COMMUNICATION AND INFORMATION BARRIERS TO HEALTH ASSISTANCE FOR DEAF PATIENTS

IN BRAZIL, recent regulations require changes in private and public health systems to make special services available to deaf patients. in the present article, the researchers analyze the perceptions of 25 sign language using patients regarding this assistance. The researchers found communication difficulties between these patients and health services staff, as well as a culture clash and a harmful inability among the service providers to distinguish among the roles of companions, caretakers, and professional translator/interpreters. Thus, it became common for the patients to experience prejudice in the course of treatment and information exchange, damage to their autonomy, limits on their access to services, and reduced efficacy of therapy. The researchers conclude that many issues must be dealt with if such barriers to health access are to be overcome, in particular the worrying degree of exclusion of deaf patients from health care systems.

Operant measurement of auditory threshold in prelingually deaf users of cochlear implants: II

Two experiments evaluated an operant procedure for establishing stimulus control using auditory and electrical stimuli as a baseline for measuring the electrical current threshold of electrodes implanted in the cochlea. Twenty-one prelingually deaf children, users of cochlear implants, learned a Go/No Go auditory discrimination task (i.e., pressing a button in the presence of the stimulus but not in its absence). When the simple discrimination baseline became stable, the electrical current was manipulated in descending and ascending series according to an adapted staircase method. Thresholds were determined for three electrodes, one in each location in the cochlea (basal, medial, and apical). Stimulus control was maintained within a certain range of decreasing electrical current but was eventually disrupted. Increasing the current recovered stimulus control, thus allowing the determination of a range of electrical currents that could be defined as the threshold. The present study demonstrated the feasibility of the operant procedure combined with a psychophysical method for threshold assessment, thus contributing to the routine fitting and maintenance of cochlear implants within the limitations of a hospital setting.

Wake instability issues: From circular cylinders to stalled airfoils

Some recent results regarding the global dynamical behaviour of the wake of circular cylinders and airfoils with massive separation are reviewed in this paper. In order to investigate the effect of interference, the three-dimensional instability modes are analysed for the flow around two circular cylinders in tandem. In the same way, the flow around a stalled airfoil is investigated in order to provide a better understanding of the three-dimensional characteristics of wakes forming downstream of a lifting body with massive separation. These results are compared with those found for an isolated cylinder. Some fundamental differences among these flows are discussed. (C) 2011 Elsevier Ltd. All rights reserved.

Thermodynamic self-consistency issues related to the Cluster Variation Method: The case of the BCC Cr-Fe (Chromium-Iron) system

The Cluster Variation Method (CVM), introduced over 50 years ago by Prof. Dr. Ryoichi Kikuchi, is applied to the thermodynamic modeling of the BCC Cr-Fe system in the irregular tetrahedron approximation, using experimental thermochemical data as initial input for accessing the model parameters. The results are checked against independent data on the low-temperature miscibility gap, using increasingly accurate thermodynamic models, first by the inclusion of the magnetic degrees of freedom of iron and then also by the inclusion of the magnetic degrees of freedom of chromium. It is shown that a reasonably accurate description of the phase diagram at the iron-rich side (i.e. the miscibility gap borders and the Curie line) is obtained, but only at expense of the agreement with the above mentioned thermochemical data. Reasons for these inconsistencies are discussed, especially with regard to the need of introducing vibrational degrees of freedom in the CVM model. (C) 2008 Elsevier Ltd. All rights reserved.

ELUCIDATING ENIGMATIC FLORAL ISSUES IN COPAIFERA LANGSDORFFII DESF. (LEGUMINOSAE, CAESALPINIOIDEAE)

This study focuses on the floral development of Copaifera langsdorffii to elucidate uncertain features in its floral morphology, such as the tetramerous calyx, lack of petals, blackened anthers and their supposed sterility, as well as polyembryony. Buds and flowers were dissected and prepared for examination under scanning electron and light microscopes. The floral apex initiates two bracteoles, five sepals, five petals, five outer stamens, five inner stamens, and one carpel. Order is helical for sepals, reversed unidirectional for the petals, and unidirectional for two whorls of stamens. The tetramerous calyx results from the union of two adaxial sepal primordia, which forms one large sepal and three other smaller sepals. Although the flower lacks petals, the petal primordia are initiated but do not elongate like the other floral organs, remaining as petal rudiments. Ten stamens are formed in two distinct whorls. Formation within each whorl is almost simultaneous, and the inner whorl is formed shortly after the outer. During organ elongation, the inner stamen primordia bases are reoriented outward, resulting in a single whorl of stamens. The darkened anthers have viable pollen grains. Thus, there is no relation between sterility and the dark coloration of the anthers. No signs of extranumerary embryos are observed; therefore, polyembryony is not confirmed. Although studies on floral development of Detarieae have been reported, few Neotropical genera of the tribe (such as Copaifera) have been studied.

Beauty, Class and Discourse: Issues in Debate

In this text we proceed through a brief review of Naomi Lee`s (2009) article, highlighting her significant contributions to social and cultural psychology. In our dialogue with her text we inquire about some arguments and methodological procedures she presents. We raise some specific questions related to how the issue of beauty is framed, and we ponder on how a broadening of the scope to include history-of ideas, of relations-would bring some important elements to her approach. As Lee relates beauty and class, we examine the nuanced meanings of lack and deficiency in her analytical work. We also discuss her assumptions and position concerning discourse and dialogue which mark her ways of proceeding through the analysis of the interviews. We speculate that the depersonalized answer appointed in the interviewees` discourse can be related to a way of considering beauty as disembodied.

In the eye of the storm: exploring the introduction of environmental issues in the production function in Brazilian companies

This article aims to analyse the introduction of environmental issues in the context of the production function, which has been referred to as the organisational area to lead corporate environmental management. With that purpose, the theoretical references for corporate environmental management and the necessary alterations in production function have been organised to include environmental aspects, especially in terms of product and process development, quality management, and logistics. Considering that this research field still lacks empirical evidence for Brazilian companies, four case studies were conducted using companies located in the country. The environmental management maturity level of those companies tends to follow the rate with which the environmental issue is introduced in production sub-areas, especially in the product development process. However, in most cases we found that the companies had difficulties in structuring the insertion of the environmental dimension in logistics. The final notes point out the distance observed between what is recommended by international literature and the reality of Brazilian companies in the challenge of making the production function environmentally friendly.

Emerging Issues Concerning the Education of Speech and Language Pathologists and Audiologists in Brazil and South America

Diversity is one of the major characteristics of Brazil and all South America. This paper presents an overview of the current situation of the education of speech and language pathologists (SLP) and audiologists in Brazil and in several other countries of South America. This paper also discusses the main challenges shared by these countries. The discussion is focused on the mutual interferences between education and the areas of professional practice, cultural diversity and continued education. There are many emerging issues about the education of SLP and audiologists in South America. The suggested conclusion is that, despite the many differences, the South American SLP and audiologists` education would benefit from joint efforts and collaborative experiences. Copyright (C) 2010 S. Karger AG, Basel

Assessing deaf and hearing children`s communication in Brazil

In Brazil there are no specific tests for either signed or spoken language for deaf children. A protocol evaluating communicative abilities independent of modality of communication (sign language or spoken language), and comprising assessments of (a) pragmatic profile; (b) modality of communication and linguistic level; (c) complexity of communication; and (d) style and efficacy of communication between parent and child was administered to 127 deaf and hearing children. The children, aged 3-6 years old, were distributed in three groups: 20 with severe hearing loss, 40 with profound hearing loss and 67 normally hearing. Deaf children were found to be delayed, independent of their linguistic level and preferred modality of communication. The protocol in this study proved to be an useful instrument for gathering relevant information about the three groups of preschool children`s communicative abilities, and particularly suitable for use in countries where standardized assessments are not available. Learning outcomes: The reader will be introduced to the use of an assessment protocol comprising its development, application and data analysis. The reader will be informed about assessment of deaf children`s preferred modality of communication, by the participation of a bilingual (sign language user) professional. Communication abilities can be assessed independently of the linguistic modality. In developing countries in general, where simple and easy to administer assessments tools are scarce, such a protocol is of specific value. (c) 2010 Elsevier Inc. All rights reserved.

Critical, issues and needs in management of primary immunodeficiency diseases in Latin America

Experts from six Latin American countries met to discuss critical issues and needs in the diagnosis and management of primary immunodeficiency diseases (PIDD). The diagnosis of PIDD is generally made following referral to an immunology centre located in a major city, but many paediatricians and general practitioners are not sufficiently trained to suspect PIDD in the first place. Access to laboratory testing is generally limited, and only some screening tests are typically covered by government health programmes. Specialised diagnostic tests are generally not reimbursed. Access to treatment varies by country reflecting differences in healthcare systems and reimbursement policies. An online PIDD Registry Programme for Latin America has been available since 2009, which will provide information about PIDD epidemiology in the region. Additional collaboration across countries appears feasible in at least two areas: a laboratory network to facilitate the diagnosis of PIDD, and educational programmes to improve PIDD awareness. In total, these collaborations should make it possible to advance the diagnosis and management of PIDD in Latin America. (C) 2010 SEICAP. Published by Elsevier Espana, S.L. All rights reserved.

Efficiency issues of evolutionary k-means

One of the top ten most influential data mining algorithms, k-means, is known for being simple and scalable. However, it is sensitive to initialization of prototypes and requires that the number of clusters be specified in advance. This paper shows that evolutionary techniques conceived to guide the application of k-means can be more computationally efficient than systematic (i.e., repetitive) approaches that try to get around the above-mentioned drawbacks by repeatedly running the algorithm from different configurations for the number of clusters and initial positions of prototypes. To do so, a modified version of a (k-means based) fast evolutionary algorithm for clustering is employed. Theoretical complexity analyses for the systematic and evolutionary algorithms under interest are provided. Computational experiments and statistical analyses of the results are presented for artificial and text mining data sets. (C) 2010 Elsevier B.V. All rights reserved.

On the influence of imputation in classification: practical issues

The substitution of missing values, also called imputation, is an important data preparation task for many domains. Ideally, the substitution of missing values should not insert biases into the dataset. This aspect has been usually assessed by some measures of the prediction capability of imputation methods. Such measures assume the simulation of missing entries for some attributes whose values are actually known. These artificially missing values are imputed and then compared with the original values. Although this evaluation is useful, it does not allow the influence of imputed values in the ultimate modelling task (e.g. in classification) to be inferred. We argue that imputation cannot be properly evaluated apart from the modelling task. Thus, alternative approaches are needed. This article elaborates on the influence of imputed values in classification. In particular, a practical procedure for estimating the inserted bias is described. As an additional contribution, we have used such a procedure to empirically illustrate the performance of three imputation methods (majority, naive Bayes and Bayesian networks) in three datasets. Three classifiers (decision tree, naive Bayes and nearest neighbours) have been used as modelling tools in our experiments. The achieved results illustrate a variety of situations that can take place in the data preparation practice.

Design issues for knowledge artifacts

The notion of knowledge artifact has rapidly gained popularity in the fields of general knowledge management and more recently knowledge-based systems. The main goal on this paper is to propose and discuss a methodology for the design and implementation of knowledge-based systems founded on knowledge artifacts. We advocate that the systems built according to this methodology can be effective to convey the flow of knowledge between different communities of practice. Our methodology has been developed from the ground up, i.e. we have built some concrete systems based on the abstract notion of knowledge artifact and synthesized our methodology based on reflections upon our experiences building these systems. In this paper, we also describe the most relevant systems we have built and how they have guided us to the synthesis of our proposed methodology. (C) 2008 Elsevier B.V. All rights reserved.