Highlights Tourism and environmental sciences' students are compared. Tourism students highlight topics related to “Profit” and “People”. Sustainability literacy in tourism cannot solely depend on the interest of teachers. Tourism academic programmes should be adapted to teach “strong sustainability”. Environmental sciences professors could be invited to lecture in tourism courses.
Background: Primary Human Papilloma Virus (HPV) testing is the currently recommended cervical cancer (CxCa) screening strategy by the Portuguese Society of Gynecology (SPG) clinical consensus. However, primary HPV testing has not yet been adopted by the Portuguese organized screening programs. This modelling study compares clinical benefits and costs of replacing the current practice, namely cytology with ASCUS HPV triage, with 2 comparative strategies: 1) HPV (pooled) test with cytology triage, or 2) HPV test with 16/18 genotyping and cytology triage, in organized CxCa screenings in Portugal. Methods: A budget impact model compares screening performance, clinical outcomes and budget impact of the 3 screening strategies. A hypothetical cohort of 2,078,039 Portuguese women aged 25-64 years old women is followed for two screening cycles. Screening intervals are 3 years for cytology and 5 years for the HPV strategies. Model inputs include epidemiological, test performance and medical cost data. Clinical impacts are assessed with the numbers of CIN2-3 and CxCa detected. Annual costs, budget impact and cost of detecting one CIN2+ were calculated from a public healthcare payer's perspective. Results: HPV testing with HPV16/18 genotyping and cytology triage (comparator 2) shows the best clinical outcomes at the same cost as comparator 1 and is the most cost-effective CxCa screening strategy in the Portuguese context. Compared to screening with cytology, it would reduce annual CxCa incidence from 9.3 to 5.3 per 100,000, and CxCa mortality from 2.7 to 1.1 per 100,000. Further, it generates substantial cost savings by reducing the annual costs by €9. 16 million (− 24%). The cost of detecting CIN2+ decreases from the current €15,845 to €12,795. On the other hand, HPV (pooled) test with cytology triage (comparator 1) reduces annual incidence of CxCa to 6.9 per 100,000 and CxCa mortality to 1.6 per 100,000, with a cost of €13,227 per CIN2+ detected with annual savings of €9.36 million (− 24%). The savings are mainly caused by increasing the length of routine screening intervals from three to five years. Conclusion: The results support current clinical recommendations to replace cytology with HPV with 16/18 genotyping with cytology triage as screening algorithm.
Objective: The purpose of this study is to evaluate the influence of the type of scanner and scanning direction on the accuracy of the final cast. Material and Methods: A partial master cast was used as a reference. A total of 128 scans were obtained and divided into two groups: the conventional method and the digital method. The digital group was divided into three groups: TRIOS 3, Omnicam and CS 3600. Each of these groups was subdivided according to the scanning direction, and each scan was overlaid on the digital reference cast to measure the trueness and precision of the procedures. Results: The overall precision values for the type of impression were 59.89 ± 13.08 mm for conventional and 13.42 ± 4.28 mm for digital; the values for trueness were 49.37 ± 19.13 mm for conventional and 53.53 ± 4.97 mm for digital; the scanning direction trueness values were 53.05 ± 4.36 mm for continuous and 54.03 ± 5.52 mm for segmented; and the precision values were 14.18 ± 4.67 mm for continuous and 12.67 ± 3.75 mm for segmented (p> 0.05). For the scanner type, the trueness values were 50.06 ± 2.65 mm for Trios 3, 57.45 ± 4.63 mm for Omnicam, and 52.57 ± 4.65 mm for Carestream; and those for precision were 11.7 ± 2.07 mm for Trios 3, 10.09 ± 2.24 mm for Omnicam, and 18.49 ± 2.42 mm for Carestream (p <0.05). Conclusions: The digital impression method is the most favorable method regarding precision; in terms of trueness, there are no differences between the types of impressions. KEYWORDS Conventional impression; Intra oral impression; Accuracy; Trueness.
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