A global health problem caused by arsenic from natural sources

Arsenic is a carcinogen to both humans and animals. Arsenicals have been associated with cancers of the skin, lung, and bladder. Clinical manifestations of chronic arsenic poisoning include non-cancer end point of hyper- and hypo-pigmentation, keratosis, hypertension, cardiovascular diseases and diabetes. Epidemiological evidence indicates that arsenic concentration exceeding 50 mug l(-1) in the drinking water is not public health protective. The current WHO recommended guideline value for arsenic in drinking water is 10 mug l(-1), whereas many developing countries are still having a value of 50 mug 1(-1). It has been estimated that tens of millions of people are. at risk exposing to excessive levels of arsenic from both contaminated water and arsenic-bearing coal from natural sources. The global health implication and possible intervention strategies were also discussed in this review article. (C) 2003 Elsevier Ltd. All rights reserved.

Cherbourg revisited: hearing health changes in an Aboriginal community, 1972 to 2000

The aim of this study was to investigate current audiological outcomes of Cherbourg schoolchildren and compare these outcomes to those obtained in a 1972 study of hearing health in the same community. Seventy-eight primary school children of Cherbourg State School participated in the study. Their peripheral hearing and middle ear function were tested using pure-tone air conduction audiometry and tympanometry respectively. A significant improvement in the hearing status of this population was noted compared to that reported in 1972. The improvements in the hearing status of Indigenous schoolchildren at Cherbourg can be attributed to a number of factors, including increased awareness of both ear health and general health, as well as the introduction of hearing health care services, over the past three decades.

Unraveling the barriers to reconceptualization of the problem in chronic pain: The actual and perceived ability of patients and health professionals to understand the neurophysiology

To identify why reconceptualization of the problem is difficult in chronic pain, this study aimed to evaluate whether (1) health professionals and patients can understand currently accurate information about the neurophysiology of pain and (2) health professionals accurately estimate the ability of patients to understand the neurophysiology of pain. Knowledge tests were completed by 276 patients with chronic pain and 288 professionals either before (untrained) or after (trained) education about the neurophysiology of pain. Professionals estimated typical patient performance on the test. Untrained participants performed poorly (mean +/- standard deviation, 55% +/- 19% and 29% +/- 12% for professionals and patients, respectively), compared to their trained counterparts (78% +/- 21% and 61% +/- 19%, respectively). The estimated patient score (46% +/- 18%) was less than the actual patient score (P < .005). The results suggest that professionals and patients can understand the neurophysiology of pain but professionals underestimate patients' ability to understand. The implications are that (1) a poor knowledge of currently accurate information about pain and (2) the underestimation of patients' ability to understand currently accurate information about pain represent barriers to reconceptualization of the problem in chronic pain within the clinical and lay arenas. (C) 2003 by the American Pain Society.

Evidence and information for health policy: a decade of change

Over the past decade or so, there has been increasing demand for greater clarity about the major causes of disease and injury, how these differentially affect populations, and how they are changing. In part, this demand has been motivated by resource constraints and a realisation that better health is possible with more informed allocation of resources. At the same time, there has been a change in the way population health and its determinants are quantified, with a much closer integration of the quantitative population sciences (such as epidemiology, demography and health economics) to strengthen and broaden the evidence base for healthcare policy.

Gender wage and productivity differentials in the Portuguese tourism industry

The objective of this paper is to provide empirical evidence on the determinants of gender wage inequality in the Portuguese tourism industry. Relying on firm level wage equations and production functions, gender wage and productivity differentials are estimated and then compared in order to infer whether observed gender disparities are justifiable on the grounds that women are relatively less productive than men, or instead disparities are due to gender wage discrimination. This approach is applied to tourism industry data gathered in the matched employer-employee data set Quadros de Pessoal (Employee Records). The main findings indicate that female employees in the tourism industry in Portugal are less productive than their male colleagues and that gender differences in wages are fully explained by gender differences in productivity.

Gender, wages, and productivity: an analysis of the tourism industry in northern Portugal

Tourism represents a major economic activity in Portugal, with an enormous wealth and employment growth potential. A significant proportion of jobs in the industry tourism are occupied by women, given that this industry is characterized by a relatively higher percentage of female employees. Despite the evidence of female progress with regard to their role in the Portuguese labor market, women continue to earn less than their male counterparts. This is clearly the case of the tourism industry, where statistics reveal a persistent gender wage gap. The objective of this paper is to provide empirical evidence on the determinants of gender wage inequality in the tourism industry in northern Portugal. Relying on firm-level wage equations and production functions, gender wage and productivity differentials are estimated and then compared. The comparison of these differentials allows inferring whether observed wage disparities are attributable to relatively lower female productivity, or instead disparities are due to gender wage discrimination. This approach is applied to tourism industry data gathered in the matched employer-employee data set Quadros de Pessoal (Employee Records). The main findings indicate that female employees in the tourism industry in northern Portugal are less productive than their male colleagues and that gender differences in wages are fully explained by gender differences in productivity.

Residents’ perceptions of tourism impacts in Guimarães (Portugal): a cluster analysis

In this investigation, a cluster analysis was used to separate Guimara˜es (Portugal) residents into clusters according to their perceptions of the impacts of tourism development. This approach is uncommonly applied to Portugal data and is even rarer for world heritage sites. The world heritage designation is believed to make an area more attractive to tourists. The clustering procedure analysed 400 data observations from a Guimara˜es resident survey and revealed the existence of three clusters: the Sceptics, the Moderately Optimistic and the Enthusiasts. The results were consistent with the empirical literature’s results, with the emergent nature of the destination found to be relevant. The fact that tourism is relatively recent in this destination has its major reflex in the devaluation by most of the residents of the negative impacts of tourism development.

Cultural tourism in Northwest Portugal – the case of the world heritage site of Guimarães

A cidade de Guimarães, no noroeste português, é um espaço imbuído de um forte significado simbólico e cultural. A acreditação pela U.N.E.S.C.O. do seu centro histórico como Património Cultural da Humanidade, em Dezembro de 2001, contribuiu significativamente para aumentar o seu potencial em termos turísticos. Na realidade, desde aquela data, tem-se assistido a um aumento sustentado do número de visitantes. O presente capítulo debruça-se sobre a análise de alguns resultados de um inquérito por questionário aplicado aos residentes do município de Guimarães com o objetivo de avaliar a sua perceção dos benefícios que a atividade turística pode trazer. O inquérito foi implementado entre Janeiro e Março de 2010. Os resultados mostram que aqueles revelam uma perceção favorável dos impactos do turismo e que esta perceção está correlacionada com a idade e o nível de instrução dos inquiridos.

Participatory Online Platforms and the Construction of Citizen’s Autonomy in Health Issues

The goal of the present study is mapping the nature of possible contributions of participatory online platforms in citizen actions that may contribute in the fight against cancer and its associated consequences. The research is based on the analysis of online solidarity networks, namely the ones residing on Facebook and the blogosphere, that citizens have been gradually resorting to. The research is also based on the development of newer and more efficient solutions that provide the individual (directly or indirectly affected by issues of oncology) with the means to overcome feelings of impotence and fatality. In this chapter, the authors summarize the processes of usage of these decentralized, freer participatory platforms by citizens and institutions, while attempting to unravel existing hype and stigma; the authors also provide a first survey of the importance and the role of institutions in this kind of endeavor; lastly, they present a prototype, developed in the context of the present study that is specifically dedicated to addressing oncology through social media.

A mobile health care rule-based system

The relation between patient and physician in most modern Health Care Sys- tems is sparse, limited in time and very in exible. On the other hand, and in contradiction with several recent studies, most physicians do not rely their patient diagnostics evaluations on intertwined psychological and social nature factors. Facing these problems and trying to improve the patient/physician relation we present a mobile health care solution to im- prove the interaction between the physician and his patients. The solution serves not only as a privileged mean of communication between physicians and patients but also as an evolutionary intelligent platform delivering a mobile rule based system.

The main benefits associated with health and safety management systems certification in Portuguese small and medium enterprises post quality management system certification

The purpose of this study is to characterize how Portuguese Small and Medium Enterprises (SMEs) view the Occupational Health and Safety Management Systems (OHSMSs) certification process, after receiving the Quality Management System (QMS) certification. References were based on the ISO 9001 standard for a QMS and OHSAS 18001 for OHSMS. The method used to evaluate the implemented systems, was by form of questionnaire. Those questioned had to have a certified quality management system, an implemented OHSMS and be a SME. The questionnaire was sent to 300 SMEs; 46 responses were received and validated. Of them, only 12 SMEs had the OHSMS certificate according to OHSAS 18001. Within those 12 companies that participated: 7 SMEs are from the industrial sector; 3 belong to the electricity/telecommunications sector and 2 SMEs are from the trade/services activity sector. The size of the sample was small, but corresponds to Portuguese reality. Moreover, 34 SMEs did not have the OHSMS certificate. The questionnaire requested the main reasons for SMEs to opt for non-certification and it was related with high costs, while the main reasons to certificate were, among others, needed to eliminate or minimize risks to workers. The main benefits that Portuguese SMEs have gained from the referred certifications have been, improved working conditions, ensuring compliance with legislation and better internal communication about risks and hazards. Also presented are the main difficulties in achieving an OHSMS certification including high certification costs, difficulties motivating personnel, difficulties in changing the company’s culture and increased bureaucracy.

Medicis: a personal health care assistant

The relation between patient and physician in most modern Health Care Systems is sparse, limited in time and very inflexible. On the other hand, and in contradiction with several recent studies, most physicians do not rely their patient diagnostics evaluations on intertwined psychological and social nature factors. Facing these problems and trying to improve the patient/physician relation we present a mobile health care solution to improve the interaction between the physician and his patients. The solution serves not only as a privileged mean of communication between physicians and patients but also as an evolutionary intelligent platform delivering a mobile rule based system.

Planning Considerations for Tourism in the Minho-Lima Region (Northwest Portugal)

In administering their territories, most local municipalities aim to preserve their natural, historical and ethnographical resources while simultaneously using them to increase revenue and employment. In order to efficiently promote the products and services available and attract tourists, decision makers, private and public, need to know and incorporate tourists’ preferences in their marketing strategies. In this chapter we illustrate the use of stated preferences as an instrument to identify national and foreign tourists’ preferences regarding the products and services that the touristic destination of the Minho-Lima region (Northwest Portugal) should offer. As a starting point, we have taken the three general groups of touristic resources mentioned above as attributes. We take Ponte de Lima, a municipality in this region that has a strong cultural tourism potential as an example to identify possible future tourism scenarios for this territory. We believe the previously identified methodology can be a valuable instrument in the identification of the strengths and weaknesses of the selected territory and, thus, support the decision making process behind its future tourist development and marketing strategies.

Residents’ perception of the benefits of cultural tourism: the case of Guimarães

In many cities throughout Europe and the rest of the world, cultural tourism plays a major role in local economic development. Tourism also acts to preserve cultural heritage, as it provides a way to acquire the revenue needed to restore and preserve historical buildings, and encourages local people to value their traditions and festivals. However, tourism success can be a double-edged sword with tourist flows having a strong impact on the quality of life of residents when certain tourist thresholds are surpassed. This paper aims to address local residents’ perception of the benefits of cultural tourism. To capture their perception, a survey was implemented, addressed to both the city centre inhabitants and the non-urban residents of the Guimarães municipality.