Cost minimization of 3 methods of acquiring dental radiographic image

The objective of this study is to develop a complete economic evaluation of 3 diagnostic techniques for interproximal radiographic, comparing the conventional radiographic technique, direct (CMOS) and indirect (PSP) digital techniques in the diagnosis of dental caries, from the perspective of SESC/Brazil (Social Trade Service). A complete cost-minimization economic assessment was performed. Initially, a systematic review was performed and it was verified that the accuracy for the diagnosis is similar between the techniques. The direct medical costs (related to the technique) were estimated by the bottom-up technique, taking into account the value of the clinical hours of the professionals, equipments and materials used. The time horizon was 10 years. The values were discounted at 3% per year, and a sensitivity analysis was prepared into two scenarios (one more pessimistic with costs 20% higher than estimated and one more optimistic with costs 20% lower). Direct digital radiography proved to be the option with the lowest cost (US$ 1.16), followed by semi-direct (US$ 1.35) and conventional (US$ 1.47). Conventional radiography presented the highest cost for the period (US$ 74,943.65), and the use of digital radiographs could promote savings of US$ 6,000.59 and US$ 15,448.35, if used by the semi-direct and direct method. respectively. Regarding the sensitivity analysis, in the most optimistic scenario of the time horizon there would be savings of US$ 4,800.47 (semi-direct digital) to US$ 12,446.09 (direct digital) compared to the traditional technique (films). In the most pessimistic scenario, these values vary in savings over the time horizon from US$ 7,200.71 (semi-direct) to US$ 18,538.02 (direct). It is concluded that the direct radiographic technique was the most cost effective and its incorporation in the SESC units is suggested.

Key messages

Digital dental radiography. Cost minimization analysis. Health technology assessment.

Avaliação do Projecto Integrado para a Prevenção do Abuso Sexual (PIPAS): Estudo preliminar

Neste artigo apresenta-se um programa de prevenção do abuso sexual implementado na Casa Pia de Lisboa e respectiva avaliação e discutem-se, ainda, critérios para a avaliação de programas. No estudo de avaliação utilizou-se um design longitudinal quantitativo, por questionário, com dois momentos, pré e pós-teste, com seis meses de intervalo entre si. Os participantes (N = 188), do 3º ao 6º ano, foram distribuídos aleatoriamente por grupos controlo e experimental, respondendo a um conjunto de questionários considerados adequados para a avaliação das principais competências treinadas no programa. Os grupos não se mostraram diferentes entre o início e o final da intervenção, mas o papel do colégio e o maior número de sessões contribuíram significativamente para o aumento das competências sócio-emocionais dos jovens. Por fim, discutem-se aspectos da aplicação do programa essenciais para a compreensão dos resultados encontrados e fazem-se recomendações sobre práticas de implementação do programa que optimizem a sua eficácia.

Low-temperature post-treatment of anaerobically treated-sewage in anaerobic filter with cationic-polymer addition

The post-treatment of domestic sewage pretreated in a 6 m3 UASB was investigated in two high-rate anaerobic filter (AF) reactors operated in parallel. The difference between the two AF reactors was only the addition of cationic polymer to the second reactor (AF + P). The reactors were operated at low temperatures, ranged between 13 and 20 degrees C. The media in each AF reactor consisted of vertical sheets of reticulated-polyurethane foam (RPF) with knobs. The results demonstrated that the AF + P reactor (HRT = 3 h) with cationic polymer addition (2 mg/L) was an efficient system for post-treatment. The removal efficiencies for total, suspended, colloidal and dissolved COD were, respectively, 41, 86 and 76 and 12% in the AF + P reactor and they were, respectively, 80, 97, 77 and 66% in the UASB + (AF + P) system. The removal of total, suspended and colloidal COD in the UASB + (AF + P) system were significantly higher than those achieved in the UASB + AF system. As hardly any nutrient was removed in the UASB + (AF + P) system, the effluent after pathogen removal is a valuable product for irrigation and fertilisation to close the water and nutrients cycle.