The importance of retesting the hearing screening as an indicator of the real early hearing disorder

Early diagnosis of hearing loss minimizes its impact on child development. We studied factors that influence the effectiveness of screening programs. To investigate the relationship between gender, weight at birth, gestational age, risk factors for hearing loss, venue for newborn hearing screening and pass and fail results in the retest. Prospective cohort study was carried out in a tertiary referral hospital. The screening was performed in 565 newborns through transient evoked otoacoustic emissions in three admission units before hospital discharge and retest in the outpatient clinic. Gender, weight at birth, gestational age, presence of risk indicators for hearing loss and venue for newborn hearing screening were considered. Full-term infants comprised 86% of the cases, preterm 14%, and risk factors for hearing loss were identified in 11%. Considering the 165 newborns retested, only the venue for screening, Intermediate Care Unit, was related to fail result in the retest. Gender, weight at birth, gestational age and presence of risk factors for hearing loss were not related to pass and/or fail results in the retest. The screening performed in intermediate care units increases the chance of continued fail result in the Transient Otoacoustic Evoked Emissions test.

Support area as an indicator of environmental load: Comparison between Embodied Energy, Ecological Footprint, and Emergy Accounting methods

Environmental aspects have been acknowledged as an important issue in decision making at any field during the last two decades. There are several available methodologies able to assess the environmental burden, among which the Ecological Footprint has been widely used due to its easy-to-understand final indicator. However, its theoretical base has been target of some criticisms about the inadequate representation of the sustainability concept by its final indicator. In a parallel way, efforts have been made to use the theoretical strength of the Emergy Accounting to obtain an index similar to that supplied by the Ecological Footprint. Focusing on these aspects, this work assesses the support area (SA) index for Brazilian sugarcane and American corn crop through four different approaches: Embodied Energy Analysis (SA(EE)), Ecological Footprint (SA(EF)), Renewable Empower Density (SA(R)), and Emergy Net Primary Productivity (SA(NPP)). Results indicate that the load on environment varies accordingly to the methodology considered for its calculation, in which emergy approach showed the higher values. Focusing on crops comparison, the load by producing both crops are similar with an average of 0.04 ha obtained by SA(EE), 1.86 ha by SA(EF), 4.24 ha by SA(R), and 4.32 ha by SA(NPP). Discussion indicates that support area calculated using Emergy Accounting is more eligible to represent the load on the environment due to its global scale view. Nevertheless, each methodology has its contribution depending of the study objectives, but it is important to consider the real meaning and the scope of each one. (C) 2012 Elsevier Ltd. All rights reserved.