Shortened first-line TB treatment in Brazil: potential cost savings for patients and health services.

BACKGROUND: Shortened treatment regimens for tuberculosis are under development to improve treatment outcomes and reduce costs. We estimated potential savings from a societal perspective in Brazil following the introduction of a hypothetical four-month regimen for tuberculosis treatment. METHODS: Data were gathered in ten randomly selected health facilities in Rio de Janeiro. Health service costs were estimated using an ingredient approach. Patient costs were estimated from a questionnaire administered to 126 patients. Costs per visits and per case treated were analysed according to the type of therapy: self-administered treatment (SAT), community- and facility-directly observed treatment (community-DOT, facility-DOT). RESULTS: During the last 2 months of treatment, the largest savings could be expected for community-DOT; on average USD 17,351-18,203 and USD 43,660-45,856 (bottom-up and top-down estimates) per clinic. Savings to patients could also be expected as the median (interquartile range) patient-related costs during the two last months were USD 108 (13-291), USD 93 (36-239) and USD 11 (7-126), respectively for SAT, facility-DOT and community-DOT. CONCLUSION: Introducing a four-month regimen may result in significant cost savings for both the health service and patients, especially the poorest. In particular, a community-DOT strategy, including treatment at home, could maximise health services savings while limiting patient costs. Our cost estimates are likely to be conservative because a 4-month regimen could hypothetically increase the proportion of patients cured by reducing the number of patients defaulting and we did not include the possible cost benefits from the subsequent prevention of costs due to downstream transmission averted and rapid clinical improvement with less side effects in the last two months

ISÓTOPOS DE ESTRÔNCIO NO SÍTIO ARMAÇÃO DO SUL, FLORIANÓPOLIS/SC: RESULTADOS PARCIAIS, REFLEXÕES INICIAIS

de estrôncio (87Sr/86Sr) presentes no esmalte dentário dos indivíduos sepultados no sítio Armação do Sul, procuramos compreender melhor as mudanças que ocorrem no sítio conchífero Armação do Sul (Florianópolis/SC) e no contexto maior de sambaquis do litoral catarinense a partir de 2.000 A.P

A crise social desenhada pelas crianças: imaginação e conhecimento social

A crise social e económica que tem atingido o mundo desde 2008, com efeitos especialmente sentidos nos países do Sul da Europa, causou impactos fortes e visíveis na infância, como o aumento das taxas efetivas e de risco de pobreza e a vulnerabilidade e a exposição a fatores de risco social e de perda consistente de direitos. A análise dessas incidências tem vindo a ser trabalhada num conjunto de relatórios nacionais e internacionais, de ONG’s e estudos académicos. No entanto, poucos estudos têm dedicado atenção ao modo como a interpretação das representações das crianças sobre a crise é feita e sobre as expressões específicas que estas assumem na sua vida quotidiana. As crianças são capazes de observar os modos como a crise impacta o seu próprio grupo geracional, bem como os adultos que mais lhe são próximos. Da mesma forma, promovem interpretações económicas sobre os fenómenos, sejam elas mais “ingénuas” ou mais complexas. Este artigo incide sobre as representações das crianças sobre a crise social e económica em Portugal. São especialmente analisadas narrativas gráficas produzidas por crianças oriundas de classes trabalhadoras, com idades compreendidas entre os 6 e os 10 anos de idade. Por meio dessas narrativas, as crianças constroem formas visuais a partir da sua imaginação sobre a sua condição. Assim, a imaginação das crianças é um modo de acesso ao conhecimento na sociedade onde se inserem e aos seus modos próprios de compreensão de realidades complexas.The social and economic crisis that has hit the world since 2008, with effects strongly felt in the countries of Southern Europe, has had fierce and visible impacts in childhood with the increase of the effective rates, the risk of poverty and vulnerability, and the exposure to factors of social risk and consistent loss of rights. The analysis of these incidents has been worked on in a series of national and international reports from NGOs and academic studies. However, few studies have devoted attention to the way in which the interpretation of the representations of children about the crisis is made and the specific expressions that they assume in their daily lives. Children are able to observe the ways in which the crisis affects their own generational group as well as the adults closest to them. In the same way, they promote economic interpretations of phenomena, whether “naïve” or more complex. This article focuses on the representations of children about the social and economic crisis in Portugal. Graphical narratives produced by children from working classes, aged between 6 and 10 years old, are given focus. From these narratives, children construct visual forms from their imagination about their social condition. Thus, the child’s imagination is a way of accessing knowledge in the society they belong to and their own way of understanding complex realities.CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT), Portugalinfo:eu-repo/semantics/publishedVersio

ISÓTOPOS DE ESTRÔNCIO NO SÍTIO ARMAÇÃO DO SUL, FLORIANÓPOLIS/SC: RESULTADOS PARCIAIS, REFLEXÕES INICIAIS

de estrôncio (87Sr/86Sr) presentes no esmalte dentário dos indivíduos sepultados no sítio Armação do Sul, procuramos compreender melhor as mudanças que ocorrem no sítio conchífero Armação do Sul (Florianópolis/SC) e no contexto maior de sambaquis do litoral catarinense a partir de 2.000 A.P

A complex scenario of tuberculosis transmission is revealed through genetic and epidemiological surveys in Porto

Tuberculosis (TB) incidence is decreasing worldwide and eradication is becoming plausible. In low-incidence countries, intervention on migrant populations is considered one of the most important strategies for elimination. However, such measures are inappropriate in European areas where TB is largely endemic, such as Porto in Portugal. We aim to understand transmission chains in Porto through a genetic characterization of Mycobacterium tuberculosis strains and through a detailed epidemiological evaluation of cases.This work was developed under the scope of the project NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER), and supported by contributions from Iceland, Liechtenstein and Norway through the European Economic Area Grants under the Public Health Initiative programme, (PT06, Project 000138DT1). TR is supported by the Portuguese Foundation for Science and Technology (FCT) through a post-doctoral grant (SFRH/BPD/108126/2015)info:eu-repo/semantics/publishedVersio