Impacto da reforma de financiamento de hospitais de ensino no Brasil

OBJECTIVE: To assess the impact of funding reform on the productivity of teaching hospitals. METHODS: Based on the Information System of Federal University Hospitals of Brazil, 2003 and 2006 efficiency and productivity were measured using frontier methods with a linear programming technique, data envelopment analysis, and input-oriented variable returns to scale model. The Malmquist index was calculated to detect changes during the study period: "technical efficiency change," or the relative variation of the efficiency of each unit; and "technological change" after frontier shift. RESULTS: There was 51% mean budget increase and improvement of technical efficiency of teaching hospitals (previously 11, 17 hospitals reached the empirical efficiency frontier) but the same was not seen for the technology frontier. Data envelopment analysis set benchmark scores for each inefficient unit (before and after reform) and there was a positive correlation between technical efficiency and teaching intensity and dedication. CONCLUSIONS: The reform promoted management improvements but there is a need of further follow-up to assess the effectiveness of funding changes.OBJETIVO: Evaluar el impacto de la reforma de financiamiento en la productividad de hospitales de enseñanza. MÉTODOS: A partir del Sistema de Informaciones de los Hospitales Universitarios Federales de Brasil, se construyeron fronteras de eficiencia y productividad en 2003 y 2006 con técnicas de programación linear, por medio de análisis envoltorio de datos, considerando retornos variables de escala y orientación a input. Se calculó el Índice de Malmquist para identificar cambios de desempeño a lo largo de los años con relación a la eficiencia técnica (cociente entre los puntajes de eficiencia en tiempos distintos) y eficiencia tecnológica (desplazamiento de la frontera en el período considerado). RESULTADOS: Hubo aumento del aporte financiero en 51% y de la eficiencia técnica de los hospitales de enseñanza (de 11, pasaron a ser 17 en la frontera empírica de eficiencia), no ocurriendo el mismo con la frontera tecnológica. El uso del análisis envoltorio de datos estableció los benchmarks para las unidades ineficientes (antes y después de la reforma) y los puntajes de eficiencia mostraron una posible correlación entre la eficiencia técnica encontrada y la intensidad y dedicación de enseñanza. CONCLUSIONES: La reforma permitió el desarrollo de mejoras gerenciales, pero es necesario mayor tiempo de acompañamiento para observar cambios más efectivos del modelo de financiamiento.OBJETIVO: Avaliar o impacto da reforma de financiamento na produtividade de hospitais de ensino. MÉTODOS: A partir do Sistema de Informações dos Hospitais Universitários Federais, foram construídas fronteiras de eficiência e produtividade em 2003 e 2006 com técnicas de programação linear, por meio de análise envoltória de dados, considerando retornos variáveis de escala e orientação a input. Calculou-se o Índice de Malmquist para identificar mudanças de desempenho ao longo dos anos quanto à eficiência técnica (razão entre os escores de eficiência em tempos distintos) e eficiência tecnológica (deslocamento da fronteira no período considerado). RESULTADOS: Houve aumento do aporte financeiro em 51% e da eficiência técnica dos hospitais de ensino (de 11, passaram a ser 17 na fronteira empírica de eficiência), o mesmo não ocorrendo com a fronteira tecnológica. O uso de análise envoltória de dados estabeleceu os benchmarks para as unidades ineficientes (antes e depois da reforma) e os escores de eficiência mostraram uma possível correlação entre a eficiência técnica encontrada e a intensidade e dedicação de ensino. CONCLUSÕES: A reforma permitiu o desenvolvimento de melhorias gerenciais, mas é necessário maior tempo de acompanhamento para observar mudanças mais efetivas do modelo de financiamento

Dynamics of a Quantum Phase Transition and Relaxation to a Steady State

We review recent theoretical work on two closely related issues: excitation of an isolated quantum condensed matter system driven adiabatically across a continuous quantum phase transition or a gapless phase, and apparent relaxation of an excited system after a sudden quench of a parameter in its Hamiltonian. Accordingly the review is divided into two parts. The first part revolves around a quantum version of the Kibble-Zurek mechanism including also phenomena that go beyond this simple paradigm. What they have in common is that excitation of a gapless many-body system scales with a power of the driving rate. The second part attempts a systematic presentation of recent results and conjectures on apparent relaxation of a pure state of an isolated quantum many-body system after its excitation by a sudden quench. This research is motivated in part by recent experimental developments in the physics of ultracold atoms with potential applications in the adiabatic quantum state preparation and quantum computation.Comment: 117 pages; review accepted in Advances in Physic

Diversity of lactic acid bacteria of the bioethanol process

<p>Abstract</p> <p>Background</p> <p>Bacteria may compete with yeast for nutrients during bioethanol production process, potentially causing economic losses. This is the first study aiming at the quantification and identification of Lactic Acid Bacteria (LAB) present in the bioethanol industrial processes in different distilleries of Brazil.</p> <p>Results</p> <p>A total of 489 LAB isolates were obtained from four distilleries in 2007 and 2008. The abundance of LAB in the fermentation tanks varied between 6.0 × 10⁵and 8.9 × 10⁸CFUs/mL. Crude sugar cane juice contained 7.4 × 10⁷to 6.0 × 10⁸LAB CFUs. Most of the LAB isolates belonged to the genus <it>Lactobacillus </it>according to rRNA operon enzyme restriction profiles. A variety of <it>Lactobacillus </it>species occurred throughout the bioethanol process, but the most frequently found species towards the end of the harvest season were <it>L. fermentum </it>and <it>L. vini</it>. The different rep-PCR patterns indicate the co-occurrence of distinct populations of the species <it>L. fermentum </it>and <it>L. vini</it>, suggesting a great intraspecific diversity. Representative isolates of both species had the ability to grow in medium containing up to 10% ethanol, suggesting selection of ethanol tolerant bacteria throughout the process.</p> <p>Conclusions</p> <p>This study served as a first survey of the LAB diversity in the bioethanol process in Brazil. The abundance and diversity of LAB suggest that they have a significant impact in the bioethanol process.</p

Relationship between functional fitness, medication costs and mood in elderly people

Objective: to verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people. Methods: a cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. Results: an inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01). Conclusion: elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt