Regional Inequality and Decentralization - An Empirical Analysis

This paper analyzes the impact of political and fiscal decentralization on regional inequalities using a unique data set which covers 56 countries at different stages of economic develop-ment. Cross-section and panel data estimations show that decentralization decreases regional inequalities in general. However, estimations using an interaction variable approach imply that the effect depends on the level of economic development. While rich countries benefit from decentralization with regard to a more equal regional income distribution, decentralization may lead to higher regional inequalities in developing and emerging economies. The results are pointing in the same direction for measures of fiscal and political decentralization implying that both - autonomy in decision making and fiscal authority - are decisive in this context. Thus, when fostering decentralization in developing countries - as proposed by international development agencies - the potential negative redistributional consequences should be taken into account.regional inequality, decentralization, panel data

Regional inequality and decentralization – an empirical analysis

This paper analyzes the impact of political and fiscal decentralization on regional inequalities using a unique data set which covers 56 countries at different stages of economic development. Cross-section and panel data estimations show that decentralization decreases regional inequalities in general. However, estimations using an interaction variable approach imply that the effect depends on the level of economic development. While rich countries benefit from decentralization with regard to a more equal regional income distribution, decentralization may lead to higher regional inequalities in developing and emerging economies. The results are pointing in the same direction for measures of fiscal and political decentralization implying that both -autonomy in decision making and fiscal authority- are decisive in this context. Thus, when fostering decentralization in developing countries -as proposed by international development agencies- the potential negative redistributional consequences should be taken into account

Notas acerca da democracia participativa e as políticas de esporte e lazer

O trabalho discute a democracia participativa e sua relação com as políticas de esporte e lazer nos governo federal e municipal (Fortaleza/CE), tomando como marco o governo Lula da Silva e o governo Luizianne Lins. Trata-se de uma discussão teórica, com base em autores como Poulantzas (1985) e Pateman (1992), entre outros. Pretende-se problematizar o conceito de democracia participativa nas políticas de esporte e lazer e entender a expressão do seu significado no quadro destas políticas.El trabajo presenta un analysis sobre la democracia participativa y su relación con las políticas de deporte y ocio de los gobiernos federal y municipal (Fortaleza/CE), teniendose como marco el gobierno Lula da Silva y el gobierno de Luizianne Lins. Tratase de un debate teórico, formulado con base en los autores como Poulantzas (1985) y Pateman (1992), etc. Intentase problematizar el concepto de la democracia participativa en las políticas de deporte y ocio y entender la expresión del significado en el cuadro de estas políticas.This paper presents an analysis about the participative democracy and the relation with the policy of the sport and leisure in the federal and local governments (Lula da Silva and Luizianne Lins). The study was based in the authors like Poulantzas (1985), Pateman (1992). The aim is discussed the notion of the participative democracy in the sport and leisure’s policies

El Segrià a estudi: Definició de l’espai i la seva gent

Les planes que segueixen fan un estudi geogràfic i demogràfic de la comarca del Segrià. Partint de la cerca de trets distintius (físics, climàtics, comunicacions, econòmics i culturals), hem dividit el Segrià en vuit zones prou definides i amb personalitat pròpia: 1) el Segrià Sud; 2) el Baix Segre; 3) el Segrià Sec; 4) les colònies de l’oest; 5) la Séquia de Pinyana; 6) l’aiguabarreig del Noguera Ribagorçana i el Segre; 7) la Plana de Lleida, i 8) el Segrià urgellenc. Aquest estudi és un punt de partida per definir l’espai de la comarca i la gent que hi habita.The pages that follow make a geographic and demographic study of the region of El Segrià. Based on the search for distinctive features (physical, climatic, communications, economic and cultural), we have divided the Segrià into eight well-defined areas with their own personality: 1) Segrià Sud; 2) Baix Segre; 3) Segrià Sec; 4) the colonies of the west; 5) the Pinyana Channel; 6) the Noguera Ribagorçana and Segre lagoon; 7) la Plana de Lleida, and 8) Segrià Urgellenc. This study is a starting point to define the region and the people that live there

Laryngectomy: Phonation Alternatives and Their Impact on the Quality of Life

Background The decision to consent to surgery is a life-changing moment. This study addresses the impact of total laryngectomy (TL) on phonation and its effect on the quality of life (QoL) of patients. The primary objective of this cohort study is to compare the alternatives in phonation rehabilitation, and the secondary objective is to identify concurrent predictors of vocal outcomes. Methodology To perform a comprehensive analysis, we reviewed data from patients who underwent TL with bilateral radical neck dissection in the Department of Otolaryngology, Head and Neck Surgery at Centro Hospitalar Universitário de Santo António between January 2010 and October 2022. Adult patients who consented to participate in the study and underwent subjective evaluation were included in this study. Data regarding clinical history was primarily collected. Statistical analysis was performed using SPSS version 26 (IBM Corp., Armonk, NY, USA). Different types of vocal rehabilitation formed the subgroups to be compared. An additional analysis was performed for baseline variables collected in the clinical records, and vocal outcomes were measured using the Self-Evaluation of Communication Experiences After Laryngectomy (SECEL) questionnaire. Furthermore, linear models taking SECEL scores as the outcome were developed. Results The first search identified a total of 124 patients operated during the study period. In total, 63 patients were alive at the time of the current follow-up, with 61 deaths (49%). Overall, 26 of the 63 alive patients completed the SECEL questionnaire. All patients were male. The mean age at diagnosis was 62.2 ± 10.6 years. The mean age at the time of subjective vocal assessment with the SECEL questionnaire was 66.3 ± 10.4 years. The mean time of follow-up after the initial diagnosis was 4 ± 3.8 years. A statistically significant difference was observed in esophageal speech (ES), which was inferior to other modalities (mean SECEL total score for ES: 46.6 ± 12.2 vs. mean SECEL total score for all other modalities: 33 ± 15.1; p = 0.03). The follow-up time correlated significantly with vocal function, as measured by the SECEL questionnaire (p = 0.013). Conclusions The SECEL questionnaire can be a valuable tool to evaluate QoL in laryngectomy patients, given its usefulness in assessing the psychological impact derived from vocal functionality in this group. ES appears inferior to other modalities regarding voice-related QoL.info:eu-repo/semantics/publishedVersio

Multi-stage nanofiltration for brine concentration: experimental and modelling study

Multi-stage nanofiltration (NF) has been proposed in several configurations for brine concentration applications where reverse osmosis (RO) is impractical due to high osmotic pressures. For example, the nNF-RO configuration, comprising several NF stages followed by a RO stage, has been proposed for liquid desiccant air-conditioning (LDAC). The RO-nNF configuration, comprising a RO stage followed by several NF stages, has been proposed for zero liquid discharge (ZLD). Previous theoretical investigations of nNF-RO and RO-nNF were based on idealised assumptions. Here, a two-stage system has been constructed and tested. By accounting for energy and pressure losses, more accurate models were developed. Experimental and model results agreed within 11%. The models were extended to four-stage systems, representing 3NF-RO and RO-3NF, and applied to two cases: LDAC using MgCl2 for greenhouses and ZLD using NaCl brine approaching crystallisation. A range of feed concentrations, energy recovery devices, and solution temperatures were modelled. The four-stage systems have SECel of 45–140 and 4–40 kWhel/m3 in LDAC and ZLD, respectively. In comparison, their thermal alternatives require 120 and 25 kWhel/m3, respectively. Thus, compared to thermal brine concentration, multistage NF is consistently more energy efficient in LDAC and more efficient at feed concentrations below 90 g/L in ZLD

Pre-operative speech-language pathology counselling in patients undergoing total laryngectomy: A pilot randomized clinical trial

Total Laryngectomy seriously affects on patients Quality of Life and on their psychological well-being. The aim of this study was to verify the effects of pre-operative Speech-Language Pathology counselling on laryngectomized patients. Pilot randomized controlled trial. Twenty-seven patients undergoing total laryngectomy and primary tracheoesophageal puncture were randomized as follows: 14/27 subjects were collocated in the Experimental group who received preoperative Speech-Language Pathology counselling and 13/27 in the Control group group that did not receive it. Two interviews and four questionnaires (Psychological Distress Inventory, Impact of Event Scale-Revised, Hospital Anxiety and Depression Scale, Italian-Self-Evaluation of Communication Experiences after Laryngeal Cancer) were administered immediately after surgery (T0), 1- (T1) and 3-months (T2) after hospital discharge in order to asses levels of distress, post-traumatic stress and anxious-depressive symptoms, acquisition and acceptance of the new voice. Student’s t test and chi square test showed that the two groups of patients were equivalent. Experimental group was more satisfied with the information and obtained statistically better (p < 0.05) scores in terms of levels of distress, post-traumatic stress, anxious-depressive symptoms and acceptance of the new voice than the Control group. The Speech-Language Pathology counselling may reduce the anguish, sadness and anticipatory anxiety deriving from the uncertainty of the post-operative course and it might facilitate the process of emotional adaptation, making patients more capable and prepared to face their new condition

Self evaluation of communication experiences after laryngeal cancer – A longitudinal questionnaire study in patients with laryngeal cancer

<p>Abstract</p> <p>Background</p> <p>Aim of this longitudinal study was to investigate the sensitivity to change of the Swedish Self Evaluation of Communication Experiences after Laryngeal Cancer questionnaire (the S-SECEL), addressing communication dysfunction in patients treated for laryngeal cancer. Previous studies have highlighted the need for more specific questionnaires for this purpose.</p> <p>Methods</p> <p>100 patients with Tis-T4 laryngeal cancer were included prior to treatment onset. Patients answered four questionnaires at six occasions during one year; the S-SECEL, the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Core Questionnaire (QLQ-C30) supplemented by the Head and Neck cancer module (QLQ-H&N35) and the Hospital Anxiety and Depression (HAD) scale. In addition, performance status was assessed. Differences within groups were tested with the Wilcoxon paired signed ranks test and between-group analyses were carried out using the Mann-Whitney <it>U </it>test. Magnitude of group differences was analyzed by means of effect sizes.</p> <p>Results</p> <p>The S-SECEL was well accepted with a response rate of 76%. Communication dysfunction increased at 1 month, followed by a continuous decrease throughout the year. Changes were statistically significant at most measurement, demonstrating the sensitivity of the S-SECEL to changes in communication over time. The S-SECEL and the EORTC QLQ-C30 with the QLQ-H&N35 demonstrated similar results; however the S-SECEL was more sensitive regarding communication dysfunction. The largest changes were found in the most diagnose specific items concerning voice and speech.</p> <p>Conclusion</p> <p>The S-SECEL was investigated in the largest Scandinavian longitudinal study concerning health-related quality of life (HRQL) in laryngeal cancer patients. The questionnaire was responsive to change and showed convergent results when compared to established HRQL questionnaires. Our findings also indicate that the S-SECEL could be a more suitable instrument than the EORTC QLQ-C30 with QLQ-H&N35 when measuring communication experiences in patients with laryngeal cancer; it is more sensitive, shorter and can be used on an individual basis. As a routine screening instrument the S-SECEL could be a valuable tool for identifying patients at risk for psychosocial problems and to help plan rehabilitation. It is therefore recommended for clinical use in evaluation of communication dysfunction for all patients with laryngeal cancer irrespective of treatment.</p