Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system. A mixed methods approach

This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations. Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels. We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation.

A systematic review of characteristics and validity of monitoring technologies to assess Parkinson’s disease symptoms and signs

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Monitoring influenza vaccine effectiveness using the national influenza surveillance system

Background: Flu vaccine composition is reformulated on a yearly basis. As such, the vaccine effectiveness (VE) from previous seasons cannot be considered for subsequent years, and it is necessary to monitor the VE for each season. This study (MonitorEVA- monitoring vaccine effectiveness) intends to evaluate the feasibility of using the national influenza surveillance system (NISS) for monitoring the influenza VE. Material and methods: Data was collected within NISS during 2004 to 2014 seasons. We used a case-control design where laboratory confirmed incident influenza like illness (ILI) patients (cases) were compared to controls (ILI influenza negative). Eligible individuals consisted on all aged individuals that consult a general practitioner or emergency room with ILI symptoms with a swab collected within seven days of symptoms onset. VE was estimated as 1- odds ratio of being vaccinated in cases versus controls adjusted for age and month of onset by logistic regression. Sensitivity analyses were conducted to test possible effect of assumptions on vaccination status, ILI definition and timing of swabs (<3 days after onset). Results: During the 2004-2014 period, a total of 5302 ILI patients were collected but 798 ILI were excluded for not complying with inclusion criteria. After data restriction the sample size in both groups was higher than 148 individuals/ season; minimum sample size needed to detect a VE of at least 50% considering a level of significance of 5% and 80% power. Crude VE point estimates were under 45% in 2004/05, 2005/06, 2011/12 and 2013/14 season; between 50%-70% in 2006/07, 2008/09 and 2010/11 seasons, and above 70% in 2007/08 and 2012/13 season. From season 2006/07 to 2013/14, all crude VE estimates were statistically significant. After adjustment for age group and month of onset, the VE point estimates decreased and only 2008/09, 2012/13 and 2013/14 seasons were significant. Discussion and Conclusions: MonitorEVA was able to provide VE estimates for all seasons, including the pandemic, indicating if the VE was higher than 70% and less than 50%. When comparing with other observational studies, MonitorEVA estimates were comparable but less precise and VE estimates were in accordance with the antigenic match of the circulating virus/ vaccine strains. Given the sensitivity results, we propose a MonitorEVA based on: a) Vaccination status defined independently of number of days between vaccination and symptoms onset; b) use of all ILI data independent of the definition; c) stratification of VE according to time between onset and swab (< 3 and ≥3 days).

Mesozooplankton and phytoplankton time series of the Baltic Monitoring Program (BMP)

Within the monitoring programme of the Helsinki Commission (HELCOM) the mesozooplankton of the Bornholm Basin (ICES subdivision 25, station BMP-K2) was sampled by the WP-2 net (lOOfJm) 5-8 times a year in 1988-1992. Abundance, biomass, secondary production and productivity (P/B) were given for mesozooplankton groups and copepod species. Environmental factors recorded were temperature, chlorophyll a and primary production. Within copepods, the dominant species were Temora longicornis and Pseudocalanus minutus with yearly peak values of 40-50% of the monthly copepod numbers and biomasses. The annual production of Temora longicornis was highest (6.5g C/m**2/y). The biomass of all copepods was at its maximum in June (mean = 2.25g C/m**2), especially in 1992 (3.65g C/m**2). The differences between results from two methods used to calculate the production of copepods were greatest in June and July. The cladocerans were only important in summer and the appendicularians only in spring. The productivity (P/B) of the appendicularians was highest of all mesozooplankton groups. Numbers and the biomass of the meroplankton were one or two orders of magnitude below the holoplanktic groups.

Comparison of methods for the determination of total available residual chlorine in various sample matrices /

Bibliography: p. 28-29.

General methods for remedial operations performance evaluations.

Mode of access: Internet.

USEPA manual of methods for virology : chapter 13.

Chiefly tables.

The development of a speed monitoring program for Indiana.

Indiana Department of Transportation, Indianapolis

Planning for court monitoring. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Mass transit grants: UMTA needs to improve procurement monitoring at local transit authority.

Mode of access: Internet.

Handbook of methods for acid deposition studies : laboratory analyses for soil chemistry /

Mode of access: Internet.

An intensive survey of the Vermilion River Basin (Wabash River drainage) 1997 : data collection methods and summary /

"The Illinois Environmental Protection Agency monitors surface waters (i.e. lakes and streams) through a variety of programs. The most extensive is the Ambient Water Quality Monitoring Network (AWQMN) which consists of 203 stream stations statewide sampled on a 6 week cycle since October 1977." -- p. 1.

Data collection methods and summaries for the assessment of stream water quality in the Vermilion River Basin (Wabash River), 2001 /

Cover title.

Determining resource quality and potential reasons for impairment of Illinois streams, inland lakes, and Lake Michigan : (Methods used for 2002 305(b) reporting).

According to Section 305(b) of the Clean Water Act (i.e. a generic name that refers to the Federal Water Pollution Control Act of 1972, the Clean Water Act of 1977, and subsequent amendments) and guidance provided by the United States Environmental Protection Agency (USEPA), each state must prepare and submit annually to the U.S. Congress and the USEPA report that describes the resource quality of the surface waters of the state. Every other year, this report, commonly referred to as the "305(b) report," must be provided in written form, whereas in alternate years each state may submit an electronic database to meet the reporting requirement. In the 305(b) report, states must also explain how they determined the resource quality of the waters of the state in terms of the degree to which predefined beneficial uses of those waters are supported. Also, in the 305(b) report when any designated use for any water body is not fully supported, the state must report potential reasons for the impairment. Herein, is explained how the Illinois Environmental Protection Agency determines the resource quality of Illinois streams, inland lakes, and Lake Michigan.

Development of a Conceptual Site Model for Evaluating Seawater Intrusion under Sea Level Rise Scenarios Using Analytical Methods

Island County is located in the Puget Sound of Washington State and includes several islands, the largest of which is Whidbey Island. Central Whidbey Island was chosen as the project site, as residents use groundwater for their water supply and seawater intrusion near the coast is known to contaminate this resource. In 1989, Island County adopted a Saltwater Intrusion Policy and used chloride concentrations in existing wells in order to define and map “risk zones.” In 2005, this method of defining vulnerability was updated with the use of water level elevations in conjunction with chloride concentrations. The result of this work was a revised map of seawater intrusion vulnerability that is currently in use by Island County. This groundwater management strategy is defined as trigger-level management and is largely a reactive tool. In order to evaluate trends in the hydrogeologic processes at the site, including seawater intrusion under sea level rise scenarios, this report presents a workflow where groundwater flow and discharge to the sea are quantified using a revised conceptual site model. The revised conceptual site model used several simplifying assumptions that allow for first-order quantitative predictions of seawater intrusion using analytical methods. Data from water well reports included lithologic and well construction information, static water levels, and aquifer tests for specific capacity. Results from specific capacity tests define the relationship between discharge and drawdown and were input for a modified Theis equation to solve for transmissivity (Arihood, 2009). Components of the conceptual site model were created in ArcGIS and included interpolation of water level elevation, creation of groundwater basins, and the calculation of net recharge and groundwater discharge for each basin. The revised conceptual site model was then used to hypothesize regarding hydrogeologic processes based on observed trends in groundwater flow. Hypotheses used to explain a reduction in aquifer thickness and hydraulic gradient were: (1) A large increase in transmissivity occurring near the coast. (2) The reduced aquifer thickness and hydraulic gradient were the result of seawater intrusion. (3) Data used to create the conceptual site model were insufficient to resolve trends in groundwater flow. For Hypothesis 2, analytical solutions for groundwater flow under Dupuit assumptions were applied in order to evaluate seawater intrusion under projected sea level rise scenarios. Results indicated that a rise in sea level has little impact on the position of a saltwater wedge; however, a reduction in recharge has significant consequences. Future work should evaluate groundwater flow using an expanded monitoring well network and aquifer recharge should be promoted by reducing surface water runoff.