"INTERMED": a method to assess health service needs. I. Development and reliability.

The purpose of this paper is to describe the development and to test the reliability of a new method called INTERMED, for health service needs assessment. The INTERMED integrates the biopsychosocial aspects of disease and the relationship between patient and health care system in a comprehensive scheme and reflects an operationalized conceptual approach to case mix or case complexity. The method is developed to enhance interdisciplinary communication between (para-) medical specialists and to provide a method to describe case complexity for clinical, scientific, and educational purposes. First, a feasibility study (N = 21 patients) was conducted which included double scoring and discussion of the results. This led to a version of the instrument on which two interrater reliability studies were performed. In study 1, the INTERMED was double scored for 14 patients admitted to an internal ward by a psychiatrist and an internist on the basis of a joint interview conducted by both. In study 2, on the basis of medical charts, two clinicians separately double scored the INTERMED in 16 patients referred to the outpatient psychiatric consultation service. Averaged over both studies, in 94.2% of all ratings there was no important difference between the raters (more than 1 point difference). As a research interview, it takes about 20 minutes; as part of the whole process of history taking it takes about 15 minutes. In both studies, improvements were suggested by the results. Analyses of study 1 revealed that on most items there was considerable agreement; some items were improved. Also, the reference point for the prognoses was changed so that it reflected both short- and long-term prognoses. Analyses of study 2 showed that in this setting, less agreement between the raters was obtained due to the fact that the raters were less experienced and the scoring procedure was more susceptible to differences. Some improvements--mainly of the anchor points--were specified which may further enhance interrater reliability. The INTERMED proves to be a reliable method for classifying patients' care needs, especially when used by experienced raters scoring by patient interview. It can be a useful tool in assessing patients' care needs, as well as the level of needed adjustment between general and mental health service delivery. The INTERMED is easily applicable in the clinical setting at low time-costs.

South Central Regional E-911 Service Board, Independent Auditor's Reports, Finacial Statements and Supplementary Information, Schedule of Findings, June 30, 2004

Other Audit Reports - 28E Organizations

El ocio terapéutico y educativo en los centros penitenciarios. Aprenentatge i Servei en el Centre Penitenciari de Lledoners

El Aprendizaje y Servicio (APS) es una propuesta educativa que combina procesos de aprendizaje y de servicio a la comunidad en un solo proyecto. El Aprenentatge i Servei en el Centre Penitenciari de Lledoners nace de la voluntad de estudiantes y docentes de la Facultad de Educación Social y Trabajo Social Pere Tarrés (URL) y del Grupo 33, una Plataforma Ciudadana de Sensibilización y Movilización, formada por más de 7.000 personas de todos los sectores de la sociedad civil, que trabaja para conseguir la reinserción real de las personas privadas de libertad. El proyecto pretende hacer frente al actual modelo de prisiones de Cataluña y promover cambios hacia un modelo rehabilitador.

Assessment and reuse of contents in the competence-based educational platform InterMediActor

This paper describes a failure alert system and a methodology for content reuse in a new instructional design system called InterMediActor (IMA). IMA provides an environment for instructional content design, production and reuse, and for students’ evaluation based in content specification through a hierarchical structure of competences. The student assessment process and information extraction process for content reuse are explained.

The migration towards Digital Terrestrial Television: challenges for public policy and public broadcasters

This paper initially identifies the main transformations of the television system that are caused by digitalization. Its development in several broadcasting platforms is analyzed as well as the particular obstacles and requirements that are detected for each of them. Due to its technical characteristics and its historical link to the public services, the terrestrial network requires migration strategies different from those strictly commercial, and public intervention might be needed. The paper focuses on such migration strategies towards DTT and identifies the main issues for public intervention in the areas of the digital scenario: technology, business and market transformation and the reception field. Moreover, it describes and classifies the challenges that public broadcasters should confront due to digitalization. This paper finally concludes that the leadership of the public broadcasters during the migration towards DTT is an interesting tool for public policy. The need for foster the digitalization of the terrestrial platform and to achieve certain social and public goal besides the market interest brings an opportunity for public institutions and public broadcasters to work together. That leading role could also be positive for the public service to face its necessary redefinition and reallocation within the digital context.

A general definition and nomenclature for alternative splicing events

Understanding the molecular mechanisms responsible for the regulation of the transcriptome present in eukaryotic cells isone of the most challenging tasks in the postgenomic era. In this regard, alternative splicing (AS) is a key phenomenoncontributing to the production of different mature transcripts from the same primary RNA sequence. As a plethora ofdifferent transcript forms is available in databases, a first step to uncover the biology that drives AS is to identify thedifferent types of reflected splicing variation. In this work, we present a general definition of the AS event along with anotation system that involves the relative positions of the splice sites. This nomenclature univocally and dynamically assignsa specific ‘‘AS code’’ to every possible pattern of splicing variation. On the basis of this definition and the correspondingcodes, we have developed a computational tool (AStalavista) that automatically characterizes the complete landscape of ASevents in a given transcript annotation of a genome, thus providing a platform to investigate the transcriptome diversityacross genes, chromosomes, and species. Our analysis reveals that a substantial part—in human more than a quarter—ofthe observed splicing variations are ignored in common classification pipelines. We have used AStalavista to investigate andto compare the AS landscape of different reference annotation sets in human and in other metazoan species and found thatproportions of AS events change substantially depending on the annotation protocol, species-specific attributes, andcoding constraints acting on the transcripts. The AStalavista system therefore provides a general framework to conductspecific studies investigating the occurrence, impact, and regulation of AS.

Alternative Solutions to Meet the Service Needs of Low Volume Bridges in lowa, June 2004

There is a nationwide need for a safe, efficient and cost effective transportation system. An essential component of this system is the bridges. Local agencies perhaps have an even greater task than federal and state agencies in maintaining the low volume road (LVR) bridge system due to lack of sufficient resources and funding. The primary focus of this study was to review the various aspects of off-system bridge design, rehabilitation, and replacement. Specifically, a reference report was developed to address common problems in LVR bridges. The source of information included both Iowa and national agencies. This report is intended to be a “user manual” or “tool box” of information, procedures and choices for county engineers to employ in the management of their bridge inventory plus identify areas and problems that need to be researched

Invisible work, unseen hazards: the health of women immigrant household service workers in Spain

Backgroud: Household service work has been largely absent from occupational health studies. We examine the occupational hazards and health effects identified by immigrant women household service workers. Methods: Exploratory, descriptive study of 46 documented and undocumented immigrant women in household services in Spain, using a phenomenological approach. Data were collected between September 2006 and May 2007 through focus groups and semi-structured individual interviews. Data were separated for analysis by documentation status and sorted using a mixed-generation process. In a second phase of analysis, data on psychosocial hazards were organized using the Copenhagen Psychosocial Questionnaire as a guide. Results: Informants reported a number of environmental, ergonomic and psychosocial hazards and corresponding health effects. Psychosocial hazards were especially strongly present in data. Data on reported hazards were similar by documentation status and varied by several emerging categories: whether participants were primarily cleaners or carers and whether they lived in or outside of the homes of their employers. Documentation status was relevant in terms of empowerment and bargaining, but did not appear to influence work tasks or exposure to hazards directly. Conclusions:Female immigrant household service workers are exposed to a variety of health hazards that could be acted upon by improved legislation, enforcement, and preventive workplace measures, which are discussed.

Iowa Commission on Volunteer Service, Fiscal Year 2005 Annual Report

Annual Report

Smoking, prevalence of disease and health service utilization among the Swiss population.

The data of the 1981-83 Swiss National Health Survey "SOMIPOPS", based on a randomly selected sample of 4,235 individuals aged 20 or over representative of the whole Swiss population, were used to investigate the relation between smoking, prevalence of disease and frequency of health care utilization. The risks of several conditions, including hypertension, myocardial infarction and other heart diseases, asthma, tuberculosis and kidney disease were elevated among ex-smokers. The diseases showing elevated risks among current smokers and significantly positive dose-risk trends included acute bronchitis (relative risk, RR = 3.2 for heavy cigarette smokers vs never smokers), chronic bronchitis or lung emphysema (RR = 2.0), gastro-duodenal ulcer (RR = 1.8) and bone fractures (RR = 1.6). For respiratory conditions, the risk of pipe or cigar smokers was comparable to that of moderate cigarette smokers, whereas for ulcer (RR = 4.1) or fractures (RR = 2.0) the point estimates were even higher than for heavy cigarette smokers. Smokers tended to consult more frequently general practitioners, used more other outpatients services, and were more frequently admitted to hospital during the year preceding the interview. These effects were consistent across strata of age, socio-economic indicators, and persisted after allowance for major identified potential distorting factors. Thus, the results of this survey confirm that smoking is an important cause of morbidity and a major contributory factor to the use of health services.

Platform for Automatic, Normalized Annotation and Cost-Effective Acquisition of Language Resources for Human Language Technologies: PANACEA

El objetivo de PANACEA es engranar diferentes herramientas avanzadas para construir una fábrica de Recursos Lingüísticos (RL), una línea de producción que automatice los pasos implicados en la adquisición, producción, actualización y mantenimiento de los RL que la Traducción Automática y otras tecnologías lingüísticas, necesitan.

Defining the Attributes of Good In-Service Portland Cement Concrete Pavements, December 2004

Much of the current research in portland cement concrete (PCC) pavements deals with the analysis of early pavement life failures and seeks to find ways to prevent those from reoccurring. The Long Term Pavement Performance (LTPP) portion of the Strategic Highway Research Program (SHRP) has identified some of the key factors in designing and building new PCC pavements. This statement will build on the Iowa Highway Research Board (IHRB) project TR-463, Field Performance Study of Past Iowa Pavement Research: A Look Back. In Iowa and across the nation, there are multiple pavements that were built more than 20 years ago that have been and are continuing to provide very good service to the public. They are found on both state and local routes and in both low and high traffic volume areas. There is a need to learn what went into those pavements, from the subgrade through the surface, that makes them perform so well. The purpose of this research project was to conduct a scoping study that could be used to evaluate the need for additional research to study the attributes of well-performing concrete pavements. The concept of zero-maintenance jointed plain concrete pavements” was iterated in this study for long-lasting, well-performing portland cement concrete pavement sections. The scope of the study was limited to a brief literature survey, pavement performance data collection from many counties, cities, and primary and interstate roads in Iowa, field visits to many selected pavement sites, and analysis of the collected data. No laboratory orfield testing was conducted for this phase of the project. A problem statement with a research plan was created that could be used to guide the second phase of the project.

PANACEA (Platform for Automatic, Normalised Annotation and Cost-Effective Acquisition of Language Resources for Human Language Technologies)

The objective of PANACEA is to build a factory of LRs that automates the stages involved in the acquisition, production, updating and maintenance of LRs required by MT systems and by other applications based on language technologies, and simplifies eventual issues regarding intellectual property rights. This automation will cut down the cost, time and human effort significantly. These reductions of costs and time are the only way to guarantee the continuous supply of LRs that MT and other language technologies will be demanding in the multilingual Europe.

Mining and exploiting domain-specific corpora in the PANACEA platform

The objective of the PANACEA ICT-2007.2.2 EU project is to build a platform that automates the stages involved in the acquisition,production, updating and maintenance of the large language resources required by, among others, MT systems. The development of a Corpus Acquisition Component (CAC) for extracting monolingual and bilingual data from the web is one of the most innovative building blocks of PANACEA. The CAC, which is the first stage in the PANACEA pipeline for building Language Resources, adopts an efficient and distributed methodology to crawl for web documents with rich textual content in specific languages and predefined domains. The CAC includes modules that can acquire parallel data from sites with in-domain content available in more than one language. In order to extrinsically evaluate the CAC methodology, we have conducted several experiments that used crawled parallel corpora for the identification and extraction of parallel sentences using sentence alignment. The corpora were then successfully used for domain adaptation of Machine Translation Systems.