The universal newborn hearing screening in Brazil: From identification to intervention

Objective: The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started. Methods: A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, Sao Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of Sao Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America. Results: 11,466 newborns were submitted to hearing screening, corresponding to 90.52% of the living newborns. The prevalence of sensorineural hearing loss was 0.96:1000. Of the 11 children with sensorineural hearing loss, eight children received hearing aids and five started the therapeutic process before the age of 1. Currently, four children between the ages of 11 months and 2 years old were submitted to cochlear implant surgery. The cost of hearing screening was US$7.00 and the annual cost of the universal newborn hearing screening program was US$26,940.47. Conclusion: The hospital-based universal newborn hearing screening carried out through the Brazilian National Health System is viable, with promising results. However, in a country such as Brazil, which presents large socio-economic differences, the same type of analyses should be performed in several regions, so as to take into account specific aspects, to implement the newborn hearing screening along with the Public System. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

A typology of community opportunity and vulnerability in metropolitan Australia

A multivariate model using hierarchical clustering and discriminant analysis is used to identify clusters of community opportunity and community vulnerability across Australia's mega metropolitan regions, Variables used in the model measure aspects of structural economic change, occupational change, human capital, income, unemployment, family/household disadvantage, and housing stress. A nine-cluster solution is used to categorise communities across metropolitan space. Significant between-city variations in the incidence of these clusters of opportunity and vulnerability are apparent, suggesting the emergence of marked differentiation between Australia's mega metropolitan regions in their adjustments to changing economic and social conditions. JEL classification: C49, R11, R12.

Wildlife-based tourism & increased support for nature conservation financially and otherwise: evidence from sea-turtle ecotourism at Mon Repos

The arguments of most conservationists supporting ecotourism have been based on the view that it is environmentally friendly as a resource-use and that receipts from it can counter demands to use the natural resources involved for more extractive economic purposes. But wildlife-based ecotourism can also have positive impacts in itself on the willingness of tourists to pay for wildlife conservation, strengthen the pro-conservation attitudes of tourists, and foster personal actions by them that contribute to wildlife conservation. These aspects are explored in this article on the basis of a survey of tourists visiting Mon Repos Beach near Bundaberg, Queensland, for the purpose of watching marine turtles. The results enable several of the conservation impacts of this experience on tourists to be quantified, and highlight important relationships between specific socio-economic variables and the willingness of tourists to pay for the protection of sea turtles. Furthermore, it is shown that the on-site experiences of ecotourists have positive impacts on the willingness of tourists to pay for the conservation of wildlife, and that willingness to pay is sensitive to whether or not wildlife is seen. It is suggested that in situ ecotourism is likely to be a more powerful force for fostering pro-conservation attitudes and actions among visitors than ex situ wildlife-based tourism in aquaria and zoos.

Increasing profits and reducing risks in crop production using participatory systems simulation approaches

The development of cropping systems simulation capabilities world-wide combined with easy access to powerful computing has resulted in a plethora of agricultural models and consequently, model applications. Nonetheless, the scientific credibility of such applications and their relevance to farming practice is still being questioned. Our objective in this paper is to highlight some of the model applications from which benefits for farmers were or could be obtained via changed agricultural practice or policy. Changed on-farm practice due to the direct contribution of modelling, while keenly sought after, may in some cases be less achievable than a contribution via agricultural policies. This paper is intended to give some guidance for future model applications. It is not a comprehensive review of model applications, nor is it intended to discuss modelling in the context of social science or extension policy. Rather, we take snapshots around the globe to 'take stock' and to demonstrate that well-defined financial and environmental benefits can be obtained on-farm from the use of models. We highlight the importance of 'relevance' and hence the importance of true partnerships between all stakeholders (farmer, scientists, advisers) for the successful development and adoption of simulation approaches. Specifically, we address some key points that are essential for successful model applications such as: (1) issues to be addressed must be neither trivial nor obvious; (2) a modelling approach must reduce complexity rather than proliferate choices in order to aid the decision-making process (3) the cropping systems must be sufficiently flexible to allow management interventions based on insights gained from models. The pro and cons of normative approaches (e.g. decision support software that can reach a wide audience quickly but are often poorly contextualized for any individual client) versus model applications within the context of an individual client's situation will also be discussed. We suggest that a tandem approach is necessary whereby the latter is used in the early stages of model application for confidence building amongst client groups. This paper focuses on five specific regions that differ fundamentally in terms of environment and socio-economic structure and hence in their requirements for successful model applications. Specifically, we will give examples from Australia and South America (high climatic variability, large areas, low input, technologically advanced); Africa (high climatic variability, small areas, low input, subsistence agriculture); India (high climatic variability, small areas, medium level inputs, technologically progressing; and Europe (relatively low climatic variability, small areas, high input, technologically advanced). The contrast between Australia and Europe will further demonstrate how successful model applications are strongly influenced by the policy framework within which producers operate. We suggest that this might eventually lead to better adoption of fully integrated systems approaches and result in the development of resilient farming systems that are in tune with current climatic conditions and are adaptable to biophysical and socioeconomic variability and change. (C) 2001 Elsevier Science Ltd. All rights reserved.

A decision support system for selecting sanitation systems in developing countries

Due to the socio-economic inhomogeneity of communities in developing countries, the selection of sanitation systems is a complex task. To assist planners and communities in assessing the suitability of alternatives, the decision support system SANEX™ was developed. SANEX™ evaluates alternatives in two steps. First, Conjunctive Elimination, based on 20 mainly technical criteria, is used to screen feasible alternatives. Subsequently, a model derived from Multiattribute Utility Technique (MAUT) uses technical, socio-cultural and institutional criteria to compare the remaining alternatives with regard to their implementability and sustainability. This paper presents the SANEX™ algorithm, examples of its application in practice, and results obtained from field testing.

Knowledge of the national emergency telephone number and prevalence and characteristics of those trained in CPR in Queensland: baseline information for targeted training interventions

Members of the community contribute to survival from out-of-hospital cardiac arrest by contacting emergency medical services and performing cardiopulmonary resuscitation (CPR) prior to the arrival of an ambulance. In Australia there is a paucity of information of the extent that community members know the emergency telephone number and are trained in CPR. A survey of Queensland adults (n = 4490) was conducted to ascertain current knowledge and training levels and to target CPR training. Although most respondents (88.3%) could state the Australian emergency telephone number correctly, significant age differences were apparent (P < 0.001). One in five respondents aged 60 years and older could not state the emergency number correctly. While just over half the respondents (53.9%) had completed some form of CPR training, only 12.1% had recent training. Older people were more likely to have never had CPR training than young adults. Additional demographic and socio-economic differences were found between those never trained in CPR and those who were. The results emphasise the need to increase CPR training in those aged 40 and over, particularly females, and to increase the awareness of the emergency telephone number amongst older people. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

Phenomenological turbulence and innovation in knowledge systems

Most considerations of knowledge management focus on corporations and, until recently, considered knowledge to be objective, stable, and asocial. In this paper we wish to move the focus away from corporations, and examine knowledge and national innovation systems. We argue that the knowledge systems in which innovation takes place are phenomenologically turbulent, a state not made explicit in the change, innovation and socio-economic studies of knowledge literature, and that this omission poses a serious limitation to the successful analysis of innovation and knowledge systems. To address this lack we suggest that three evolutionary processes must be considered: self-referencing, self-transformation and self-organisation. These processes, acting simultaneously, enable system cohesion, radical innovation and adaptation. More specifically, we argue that in knowledge-based economies the high levels of phenomenological turbulence drives these processes. Finally, we spell out important policy principles that derive from these processes.

A informalidade do mercado de trabalho : um desafio institucional permanente para a economia brasileira

A economia informal compõe o mundo do trabalho de todas as sociedades capitalistas, em menor ou em maior grau. No Brasil, historicamente observa-se que esse fenômeno tem sido sempre muito abrangente, sobretudo motivado pelo e resultante do contexto socioeconômico, jurídico e político. Devido às idiossincrasias nacionais, desde o surgimento do mercado de trabalho no país, esta situação persiste em diversos panoramas e com vários matizes, obstaculizando uma melhor performance global da economia brasileira e negando oportunidades de desenvolvimento individual e social ao longo do tempo. Sendo assim, e através do prisma da Economia Social e do Trabalho, o objetivo desta dissertação é analisar os principais fatores conjunturais e estruturais da informalidade observada no mercado nacional de trabalho no interregno 1980-2012, apresentando a dimensão desse problema e expondo suas raízes econômicas e institucionais, a fim de contribuir com novos elementos para o debate da informalidade em nível nacional. A hipótese central dessa pesquisa é de que o elevado GI no Brasil persiste essencialmente – mesmo que com diferentes especificidades históricas – ao nível das mentalidades dos diversos agentes, isto é, antes de ter-se um mercado nacional de trabalho com um alto GI, tem-se uma sociedade brasileira altamente informal. A instituição “trabalho informal” persiste como um hábito incrustado mesmo diante de mudanças de ordem socioeconômica, o que impede que grande parcela da população brasileira tenha acesso ao trabalho formalizado e decente (a là OIT). É mister que haja maior efetividade das leis e aprimoramentos institucionais acompanhados de coordenação e “vontade política”, alicerçados pela tomada de consciência crescente da sociedade civil no que se refere à importância da formalização e aos males da informalidade tanto para seus cidadãos quanto para a nação. Sugere-se como uma possível alternativa para diminuir o GI de forma mais consistente a consideração, para além dos aspectos econômicos e jurídicos, do arcabouço cultural, histórico, comportamental e dos hábitos sociais incrustados que os condicionam e os orientam. Isto porque são estes os eixos que norteiam o processo de desenvolvimento individual e social. Nesse sentido, o estudo (de caráter descritivo e analítico) é fundamentado pelas teorias sistêmicas e multidisciplinares desenvolvidas por Karl Paul Polanyi e Amartya Kumar Sen, interpretadas como artífices de uma vida digna, além de apregoarem o “reincrustamento” da economia na sociedade e, por analogia, o “desincrustamento” da informalidade institucionalmente enraizada na sociedade brasileira. Isso se dará à medida que forem expandidas as liberdades instrumentais e substantivas, em uma espécie de “causação circular cumulativa” aplicada à questão da informalidade, tendo como “efeito colateral altamente desejável” o desenvolvimento socioeconômico. As principais contribuições deste estudo emergiram justamente das concepções teóricas dos dois autores, combinadas aos nexos de convergência estabelecidos entre a economia brasileira, seus desdobramentos institucionais e a informalidade no mercado nacional de trabalho no período estudado.

Physical consequences of falls in the elderly: a literature review from 1995 to 2010

In the last decade, population ageing has been registered as a global phenomenon. A relation exists between falling and ageing, since falling frequency increases significantly with age. In fact, one in three older adult falls annually. Although ageing is generically associated with decrease and degeneration of psychological and physical functions, it is still not common for the correct identification of risk factors to lead to a clinical prognosis of the elder being in risk of falling. Therefore, the goal of this review article is to identify, categorise and analyse typical ageing and fall factors mentioned in the literature as well as to quantify the number of times they were referenced. The research considered hundreds of publications, but analysis was then restricted to the 87 most pertinent articles written in English and published in journals or scientific magazines between 1995 and 2010. We concluded that falls among older adults can be characterised by the following: anatomic characteristics and physiological consequences of ageing; the pathologies that induce falls, which can be neurological, musculoskeletal, cardiovascular and other diseases; causes and risk factors of falls that can be behavioural, biological, environmental or socio-economic; type of physical consequences of falls, including fractures, bruises, injuries or other physical consequences; and strategies to prevent, mitigate or rehabilitate, which can be of a physical, environmental or behavioural nature.

Physical consequences of falls in the elderly: a literature review from 1995 to 2010

In the last decade, population ageing has been registered as a global phenomenon. A relation exists between falling and ageing, since falling frequency increases significantly with age. In fact, one in three older adult falls annually. Although ageing is generically associated with decrease and degeneration of psychological and physical functions, it is still not common for the correct identification of risk factors to lead to a clinical prognosis of the elder being in risk of falling. Therefore, the goal of this review article is to identify, categorise and analyse typical ageing and fall factors mentioned in the literature as well as to quantify the number of times they were referenced. The research considered hundreds of publications, but analysis was then restricted to the 87 most pertinent articles written in English and published in journals or scientific magazines between 1995 and 2010. We concluded that falls among older adults can be characterised by the following: anatomic characteristics and physiological consequences of ageing; the pathologies that induce falls, which can be neurological, musculoskeletal, cardiovascular and other diseases; causes and risk factors of falls that can be behavioural, biological, environmental or socio-economic; type of physical consequences of falls, including fractures, bruises, injuries or other physical consequences; and strategies to prevent, mitigate or rehabilitate, which can be of a physical, environmental or behavioural nature.

The ICT use in the implementation of Directive 2011/24/EU

This article has as main objective to evaluate the role of information and communication technologies (ICTs), in particular the eHealth (electronic health), in the implementation of the directive 2011/24/EU, of the European Parliament and of the Council of March 9th, on the exercise of patients' rights in cross-border healthcare within Member States of European Union. Being currently underway the deadline for transposition of the Directive, it is important to analyze the probable results for national health systems. Innovatively, the Directive specifically proposes the implementation of a European network of eHealth in the provision of cross-border healthcare. Within ICT, we focus on telemedicine as a key tool for the implementation, on a context of public budgets constrains. In this context, it is assumed that the EU will support and promote cooperation and the exchange of scientific information between member states within the framework of a voluntary network composed by the national authorities responsible for health (or eHealth). We apply the S.W.O.T. (strengths and weaknesses, opportunities and threats) analysis to forecast the main points that should be focused on deeper research. We discuss the technological, economic and social aspects of the use of ICT on the implementation of the directive. It is thus important to evaluate the context of ICT by S.W.O.T. tool to define strategies to sensitize policy-makers, health managers, and citizens, in order to be able to turn threats into opportunities and mitigating the weaknesses in the implementation of the Directive and to promote a better healthcare access for citizens, ensuring safe, effective healthcare and with different quality.

Residents’ perceptions on impacts of hosting the “Guimarães 2012 European Capital of Culture”: comparisons of the pre-and post-2012 ECOC

Residents tend to have high expectations about the benefits of hosting a mega‐event. So, it was not surprising that the nomination of Guimarães, Portugal, as the 2012 European Capital of Culture (2012 ECOC) had raised great expectations in the local community towards its socio‐economic and cultural benefits. The present research was designed to examine the Guimarães residents’ perceptions on the impacts of hosting the 2012 ECOC approached in two different time schedules, the pre‐ and the post‐event, trying to capture the evolution of the residents` evaluation of its impacts. For getting the data, two surveys were applied to Guimarães` residents, one in the pre‐event phase, in 2011, and another in the post‐event phase, in 2013. This approach is uncommonly applied to Portugal data and it is even the first time it was done to a Portuguese European Capital of Culture. After a factor analysis, the results of t‐tests indicate that there were significant differences (p<0.05) between the samples from the pre‐ and post‐2012 ECOC on two positive impact factors (Community’ benefits and Residents’ benefits) and one negative impact factor (Economic, social and environmental costs). Respondents also showed a negative perception of the impacts in all dimensions, except Changes in habits of Guimarães residents.

Residents’ perceptions on impacts of hosting the “Guimarães 2012 European Capital of Culture”: comparisons of the pre-and post-2012 ECOC

The nomination of Guimarães, a small city located in the northwest of Portugal, as European capital of culture (ECOC) in 2012 raised great expectations in the local community towards its socio-economic and cultural benefits. As noted by various authors, namely Kim and Petrick (2005), Kim, Gursoy and Lee (2006) and Gursoy, Chi, Ai and Chen (2011), residents tend to have high expectations about the benefits of hosting a mega-event, although they tend to recognize that some costs will result from it. Therefore, the present research was designed to examine the Guimarães residents’ perceptions on the impacts of the 2012 European capital of culture (2012 ECOC) on the city and the municipality of Guimarães before and after the mega-event and the differences found between the two time periods.

“The Voiceless in Goan Historiography”

This essay was presented at the first Seminar on Indo-Portuguese History (ISIPH-I) organized in Goa by Rev. Dr. John Correia-Afonso, S.J. in November 1978. It represented a call for a critical revision of Goan historiography in the post-colonial era, following Goa's liberation and the 25th April 1974 change in Portugal. The essay was a sort of manifesto and definition of research plan for the newly established Xavier Centre of Historical Research. The article surveys critically the documentary sources little tapped until recently. Includes the first ever analysis of the records relating to the Pastoral Visits in Goa, a prized source of information for the socio-economic history of Goa in the 19th century.

"Golden Goa is Really a Romanticized Myth"

Interview with Maria de Lima Pereira, Herald reporter on the eve of the release of the new edition of *Medieval Goa* in Panjim, Goa