Uso e conservação de solos arenosos sob pastagens em São Gabriel do Oeste, MS: recomendações técnicas.

O objetivo do trabalho foi medir a erosão hídrica dos solos arenosos no município de São Gabriel do Oeste e suas consequências, no sistema de pastagem de Brachiaria decumbens degradada. Logo, nesta publicação, serão abordadas características gerais dos solos da região, sua utilização agrícola, os resultados de perda de solo e água e as recomendações de uso e manejo dos solos.bitstream/item/62847/1/CNPS-CIR.-TEC.-3-98.pd

Economic Evaluation of Population-Based BRCA1/BRCA2 Mutation Testing across Multiple Countries and Health Systems

Clinical criteria/Family history-based BRCA testing misses a large proportion of BRCA carriers who can benefit from screening/prevention. We estimate the cost-effectiveness of population-based BRCA testing in general population women across different countries/health systems. A Markov model comparing the lifetime costs and effects of BRCA1/BRCA2 testing all general population women ≥30 years compared with clinical criteria/FH-based testing. Separate analyses are undertaken for the UK/USA/Netherlands (high-income countries/HIC), China/Brazil (upper–middle income countries/UMIC) and India (low–middle income countries/LMIC) using both health system/payer and societal perspectives. BRCA carriers undergo appropriate screening/prevention interventions to reduce breast cancer (BC) and ovarian cancer (OC) risk. Outcomes include OC, BC, and additional heart disease deaths and incremental cost-effectiveness ratio (ICER)/quality-adjusted life year (QALY). Probabilistic/one-way sensitivity analyses evaluate model uncertainty. For the base case, from a societal perspective, we found that population-based BRCA testing is cost-saving in HIC (UK-ICER = $−5639/QALY; USA-ICER =$−4018/QALY; Netherlands-ICER = $−11,433/QALY), and it appears cost-effective in UMIC (China-ICER =$18,066/QALY; Brazil-ICER = $13,579/QALY), but it is not cost-effective in LMIC (India-ICER =$23,031/QALY). From a payer perspective, population-based BRCA testing is highly cost-effective in HIC (UK-ICER = $21,191/QALY, USA-ICER =$16,552/QALY, Netherlands-ICER = $25,215/QALY), and it is cost-effective in UMIC (China-ICER =$23,485/QALY, Brazil−ICER = $20,995/QALY), but it is not cost-effective in LMIC (India-ICER =$32,217/QALY). BRCA testing costs below $172/test (ICER =$19,685/QALY), which makes it cost-effective (from a societal perspective) for LMIC/India. Population-based BRCA testing can prevent an additional 2319 to 2666 BC and 327 to 449 OC cases per million women than the current clinical strategy. Findings suggest that population-based BRCA testing for countries evaluated is extremely cost-effective across HIC/UMIC health systems, is cost-saving for HIC health systems from a societal perspective, and can prevent tens of thousands more BC/OC cases

Processos educativos desvelados no conviver: curso equidade

ResumoO presente artigo busca compreender os processos educativos desvelados no conviver do curso de ação afirmativa “Equidade no acesso à pós-graduação para populações sub-representadas”, no ano de 2012. Para isto, foi adotada a investigação qualitativa, inspirada na fenomenologia. No estudo foram analisados relatos de 8 participantes do curso. A análise dos dados possibilitou a configuração de seis categorias: A) Aprender a pensar e escrever de forma crítica, com autonomia; B) Aprender sobre o conceito de humildade; C) Vínculo de amizade, solidariedade, companheirismo; D) Acolhimento, diálogo, amorosidade; E) Fortalecimento do pertencimento étnico-racial, da negritude; F) Compromisso com a temática da educação étnico-racial e luta contra o racismo e desigualdades. Tais compreensões podem possibilitar alternativas à ausência de representantes negros e indígenas nos Programas de Pós-Graduação no Brasil e ajudar na criação de novas políticas públicas de ações afirmativas.Palavras-chave: Processos Educativos. Equidade. Ações Afirmativas. Conviver.The educational process revealed through students interaction: equality courseAbstractThe present article seeks to understand the educational processes unveiled by living during the affirmative action capacitation “Equity in the postgraduation access for underrepresented population”, in the year 2012. With this purpose, was adopted a qualitative investigation, inspired in the phenomenology. In this study were analyzed reports from 8 course participants. The data analysis allowed to configure into six categories: A) Learn to think and write critically, with autonomy; B) Learn about the humility concept; C) Friendship, solidarity and companionship bond; D) welcoming, dialogue and loving; E) ethnic-racial belonging strengthening, of blackness; F) Commitment with ethnic-racial education thematic and fight against racism and inequalities. Such understanding can enable alternatives to the absence of black and indigenous representatives in the postgraduation programs in Brazil and help to create new affirmative public policies.Keywords: Educational Processes. Equity. Affirmative Actions. Living.Los procesos educativos develados en el convivir: curso equidadResumenEl presente artículo busca comprender los procesos educativos develados en el convivir del curso de acción afirmativa “Equidad en el acceso a la educación de postgrado a las poblaciones subrepresentadas” en el año de 2012. Para esto, fue adoptada la investigación cualitativa, inspirada en la fenomenología. El estudio analizó 8 relatos de los participantes del curso. El análisis de los datos tornó posible la configuración de seis categorías: A) Aprender a pensar y escribir de manera crítica, con autonomía; B) Aprender sobre el concepto de humildad; C) Vínculo de amistad, solidaridad, hermandad; D) La cálida bienvenida, el diálogo y la amorosidad; E) Fortalecimiento de la pertenencia étnico-racial y lucha contra el racismo y las desigualdades. Tales entendimientos pueden posibilitar alternativas a la ausencia de representantes negros e indígenas en los programas de postgrado en Brasil y ayudar en la creación de nuevas políticas públicas de acciones afirmativas.Palabras clave: Procesos Educativos. Equidad. Acción Afirmativa. Convivir

Cost effectiveness of the cancer prevention program for carriers of the BRCA1/2 mutation

OBJECTIVE: To analyze the cost effectiveness of the diagnostic program for the germline mutation in BRCA1/2 genes and of preventative strategies for the relatives of patients diagnosed with ovarian cancer associated with this mutation. METHODS: The study analyzed the cost effectiveness by developing an analysis of the Markov decision process from the perspective of the National Health System. The strategies compared reflect upon the adoption of genetic testing and preventative strategies for relatives or the usual care currently proposed. The incremental cost-effectiveness ratio was expressed in terms of cost per case avoided. The sensitivity analysis was performed in a univariate and deterministic manner. RESULTS: The study showed increments for effectiveness and for costs when performing genetic testing and adopting prophylactic measures for family members. The incremental cost-effectiveness ratio was estimated at R$908.58 per case of cancer avoided, a figure considered lower than the study's cost-effectiveness threshold (R$7,543.50). CONCLUSIONS: The program analyzed should be considered a cost-effective strategy for the national situation. Studies in various other countries have reached similar conclusions. One possible ramification of this research might the need to perform a budgetary-impact analysis of making the program one of the country's health policies

Impact on the Quality of Life of an Educational Program for the Prevention of Work-Related Musculoskeletal Disorders: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Work-related musculoskeletal disorders (WMSD) are a major cause for concern in public health and the main causes of sick leave. Treatments for WMSD have given disappointing results; prevention is the best strategy, but results of preventive measures have not been consistent. To the best of our knowledge there are few studies in literature that evaluated the impact of a specific program aimed at preventing WMSD on the quality of life of employed persons.</p> <p>Methods</p> <p>One hundred and one clerical and production workers in a steel trading company were enrolled in an open-label randomized controlled clinical trial (parallel groups) to compare the efficacy of an educational program for primary prevention of WMSD with control intervention. The primary outcome was a change in the physical functioning domain of the quality of life (QL) measured by Medical Outcomes Study Short Form 36 Health Survey (SF-36). The intervention group underwent six consecutive weekly sessions concerning specific orientations for the prevention of WMSD, while the control group received general health education in an identical schedule. The SF-36 and theses Work Limitation Questionnaire (WLQ) were evaluated at weeks zero, five and 26.</p> <p>Results</p> <p>Baseline characteristics of the interventions groups were comparable, and both groups comprised predominantly young healthy individuals. No significant differences in the variation of the SF-36 and WLQ between the groups were observed at weeks five and 26. However, both groups demonstrated improvement in some aspects of SF-36, suggesting that both educational interventions have beneficial impacts on QL.</p> <p>Conclusions</p> <p>A specific educational program aimed at the preventing of WMSD was comparable with general health orientation for the improvement of QL and work capacity in a sample of healthy workers during a six month period.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00981877">NCT00874718</a></p> <p>Trial Registration</p

Economic Evaluation of Population-BasedBRCA1/BRCA2Mutation Testing across Multiple Countries and Health Systems

Clinical criteria/Family history-based BRCA testing misses a large proportion of BRCA carriers who can benefit from screening/prevention. We estimate the cost-effectiveness of population-based BRCA testing in general population women across different countries/health systems. A Markov model comparing the lifetime costs and effects of BRCA1/BRCA2 testing all general population women ≥30 years compared with clinical criteria/FH-based testing. Separate analyses are undertaken for the UK/USA/Netherlands (high-income countries/HIC), China/Brazil (upper-middle income countries/UMIC) and India (low-middle income countries/LMIC) using both health system/payer and societal perspectives. BRCA carriers undergo appropriate screening/prevention interventions to reduce breast cancer (BC) and ovarian cancer (OC) risk. Outcomes include OC, BC, and additional heart disease deaths and incremental cost-effectiveness ratio (ICER)/quality-adjusted life year (QALY). Probabilistic/one-way sensitivity analyses evaluate model uncertainty. For the base case, from a societal perspective, we found that population-based BRCA testing is cost-saving in HIC (UK-ICER = $-5639/QALY; USA-ICER =$-4018/QALY; Netherlands-ICER = $-11,433/QALY), and it appears cost-effective in UMIC (China-ICER =$18,066/QALY; Brazil-ICER = $13,579/QALY), but it is not cost-effective in LMIC (India-ICER =$23,031/QALY). From a payer perspective, population-based BRCA testing is highly cost-effective in HIC (UK-ICER = $21,191/QALY, USA-ICER =$16,552/QALY, Netherlands-ICER = $25,215/QALY), and it is cost-effective in UMIC (China-ICER =$23,485/QALY, Brazil-ICER = $20,995/QALY), but it is not cost-effective in LMIC (India-ICER =$32,217/QALY). BRCA testing costs below $172/test (ICER =$19,685/QALY), which makes it cost-effective (from a societal perspective) for LMIC/India. Population-based BRCA testing can prevent an additional 2319 to 2666 BC and 327 to 449 OC cases per million women than the current clinical strategy. Findings suggest that population-based BRCA testing for countries evaluated is extremely cost-effective across HIC/UMIC health systems, is cost-saving for HIC health systems from a societal perspective, and can prevent tens of thousands more BC/OC cases