Evaluation of dengue fever reports during an epidemic, Colombia

OBJECTIVE To assess the validity of dengue fever reports and how they relate to the definition of case and severity. METHODS Diagnostic test assessment was conducted using cross-sectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics. RESULTS We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%. CONCLUSIONS Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases.

Da concorrência fiscal prejudicial ao uso e abuso das doutrinas judiciais anti-abuso : uma análise do caso português

Mestrado em Fiscalidade

As locações - impacto contabilístico e fiscal: caso das viaturas de turismo

Com a entrada em vigor do Sistema de Normalização Contabilística (SNC) o tratamento contabilístico das Locações passou a ser regulamentado pela Norma Contabilística e de Relato Financeiro (NCRF) n.º 9 – Locações, estando previstos dois tipos de locações: a financeira e a operacional. No exercício da nossa atividade profissional de Técnico Oficial de Contas (TOC) somos, muitas vezes, confrontados com as questões: na aquisição de uma viatura de turismo devemos optar pela locação financeira ou pela locação operacional? Quais as vantagens e desvantagens de cada uma delas em termos contabilísticos e fiscais? O resultado indica que as locações operacionais têm vantagens nos indicadores financeiros, mas as locações financeiras permitem uma maior poupança fiscal. Caberá aos titulares do órgão de gestão e ao TOC a escolha do tipo de locação que melhor responde às necessidades da empresa.

Planeamento fiscal abusivo: exemplificação de alguns esquemas

Dissertação de Mestrado apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Contabilidade e Finanças sobre a orientação do Doutor José Campos Amorim.

O regime fiscal cooperativo – análise crítica e desafios

Dissertação de Mestrado apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Contabilidade e Finanças, sob orientação de Doutora Deolinda Meira e Doutora Nina Aguiar

EcoTerra Model - application of environmental fiscal reform in local government financing in Portugal

Critical Issues in Environmental Taxation: International and Comparative Perspectives: Volume VI, 699-715

Política fiscal e crescimento económico

Os recentes desenvolvimentos da teoria do crescimento económico sugerem que a política fiscal pode ter efeitos importantes no crescimento económico de longo prazo. O objectivo deste artigo é investigar o impacto da política fiscal no crescimento económico de longo prazo, utilizando dados em painel para os Estados-membros da UE15 (com excepção de Luxemburgo), no período 1965-2000. Partindo do enquadramento teórico de Barro (1990), formula-se um modelo onde a taxa de crescimento real é determinada por variáveis das finanças públicas, esperando que a redução de impostos distorcionários e o aumento de despesas públicas produtivas fomentem o crescimento económico. No caso da UE15, os resultados sugerem que o aumento da dimensão do sector público (despesas ou impostos) retarda o crescimento e, em particular, uma redução dos impostos sobre o trabalho e o capital podem acelerar o crescimento económico de longo prazo.

Os efeitos não-keynesianos da política fiscal: consolidações fiscais expansionistas ou contraccionistas? Estudo de caso: Portugal

No presente artigo faz-se uma revisão da literatura teórica e empírica dos efeitos não-keynesianos da política orçamental e o estudo do caso português no período1980-2005. Discutem-se as perspectivas keynesiana, ricardiana e neoclássica dos efeitos dos défices na actividade económica, descrevem-se os efeitos não-keynesianos da política orçamental numa perspectiva teórica e empírica; igualmente identificam-se os episódios de consolidação orçamental na economia portuguesa e avalia-se o sucesso destas consolidações; e, por último, apresentam-se as conclusões.

Clinical and laboratory findings of Plasmodium vivax malaria in Colombia, 2001

A descriptive study was carried out in 104 patients with Plasmodium vivax malaria, from the region of Turbo (Antioquia, Colombia). Clinical features and levels of hemoglobin, glycemia, serum bilirubin, alanine-aminotransferase (ALT), aspartate-aminotransferase (AST), creatinine and complete blood cell profile were established. 65% of the studied individuals were men and their mean age was 23. Of all individuals 59% had lived in the region for > 1 year and 91% were resident in the rural area. 42% were farmers and 35% had a history of malaria. The mean parasitaemia was 5865 parasites/mm³. The evolution of the disease was short (average of 4.0 days). Fever, headache and chills were observed simultaneously in 91% of the cases while the most frequent signs were palmar pallor (46%), jaundice (15%), hepatomegaly (17%), and spleen enlargement (12%). Anemia was found in 39% of the women and in 51% of the men, 8% of individuals had thrombocytopaenia and 41% had hypoglycemia.

Fatal septicemia caused by Chromobacterium violaceum in a child from Colombia

A 4-year old child living in Colombia presented with a history of fever and severe abdominal pain for four days. The patient developed pneumonia, septic shock, multiple organ failure and died on the fifth day of hospitalization. Chromobacterium violaceum was isolated from admission blood cultures and was resistant to ampicillin, cephalosporins, carbapenems and aminoglycosides.

Giardia intestinalis and nutritional status in children participating in the complementary nutrition program, Antioquia, Colombia, May to October 2006

Giardia intestinalis infection is prevalent throughout the world and widely distributed in developing countries. In general, children display serious consequences to their state of health, including slow height-weight development; therefore, the main aim of this study was to determine the association between Giardia infection and the nutritional status of children who participate in the program of complementary feeding (Mejoramiento Alimentario y Nutricional de Antioquia (MANA) - Instituto Colombiano de Bienestar Familiar (ICBF)). A cross-sectional study examining the association of giardiasis with nutritional status was conducted. A total of 2035 children aged eight months to six years-old were studied. Data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and stool samples. Analysis of the results showed that 27.6% of children were infected with G. intestinalis, while 8.1% and 1.9% were mildly and significantly underweight, respectively, and 14.1% presented stunting. Giardiasis was statistically identified as a strong predictor of stunting in this study population.

Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia

In Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems), cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145) or a thermotherapy (Thermomed®) application of 50 °C for 30 seconds over the lesion and surrounding area (n = 149). Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients) and 69% (85/145 patients), respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol) between the two treatments. ClinicalTrials.gov: NCT00471705.

Fiscal decentralisation and economic theory

There is no complete overview or discussion of the literature of the economics of federalism and fiscal decentralization, even though scholarly interest in the topic has been increasing significantly over recent years. This paper provides a general, brief but comprehensive overview of the main insights from the literature on fiscal federalism and decentralization. In doing so, literature on fiscal federalism and decentralization is grouped into two main approaches: “first generation of theories” and “second generation of theories”.