Evolução na utilização e nos gastos de uma operadora de saúde

Brazil’s aging population and the rising number of people reliant upon the country’s supplementary healthcare system have elicited the concern of public and private managers regarding the increase in healthcare costs. In this paper, the costs per gender, per type of medical expenses and per age group of a major Brazilian self-managed healthcare provider between 2007 and 2013 were analyzed. This healthcare provider is of interest because, besides portraying a single condition of revenue growth restricted to the existing contributors, it also replicates the demographic profile expected for Brazil in 2050, when approximately one-third of its population will be over 60 years of age. The analyses confirm the current literature as they show an increase in healthcare plan usage by the elderly and the difference between admission rates by gender. They also reveal an increase in average length of stay in hospital and the increase in medical costs far above inflation, especially for materials and medicines. It is hoped that this study will help scholars and others interested in comparisons of medical expense trends, especially by age and sex, and that it encourages further collaboration on the sustainability of health insurance providers in Brazil

O ethos e o pathos na sala de parto

RESUMO Objetivo Compreender o ethos e o pathos presentes nos discursos de mulheres parturientes e profissionais de saúde no contexto da sala de parto. Método Pesquisa qualitativa do tipo interpretativa. Utilizou-se o método da Análise do Discurso. Participaram das entrevistas 36 mulheres e 24 profissionais de saúde de maternidades do interior de Minas Gerais. Resultados Os discursos sinalizam a concepção que as mulheres têm do parto, centrada no olhar do outro e nas suas representações; as dificuldades das enfermeiras para operacionalizar o cuidado e construir uma imagem profissional autônoma. O discurso médico enfatiza a especialidade, a capacidade de intervir em situações de risco e as mudanças no status da profissão. Conclusões A construção do ethos de médicos e enfermeiros é fundamental para o delineamento de campos de saberes mais flexíveis e parauma atuação profissional condizente com os seus papéis e comprometida com os preceitos éticos e legais do cuidado obstétrico

Accreting Black Holes

This chapter provides a general overview of the theory and observations of black holes in the Universe and on their interpretation. We briefly review the black hole classes, accretion disk models, spectral state classification, the AGN classification, and the leading techniques for measuring black hole spins. We also introduce quasi-periodic oscillations, the shadow of black holes, and the observations and the theoretical models of jets.Comment: 41 pages, 18 figures. To appear in "Tutorial Guide to X-ray and Gamma-ray Astronomy: Data Reduction and Analysis" (Ed. C. Bambi, Springer Singapore, 2020). v3: fixed some typos and updated some parts. arXiv admin note: substantial text overlap with arXiv:1711.1025

A nanocommunication system for endocrine diseases

Nanotechnology is a newand very promising area of research which will allow several new applications to be created in different fields, such as, biological, medical, environmental, military, agricultural, industrial and consumer goods. This paper focuses specifically on nanocommunications, which will allow interconnected devices, at the nano-scale, to achieve collaborative tasks, greatly changing the paradigm in the fields described. Molecular communication is a new communication paradigm which allows nanomachines to exchange information using molecules as carrier. This is the most promising nanocommunication method within nanonetworks, since it can use bio-inspired techniques, inherit from studied biological systems, which makes the connection of biologic and man-made systems a easier process. At this point, the biggest challenges in these type of nanocommunication are to establish feasible and reliable techniques that will allow information to be encoded, and mechanisms that ensure a molecular communication between different nodes. This paper focus on creating concepts and techniques to tackle these challenges, and establishing new foundations on which future work can be developed. The created concepts and techniques are then applied in an envisioned medical application, which is based on a molecular nanonetwork deployed inside the Human body. The goal of this medical application is to automatously monitor endocrine diseases using the benefits of nanonetworks, which in turn connects with the internet, thus creating a Internet of NanoThings system. The concepts and techniques developed are evaluated by performing several simulations and comparing with other researches, and the results and discussions are presented on the later sections of this paper

A simulation study comparing aberration detection algorithms for syndromic surveillance

BACKGROUND: The usefulness of syndromic surveillance for early outbreak detection depends in part on effective statistical aberration detection. However, few published studies have compared different detection algorithms on identical data. In the largest simulation study conducted to date, we compared the performance of six aberration detection algorithms on simulated outbreaks superimposed on authentic syndromic surveillance data. METHODS: We compared three control-chart-based statistics, two exponential weighted moving averages, and a generalized linear model. We simulated 310 unique outbreak signals, and added these to actual daily counts of four syndromes monitored by Public Health – Seattle and King County's syndromic surveillance system. We compared the sensitivity of the six algorithms at detecting these simulated outbreaks at a fixed alert rate of 0.01. RESULTS: Stratified by baseline or by outbreak distribution, duration, or size, the generalized linear model was more sensitive than the other algorithms and detected 54% (95% CI = 52%–56%) of the simulated epidemics when run at an alert rate of 0.01. However, all of the algorithms had poor sensitivity, particularly for outbreaks that did not begin with a surge of cases. CONCLUSION: When tested on county-level data aggregated across age groups, these algorithms often did not perform well in detecting signals other than large, rapid increases in case counts relative to baseline levels

Silicon-hydroxyapatite bioactive coatings (Si-HA) from diatomaceous earth and silica. Study of adhesion and proliferation of osteoblast-like cells

The aim of this study consisted on investigating the influence of silicon substituted hydroxyapatite (Si–HA) coatings over the human osteoblast-like cell line (SaOS-2) behaviour. Diatomaceous earth and silica, together with commercial hydroxyapatite were respectively the silicon and HA sources used to produce the Si–HA coatings. HA coatings with 0 wt% of silicon were used as control of the experiment. Pulsed laser deposition (PLD) was the selected technique to deposit the coatings. The Si–HA thin films were characterized by Fourier Transformed Infrared Spectroscopy (FTIR) demonstrating the efficient transfer of Si to the HA structure. The in vitro cell culture was established to assess the cell attachment, proliferation and osteoblastic activity respectively by, Scanning Electron Microscopy (SEM), DNA and alkaline phosphatase (ALP) quantification. The SEM analysis demonstrated a similar adhesion behaviour of the cells on the tested materials and the maintenance of the typical osteoblastic morphology along the time of culture. The Si–HA coatings did not evidence any type of cytotoxic behaviour when compared with HA coatings. Moreover, both the proliferation rate and osteoblastic activity results showed a slightly better performance on the Si–HA coatings from diatoms than on the Si–HA from silica.This work was supported by the UE-Interreg IIIA (SP1.P151/03) Proteus project and Xunta de Galicia ( Projects: 2006/12 and PGIDITO5PXIC30301PN)