Mobile competence network for community health workers in rural Myanmar: a supportive information system that facilitates the improvement of health services.

The goal of this project is the development of international cooperation for fostering solutions to provide better access to basic healthcare services.

The Houston Academy of Medicine--Texas Medical Center Library management information system.

A management information system (MIS) provides a means for collecting, reporting, and analyzing data from all segments of an organization. Such systems are common in business but rare in libraries. The Houston Academy of Medicine-Texas Medical Center Library developed an MIS that operates on a system of networked IBM PCs and Paradox, a commercial database software package. The data collected in the system include monthly reports, client profile information, and data collected at the time of service requests. The MIS assists with enforcement of library policies, ensures that correct information is recorded, and provides reports for library managers. It also can be used to help answer a variety of ad hoc questions. Future plans call for the development of an MIS that could be adapted to other libraries' needs, and a decision-support interface that would facilitate access to the data contained in the MIS databases.

AN OCCUPATIONAL INJURY MANAGEMENT INFORMATION SYSTEM FOR THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

The purpose of this research and development project was to develop a method, a design, and a prototype for gathering, managing, and presenting data about occupational injuries.^ State-of-the-art systems analysis and design methodologies were applied to the long standing problem in the field of occupational safety and health of processing workplace injuries data into information for safety and health program management as well as preliminary research about accident etiologies. The top-down planning and bottom-up implementation approach was utilized to design an occupational injury management information system. A description of a managerial control system and a comprehensive system to integrate safety and health program management was provided.^ The project showed that current management information systems (MIS) theory and methods could be applied successfully to the problems of employee injury surveillance and control program performance evaluation. The model developed in the first section was applied at The University of Texas Health Science Center at Houston (UTHSCH).^ The system in current use at the UTHSCH was described and evaluated, and a prototype was developed for the UTHSCH. The prototype incorporated procedures for collecting, storing, and retrieving records of injuries and the procedures necessary to prepare reports, analyses, and graphics for management in the Health Science Center. Examples of reports, analyses, and graphics presenting UTHSCH and computer generated data were included.^ It was concluded that a pilot test of this MIS should be implemented and evaluated at the UTHSCH and other settings. Further research and development efforts for the total safety and health management information systems, control systems, component systems, and variable selection should be pursued. Finally, integration of the safety and health program MIS into the comprehensive or executive MIS was recommended. ^

INFLUENCE OF A CLINIC BASED IMMUNIZATION INFORMATION SYSTEM ON INFANT IMMUNIZATIONS

This study focuses on the impact of a clinic-based intervention program on the immunization status of limited-income urban children. The intervention program consisted of an information session for clinic health care providers and the placement of individualized immunization information labels on clinic notes at the time of each visit. The degree of impact of the intervention on immunization administration was ascertained through a comparison of two similar groups of infants born in the same months of the year immediately before (N = 201) and after (N = 203) the information session and initiation of the labeling system. The timeliness of administration of each diphtheria, pertussis, tetanus and trivalent oral polio vaccine (DPT/TOPV) in the first year series of three was compared pre- to postintervention. Significantly more third immunizations were given the postintervention subjects within ten days of the recommended time of application ( p = .0361). Life table analysis indicated that the probability of an infant's passing one year of age without the administration of the third immunization decreased for postintervention infants (p = .0515). The intervention was most successful in assuring administration of the series of immunizations in those infants who were seen by the health care provider for at least 50% of their first year visits. Results indicate that minor changes in the format of information given a relatively continuous provider can increase completion of immunization series in infants. ^

A MANAGEMENT INFORMATION SYSTEM AND EVALUATION SCHEME FOR THE UNIVERSITY OF TEXAS EMPLOYEE ASSISTANCE PROGRAMS

Early Employee Assistance Programs (EAPs) had their origin in humanitarian motives, and there was little concern for their cost/benefit ratios; however, as some programs began accumulating data and analyzing it over time, even with single variables such as absenteeism, it became apparent that the humanitarian reasons for a program could be reinforced by cost savings particularly when the existence of the program was subject to justification.^ Today there is general agreement that cost/benefit analyses of EAPs are desirable, but the specific models for such analyses, particularly those making use of sophisticated but simple computer based data management systems, are few.^ The purpose of this research and development project was to develop a method, a design, and a prototype for gathering managing and presenting information about EAPS. This scheme provides information retrieval and analyses relevant to such aspects of EAP operations as: (1) EAP personnel activities, (2) Supervisory training effectiveness, (3) Client population demographics, (4) Assessment and Referral Effectiveness, (5) Treatment network efficacy, (6) Economic worth of the EAP.^ This scheme has been implemented and made operational at The University of Texas Employee Assistance Programs for more than three years.^ Application of the scheme in the various programs has defined certain variables which remained necessary in all programs. Depending on the degree of aggressiveness for data acquisition maintained by program personnel, other program specific variables are also defined. ^

Two Perspectives on GIS/LIS Education in the United States

Education in Geographic information science (GIS/LIS) happens in the United States both within surveying-related academic programs and in other academic programs that use spatially oriented data and information. This article presents an overview of two such programs. The first is a four-year Bachelor of Science degree program in Geographic Information Science at Texas A&M University-Corpus Christi. The second is a concentration with a four-year Bachelor of Science degree program in Natural Resources at the University of Connecticut (UConn). Geographic information science is the primary focus of the Texas A&M program, whereas GIS/LIS is an emphasis of the UConn program. Both approaches are presented for comparison.

Using GIS methods to assess the occurrence of neural tube defect births by residential proximity at conception to hazardous waste sites

In the United States, approximately 4,000 pregnancies each year are affected by the two most common birth defects, spina bifida and anencephaly. Studies have shown that exposure to environmental chemicals before and after conception may adversely affect reproduction by inducing cell death or dysfunction, which leads to infertility, fetal loss, lowered weight at birth, or birth anomalies in the offspring. The objective of the study was to evaluate the relationship between Neural Tube Defect births and residence at conception in proximity to hazardous waste sites in the Texas-Mexico border region between 1993 and 2000. ^ The study design was a nested matched case-control and utilized secondary data from a project, “The role of chemical and biological factors in the etiology of neural tube birth defects births along the Texas-Mexico Border” (Irina Cech, Principal Investigator). Geographic Information Systems (GIS) database methods were used to compare Neural Tube Defects cases to controls on status of conception residence occurring within a one-mile radius from hazardous waste sites, as compared to conception residence further away. Information on the exposures was obtained from the OnTarget Database and Environment Protection Agency website. Conditional logistic regression was used for the matched case-control study to investigate the relationship between an outcome of being a case or a control and proximity to hazardous waste sites. ^ The result of the study showed a 36 percent non-significant increased risk of having an NTD birth associated with maternal proximity to abandoned hazardous waste sites (95% CI = 0.62–3.02). In addition, there was a 24% non-significant elevated risk of having an NTD birth when living in proximity to air pollutant sites than when living further away (95% CI = 0.67–2.32). Although this study did not find statistically significant associations, it will expand on the existing knowledge of the relationship between NTD and proximity to hazardous waste sites. ^

Hazardous air pollutants and childhood lymphohematopoietic cancer in Southeast Texas, 1995--2004

Southeast Texas, including Houston, has a large presence of industrial facilities and has been documented to have poorer air quality and significantly higher cancer rates than the remainder of Texas. Given citizens’ concerns in this 4th largest city in the U.S., Mayor Bill White recently partnered with the UT School of Public Health to determine methods to evaluate the health risks of hazardous air pollutants (HAPs). Sexton et al. (2007) published a report that strongly encouraged analytic studies linking these pollutants with health outcomes. In response, we set out to complete the following aims: 1. determine the optimal exposure assessment strategy to assess the association between childhood cancer rates and increased ambient levels of benzene and 1,3-butadiene (in an ecologic setting) and 2. evaluate whether census tracts with the highest levels of benzene or 1,3-butadiene have higher incidence of childhood lymphohematopoietic cancer compared with census tracts with the lowest levels of benzene or 1,3-butadiene, using Poisson regression. The first aim was achieved by evaluating the usefulness of four data sources: geographic information systems (GIS) to identify proximity to point sources of industrial air pollution, industrial emission data from the U.S. EPA’s Toxic Release Inventory (TRI), routine monitoring data from the U.S. EPA Air Quality System (AQS) from 1999-2000 and modeled ambient air levels from the U.S. EPA’s 1999 National Air Toxic Assessment Project (NATA) ASPEN model. Further, once these four data sources were evaluated, we narrowed them down to two: the routine monitoring data from the AQS for the years 1998-2000 and the 1999 U.S. EPA NATA ASPEN modeled data. We applied kriging (spatial interpolation) methodology to the monitoring data and compared the kriged values to the ASPEN modeled data. Our results indicated poor agreement between the two methods. Relative to the U.S. EPA ASPEN modeled estimates, relying on kriging to classify census tracts into exposure groups would have caused a great deal of misclassification. To address the second aim, we additionally obtained childhood lymphohematopoietic cancer data for 1995-2004 from the Texas Cancer Registry. The U.S. EPA ASPEN modeled data were used to estimate ambient levels of benzene and 1,3-butadiene in separate Poisson regression analyses. All data were analyzed at the census tract level. We found that census tracts with the highest benzene levels had elevated rates of all leukemia (rate ratio (RR) = 1.37; 95% confidence interval (CI), 1.05-1.78). Among census tracts with the highest 1,3-butadiene levels, we observed RRs of 1.40 (95% CI, 1.07-1.81) for all leukemia. We detected no associations between benzene or 1,3-butadiene levels and childhood lymphoma incidence. This study is the first to examine this association in Harris and surrounding counties in Texas and is among the first to correlate monitored levels of HAPs with childhood lymphohematopoietic cancer incidence, evaluating several analytic methods in an effort to determine the most appropriate approach to test this association. Despite recognized weakness of ecologic analyses, our analysis suggests an association between childhood leukemia and hazardous air pollution.^

A community-based assessment of the spatiotemporal distribution of influenza in a U.S.-Mexico border county during the spring 2009 novel H1N1 swine-origin influenza A pandemic

This study retrospectively evaluated the spatial and temporal disease patterns associated with influenza-like illness (ILI), positive rapid influenza antigen detection tests (RIDT), and confirmed H1N1 S-OIV cases reported to the Cameron County Department of Health and Human Services between April 26 and May 13, 2009 using the space-time permutation scan statistic software SaTScan in conjunction with geographical information system (GIS) software ArcGIS 9.3. The rate and age-adjusted relative risk of each influenza measure was calculated and a cluster analysis was conducted to determine the geographic regions with statistically higher incidence of disease. A Poisson distribution model was developed to identify the effect that socioeconomic status, population density, and certain population attributes of a census block-group had on that area's frequency of S-OIV confirmed cases over the entire outbreak. Predominant among the spatiotemporal analyses of ILI, RIDT and S-OIV cases in Cameron County is the consistent pattern of a high concentration of cases along the southern border with Mexico. These findings in conjunction with the slight northward space-time shifts of ILI and RIDT cluster centers highlight the southern border as the primary site for public health interventions. Finally, the community-based multiple regression model revealed that three factors—percentage of the population under age 15, average household size, and the number of high school graduates over age 25—were significantly associated with laboratory-confirmed S-OIV in the Lower Rio Grande Valley. Together, these findings underscore the need for community-based surveillance, improve our understanding of the distribution of the burden of influenza within the community, and have implications for vaccination and community outreach initiatives.^

Calidad del 'sitio' en el oasis norte, Mendoza (Argentina)

La disminución del agua destinada al uso agrícola, la salinización de los acuíferos subterráneos y el advenimiento de la tecnología de Sistemas de Información Geográfica (SIG) han posibilitado conocer la calidad de los sitios, fundamentalmente los riesgos de salinización de los suelos del oasis del río Mendoza-Argentina. El presente trabajo se fundamenta en dos estudios anteriores: uno de relevantamiento de suelos y el otro de análisis de calidad de aguas subterráneas. En el primero se efectúo la actualización del relevantamiento de suelos del río Mendoza usando SIG. El muestreo de suelos y los análisis físicos (textura) y químicos (salinidad, conductividad eléctrica) se realizaron en 1974. Los lugares de muestreo y sus atributos, graficados como cobertura de puntos, se extrapolaron a sus zonas de influencia convirtiéndolos en polígonos y posteriormente se rasterizaron. El segundo trabajo fue la digitalización y georreferenciación, también al sistema de coordenadas Universal Transverse Mercator (UTM), de los mapas de las curvas de isosalinidad. La salinidad está medida por la conductividad eléctrica específica del agua subterránea de los tres niveles de explotación que existen en la cuenca norte de Mendoza. El monitoreo se realizó en el período 1990/1991. Las isolíneas, posteriormente, fueron rasterizadas. Con los procesos de superposición y tabulación cruzada de los SIG se integraron las diversas "capas" de datos de suelos y calidades de aguas subterráneas y se generaron mapas temáticos que expresan la clasificación y localización regional de calidades del sitio, basado fundamentalmente en los riesgos de salinización de los suelos.

Un sistema de información ambiental para Mendoza

Se presenta los antecedentes y contenidos del proyecto SIA, Sistema de Información Ambiental para Mendoza fue realizado por CIFOT para el Ministerio de Medio Ambiente, Urbanismo y Vivienda del Gobierno de la Provincia en 1993. Mediante convenio, se provee de información sistematizada y cartografía actualizada, debidamente georeferenciada y fácilmente disponible para tomar decisiones territoriales que mejoren la calidad de vida de los mendocinos. La década de 1990 es una etapa de reflexión sobre las acciones emprendidas, los efectos adversos y las correcciones necesarias para alcanzar el desarrollo sostenible, como se comienza a imponer en América Latina luego de la declaración de Río. El gobernador de Mendoza en 1992, Dr. Arturo Lafalla, ve la necesidad de contar con información precisa, accesible en tiempo y forma, para disminuir la incertidumbre del que debe decidir. El tipo de información que se incluye está relacionada con los recursos del medio natural, la población, equipamiento e infraestructura, así como los Usos del suelo resultantes.

El CIFOT como apoyo a la gestión gubernamental : inconveniente para la inversión minera

La falta de información sistematizada sobre reservas mineras causa desinterés de los capitales extranjeros, que demandan un conocimiento preciso sobre localización de yacimientos y un catastro saneado (con los títulos de propiedad correctos). En este artículo se presenta la experiencia del CIFOT en el trabajo solicitado a tales fines por la Dirección de Minería, denominado Situación de la Información Minera- Provincia de Mendoza, 1993" El objetivo principal fue evaluar la información disponible en la Dirección, procesarla, graficarla y generar cartografía temática a partir del uso de GIS, para ser presentada por las autoridades gubernamentales en Denver, USA, ante diversos inversores del sector. Se logra evidenciar la representatividad de la minería en Mendoza, por departamentos, la distribución de los yacimientos mineros, el estado de cada uno y la infraestructura vial de acceso. Esto permite a la Dirección de Minería implementar un sistema unificado de información minera, tarea que a posteriori es completada por el programa nacional PASMA.

Modelo de indicadores ambientales : observatorio ambiental

Los indicadores ambientales son una herramienta para efectuar el monitoreo de la biodiversidad a través de la recolección sistemática de datos obtenidos mediante mediciones u observaciones en series de tiempo y espacio. Se entiende por indicador ambiental a una variable o suma de variables que proporciona una información sintética sobre un fenómeno ambiental complejo que permite conocer y evaluar el estado y variación de la calidad ambiental. Para la caracterización y detección de indicadores ambientales del litoral de Río Negro se identifican y jerarquizan los conflictos o problemáticas del ambiente, a partir de lo cual se seleccionan las principales variables que componen el sistema de indicadores y por último, se recopilan los niveles de información existentes y los que requieren ser relevados e incorporados a bases de datos relacionales. Los requisitos que deben tener los indicadores seleccio nados son: ser medibles (cuali y cuantitativamente), compresibles, fáciles de usar e interrelacionar, tener dimensión espacial y temporal, ser objetivos sensibles a los cambios y permitir el diagnóstico y pronóstico en función de la detección de situaciones de alerta ambiental. Se realiza una aproximación a la selección de variables e indicadores con el fin de definir el modelo de datos y categorías de agrupamiento. El sistema de indicadores generados se agrupa en función de la disponibilidad de datos existentes y la posibilidad de recopilación para un correcto funcionamiento del prototipo del Observatorio. El modelo adoptado incorpora 3 subsistemas (ambiental, social y económico) interrelacionando con 3 nodos institucionales (que proveen y/o precisan estos datos para la toma de decisiones). Cada indicador se describe en una ficha metodológica, cuyo diseño es normalizado para un correcto funcionamiento del Observatorio. La implementación del modelo de indicadores exige contar con una infraestructura que permita la aplicación de mediciones, observaciones y registros y contar además, con personal idóneo para una correcta manipulación y análisis.