Aircraft Engines Maintenance Costs and Reliability: An Appraisal of the Decision Process to Remove an Engine for a Shop Visit Aiming at Minimum Maintenance Unit Cost

Dissertação apresentada como requisito parcial para obtenção do grau de Mestre em Estatística e Gestão de Informação.

Changing environmental behaviors through smartphone-based augmented experiences

Dissertação para obtenção do Grau de Mestrado em Engenharia de Informática

Health survey on the Ilha da Conceição, state of Rio de Janeiro: I. Study design and report of selected demographic and environmental characteristics

During July and August of 1968, a Health survey was conducted on the Ilha da Conceição, an area of Niterói containing approximately one thousand households. The survey was conducted by students from the Universidade Federal Fluminense and the University of Maryland, and was under the supervision of faculty of the Department of Tropical Medicine at U.F.F. and from the Department of Preventive Medicine at the University of Maryland, Baltimore, Maryland, U.S.A. The survey was focused on a 25 percent random sample of the households on the island. Information was obtained from a responsible adult at each Household for completion of a Health questionnaire. Physical measurements, as well as laboratory study information were obtained from, all children in these households. A number of environmental sanitation problems were identified on the Ilha da Conceição. In addition, the survey indicated that approximately half the children had not been adequately immunized against diphteria, pertussis and typhoid. Preventable communicable diseases were the major cause of reported deaths which had occurred in infants ou Household members. The Health of the population on the Ilha da Conceição could well be enhanced by the development of an intelligence system indicating the immunization status of all children in the area. In addition a Health education program for the residents could well be beneficial for improvement of sanitary conditions on the island, as well as maternity and well baby care.

A Pilot Cost-Effectiveness Analysis of Treatments in Newly Diagnosed High-Grade Gliomas: The Example of 5-Aminolevulinic Acid Compared With White-Light Surgery

BACKGROUND: High-grade gliomas are aggressive, incurable tumors characterized by extensive diffuse invasion of the normal brain parenchyma. Novel therapies at best prolong survival; their costs are formidable and benefit is marginal. Economic restrictions thus require knowledge of the cost-effectiveness of treatments. Here, we show the cost-effectiveness of enhanced resections in malignant glioma surgery using a well-characterized tool for intraoperative tumor visualization, 5-aminolevulinic acid (5-ALA). OBJECTIVE: To evaluate the cost-effectiveness of 5-ALA fluorescence-guided neurosurgery compared with white-light surgery in adult patients with newly diagnosed high-grade glioma, adopting the perspective of the Portuguese National Health Service. METHODS: We used a Markov model (cohort simulation). Transition probabilities were estimated with the use of data from 1 randomized clinical trial and 1 noninterventional prospective study. Utility values and resource use were obtained from published literature and expert opinion. Unit costs were taken from official Portuguese reimbursement lists (2012 values). The health outcomes considered were quality-adjusted life-years, lifeyears, and progression-free life-years. Extensive 1-way and probabilistic sensitivity analyses were performed. RESULTS: The incremental cost-effectiveness ratios are below €10 000 in all evaluated outcomes, being around €9100 per quality-adjusted life-year gained, €6700 per life-year gained, and €8800 per progression-free life-year gained. The probability of 5-ALA fluorescence-guided surgery cost-effectiveness at a threshold of €20000 is 96.0% for quality-adjusted life-year, 99.6% for life-year, and 98.8% for progression-free life-year. CONCLUSION: 5-ALA fluorescence-guided surgery appears to be cost-effective in newly diagnosed high-grade gliomas compared with white-light surgery. This example demonstrates cost-effectiveness analyses for malignant glioma surgery to be feasible on the basis of existing data.

Establishment of environmental and biological bases to optimise the production of the European clam Ruditapes decussatus (Linnaeus, 1758)

Dissertação para obtenção do Grau de Doutor em Ambiente

Cost-Effectiveness of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation in Portugal

INTRODUCTION AND OBJECTIVES:Recently, three novel non-vitamin K antagonist oral anticoagulants received approval for reimbursement in Portugal for patients with non-valvular atrial fibrillation (AF). It is therefore important to evaluate the relative cost-effectiveness of these new oral anticoagulants in Portuguese AF patients. METHODS: A Markov model was used to analyze disease progression over a lifetime horizon. Relative efficacy data for stroke (ischemic and hemorrhagic), bleeding (intracranial, other major bleeding and clinically relevant non-major bleeding), myocardial infarction and treatment discontinuation were obtained by pairwise indirect comparisons between apixaban, dabigatran and rivaroxaban using warfarin as a common comparator. Data on resource use were obtained from the database of diagnosis-related groups and an expert panel. Model outputs included life years gained, quality-adjusted life years (QALYs), direct healthcare costs and incremental cost-effectiveness ratios (ICERs). RESULTS:Apixaban provided the most life years gained and QALYs. The ICERs of apixaban compared to warfarin and dabigatran were €5529/QALY and €9163/QALY, respectively. Apixaban was dominant over rivaroxaban (greater health gains and lower costs). The results were robust over a wide range of inputs in sensitivity analyses. Apixaban had a 70% probability of being cost-effective (at a threshold of €20 000/QALY) compared to all the other therapeutic options. CONCLUSIONS:Apixaban is a cost-effective alternative to warfarin and dabigatran and is dominant over rivaroxaban in AF patients from the perspective of the Portuguese national healthcare system. These conclusions are based on indirect comparisons, but despite this limitation, the information is useful for healthcare decision-makers.

Environmental contamination by Toxocara sp eggs in public areas of Salvador, Bahia state, Brazil

A survey ofparasite eggs and cysts in soil and dog feces collected in public places of 23 boroughs of Salvador, a city in the Northeast of Brazil, was performed. High degree of contamination by Toxocara sp eggs was observed in all boroughs studied; other parasites found included: Ascaris lumbricoides, hookworms, whipworms and protozoan cysts. Parks andpublic gardens were more contaminated than streets and beachesfor all parasites, including Toxocara sp.

Carbon monoxide, autophagy and cytoprotection in response to cerebral ischemia

Dissertação para obtenção do Grau de Mestre em Genética Molecular e Biomedicina

Leveraging facebook’s open graph to develop an environmental persuasive application

Dissertação para obtenção do Grau de Mestre em Engenharia Informática

Urban containment: An effective tool for environmental protection?

This paper examines the effectiveness of urban containment policies to protect forestland from residential conversion and to increase the provision of forest public goods in the presence of irreversible investments and policy uncertainty. We develop a model of a single landowner that allows for switching between competing land uses (forestry and residential use) at some point in the future. Our results show that urban containment policies can protect (even if temporarily) forestland from being developed but must be supplemented with policies that influence the length and number of harvesting cycles if the goal is to increase nontimber benefits. The threat of a development prohibition creates incentives for preemptive timber harvesting and land conversion. In particular, threatened regulation creates an incentive to shorten rotation cycles to avoid costly land-use restrictions. However, it has an ambiguous effect on forestland conversion as the number of rotation cycles can also be adjusted to maximize the expected returns to land. Finally, in the presence of irreversibility, forestland conversion decisions should be done using real option theory rather than net present value analysis

Industrial symbiosis potential of the Sines oil refinery – environmental and economic evaluation

Dissertação para obtenção do Grau de Mestre em Engenharia do Ambiente – Perfil Gestão e Sistemas Ambientais

Innovation and environmental policy: Clean vs. dirty technical change

We study a two sector endogenous growth model with environmental quality with two goods and two factors of production, one clean and one dirty. Technological change creates clean or dirty innovations. We compare the laissez-faire equilibrium and the social optimum and study first- and second-best policies. Optimal policy encourages research toward clean technologies. In a second-best world, we claim that a portfolio that includes a tax on the polluting good combined with optimal innovation subsidy policies is less costly than increasing the price of the polluting good alone. Moreover, a discriminating innovation subsidy policy is preferable to a non-discriminating one.

Hospital-acquired infections: a cost estimation for CLABSI in Portugal

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics

Portuguese average cost of capital

The oldest Portuguese share index still being calculated is the BVL/PSI-General, one which started the daily series on 5/Jan/1988 with a base value of 1000 points. Everyday a single value is computed based on the closing prices of all the shares included in the sample. Also, all corporate events affecting the price of any share beyond market sentiment are taken into account through proper adjustments, either in the numerator or the denominator of the formula. However, for dates before January 1988, there is nothing comparable to this index since the two different series known either never disclosed the methodology adopted to calculate the index or followed solutions not compatible with the above index. The present paper explains the solutions adopted to replicate as closely as possible the methodology of the BVL-General index to the main market of the Lisbon Exchange for the period 1978 – 1987. This is the first estimate of the historical Equity Risk Premium in Portugal above short-term risk-free rate from the re-opening of the market following the Carnation Revolution (and the accompanying nationalizations), to the present. In showing a value of the same order of magnitude found in other countries, the paper invites further studies on the effects of political decisions such as privatizations and joining the European Union.

Cost efficiency in the Portuguese water sector: The case of multimunicipal systems operating at the bulk level

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics