RESUMO
As part of the Dynamics-Aerosol-Chemistry-Cloud Interactions in West Africa (DACCIWA) project, extensive in-situ measurements of the southern West African atmospheric boundary layer (ABL) have been performed at three supersites Kumasi (Ghana), Savè (Benin) and Ile-Ife (Nigeria) during the 2016 monsoon period (June and July). The measurements were designed to provide data for advancing our understanding of the relevant processes governing the formation, persistence and dissolution of nocturnal low-level stratus clouds and their influence on the daytime ABL in southern West Africa. An extensive low-level cloud deck often forms during the night and persists long into the following day strongly influencing the ABL diurnal cycle. Although the clouds are of a high significance for the regional climate, the dearth of observations in this region has hindered process understanding. Here, an overview of the measurements ranging from near-surface observations, cloud characteristics, aerosol and precipitation to the dynamics and thermodynamics in the ABL and above, and data processing is given. So-far achieved scientific findings, based on the dataset analyses, are briefly overviewed.
RESUMO
Background The list of oral and expensive chemotherapy agents has lengthened over the last few years and has created unique medication adherence concerns. In a real-life setting, patients often do not take their medications as prescribed. This pattern is associated with poor outcomes and increased health care costs. Objectives To estimate the adherence to oral anticancer chemotherapies and to determine the economic burden of unused medicines due to patients' death. Setting Alsace (France). Method This retrospective study was carried out by using ERASME, an Insurance Healthcare database. Main outcome measures Adherence was calculated using medication possession ratio and economic impact using prescription refill data. Results 10,734 patients were treated with oral anticancer medicines (cytotoxic agents, hormonal and targeted therapies). Averaged adherence of 0.86 was observed although it varied significantly between subclasses (cytotoxic agents: 0.69 ± 0.14, hormonal therapy: 0.91 ± 0.17 and targeted therapy: 0.79 ± 0.17). 1631 patients died during the study period. The expenses related to unused chemotherapies amounted to 152,175. Conclusions Our data showed that overall adherence to oral anticancer medicines was above the acceptable limit of adherence of 80% with a marked graduation in values between cytotoxic agents, hormonal and targeted therapies. These statistical significant differences in medication possession ratio could be related to the intrinsic toxicity of the three subclasses of molecules, their tolerance and adverse effects. To limit the cost associated with unused medicines, interventions such as dispensing expensive oral anticancer chemotherapies per unit over shorter periods and not only on monthly intervals could be implement.