The relationship of drug reimbursement with the price and the quality of pharmaceutical innovations

This paper studies the strategic interaction between pharmaceutical firms' pricing decisions and government agencies' reimbursement decisions which discriminate between patients by giving reimbursement rights to patients for whom the drug is most effective. We show that if the reimbursement decision preceeds the pricing decision, the agency only reimburses some patients if the private and public health benefits from the new drug diverge. That is, when (i) there are large externalities of consuming the drug and (ii) the difference in costs between the new drug and the alternative treatment is large. Alternatively, if the firm can commit to a price in advance of the reimbursement decision, we identify a strategic effect which implies that by committing to a high price ex ante, the firm can force a listing outcome and make the agency more willing to reimburse than in the absence of commitment

Context-aware mobile app for the multidimensional assessment of the elderly,

Rural areas in Europe are presenting a decreasing population density and an increasing age index. These elders usually present multiple diseases that require complex tools to identify the exact cares that they need. Currently, different frameworks can evaluate their functional status and identify the required cares to maintain their Quality of Life, together with the associated cost to the health system. Nevertheless, these frameworks are usually questionnaires that have to be performed by already overloaded professionals. In this paper, we make use of mobile technologies to build a system capable of monitoring the activities of the elderly and analysing these data to assess their functional status. The experiments carried out show us that it correctly evaluates these patients and reduces the effort required by health professionals

Geometric Phase and Modulo Relations for Probability Amplitudes as Functions on Complex Parameter Spaces

We investigate general differential relations connecting the respective behavior s of the phase and modulo of probability amplitudes of the form \amp{\psi_f}{\psi}, where $\ket{\psi_f}$ is a fixed state in Hilbert space and $\ket{\psi}$ is a section of a holomorphic line bundle over some complex parameter space. Amplitude functions on such bundles, while not strictly holomorphic, nevertheless satisfy generalized Cauchy-Riemann conditions involving the U(1) Berry-Simon connection on the parameter space. These conditions entail invertible relations between the gradients of the phase and modulo, therefore allowing for the reconstruction of the phase from the modulo (or vice-versa) and other conditions on the behavior of either polar component of the amplitude. As a special case, we consider amplitude functions valued on the space of pure states, the ray space ${\cal R} = {\mathbb C}P^n$, where transition probabilities have a geometric interpretation in terms of geodesic distances as measured with the Fubini-Study metric. In conjunction with the generalized Cauchy-Riemann conditions, this geodesic interpretation leads to additional relations, in particular a novel connection between the modulus of the amplitude and the phase gradient, somewhat reminiscent of the WKB formula. Finally, a connection with geometric phases is established.Comment: 11 pages, 1 figure, revtex

A proposal of sensitive indicators of the rehabilitation nursing care of people in the surgical process, to be included in the ontology of aging

Given the complex surgical scenario observed today, it is necessary to change the urgent definition of a specific ontology, especially in terms of aging. The interventions of the Specialist Nurse in Rehabilitation Nursing to the person in the surgical process are primordial for the maintenance of the functional capacities, prevention of complications and impediment of incapacities. However, it is necessary to provide individualized and fostered care in a practice of excellence, and the consequent organized reading of records of an aging ontology for decision making on rehabilitation indicators. Method: a systematic review of the literature was carried out using the EBSCO host (MEDLINE with Full Text, CINAHL Plus with Full Text and MedicLatina), using the PI [C] O method, and 11 articles were selected. Results: 41 indicators were identified to be included in the ontology classes of aging: pain control, patient and family education, support and communication, reduction of postoperative complications, gain of functionality, restoration of physical function, mobility, multidisciplinary intervention and the frequency of interventions. Conclusion: it is considered that it was imperative to identify sensitive indicators for rehabilitation nursing care, based on scientific evidence and thus provide an opportunity for nurses to reflect on their daily practices and conduct their actions towards excellence in care, to propose a set of 41 classes internationally on the ontology of aging

Neural-Network Vector Controller for Permanent-Magnet Synchronous Motor Drives: Simulated and Hardware-Validated Results

This paper focuses on current control in a permanentmagnet synchronous motor (PMSM). The paper has two main objectives: The first objective is to develop a neural-network (NN) vector controller to overcome the decoupling inaccuracy problem associated with conventional PI-based vector-control methods. The NN is developed using the full dynamic equation of a PMSM, and trained to implement optimal control based on approximate dynamic programming. The second objective is to evaluate the robust and adaptive performance of the NN controller against that of the conventional standard vector controller under motor parameter variation and dynamic control conditions by (a) simulating the behavior of a PMSM typically used in realistic electric vehicle applications and (b) building an experimental system for hardware validation as well as combined hardware and simulation evaluation. The results demonstrate that the NN controller outperforms conventional vector controllers in both simulation and hardware implementation

Contributions to the ontology of aging, the sensitive indicators of rehabilitation nursing care, in terms of self-care, in people with respiratory disorders

With the increase in the average life expectancy, the appearance of chronic diseases and, in particular, in the respiratory forum and its disadvantages in the autonomy and self-care of patients, brought an important paradigm for health care and, in particular, rehabilitation nursing, with implications for the development of ontologies of aging. Thus, it is imperative to systematize them in scientifically measurable indicators to demonstrate the benefit that rehabilitation nursing brings to improve patients' quality of life, thus ensuring excellence. Each area of scientific health should contribute to the construction of aging ontology. Objective: to identify indicators sensitive to nursing care of rehabilitation, in terms of self-care, in relation to those with respiratory pathology, to be integrated into the ontology of aging. Methods: A systematic review of the literature was performed using the EBSCO (full-text MEDLINE, CINAHL, Full-Text Plus, British Nursing Index), using the PI [C] O method with 6 emergent articles. Results: A total of 20 indicators were identified, including: Ability to perform activities, increase physical and functional independence, symptom management, reduction of complications, increase in quality of life, which can be allocated as a proposal for classes of the aging ontology. Conclusion: Knowledge of indicators sensitive to nursing care recognition of the importance of rehabilitation nursing in increasing self-care and autonomy for people with respiratory pathology, and research in this area is fundamental for its effectiveness and efficiency, and its integration in the ontologies of aging is fundamental

Enriched elderly virtual profiles by means of a multidimensional integrated assessment platform

The pressure over Healthcare systems is increasing in most developed countries. The generalized aging of the population is one of the main causes. This situation is even worse in underdeveloped, sparsely populated regions like Extremadura in Spain or Alentejo in Portugal. The authors propose to use the Situational-Context, a technique to seamlessly adapt Internet of Things systems to the needs and preferences of their users, for virtually modeling the elderly. These models could be used to enhance the elderly experience when using those kind of systems without raising the need for technical skills or the costs of implementing such systems by the regional healthcare systems. In this paper, the integration of a multidimensional integrated assessment platform with such virtual profiles is presented. The assessment platform provides and additional source of information for the virtual profiles that is used to better adapt existing systems to the elders needs

Ehrenfest dynamics is purity non-preserving: a necessary ingredient for decoherence

We discuss the evolution of purity in mixed quantum/classical approaches to electronic nonadiabatic dynamics in the context of the Ehrenfest model. As it is impossible to exactly determine initial conditions for a realistic system, we choose to work in the statistical Ehrenfest formalism that we introduced in Ref. 1. From it, we develop a new framework to determine exactly the change in the purity of the quantum subsystem along the evolution of a statistical Ehrenfest system. In a simple case, we verify how and to which extent Ehrenfest statistical dynamics makes a system with more than one classical trajectory and an initial quantum pure state become a quantum mixed one. We prove this numerically showing how the evolution of purity depends on time, on the dimension of the quantum state space $D$, and on the number of classical trajectories $N$ of the initial distribution. The results in this work open new perspectives for studying decoherence with Ehrenfest dynamics.Comment: Revtex 4-1, 14 pages, 2 figures. Final published versio