Expressing medicine side effects: assessing the effectiveness of absolute risk, relative risk, and number needed to harm, and the provision of baseline risk information

Objective: To assess the effectiveness of absolute risk, relative risk, and number needed to harm formats for medicine side effects, with and without the provision of baseline risk information. Methods: A two factor, risk increase format (relative, absolute and NNH) x baseline (present/absent) between participants design was used. A sample of 268 women was given a scenario about increase in side effect risk with third generation oral contraceptives, and were required to answer written questions to assess their understanding, satisfaction, and likelihood of continuing to take the drug. Results: Provision of baseline information significantly improved risk estimates and increased satisfaction, although the estimates were still considerably higher than the actual risk. No differences between presentation formats were observed when baseline information was presented. Without baseline information, absolute risk led to the most accurate performance. Conclusion: The findings support the importance of informing people about baseline level of risk when describing risk increases. In contrast, they offer no support for using number needed to harm. Practice implications: Health professionals should provide baseline risk information when presenting information about risk increases or decreases. More research is needed before numbers needed to harm (or treat) should be given to members of the general populations. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Capturing temporality and intentionality in information systems

Information modelling is a topic that has been researched a great deal, but still many questions around it have not been solved. An information model is essential in the design of a database which is the core of an information system. Currently most of databases only deal with information that represents facts, or asserted information. The ability of capturing semantic aspect has to be improved, and yet other types, such as temporal and intentional information, should be considered. Semantic Analysis, a method of information modelling, has offered a way to handle various aspects of information. It employs the domain knowledge and communication acts as sources of information modelling. It lends itself to a uniform structure whereby semantic, temporal and intentional information can be captured, which builds a sound foundation for building a semantic temporal database.

Modeling requirement driven architecture of adaptive healthcare system based on semiotics

In order to improve the quality of healthcare services, the integrated large-scale medical information system is needed to adapt to the changing medical environment. In this paper, we propose a requirement driven architecture of healthcare information system with hierarchical architecture. The system operates through the mapping mechanism between these layers and thus can organize functions dynamically adapting to user’s requirement. Furthermore, we introduce the organizational semiotics methods to capture and analyze user’s requirement through ontology chart and norms. Based on these results, the structure of user’s requirement pattern (URP) is established as the driven factor of our system. Our research makes a contribution to design architecture of healthcare system which can adapt to the changing medical environment.

NeuroHub: a research information environment for neuroscientists

The NeuroHub project aims to develop a research information system for neuroscientists at three different partner institutions: Oxford, Reading and Southampton. Each research group has different working practices, research methodologies and user requirements, which have lead to the development of a system that supports a wide variety of tasks in the neuroscience research life cycle. In this paper, we present how these user requirements have been translated in a research information environment that supports a community of over 70 researchers using the system for day-to-day research tasks.

Trends in Morbid Obesity and in Bariatric Surgeries Covered by the Brazilian Public Health System

Obesity is an increasingly serious public health problem on a global level. Morbid obesity, defined as a body mass index greater than 40 kg/m(2), is associated with increased mortality and a high burden of obesity-related morbidities. To study the prevalence of morbid obesity in Brazil, three national anthropometric surveys were reanalyzed. Data about bariatric surgeries were obtained from the Ministry of Health Hospital Information System, which is available online. A 255% rise in the prevalence of morbid obesity was observed, starting at 0.18% in 1975-1976 and growing to 0.33% in 1989 and 0.64% in 2002-2003. There was a higher rate in the South in the first two surveys, but the prevalence in the Southeast rose steadily, reaching 0.77% in 2002-2003 and overtaking the South. Since 1999, the Brazilian Unified Health System has covered surgical treatment for morbid obesity. From 2000 to 2006, there was a sixfold increase in the number of surgeries, which topped the 2,500 mark in 2006. The geographic distribution of these surgeries is heavily concentrated in the Southeast, the most developed region of Brazil, where there is also the highest prevalence of morbid obesity. This was followed by the Southern region. The figures for the rise in morbid obesity in Brazil are startling, especially the increase among men. This is a situation that calls for further study, alongside measures to encourage the adoption of healthy lifestyles. Preventive measures aimed at slowing down or reversing the obesity epidemic are urgently required.

Flood Risk Assessment in Coastal Drainage Basins through a Multivariate Analysis within a GIS-Based Model

This paper presents a GIS-based multicriteria flood risk assessment and mapping approach applied to coastal drainage basins where hydrological data are not available. It involves risk to different types of possible processes: coastal inundation (storm surge), river, estuarine and flash flood, either at urban or natural areas, and fords. Based on the causes of these processes, several environmental indicators were taken to build-up the risk assessment. Geoindicators include geological-geomorphologic proprieties of Quaternary sedimentary units, water table, drainage basin morphometry, coastal dynamics, beach morphodynamics and microclimatic characteristics. Bioindicators involve coastal plain and low slope native vegetation categories and two alteration states. Anthropogenic indicators encompass land use categories properties such as: type, occupation density, urban structure type and occupation consolidation degree. The selected indicators were stored within an expert Geoenvironmental Information System developed for the State of Sao Paulo Coastal Zone (SIIGAL), which attributes were mathematically classified through deterministic approaches, in order to estimate natural susceptibilities (Sn), human-induced susceptibilities (Sa), return period of rain events (Ri), potential damages (Dp) and the risk classification (R), according to the equation R=(Sn.Sa.Ri).Dp. Thematic maps were automatically processed within the SIIGAL, in which automata cells (""geoenvironmental management units"") aggregating geological-geomorphologic and land use/native vegetation categories were the units of classification. The method has been applied to the Northern Littoral of the State of Sao Paulo (Brazil) in 32 small drainage basins, demonstrating to be very useful for coastal zone public politics, civil defense programs and flood management.

Vägen till jämställdhet - Kvinnor i styrelserum eller män i förskolan? : En kritisk analys av den svenska jämställdhetsdiskursen

Equality between the sexes has been discussed in Sweden for more than 50 years. In the 60´s and during the 70´s the discourse that dominated the debate was based on the assumption that both men and women needed to liberate themselves from their traditional gender roles. In this approach information and education was perceived as the key to equality. During the 80´s however, power and subordination became the main focal point of concern within this debate, and focus upon changing the patriarchal power structures dominating society were perceived as the principal key for establishing equality between the sexes. Today, the latter discourse still dominates both the scientific and the political perspective upon equality. By examining the debate on equality from two different fields of occupation this paper tries to analyse the fact that the Swedish equality discourse looks very different on male - versus female domination. Although the proportion of male teachers in Swedish preschools is about 3 % and the amount of women serving as public company directors is about 20 %, the current discourse views male dominance within the business sector as problematic, whilst, the dominance of women in the preschool childcare sector as less problematic. In respect of the theory supported by Bourdieu (1999), Hirdman (1990 & 2003) and Foucault (1998 & 2002) this paper advocates that the discourse is biased and simplified and that a perspective that only focuses on areas of male domination sets the wrong priorities. With regards to equality ideals prevalent throughout Norway this paper concludes that the Swedish equality discourse needs a broader and more open approach to assure that Swedish institutions promote equality between men and women in the best possible way.

Expert system to calculate the cofficient of friction : an approach to enhance traffic safety

Friction plays a key role in causing slipperiness as a low coefficient of friction on the road may result in slippery and hazardous conditions. Analyzing the strong relation between friction and accident risk on winter roads is a difficult task. Many weather forecasting organizations use a variety of standard and bespoke methods to predict the coefficient of friction on roads. This article proposes an approach to predict the extent of slipperiness by building and testing an expert system. It estimates the coefficient of friction on winter roads in the province of Dalarna, Sweden using the prevailing weather conditions as a basis. Weather data from the road weather information system, Sweden (RWIS) was used. The focus of the project was to use the expert system as a part of a major project in VITSA, within the domain of intelligent transport systems

Utbildningens påverkan på människors acceptans för ett kommunikationssystem

I denna studie, som bedrivits på Landstinget Dalarna, har kommunikationssystemet Microsoft Lync studerats. Lync består av kommunikationsmodulerna chatt, video- och telefonkonferens samt dela dokument. Syftet med denna rapport är att förklara hur utbildning kan påverka människors acceptans för ett kommunikationssystem samt vilka orsaker som kan finnas för att det inte används. För att kunna besvara studiens syfte användes ett kvasiexperiment som genomfördes genom två intervjuomgångar och en utbildning mellan dessa intervjuomgångar. Utifrån intervjuomgångarna kunde slutsatser dras om hur utbildningen hade påverkat acceptansen för kommunikationssystemet Lync. Modellen Unified Theory of Acceptance and Use of Technology (UTAUT) användes för att studera de olika faktorer som påverkar acceptansen för teknik. Slutsatsen ska besvara frågorna, om utbildning påverkar människors acceptans och vad som kan vara orsaker till att ett kommunikationssystem som Lync inte används. Efter utbildningen hade en viss påverkan skett för kommunikationsmodulen chatt, inställningen hade ändrats och respondenterna såg en ökad nytta efter utbildningen. Utbildningen hade ingen påverkan när respondenterna inte såg nytta.

Development Of Water Pollution Early Warning System For Oyster Harvesting Areas

The objective of this study is to develop a Pollution Early Warning System (PEWS) for efficient management of water quality in oyster harvesting areas. To that end, this paper presents a web-enabled, user-friendly PEWS for managing water quality in oyster harvesting areas along Louisiana Gulf Coast, USA. The PEWS consists of (1) an Integrated Space-Ground Sensing System (ISGSS) gathering data for environmental factors influencing water quality, (2) an Artificial Neural Network (ANN) model for predicting the level of fecal coliform bacteria, and (3) a web-enabled, user-friendly Geographic Information System (GIS) platform for issuing water pollution advisories and managing oyster harvesting waters. The ISGSS (data acquisition system) collects near real-time environmental data from various sources, including NASA MODIS Terra and Aqua satellites and in-situ sensing stations managed by the USGS and the NOAA. The ANN model is developed using the ANN program in MATLAB Toolbox. The ANN model involves a total of 6 independent environmental variables, including rainfall, tide, wind, salinity, temperature, and weather type along with 8 different combinations of the independent variables. The ANN model is constructed and tested using environmental and bacteriological data collected monthly from 2001 – 2011 by Louisiana Molluscan Shellfish Program at seven oyster harvesting areas in Louisiana Coast, USA. The ANN model is capable of explaining about 76% of variation in fecal coliform levels for model training data and 44% for independent data. The web-based GIS platform is developed using ArcView GIS and ArcIMS. The web-based GIS system can be employed for mapping fecal coliform levels, predicted by the ANN model, and potential risks of norovirus outbreaks in oyster harvesting waters. The PEWS is able to inform decision-makers of potential risks of fecal pollution and virus outbreak on a daily basis, greatly reducing the risk of contaminated oysters to human health.

Contribuições ao uso de novas tecnologias da informação e comunicação no ensino de engenharia

Neste trabalho, descreve-se o processo de produção de tecnologias educacionais e de Tecnologias da Informação e Comunicação (TICs), relacionando-as ao uso do ensino em Engenharia Geotécnica. Desenvolveu-se um sistema de informação baseado num modelo que integra recursos educacionais produzidos em diferentes formatos eletrônicos e um software baseado na Web para gestão destes recursos e das informações da disciplina Fundações. O software, denominado ENGEO, auxilia a estruturação do conhecimento envolvido no domínio de aplicação, fornecendo ao professor, ou equipe de gestão, ferramentas remotas de administração dos conteúdos e dos recursos educacionais. Aos alunos, a aplicação ENGEO fornece disponibilidade de informações e de conteúdo em um ambiente flexível. Este aplicativo foi desenvolvido para o curso de Engenharia Geotécnica, particularizado para Engenharia de Fundações, com o objetivo de introduzir e incentivar a utilização de sistemas baseados na Web para compartilhamento de conteúdo das disciplinas, implementar Tecnologias de Informação e Comunicação em aplicações para fins educacionais e fomentar discussões a respeito da identidade e perfil do Engenheiro e o papel da TICs no processo de formação do profissional de Engenharia.

Análise do custo-aluno das creches municipais diretas do município de Santo André

O presente estudo tem como foco o levantamento e análise do custo-aluno das creches, primeira etapa da Educação Infantil, que compreende as crianças de 0 a 3 anos de idade. Ele responde à situação problema apresentada pela Secretaria de Educação do Município de Santo André (SP), caracterizada pela necessidade do aprimoramento da gestão dos recursos financeiros em um cenário de dificuldades orçamentárias e aumento de demanda. Foram selecionadas 12 unidades municipais da rede direta, com atendimento exclusivo a crianças nesta faixa etária. A metodologia utilizada teve como base a utilização do Sistema de Informações do Orçamento Público municipal, a partir do qual foram realizadas as consultas e definições dos componentes do custo do objeto em estudo, sendo que a metodologia de acumulação de custos utilizada foi o custeio por absorção. Adicionalmente, os autores analisaram os processos administrativos relacionados aos itens de custeio e realizaram entrevistas com os diversos atores envolvidos nos processos de gestão daquela e de outras secretarias, bem como acadêmicos dedicados ao estudo de custos no setor público, cujas experiências relatadas subsidiaram a pesquisa e as avaliações realizadas. O estudo apontou um custo-aluno médio de R$ 11.970,72 sendo que, para melhor análise dos resultados, as unidades escolares foram agrupadas em três categorias de acordo com o número de alunos: i) pequeno porte: com até 149 alunos (três unidades); ii) médio porte: entre 150 e 190 alunos (cinco unidades); e, iii) grande porte: com mais de 190 alunos (quatro unidades). A partir dessa divisão foi possível concluir que as creches de grande porte apresentaram vantagem comparativa em relação às demais, com custo-aluno médio de R$ 11.684,03, seguidas das creches de médio porte, R$ 11.751,46 e pelas unidades de pequeno porte, que apresentaram o custo-aluno de R$ 13.235,88, ou seja, 13,23% acima das escolas de grande porte. Esses resultados indicam a existência de ganhos de escalas de acordo com o porte da creche e pode subsidiar a tomada de decisão dos gestores para futuros projetos de expansão da rede pública de creches.

Mortalidade por câncer de boca e condição sócio-econômica no Brasil

BORGES,D. M. L.et al. Mortalidade por câncer de boca e condição sócio-econômica no Brasil.Cad. Saúde Pública, Rio de Janeiro, v.25,n.2, p.321-327, fev, 2009

Qualidade do gasto público em educação para os municípios da região metropolitana de Natal-2007

The aim of this thesis is to evaluate the quality of public spending on education for the municipalities of the Metropolitan Region of Natal (RMN) in 2009 by use of two theories: The Theory of Welfare (Welfare State) and the Public Choice Theory (TEP), both important to understand the relationship between education and economics. The study also uses principles of microeconomics and public sector economics to get a better idea of the role of education in economy and society. It describes the development of the educational policy in Brazil from 1988 to the Federal Constitution of 2010, following the major changes in basic education during each government. The characteristics of the RMN municipalities were illustrated with socioeconomic indicators, while educational indicators were used to characterize each municipality regarding education. The model used in this study was developed by Bertê, Brunet and Borges, the data was collected on the back of the School Census 2009 and the Brazil Exam 2009 and it was processed quantitavely in the Information System on Public Budgets in Education (SIOPE) by use of the statistical method called standardized score of the normal cumulative distribution function. The quality of public spending on education is the result of the relation between performance indicator ratio and expense ratio. For the qualitative analysis of results, the criteria of efficiency, efficacy and effectiveness were used. The study found that municipalities with higher expenses showed a worse quality of spending and failed to convert the expenditure incurred into performance, thus confirming ineffectiveness

Perfil de mortalidade de idosos no Rio Grande do Norte: estudo comparativo entre duas faixas etárias e fatores relacionados

Measures of mortality represent one of the most important indicators of health conditions. For comprising the larger rate of deaths, the study of mortality in the elderly population is regarded as essential to understand the health situation. In this sense, the present study aims to analyze the mortality profile of the population from 60 to 69 (young elders) and older than 80 years old (oldest old) in the Rio Grande do Norte state (Brazil) in the period 2001 to 2011, and to identify the association with contextual factors and variables about the quality of the Mortality Information System (SIM). For this purpose, Mortality Proportional (MP) was calculated for the state and Specific Mortality Rate by Age (CMId) , according to chapters of ICD- 10, to the municipalities of Rio Grande do Norte , through data from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IGBE). In order to identify groups of municipalities with similar mortality profiles, Nonhierarchical Clustering K-means method was applied and the Factor Analysis by the Principal Components Analysis was resort to reduce contextual variables. The spatial distribution of these groups and the factors were visualized using the Spatial Analysis Areas technique. During the period investigated, 21,813 younger elders deaths were recorded , with a predominance of deaths from circulatory diseases (32.75%) and neoplasms (22.9 %) . Among the oldest old, 50,637 deaths were observed, which 35.26% occurred because of cardiovascular diseases and 17.27% of ill-defined causes. Clustering Analysis produced three clusters to the two age groups and Factor Analysis reduced the contextual variables into three factors, also the sum of the factor scores was considered. Among the younger elders, the groups are called misinformation profile, development profile and development paradox, which showed a statistically significant association with education and poverty and extreme poverty factors, factorial sum and the variable related to underreporting of deaths. Misinformation profile remained in the oldest old group, accompanied by the epidemiological transition profile and the epidemiological paradox, that were statistically associated with the development and health factor, as well as with the variables that indicate the SIM quality: proportion of blank fields about the schooling and underreporting. It proposed that the mortality profiles of the younger elders and oldest old differ on the importance of the basic causes and that are influenced by different contextual aspects , observing that 60 to 69 years group is more affected by such aspects. Health inequalities can be reduced by measures aimed to improve levels of education and poverty, especially in younger elders, and by optimizing the use of health services, which is more associated to the oldest old health situation. Furthermore, it is important to improve the quality of information for the two age groups