6 1. ABSTRACT Background: This study is primarily aimed at describing migraine illnesses, the existing patient care algorithm with this diagnosis and to estimate the direct costs of treatment of migraine from the point of view of the health care system in the Czech Republic. In the theoretical part, the basic concepts and procedures of health economics and the health technologies assessment are examined, especially the cost-of-illness of the analysis that is conducted in the practical part, namely just on the illness of migraine. Methods: The cost of drugs used to treat migraine is determined using FNHK (Fakultni nemocnice Hradec Kralove) prescription data. Further, using the data on health care (both ambulatory and inpatient care), these services are being appraised and this way the cost of treatment of a patient with the disease estimated from the point of view of the health system in the Czech Republic. Results: The average annual cost of treatment of one patient with episodic migraine was assessed at CZK 1,182 for outpatient care, CZK 786 for hospitalization and CZK 2,707 for medication. For chronic migraines, the average cost is higher and estimated at CZK 3,321 for outpatient care, CZK 2,745 for hospitalization and CZK 7,415 for medication. Conclusions: The total direct annual cost of the patient was...

Potentially Inappropriate Prescribing (PIP) is common in Canada yet little is known about its health system costs or which PIPs have the greatest cost impact. This thesis examined the health system costs from hospitalizations, emergency department (ED) visits and medications from all PIP, and for distinct PIP. PIPs were identified in a cohort of older adults in Ontario using a subset of the STOPP/START criteria applicable to health administrative databases, and all analyses were conducted by comparing participants with and without PIP. In study one, the costs from hospitalization, ED visits and newly prescribed medications were identified using population attributable fractions. PIP was identified as responsible for a sizeable portion of all three cost categories, with hospitalization and ED visits costs most highly impacted. Study two compared the incremental costs due to PIP among four distinct PIP criteria selected based on differing frequency and crude costs to validate the use of such characteristics for priority-setting. The crude healthcare costs, as well as the cost of the drug causing the PIP and the frequency of the PIP were identified as likely key characteristics of high-impact PIP. Combined, these studies provide evidence on the overall burden of PIP, while also identifying likely characteristics of high-impact PIP. They suggest interventions at the health system level may be needed to address medication appropriateness and provide information which may be helpful to decision-makers when identifying which PIPs should be targeted for intervention, given no health system level interventions for PIP are currently in place.

Introdução: nas quatro últimas décadas, os medicamentos psicotrópicos assumiram uma significativa importância na vida de milhões de pessoas. Os custos diretos e indiretos associados aos psicotrópicos são frequentemente desconhecidos. Aspectos econômicos dos psicotrópicos foram estudados em outros países, mas essas informações ainda são escassas no Brasil. Uma fonte de dados para estudos sobre despesas familiares e gastos em saúde é a Pesquisa de Orçamentos Familiares. Objetivos: desenhar o perfil de brasileiros que adquirem medicamentos psicotrópicos, bem como, avaliar o gasto com esses medicamentos e o seu impacto no orçamento familiar brasileiro nos últimos anos. Métodos: estudo transversal, onde os dados utilizados são provenientes da Pesquisa de Orçamentos Familiares de 2002-2003 e de 2008-2009, envolvendo entrevistas de uma amostra complexa, composta por 48.470 domicílios pesquisados em 2003, 128.300 pessoas e 55.970 domicílios visitados em 2009. Modelos de regressão multivariáveis de Poisson com variância robusta foram construídos através do SAS/SUDAAN 10.0.1. Todos os rendimentos e despesas foram convertidos para valores mensais e corrigidos para a inflação do período. Resultados: a prevalência de aquisição de psicotrópicos pela população brasileira em 2008-2009 foi de 5,2% (IC95%=5,0-5,5), resultando em um gasto anual de R$507 milhões. Essa aquisição foi mais frequente em mulheres, indivíduos brancos, de idades mais avançadas, que não vivem com o cônjuge, com grau mais 9 elevado de instrução e de maior renda. Indivíduos que gastaram com psicotrópicos apresentaram despesas maiores com plano de saúde (RP=1,40, IC95%: 1,30-1,50) e consultas médicas (RP=2,51, IC95%: 2,32-2,72). A média mensal de despesas com psicotrópicos, por domicílio, aumentou de R$ 54,38 em 2003 para R$ 78,73 em 2009, com os valores já corrigidos pela inflação. Entre os domicílios que não gastaram com psicotrópicos, a renda média mensal per capita foi de R$1.026,73 e os gastos mensais per capita foram de, em média, R$73,92 com saúde, R$130,17 com alimentação e R$12,77 com lazer. Entre os domicílios que adquiriram psicotrópicos, a renda média mensal per capita foi de R$1.154,40 e, suas despesas mensais médias, per capita, de R$210,38 com saúde, R$162,08 com alimentação e R$15,45 com lazer. Conclusões: houve um aumento acima da inflação nos gastos com medicamentos psicotrópicos entre os anos avaliados. A aquisição desses medicamentos está relacionada a famílias de níveis socioeconômicos mais elevados. As diferenças encontradas podem representar diferentes níveis tanto de acesso aos serviços médicos de diagnóstico e tratamento quanto aos próprios medicamentos. O orçamento das famílias brasileiras não parece mostrar remanejamento de recursos em função da compra de psicotrópicos. Se a mudança epidemiológica, em sua primeira etapa, representou a transição das doenças infecciosas para as doenças crônicas não transmissíveis, o quadro que pode representar o futuro seriam as doenças neurodegenerativas, mantidas as tendências de aumento da expectativa de vida. / Introduction: over the past four decades the use of psychotropic drugs increased its relevancy to the lives of millions of people. The direct and indirect costs associated to psychotropics are usually unknown. Economic aspects of psychotropic medicine have been studied in other countries, although such information is still scarce in Brazil. A data source for studies about household expenditure and health care costs is the Survey on Household Budgets. Objectives: to draw a profile of Brazilian people that acquire psychotropic drugs, as well as evaluate spends with these medicine and its impacts on the Brazilian household budget on the recent years. Methods: a cross-sectional study, with data used are from the Survey on Household Budgets from 2002-2003 and from 2008-2009, which involved interviews of a complex sample made of 48,470 households on 2003, 128,300 people and 55.970 homes in 2009. Poisson multilevel regression models with robust variance were made by SAS/SUDAAN 10.0.1. All income and spends were adjusted to a monthly basis and indexed by inflation. Results: the prevalence of psychotropics acquisition in the Brazilian population in 2008-2009 was of 5.2% (CI95%=5.0-5.5), resulting in an annual expenditure of R$507 millions. The use of psychotropic drugs was more frequent among women, white people, older people, do not co-habit with a spouse or partner, more schooled and wealthier. Individuals that spent with psycotropics had more 11 spends with health insurance (PR=1.40, CI95%: 1.30-1.50) and medical consults (PR=2.51, CI95%: 2.32-2.72). The average monthly spends with psychotropics per household increased from R$54.38 in 2003 to R$78.73 in 2009, with values indexed by inflation. Among the households that did not purchase psychotropics, the average monthly per capita income was of R$1,026.73 and the monthly per capita spends were, in average, of R$73.92 with health care, R$103.17 with food and R$12.77 with leisure. Among the household that presented expenditure with psychotropics, the average monthly per capita income was of R$1,154.40 and its average monthly per capita spends were of R$210.38 with health care, R$162.087 with food and R$15.45 with leisure. Conclusion: there was an above inflation increase in the psychotropic drugs spends between the evaluated years. The psychotropics acquisition relates to higher socio-economic leveled families. The differences that were found may represent different levels of access to medical diagnose and treatment and to medication. The Brazilian household budgets do not seem to re-adequate resources to meet the purchase of psychotropics. If the epidemiologic change, at its first stage, represented the transition from infectious diseases to non-transmissive chronic illnesses. the picture that can represent the future would be the neurodegenerative diseases, if the trend of increasing life expectancy is kept.

Ao considerar que as empresas de serviços contábeis não prestam somente serviços na área contábil, mas também nas áreas societária, trabalhista e tributária, dentre outras; que clientes de portes semelhantes geram serviços com dificuldades de elaboração diferenciada em razão da forma de tributação, da atividade exercida e de questões de organização interna de cada empresa, entre outros fatores; que muitos dos escritórios contábeis cresceram e hoje são considerados empresas de serviços contábeis e constituem um segmento de grande importância no cenário empresarial brasileiro, faz-se necessário estudos quanto aos custos dos serviços prestados, a fixação do preço de venda destes serviços e a análise da lucratividade de cada cliente. O presente estudo, que tem como objetivo de propor um modelo de mensuração de custos mensais para as empresas de serviços contábeis, com o intuito de viabilizar a análise da lucratividade de cada um de seus clientes. O trabalho parte de uma abordagem administrativa, com enfoque gerencial da empresa de serviços contábeis, identifica custos e despesas, utiliza-se de conceitos de diversos métodos de custeio para direcionar os custos a cada departamento da empresa de serviços contábeis e, consequentemente, a cada cliente usuário dos serviços. Identifica, portanto, os custos, compara com os preços de venda praticados, e analisa, individualmente, a lucratividade de cada cliente da empresa de serviços contábeis. / Considering that accounting services companies do not only provide services in accounting, but also in corporation, labor and taxation, and other fields, considering that clients of similar sizes generate services with special development difficulties due to the way they are taxed, the type of business being carried out, and matters of each company’s internal structure, among other factors, considering that many accounting firms grew and today are considered financial services companies which constitute a segment of great importance in the Brazilian business scenario, studies on the costs of services provided to each client are made necessary as well as fixing the selling price of services and profitability analysis of each client. The present study aims to propose a measurement model of monthly costs for businesses providing accounting services, it intends to facilitate the analysis of the profitability of each client. It comes from an administrative perspective, with a managerial focus on accounting services companies, it identifies costs and expenses and uses the concepts of various defrayment methods to direct the costs to each department of the accounting services company and therefore to each client user of the services. Therefore it identifies the costs, compares them with the sales prices, and analyzes individually the profitability of each client of the accounting services company.

The aim of this diploma thesis is to find and evaluate decisive operational and economic indicators in a statistically significant group of trucks. They have a high level of chance and are therefore very difficult to determine in advance. These operating and economic indicators included repair and maintenance costs obtained from invoices, financial statements and the results of transport companies' operations. These costs were monitored for the time of operation of these trucks.

Made available in DSpace on 2014-06-11T19:35:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-04-18Bitstream added on 2014-06-13T20:07:05Z : No. of bitstreams: 1 polizelneto_a_dr_botfmvz.pdf: 959880 bytes, checksum: 6baf692c005332ccadf331237561b0e8 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Universidade Estadual Paulista (UNESP) / Este estudo objetivou avaliar os efeitos da torta de algodão (TA) como fonte lipídica na terminação de bovinos confinados. Para tanto, foram utilizados 40 machos da raça Nelore, não-castrados, com idade média inicial de 17 meses e peso vivo médio inicial de 313,8±41,2 kg, confinados por 102 dias com dietas contendo TA ou soja (SO). A inclusão da TA foi com base no teor de extrato etéreo (EE) da dieta: 3%, 4% e 5%. Também foram testados outros dois tratamentos referências, com teores de 3% e 5% de EE, tendo SO como fonte lipídica. As médias foram comparadas por meio de quatro contrastes não ortogonais: C1 = 3SO versus 3TA; C2 = 5SO versus 5TA; C3 = 3TA versus 5TA, e C4 = 3TA + 5TA versus 4TA. Nas dietas com 3% de EE, a TA não alterou as variáveis estudadas, contudo, nas dietas com 5% de EE, os animais alimentados com TA apresentaram maior consumo de matéria seca, 8,94 para 10,3 kg/dia, e redução da eficiência alimentar, 166 g/kg com SO e 145 g/kg com TA. Porém, por ser um ingrediente de menor custo, houve redução do custo do ganho, 3,15 e 2,63 R$/kg, respectivamente para SO e TA. Maior inclusão do teor de TA na dieta propiciou aumento do peso vivo final dos animais, respectivamente, 433, 454 e 467 kg nas dietas 3TA, 4TA e 5TA; e também aumentou do consumo de matéria seca, respectivamente, 8,34, 9,90 e 10,3 kg/dia. Além de, o aumento da TA nas dietas elevou o tempo despendido em ruminação pelos animais, sem alterar o tempo gasto na alimentação. Assim, o uso da torta de algodão não alterou o ganho de peso, as características de carcaça, e o comportamento ingestivo animais, contudo, nas dietas com maior teor lipídico, a TA elevou o consumo de matéria seca, mas reduziu o custo do ganho de peso. O aumento do teor de TA na dieta elevou o ganho de peso, o consumo de matéria seca e o tempo despendido em ruminação pelos animais, sem alterar a eficiência alimentar... / This study aimed to evaluate effects of cottonseed cake (CC) inclusion as fat source in finishing diet of beef cattle. Forty Nellore males, no castrated, with 17 months of initial age and 313.8±41.2 kg of average initial weight, were finished on feedlot for 102 days with diets containing CC or soybean products (SO). CC inclusion was based on diet ether extract (EE): 3%, 4% and 5%. Others control treatments, with 3% and 5% of EE, having SO as fat source were also tested. Means were tested using four non-orthogonal contrasts: C1 = 3SO versus 3CC; C2 = 5SO versus 5CC; C3 = 3CC versus 5CC, e C4 = 3CC + 5CC versus 4CC. In diets with 3% of EE, CC did not change the variables studied, but, in diets with 5% of EE, animals fed with CC showed major dry matter intake, 8.94 to 10.3 kg/day, and gain:feed reduction, 166 g/kg to SO and 145 g/kg to CC. However, to be a cheap ingredient, promoted gain cost reduction, 3.15 and 2.63 R$/kg, respectively to SO and CC. Major CC diet inclusion increased final live weight of the animals, respectively, 433, 454 and 467 kg on 3CC, 4CC and 5CC diets; and increased dry matter intake too, respectively, 8.34, 9.90 and 10.3 kg/day. In addition, major CC on diet increased chewing time, without changed intake spending time. So, CC use did not change weight gain, carcass traits, and intake behavior, but, in high fat level diets, CC increased dry matter intake and reduced gain cost of the animals. The diet CC inclusion, increased weight gain, dry matter intake, and chewing time, without change gain:feed, gain cost, intake spending time and carcass traits of Nellore bulls, on feedlot

Com a reestruturação do setor elétrico brasileiro ocorreu a abertura no mercado de energia elétrica, a criação das figuras do consumidor livre e produtor independente e o surgimento de novas alternativas de fornecimento de energia aos consumidores do Grupo A, grupo conectado a alta tensão que compreende os níveis de 230 kV até 2,3 kV, composto basicamente por consumidores industriais. De acordo com a regulamentação atual, uma planta industrial pode ser atendida através da distribuidora local, do mercado livre, de fonte convencional ou incentivada e da autoprodução. No atual contexto de mercado faz-se necessário analisar qual a alternativa que melhor se adapte ao perfil da planta industrial e também represente economia na fatura de energia elétrica. O presente trabalho apresenta uma metodologia para avaliação destas alternativas, que permite comparar os custos com energia, auxiliando à tomada de decisão. Para a aplicação da metodologia, foram realizados estudos de caso que englobam diferentes consumidores do Grupo A, visando a economia e eficiência energética para o consumidor. / With the restructuration of the Brazilian electrical sector, came the opening of the electric energy market, the creation of characters such as the free consumer and independent producer, and the appearance of new supplying alternatives of energy to Group A consumers, a high-tension group which comprehends the levels from 230 kV to 2,3 kV that is composed basically of industrial consumers. According to the current regulations, an industrial plant can be attended through the local distributer, in the free market, of a conventional or motivated source and through auto-production. In the present market context, it is necessary to analyze which alternative adapts better to the industrial plant profile and also represents economy in the monthly electric bill. This work presents a methodology to evaluate these alternatives, allowing the comparison of the energy costs, thus helping the decision process. In order to apply the methodology, case studies involving different consumers of Group A, were conducted aiming at the economy and energetic efficiency for the consumer.

Master of Agribusiness / Department of Agricultural Economics / Allen M. Featherstone / Bananas are the number one selling produce item in the grocery store. On average, bananas account for 6% of produce department sales and 1% of total grocery store sales. According to The Packer’s “2010 Fresh Trends”, 88% of consumers in all categories purchase bananas. Also, 94% of consumers in the study purchased bananas within the last twelve months. Over the last decade, fuel prices have increased to a point where logistics and shipping have become more important than ever to the banana industry. This logistics challenge is compounded because there are no bananas grown in the United States and the fruit has to be shipped from around the world. Fuel is used at high rates via the ocean cargo and trucking shipments to meet yearly demand. To manage these logistical challenges, this thesis analyzes the optimal shipping route for bananas arriving to the west coast from Central and South America to various markets using a transshipment model. The goal of the transshipment model estimates the supply chain that creates the lowest cost. Through analysis of fuel, trucking, and shipping markets, the model makes the optimal decision regarding transportation routing. The model is limited to transportation costs only. However, items such as fruit costs and other additional up charges could be analyzed.

abstract: Insider trading potentially reveals proprietary information, allowing rivals to compete more effectively against the insiders' firm. This paper examines whether proprietary costs are associated with insiders' trading decisions and the profitability of their trades. Using a variety of approaches to identify proprietary information risk, I find proprietary costs significantly deter insiders' trading activities. The deterrence effect is more pronounced when insider trading is likely to be more informative to rivals. Specifically, trades by top executives, non-routine trades, and trades at low complexity firms are curbed to a greater extent by proprietary costs. Examining the mechanisms of this deterrence effect, I find firms with higher proprietary costs are more likely to impose insider trading restrictions, and insiders' trading decisions are more sensitive to proprietary costs when they have higher share ownership of the company. These results suggest insiders reduce trading activities not only due to firm policies, but also due to incentive alignment. Finally, when insiders trade despite higher proprietary costs, they earn significantly higher abnormal profits from their purchase transactions. Overall, this study suggests product market considerations are an important factor associated with insiders' trading decisions and profitability of their trades. These findings are likely to be of interest to regulators and corporate boards in setting insider trading policies, and help investors make investment decisions using insider trading signals. / Dissertation/Thesis / Doctoral Dissertation Accountancy 2017

Submitted by Simone Souza (simonecgsouza@hotmail.com) on 2017-10-06T13:08:21Z No. of bitstreams: 1 DISS_2014_Arlene Ramirez Pena.pdf: 9065918 bytes, checksum: 7106bef200928cec7a55efd430b56368 (MD5) / Approved for entry into archive by Jordan (jordanbiblio@gmail.com) on 2017-11-06T11:46:06Z (GMT) No. of bitstreams: 1 DISS_2014_Arlene Ramirez Pena.pdf: 9065918 bytes, checksum: 7106bef200928cec7a55efd430b56368 (MD5) / Made available in DSpace on 2017-11-06T11:46:06Z (GMT). No. of bitstreams: 1 DISS_2014_Arlene Ramirez Pena.pdf: 9065918 bytes, checksum: 7106bef200928cec7a55efd430b56368 (MD5) Previous issue date: 2014-12-09 / CAPES / O problema do déficit habitacional é vivenciado na maioria dos países do mundo. Muitos governos e profissionais tem tentado diminuir este déficit com a criação de distintos programas e projetos de habitação de interesse social. O que acontece com a maior parte destas habitações é que construtivamente são muito rígidas e construídas em serie, pensadas para uma única configuração familiar tradicional, não se adaptando assim às diversas e mutáveis necessidades dos usuários na atualidade. No momento que o morador for realizar modificações, estas tornam se mais custosas e com menor qualidade do que poderiam ser se a moradia fosse planejada inicialmente para evoluir. Embora as vantagens das habitações evolutivas sejam aparentemente maiores do que as desvantagens, a construção das mesmas ainda não é uma prática comum. A ideia de projetar de forma “inacabada” em termos de espaços e de acabamentos, deixando que o usuário seja o seu próprio arquiteto, não é uma prática utilizada por empreendedores e promotores dos conjuntos habitacionais de interesse social. O propósito do presente trabalho é avaliar os custos das habitações do tipo embrião em comparação com as habitações padrão tradicionais não evolutivas. Mediante elaboração de orçamentos, em diferentes cenários, espera-se encontrar alternativas de moradias flexíveis que possam ser viáveis economicamente. A intenção é também despertar o interesse na temática das habitações evolutivas e flexíveis e motivar a criação de novas propostas que de melhor qualidade que proporcionem maior conforto aos usuários das habitações. Os resultados mostraram que os empreendimentos evolutivos, em sua maioria, são projetados para serem ampliados para as laterais e os fundos. O projeto proposto demostrou ser uma boa opção quanto à flexibilidade e diversidade de opções de ampliação. Quanto à parte financeira, possui uma diminuição do custo inicial em comparação com o projeto referência que pode permitir o acesso à habitação a pessoas de mais escassos recursos, como também estes fundos podem ser redirecionados para a compra de terrenos melhores localizados. / The problem of housing shortage is experienced in most countries of the world. Many governments and professionals have been trying to reduce this deficit by creating different programs and projects of social housing. The majority of these houses are designed to be built in series and in a rigid way. These are intended for a traditional family house setting. Therefore, house constructions are not adapted to the changing need of users nowadays. During the occupation phase the dweller usually make changes, personalize or expand his house, but these interventions become more expensive and with less quality than they could be if the house was originally planned to grow. Although the advantages of evolutionary housing are apparently greater than its disadvantages, the construction industry hasn’t adopted this concept as a common practice. The concept of an "unfinished" design, in terms of spaces and finishes, that allows the dweller to be his own architect, is not a practice used by entrepreneurs or housing projects developers. The purpose of this study is to evaluate the costs of embryo type dwellings compared with standard non-progressive traditional dwellings. Through budgeting, in different scenarios, is expected to find economically feasible flexible housing alternatives. The intention is to generate interest in the subject of evolutionary and flexible housing and inspire the creation of new proposals with superior quality and with greater comfort for its users. The results showed that the evolutionary developments mostly are designed to be extended to the sides and to the back of the ground. The proposed project has shown to be a good option for flexibility and diversity of expansion options. As for the financial part, the embryo house has a decreased initial cost compared to the reference design. In this way it can allow access to housing to people of scarce resources, and these initial savings can be redirected to buy a better located land to the residential.