Using small area estimation and geographic information systems technology to target health services for the uninsured

The three articles that comprise this dissertation describe how small area estimation and geographic information systems (GIS) technologies can be integrated to provide useful information about the number of uninsured and where they are located. Comprehensive data about the numbers and characteristics of the uninsured are typically only available from surveys. Utilization and administrative data are poor proxies from which to develop this information. Those who cannot access services are unlikely to be fully captured, either by health care provider utilization data or by state and local administrative data. In the absence of direct measures, a well-developed estimation of the local uninsured count or rate can prove valuable when assessing the unmet health service needs of this population. However, the fact that these are “estimates” increases the chances that results will be rejected or, at best, treated with suspicion. The visual impact and spatial analysis capabilities afforded by geographic information systems (GIS) technology can strengthen the likelihood of acceptance of area estimates by those most likely to benefit from the information, including health planners and policy makers. ^ The first article describes how uninsured estimates are currently being performed in the Houston metropolitan region. It details the synthetic model used to calculate numbers and percentages of uninsured, and how the resulting estimates are integrated into a GIS. The second article compares the estimation method of the first article with one currently used by the Texas State Data Center to estimate numbers of uninsured for all Texas counties. Estimates are developed for census tracts in Harris County, using both models with the same data sets. The results are statistically compared. The third article describes a new, revised synthetic method that is being tested to provide uninsured estimates at sub-county levels for eight counties in the Houston metropolitan area. It is being designed to replicate the same categorical results provided by a current U.S. Census Bureau estimation method. The estimates calculated by this revised model are compared to the most recent U.S. Census Bureau estimates, using the same areas and population categories. ^

Correlation of tuberculosis and human immunodeficiency virus in Harris County, Texas from 2009 through 2010 using Geographic Information Systems

A population based ecological study was conducted to identify areas with a high number of TB and HIV new diagnoses in Harris County, Texas from 2009 through 2010 by applying Geographic Information Systems to determine whether distinguished spatial patterns exist at the census tract level through the use of exploratory mapping. As of 2010, Texas has the fourth highest occurrence of new diagnoses of HIV/AIDS and TB.[31] The Texas Department of State Health Services (DSHS) has identified HIV infected persons as a high risk population for TB in Harris County.[29] In order to explore this relationship further, GIS was utilized to identify spatial trends. ^ The specific aims were to map TB and HIV new diagnoses rates and spatially identify hotspots and high value clusters at the census tract level. The potential association between HIV and TB was analyzed using spatial autocorrelation and linear regression analysis. The spatial statistics used were ArcGIS 9.3 Hotspot Analysis and Cluster and Outlier Analysis. Spatial autocorrelation was determined through Global Moran's I and linear regression analysis. ^ Hotspots and clusters of TB and HIV are located within the same spatial areas of Harris County. The areas with high value clusters and hotspots for each infection are located within the central downtown area of the city of Houston. There is an additional hotspot area of TB located directly north of I-10 and a hotspot area of HIV northeast of Interstate 610. ^ The Moran's I Index of 0.17 (Z score = 3.6 standard deviations, p-value = 0.01) suggests that TB is statistically clustered with a less than 1% chance that this pattern is due to random chance. However, there were a high number of features with no neighbors which may invalidate the statistical properties of the test. Linear regression analysis indicated that HIV new diagnoses rates (β=−0.006, SE=0.147, p=0.970) and census tracts (β=0.000, SE=0.000, p=0.866) were not significant predictors of TB new diagnoses rates. ^ Mapping products indicate that census tracts with overlapping hotspots and high value clusters of TB and HIV should be a targeted focus for prevention efforts, most particularly within central Harris County. While the statistical association was not confirmed, evidence suggests that there is a relationship between HIV and TB within this two year period.^

A geographic information science (GIS) approach to conducting comparative area-level community assessments in the Texas CORD Study

This study assessed and compared sociodemographic and income characteristics along with food and physical activity assets (i.e. grocery stores, fast food restaurants, and park areas) in the Texas Childhood Obesity Research Demonstration (CORD) Study intervention and comparison catchment areas in Houston and Austin, Texas. The Texas CORD Study used a quasi-experimental study design, so it is necessary to establish the interval validity of the study characteristics by confirming that the intervention and comparison catchment areas are statistically comparable. In this ecological study, ArcGIS and Esri Business Analyst were used to spatially relate U.S. Census Bureau and other business listing data to the specific school attendance zones within the catchment areas. T-tests were used to compare percentages of sociodemographic and income characteristics and densities of food and physical activity assets between the intervention and comparison catchment areas.^ Only five variables were found to have significant differences between the intervention and comparison catchment areas: Age groups 0-4 and 35-64, the percentage of owner-occupied and renter-occupied households, and the percentage of Asian and Pacific Islander residents. All other variables showed no significant differences between the two groups. This study shows that the methodology used to select intervention and comparison catchment areas for the Texas CORD Study was effective and can be used in future studies. The results of this study can be used in future Texas CORD studies to confirm the comparability of the intervention and comparison catchment areas. In addition, this study demonstrates a methodology for describing detailed characteristics about a geographic area that practitioners, researchers, and educators can use.^

Proposal for the Management of temporal and semantic components of Geographic Information

This poster raises the issue of a research work oriented to the storage, retrieval, representation and analysis of dynamic GI, taking into account The ultimate objective is the modelling and representation of the dynamic nature of geographic features, establishing mechanisms to store geometries enriched with a temporal structure (regardless of space) and a set of semantic descriptors detailing and clarifying the nature of the represented features and their temporality. the semantic, the temporal and the spatiotemporal components. We intend to define a set of methods, rules and restrictions for the adequate integration of these components into the primary elements of the GI: theme, location, time [1]. We intend to establish and incorporate three new structures (layers) into the core of data storage by using mark-up languages: a semantictemporal structure, a geosemantic structure, and an incremental spatiotemporal structure. Thus, data would be provided with the capability of pinpointing and expressing their own basic and temporal characteristics, enabling them to interact each other according to their context, and their time and meaning relationships that could be eventually established

Managing Industrial Simulator Visual Databases Using Geographic Information Systems

Geographic Information Systems are developed to handle enormous volumes of data and are equipped with numerous functionalities intended to capture, store, edit, organise, process and analyse or represent the geographically referenced information. On the other hand, industrial simulators for driver training are real-time applications that require a virtual environment, either geospecific, geogeneric or a combination of the two, over which the simulation programs will be run. In the final instance, this environment constitutes a geographic location with its specific characteristics of geometry, appearance, functionality, topography, etc. The set of elements that enables the virtual simulation environment to be created and in which the simulator user can move, is usually called the Visual Database (VDB). The main idea behind the work being developed approaches a topic that is of major interest in the field of industrial training simulators, which is the problem of analysing, structuring and describing the virtual environments to be used in large driving simulators. This paper sets out a methodology that uses the capabilities and benefits of Geographic Information Systems for organising, optimising and managing the visual Database of the simulator and for generally enhancing the quality and performance of the simulator.

Proposal for the Management of temporal and semantic components of Geographic Information

This poster raises the issue of a research work oriented to the storage, retrieval, representation and analysis of dynamic GI, taking into account the semantic, the temporal and the spatiotemporal components. We intend to define a set of methods, rules and restrictions for the adequate integration of these components into the primary elements of the GI: theme, location, time [1]. We intend to establish and incorporate three new structures (layers) into the core of data storage by using mark-up languages: a semantictemporal structure, a geosemantic structure, and an incremental spatiotemporal structure. The ultimate objective is the modelling and representation of the dynamic nature of geographic features, establishing mechanisms to store geometries enriched with a temporal structure (regardless of space) and a set of semantic descriptors detailing and clarifying the nature of the represented features and their temporality. Thus, data would be provided with the capability of pinpointing and expressing their own basic and temporal characteristics, enabling them to interact each other according to their context, and their time and meaning relationships that could be eventually established

A Tele-Health Communication and Information System for Underserved Children in Rural Areas of Nicaragua

Millennium Development Goals point out the necessity of actively promoting maternal-child health care status, especially in underserved areas. This article details the development actions carried out between 2008 and 2011 in some rural communities of Nicaragua with the aim to provide a low-cost tele-health communication service. The service is managed by the health care center of Cusmapa, which leads the program and maintains a communication link between its health staff and the health brigades of 26 distant communities. Local agents can use the system to report urgent maternal-child health care episodes to be assessed through WiMAX-WiFi voice and data communications attended by two physicians and six nurses located at the health care center. The health and nutritional status of the maternal-child population can be monitored to prevent diseases, subnutrition, and deaths. The action approach assumes the fundamentals of appropriate technology and looks for community- based, sustainable, replicable, and scalable solutions to ensure future deployments according to the strategies of the United Nations.

Tomas Lopez's Geographic Atlas of Spain (1787) and its Hydrographic Network: GIS analysis of the Reyno de Jaen

Knowledge of the development of hydrographic networks can be useful for a number of research works in hydraulic engineering. We thus, intend to analyse the cartography regarding the first work that systematically encompasses the entire hydrographic network: Tomas Lopez’s Geographic Atlas of Spain (1787). In order to achieve this goal, we will first analyze –by way of the Geographic Information System (GIS) – both the present and referred historical cartographies. In comparing them, we will use the then-existing population centres that correspond to modern ones. The aim is to compare the following research variables in the hydrographic network: former toponyms, length of riverbeds and distance to population centres. The results of this study will show the variation in the riverbeds and the probable change in their denomination.

Assessment of "mobile mapping system": A GIS-based support methodology

In this article, the authors examine the current status of different elements that integrate the landscape of the municipality of Olias del Rey in Toledo (Spain). A methodology for the study of rural roads, activity farming and local hunting management. We used Geographic Information Technologies (GIT) in order to optimize spatial information including the design of a Geographic Information System (GIS). In the acquisition of field data we have used vehicle "mobile mapping" instrumentation equipped with GNSS, LiDAR, digital cameras and odometer. The main objective is the integration of geoinformation and geovisualization of the information to provide a fundamental tool for rural planning and management.

Developing an information system for deaf

This paper presents the SAILSE Project (Sistema Avanzado de Información en Lengua de Signos Española ? Spanish Sign Language Advanced Information System). This project aims to develop an interactive system for facilitating the communication between a hearing and a deaf person. The first step has been the linguistic study, including a sentence collection, its translation into LSE (Lengua de Signos Española - Spanish Sign Language), and sign generation. After this analysis, the paper describes the interactive system that integrates an avatar to represent the signs, a text to speech converter and several translation technologies. Finally, this paper presents the set up carried out with deaf people and the main conclusions extracted from it.