Impact of mutual health organizations: evidence from West Africa

Mutual health organizations (MHOs) are voluntary membership organizations providing health insurance services to their members. MHOs aim to increase access to health care by reducing out-of-pocket payments faced by households. We used multiple regression analysis of household survey data from Ghana, Mali and Senegal to investigate the determinants of enrolment in MHOs, and the impact of MHO membership on use of health care services and on out-of-pocket health care expenditures for outpatient care and hospitalization. We found strong evidence that households headed by women are more likely to enrol in MHOs than households headed by men. Education of the household head is positively associated with MHO enrolment. The evidence on the association between household economic status and MHO enrolment indicates that individuals from the richest quintiles are more likely to be enrolled than anyone else. We did not find evidence that individuals from the poorest quintiles tend to be excluded from MHOs

Characterization of citrus farms production systems used in Rio Grande do Sul, Brazil.

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Characterization of oxygen self-diffusion in TiO2 resistive-switching layers by nuclear reaction profiling

Oxygen self-diffusion was investigated in TiO2 layers employed for resistive-switching memories using resonant nuclear reaction profiling (NRP) and 18O labeling. The layers were grown using physical vapor deposition technique (sputtering) and were polycrystalline. The diffusivity was measured over the temperature range 600–800 °C and the activation energy for oxygen self-diffusion in sputter-deposited TiO2 films determined to be 1.09 ± 0.16 eV, a value consistent with results obtained by previous studies (Marmitt et al., 2017).This study was financed in part by the Coordena de Aperfei oamento de Pessoal de Nvel Superior – Brasil (CAPES) – Finance Code 001, by CNPq and PRONEX-FAPERGS. We acknowledge support from the NCRIS ANFF and Heavy-Ion Accelerator Capabilities, with particular thanks to Dr. Fouad Karouta for the deposition of the (Si3N4) at ANU. RGE and MV further acknowledge the ARC funding program for financial support

Track E Implementation Science, Health Systems and Economics

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138412/1/jia218443.pd

Pharmacological treatment and staging in bipolar disorder: evidence from clinical practice

Objectives:Staging models for medical diseases are widely used to guide treatment and prognosis. Bipolar disorder (BD) is a chronic condition and it is among the most disabling disorders in medicine. The staging model proposed by Kapczinski in 2009 presents four progressive clinical stages of BD. Our aim was to evaluate pharmacological maintenance treatment across these stages in patients with BD.Methods:One hundred and twenty-nine subjects who met DSM-IV criteria for BD were recruited from the Bipolar Disorders Program at Hospital de Clínicas de Porto Alegre, Brazil. All patients were in remission. The subjects were classified according to the staging model: 31 subjects were classified as stage I, 44 as stage II, 31 as stage III, and 23 as stage IV.Results:Patterns of pharmacological treatment differed among the four stages (p = 0.001). Monotherapy was more frequent in stage I, and two-drug combinations in stage II. Patients at stages III and IV needed three or more medications or clozapine. Impairment in functional status (Functioning Assessment Short Test [FAST] scale scores) correlated positively with the number of medications prescribed.Conclusions:This study demonstrated differences in pharmacological treatment in patients with stable BD depending on disease stage. Treatment response can change with progression of BD. Clinical guidelines could consider the staging model to guide treatment effectiveness