Economic preferences in the health setting. Three case studies concerning the needs of breast cancer patients, pain management in oncology and extreme end-of-life decisions

The thesis describes three studies concerning the role of the Economic Preference set investigated in the Global Preference Survey (GPS) in the following cases: 1) the needs of women with breast cancer; 2) pain undertreament in oncology; 3) legal status of euthanasia and assisted suicide. The analyses, based on regression techniques, were always conducted on the basis of aggregate data and revealed in all cases a possible role of the Economic Preferences studied, also resisting the concomitant effect of the other covariates that were considered from time to time. Regarding individual studies, the related conclusion are: 1) Economic Preferences appear to play a role in influencing the needs of women with breast cancer, albeit of non-trivial interpretation, statistically "resisting" the concomitant effect of the other independent variables considered. However, these results should be considered preliminary and need further confirmation, possibly with prospective studies conducted at the level of the individual; 2) the results show a good degree of internal consistency with regard to pro-social GPS scores, since they are all found to be non-statistically significant and united, albeit only weakly in trend, by a negative correlation with the % of pain undertreated patients. Sharper, at least statistically, is the role of Patience and Willingness to Take Risk, although of more complex empirical interpretation. 3) the results seem to indicate an obvious role of Economic Preferences, however difficult to interpret empirically. Less evidence, at least on the inferential level, emerged, however, regarding variables that, based on common sense, should play an even more obvious role than Economic Preferences in orienting attitudes toward euthanasia and assisted suicide, namely Healthcare System, Legal Origin, and Kinship Tightness; striking, in particular, is the inability to prove a role for the dominant religious orientation even with a simple bivariate analysis.

Essays in macroeconomics: insurance, market power, and inequality

This thesis investigates a broad range of topics related to insurance, market power, and inequality, both from an empirical and a theoretical perspective. In the first chapter, I exploit the significant heterogeneity of the shocks hitting Ethiopian households and their heterogeneous response, using relatively recent data (World Bank's LSMS-ISA for households and satellite data for weather shocks). On the one hand, households seem able to insure against most idiosyncratic and mild adverse weather shocks. On the other hand, vulnerability to stronger weather shocks (especially droughts) remains elevated. In the second chapter, starting from firms' individual data, aggregate trends about industry concentration and other proxies of competition are built. This chapter is part of a larger project conducted at the OECD in the Productivity Innovation and Entrepreneurship Division of the STI Directorate The project innovates on the existing literature in its measurement of concentration, aimed at reflecting markets more accurately. On average, aggregate concentration is found to be increasing. In the third chapter, which only lays out some preliminary steps of a more extensive inquiry, I model the heterogeneous effects of aggregate technological progress on individual economic agents and show how this can affect aggregate inequality and other aggregate indicators studied in the macroeconomics literature, such as the entrepreneurship rate and the overall firm distribution. It should be noted, however, that this note is a simple exposition of a possible modelling device rather than a full explanation of these phenomena.

Esportes na natureza : estrategias de ensino do canionismo para pessoas com deficiencia visual

Universidade Estadual de Campinas . Faculdade de Educação Física

Metodo de reconstrução tridimensional para avaliação postural

Universidade Estadual de Campinas. Faculdade de Educação Física

Impactos na saúde das deficiências de acesso a água

O acesso regular à água potável e segura tem causado preocupação, principalmente em países em desenvolvimento e, mais enfaticamente em áreas periurbanas, que abrigam a população socialmente excluída. O objetivo deste trabalho é abordar questões de acesso à água em regiões periurbanas e para tanto foi realizado levantamento bibliográfico nas bases de dados Pubmed, Medline e SciELO assim como relatórios da OMS, OPAS, IBGE e Ministério das Cidades. A falta ou a precariedade do acesso à água representa situação de risco que propicia aumento da incidência de doenças infecciosas agudas e da prevalência de doenças crônicas. O estabelecimento do grau de acesso à água de qualidade considera fatores como distância e tempo percorrido até a fonte de água, volume coletado, demanda atendida e nível de prioridade de ações de intervenção. Na qualidade da água, consideram-se como fatores de impacto o manuseio - maneira como ocorre a coleta, o transporte, o armazenamento e o uso -, a presença de patógenos nas fontes e as práticas rotineiras da população. A determinação da presença de patógenos nas fontes evidencia o risco à saúde e a identificação do agente etiológico indica a origem da contaminação. O caminho para reverter esse cenário é a implementação integrada de políticas públicas de gestão, que envolvam ações conjuntas e ajustadas nos setores de desenvolvimento urbano, habitação, saneamento e saúde e que visem à promoção e à proteção da saúde da população local e ao enfrentamento da complexidade de fatores que evidenciam sua vulnerabilidade.

Gross anatomical features of the oropharyngeal cavity of the ostrich (Struthio camelus)

Most descriptions of the ostrich oropharynx and oesophagus are superficial and supply little meaningful morphological data. The aim of this investigation is describe the ostrich oropharingeal cavity, in order to supply the deficiency of macroscopic data about this important animal. Five heads of 12 to 14-month-old ostriches of either sex were anatomically dissected to expose the oropharynx. The ostrich oropharynx was "bell-shaped" composed by the maxillary and mandibular ramphoteca. The roof and floor presented two distinct regions different in colour of the mucosa. The rostral region was pale pink contrasting to creamy-pink coloured caudal region. The median longitudinal ridge extended rostrally from the apex of the choana to the tip of the beak in the roof and it is clearly more prominent and rigid than the homolog in the floor that appeared thin and stretched rostrally, continuing caudally surrounding the tongue and the laryngeal mound eventually merging with the oesophageal mucosa. The floor was formed by the interramal region, tongue and laryngeal mound containing shield-shaped glottis. It can be concluded that the present study, in addition to confirming the basic features of the oropharynx previously described for the ostrich, clarified the contradictory information presented in the literature and also provided new, unreported morphological data, some of which may be important when studying nutrition and health in these birds.

Qualidade de vida associada a saúde e condições de trabalho entre profissionais de enfermagem

OBJETIVO: Avaliar condições de trabalho associadas à qualidade de vida relacionada à saúde entre profissionais de enfermagem. MÉTODOS: Estudo transversal realizado em um hospital universitário de São Paulo, SP, em 2004-2005. A população estudada foi de 696 enfermeiros, técnicos e auxiliares de enfermagem, predominantemente feminina (87,8 por cento) e que trabalhava em turnos diurnos e/ou noturnos. Os dados sociodemográficos, de condições de trabalho e de vida, hábitos de vida e sintomas de saúde auto-referidos foram obtidos por meio de questionários auto-aplicados: Resultados de Estudos de Saúde - versão reduzida, Escala de Estresse no Trabalho e Desequilíbrio Esforço-Recompensa. Valores do coeficiente 1,01 significam mais esforços do que recompensas no trabalho. Modelos de regressão logística ordinal de chances proporcionais foram ajustados para cada dimensão do SF-36. RESULTADOS: Aproximadamente 22 por cento da população foi classificada como trabalhando em condições de alto desgaste e 8 por cento com mais esforços do que recompensas no trabalho. As dimensões com piores escores médios no SF-36 foram vitalidade, dor e saúde mental. Alto desgaste no trabalho, ter mais esforços que recompensas e ser enfermeira associaram-se de maneira independente aos baixos escores da dimensão de aspectos emocionais. As dimensões relacionadas à saúde mental foram as que mais sofreram influência dos fatores psicossociais do trabalho. CONCLUSÕES: Apresentar mais esforços do que recompensas no trabalho foi mais significativo para a qualidade de vida associada à saúde do que o alto desgaste no trabalho (altas demandas e baixo controle). Os resultados indicam que a análise conjunta dos fatores psicossociais de desequilíbrio esforço-recompensa e demanda-controle contribuiu para a discussão sobre os papéis profissionais, condições de trabalho e qualidade de vida relacionada à saúde de profissionais de enfermagem

Predicting MAOD using only a supramaximal exhaustive test

The objective of this study was to propose an alternative method (MAOD(ALT)) to estimate the maximal accumulated oxygen deficit (MAOD) using only one supramaximal exhaustive test. Nine participants performed the following tests: (a) a maximal incremental exercise test, (b) six submaximal constant workload tests, and (c) a supramaximal constant workload test. Traditional MAOD was determined by calculating the difference between predicted O(2) demand and accumulated O(2) uptake during the supramaximal test. MAOD(ALT) was established by summing the fast component of excess post-exercise oxygen consumption and the O(2) equivalent for energy provided by blood lactate accumulation, both of which were measured during the supramaximal test. There was no significant difference between MAOD (2.82 +/- 0.45 L) and MAOD(ALT) (2.77 +/- 0.37 L) (p = 0.60). The correlation between MAOD and MAOD(ALT) was also high (r = 0.78; p = 0.014). These data indicate that the MAOD(ALT) can be used to estimate the MAOD.

Hardened properties of self-compacting concrete - A statistical approach

This work presents a statistical study on the variability of the mechanical properties of hardened self-compacting concrete, including the compressive strength, splitting tensile strength and modulus of elasticity. The comparison of the experimental results with those derived from several codes and recommendations allows evaluating if the hardened behaviour of self-compacting concrete can be appropriately predicted by the existing formulations. The variables analyzed include the maximum size aggregate, paste and gravel content. Results from the analyzed self-compacting concretes presented variability measures in the same range than the expected for conventional vibrated concrete, with all the results within a confidence level of 95%. From several formulations for conventional concrete considered in this study, it was observed that a safe estimation of the modulus of elasticity can be obtained from the value of compressive strength; with lower strength self-compacting concretes presenting higher safety margins. However, most codes overestimate the material tensile strength. (C) 2010 Elsevier Ltd. All rights reserved.

Assessing the effects of early silvicultural management on long-term site productivity of fast-growing eucalypt plantations: the Brazilian experience

Eucalyptus is the dominant and most productive planted forest in Brazil, covering around 3.4 million ha for the production of charcoal, pulp, sawtimber, timber plates, wood foils, plywood and for building purposes. At the early establishment of the forest plantations, during the second half of the 1960s, the eucalypt yield was 10 m(3) ha(-1) y(-1). Now, as a result of investments in research and technology, the average productivity is 38 m3 ha(-1) y(-1). The productivity restrictions are related to the following environmental factors, in order of importance: water deficits > nutrient deficiency > soil depth and strength. The clonal forests have been fundamental in sites with larger water and nutrient restrictions, where they out-perform those established from traditional seed-based planting stock. When the environmental limitations are small the productivities of plantations based on clones or seeds appear to be similar. In the long term there are risks to sustainability, because of the low fertility and low reserves of primary minerals in the soils, which are, commonly, loamy and clayey oxisols and ultisols. Usually, a decline of soil quality is caused by management that does not conserve soil and site resources, damages soil physical and chemical characteristics, and insufficient or unbalanced fertiliser management. The problem is more serious when fast-growing genotypes are planted, which have a high nutrient demand and uptake capacity, and therefore high nutrient output through harvesting. The need to mobilise less soil by providing more cover and protection, reduce the nutrient and organic matter losses, preserve crucial physical properties as permeability ( root growth, infiltration and aeration), improve weed control and reduce costs has led to a progressive increase in the use of minimum cultivation practices during the last 20 years, which has been accepted as a good alternative to keep or increase site quality in the long term. In this paper we provide a synthesis and critical appraisal of the research results and practical implications of early silvicultural management on long-term site productivity of fast-growing eucalypt plantations arising from the Brazilian context.

Inter-subband redundancy prediction using neural network for video coding

High performance video codec is mandatory for multimedia applications such as video-on-demand and video conferencing. Recent research has proposed numerous video coding techniques to meet the requirement in bandwidth, delay, loss and Quality-of-Service (QoS). In this paper, we present our investigations on inter-subband self-similarity within the wavelet-decomposed video frames using neural networks, and study the performance of applying the spatial network model to all video frames over time. The goal of our proposed method is to restore the highest perceptual quality for video transmitted over a highly congested network. Our contributions in this paper are: (1) A new coding model with neural network based, inter-subband redundancy (ISR) prediction for video coding using wavelet (2) The performance of 1D and 2D ISR prediction, including multiple levels of wavelet decompositions. Our result shows a short-term quality enhancement may be obtained using both 1D and 2D ISR prediction.

Adjusting prices in the multiple-partners assignment game

Starting with an initial price vector, prices are adjusted in order to eliminate the excess demand and at the same time to keep the transfers to the sellers as low as possible. In each step of the auction, to which set of sellers should those transfers be made is the key issue in the description of the algorithm. We assume additively separable utilities and introduce a novel distinction by considering multiple sellers owing multiple identical objects and multiple buyers with an exogenously defined quota, consuming more than one object but at most one unit of a seller`s good and having multi-dimensional payoffs. This distinction induces a necessarily more complicated construction of the over-demanded sets than the constructions of these sets for the other assignment games. For this approach, our mechanism yields the buyer-optimal competitive equilibrium payoff, which equals the buyer-optimal stable payoff. The symmetry of the model allows to getting the seller-optimal stable payoff and the seller-optimal competitive equilibrium payoff can then be also derived.

Sucrose Fermentation by Brazilian Ethanol Production Yeasts in Media Containing Structurally Complex Nitrogen Sources

Four Saccharomyces cerevisiae Brazilian industrial ethanol production strains were grown, under shaken and static conditions, in media containing 22% (w/v) sucrose supplemented with nitrogen sources varying from a single ammonium salt (ammonium sulfate) to free amino acids (casamino acids) and peptides (peptone). Sucrose fermentations by Brazilian industrial ethanol production yeasts strains were strongly affected by both the structural complexity of the nitrogen source and the availability of oxygen. Data suggest that yeast strains vary in their response to the nitrogen source`s complex structure and to oxygen availability. In addition, the amount of trehalose produced could be correlated with the fermentation performance of the different yeasts, suggesting that efficient fuel ethanol production depends on finding conditions which are appropriate for a particular strain, considering demand and dependence on available nitrogen sources in the fermentation medium.

Comparison of Full Versus Short Induced-Sleep Polysomnography for the Diagnosis of Sleep Apnea

Objectives/Hypothesis: Polysomnography (PSG) is the gold-standard method for diagnosing obstructive sleep apnea (OSA). However, the gap between demand and capacity in performing PSG is a major health-care problem. We sought to validate a short day-time induced sleep for the diagnosis of OSA. Study Design: Prospective diagnostic method validation. Methods: We studied 25 consecutive patients referred to the sleep laboratory and 15 healthy volunteers. All subjects were evaluated by means of full overnight PSG (Full-PSG) and short day-time induced-sleep PSG (Induced-PSG). Sleep was monitored during both procedures (Embla, 16 channels). Sleep was induced by slow intravenous drip infusion of midazolam. Results: The population studied (N = 40) was 60% male (mean age, 42 +/- 10 years; body mass index, 29 +/- 6.5 kg/m(2)). Sleep was successfully induced in all subjects, and no complications were observed (midazolam doses, 6.2 +/- 3.8 mg; time of induced sleep 41.5 +/- 18.9 minutes). The apnea-hypopnea index (AHI) and minimal oxygen saturation during Full-PSG versus Induced-PSG were similar: median AHI (with 25%-75% interquartile range) was 13 (3-35) events per hour versus 17 (4-36) events per hour, and median oxygen saturation was 84% (75-90) versus 85% (76-92); P = .89 and P = .53, respectively. The majority of the respiratory events during induced sleep were obstructive and similar to those observed during Full-PSG. AHI and lowest oxygen saturation during Induced-PSG correlated significantly with Full-PSG (r = 0.67 and r = 0.77, respectively). Sensitivity and specificity for the diagnosis of OSA (AHI > 15 events per hour) by Induced-PSG were 0.83 and 0.72, respectively. Conclusions: Induced-PSG by midazolam during the day is safe and correlates with Full-PSG; it therefore is a promising alternative method in the diagnosis of OSA.

Linking policies for biodiversity conservation with advances in behavioural economics

Global biodiversity loss and its consequences for human welfare and sustainable development have become major concerns. Economists have, therefore, given increasing attention to the policy issues involved in the management of genetic resources. To do so, they often apply empirical methods developed in behavioral and experimental economics to estimate economic values placed on genetic resources. This trend away from almost exclusive dependence on axiomatic methods is welcomed. However, major valuation methods used in behavioral economics raise new scientific challenges. Possibly the most important of these include deficiencies in the knowledge of the public (and researchers) about genetic resources, implications for the formation of values of supplying information to focal individuals, and limits to rationality. These issues are explored for stated-preference techniques of valuation (e.g., contingent valuation) as well as revealed preference techniques, especially the travel cost method. They are illustrated by Australian and Asian examples. Taking into account behavioral and psychological models and empirical evidence, particular attention is given to how elicitation of preferences, and supply of information to individuals, influences their preferences about biodiversity. Policy consequences are outlined.