PERFECT Stroke : PERFormance, Effectiveness, and Costs of treatment episodes in Stroke

Stroke is a major cause of death and disability, incurs significant costs to healthcare systems, and inflicts severe burden to the whole society. Stroke care in Finland has been described in several population-based studies between 1967 and 1998, but not since. In the PERFECT Stroke study presented here, a system for monitoring the Performance, Effectiveness, and Costs of Treatment episodes in Stroke was developed in Finland. Existing nationwide administrative registries were linked at individual patient level with personal identification numbers to depict whole episodes of care, from acute stroke, through rehabilitation, until the patients went home, were admitted to permanent institutional care, or died. For comparisons in time and between providers, patient case-mix was adjusted for. The PERFECT Stroke database includes 104 899 first-ever stroke patients over the years 1999 to 2008, of whom 79% had ischemic stroke (IS), 14% intracerebral hemorrhage (ICH), and 7% subarachnoid hemorrhage (SAH). A 18% decrease in the age and sex adjusted incidence of stroke was observed over the study period, 1.8% improvement annually. All-cause 1-year case-fatality rate improved from 28.6% to 24.6%, or 0.5% annually. The expected median lifetime after stroke increased by 2 years for IS patients, to 7 years and 7 months, and by 1 year for ICH patients, to 4 years 5 months. No change could be seen in median SAH patient survival, >10 years. Stroke prevalence was 82 000, 1.5% of total population of Finland, in 2008. Modern stroke center care was shown to be associated with a decrease in both death and risk of institutional care of stroke patients. Number needed to treat to prevent these poor outcomes at one year from stroke was 32 (95% confidence intervals 26 to 42). Despite improvements over the study period, more than a third of Finnish stroke patients did not have access to stroke center care. The mean first-year healthcare cost of a stroke patient was ~20 000 , and among survivors ~10 000 annually thereafter. Only part of this cost was incurred by stroke, as the same patients cost ~5000 over the year prior to stroke. Total lifetime costs after first-ever stroke were ~85 000 . A total of 1.1 Billion , 7% of all healthcare expenditure, is used in the treatment of stroke patients annually. Despite a rapidly aging population, the number of new stroke patients is decreasing, and the patients are more likely to survive. This is explained in part by stroke center care, which is effective, and should be made available for all stroke patients. It is possible, in a suitable setting with high-quality administrative registries and a common identifier, to avoid the huge workload and associated costs of setting up a conventional stroke registry, and still acquire a fairly comprehensive dataset on stroke care and outcome.

Do Households Have Rational Expectations on Future Consumption? Evidence from the Finnish Consumer Survey

Ever since its initial introduction some fifty years ago, the rational expectations paradigm has dominated the way economic theory handles uncertainty. The main assertion made by John F. Muth (1961), seen by many as the father of the paradigm, is that expectations of rational economic agents should essentially be equal to the predictions of relevant economic theory, since rational agents should use information available to them in an optimal way. This assumption often has important consequences on the results and interpretations of the models where it is applied. Although the rational expectations assumption can be applied to virtually any economic theory, the focus in this thesis is on macroeconomic theories of consumption, especially the Rational Expectations–Permanent Income Hypothesis proposed by Robert E. Hall in 1978. The much-debated theory suggests that, assuming that agents have rational expectations on their future income, consumption decisions should follow a random walk, and the best forecast of future consumption level is the current consumption level. Then, changes in consumption are unforecastable. This thesis constructs an empirical test for the Rational Expectations–Permanent Income Hypothesis using Finnish Consumer Survey data as well as various Finnish macroeconomic data. The data sample covers the years 1995–2010. Consumer survey data may be interpreted to directly represent household expectations, which makes it an interesting tool for this particular test. The variable to be predicted is the growth of total household consumption expenditure. The main empirical result is that the Consumer Confidence Index (CCI), a balance figure computed from the most important consumer survey responses, does have statistically significant predictive power over the change in total consumption expenditure. The history of consumption expenditure growth itself, however, fails to predict its own future values. This indicates that the CCI contains some information that the history of consumption decisions does not, and that the consumption decisions are not optimal in the theoretical context. However, when conditioned on various macroeconomic variables, the CCI loses its predictive ability. This finding suggests that the index is merely a (partial) summary of macroeconomic information, and does not contain any significant private information on consumption intentions of households not directly deductible from the objective economic variables. In conclusion, the Rational Expectations–Permanent Income Hypothesis is strongly rejected by the empirical results in this thesis. This result is in accordance with most earlier studies conducted on the topic.

Analytical models for energy consumption in infrastructure WLAN STAs carrying TCP traffic

We develop analytical models for estimating the energy spent by stations (STAs) in infrastructure WLANs when performing TCP controlled file downloads. We focus on the energy spent in radio communication when the STAs are in the Continuously Active Mode (CAM), or in the static Power Save Mode (PSM). Our approach is to develop accurate models for obtaining the fraction of times the STA radios spend in idling, receiving and transmitting. We discuss two traffic models for each mode of operation: (i) each STA performs one large file download, and (ii) the STAs perform short file transfers. We evaluate the rate of STA energy expenditure with long file downloads, and show that static PSM is worse than just using CAM. For short file downloads we compute the number of file downloads that can be completed with given battery capacity, and show that PSM performs better than CAM for this case. We provide a validation of our analytical models using the NS-2 simulator.

Optimal Sleep-Wake Scheduling for Quickest Intrusion Detection using wireless sensor Networks

We consider the problem of quickest detection of an intrusion using a sensor network, keeping only a minimal number of sensors active. By using a minimal number of sensor devices,we ensure that the energy expenditure for sensing, computation and communication is minimized (and the lifetime of the network is maximized). We model the intrusion detection (or change detection) problem as a Markov decision process (MDP). Based on the theory of MDP, we develop the following closed loop sleep/wake scheduling algorithms: 1) optimal control of Mk+1, the number of sensors in the wake state in time slot k + 1, 2) optimal control of qk+1, the probability of a sensor in the wake state in time slot k + 1, and an open loop sleep/wake scheduling algorithm which 3) computes q, the optimal probability of a sensor in the wake state (which does not vary with time),based on the sensor observations obtained until time slot k.Our results show that an optimum closed loop control onMk+1 significantly decreases the cost compared to keeping any number of sensors active all the time. Also, among the three algorithms described, we observe that the total cost is minimum for the optimum control on Mk+1 and is maximum for the optimum open loop control on q.

Comparison of North American universities with and without medical schools and their technology transfer initiatives

Empirical research available on technology transfer initiatives is either North American or European. Literature over the last two decades shows various research objectives such as identifying the variables to be measured and statistical methods to be used in the context of studying university based technology transfer initiatives. AUTM survey data from years 1996 to 2008 provides insightful patterns about the North American technology transfer initiatives, we use this data in our paper. This paper has three sections namely, a comparison of North American Universities with (n=1129) and without Medical Schools (n=786), an analysis of the top 75th percentile of these samples and a DEA analysis of these samples. We use 20 variables. Researchers have attempted to classify university based technology transfer initiative variables into multi-stages, namely, disclosures, patents and license agreements. Using the same approach, however with minor variations, three stages are defined in this paper. The first stage is to do with inputs from R&D expenditure and outputs namely, invention disclosures. The second stage is to do with invention disclosures being the input and patents issued being the output. The third stage is to do with patents issued as an input and technology transfers as outcomes.

Embodied energy assessment of building materials in India using process and input-output analysis

Growing demand for urban built spaces has resulted in unprecedented exponential rise in production and consumption of building materials in construction. Production of materials requires significant energy and contributes to pollution and green house gas (GHG) emissions. Efforts aimed at reducing energy consumption and pollution involved with the production of materials fundamentally requires their quantification. Embodied energy (EE) of building materials comprises the total energy expenditure involved in the material production including all upstream processes such as raw material extraction and transportation. The current paper deals with EE of a few common building materials consumed in bulk in Indian construction industry. These values have been assessed based on actual industrial survey data. Current studies on EE of building materials lack agreement primarily with regard to method of assessment and energy supply assumptions (whether expressed in terms of end use energy or primary energy). The current paper examines the suitability of two basic methods; process analysis and input-output method and identifies process analysis as appropriate for EE assessment in the Indian context. A comparison of EE values of building materials in terms of the two energy supply assumptions has also been carried out to investigate the associated discrepancy. The results revealed significant difference in EE of materials whose production involves significant electrical energy expenditure relative to thermal energy use. (C) 2014 Elsevier B.V. All rights reserved.

Economic tradeoffs in mitigation, due to different atmospheric lifetimes of CO2 and black carbon

Tradeoffs are examined between mitigating black carbon (BC) and carbon dioxide (CO2) for limiting peak global mean warming, using the following set of methods. A two-box climate model is used to simulate temperatures of the atmosphere and ocean for different rates of mitigation. Mitigation rates for BC and CO2 are characterized by respective timescales for e-folding reduction in emissions intensity of gross global product. There are respective emissions models that force the box model. Lastly there is a simple economics model, with cost of mitigation varying inversely with emission intensity. Constant mitigation timescale corresponds to mitigation at a constant annual rate, for example an e-folding timescale of 40 years corresponds to 2.5% reduction each year. Discounted present cost depends only on respective mitigation timescale and respective mitigation cost at present levels of emission intensity. Least-cost mitigation is posed as choosing respective e-folding timescales, to minimize total mitigation cost under a temperature constraint (e.g. within 2 degrees C above preindustrial). Peak warming is more sensitive to mitigation timescale for CO2 than for BC. Therefore rapid mitigation of CO2 emission intensity is essential to limiting peak warming, but simultaneous mitigation of BC can reduce total mitigation expenditure. (c) 2015 Elsevier B.V. All rights reserved.

Optimal Guidance for Accurate Lunar Soft Landing with Minimum Fuel Consumption using Model Predictive Static Programming

In this paper the soft lunar landing with minimum fuel expenditure is formulated as a nonlinear optimal guidance problem. The realization of pinpoint soft landing with terminal velocity and position constraints is achieved using Model Predictive Static Programming (MPSP). The high accuracy of the terminal conditions is ensured as the formulation of the MPSP inherently poses final conditions as a set of hard constraints. The computational efficiency and fast convergence make the MPSP preferable for fixed final time onboard optimal guidance algorithm. It has also been observed that the minimum fuel requirement strongly depends on the choice of the final time (a critical point that is not given due importance in many literature). Hence, to optimally select the final time, a neural network is used to learn the mapping between various initial conditions in the domain of interest and the corresponding optimal flight time. To generate the training data set, the optimal final time is computed offline using a gradient based optimization technique. The effectiveness of the proposed method is demonstrated with rigorous simulation results.

Gasto público social : conceptos y alcances

Resumen: La definición del gasto público social, a pesar de ser un concepto difundido, no encuentra consenso en la literatura. En este sentido, los países utilizan definiciones operativas y ello imposibilita las comparaciones. Las modalidades de intervención del Estado en la política social, son: a) centralización y descentralización y b) tipos de políticas: universalización y focalización. El problema de la descentralización se ubica en un contexto más amplio que debería solucionarse con cambios sustanciales en la coparticipación federal, avanzando tanto en la descentralización de ingresos como en las responsabilidades de recaudación local. La focalización facilita la universalidad que es la esencia misma de la política social. En la práctica es imposible llegar a la universalidad con instrumentos tradicionales y la focalización es la herramienta útil para llegar a las personas más pobres, que en el largo plazo, deben ser sujetos de carácter universal.

Argentina. Crisis de pagos y sinergia entre programas del FMI y Club de París. 1956-2009

Desde 1956, en ocho ocasiones la Argentina refinanció deudas oficiales en el ámbito del Club de París. Estas refinanciaciones implicaron implementar programas de ajuste, acompañados en seis oportunidades por acuerdos contingentes con el FMI. Pero la apreciación subsiguiente de la moneda doméstica y los compromisos de facilitar importaciones pactados en tales acuerdos, desencadenan un ciclo de auge y deterioro de la cuenta corriente del balance de pagos que finaliza con una nueva crisis y una deuda externa incrementada, agravando la restricción de divisas originante de tal situación, en un contexto de salida masiva de capitales, inflación y recesión.

Conflitos temporais entre os processos legislativos ordinário e orçamentário

Analisa a interdependência, com ênfase no aspecto temporal, entre o processo legislativo ordinário, bicameral, produtor de normas permanentes, com prazos impróprios, em que se avalia o mérito e o processo orçamentário, congressual, prazos constitucionais, expedito e conciso. São usados como exemplos o PL 7749/10, que fixa o subsídio dos Ministros do Supremo Tribunal Federal por ato administrativo autorizado na LDO, e o entendimento comum de considerar-se como lacuna da Proposta Orçamentária da União para 2011, PL 59/10-CN, Lei 12.381/11, conforme Nota Técnica CONOF/CD nº 13/2010, a ausência de valores referentes a proposições em tramitação no processo legislativo bicameral, produtor de cogência normativa sob a forma de despesas obrigatórias continuadas.

Population age structure and private consumption in Spain

In this paper we study the effect of population age distribution upon private consumption expenditure in Spain from 1964 to 1997 using aggregate data. We obtain four main results. First, changes in the population pyramid have substantial effects upon the behaviour of private consumption. Second, the pattern of the coefficients of the demographic variables is not consistent with the simplest version of the life cycle hypothesis. Third, we estimate the impact of the demographic transition upon consumption and find positive values associated with episodes in which the shares of groups of individuals with expenditure levels higher (lower) than the mean increased (decreased). Fourth, the results are robust to alternative specifications for the population age distribution.

Capacidades tecnológicas y certificaciones de calidad: Aplicación empírica a las pymes familiares de La Rioja

Ponencia presentada y defendida en las XIV Jornadas Hispano-Lusas de Gestión Científica celebradas en las Azores en febrero de 2004.

Interim report on the progress of an inventory of artesian wells in Florida: leading to the enforcement of sections 370.051 - 370.54, Florida statues

One of the causes of lower artesian pressure, water waste and aquifer contamination is the misuse and insufficient care of artesian wells. In 1953, Senate Bill No. 57, entitled "An Act to Protect and Control the Artesian Waters of the State" (see Appendix) became a law. This law was passed through the efforts exerted by leading members of the Senate and the House of Representatives, who understood the need for a wise and controlled expenditure of our most valuable natural resource. The State Geologist and his authorized representatives were designated by this law to enforce this conservation measure; however, no financial provision was included for the 1953-55 biennium. The proposed program of the Florida Geological Survey for this biennium did not include the funds nor provide any full-time personnel for the enforcement of this statute. As a result, little actual work was accomplished during these two years, although much time was given to planning and discussion of the problem. Realizing that this program could provide additional basic data needed in the analysis of the water-supply problem, the State Geologist sought and was granted by the 1955 Legislature adequate funds with which to activate the first phase of the enforcement of Florida Statute No. 370.051-054. Enumerated below is a summary of the progress made on this investigation as outlined previously: 1. Data have been collected on 967 wildly flowing wells in 22 counties. 2. Chloride determinations have been run on 850 of the 967 wells. 3. Of the 967 wells, 554 have chlorides in excess of the 250 ppm, the upper limit assigned by the State Board of Health for public consumption. 4. Water escapes at the rate of 37, 762 gallons per minute from these 967 wells. This amounts to 54, 377, 280 gallons per day. The investigation is incomplete at this time; therefore, no final conclusions can be reached. However, from data already collected, the following recommendations are proposed: 1. That the present inventory of wildly flowing wells be completed for the entire State. 2. That the current inventory of wildly flowing wells be expanded at the conclusion of the present inventory to include all flowing wells. 3. That a complete statewide inventory program be established and conducted in cooperation with the Ground Water Branchof the U.S. Geological Survey. 4. That the enforcement functions as set down in Sections 370.051/.054, Florida Statutes, be separated from the program to collect water-resource data and that these functions be given to the Water Resources Department, if such is created (to be recommended by the Water Resources Study Commission in a water policy law presented to the 1957 Legislature). 5. That the research phase (well inventory) of the program remain under the direction of the Florida Geological Survey. (PDF contains 204 pages.)

Integration of technologies for understanding the functional relationship between reef habitat and fish growth and production

Functional linkage between reef habitat quality and fish growth and production has remained elusive. Most current research is focused on correlative relationships between a general habitat type and presence/absence of a species, an index of species abundance, or species diversity. Such descriptive information largely ignores how reef attributes regulate reef fish abundance (density-dependent habitat selection), trophic interactions, and physiological performance (growth and condition). To determine the functional relationship between habitat quality, fish abundance, trophic interactions, and physiological performance, we are using an experimental reef system in the northeastern Gulf of Mexico where we apply advanced sensor and biochemical technologies. Our study site controls for reef attributes (size, cavity space, and reef mosaics) and focuses on the processes that regulate gag grouper (Mycteroperca microlepis) abundance, behavior and performance (growth and condition), and the availability of their pelagic prey. We combine mobile and fixed-active (fisheries) acoustics, passive acoustics, video cameras, and advanced biochemical techniques. Fisheries acoustics quantifies the abundance of pelagic prey fishes associated with the reefs and their behavior. Passive acoustics and video allow direct observation of gag and prey fish behavior and the acoustic environment, and provide a direct visual for the interpretation of fixed fisheries acoustics measurements. New application of biochemical techniques, such as Electron Transport System (ETS) assay, allow the in situ measurement of metabolic expenditure of gag and relates this back to reef attributes, gag behavior, and prey fish availability. Here, we provide an overview of our integrated technological approach for understanding and quantifying the functional relationship between reef habitat quality and one element of production – gag grouper growth on shallow coastal reefs.