Music and health in Kenya : sound, spirituality and altered consciousness juxtaposed with emotions

Music and Healing, African Music, Music therapy, Healing Rituals, Kenyan Music

Cardiac Surgery Costs According to the Preoperative Risk in the Brazilian Public Health System

AbstractBackground:Heart surgery has developed with increasing patient complexity.Objective:To assess the use of resources and real costs stratified by risk factors of patients submitted to surgical cardiac procedures and to compare them with the values reimbursed by the Brazilian Unified Health System (SUS).Method:All cardiac surgery procedures performed between January and July 2013 in a tertiary referral center were analyzed. Demographic and clinical data allowed the calculation of the value reimbursed by the Brazilian SUS. Patients were stratified as low, intermediate and high-risk categories according to the EuroSCORE. Clinical outcomes, use of resources and costs (real costs versus SUS) were compared between established risk groups.Results:Postoperative mortality rates of low, intermediate and high-risk EuroSCORE risk strata showed a significant linear positive correlation (EuroSCORE: 3.8%, 10%, and 25%; p < 0.0001), as well as occurrence of any postoperative complication EuroSCORE: 13.7%, 20.7%, and 30.8%, respectively; p = 0.006). Accordingly, length-of-stay increased from 20.9 days to 24.8 and 29.2 days (p < 0.001). The real cost was parallel to increased resource use according to EuroSCORE risk strata (R$ 27.116,00 ± R$ 13.928,00 versus R$ 34.854,00 ± R$ 27.814,00 versus R$ 43.234,00 ± R$ 26.009,00, respectively; p < 0.001). SUS reimbursement also increased (R$ 14.306,00 ± R$ 4.571,00 versus R$ 16.217,00 ± R$ 7.298,00 versus R$ 19.548,00 ± R$935,00; p < 0.001). However, as the EuroSCORE increased, there was significant difference (p < 0.0001) between the real cost increasing slope and the SUS reimbursement elevation per EuroSCORE risk strata.Conclusion:Higher EuroSCORE was related to higher postoperative mortality, complications, length of stay, and costs. Although SUS reimbursement increased according to risk, it was not proportional to real costs.

Acute Coronary Syndrome Treatment Costs from the Perspective of the Supplementary Health System

AbstractBackground:Acute coronary syndrome (ACS) is defined as a “group of clinical symptoms compatible with acute myocardial ischemia”, representing the leading cause of death worldwide, with a high clinical and financial impact. In this sense, the development of economic studies assessing the costs related to the treatment of ACS should be considered.Objective:To evaluate costs and length of hospital stay between groups of patients treated for ACS undergoing angioplasty with or without stent implantation (stent+ / stent-), coronary artery bypass surgery (CABG) and treated only clinically (Clinical) from the perspective of the Brazilian Supplementary Health System (SHS).Methods:A retrospective analysis of medical claims of beneficiaries of health plans was performed considering hospitalization costs and length of hospital stay for management of patients undergoing different types of treatment for ACS, between Jan/2010 and Jun/2012.Results:The average costs per patient were R$ 18,261.77, R$ 30,611.07, R$ 37,454.94 and R$ 40,883.37 in the following groups: Clinical, stent-, stent+ and CABG, respectively. The average costs per day of hospitalization were R$ 1,987.03, R$ 4,024.72, R$ 6,033.40 and R$ 2,663.82, respectively. The average results for length of stay were 9.19 days, 7.61 days, 6.19 days and 15.20 days in these same groups. The differences were significant between all groups except Clinical and stent- and between stent + and CABG groups for cost analysis.Conclusion:Hospitalization costs of SCA are high in the Brazilian SHS, being significantly higher when interventional procedures are required.

Social inequalities in health among children and adolescents in Germany : an investigation of political approaches

The present diploma thesis analyses the German political understanding of social inequalities in health (SIH) among children and adolescents, and explores the political strategies that are perceived as most effective to tackle SIH. The study is based on the qualitative content analysis of official political documents developed at different political levels, which were the national level as well as two purposefully selected counties, Mecklenburg-Vorpommern and Niedersachsen. The study's findings indicate a beginning awareness of the existence of SIH in Germany. Nevertheless, this judgement refers to few publishing ministries only, both at national and county levels. The suggested approaches to tackle SIH vary significantly among the analysed documents, and no consensus can be identified with regard to the preference of upstream or downstream policies. The existence of the social gradient is not criticised in any of the analysed data. However, there seems to be a common agreement on the importance of setting related interventions and the contribution of both the national, regional, and local politic levels. As the absence of a central coordinator can explain these highly heterogeneous findings, key recommendations concern the establishment of a nation-wide coordinator and a nation-wide collection of best practice examples. Here, the Federal Centre for Health Education has an adequate position and the required competences to act as a coordinator and facilitator. Further requirements for a successful reduction of SIH in Germany are the extension of a continuous communication between all actors, the adoption of the planned German Prevention Law, and the nation-wide and early promotion of children as part of education policies in the federal states.

CD95-induced apoptosis in health and disease dimers at the DISC and the effect of c-FLIP R on L. Monocytogenes infection

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2013

Development of a new isogeometric finite element and its application for Lamb wave based structural health monitoring

Magdeburg, Univ., Fak. für Maschinenbau, Diss., 2012

Japan, as represented in Field Museum of Natural History / by Helen C. Gunsaulus, Assistant Curator of Japanese Ethnology.

Fieldiana, Popular Series, Anthropology, no. 3, 11

The wild tribes of Davao district, Mindanao / by Fay-Cooper Cole, Assistant Curator of Malayan Ethnology. The R.F. Cummings Philippine Expedition. George A. Dorsey --

v.12:no.2(1913)

Use of tobacco in Mexico and South America / by J. Alden Mason, Formerly Assistant Curator of Mexican and South American Archaeology.

no.16(1924)

Japanese collections : Frank W. Gunsaulus Hall / by Helen C. Gunsaulus, Assistant Curator of Japanese Ethnology

no.3(1922)

A correlation of the Mayan and European calendars / by J. Eric Thompson, Assistant Curator of Mexican and South American Archaeology ; Berthold Laufer, Curator of Anthropology, editor.

v.17:no.1(1927)

The Japanese sword and its decoration / by Helen C. Gunsaulus, Assistant Curator of Japanese Ethnology.

no.20(1924)

Annual ceremony of the Pawnee medicine men / by Ralph Linton, Assistant Curator of North American Ethnology.

no.8(1923)

Egyptian stelae in Field Museum of Natural History / by Thomas George Allen, Assistant Curator of Egyptian Archaeology. 43 plates and 43 copies of inscriptions in the text. Paul S. Martin, Curator, Department of Anthropology, editor.

v.24:no.1(1936)