Variabilidade de preços de aquisição de medicamentos do grupo 1B do Componente Especializado da Assistência Farmacêutica

Resumo No Sistema Único de Saúde os medicamentos do grupo 1 do Componente Especializado da Assistência Farmacêutica (CEAF) são financiados pela União e adquiridos de forma centralizada (grupo 1A) ou por cada Unidade Federativa (UF) (grupo 1B). Diferentemente de outros países onde se negocia um preço fixo a ser praticado no sistema público, no Brasil as aquisições são realizadas por licitação, o que pode levar a diferentes preços. Para permitir a comparação de preços, foi pactuada a obrigatoriedade de registro das aquisições públicas no Banco de Preços em Saúde (BPS). O estudo teve como objetivo analisar a variabilidade dos preços de medicamentos do grupo 1B adquiridos pelas UF do Brasil em 2021. Foram obtidas as aquisições de medicamentos do grupo 1B realizadas pelas Secretarias de Estado das 27 UF por consulta ao BPS excluindo-se os medicamentos sem preço de ressarcimento estabelecido em dezembro/2021. Foi obtido do Sistema de Informações Ambulatoriais o ressarcimento para cada UF. Verificou-se grande variabilidade dos preços de aquisição para cada medicamento entre as UF e dentro da mesma UF. O estudo demonstrou potencial iniquidade de acesso ao CEAF, privilegiando com menores preços UF mais favorecidas (maior população e riqueza).</jats:p

Transparency, Openness and Knowledge Sharing for Rebuilding and Strengthening Government Institutions

The developing of the Open Government Model is allowing an organizational revolution for public administrations, providing to citizens and entrepreneurs a better access to information and public services. It also can allow the increasing of transparency in public agencies and citizen participation, indirectly enhancing collaboration and facilitating democratic processes. Transparency and open data can be powerful tools to stimulate and support public services’ improvements, faster innovation and empower citizens’ rights. So actually many governmental organizations are reviewing and rearranging their processes, information and data to improve policies, enhance legitimacy and openness toward outside parties and citizens. An “open” public knowledge may contribute to establish a collaboration and participation culture among the main stakeholders. In this paper authors focus on a new organizational model to deliver transparent services and to improve an effective collaboration between the public administrations. The research methodology adopted is based on a theoreticaldeductive approach. The study describes general principles to come, through the case strategy, to the empirical analysis of an innovative national government portal called “Transparency Compass Portal”. It tries also to identify the distinctive aspects of some administrative services offered by several public organizations

Knowledge sharing in family SMEs: the role of communities of practice

PurposeThe aim of this paper is to analyse the role of communities of practice (CoP) as knowledge-sharing tools in family small and medium-sized enterprises (SMEs). In this context, CoPs that jointly involve family and non-family members are expected to act as knowledge-sharing tools.Design/methodology/approachThis paper employs a multiple case study methodology, analysing the cases of six small companies in different sectors and countries over a period of 8 years. Both primary and secondary data are used.FindingsThe results show the role CoPs play in involving family and non-family members in empowering knowledge-sharing initiatives. A CoP's role in knowledge sharing depends on the presence (or lack) of a family leader, the leadership approach, the degree of cohesion around shared approaches and values within the CoP, and the presence of multiple generations at work.Originality/valueThis paper contributes to the literature on knowledge sharing in family businesses, by exploring for the first time the role of the CoP as a knowledge-sharing tool, depending on families' involvement in the CoP

History states of one-dimensional quantum walks

We analyze the application of the history state formalism to quantum walks. The formalism allows one to describe the whole walk through a pure quantum history state, which can be derived from a timeless eigenvalue equation. It naturally leads to the notion of system-time entanglement of the walk, which can be considered as a measure of the number of orthogonal states visited in the walk. We then focus on one-dimensional discrete quantum walks, where it is shown that such entanglement is independent of the initial spin orientation for real Hadamard-type quantum coins and real initial states (in the standard basis) with definite site-parity. Moreover, in the case of an initially localized particle it can be identified with the entanglement of the unitary global operator that generates the whole history state, which is related to its entangling power and can be analytically evaluated. Besides, it is shown that the evolution of the spin subsystem can also be described through a spin history state with an extended clock. A connection between its average entanglement (over all initial states) and that of the operator generating this state is also derived. A quantum circuit for generating the quantum walk history state is as well provided.Comment: 12 pages, 7 figure

The Institute for Religious works: key features of financial intermediation

Corresponding author: F. Arnaboldi, email: [email protected]. While the paper is the result of intense collaboration between the two authors, sections 3 is attributable to F. Arnaboldi and section 1 and 2 to B. Rossignoli. Section 4 is a joint effort. The authors wish to thank P. Mottura and two anonymous referees for their valuable comments. All errors are ours.  Article peer reviewed. SUMMARY: 1. Introduction – 2. Background to anti-money laundering – 3. Financial intermediation, 2011–2014 – 4. Conclusion

Bipartite representations and many-body entanglement of pure states of NN indistinguishable particles

We analyze a general bipartite-like representation of arbitrary pure states of $N$-indistinguishable particles, valid for both bosons and fermions, based on $M$- and $(N-M)$-particle states. It leads to exact $(M,N-M)$ Schmidt-like expansions of the state for any $M<N$ and is directly related to the isospectral reduced $M$- and $(N-M)$-body density matrices $\rho^{(M)}$ and $\rho^{(N-M)}$. The formalism also allows for reduced yet still exact Schmidt-like decompositions associated with blocks of these densities, in systems having a fixed fraction of the particles in some single particle subspace. Monotonicity of the ensuing $M$-body entanglement under a certain set of quantum operations is also discussed. Illustrative examples in fermionic and bosonic systems with pairing correlations are provided, which show that in the presence of dominant eigenvalues in $\rho^{(M)}$, approximations based on a few terms of the pertinent Schmidt expansion can provide a reliable description of the state. The associated one- and two-body entanglement spectrum and entropies are also analyzed.Comment: 17 pages, 5 figure

First Report of Paralytic Shellfish Toxins in Marine Invertebrates and Fish in Spain

A paralytic shellfish poisoning (PSP) episode developed in summer 2018 in the Rías Baixas (Galicia, NW Spain). The outbreak was associated with an unprecedentedly intense and long-lasting harmful algal bloom (HAB) (~one month) caused by the dinoflagellate Alexandrium minutum. Paralytic shellfish toxins (PSTs) were analyzed in extracts of 45 A. minutum strains isolated from the bloom by high-performance liquid chromatography with post-column oxidation and fluorescence detection (HPLC-PCOX-FLD). PSTs were also evaluated in tissues from marine fauna (invertebrates and fish) collected during the episode and in dolphin samples. The analysis of 45 A. minutum strains revealed a toxic profile including GTX1, GTX2, GTX3 and GTX4 toxins. With regard to the marine fauna samples, the highest PSTs levels were quantified in bivalve mollusks, but the toxins were also found in mullets, mackerels, starfish, squids and ascidians. This study reveals the potential accumulation of PSTs in marine invertebrates other than shellfish that could act as vectors in the trophic chain or pose a risk for human consumption. To our knowledge, this is the first time that PSTs are reported in ascidians and starfish from Spain. Moreover, it is the first time that evidence of PSTs in squids is described in Europe.En prens

In-farm cost of an outbreak of diarrhoea in lambs

This article analyses the cost of diarrhoea in lambs on dairy sheep farms located in Grosseto (Italy). Farmers’ profits have recently declined due to a stable product price but increasing production costs. Animal diseases have a cascade of effects on farm productivity. Lamb enteric disease outbreaks, which result in mortality in the herd and reduced weight gain, can drastically compromise the income of farmers. An economic analysis of the impact of an outbreak of diarrhoea in lambs was thus performed, evaluating the cost of disease based on the main visible production losses (such as mortality, reduced weight gain and variation in milk production). A sensitivity analysis was also conducted by applying different observed ranges of prevalence and mortality associated with the disease. Finally, an economic scenario analysis was performed, considering different in-farm management options for delivering lambs to the abattoir, i.e. early, standard and late delivery. The results showed that a dairy sheep farm with around 300 lambs that delivers them to the abattoir at 30 days of age would experience a loss of between 50 and 1200 Euro during an outbreak of diarrhoea with a prevalence of 34.21 (23.54–44.88)% and a mortality of 15.69 (9.98–21.4)%

When customer behaviours change, should banks’ approaches to online trading stay the same?

What drives the behaviors of banks and their customers in time of profound changes? The modern economic crisis has significantly affected consumers' willingness to invest and made them more price sensitive, more rational in their decision making, and thus more challenging for banks to serve. Considering these relevant changes, banks have pursued projects to improve their internal processes and online services. Considering these changes in customer behavior and in the banking sector, some crucial questions arise. How has the strategy banks use to provide online trading services changed in the past decade? Can outsourcing and new managerial practices resolve the lack of specific competencies and assets that marked the banking sector in the past? This study, conducted in an Italian banking context, suggests that banks can attain all three elements by engaging in smart sourcing of online services to minimize costs, gain and sustain competitive advantages, and promote strategic assets

Socioeconomic factors influencing access to drugs from the Specialized Component of Pharmaceutical Services in Paraná-Brazil: An observational, cross-sectional retrospective study

The Specialized Component of Pharmaceutical Services (CEAF) is a crucial strategy for accessing medicines through the Brazilian Public Health System, holding the highest budgetary impact on outpatient pharmaceutical care. This study aimed to assess the association of socioeconomic factors with access to CEAF drugs in municipalities throughout Paran & aacute; from 2010 to 2019. It utilized a retrospective, observational, cross-sectional approach, evaluating dispensed medication units, medication expenditure, and average unit cost. Analyses were performed to identify a correlation between the use of CEAF drugs and socioeconomic indicators. In these 10 years, the number of dispensed units practically quadrupled, and the expenditure on these drugs doubled, from BRL 214 million to BRL 476 million. The Index of Paran & aacute; Institute for Economic and Social Development of Municipal Performance (IPDM) showed a greater association with the use of CEAF drugs, and no correlation was observed between gross domestic product (GDP) per capita and the municipal population. Overall, the IPDM index that includes income, education, and health are socioeconomic factors that influence the utilization of CEAF drugs. These findings emphasize the need for health education among users and adjustment of public policies to mitigate inequalities in the CEAF drug access for the citizens of Paran & aacute;