CPITN: time and cost estimates for periodontal prevention and treatment procedures.

The aim of this study was to estimate the necessary time and cost for periodontal prevention and treatment in a working population from sugar and alcohol refineries in Araraquara, SP, Brazil. A stratified sample of 528 employees aged 18-64 from administrative, industrial and agricultural staffs was examined by one examiner, previously trained, according to the community periodontal index of treatment needs (CPITN). The time required for procedures and the cost was extrapolated to the total worker population. The results showed that the estimated time required for periodontal prevention/treatment was 4527 hours. Of this time, 1783 hours were required for oral hygiene instruction, 2531 for scaling, 151 for surgery and 62 for maintenance. The cost would be US $17,655 for hiring a dentist for 8 hours/day to provide oral hygiene instruction, scaling, surgery and maintenance. However, the cost would be US $9,028 for hiring a dentist for 4 hours/day to provide surgery and maintenance and a dental hygienist for 8 hours/day to provide scaling and oral hygiene instruction. Taking into account epidemiologic, technical and economic aspects, the decision relating to manpower should be this second option.

Cost-benefit of hospitalization compared with outpatient care for pregnant women with pregestational and gestational diabetes or with mild hyperglycemia, in Brazil

CONTEXTO E OBJETIVO: Gestações complicadas pelo diabetes estão associadas com aumento de complicações maternas e neonatais. Os custos hospitalares aumentam de acordo com a assistência prestada. O objetivo foi calcular o custo-benefício e a taxa de rentabilidade social da hospitalização comparada ao atendimento ambulatorial em gestantes com diabetes ou com hiperglicemia leve. DESENHO do ESTUDO: Estudo prospectivo, observacional, quantitativo, realizado em hospital universitário, sendo incluídas todas as gestantes com diabetes pregestacional e gestacional ou com hiperglicemia leve que não desenvolveram intercorrências clínicas na gestação e que tiveram parto no Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (HC-FMB-Unesp). MÉTODOS: Trinta gestantes tratadas com dieta foram acompanhadas em ambulatório e 20 tratadas com dieta e insulina foram abordadas com hospitalizações curtas e frequentes. Foram obtidos custos diretos (pessoal, material e exames) e indiretos (despesas gerais) a partir de dados contidos no prontuário e no sistema de custo por absorção do hospital e posteriormente calculado o custo-benefício. RESULTADOS: O sucesso do tratamento das gestantes diabéticas evitou o gasto de US$ 1.517,97 e US$ 1.127,43 para pacientes hospitalizadas e ambulatoriais, respectivamente. O custo-benefício da atenção hospitalizada foi US$ 143.719,16 e ambulatorial, US$ 253.267,22, com rentabilidade social 1,87 e 5,35 respectivamente. CONCLUSÃO: A análise árvore de decisão confirma que o sucesso dos tratamentos elimina custos no hospital. A relação custo-benefício indicou que o tratamento ambulatorial é economicamente mais vantajoso do que a hospitalização. A rentabilidade social de ambos os tratamentos foi maior que 1, indicando que ambos os tipos de atendimento à gestante diabética têm benefício positivo.

Haemonchus contortus: A multiple-resistant Brazilian isolate and the costs for its characterization and maintenance for research use

The aim of this work was to determine the resistance level of Haemonchus contortus isolated from the Santa Inês flock of the Embrapa (Brazilian government's Agricultural Research Company), Southeast Livestock Unit (CPPSE), as well as to determine costs of characterizing and maintaining this isolate in host donors. Forty-two male Santa Inês lambs were experimentally infected with 4000 H. contortus infective larvae of the field isolate of CPPSE, called Embrapa2010, and divided into six treatment groups, which received triclorfon, albendazol plus cobalt sulfate, ivermectin, moxidectin, closantel and levamisole phosphate, as well as a negative control group (water). Egg per gram (EPG) counts were performed at 0, 3, 7, 10 and 14. days post treatment when the animals were slaughtered for parasite count. The data were analyzed using the RESO statistical program, considering anthelmintic resistance under 95% of efficacy. EPG and worm count presented a linear and significant relation with 94% determination coefficient. The susceptibility results obtained by RESO through both criteria (EPG and worm count) were equal, except for closantel, showing that the isolate Embrapa2010 is resistant to benzimidazoles, macrocyclic lactones and imidazothiazoles. The need of a control group did not appear to be essential since the result for susceptibility in the analyses with or without this group was the same. Suppression in egg production after treatment did not occur in the ivermectin and moxidectin groups. In the control group, the establishment percentage was just 12.5 because of the low number of third-stage larvae, resistance (innate and infection immunity) of the animals studied plus good nutrition. Drug classes presented similar efficacy between adults and immature stages. The costs for isolate characterization were calculated for 42 animals during 60. days. The total cost based on local market rates was approximately US$ 8000. The precise identification of Brazilian isolates and their establishment in host donors would be useful for laboratorial anthelmintic resistance diagnoses through in vitro tests, which has an annual cost of approximately US$ 2500 for maintenance in host donors. © 2012 Elsevier B.V.

The impact of physical activity on mitigation of health care costs related to diabetes mellitus: findings from developed and developing settings Diabetes mellitus and physical exercise

Over the last decades, the prevalence of diabetes mellitus (DM) has been increasing globally such that nowadays the disease constitutes an important outcome related to early mortality among adults. In parallel with the high prevalence, healthcare costs related to DM treatment have increased significantly, exacerbating its burden on modern society. The scientific literature points out that obesity and physical inactivity have a central role in the development of most DM cases. In fact, either physical exercise practice or an increase in the level of physical activity, constitute relevant tools in the guidelines for treatment of the disease. On the other hand, the effect of physical activity on the economic consequences of DM is not completely clear. The identification of the actual burden of lifestyle changes on the reduction of healthcare costs related to DM is relevant, primarily for developing nations, where it could represent a cheaper strategy for treating the disease and its complications than paying for drug treatment, which is commonly related to collateral effects. That being said, the prevention of DM and other diseases and consequently the mitigation of the costs related to these outcomes seem to depend essentially on the promotion of healthy habits. The aim of the present review was therefore to discuss recent evidence on the effects of physical activity/exercise on mitigation of health care cost related to DM.

Tamanho de amostra e estimativa de custo em levantamento epidemiológico de cárie dentária

This study aimed to analyze how the prevalence and the distribution of dental caries influence the sample size in epidemiological surveys, and how much are the costs. Secondary data of oral health surveys in 12-year-old schoolchildren from Bauru in 1976, 1984, 1990, 1994, and 2001, and from Piracicaba in 2001 and 2005 were studied. Sample sizes were estimated taking into account the mean DMFT and standard deviation of each survey, establishing sampling errors of 1%, 2%, 5%, and 10%. Costs were estimated considering permanent material, consumption material and human resources. The sample size in both towns needed to be increased, ranging from 119 in 1976 to 1,118 in 2001 in Bauru, and from 954 in 2001 to 1,252 in 2005 in Piracicaba, when a sampling error of 10% was considered. The cost of dental caries surveys was verified considering different sampling errors. This cost depends on how acceptable is the margin of difference between the true mean and the one found in the survey. In conclusion, the reduction in the prevalence of dental caries has determined the need for increase in sample size and in costs for conducting the surveys.

Avaliações farmacoeconômicas em vigilância de medicamentos

The study aimed to identify pharmacoeconomic studies in pharmacovigilance and to observe the economic outcomes in post-marketing surveillance. Therefore, a bibliographic survey was performed in databases Lilacs, PubMed/ Bireme. The search strategy was done by using scientific health descriptors [ "adverse drug reaction reporting systems " OR " medication errors " OR "product surveillance, postmarketing" OR " sentinel surveillance" ] AND [ " cost-benefit analysis" OR "cost efficiency analysis " OR " costs and cost analysis " OR " hospital costs " OR " cost-effectiveness " OR " cost-effectiveness evaluation " OR " drug costs " ]. Manuscripts published in the last 10 years were selected. We chose 13 articles, of which 12 corresponded to cost-benefit analysis and only one to cost-effectiveness assessment. In only one study there was no economy, all the other ones generated savings, ranging from 13.7 to 30% in spending valued service. Surveillance actions were: continuing education; active search through tracking devices and / or implementation of round; teamwork and multidisciplinary deployment; computerized security services management, enabling traceability of information and alerts. The results of the proposed actions have led to the prevention of adverse drug reactions, to decline of risks to the patient, to the reduction of inappropriate prescriptions, as well as the length of hospital stay spending valued service. Surveillance actions were: continuing education; active search through tracking devices and / or implementation of round; teamwork and multidisciplinary deployment; computerized security services management, enabling traceability of information and alerts. The results of the proposed actions have led to the prevention of adverse drug reactions, to decline of risks to the patient, to the reduction of inappropriate prescriptions, as well as the length of hospital stay

Electricity, hot water and cold water production from biomass. Energetic and economical analysis of the compact system of cogeneration run with woodgas from a small downdraft gasifier

Wood gasification technologies to convert the biomass into fuel gas stand out. on the other hand, producing electrical energy from stationary engine is widely spread, and its application in rural communities where the electrical network doesn't exist is very required. The recovery of exhaust gases (engine) is a possibility that makes the system attractive when compared with the same components used to obtain individual heat such as electric power. This paper presents an energetic alternative to adapt a fixed bed gasifier with a compact cogeneration system in order to cover electrical and thermal demands in a rural area and showing an energy solution for small social communities using renewable fuels. Therefore, an energetic and economical analysis from a cogeneration system producing electric energy, hot and cold water, using wooden gas as fuel from a small-sized gasifier was calculated. The energy balance that includes the energy efficiency (electric generation as well as hot and cold water system; performance coefficient and the heat exchanger, among other items), was calculated. Considering the annual interest rates and the amortization periods, the costs of production of electrical energy, hot and cold water were calculated, taking into account the investment, the operation and the maintenance cost of the equipments. Crown Copyright (C) 2010 Published by Elsevier Ltd. All rights reserved.

Hydrogen production by biogas steam reforming: A technical, economic and ecological analysis

Fuel cells are electrochemical energy conversion devices that convert fuel and oxidant electrochemically into electrical energy, water and heat. Compared to traditional electricity generation technologies that use combustion processes to convert fuel into heat, and then into mechanical energy, fuel cells convert the hydrogen and oxygen chemical energy into electrical energy, without intermediate conversion processes, and with higher efficiency. In order to make the fuel cells an achievable and useful technology, it is firstly necessary to develop an economic and efficient way for hydrogen production. Molecular hydrogen is always found combined with other chemical compounds in nature, so it must be isolated. In this paper, the technical, economical and ecological aspects of hydrogen production by biogas steam reforming are presented. The economic feasibility calculation was performed to evaluate how interesting the process is by analyzing the investment, operation and maintenance costs of the biogas steam reformer and the hydrogen production cost achieved the value of 0.27 US$/kWh with a payback period of 8 years. An ecological efficiency of 94.95%, which is a good ecological value, was obtained. The results obtained by these analyses showed that this type of hydrogen production is an environmentally attractive route. © 2013 Elsevier Ltd.

Ecological efficiency and thermoeconomic analysis of a cogeneration system at a hospital

This work aims with an approach for cogeneration plants evaluation based on thermoeconomic functional diagram analysis. The second law of thermodynamics is used to develop a methodology to analyse cogeneration systems, based on exergoeconomics evaluation. The thermoeconomic optimisation method developed is applied to allow a better configuration of the cogeneration plant associated to a university hospital. Also ecological efficiency is evaluated. The method was efficient and contributes for thermoeconomics modelling and analysis and can be applied to any sort of thermal system, especially those with combined heat and power in thermal parity. (C) 2012 Elsevier Ltd. All rights reserved.

Performance, carcass traits, meat quality and economic analysis of feedlot of young bulls fed oilseeds with and without supplementation of vitamin E

The objective of this research was to evaluate average daily gain (ADG), carcass traits, meat tenderness and profitability of keeping cattle fed different oilseeds and vitamin E in feedlot. A total of 40 Red Norte young bulls with initial average body weight of 339±15 kg were utilized. The experimental design was completely randomized in a 2 × 2 factorial arrangement. The experiment lasted 84 days and experimental diets presented soybeans or cottonseeds as lipid sources associated or not to daily supplementation of 2,500 UI vitamin E per animal. The concentrate:roughage ratio was 60:40. Diets had the same amount of nitrogen (13% CP) and ether extract (6.5%). The data were analyzed by means of statistical software SAS 9.1. Neither vitamin supplementation nor lipid source affected ADG. There was no interaction between lipid source and vitamin supplementation for the variables studied. The inclusion of cottonseed reduced the carcass yield. There was no effect of diets on hot and cold carcass weights or prime cuts. The inclusion of cottonseed reduced the backfat thickness. No effect of experimental diets on the rib-eye area was observed. There was no effect of lipid source or vitamin supplementation on meat tenderness, which was affected, however, by ageing time. Diets with soybeans presented higher cost per animal. The utilization of soybean implied reduction of the gross margin (R$ 59.17 and R$ 60.51 for diets based on soy with and without supplemental vitamin, respectively, vs. R$ 176.42 and R$ 131.79 for diets based on cottonseed). The utilization of cottonseed enables improvement of profitability of feedlot fattening, in spite of negatively affecting some carcass characteristics.

Simulation and economic analysis of bovine sex selection

A simulation model implemented in the programming software Delphi XE® was applied to evaluate sex selection in bovine. The hypothesis under investigation was that a dynamic model with stochastic and deterministic elements could detect the sexed semen technique to minimize pregnancy cost and to determine the adequate number of recipients required for in vivo (ET) and in vitro embryo production (IVP) in the proposed scenarios. Sex selection was compared through semen sexed using flow cytometry (C1) and density gradient centrifugation techniques (C2) in ET and IVP. Sensibility analyses were used to identify the adequate number of recipients for each scenario. This number was reinserted into the model to determine the biological and financial values that maximized ET and IVP using sexed semen (C1M and C2M). New scenarios showed that the density gradient technique minimized pregnancy cost based on the proposed scenarios. In addition, the adequate number of recipients (ET - C1M - 115 and C2M - 105)/(IVP - C1M - 145 and C2M - 140) per donor used was determined to minimize the pregnancy cost in all scenarios.

A theoretical and experimental analysis of cold-formed steel shapes subjected to bending - Channel and simple lipped channel

Cold-formed steel shapes have been widely employed in steel construction, where they frequently offer a lower cost solution than do traditional laminated shapes. A classic application of cold-formed steel shapes is purlins in the roof panel of industrial buildings, connected to the roof panel by means of screws. The combined effect of these two elements has been the subject of investigations in some countries. Design criteria were included in the AISI Code in 1991 and 1996. This paper presents and discusses the results obtained from bending tests carried out on shapes commonly used in Brazil, i.e., the channel and the simple lipped channel, Tests were carried out on double shapes with 4.5 and 6.0 meter spans, which were subjected to concentrated loads and braced against each other on the supports and at intermediary points in three different load situations. The panel shape was also analyzed experimentally, simulating the action of wind by means of a vacuum box designed specifically for this purpose. The test results were then compared to those obtained through the theoretical analysis, enabling us to extract important information upon which to base proposed design criteria for the new Brazilian code.

Thermodynamic and economic analysis of hydrogen production integration in the Brazilian sugar and alcohol industry

One of the biggest challenges today is to develop clean fuels, which do not emit pollutant and with viable implementation. One of the options currently under study is the hydrogen production process. In this context, this work aims to study the technical and economical aspects of the incorporation process of hydrogen producing by ethanol steam reforming in the sugar cane industry and MCFC (molten carbonate fuel cell) application on it to generate electric power. Therefore, it has been proposed a modification in the traditional process of sugar cane industry, in order to incorporate hydrogen production, besides the traditional products (sugar, ethylic, hydrated and anhydric alcohol). For this purpose, a detailed theoretical study of the ethanol production process, describing the considerations to incorporate the hydrogen production will be performed. After that, there will be a thermodynamic study for analysing the innovation of this production chain, as well as a study of economic engineering to allocate the costs of products of the new process, optimising it and considering the thermoeconomics as being as an analysis tool. This proposal aims to improve Brazil's position in the ranking of international biofuels, corroborating the nation to be a power in the hydrogen era. (C) 2013 Elsevier Ltd. All rights reserved.

Energetic and economic analysis of a Brazilian compact cogeneration system: Comparison between natural gas and biogas

Cogeneration may be defined as the simultaneous production of electric power and useful heat from the burning of a single fuel. This technique of combined heat and power production has been applied in both the industrial and tertiary sectors. It has been mainly used because of its overall efficiency, and the guarantee of electricity with a low level of environmental impact. The compact cogeneration systems using internal combustion engine as prime movers are thoroughly applied because of the good relationship among cost and benefit obtained in such devices. The cogeneration system of this study consists of an internal combustion engine using natural gas or biogas as fuel, combined with two heat exchangers and an absorption chiller utilising water-ammonia as working mixture. This work presents an energetic and economic comparison between natural gas and biogas as fuel used for the system proposed. The results are useful to identify the feasible applications for this system, such as residential sector in isolated areas, hotels, universities etc. (C) 2014 Elsevier Ltd. All rights reserved.

Using ecological thresholds to evaluate the costs and benefits of set-asides in a biodiversity hotspot

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)