, are obtained by sub-reactions. The latter would be in times of moderate levels of uncertainty. In the Small Caps the behavioral responses in 2005 and 2007 occur in reverse to those observed in the Mid-Large Cap. Now in times of crisis would have a marked conservatism while near the end of trading on the Bovespa speaker, accompanied by an increase of negotiations, there is an overreaction by investors. The other heuristics in SMLL occurred at the end of the period studied, this being a under-reaction and the other a over-reaction and the second occurring in a period of financial-economic more positive than the first. As regards the under / over-reactivity in both types, there is detected a predominance of either, which probably be different in the context in MLCX without crisis. For the period in which such phenomena occur in a statistically significant to note that, in most cases, such phenomena occur during the periods for MLCX while in SMLL not only biases are less present as there is no concentration of these at any time . Given the above, it is believed that while detecting the presence of bias behavior at certain times, these do not tend to appear to a specific type or heuristics and while there were some indications of a seasonal pattern in Mid- Large Caps, the same behavior does not seem to be repeated in Small Caps. The tests would then suggest that momentary failures in the Efficient Market Hypothesis when tested in semistrong form as stated by Behavioral Finance. This result confirms the theory by stating that not only rationality, but also human irrationality, is limited because it would act rationally in many circumstances

Obtenção de álcool alílico (PROP-2-EN-1-OL) a partir da glicerina derivada do biodiesel de óleo de mamona

In this work, biodiesel was produced from castor oil that was a byproduct glycerin. The molar ratio between oil and alcohol, as well as the use of (KOH) catalyst to provide the chemical reaction is based on literature. The best results were obtained using 1 mol of castor oil (260g) to 3 moles of methyl alcohol (138g), using 1.0% KOH as catalyst at a temperature of 260 ° C and shaken at 120 rpm. The oil used was commercially available, the process involves the reaction of transesterification of a vegetable oil with methyl alcohol. The product of this reaction is an ester, biodiesel being the main product and the glycerin by-product which has undergone treatment for use as raw material for the production of allyl alcohol. The great advantage of the use of glycerin to obtain allyl alcohol is that its use eliminates the large amount of waste of the biodiesel and various forms of insult to the environment. The reactions for the formation of allyl alcohol was conducted from formic acid and glycerin in a ratio 1/1, at a temperature of 260oC in a heater blanket, being sprayed by a spiral condenser for a period of 2 hours and the product obtained contains mostly the allylic alcohol .. The monitoring of reactions was performed by UV-Visible Spectrophotometer: FTIR Fourier transform, the analysis showed that these changes occur spectrometer indicating the formation of the product allylic alcohol (prop-2-en-1-ol) in the presence of water, This alcohol was appointed Alcohol GL. The absorption bands confirms that the reaction was observed in (υ C = C) 1470 -1600 cm -1 and (υ CO), 3610-3670 attributed to C = C groups and OH respectively. The thermal analysis was carried out in a thermogravimetric analyzer SDT Q600, where the mass and temperature are displayed against time, that allows checking the approximate rate of heating. The innovative methodology developed in the laboratory (LABTAM, UFRN), was able to treat the glycerine produced by transesterification of castor oil and used as raw material for production of allyl alcohol, with a yield of 80%, of alcohol, the same is of great importance in the manufacture of polymers, pharmaceuticals, organic compounds, herbicides, pesticides and other chemicals

Chronic exposure to sub-lethal concentration of a glyphosate-based herbicide alters hormone profiles and affects reproduction of female Jundia (Rhamdia quelen)

This work was carried out to verify the effect of a glyphosate-based herbicide on Jundia hormones (cortisol, 17 beta-estradiol and testosterone), oocyte and swim-up fry production. Earthen ponds containing Jundia females were contaminated with glyphosate (3.6 mg/L); blood samples were collected from eight females from each treatment immediately before, or at 1, 10, 20 30 and 40 days following contamination. A typical post-stress rise in cortisol levels was observed at the 20th and 40th days following exposure to glyphosate. At the 40th day, 17 beta-estradiol was decreased in the exposed females. A similar number of oocytes were stripped out from females from both groups, however, a lower number of viable swim-up fry were obtained from the herbicide exposed females, which also had a higher liver-somatic index (LSI). The results indicate that the presence of glyphosate in water was deleterious to Rhamdia quelen reproduction, altering steroid profiles and egg viability. (c) 2006 Elsevier B.V. All rights reserved.

Cytogenetic analysis of the neotropical spider Nephilengys cruentata (Araneomorphae, tetragnathidae): standard staining, NORs, C-bands and base-specific fluorochromes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação dos parâmetros genéticos em progênies de meio-irmãos de uma sub-população de milho composto Flint para resistência à lagarta-da-espiga Helicoverpa zea (Bod.)

Foram estudadas 100 progênies de meio-irmãos de uma sub-população de milho (Zea mays L.) Composto Flint com o objetivo de avaliar a resistência de genótipos à lagarta-da-espiga Helicoverpa zea (Bod.). Foram obtidos os valores de danos médios da lagarta-da-espiga de 1,14 cm de comprimento na espiga determinado pela escala de Widstrom e coeficiente de variação experimental (CVE) de 23,4%. Dos parâmetros genéticos avaliados, a estimativa de herdabilidade (h²) foi de 6%, variância genética (VG) de 0,0015 cm² e variância fenotípica (VF) de 0,025 cm² para danos de H. zea. No entanto, o comprimento da ponta da bráctea e compactação da bráctea alcançaram resultados de herdabilidade de 75% e 72% respectivamente. Essa sub-população de milho apresenta variabilidade genética suficiente para utilização em programas de melhoramento, sendo que a resistência à lagarta-da-espiga pode ser obtida através da melhoria dos caracteres morfológicos diretamente relacionados à praga, como a compactação e comprimento da bráctea.

Intravitreal injection versus sub-Tenon's infusion of triamcinolone acetonide for refractory diabetic macular edema: A randomized clinical trial

PURPOSE. To compare the effectiveness of posterior sub-Tenon's infusion (STi) and intravitreal injection (IVI) of triamcinolone acetonide (TA) for treatment of refractory diffuse diabetic macular edema.METHODS. Thirty-six phakic diabetic patients with refractory diffuse diabetic macular edema were prospectively enrolled. Patients randomly received either 40 mg STi or 4 mg IVI of TA. Comprehensive ophthalmic evaluation was performed at baseline and 1, 2, 4, 8 +/- 1, 12 +/- 2 and 24 +/- 2 weeks after treatment. Macular morphologic changes detected by optical coherence tomography and visual acuity, intraocular pressure, and lens status were evaluated.RESULTS. Twenty-eight patients (28 eyes) completed the 24-week study. Central macular thickness was significantly reduced in the IVI group when compared with the STi group at 2, 4, 8, 12, and 24 weeks after treatment (P < 0.01). Mean visual acuities (in logarithm of the minimum angle of resolution [logMAR]) at week-4, -8, and -12 follow-up examinations were significantly higher in the IVI group (0.74, 0.75, and 0.82, respectively) when compared with the STi group (0.88, 0.88, and 0.90, respectively; P < 0.01). A significant change from baseline in mean intraocular pressure (mm Hg) was seen at weeks 4 (+/- 3.21) and 8 (+/- 3.35) in STi the group (P < 0.01), and at week 8 (+/- 2.78) in the IVI group (P < 0.05). No patient had cataract progression during the study.CONCLUSIONS. Although the number of patients and length of follow-up in this preliminary study were limited, the changes in central macular thickness and visual acuity observed after treatment suggest that IVI TA may be more effective than STi for the management of refractory diffuse diabetic macular edema. Further studies are needed to confirm these preliminary findings.

Natural infection of gastrointestinal nematodes in long-nosed armadillos Dasypus novemcinctus Linnaeus, 1758 from Pantanal wetlands, Aquidauana sub-region, Mato Grosso do Sul State, with the description of Hadrostrongylus speciosum n. gen. et n. sp (Molineidae : Anoplostrongylinae)

This study evaluated the gastrointestinal helminth fauna of long-nosed armadillos, Dasypus novemcinctus, from the Pantanal wetlands, Aquidauana sub-region, Aquidauana County, Mato Grosso do Sul State, Brazil. Thirteen species of nematodes, comprising seven genera and four families, were recovered from their gastrointestinal tracts. The following descriptors of infection were determined: prevalence, variation of intensity, average intensity and abundance. Hadrostrongylus speciosum n. gen. et n. sp. is first described here. (c) 2006 Published by Elsevier B.V.

Antigenic characterization of Trypanosoma evansi using sera from experimentally and naturally infected bovines, equines, dogs, and coatis

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

Modelagem de dados de falhas de equipamentos de sub-superfície em poços de petróleo da Bacia Potiguar

This master´s thesis presents a reliability study conducted among onshore oil fields in the Potiguar Basin (RN/CE) of Petrobras company, Brazil. The main study objective was to build a regression model to predict the risk of failures that impede production wells to function properly using the information of explanatory variables related to wells such as the elevation method, the amount of water produced in the well (BSW), the ratio gas-oil (RGO), the depth of the production bomb, the operational unit of the oil field, among others. The study was based on a retrospective sample of 603 oil columns from all that were functioning between 2000 and 2006. Statistical hypothesis tests under a Weibull regression model fitted to the failure data allowed the selection of some significant predictors in the set considered to explain the first failure time in the wells

SurRFE -Sub-rede de filtragens específicas

The increasing of the number of attacks in the computer networks has been treated with the increment of the resources that are applied directly in the active routers equip-ments of these networks. In this context, the firewalls had been consolidated as essential elements in the input and output control process of packets in a network. With the advent of intrusion detectors systems (IDS), efforts have been done in the direction to incorporate packets filtering based in standards of traditional firewalls. This integration incorporates the IDS functions (as filtering based on signatures, until then a passive element) with the already existing functions in firewall. In opposite of the efficiency due this incorporation in the blockage of signature known attacks, the filtering in the application level provokes a natural retard in the analyzed packets, and it can reduce the machine performance to filter the others packets because of machine resources demand by this level of filtering. This work presents models of treatment for this problem based in the packets re-routing for analysis by a sub-network with specific filterings. The suggestion of implementa- tion of this model aims reducing the performance problem and opening a space for the consolidation of scenes where others not conventional filtering solutions (spam blockage, P2P traffic control/blockage, etc.) can be inserted in the filtering sub-network, without inplying in overload of the main firewall in a corporative network