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Each year, evidence-based clinical guidelines gain more space in the health professionals' practice and in services organization. Due to the scarcity of scientific publications focused on diseases of poverty, the development of well-founded clinical guidelines becomes more and more important. In view of that, this paper aims to evaluate the quality of Brazilian guidelines for those diseases. The AGREE II method was used to evaluate 16 guidelines for poverty-related diseases (PRD) and 16 guidelines for global diseases whose treatment require high-cost technologies (HCD), with the ultimate aim of comparing the results. It was found that, in general, the guideline development quality standard is higher for the HCD guidelines than for the PRD guidelines, with emphasis on the "rigour of development" (48% and 7%) and "editorial independence" (43% and 1%) domains, respectively, which had the greatest discrepancies. The HCD guidelines showed results close to or above international averages, whereas the PRD guidelines showed lower results in the 6 domains evaluated. It can be concluded that clinical protocol development priorities need some redirecting in order to qualify the guidelines that define the healthcare organization and the care of vulnerable populations.

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La fracción de su riqueza que Venezuela dedica a la ciencia y tecnología ha sido el 0,21 por ciento del PIB para los años 1954 al 1999 (o del 0,39 por ciento del PIB para el período 1984-2000). Dentro del sector ciencia y tecnología venezolano, el INTEVEP ha sido la institución más significativa con un empleo del 31 por ciento de los recursos sectoriales, seguido por las dependencias de investigación y desarrollo de las universidades nacionales con un 27 por ciento. El CONICIT, como órgano rector sectorial, ha consumido un 18 por ciento. El IVIC ha recibido un 12 por ciento total sectorial pero, a su vez, es la institución que más ha contribuido a la producción de artículos indexados con 2685 trabajos (27 por ciento del total nacional). En esto último lo siguen las universidades Central de Venezuela (24 por ciento), los Andes (16 por ciento), la Simón Bolívar (14 por ciento) e INTEVEP (con solo 3 por ciento). El costo de una publicación indexada en el IVIC fue calculado en 969 mil Bs. constantes de base año 1984 (o su equivalente, unos US$ 77330 por publicación). Para la Universidad Central de Venezuela se calculó un costo unitario de sus publicaciones indexadas en Bs. 654 mil (constantes al año 1984) y para la Simón Bolívar fue de Bs. 367 mil (constantes del año 1984). Después de analizar el peso relativo de los insumos unitarios institucionales, se llegó a la conclusión que los valores del IVIC constituyen la mejor aproximación para el sistema de ciencia venezolano. A partir de ahí se pudo extraer un factor de corrección aplicable a las universidades nacionales y que podría permitir la determinación de valores más reales de sus costos unitarios, los cuales no contemplan salarios ni costos de servicios

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The objective of this paper is to present a multi-criteria decision making (MCDM) approach to support public health decision making that takes into consideration the fuzziness of the decision goals and the behavioural aspect of the decision maker. The approach is used to analyse the process of health technology procurement in a University Hospital in Rio de Janeiro, Brazil. The method, known as TODIM, relies on evaluating alternatives with a set of decision criteria assessed using an ordinal scale. Fuzziness in generating criteria scores and weights or conflicts caused by dealing with different viewpoints of a group of decision makers (DMs) are solved using fuzzy set aggregation rules. The results suggested that MCDM models, incorporating fuzzy set approaches, should form a set of tools for public health decision making analysis, particularly when there are polarized opinions and conflicting objectives from the DM group.

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Clausulas contractuales. Incumplimiento del vendedor. Alternativas de financiación: compras al contado, leasings, alquileres. Tasa de interes. Análisis de valor para maximizar la efectividad, eficiencia y eficacia del equipo analizado

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Clausulas contractuales. Incumplimiento del vendedor. Alternativas de financiación: compras al contado, leasings, alquileres. Tasa de interes. Análisis de valor para maximizar la efectividad, eficiencia y eficacia del equipo analizado

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PIP: Most of Brazil's medical and hospital services are delivered through the private sector but are paid for by the government through the National Institute of Medical Care and Social Security (INMAPS). During 1981 and 1982, INMAPS took a number of measures designed to cut costs and improve operation of this system. It has also introduced a number of changes since 1983 directed at cost control. Still, it appears that health costs in Brazil are frequently higher than those in developed countries. This problem has gone hand in hand with substantial expenditures on high technology services that are frequently not needed or that are very costly and benefit relatively few patients. In seeking to confront and ameliorate these problems, what is needed is development of a system or environment that will encourage a more socially efficient use of health services. In this regard it is important to recall that creation of such a system requires a more effective use of prices as signals to physicians, who are the system's decision-makers.^ieng

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In order to face the current economical problems of the country, our Institute has intensified its efforts to replace the imports of medical goods by developing its own medical technology. This article summarizes what we have achieved in this field and describes the rules to be followed in the future. We describe the program on the designing and development of heart valve prosthesis together with an hydraulic-electrical system to test them. In the field of computed instruments, we have developed a system of "synchronos color pictures" to be applied in nuclear medicine. In the field of electrocardiography; an EKG paste, a computed program for automatic EKG interpretation and a "filter" of the 60 cycle interference. The Institute is engaged in the designing of a sophisticated EKG machine at low cost, and EKG tracing simulator for teaching purposes. These programs have been shared with others institutions of the country.

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