Cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine into the universal immunisation of infants in Brazil

Background Cost-effectiveness studies have been increasingly part of decision processes for incorporating new vaccines into the Brazilian National Immunisation Program. This study aimed to evaluate the cost-effectiveness of 10-valent pneumococcal conjugate vaccine (PCV10) in the universal childhood immunisation programme in Brazil. Methods A decision-tree analytical model based on the ProVac Initiative pneumococcus model was used, following 25 successive cohorts from birth until 5 years of age. Two strategies were compared: (1) status quo and (2) universal childhood immunisation programme with PCV10. Epidemiological and cost estimates for pneumococcal disease were based on National Health Information Systems and literature. A 'top-down' costing approach was employed. Costs are reported in 2004 Brazilian reals. Costs and benefits were discounted at 3%. Results 25 years after implementing the PCV10 immunisation programme, 10 226 deaths, 360 657 disability-adjusted life years (DALYs), 433 808 hospitalisations and 5 117 109 outpatient visits would be avoided. The cost of the immunisation programme would be R$10 674 478 765, and the expected savings on direct medical costs and family costs would be R$1 036 958 639 and R$209 919 404, respectively. This resulted in an incremental cost-effectiveness ratio of R$778 145/death avoided and R$22 066/DALY avoided from the society perspective. Conclusion The PCV10 universal infant immunisation programme is a cost-effective intervention (1-3 GDP per capita/DALY avoided). Owing to the uncertain burden of disease data, as well as unclear long-term vaccine effects, surveillance systems to monitor the long-term effects of this programme will be essential.

Universal behavior of the Shannon mutual information of critical quantum chains

We consider the Shannon mutual information of subsystems of critical quantum chains in their ground states. Our results indicate a universal leading behavior for large subsystem sizes. Moreover, as happens with the entanglement entropy, its finite-size behavior yields the conformal anomaly c of the underlying conformal field theory governing the long-distance physics of the quantum chain. We study analytically a chain of coupled harmonic oscillators and numerically the Q-state Potts models (Q = 2, 3, and 4), the XXZ quantum chain, and the spin-1 Fateev-Zamolodchikov model. The Shannon mutual information is a quantity easily computed, and our results indicate that for relatively small lattice sizes, its finite-size behavior already detects the universality class of quantum critical behavior.

Asignación de profundidad significativa a las observaciones remotas de la temperatura superficial del mar

Se asigna una profundidad efectiva para las medidas de temperatura superficial del mar obtenida mediante AVHRR en aguas del Atlántico Centro-Oriental. Las distribuciones espaciales de temperatura a cierta profundidad pueden definirse por satélite. En la mesoescala (l° mes) y para una precisión absoluta de 1ºK. Se encuentra que el espesor de la capa homogénea varía entre unos 100 m en febrero aproximadamente 20m de septiembre. ABSTRACT: Using a 11 years time series of monthly mean AVHRR sea surface temperatures and a comparable time series of XBT data for Central Eastem Atlantic, a representative depth is assigned to satellite measurements. At mesoscale (1 degree, month resolution) the thickness of fue homogeneous surface layer varíes from approximately 100 m in February to only 20 m in september, for an accuracy of loK in the temperature deterrnination.

Evaluación del factor peso inferior a 1500 gramos al nacer como indicador de riesgo para la hipoacusia neurosensorial en el programa de cribaje universal de la hipoacusia infantil del Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria durante el periodo 2007-2010

Programa de doctorado: Avances en Traumatología, Medicina del Deporte y Cuidados de Heridas.

Evaluación de la hiperbilirrubinemia como factor de riesgo de hipoacusia neurosensorial en el programa de screening universal de hipoacusia infantil del Complejo Hospitalario Universitario Universitario Insular Materno Infantil de Gran Canaria ente los años 2007 al 2011

Programa de doctorado: Avances en Traumatología, Medicina del Deporte y Cuidados de Heridas.

Evaluación de la ototoxicidad como factor de riesgo en el programa de Cribaje Universal de Hipoacusia Infantil del Complejo Hospitalario Materno-Infantil de Gran Canaria entre los años 2007-2009

Programa de doctorado: Patología Quirúrgica, Reproducción Humana y Factores Psicológicos y el Proceso de Enfermar

The universal language of Freemasonry

Freimaurer verwenden eine spezielle Art von Kommunikation: Zeichensprache, Metaphern, Symbole, Neologismen, Fachsprachen, rituelle 'Reisen' usw. Untersucht werden soll hier der masonische Anspruch, eine 'Universalsprache' zu besitzen. Das Gerüst dieser Dissertation ist ein Vergleich der ganzen Bandbreite der Freimaurerei - Orden für Männer, Frauen, Jugendliche, Farbige, sowie quasi-masonische Freizeitclubs - mit nachahmerischen Fraternitäten, wie z.B. den frühen amerikanischen Versicherungsgesellschaften und deren Kommunikationsmodellen. Die experimentelle Methode der Autorin schließt die Erforschung freimaurerischer und anderer bruderschaftlicher Quellen der letzten drei Jahrhunderte ein, sowie Besuche freimaurerischer Institutionen und Interviews mit Freimaurern. Diese Aktivitäten führten zu dem Ergebnis, daß - während die Symbole allgemein anwendbar sind - die schriftliche Freimaurersprache nicht in allen Ländern uniform ist. Die ethischen Lehren, die aus der symbolischen Freimaurerkommunikation gezogen werden sollen, haben einen internationalen Standard erreicht. So ist die Freimaurersprache seit der offiziellen Gründung der Freimaurerei im Jahre 1717 immer noch lebendig. Die rituelle Phraseologie der frühen nordamerikanischen Gewerkschaften und Versicherungsgesellschaften hingegen ist entweder verloren gegangen oder stellt nur noch pompöse Worthülsen dar, die sich um ein weltliches Thema - wie Versicherungen - ranken.

A universal delta model

This thesis presents a universal model of documents and deltas. This model formalize what it means to find differences between documents and to shows a single shared formalization that can be used by any algorithm to describe the differences found between any kind of comparable documents. The main scientific contribution of this thesis is a universal delta model that can be used to represent the changes found by an algorithm. The main part of this model are the formal definition of changes (the pieces of information that records that something has changed), operations (the definitions of the kind of change that happened) and deltas (coherent summaries of what has changed between two documents). The fundamental mechanism tha makes the universal delta model a very expressive tool is the use of encapsulation relations between changes. In the universal delta model, changes are not always simple records of what has changed, they can also be combined into more complex changes that reflects the detection of more meaningful modifications. In addition to the main entities (i.e., changes, operations and deltas), the model describes and defines also documents and the concept of equivalence between documents. As a corollary to the model, there is also an extensible catalog of possible operations that algorithms can detect, used to create a common library of operations, and an UML serialization of the model, useful as a reference when implementing APIs that deal with deltas. The universal delta model presented in this thesis acts as the formal groundwork upon which algorithm can be based and libraries can be implemented. It removes the need to recreate a new delta model and terminology whenever a new algorithm is devised. It also alleviates the problems that toolmakers have when adapting their software to new diff algorithms.

The Dynamics of Passive Torsional Fatigue Test Rigs: Innovative Applications of Universal Joints

The dynamics of a passive back-to-back test rig have been characterised, leading to a multi-coordinate approach for the analysis of arbitrary test configurations. Universal joints have been introduced into a typical pre-loaded back-to-back system in order to produce an oscillating torsional moment in a test specimen. Two different arrangements have been investigated using a frequency-based sub-structuring approach: the receptance method. A numerical model has been developed in accordance with this theory, allowing interconnection of systems with two-coordinates and closed multi-loop schemes. The model calculates the receptance functions and modal and deflected shapes of a general system. Closed form expressions of the following individual elements have been developed: a servomotor, damped continuous shaft and a universal joint. Numerical results for specific cases have been compared with published data in literature and experimental measurements undertaken in the present work. Due to the complexity of the universal joint and its oscillating dynamic effects, a more detailed analysis of this component has been developed. Two models have been presented. The first represents the joint as two inertias connected by a massless cross-piece. The second, derived by the dynamic analysis of a spherical four-link mechanism, considers the contribution of the floating element and its gyroscopic effects. An investigation into non-linear behaviour has led to a time domain model that utilises the Runge-Kutta fourth order method for resolution of the dynamic equations. It has been demonstrated that the torsional receptances of a universal joint, derived using the simple model, result in representation of the joint as an equivalent variable inertia. In order to verify the model, a test rig has been built and experimental validation undertaken. The variable inertia of a universal joint has lead to a novel application of the component as a passive device for the balancing of inertia variations in slider-crank mechanisms.

Agents, nodes & resources: Universal naming system for a coordination middleware

La tesi si propone di sviluppare un modello, l'architettura e la tecnologia per il sistema di denominazione del Middleware Coordinato TuCSoN, compresi gli agenti, i nodi e le risorse. Identità universali che rappresentano queste entità, sia per la mobilità fisica sia per quella virtuale, per un Management System (AMS, NMS, RMS) distribuito; tale modulo si occupa anche di ACC e trasduttori, prevedendo questioni come la tolleranza ai guasti, la persistenza, la coerenza, insieme con il coordinamento disincarnata in rete, come accade con le tecnologie Cloud. All’interno dell’elaborato, per prima cosa si è fatta una introduzione andando a descrivere tutto ciò che è contenuto nell’elaborato in modo da dare una visione iniziale globale del lavoro eseguito. Di seguito (1° capitolo) si è descritta tutta la parte relativa alle conoscenze di base che bisogna avere per la comprensione dell’elaborato; tali conoscenze sono relative a TuCSoN (il middleware coordinato con cui il modulo progettato dovrà interfacciarsi) e Cassandra (sistema server distribuito su cui si appoggia la parte di mantenimento e salvataggio dati del modulo). In seguito (2° capitolo) si è descritto JADE, un middleware da cui si è partiti con lo studio per la progettazione del modello e dell’architettura del modulo. Successivamente (3° capitolo) si è andati a spiegare la struttura e il modello del modulo considerato andando ad esaminare tutti i dettagli relativi alle entità interne e di tutti i legami fra esse. In questa parte si è anche dettagliata tutta la parte relativa alla distribuzione sulla rete del modulo e dei suoi componenti. In seguito (4° capitolo) è stata dettagliata e spiegata tutta la parte relativa al sistema di denominazione del modulo, quindi la sintassi e l’insieme di procedure che l’entità consumatrice esterna deve effettuare per ottenere un “nome universale” e quindi anche tutti i passaggi interni del modulo per fornire l’identificatore all’entità consumatrice. Nel capitolo successivo (5° capitolo) si sono descritti tutti i casi di studio relativi alle interazioni con le entità esterne, alle entità interne in caso in cui il modulo sia o meno distribuito sulla rete, e i casi di studio relativi alle politiche, paradigmi e procedure per la tolleranza ai guasti ed agli errori in modo da dettagliare i metodi di riparazione ad essi. Successivamente (6° capitolo) sono stati descritti i possibili sviluppi futuri relativi a nuove forme di interazione fra le entità che utilizzano questo modulo ed alle possibili migliorie e sviluppi tecnologici di questo modulo. Infine sono state descritte le conclusioni relative al modulo progettato con tutti i dettagli in modo da fornire una visione globale di quanto inserito e descritto nell’elaborato.

The quality of primary care in a country with universal health care coverage

Standard indicators of quality of care have been developed in the United States. Limited information exists about quality of care in countries with universal health care coverage.