Costs Associated with Malaria in Pregnancy in the Brazilian Amazon, a Low Endemic Area Where Plasmodium vivax Predominates.

BACKGROUND: Information on costs associated with malaria in pregnancy (MiP) in low transmission areas where Plasmodium vivax predominates is so far missing. This study estimates health system and patient costs of MiP in the Brazilian Amazon. METHODS/PRINCIPAL FINDINGS: Between January 2011 and March 2012 patient costs for the treatment of MiP were collected through an exit survey at a tertiary referral hospital and at a primary health care centre in the Manaus metropolitan area, Amazonas state. Pregnant and post-partum women diagnosed with malaria were interviewed after an outpatient consultation or at discharge after admission. Seventy-three interviews were included in the analysis. Ninety-six percent of episodes were due to P. vivax and 4% to Plasmodium falciparum. In 2010, the total median costs from the patient perspective were estimated at US $45.91 and US$216.29 for an outpatient consultation and an admission, respectively. When multiple P. vivax infections during the same pregnancy were considered, patient costs increased up to US $335.85, representing the costs of an admission plus an outpatient consultation. Provider direct and overhead cost data were obtained from several sources. The provider cost associated with an outpatient case, which includes several consultations at the tertiary hospital was US$103.51 for a P. vivax malaria episode and US $83.59 for a P. falciparum malaria episode. The cost of an inpatient day and average admission of 3 days was US$118.51 and US $355.53, respectively. Total provider costs for the diagnosis and treatment of all malaria cases reported in pregnant women in Manaus in 2010 (N = 364) were US$17,038.50, of which 92.4% (US$ 15,741.14) due to P. vivax infection. CONCLUSION: Despite being an area of low risk malaria transmission, MiP is responsible for a significant economic burden in Manaus. Especially when multiple infections are considered, costs associated with P. vivax are higher than costs associated with P. falciparum. The information generated may help health policy decisions for the current control and future elimination of malaria in the area

The Indoor Radon Concentration within the Tunnels of the Cholula Pyramid Through a Nuclear Tracks Methodology

Global organizations, including the World Health Organization (WHO), the Environmental Protection Agency of the United States (US-EPA) and the European Atomic Energy Community (EURATOM) recognize that radon gas as one of the main contributors to environmental radiation exposure for humans. Accordingly, a study and analysis of the indoors radon concentrate in the Cholula Pyramid contributes to understand the Radon dynamic inside of the Pyramid tunnels and to evaluate the radiological health risk to visitors, archaeologists, anthropologists and persons who spend extended periods inside the Pyramid. In this paper, the radon measurements along the Pyramid tunnels are presented. The Nuclear Track Methodology (NTM) was chosen for the measurements, using a close end-cup device developed at the Dosimetry Application Project (DAP) of the Physics Institute UNAM, following very well established protocols for the chemical etching and reading with the Counting Analysis Digital Imaging System (CADIS). The Cholula Pyramid consists of eight stages of constructions, each built in different periods of time. Cholula Pyramid is recognized as the pyramid with the largest base in the World, with 400 meters per side and 65 meters high. The tunnels of the pyramid were built in 1931 by architect Ignacio Marquina, with the aim of exploring and studying the structure. The results show an important indoor radon concentration in the measured tunnels, several times higher than levels recommended by United States Environmental Protection Agency (US-EPA). The recommendation will be to mitigate the radon concentration levels, in order to avoid unnecessary exposition to the people

Analysis and characterization of neutron scattering of a Linear Accelerator (LINAC) on medical applications.

In several theoretical and experimental studies, the topic of the undesirable generation of photoneutrons in rooms where a linear accelerator (LINAC) operates has been discussed. When energies above 10 MeV are used to produce X-rays and give radiotherapy treatment to patients resulting in additional radiation to patients. Accordingly, an analysis and characterization of the neutron scattering distribution on different zones in a treatment room contributes to evaluate the radiological health risk to patients, technical and other workers involved in treatment. For the evaluation, a device developed at the PAD-IFUNAM formed by a CR-39 detector enclosed by two 3mm thick acrylic plates was employed. To avoid environmental contamination, the CR-39 and the acrylics plates are enclosed in a round plastic box. Sixteen of these devices were settled in different places inside the treatment room, where a linear accelerator is used. The results show a significant concentration of neutron scattering in areas near the head of irradiation. The recommendation will be to evaluate the neutron scattering concentration in all rooms that’s operates a LINAC in order to verify the radiological health risk and to mitigate the neutron scattering when concentration levels are to high like those in our case, in order to avoid unnecessary exposition to patients and personnel in general

Reducing the debt : is it optimal to outsource an investment?

International audienceWe deal with the problem of outsourcing the debt for a big investment, according two situations: either the firm outsources both the investment (and the associated debt) and the exploitation to a private consortium, or the firm supports the debt and the investment but outsources the exploitation. We prove the existence of Stackelberg and Nash equilibria between the firm and the private consortium, in both situations. We compare the benefits of these contracts. We conclude with a study of what happens in case of incomplete information, in the sense that the risk aversion coefficient of each partner may be unknown by the other partner

Resummation Methods at Finite Temperature: The Tadpole Way

We examine several resummation methods for computing higher order corrections to the finite temperature effective potential, in the context of a scalar $\phi^4$ theory. We show by explicit calculation to four loops that dressing the propagator, not the vertex, of the one-loop tadpole correctly counts ``daisy'' and ``super-daisy'' diagrams.Comment: 18 pages, LaTeX, CALT-68-1858, HUTP-93-A011, EFI-93-2

State-of-the-art of the historical seismology in Colombia

In Colombia are available a discreet number of historical seismology investigations, dating back 50 years. This paper reviews basic information about earthquakes studies in Colombia, such as primary sources, compilation of descriptive catalogues and parametric catalogues. Father Jesús Emilio Ramírez made the main systematic study before 1975. During the last 20 years, great earthquakes hit Colombia and, as consequence, historical seismology investigation was developed in the frame of seismic hazard projects

Self-consistently Improved Finite Temperature Effective Potential for Gauge Theories

The finite temperature effective potential of the Abelian Higgs Model is studied using the self-consistent composite operator method, which sums up the contributions of daisy and superdaisy diagrams. The effect of the momentum dependence of the effective masses is estimated by using a Rayleigh-Ritz variational approximation.Comment: 29 pages, 7 figures not included, Plain Tex, BUHEP-93-12, to appear in Physical Review D49. (additional comments on renormalization and a more quantitative comparison with previous results have been included, one more figure, two new references, two references updated

Sphaleron Effects Near the Critical Temperature

We discuss one-loop radiative corrections to the sphaleron-induced baryon number-violating transition rate near the electroweak phase transition in the standard model. We emphasize that in the case of a first-order transition a rearrangement of the loop expansion is required close to the transition temperature. The corresponding expansion parameter, the effective 3-dimensional gauge coupling approaches a finite $\lambda$ dependent value at the critical temperature. The $\lambda$ (Higgs mass) dependence of the 1-loop radiative corrections is discussed in the framework of the heat kernel method. Radiative corrections are small compared to the leading sphaleron contribution as long as the Higgs mass is small compared to the W mass. To 1-loop accuracy, there is no Higgs mass range compatible with experimental limits where washing-out of a B+L asymmetry could be avoided for the minimal standard model with one Higgs doublet.Comment: 17 pages, RevTeX, (4 figures in a separate uuencoded file), HD-THEP-93-23re

Spherical Shells of Classical Gauge Field and their Topological Charge as a Perturbative Expansion

We consider the classical equations of motion of $SU(2)$ gauge theory, without a Higgs field, in Minkowski space. We work in the spherical ansatz and develop a perturbative expansion in the coupling constant $g$ for solutions which in the far past look like freely propagating spherical shells. The topological charge $Q$ of these solutions is typically non-integer. We then show that $Q$ can be expressed as a power series expansion in $g$ which can be nonzero at finite order. We give an explicit analytic calculation of the order $g^5$ contribution to $Q$ for specific initial pulses. We discuss the relation between our findings and anomalous fermion number violation, and speculate on the physical implications of our results.Comment: 18 pages in REVTE