Établir des priorités en soins de santé. Comment passer des besoins vitaux aux taux de remboursement?

Choisir est consubstantiel à l’existence humaine, mais dans le cadre de biens collectifs comme les soins de santé, dans le cadre de budgets forcément limités et objet de réduction, choisir devient un devoir éthique. Nous proposons une approche susceptible d’être féconde dans la détermination du « paquet de soins ». Cette approche est fondée sur le concept de « besoin vital » qui doit être rencontré afin d’éviter un « endommagement grave » qui altère la capacité d’agent de la personne. Nous formulons ensuite une critique de la plupart des variables focales, qui déterminent chacune une forme d’égalitarisme, avant de considérer quelques questions éthiques liées à la fixation de priorités en santé. La prise en considération des préférences de la population apparaît comme un élément incontournable à la légitimation des décisions. Elle peut s’avérer féconde si elle bénéficie d’une forme de care que nous qualifions d’informationnel.

Afinal, quantos éramos? Um estudo da mortalidade pretérita na freguesia da gloriosa Sant Anna

Search mortality in the glorious St. Anna Parish, hinterland of Rio Grande do Norte in the time frame 1788-1838 is the main objective of this research. Questions that the research aims to answer are: how many were after? Data parish deaths allow us to study mortality in Town? To conduct the research, first appealed to the population maps of the years 1777, 1810, 1811, 1824, 1844, 1853; censuses of 1872 and 1890. As well, the first two books of burials / deaths of the Parish, the first dating from 1788 to 1811 and the second from 1812 to 1838 and a book of baptism 1803-1806. Among the findings it was realized that, for now, the question of knowing, "After all, how many were?" Still cannot be answered, because during the analysis we noticed a high rate of underreporting, demonstrated through a study of the first infant mortality, in which the records we have was very high, which goes against the pre-transitional period, but with the exercise of inverse projection found the opposite, a population that would have a life expectancy higher. Demonstrating the problem of underreporting. Infant deaths occur mainly with the male children in the first months of the year due to infectious causes, and in the early days and weeks, we raised a hypothesis is that these deaths have as a backdrop the poor condition of the mother leading to poor training child, thus leading to his early death

Um estudo das condições de percolação e estabilidade em barragens de terra mediante métodos geofísicos: caso do dique de Sant Llorenç de Montgai - Espanha

The monitoring of Earth dam makes use of visual inspection and instrumentation to identify and characterize the deterioration that compromises the security of earth dams and associated structures. The visual inspection is subjective and can lead to misinterpretation or omission of important information and, some problems are detected too late. The instrumentation are efficient but certain technical or operational issues can cause restrictions. Thereby, visual inspections and instrumentation can lead to a lack of information. Geophysics offers consolidated, low-cost methods that are non-invasive, non-destructive and low cost. They have a strong potential and can be used assisting instrumentation. In the case that a visual inspection and strumentation does not provide all the necessary information, geophysical methods would provide more complete and relevant information. In order to test these theories, geophysical acquisitions were performed using Georadar (GPR), Electric resistivity, Seismic refraction, and Refraction Microtremor (ReMi) on the dike of the dam in Sant Llorenç de Montgai, located in the province of Lleida, 145 km from Barcelona, Catalonia. The results confirmed that the geophysical methods used each responded satisfactorily to the conditions of the earth dike, the anomalies present and the geological features found, such as alluvium and carbonate and evaporite rocks. It has also been confirmed that these methods, when used in an integrated manner, are able to reduce the ambiguities in individual interpretations. They facilitate improved imaging of the interior dikes and of major geological features, thus inspecting the massif and its foundation. Consequently, the results obtained in this study demonstrated that these geophysical methods are sufficiently effective for inspecting earth dams and they are an important tool in the instrumentation and visual inspection of the security of the dams

Resolución 19: Relación entre problemas económicos y de salud pública = Resolution 19: Relationship between economic and public health problems = Résolution 19: Rapports entre les problèmes économiques et la santé publique

El símbolo E/840/Rev.1 corresponde a la edición bilingüe inglés/francés publicada en 1953

Poesia em tempos de mal-estar: Charles Simic e Affonso Romano de Sant'Anna

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tempo de festas: homenagens a Santa Bárbara, N. S. da Conceição e Sant'Ana em Salvador (1860-1940)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo da variação do limite de resistência à tração ao longo da bobina de vergalhão de alumínio 1350 AA

Therebar of aluminum 1350 AA produced by CBA are used inthe manufacture of wires and cables for electric power transmission, which marketshows increasingly favorableto aluminum due to itslow densityand high electrical conductivity, but to ensure that this materialmeets all specifications of projectsfor electricity transmission, it must have homogeneity in the chemicaland mechanicalproperties.One of the points of improvement in the process of rod production isreducing the high variation of the limitof tensile strengthalong the coils, therefore, this work seeks a better understanding of the factors that significantly influence the mechanical properties of rebar, specifically assessing the influence oftemperatureat the output of the coils, which can cause a recovery effect on the material andif thereare relevantdifferences between the two modes of rebar production: auto and manual.Samples of six coils have been specifically produced forthis study, which weresubsequently subjected to different annealing temperatures for one hour and ten minutes, similar to what occurs in the output of the coil from the machine. The tensile tests showed that aluminum 1350 AA is significantly influenced by temperature, whose behavior was very similar to that presented in the literature. It was found that the phenomenon of recovery occurred more significantly at high temperatures. Through the optical electron microscope Zeiss, 18 surface maps were made with 100x magnification for each sample in different conditions and the images were analyzed using entropy and fractal dimension, aiming to relate the condition of surface hardening on mechanical property of the samples in that condition. The results showed that these methods can be applied, provided they do not have any kind of imperfection on the surface, once they can influence the results. The study concluded that a more efficient cooling is required in ... (Complete abstract click electronic access below)

As relações de trabalho e a resistência escrava em Sant'Ana de Paranaíba: província de Mato Grosso (1828- 1888)

Pós-graduação em História - FCLAS

Tectonic implications of the 1419 Ma Nova Guarita mafic intrusives paleomagnetic pole (Amazonian Craton) on the longevity of Nuna

The Nuna supercontinent was probably assembled in the Paleoproterozoic, but its paleogeography and the timing for its demise are stills matter of debate. A paleomagnetic and geochronological study carried out on the Mesoproterozoic Nova Guarita dyke swarm (northern Mato Grosso State, SW Amazonian Craton) provides additional constraints on the duration of this supercontinent. Paleomagnetic AF and thermal treatment revealed south/southwest (northeast) magnetic directions with downward (upward) inclinations for 19 analyzed sites. These directions are carried by PSD magnetite with high unblocking temperatures as indicated by additional magnetic tests, including thermomagnetic curves, hysteresis loops and the progressive acquisition of isothermal remanence in selected samples. A positive contact test with the host granite in one of the studied dykes further attests to the primary origin of the characteristic magnetic component. A mean site direction was calculated at D-m = 220.5 degrees, I-m = 45.9 degrees (alpha(95) = 6.5 degrees, K = 27.7), which yielded a paleomagnetic pole located at 245.9 degrees E, 47.9 degrees S (A(95) = 7.0 degrees). Ar-40/Ar-39 dating carried out on biotites from four analyzed dykes yielded well-defined plateau ages with a mean of 1418.5 +/- 3.5 Ma. The Nova Guarita pole precludes a long-lived Nuna configuration in which Laurentia, Baltica, North China, and Amazonia formed a long and continuous block as previously proposed for the Paleoproterozoic. It is nevertheless fully compatible with a SAMBA (Amazonia-Baltica) link at Mesoproterozoic times. (C) 2011 Elsevier B.V. All rights reserved.