Cost-effectiveness analysis of a state funded programme for control of severe asthma

<p>Abstract</p> <p>Background</p> <p>Asthma is one of the most common chronic diseases and a major economical burden to families and health systems. Whereas efficacy of current therapeutical options has been clearly established, cost-effectiveness analysis of public health interventions for asthma control are scarce.</p> <p>Methods</p> <p>81 patients with severe asthma (12–75 years) joining a programme in a reference clinic providing free asthma medication were asked retrospectively about costs and events in the previous 12 months. During 12 months after joining the programme, information on direct and indirect costs, asthma control by lung function, symptoms and quality of life were collected. The information obtained was used to estimate cost-effectiveness of the intervention as compared to usual public health asthma management. Sensitivity analysis was conducted.</p> <p>Results</p> <p>64 patients concluded the study. During the 12-months follow-up within the programme, patients had 5 fewer days of hospitalization and 68 fewer visits to emergency/non scheduled medical visits per year, on average. Asthma control scores improved by 50% and quality of life by 74%. The annual saving in public resources was US$387 per patient. Family annual income increased US$512, and family costs were reduced by US$733.</p> <p>Conclusion</p> <p>A programme for control of severe asthma in a developing country can reduce morbidity, improve quality of life and save resources from the health system and patients families.</p

Composição química da silagem de quatro variedades de sorgo-sacarino.

bitstream/item/136268/1/9-Fernanda-composicao.pd

Statistical-Mechanical foundation of the ubiquity of lévy distributions in nature

We show that the use of the recently proposed thermostatistics based on the generalized entropic form Sq≡k(1-Σipiq)/(q-1) (where q∈R, with q=1 corresponding to the Boltzmann-Gibbs-Shannon entropy -kΣipi ln pi), together with the Lévy-Gnedenko generalization of the central limit theorem, provide a basic step towards the understanding of why Lévy distributions are ubiquitous in nature. A consistent experimental verification is proposed

utjecaj sezonskih promjena tropske klime na reprodukcijske pokazatelje i hormonski status jaraca sanske pasmine

This study evaluated the effects different seasons (rainy, rainy-dry transition, dry, dry-rainy transition) throughout the year on the reproduction and endocrine profile of Saanen bucks reared in a tropical climate. During these seasons environmental data were recorded (ambient temperature and relative air humidity) to calculate the temperature and humidity index. Reproductive parameters were also evaluated in the same periods to check seasonal variations, wherey semen was collected twice a month from nine Saanen bucks using an artificial vagina. Furthermore, scrotal circumference, scrotal surface temperature and serum levels of testosterone, triiodothyronine (T3), thyroxine (T4) and cortisol were measured. The climate parameters influenced the reproductive parameters, mainly during the dry period, when higher values of ambient temperature reduced sperm quality, however, scrotal circumference and surface temperature, as well as serum levels of testosterone increased. In conclusion, Saanen bucks reared in a tropical climate are subject to heat stress, evinced by transient seasonal variations in reproductive parameters, where the first season is the most favorable to reproduction.U ovom je radu istražen utjecaj različitih sezona (kišna, prijelaz iz kišne u suhu, suha, prijelaz iz suhe u kišnu) tijekom godine na reprodukcijski i endokrini status jaraca sanske pasmine uzgojenih u tropskoj klimi. Zabilježeni su podaci iz okoliša (temperatura i relativna vlažnost zraka) za vrijeme različitih sezona kako bi se izračunao indeks topline. Za ista su razdoblja procijenjeni reprodukcijski pokazatelji kako bi se istražile njihove sezonske varijacije u koju je svrhu od 9 jaraca sanske pasmine primjenom umjetne vagine, prikupljano sjeme dva puta mjesečno. Osim toga mjereni su obujam skrotuma, temperatura površine skrotuma te razina testosterona, trijodotironina (T3), tiroksina (T4) i kortizola u serumu. Klimatski uvjeti su utjecali na reprodukcijske pokazatelje, najviše za vrijeme suhog razdoblja, kad veće vrijednosti temperature okoliša smanjuju kvalitetu sjemena jaraca. Obujam i temperatura površine skrotuma, kao i serumska razina testosterona, u navedenoj sezoni su povećani. Zaključeno je da su sanski jarci uzgojeni u tropskoj klimi pod utjecajem toplinskog stresa, što se vidi iz sezonskih varijacija njihovih reprodukcijskih pokazatelja, pri čemu je kišna sezona najpovoljnija za reprodukciju

Fixação de fósforo por um latossolo e determinação do valor «X»

An assay was conducted with the aim to evaluate the phosphorus fixation capacity of A1 (0-22cm), A3 (22-56em) and B22 (155-200cm horizons of a "Roxo Latossol". Also, the "X" value of WAUGH & FITTS (1966) of the three horizons was determinated. The main results are showed below : 1 - The phosphorus fixation capacity of the three horizons are in the following rank: B22 >; A3 >; A1. 2 - The "X" value are: 350 ppm (B22 horizon), 225 ppm (A3 horizon) and 175 ppm (A1 horizon). 3 - Correlations were found at the level of 1'% between added R and fixed R by the studied horizons.Este trabalho se refere a um ensaio conduzido em laboratório para avaliar a capacidade de fixação de fosfato dos horizontes A1 (0.22cm), A3 (22-56cm) e B22 (155-200cm) de Lotossolo Roxo Distrófico. Foi, também, determinado o valor "X" de WAUGH & FITTS (1966) dos três horizontes. Os principais resultados são apresentados a seguir: 1 - O horizonte B22 foi o que apresentou maior capacidade de fixação de fósforo, seguido pelo A3 e, finalmente, pelo A1 . 2 - Os valores "X" encontrados foram: 350 ppm, 225 ppm e 175 ppm para os horizontes B22 , A3 e A2, respectivamente. 3 - Houve uma relação muito estreita entre as quantidades de R adicionadas e as fixadas pelos três horizontes

Fixação de fósforo por um latossolo do estado de Minas Gerais

It: was studied the adsorption of R by samples of the horizons A1 (0-22cm), A3 (22-56cm) and B22 (155-200cm) of a Latossol f rom the State of Minas Gerais, Brasil, by mean of the isotherm of Langmuir. The maximum adsorption values (b) and selectivity constant (K) calculated from the linear pattern of the Langmuir equation were correlated with some physical and chemical: characteristics of the horizons. The main conclusion were as follows: a) The adsorption isotherm showed two definite regions: the one regarding to the high R fixation is in accordance with the Langmuir equation. b) It was observed big differences in respect to the values of maximum adsorption (b) as well as to the selectivity constant (K) .Foi estudada a adsorção do fósforo por amostras de três horizontes, A1 (0-22cm), A3 (22-56cm) e B22 (155-200cm), de um Latossolo do Estado de Minas Gerais por meio da isoterma de Langmuir. Os valores de adsorção máxima (b) e da constante de seletividade (K) calculados a partir da forma linear da equação de Langmuir foram correlacionados com algumas características físicas e químicas apresentadas pelos citados horizontes. Os resultados encontrados permitiram concluir que: a - As isotermas de adsorção mostraram duas regiões distintas: aquela em que o fosfato é fortemente retido foi convenientemente descrita pela equação de Langmuir. b - Em virtude da diversidade das características físicas e químicas dos horizontes houve grande variação nos valores de adsorção máxima (b) e da constante de seletividade (K)

Effect of drying temperature on yield and phytochemical quality of essential oil extracted from Mikania laevigata (Guaco) leaves / Efeito da temperatura de secagem sobre o rendimento e qualidade fitoquímica de óleo essencial extraído de folhas de Mikania laevigata (Guaco)

Mikania laevigata Sch. Bip. ex Baker, Asteraceae, commonly known as the guaco, is medicinal species native to Brazil. Among the critical points of post-harvest processing of medicinal species, the drying temperature must be considered, because its can interfere in the yield and phytochemical quality of plant material, and, consequently, in the therapeutic action. The effect of the drying temperature was evaluated on the yield and phytochemical quality of the essential oil extracted from M. laevigata leaves. The cultivation was carried out in an organic system and using the select genotype (Cenargen) for this region. The leaves were harvested and immediately submitted to drying process at 40, 50 and 60 °C. The essential oils were extracted by hydrodistillation in Clevenger apparatus and the chemical constituents was evaluated using gas chromatography coupled to the mass spectrophotometer (CG-MS). There was a reduction in the essential oil yield (p &lt;0.05) with increasing drying temperature. However, at 60 ºC there was a higher concentration of coumarin to which the bronchodilator and expectorant action is attributed. Therefore, we recommended dry the M. laevigata leaves at 60 ºC to obtain the highest coumarin content and guarantee the bronchodilator and expectorant therapeutic effect

Effect of drying temperature on the yield and phytochemical quality of the essential oil of pepper rosemary (Lippia origanoides Kunth) and of clove basil (Ocimum gratissimum L.) / Efeito da temperatura de secagem no rendimento e na qualidade fitoquímica do óleo essencial de alecrim-pimenta (Lippia origanoides Kunth) e de alfavaca (Ocimum gratissimum L.)

Among medicinal species, Lippia origanoides Kunth and Ocimum gratissimum L. stand out for its recognized therapeutic value associated with the medicinal properties of their essential oils. Drying is a critical point in post-harvest processing of medicinal plants for the conservation of bioactive compounds. This work aimed to evaluate the effect of drying temperature on the essential oil’s yield and phytochemical quality extracted from leaves of O. gratissimum and L. origanoides. The medicinal species were grown in an organic system and their leaves were harvest and immediately dried at 40, 50 and 60 °C. The essential oils were extracted from the leaves by hydrodistillation in Clevenger apparatus. There was detected a difference (P &lt;0.01) in the essential oil yield of O. gratissimum with the increase in the drying temperature, being 1.35% (40 °C), 0.83% (50 °C) and 0.45% (60 °C) ). In L. origanoides there was detected a difference (P &lt;0.01) in the essential oil yield only between 40 °C (3.4%) and 60 °C (2.84%). The increase of drying temperature reduced the levels of the major constituents of O. gratissimum (eugenol, germacrene D and caryophyllene oxide), but did not change the levels of the major constituents of L. origanoides (thymol, trans-caryophyllene and para-cymene). Considering that the increase of the drying temperature promote a reduction in the essential oil yield of both medicinal species and also in the major constituents concentration in O. gratisssimum, it is essential to select the correct drying temperature to guarantee the best yield and the phytochemical quality of the essential oil to ensure therapeutic efficacy. Here, we conclude that the best drying temperature to the essential oil’s yield and phytochemical quality is 40 °C for O. gratissimum and 40 or 50 °C for L. origanoides

Endophytic capacity of entomopathogenic fungi in a pasture grass and their potential to control the Spittlebug Mahanarva spectabilis (Hemiptera: Cercopidae).

Pests in pastures have compromised the production of biomass for feeding livestock herds. Many strategies have been applied to sustainably solve this problem. One viable and innovative technique is the delivery of entomopathogenic fungi through endophytes. Therefore, this study aimed to (i) evaluate the endophytic capacity of two entomopathogenic fungi, Fusarium multiceps UFMGCB 11443 and Metarhizium anisopliae UFMGCB 11444, in Urochloa brizantha [(Hochst. ex A. Rich.) Stapf] (Poaceae) cultivar ‘Marundu’) via foliar inoculation or seed treatment, and (ii) measure their efficiency in controlling Mahanarva spectabilis Distant, 1909 (Hemiptera: Cercopidae) in U. brizantha. In the greenhouse, the fungi colonized the tissues of U. brizantha plants when inoculated via foliar spraying or seed treatment. The fungi F. multiceps and M. anisopliae caused 88% and 97.1% epizootic effects via seed inoculation, respectively, and 100% epizootic effects via foliar inoculation. In the field, the lowest fungal dose of 0.5 kg/ha had the same effect as a fourfold greater dose, with a >86% decrease in insect pest infestation observed. In summary, the fungi F. multiceps and M. anisopliae have endophytic effects and can effectively control M. spectabilis in U. brizantha pastures