Population based resource allocation: The use of hybrid risk adjustment

The emphasis on integrated care implies new incentives that promote coordinationbetween levels of care. Considering a population as a whole, the resource allocation systemhas to adapt to this environment. This research is aimed to design a model that allows formorbidity related prospective and concurrent capitation payment. The model can be applied inpublicly funded health systems and managed competition settings.Methods: We analyze the application of hybrid risk adjustment versus either prospective orconcurrent risk adjustment formulae in the context of funding total health expenditures for thepopulation of an integrated healthcare delivery organization in Catalonia during years 2004 and2005.Results: The hybrid model reimburses integrated care organizations avoiding excessive risktransfer and maximizing incentives for efficiency in the provision. At the same time, it eliminatesincentives for risk selection for a specific set of high risk individuals through the use ofconcurrent reimbursement in order to assure a proper classification of patients.Conclusion: Prospective Risk Adjustment is used to transfer the financial risk to the healthprovider and therefore provide incentives for efficiency. Within the context of a National HealthSystem, such transfer of financial risk is illusory, and the government has to cover the deficits.Hybrid risk adjustment is useful to provide the right combination of incentive for efficiency andappropriate level of risk transfer for integrated care organizations.

Key to the adults of the most common forensic species of Diptera in South America

Flies (Diptera, blow flies, house flies, flesh flies, horse flies, cattle flies, deer flies, midges and mosquitoes) are among the four megadiverse insect orders. Several species quickly colonize human cadavers and are potentially useful in forensic studies. One of the major problems with carrion fly identification is the lack of taxonomists or available keys that can identify even the most common species sometimes resulting in erroneous identification. Here we present a key to the adults of 12 families of Diptera whose species are found on carrion, including human corpses. Also, a summary for the most common families of forensic importance in South America, along with a key to the most common species of Calliphoridae, Muscidae, and Fanniidae and to the genera of Sarcophagidae are provided. Drawings of the most important characters for identification are also included.

Diagnosis and key of the main families and species of South American Coleoptera of forensic importance

The objective of this paper is to provide diagnosis and keys of the families and species, with illustrations of the main groups. A table of all related species recorded from South America is presented, including the substrate in which they were collected and their geographical distribution. The list comprises 221 species included in 15 families, of which 70% of the species are from Brazil. Scarabaeidae is the most diverse family with 121 species, followed by Staphylinidae with 68. Also we provide one database of Coleoptera species associated with carcasses in South America.

A new species of Seira Lubbock (Collembola, Entomobryidae), with a key to the species of Paraíba, Brazil

A new species of Entomobryidae of the genus Seira Lubbock, S. paraibensis sp. nov. is described and illustrated. The type locality of the species is the municipality of Areia, state of Paraíba, Brazil. The species was found inhabiting the Atlantic forest litter and top soil environment. S. paraibensis sp. nov. resembles S. pseudoannulata in many morphological features. This is the sixth species of the genus found and described in Paraiba so far. A key with the 11 species of Seira registered so far in Paraíba is provided. Also a list with all species of the genus from Brazil is presented.

Serum procalcitonin as a marker of post-cardiac arrest syndrome and long-term neurological recovery, but not of early-onset infections, in comatose post-anoxic patients treated with therapeutic hypothermia.

OBJECTIVE: To examine the relationship of early serum procalcitonin (PCT) levels with the severity of post-cardiac arrest syndrome (PCAS), long-term neurological recovery and the risk of early-onset infections in patients with coma after cardiac arrest (CA) treated with therapeutic hypothermia (TH). METHODS: A prospective cohort of adult comatose CA patients treated with TH (33°C, for 24h) admitted to the medical/surgical intensive care unit, Lausanne University Hospital, was studied. Serum PCT was measured early after CA, at two time-points (days 1 and 2). The SOFA score was used to quantify the severity of PCAS. Diagnosis of early-onset infections (within the first 7 days of ICU stay) was made after review of clinical, radiological and microbiological data. Neurological recovery at 3 months was assessed with Cerebral Performance Categories (CPC), and was dichotomized as favorable (CPC 1-2) vs. unfavorable (CPC 3-5). RESULTS: From December 2009 to April 2012, 100 patients (median age 64 [interquartile range 55-73] years, median time from collapse to ROSC 20 [11-30]min) were studied. Peak PCT correlated with SOFA score at day 1 (Spearman's R=0.44, p<0.0001) and was associated with neurological recovery at 3 months (peak PCT 1.08 [0.35-4.45]ng/ml in patients with CPC 1-2 vs. 3.07 [0.89-9.99] ng/ml in those with CPC 3-5, p=0.01). Peak PCT did not differ significantly between patients with early-onset vs. no infections (2.14 [0.49-6.74] vs. 1.53 [0.46-5.38]ng/ml, p=0.49). CONCLUSIONS: Early elevations of serum PCT levels correlate with the severity of PCAS and are associated with worse neurological recovery after CA and TH. In contrast, elevated serum PCT did not correlate with early-onset infections in this setting.

Pseudopsis monica sp. nov. from the western Andes, Peru, with a key to the South American species of Pseudopsis Newman (Coleoptera, Staphylinidae, Pseudopsinae)

Pseudopsis Newman, 1834 is a genus of Pseudopsinae with about 46 species distributed worldwide, five of which have been reported for South America. In this paper P. monica sp. nov. is described and illustrated based on specimens collected in Lima, Peru. A key to South American species of Pseudopsis and a catalog are also provided.

Key to the Australasian and Oceanian genera of Muscidae (Diptera)

A key to 51 Australasian and Oceanian genera of Muscidae is given. The Catalogue of Australasian and Oceanian Diptera and its on line version last reviewed in May 2007 were used as taxonomic guides. Some more recently synonyms and taxonomic changes were updated. For each genus, a brief diagnosis, number of valid species in these regions and comments, when pertinent, are also included. Some morphological diagnostic characteres are illustrated in order to help the use of the key.

Long Term Recovery Planning Task Force Report, August 2008

Eighty-five of 99 Iowa counties were declared Presidential Disaster Areas for Public Assistance and/orIndividual Assistance as a result of the tornadoes, storms, and floods over the incident period May 25 through August 13, 2008. Response dominated the state’s attention for weeks, with a transition to recovery as the local situations warranted. The widespread damage and severity of the impact on Iowans and their communities required a statewide effort to continue moving forward despite being surrounded by adversity. By all accounts, it will require years for the state to recover from these disasters. With an eye toward the future, recovery is underway across Iowa. As part of the Rebuild Iowa efforts, the Long Term Recovery Planning Task Force was charged with responsibilities somewhat different from other topical Task Force assignments. Rather than assess damage and report on how the state might address immediate needs, the Long Term Recovery Planning Task Force is directed to discuss and discern the best approach to the lengthy recovery process. Certainly, the Governor and Lieutenant Governor expect the task to be difficult; when planning around so many critical issues and overwhelming needs, it is challenging to think to the future, rather than to rise to the current day’s needs.

Biología de la anchoveta peruana, Engraulis ringens Jenyns

La anchoveta es la especie clave de la cadena alimentaria del sistema de afloramiento del mar peruano, que se caracteriza por sus altos niveles de productividad no superados por ningún otro ecosistema marino. Se analizaron los principales aspectos biológicos de la anchoveta en periodos de abundancia del recurso, y cuando disminuyeron los niveles poblacionales de esta especie. La recuperación de la población de la anchoveta es rápida después de los eventos cálidos debido a que la población responde a la normalización de las condiciones ambientales, disminuyendo también su mortalidad

Description of a new species of Toumeyella Cockerell (Hemiptera, Coccidae) from Mexico, with a taxonomic key to mexican species

A new species of soft scale insect from Mexico, Toumeyella fontanai Kondo & Pellizzari sp. nov. is des-cribed and illustrated. A taxonomic key to the species of scale insects of the genus Toumeyella Cockerell known in Mexico is provided.

Tracking individuals shows spatial fidelity is a key regulator of ant social organization.

Ants live in organized societies with a marked division of labor among workers, but little is known about how this division of labor is generated. We used a tracking system to continuously monitor individually tagged workers in six colonies of the ant Camponotus fellah over 41 days. Network analyses of more than 9 million interactions revealed three distinct groups that differ in behavioral repertoires. Each group represents a functional behavioral unit with workers moving from one group to the next as they age. The rate of interactions was much higher within groups than between groups. The precise information on spatial and temporal distribution of all individuals allowed us to calculate the expected rates of within- and between-group interactions. These values suggest that the network of interaction within colonies is primarily mediated by age-induced changes in the spatial location of workers.

Pictorial identification key for species of Sarcophagidae (Diptera) of potential forensic importance in southern Brazil

Pictorial identification key for species of Sarcophagidae (Diptera) of potential forensic importance in southern Brazil. Species of the subfamily Sarcophaginae are important to forensic entomology due to their necrophagous habits. This contribution presents a pictorial key for the identification of 22 Sarcophaginae species in 10 genera that are commonly found in southern Brazil. Photographs of the main structures used in species identification, mainly from the male terminalia, are provided.

Voyages et VIH: les points-clés [Key aspects regarding HIV and travel].

The risk of contracting a sexually transmitted infection while traveling abroad is increased in certain populations. Pre-travel consultation should include the education of travelers on the prevalence of HIV in the countries visited and on appropriate prevention measures. In patients infected with HIV (PHIV), combined antiretroviral therapy (cART) improves immunity, enabling them to travel with less risk for their health. Pre-travel consultation of PVIH has the following objectives: to determine immune status, to update immunization and to decide on anti-malaria drug prophylaxis, taking into account potential drug interactions with antiretroviral therapy. Vaccine response and duration of protection is shorter-lived in PVIH, especially if the CD4 count is below 200 cells/mm3 and the HIV viral load is detectable. Therefore cART is a cornerstone for disease prevention among patients infected with HIV who travel.

First record of Anthomyiidae (Diptera) from New Caledonia with key to Australasian and Oceanian species of Anthomyia Meigen

The Anthomyiidae (Diptera) are known from about 1,100 species mostly occurring in temperate to arctic areas in the northern hemisphere. Few species have been reported from the Australasian and Oceanian Regions. New Caledonia, located in Melanesia, in the southwest Pacific Ocean, is well known for its high diversity, endemism and large number of unknown species. Specimens of Anthomyia Meigen from New Caledonia were found at the Muséum national d'Histoire naturelle (Paris) collection. The species was identified as A. medialis Colless, and represents the first record of Anthomyiidae from the island. A key to the Anthomyia species occurring in these regions is presented, as well as illustrations of the male terminalia of A. medialis.

The genome of the leaf-cutting ant Acromyrmex echinatior suggests key adaptations to advanced social life and fungus farming.

We present a high-quality (>100× depth) Illumina genome sequence of the leaf-cutting ant Acromyrmex echinatior, a model species for symbiosis and reproductive conflict studies. We compare this genome with three previously sequenced genomes of ants from different subfamilies and focus our analyses on aspects of the genome likely to be associated with known evolutionary changes. The first is the specialized fungal diet of A. echinatior, where we find gene loss in the ant's arginine synthesis pathway, loss of detoxification genes, and expansion of a group of peptidase proteins. One of these is a unique ant-derived contribution to the fecal fluid, which otherwise consists of "garden manuring" fungal enzymes that are unaffected by ant digestion. The second is multiple mating of queens and ejaculate competition, which may be associated with a greatly expanded nardilysin-like peptidase gene family. The third is sex determination, where we could identify only a single homolog of the feminizer gene. As other ants and the honeybee have duplications of this gene, we hypothesize that this may partly explain the frequent production of diploid male larvae in A. echinatior. The fourth is the evolution of eusociality, where we find a highly conserved ant-specific profile of neuropeptide genes that may be related to caste determination. These first analyses of the A. echinatior genome indicate that considerable genetic changes are likely to have accompanied the transition from hunter-gathering to agricultural food production 50 million years ago, and the transition from single to multiple queen mating 10 million years ago.