Geographic Information Systems (GIS) in Assessing Dental Health

The present study investigated the distribution profile of dental caries and its association with areas of social deprivation at the individual and contextual level. The cluster sample consisted of 1,002 12-year-old schoolchildren from Piracicaba, SP, Brazil. The DMFT Index was used for dental caries and the Care Index was used to determine access to dental services. On the individual level, variables were associated with a better oral status. On the contextual level, areas were not associated with oral status. However, maps enabled determining that the central districts have better social and oral conditions than the deprived outlying districts.

AMBIVALENT IMPLICATIONS OF HEALTH CARE INFORMATION SYSTEMS: A STUDY IN THE BRAZILIAN PUBLIC HEALTH CARE SYSTEM

This article evaluates social implications of the ""SIGA"" Health Care Information System (HIS) in a public health care organization in the city of Sao Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

Information from managing information systems as a fundamental element to support decision-making in hospitals

This article deals with the activity of defining information of hospital systems as fundamental for choosing the type of information systems to be used and also the organizational level to be supported. The use of hospital managing information systems improves the user`s decision -making process by allowing control report generation and following up the procedures made in the hospital as well.

Logistics information systems adoption: an empirical investigation in Brazil

Purpose - The purpose of this paper is to examine whether the level of logistics information systems (LIS) adoption in manufacturing companies is influenced by organizational profile variables, such as the company`s size, the nature of its operations and their subsectors. Design/methodology/approach - A review of the mainstream literature on US was carried out to identify the factors influencing the adoption of such information systems and also some research gaps. The empirical study`s strategy is based on a survey research in Brazilian manufacturing firms from the capital goods industry. Data collected were analyzed through Kruskall-Wallis and Mann Whitney`s non-parametric tests. Findings - The analysis indicates that characteristics such as the size of companies and the nature of their operations influence the levels of LIS adoption, whilst comparisons regarding the subsectors appeared to be of little influence. Originality/value - This is the first known study to examine the influence of organizational profiles such as size, nature of operations and subsector on the level of US adoption in manufacturing companies. Moreover, it is unique in portraying the Brazilian scenario on this topic and addressing the adoption of seven types of LIS in a single study.

Spatial analysis of urban violence based on emergency room data

OBJECTIVE: To estimate the spatial intensity of urban violence events using wavelet-based methods and emergency room data. METHODS: Information on victims attended at the emergency room of a public hospital in the city of São Paulo, Southeastern Brazil, from January 1, 2002 to January 11, 2003 were obtained from hospital records. The spatial distribution of 3,540 events was recorded and a uniform random procedure was used to allocate records with incomplete addresses. Point processes and wavelet analysis technique were used to estimate the spatial intensity, defined as the expected number of events by unit area. RESULTS: Of all georeferenced points, 59% were accidents and 40% were assaults. There is a non-homogeneous spatial distribution of the events with high concentration in two districts and three large avenues in the southern area of the city of São Paulo. CONCLUSIONS: Hospital records combined with methodological tools to estimate intensity of events are useful to study urban violence. The wavelet analysis is useful in the computation of the expected number of events and their respective confidence bands for any sub-region and, consequently, in the specification of risk estimates that could be used in decision-making processes for public policies.

Análise espacial e sazonal da leptospirose no município de São Paulo, SP, 1998 a 2006

OBJETIVO: Analisar a distribuição espacial e sazonal da leptospirose, identificando possíveis componentes ecológicos e sociais para a sua transmissão. MÉTODOS: Foram georreferenciados 2.490 casos em cada distrito do município de São Paulo, SP, registrados de 1998 a 2006. Os dados foram obtidos do Sistema de Informação de Agravos de Notificação. Foram realizados mapas temáticos com as variáveis taxa de incidência, letalidade, taxa de alfabetização, renda média mensal, número de moradores por domicilio, abastecimento de água e rede de esgoto. Para identificar o padrão espacial (disperso, em aglomerado ou randômico), foram analisadas pelo Índice de Moran global e local. Foi utilizado o coeficiente de correlação de Spearman para testar associações entre as variáveis com padrão espacial em aglomerados. RESULTADOS: O padrão espacial em aglomerados foi observado nas variáveis taxa de incidência de leptospirose, taxa de alfabetização, renda média mensal, número de moradores por domicílio, abastecimento de água e rede de esgoto. Foram notificados 773 casos no período seco e 1.717 no úmido. A incidência e a letalidade estão correlacionadas com as condições socioeconômicas da população, independentemente do período. CONCLUSÕES: A leptospirose está distribuída por todo o município de São Paulo e sua incidência aumenta no período das chuvas. No período seco, os locais de aparecimento dos casos coincidem com as áreas de piores condições de moradia e, durante o período úmido, também aumenta em outros distritos, provavelmente devido à proximidade de rios e córregos.

Leishmaniose tegumentar americana no Litoral Norte Paulista, período 1993 a 2005

A leishmaniose tegumentar americana adquiriu caráter epidêmico no Litoral Norte Paulista, desde a década de 1990. A partir de dados secundários, realizou-se estudo descritivo da doença no período de 1993 a 2005 nos quatro municípios que compõem a região e analisou-se a freqüência dos flebotomíneos capturados nos locais prováveis de transmissão. Foram notificados 689 casos autóctones de leishmaniose tegumentar, com casos isolados e agrupados, determinando uma distribuição espacial heterogênea, com sincronismo na manifestação e ciclicidade, em intervalo de seis a oito anos. Todas as faixas etárias foram acometidas, com ligeiro predomínio do sexo masculino, sem associação com uma ocupação. Capturou-se 2.758 flebotomíneos e a espécie Nyssomyia intermedia predominou (80,4%), no peri e intradomicílio. A doença apresentou perfil de transmissão peri e intradomiciliar, entre o periurbano e a mata, e no interior da mata. Neste caso, a transmissão estaria mais relacionada com os focos enzoóticos.

Uso de sistemas de informação geográfica em campanhas de vacinação contra a raiva

OBJETIVO: Desenvolver método para planejamento e avaliação de campanhas de vacinação contra a raiva animal. MÉTODOS: O desenvolvimento da metodologia baseou-se em sistemas de informação geográfica para estimar a população e a densidade animal (canina e felina) por setores censitários e subprefeituras do município de São Paulo, em 2002. O número de postos de vacinação foi estimado para atingir uma dada cobertura vacinal. Foram utilizadas uma base de dados censitários para a população humana, e estimativas para razões cão:habitante e gato:habitante. RESULTADOS: Os números estimados foram de 1.490.500 cães e 226.954 gatos em São Paulo, uma densidade populacional de 1.138,14 animais domiciliados por km². Foram vacinados, na campanha de 2002, 926.462 animais, garantindo uma cobertura vacinal de 54%. O número total estimado de postos no município para atingir uma cobertura vacinal de 70%, vacinando em média 700 animais por posto foi de 1.729. Estas estimativas foram apresentadas em mapas de densidade animal, segundo setores censitários e subprefeituras. CONCLUSÕES: A metodologia desenvolvida pode ser aplicada de forma sistemática no planejamento e no acompanhamento das campanhas de vacinação contra a raiva, permitindo que sejam identificadas áreas de cobertura vacinal crítica.

Traffic-Related Air Pollution and Perinatal Mortality: A Case-Control Study

BACKGROUND: Ambient levels of air pollution may affect the health of children, as indicated by studies of infant and perinatal mortality. Scientific evidence has also correlated low birth weight and preterm birth, which are important determinants of perinatal death, with air pollution. However, most of these studies used ambient concentrations measured at monitoring sites, which may not consider differential exposure to pollutants found at elevated concentrations near heavy-traffic roadways. OBJECTIVES: Our goal was to examine the association between traffic-related pollution and perinatal mortality. METHODS: We used the information collected for a case-control study conducted in 14 districts in the City of Sao Paulo, Brazil, regarding risk factors for perinatal deaths. We geocoded the residential addresses of cases (fetal and early neonatal deaths) and controls (children who survived the 28th day of life) and calculated a distance-weighted traffic density (DWTD) measure considering all roads contained in a buffer surrounding these homes. RESULTS: Logistic regression revealed a gradient of increasing risk of early neonatal death with higher exposure to traffic-related air pollution. Mothers exposed to the highest quartile of the DWTD compared with those less exposed exhibited approximately 50% increased risk (adjusted odds ratio = 1.47; 95% confidence interval, 0.67-3.19). Associations for fetal mortality were less consistent. CONCLUSIONS: These results suggest that motor vehicle exhaust exposures may be a risk factor for perinatal mortality.

Assessment of groundwater recharge and water fluxes of the Guarani Aquifer System, Brazil

The groundwater recharge and water fluxes of the Guarani Aquifer System in the state of Sao Paulo in Brazil were assessed through a numeric model. The study area (6,748 km(2)) comprises Jacar,-Gua double dagger A(0) and Jacar,-Pepira River watersheds, tributaries of the Tiet River in the central region of the state. GIS based tools were used in the storage, processing and analysis of data. Main hydrologic phenomena were selected, leading to a groundwater conceptual model, taking into account the significant outcrops occurring in the study area. Six recharge zones were related to the geologic formation and structures of the semi-confined and phreatic aquifer. The model was calibrated against the baseflows and static water levels of the wells. The results emphasize the strong interaction of groundwater flows between watersheds and the groundwater inflow into the rivers. It has been concluded that lateral groundwater exchanges between basins, the deep discharges to the regional system, and well exploitation were not significant aquifer outflows when compared to the aquifer recharge. The results have shown that the inflows from the river into the aquifer are significant and have the utmost importance since the aquifer is potentially more vulnerable in these places.

Definition of priority areas for forest conservation through the ordered weighted averaging method

The general objective of this study was to evaluate the ordered weighted averaging (OWA) method, integrated to a geographic information systems (GIS), in the definition of priority areas for forest conservation in a Brazilian river basin, aiming at to increase the regional biodiversity. We demonstrated how one could obtain a range of alternatives by applying OWA, including the one obtained by the weighted linear combination method and, also the use of the analytic hierarchy process (AHP) to structure the decision problem and to assign the importance to each criterion. The criteria considered important to this study were: proximity to forest patches; proximity among forest patches with larger core area; proximity to surface water; distance from roads: distance from urban areas; and vulnerability to erosion. OWA requires two sets of criteria weights: the weights of relative criterion importance and the order weights. Thus, Participatory Technique was used to define the criteria set and the criterion importance (based in AHP). In order to obtain the second set of weights we considered the influence of each criterion, as well as the importance of each one, on this decision-making process. The sensitivity analysis indicated coherence among the criterion importance weights, the order weights, and the solution. According to this analysis, only the proximity to surface water criterion is not important to identify priority areas for forest conservation. Finally, we can highlight that the OWA method is flexible, easy to be implemented and, mainly, it facilitates a better understanding of the alternative land-use suitability patterns. (C) 2008 Elsevier B.V. All rights reserved.

Geographical distribution of American cutaneous leishmaniasis and its phlebotomine vectors (Diptera: Psychodidae) in the state of Sao Paulo, Brazil

Background: American cutaneous leishmaniasis (ACL) is a re-emerging disease in the state of Sao Paulo, Brazil. It is important to understand both the vector and disease distribution to help design control strategies. As an initial step in applying geographic information systems (GIS) and remote sensing (RS) tools to map disease-risk, the objectives of the present work were to: (i) produce a single database of species distributions of the sand fly vectors in the state of Sao Paulo, (ii) create combined distributional maps of both the incidence of ACL and its sand fly vectors, and (iii) thereby provide individual municipalities with a source of reference material for work carried out in their area. Results: A database containing 910 individual records of sand fly occurrence in the state of Sao Paulo, from 37 different sources, was compiled. These records date from between 1943 to 2009, and describe the presence of at least one of the six incriminated or suspected sand fly vector species in 183/645 (28.4%) municipalities. For the remaining 462 (71.6%) municipalities, we were unable to locate records of any of the six incriminated or suspected sand fly vector species (Nyssomyia intermedia, N. neivai, N. whitmani, Pintomyia fischeri, P. pessoai and Migonemyia migonei). The distribution of each of the six incriminated or suspected vector species of ACL in the state of Sao Paulo were individually mapped and overlaid on the incidence of ACL for the period 1993 to 1995 and 1998 to 2007. Overall, the maps reveal that the six sand fly vector species analyzed have unique and heterogeneous, although often overlapping, distributions. Several sand fly species - Nyssomyia intermedia and N. neivai - are highly localized, while the other sand fly species - N. whitmani, M. migonei, P. fischeri and P. pessoai - are much more broadly distributed. ACL has been reported in 160/183 (87.4%) of the municipalities with records for at least one of the six incriminated or suspected sand fly vector species, while there are no records of any of these sand fly species in 318/478 (66.5%) municipalities with ACL. Conclusions: The maps produced in this work provide basic data on the distribution of the six incriminated or suspected sand fly vectors of ACL in the state of Sao Paulo, and highlight the complex and geographically heterogeneous pattern of ACL transmission in the region. Further studies are required to clarify the role of each of the six suspected sand fly vector species in different regions of the state of Sao Paulo, especially in the majority of municipalities where ACL is present but sand fly vectors have not yet been identified.