Direct treatment costs of HIV/AIDS in Portugal

OBJECTIVE To analyze the direct medical costs of HIV/AIDS in Portugal from the perspective of the National Health Service. METHODS A retrospective analysis of medical records was conducted for 150 patients from five specialized centers in Portugal in 2008. Data on utilization of medical resources during 12 months and patients’ characteristics were collected. A unit cost was applied to each care component using official sources and accounting data from National Health Service hospitals. RESULTS The average cost of treatment was 14,277 €/patient/year. The main cost-driver was antiretroviral treatment (€ 9,598), followed by hospitalization costs (€ 1,323). Treatment costs increased with the severity of disease from € 11,901 (> 500 CD4 cells/µl) to € 23,351 (CD4 count ≤ 50 cells/ µl). Cost progression was mainly due to the increase in hospitalization costs, while antiretroviral treatment costs remained stable over disease stages. CONCLUSIONS The high burden related to antiretroviral treatment is counterbalanced by relatively low hospitalization costs, which, however, increase with severity of disease. The relatively modest progression of total costs highlights that alternative public health strategies that do not affect transmission of disease may only have a limited impact on expenditure, since treatment costs are largely dominated by constant antiretroviral treatment costs.

Uncertainty analysis based on sensitivity applied to angle-ply composite structures

This article describes a finite element-based formulation for the statistical analysis of the response of stochastic structural composite systems whose material properties are described by random fields. A first-order technique is used to obtain the second-order statistics for the structural response considering means and variances of the displacement and stress fields of plate or shell composite structures. Propagation of uncertainties depends on sensitivities taken as measurement of variation effects. The adjoint variable method is used to obtain the sensitivity matrix. This method is appropriated for composite structures due to the large number of random input parameters. Dominant effects on the stochastic characteristics are studied analyzing the influence of different random parameters. In particular, a study of the anisotropy influence on uncertainties propagation of angle-ply composites is carried out based on the proposed approach.

Mid-point for open-ended income category and the effect of equivalence scales on the income-health relationship

To estimate the mid-point of an open-ended income category and to assess the impact of two equivalence scales on income-health associations. Data were obtained from the 2010 Brazilian Oral Health Survey ( Pesquisa Nacional de Saúde Bucal – SBBrasil 2010). Income was converted from categorical to two continuous variables ( per capita and equivalized) for each mid-point. The median mid-point was R$ 14,523.50 and the mean, R$ 24,507.10. When per capita income was applied, 53% of the population were below the poverty line, compared with 15% with equivalized income. The magnitude of income-health associations was similar for continuous income, but categorized equivalized income tended to decrease the strength of association.

Socioeconomic inequality in catastrophic health expenditure in Brazil

OBJECTIVE To analyze the evolution of catastrophic health expenditure and the inequalities in such expenses, according to the socioeconomic characteristics of Brazilian families.METHODS Data from the National Household Budget 2002-2003 (48,470 households) and 2008-2009 (55,970 households) were analyzed. Catastrophic health expenditure was defined as excess expenditure, considering different methods of calculation: 10.0% and 20.0% of total consumption and 40.0% of the family’s capacity to pay. The National Economic Indicator and schooling were considered as socioeconomic characteristics. Inequality measures utilized were the relative difference between rates, the rates ratio, and concentration index.RESULTS The catastrophic health expenditure varied between 0.7% and 21.0%, depending on the calculation method. The lowest prevalences were noted in relation to the capacity to pay, while the highest, in relation to total consumption. The prevalence of catastrophic health expenditure increased by 25.0% from 2002-2003 to 2008-2009 when the cutoff point of 20.0% relating to the total consumption was considered and by 100% when 40.0% or more of the capacity to pay was applied as the cut-off point. Socioeconomic inequalities in the catastrophic health expenditure in Brazil between 2002-2003 and 2008-2009 increased significantly, becoming 5.20 times higher among the poorest and 4.17 times higher among the least educated.CONCLUSIONS There was an increase in catastrophic health expenditure among Brazilian families, principally among the poorest and those headed by the least-educated individuals, contributing to an increase in social inequality.

Fuzzy clustering applied to a demand response model in a smatr grid contingency scenario

This paper focus on a demand response model analysis in a smart grid context considering a contingency scenario. A fuzzy clustering technique is applied on the developed demand response model and an analysis is performed for the contingency scenario. Model considerations and architecture are described. The demand response developed model aims to support consumers decisions regarding their consumption needs and possible economic benefits.

Selenium role in an human biomonitoring study applied to occupational health

Selenium functions as a co-factor for the reduction of antioxidant enzymes and is an important component of antioxidant enzymes. Dietary selenium significantly inhibits the induction of skin, liver, colon, and mammary tumours in experimental animals by a number of different carcinogens, as well as the induction of mammary tumours by viruses. Selenium shows a “U” shaped curve for functionality, whereby too little is as damaging as too much. At optimal levels, selenium may protect against the formation of DNA adducts, DNA or chromosome breakage, chromosome gain or loss, mitochondrial DNA, and telomere length and function. Aim of study: Investigate the relation between selenium and genotoxic effects in a human biomonitoring study applied to occupational health.

Fuzzy linguistic controllers applied to decouple control loop effects

A fuzzy linguistic controller has been developed and implemented with the aim to cope with interactions between control loops due to coupling effects. To access the performance of the proposed approach several experiments have also been conducted using the classical PID controllers in the control loops. A mixing process has been used as test bed of all controllers experimented and the corresponding dynamic model has been derived. The successful results achieved with the fuzzy linguistic controllers suggests that they can be an alternative to classical controllers when in the presence of process plants where automatic control as to cope with coupling effects between control loops. © 2014 IEEE.

Invariant integrals applied to nematic liquid crystals with small Ericksen number and topological defects

Invariant integrals are derived for nematic liquid crystals and applied to materials with small Ericksen number and topological defects. The nematic material is confined between two infinite plates located at y = -h and y = h (h is an element of R+) with a semi-infinite plate at y = 0 and x < 0. Planar and homeotropic strong anchoring boundary conditions to the director field are assumed at these two infinite and semi-infinite plates, respectively. Thus, a line disclination appears in the system which coincides with the z-axis. Analytical solutions to the director field in the neighbourhood of the singularity are obtained. However, these solutions depend on an arbitrary parameter. The nematic elastic force is thus evaluated from an invariant integral of the energy-momentum tensor around a closed surface which does not contain the singularity. This allows one to determine this parameter which is a function of the nematic cell thickness and the strength of the disclination. Analytical solutions are also deduced for the director field in the whole region using the conformal mapping method. (C) 2013 Elsevier Ltd. All rights reserved.

Design state exploration applied to the development of a remote lab for projectile launch experiments

This paper describes the application of Design State Exploration techniques in the development of a remote lab for projectile motion experiments. The application was enabled by the existence of two independent teams: one composed of a series of internships that started first and another with two grantees that started a few months later. The paper presents evidence on how this approach provided gains in the development process conducted by the second team that benefited from design state exploration studies performed by the first team. This particular aspect is highlighted in relation to the work already presented in the 10th Remote Engineering and Virtual Instrumentation (REV) conference.

The simple economics of risk-sharing agreements between the NHS and the pharmaceutical industry

The Janssen-Cilag proposal for a risk-sharing agreement regarding bortezomib received a welcome signal from NICE. The Office of Fair Trading report included risk-sharing agreements as an available tool for the National Health Service. Nonetheless, recent discussions have somewhat neglected the economic fundamentals underlying risk-sharing agreements. We argue here that risk-sharing agreements, although attractive due to the principle of paying by results, also entail risks. Too many patients may be put under treatment even with a low success probability. Prices are likely to be adjusted upward, in anticipation of future risk-sharing agreements between the pharmaceutical company and the third-party payer. An available instrument is a verification cost per patient treated, which allows obtaining the first-best allocation of patients to the new treatment, under the risk sharing agreement. Overall, the welfare effects of risk-sharing agreements are ambiguous, and care must be taken with their use.

Hexachlorophene as a topically applied chemical for prophylaxis against Schistosoma mansoni infections in mice

Treatment of mouse tail skins with hexachlorophene (1.25% w/v) in absolute methanol or 70% isopropanol suppressed Schistosoma mansoni infections by more than 95% even when the application was performed up to three days prior to exposure to cercarial suspensions by tail immersion. Treatment with concentrations of 0.313% or higher one day prior to exposure provided at least 98% protection when the treated surface was not subjected to water washes of greater duration than 1/2 hour. Tail immersion application of 1.25% hexachlorophene one day prior to exposure still provided 87-92% protection after 3 hours water wash. Wipe application of 1.25% hexachlorophene three days prior to exposure still provided 93% protection following 3 hours water wash. High cercarial recoveries from exposure tubes at the end of exposure periods indicated high antipenetrant activity for hexachlorophene. Sufficient hexachlorophene leached from treated tail skins into the surrounding water to affect subsequently added cercariae so that they were no longer infective to untreated mice.

Soil erosion after forest fires: evaluation of mitigation measures applied to drainage channels in the northwest of Portugal

The development and implementation of measures which promote the reduction of the impacts of forest fires on soils is imperative and should be part of any strategy for forest and soil preservation and recovery, especially considering the actual scenario of continuous growth in the number of fires and burnt area. Consequently, with the dendrocaustologic reality that has characterized the Portuguese mainland in recent decades, a research project promoted by the Center for the Study of Geography and Spatial Planning (CEGOT) was implemented with the objective of applying several erosion mitigation measures in a burned area of the Peneda-Geres National Park in NW Portugal. This paper therefore seeks to present the measures applied in the study area within the project Soil Protec, relating to triggered channel processes and the results of preliminary observations concerning the evaluation of the effectiveness of erosion mitigation measures implemented, as well as their cost/benefit ratio.

Integrated ecological-economic modelling and assessment aproach for coastal ecosystem management

Thesis submitted to the Faculty of Sciences and Technology, New University of Lisbon, for the degree of Doctor of Philosophy in Environmental Sciences

Finite Element Analysis (FEA) applied to heat transfer optimization process of pultrusion die systems

The aim of this study is to optimize the heat flow through the pultrusion die assembly system on the manufacturing process of a specific glass-fiber reinforced polymer (GFRP) pultrusion profile. The control of heat flow and its distribution through whole die assembly system is of vital importance in optimizing the actual GFRP pultrusion process. Through mathematical modeling of heating-die process, by means of Finite Element Analysis (FEA) program, an optimum heater selection, die position and temperature control was achieved. The thermal environment within the die was critically modeled relative not only to the applied heat sources, but also to the conductive and convective losses, as well as the thermal contribution arising from the exothermic reaction of resin matrix as it cures or polymerizes from the liquid to solid condition. Numerical simulation was validated with basis on thermographic measurements carried out on key points along the die during pultrusion process.

Design of experiments applied to the mix design process of polymer mortar materials modified with GFRP recyclates

In this work, the effect of incorporation of recycled glass fibre reinforced plastics (GFRP) waste materials, obtained by means of shredding and milling processes, on mechanical behavior of polyester polymer mortar (PM) materials was assessed. For this purpose, different contents of GFRP recyclates (between 4% up to 12% in mass), were incorporated into polyester PM materials as sand aggregates and filler replacements. The effect of silane coupling agent addition to resin binder was also evaluated. Applied waste material was proceeding from the shredding of the leftovers resultant from the cutting and assembly processes of GFRP pultrusion profiles. Currently, these leftovers, jointly with unfinished products and scrap resulting from pultrusion manufacturing process, are landfilled, with supplementary added costs. Thus, besides the evident environmental benefits, a viable and feasible solution for these wastes would also conduct to significant economic advantages. Design of experiments and data treatment were accomplish by means of full factorial design approach and analysis of variance ANOVA. Experimental results were promising toward the recyclability of GFRP waste materials as aggregates and reinforcement for PM materials, with significant improvements on mechanical properties with regard to non-modified formulations.