Low cost calibrated mechanical noisemaker for hearing screening of neonates in resource constrained settings

Background & objectives: There is a need to develop an affordable and reliable tool for hearing screening of neonates in resource constrained, medically underserved areas of developing nations. This study valuates a strategy of health worker based screening of neonates using a low cost mechanical calibrated noisemaker followed up with parental monitoring of age appropriate auditory milestones for detecting severe-profound hearing impairment in infants by 6 months of age. Methods: A trained health worker under the supervision of a qualified audiologist screened 425 neonates of whom 20 had confirmed severe-profound hearing impairment. Mechanical calibrated noisemakers of 50, 60, 70 and 80 dB (A) were used to elicit the behavioural responses. The parents of screened neonates were instructed to monitor the normal language and auditory milestones till 6 months of age. This strategy was validated against the reference standard consisting of a battery of tests - namely, auditory brain stem response (ABR), otoacoustic emissions (OAE) and behavioural assessment at 2 years of age. Bayesian prevalence weighted measures of screening were calculated. Results: The sensitivity and specificity was high with least false positive referrals for. 70 and 80 dB (A) noisemakers. All the noisemakers had 100 per cent negative predictive value. 70 and 80 dB (A) noisemakers had high positive likelihood ratios of 19 and 34, respectively. The probability differences for pre- and post- test positive was 43 and 58 for 70 and 80 dB (A) noisemakers, respectively. Interpretation & conclusions: In a controlled setting, health workers with primary education can be trained to use a mechanical calibrated noisemaker made of locally available material to reliably screen for severe-profound hearing loss in neonates. The monitoring of auditory responses could be done by informed parents. Multi-centre field trials of this strategy need to be carried out to examine the feasibility of community health care workers using it in resource constrained settings of developing nations to implement an effective national neonatal hearing screening programme.

A report of the fisheries catch assessment surveys in the Ugandan waters of Lake Victoria for November 2005

The fisheries of Lake Victoria have undergone many changes in the recent past which have been characterized by shifts in abundance of different fish Species and changes in fishing effort. Monitoring of the population dynamics as well as the magnitude, distribution and trends of fishing effort and fish Catches is probably more necessary now than ever before for sound management of the fisheries of the lake. This will enable the formulation of appropriate fisheries policies and legislation to ensure that the fisheries are sustainable. One of the avenues to collect information to support the above process is through conducting regular Catch Assessment Surveys (CASs). The EU funded Implementation of a Fisheries Management Plan (IFMP) project for Lake Victoria through the Lake Victoria Fisheries Organization (LVFO) is supporting the implementation of regionally harmonized CASs in Lake Victoria. The CASs under IFMP are following a statistically design laid down in Standard Operating Procedures (SOPs) agreed around the whole lake. In the Ugandan part of the lake, the CASs are carried out at 54 fish landing sites selected in the eleven districts sharing the lake. They are jointly conducted by the Fisheries Resources Research Institute (FIRRI), Jinja; the Department of Fisheries Resources (DFR), Entebbe; and the Districts of Busia, Bugiri, Mayuge, Jinja, Mukono, Wakiso, Kampala, Mpigi, Masaka, Kalangala and Rakai. The CAS enumerators are recruited from the fishing communities and work under direct supervision of sub county Fisheries Officers. It is planned to involve the recently formed Beach Management Units (BMUs) in fisheries data collection when modalities for their roles have been streamlined.

A report of the Fisheries Catch Assessment Survey in the Ugandan waters of Lake Victoria for the August 2007 survey

The monitoring of fish stocks as well as the magnitude, distribution and trends of fishing effort and fish catches is required for sound fisheries resources management. Conducting regular Catch Assessment Surveys (CASs) in Lake Victoria is one of the ways through which the partner states sharing the lake are generating information to contribute to the above process. The EU funded Implementation of a Fisheries Management Plan (IFMP) project for Lake Victoria through the Lake Victoria Fisheries Organisation (LVFO) is supporting the implementation of regionally harmonised CASs in Lake Victoria . The CASs under IFMP are following a statistical design laid down in Standard Operating Procedures (SOPs) agreed by the three partner states of the East African Community sharing the lake. In the Ugandan part of the lake, the CASs are carried out at 54 fish landing sites selected in the eleven riparian districts sharing the lake. The National Fisheries Resources Research Institute (NAFIRRI), Jinja; the Department of Fisheries Resources (DFR), Entebbe; and the Districts of Busia, Bugiri, Mayuge, Jinja, Mukono, Wakiso, Kampala, Mpigi, Masaka, Kalangala and Rakai jointly conduct the surveys. The CAS enumerators are recruited from the fishing communities and work under direct supervision of subcounty Fisheries Officers. NaFIRRI seeks to continue strengthening the engagement of the Beach Management Units (BMUs) and other fisheries Co-management Institutions in fisheries data collection .

Enhancement of fish production in a reservoir after partitioning by dikes through community participation

A reservoir of 70 acres was portioned by dikes into four manageable big ponds to get more production of fishes at Basurhat, Noakhali, Bangladesh under the supervision of local community through a society of 40 people ownership. Pangus (Pangasius hypophthalmus) @ 20,000/acre, and then fry and fingerlings of different types of fishes such as catla (Catla catla), rohu (Labeo rohita), mrigal (Cirrhina mrigala), grass carp (Ctenophmyngodon idella), bighead (Aristichthys nobili), silver carp (Hypophthalmichthys molitrix), common carp (Cyprinus cmpio) and rajpunti (Puntius gonionatus) @ 500/acre were stocked. Feed containing 25% protein was used two times daily and feed was adjusted fortnightly. After 8 months, all the fishes were weighed 0.80-2.10 kg except rajpunti (150-200 g) and tilapia (150-220 g), and a total of 25 ton of fish was harvested which was five times higher than the previous production under signal ownership. The production of fishes were increased after partitioning the lake with dikes due to proper management and control.

Household Health and Cocoa Production: A Baseline Survey of Smallholder Farming Households in Western Region, Ghana

Background Chronic illness and premature mortality from malaria, water-borne diseases, and respiratory illnesses have long been known to diminish the welfare of individuals and households in developing countries. Previous research has also shown that chronic diseases among farming populations suppress labor productivity and agricultural output. As the illness and death toll from HIV/AIDS continues to climb in most of sub-Saharan Africa, concern has arisen that the loss of household labor it causes will reduce crop yields, impoverish farming households, intensify malnutrition, and suppress growth in the agricultural sector. If chronic morbidity and premature mortality among individuals in farming households have substantial impacts on household production, and if a large number of households are affected, it is possible that an increase in morbidity and mortality from HIV/AIDS or other diseases could affect national aggregate output and exports. If, on the other hand, the impact at the household farm level is modest, or if relatively few households are affected, there is likely to be little effect on aggregate production across an entire country. Which of these outcomes is more likely in West Africa is unknown. Little rigorous, quantitative research has been published on the impacts of AIDS on smallholder farm production, particularly in West Africa. The handful of studies that have been conducted have looked mainly at small populations in areas of very high HIV prevalence in southern and eastern Africa. Conclusions about how HIV/AIDS, and other causes of chronic morbidity and mortality, are affecting agriculture across the continent cannot be drawn from these studies. In view of the importance of agriculture, and particularly smallholder agriculture, in the economies of most African countries and the scarcity of resources for health interventions, it is valuable to identify, describe, and quantify the impact of chronic morbidity and mortality on smallholder production of important crops in West Africa. One such crop is cocoa. In Ghana, cocoa is a crop of national importance that is produced almost exclusively by smallholder households. In 2003, Ghana was the world’s second-largest producer of cocoa. Cocoa accounted for a quarter of Ghana’s export revenues that year and generated 15 percent of employment. The success and growth of the cocoa industry is thus vital to the country’s overall social and economic development. Study Objectives and Methods In February and March 2005, the Center for International Health and Development of Boston University (CIHD) and the Department of Agricultural Economics and Agribusiness (DAEA) of the University of Ghana, with financial support from the Africa Bureau of the U.S. Agency for International Development and from Mars, Inc., which is a major purchaser of West African cocoa, conducted a survey of a random sample of cocoa farming households in the Western Region of Ghana. The survey documented the extent of chronic morbidity and mortality in cocoa growing households in the Western Region of Ghana, the country’s largest cocoa growing region, and analyzed the impact of morbidity and mortality on cocoa production. It aimed to answer three specific research questions. (1) What is the baseline status of the study population in terms of household size and composition, acute and chronic morbidity, recent mortality, and cocoa production? (2) What is the relationship between household size and cocoa production, and how can this relationship be used to understand the impact of adult mortality and chronic morbidity on the production of cocoa at the household level? The study population was the approximately 42,000 cocoa farming households in the southern part of Ghana’s Western Region. A random sample of households was selected from a roster of eligible households developed from existing administrative information. Under the supervision of the University of Ghana field team, enumerators were graduate students of the Department of Agricultural Economics and Agribusiness or employees of the Cocoa Services Division. A total of 632 eligible farmers participated in the survey. Of these, 610 provided complete responses to all questions needed to complete the multivariate statistical analysis reported here.

The role of the community service order and the suspended sentence in Ireland: a judicial perspective

Imprisonment is the most severe penalty utilised by the criminal courts in Ireland. In recent decades the prison population has grown significantly despite expressions both official and public to reduce the use of the sanction. Two other sanctions are available to the Irish sentencer which may be used as a direct and comparable sentence in lieu of a term of imprisonment namely, the community service order and the suspended sentence. The community service order remains under-utilised as an alternative to the custodial sentence. The suspended sentence is used quite liberally but its function may be more closely related to the aim of deterrence rather than avoiding the use of the custodial sentence. Thus the aim of decarceration may not be optimal in practice when either sanction is utilised. The decarcerative effect of either sanction is largely dependent upon the specific purpose which judges invest in the sanction. Judges may also be inhibited in the use of either sanction if they lack confidence that the sentence will be appropriately monitored and executed. The purpose of this thesis is to examine the role of the community service order and the suspended sentence in Irish sentencing practice. Although community service and the suspended sentence present primarily as alternatives to the custodial sentence, the manner in which the judges utilise or fail to utilise the sanctions may differ significantly from this primary manifestation. Therefore the study proceeds to examine the judges' cognitions and expectations of both sanctions to explore their underlying purposes and to reveal the manner in which the judges use the sanctions in practice. To access this previously undisclosed information a number of methodologies were deployed. An extensive literature review was conducted to delineate the purpose and functionality of both sanctions. Quantitative data was gathered by way of sampling for the suspended sentence and the part-suspended sentence where deficiencies were apparent to show the actual frequency in use of that sanction. Qualitative methodologies were used by way of focus groups and semi-structured interviews of judges at all jurisdictional levels to elucidate the purposes of both sanctions. These methods allowed a deeper investigation of the factors which may promote or inhibit such usage. The relative under-utilisation of the community service order as an alternative to the custodial sentence may in part be explained by a reluctance by some judges to equate it with a real custodial sentence. For most judges who use the sanction, particularly at summary level, community service serves a decarcerative function. The suspended sentence continues to be used extensively. It operates partly as a decarcerative penalty but the purpose of deterrence may in practice overtake its theoretical purpose namely the avoidance of custody. Despite ongoing criticism of executive agencies such as the Probation Service and the Prosecution in the supervision of such penalties both sanctions continue to be used. Engagement between the Criminal Justice actors may facilitate better outcomes in the use of either sanction. The purposes for which both sanctions are deployed find their meaning essentially in the practices of the judges themselves as opposed to any statutory or theoretical claims upon their use or purpose.

Leisure and surveillance in Irish childhoods: A cross-class study of Cork city

This research provides an interpretive cross-class analysis of the leisure experience of children, aged between six and ten years, living in Cork city. This study focuses on the cultural dispositions underpinning parental decisions in relation to children’s leisure activities, with a particular emphasis on their child-surveillance practices. In this research, child-surveillance is defined as the adult monitoring of children by technological means, physical supervision, community supervision, or adult supervised activities (Nelson, 2010; Lareau, 2003; Fotel and Thomsen, 2004). This research adds significantly to understandings of Irish childhood by providing the first in-depth qualitative analysis of the surveillance of children’s leisure-time. Since the 1990s, international research on children has highlighted the increasingly structured nature of children’s leisure-time (Lareau, 2011; Valentine & McKendrick, 1997). Furthermore, research on child-surveillance has found an increase in the intensive supervision of children during their unstructured leisure-time (Nelson, 2010; Furedi, 2008; Fotel and Thomsen, 2004). This research bridges the gap between these two key bodies of literature, providing a more integrated overview of children’s experience of leisure in Ireland. Using Bourdieu’s (1992) model of habitus, field and capital, the dispositions that shape parents’ decisions about their children’s leisure time are interrogated. The holistic view of childhood adopted in this research echoes the ‘Whole Child Approach’ by analysing the child’s experience within a wider set of social relationships including family, school, and community. Underpinned by James and Prout’s (1990) paradigm on childhood, this study considers Irish children’s agency in negotiating with parents’ decisions regarding leisure-time. The data collated in this study enhances our understanding of the micro-interactions between parents and children and, the ability of the child to shape their own experience. Moreover, this is the first Irish sociological research to identify and discuss class distinctions in children’s agentic potential during leisure-time.

Use of Web Logs (Blogs) in Learning Environments: Blogs for Student Support

Innovation in technology and communications and particularly the advent of the Web is changing the structure of teaching and learning today. While there is much debate about the use of technology in learning and how e-learning is creating new approaches to delivery of learning there is been very little if any work on the use of of the emerging technologies in providing student support through their learning process. This paper reports on research and development undertaken by the eCentre based at the University of Greenwich School Of Computing in designing and developing a "Project Blog System" in order to address some long standing issues related to supervision of final year degree student projects. The paper will report on the methodology used to design the system and will discuss some of the results from students and staff evaluation of the system developed.

Playback Theatre: the art of being oneself. A tool for empowerment and real change for individuals and communities

This article presents the application of a theatrical technique—Playback Theatre, which was developed in the United States during the 1970s—to social intervention, as a narrative and listening space that confers value and dignity upon the person and the unique and distinct individual experiences that facilitate their social and relational integration. This art of being oneself, as the author states, uses the oral tradition and spontaneous and creative communication of psychodrama and combines them with theatrical expression. This technique has been shown to be pertinent to both community social work and support groups for persons in problematic situations. The aim of this is to celebrate some specific moment of their lives, as individuals or as a community, and to define strategies for improving living conditions or resolving or alleviating conflicts. It is also used to assess the achievements of the proposed objectives, to strengthen the motivation to change and to transform existing relationships into collaborative ones. This is possible not only owing to the participation of persons, but also to the assumption of different roles that can permit the overcoming of certain traumatic events.In addition to support groups, it is used for the training and supervision of social work professionals. The theatrical technique in question allows them to assume roles as diverse as narrator, audience or actor, whether simultaneously or successively. Taking the role of «performer» or guide to the theatrical action requires prior preparation in order for the group of participants to be able to pool their individualities and their emotions and reflect on them. The participatory methodology that Playback Theatre proposes is important in community social work and is posed in a new and transformative key.

A case study in group learning and supervision

Student units or the group-based field education and supervision of social work students offer many advantages as an efficient field placement model as well as opportunities for students to learn from each other through sharing knowledge, working collaboratively, hearing different perspectives and discussing issues. Despite the enormous potential of student units, they are a largely uncharted territory. There is a scarcity of literature on the topic and very few guidelines as to the provision of student units. The term student unit covers a broad range of student group learning opportunities and activities. This study explores this model of social work field education and its implications for student field work learning in a group context. The discussion is based on a review of the experiences, opinions and impressions of participants of an actual university based social work student unit.

Creating a Circus of Words, Music, and Sound: From Roaratorio to Owenvarragh

This article documents the creation of a work by the authors based on a score written by the composer John Cage entitled 'Owenvarragh: A Belfast Circus on The Star Factory.' The article is part of a documentary portfolio in the journal which also includes a volume of the poetry created by Dowling in accordance with the instructions of the Cage score, and a series of documentary videos on the creation of the work and its first performance. Cage's score is based on his work 'Roaratorio: An Irish Circus on Finnegan's Wake' (1979) and it provides a set of detailed instructions for the musical realisation of a literary work. The article documents this first fully realised version of the score since Cage first produced 'Roaratorio' in 1979. The work, which was motivated by the Cage centenary year in 2012, musically realises Carson's book 'The Star Factory' (1998), a novelestic autobiography of Carson's Belfast childhood. The score required the creation of a fixed media piece based on over 300 field recordings of the sounds and places mentioned in the book, a volume of poetry created from the book which is recited to form the rhythmic spine of the work, and the arrangement of a performance including these two components along with live musical performance by the authors in collaboration with three other musicians under their direction, and a video installation created for the work. The piece has been performed three times: in association with the Sonorities 2012 Festival at Queen's University of Belfast (March 2012), at The Belfast Festival at Queen's (October 2012), and in the Rymer Auditoium of the University of York (June 2013).

Additional information:

The work which the article documents was conceived by Monaghan and Dowling, and the project was initiated by Monaghan after a she received a student prize to support its development and first performance. Elements of the project will be included in her PhD dissertation for which Dowling is a supervisor. Monaghan created the fixed media piece based on over 300 field recordings, the largest single aspect of realising Cage's score. Dowling was responsible for initiating the collaboration with Ciaran Carson, and for two other components: the creation of a volume of poetry derived from the literary work which is recited in the performance, and the creation of and supervision of the technical work on a video which accompanies the piece. The co-authors consulted closely during the work on these large components from May 2011 until March 2012 when the first performance took place. The co-authors also shared in numerous other artistic and organisational aspects of the production, including the arrangement and performnance of the music, musical direction to other performers, and marketing.

Health professionals' and service users' perspectives of shared care for monitoring wet age-related macular degeneration: a qualitative study alongside the ECHoES trial

Objectives: To explore the views of eye health professionals and service users on shared community and hospital care for wet or neovascular age-related macular degeneration (nAMD).

Method: Using maximum variation sampling, 5 focus groups and 10 interviews were conducted with 23 service users and 24 eye health professionals from across the UK (consisting of 8 optometrists, 6 ophthalmologists, 6 commissioners, 2 public health representatives and 2 clinical eye care advisors to local Clinical Commissioning Groups). Data were transcribed verbatim and analysed thematically using constant comparative techniques derived from grounded theory methodology.

Results: The needs and preferences of those with nAMD appear to be at odds with the current service being provided. There was enthusiasm among health professionals and service users about the possibility of shared care for nAMD as it was felt to have the potential to relieve hospital eye service burden and represent a more patient-centred option, but there were a number of perceived barriers to implementation. Some service users and ophthalmologists voiced concerns about optometrist competency and the potential for delays with referrals to secondary care if stable nAMD became active again. The health professionals were divided as to whether shared care was financially more efficient than the current model of care. Specialist training for optometrists, under the supervision of ophthalmologists, was deemed to be the most effective method of training and was perceived to have the potential to improve the communication and trust that shared care would require.

Conclusions: While shared care is perceived to represent a promising model of nAMD care, voiced concerns suggest that there would need to be greater collaboration between ophthalmology and optometry, in terms of interprofessional trust and communication.

Cultural adaptation of websites: a comparative study of portuguese and dutch corporate websites

Master Thesis Presented at Instituto de Contabilidade e Administração do Porto for obtaining the Master’s degree in Digital Marketing under the supervision of Professor José de Freitas Santos

Obama's law : analysis of a breakthrough law on healthcare access and lessons for the Portuguese health system management

ABSTRACT - The Patient Protection and Affordable Care Act shook the foundations of the US health system, offering all Americans access to health care by changing the way the health insurance industry works. As President Obama signed the Act on 23 March 2010, he said that it stood for “the core principle that everybody should have some basic security when it comes to their health care”. Unlike the U.S., the Article 64 of the Portuguese Constitution provides, since 1976, the right to universal access to health care. However, facing a severe economic crisis, Portugal has, under the supervision of the Troika, a tight schedule to implement measures to improve the efficiency of the National Health Service. Both countries are therefore despite their different situation, in a conjuncture of reform and the use of new health management measures. The present work, using a qualitative research methodology examines the Affordable Care Act in order to describe its principles and enforcement mechanisms. In order to describe the reality in Portugal, the Portuguese health system and the measures imposed by Troika are also analyzed. The intention of this entire analysis is not only to disclose the innovative U.S. law, but to find some innovative measures that could serve health management in Portugal. Essentially we identified the Exchanges and Wellness Programs, described throughout this work, leaving also the idea of the possibility of using them in the Portuguese national health system.

Money for nothing?: The net costs of medical training

A Masters Thesis, presented as part of the requirements for the award of a Research Masters Degree in Economics from NOVA – School of Business and Economics