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.

How Does the Denver Public Library System Respond to its Customer's Requests for Global Information?

The interaction between globally available information and public library users is a changing one. Global information is readily available yet provider and user struggle to find efficiencies of time and resources. As a primary resource of global information the Denver Public Library (DPL) is approaching this challenge by providing changing technology to a changing user and by providing a customized approach to immigrant populations. DPL provides global information to library users through collections, programs and Internet. Internet and collections global information usage cannot be directly measured due to privacy restrictions. Only 12.5% of general user programs focus on global information. Four percent of budget serves the immigrant users. This is greater than national averages.

Web-based public participatory GIS

Decision support systems (DSS) have evolved rapidly during the last decade from stand alone or limited networked solutions to online participatory solutions. One of the major enablers of this change is the fastest growing areas of geographical information system (GIS) technology development that relates to the use of the Internet as a means to access, display, and analyze geospatial data remotely. World-wide many federal, state, and particularly local governments are designing to facilitate data sharing using interactive Internet map servers. This new generation DSS or planning support systems (PSS), interactive Internet map server, is the solution for delivering dynamic maps and GIS data and services via the world-wide Web, and providing public participatory GIS (PPGIS) opportunities to a wider community (Carver, 2001; Jankowski & Nyerges, 2001). It provides a highly scalable framework for GIS Web publishing, Web-based public participatory GIS (WPPGIS), which meets the needs of corporate intranets and demands of worldwide Internet access (Craig, 2002). The establishment of WPPGIS provides spatial data access through a support centre or a GIS portal to facilitate efficient access to and sharing of related geospatial data (Yigitcanlar, Baum, & Stimson, 2003). As more and more public and private entities adopt WPPGIS technology, the importance and complexity of facilitating geospatial data sharing is growing rapidly (Carver, 2003). Therefore, this article focuses on the online public participation dimension of the GIS technology. The article provides an overview of recent literature on GIS and WPPGIS, and includes a discussion on the potential use of these technologies in providing a democratic platform for the public in decision-making.

Rethinking health planning : a framework for organising information to underpin collaborative health planning

The field of collaborative health planning faces significant challenges created by the narrow focus of the available information, the absence of a framework to organise that information and the lack of systems to make information accessible and guide decision-making. These challenges have been magnified by the rise of the ‘healthy communities movement’, as a result of which, there have been more frequent calls for localised, collaborative and evidence-driven health related decision-making. This paper discusses the role of decision support systems as a mechanism to facilitate collaborative health decision-making. The paper presents a potential information management framework to underpin a health decision support system and describes the participatory process that is currently being used to create an online tool for health planners using geographic information systems. The need for a comprehensive information management framework to guide the process of planning for healthy communities has been emphasised. The paper also underlines the critical importance of the proposed framework not only in forcing planners to engage with the entire range of health determinants, but also in providing sufficient flexibility to allow exploration of the local setting-based determinants of health.

Thinking spatially, acting collaboratively : a GIS-based health decision support system for improving the collaborative health-planning practice

The field of collaborative health planning faces significant challenges due to the lack of effective information, systems and the absence of a framework to make informed decisions. These challenges have been magnified by the rise of the healthy cities movement, consequently, there have been more frequent calls for localised, collaborative and evidence-driven decision-making. Some studies in the past have reported that the use of decision support systems (DSS) for planning healthy cities may lead to: increase collaboration between stakeholders and the general public, improve the accuracy and quality of the decision-making processes and improve the availability of data and information for health decision-makers. These links have not yet been fully tested and only a handful of studies have evaluated the impact of DSS on stakeholders, policy-makers and health planners. This study suggests a framework for developing healthy cities and introduces an online Geographic Information Systems (GIS)-based DSS for improving the collaborative health planning. It also presents preliminary findings of an ongoing case study conducted in the Logan-Beaudesert region of Queensland, Australia. These findings highlight the perceptions of decision-making prior to the implementation of the DSS intervention. Further, the findings help us to understand the potential role of the DSS to improve collaborative health planning practice.

Online environmental information systems

In today’s information society, electronic tools, such as computer networks for the rapid transfer of data and composite databases for information storage and management, are critical in ensuring effective environmental management. In particular environmental policies and programs for federal, state, and local governments need a large volume of up-to-date information on the quality of water, air, and soil in order to conserve and protect natural resources and to carry out meteorology. In line with this, the utilization of information and communication technologies (ICTs) is crucial to preserve and improve the quality of life. In handling tasks in the field of environmental protection a range of environmental and technical information is often required for a complex and mutual decision making in a multidisciplinary team environment. In this regard e-government provides a foundation of the transformative ICT initiative which can lead to better environmental governance, better services, and increased public participation in environmental decision- making process.

An efficient public key management system : an application in vehicular ad hoc networks

The major purpose of Vehicular Ad Hoc Networks (VANETs) is to provide safety-related message access for motorists to react or make a life-critical decision for road safety enhancement. Accessing safety-related information through the use of VANET communications, therefore, must be protected, as motorists may make critical decisions in response to emergency situations in VANETs. If introducing security services into VANETs causes considerable transmission latency or processing delays, this would defeat the purpose of using VANETs to improve road safety. Current research in secure messaging for VANETs appears to focus on employing certificate-based Public Key Cryptosystem (PKC) to support security. The security overhead of such a scheme, however, creates a transmission delay and introduces a time-consuming verification process to VANET communications. This paper proposes an efficient public key management system for VANETs: the Public Key Registry (PKR) system. Not only does this paper demonstrate that the proposed PKR system can maintain security, but it also asserts that it can improve overall performance and scalability at a lower cost, compared to the certificate-based PKC scheme. It is believed that the proposed PKR system will create a new dimension to the key management and verification services for VANETs.

Developing a framework for planning healthy communities : the Logan Beaudesert health decision support system

In the last few decades, the focus on building healthy communities has grown significantly (Ashton, 2009). There is growing evidence that new approaches to planning are required to address the challenges faced by contemporary communities. These approaches need to be based on timely access to local information and collaborative planning processes (Murray, 2006; Scotch & Parmanto, 2006; Ashton, 2009; Kazda et al., 2009). However, there is little research to inform the methods that can support this type of responsive, local, collaborative and consultative health planning (Northridge et al., 2003). Some research justifies the use of decision support systems (DSS) as a tool to support planning for healthy communities. DSS have been found to increase collaboration between stakeholders and communities, improve the accuracy and quality of the decision-making process, and improve the availability of data and information for health decision-makers (Nobre et al., 1997; Cromley & McLafferty, 2002; Waring et al., 2005). Geographic information systems (GIS) have been suggested as an innovative method by which to implement DSS because they promote new ways of thinking about evidence and facilitate a broader understanding of communities. Furthermore, literature has indicated that online environments can have a positive impact on decision-making by enabling access to information by a broader audience (Kingston et al., 2001). However, only limited research has examined the implementation and impact of online DSS in the health planning field. Previous studies have emphasised the lack of effective information management systems and an absence of frameworks to guide the way in which information is used to promote informed decisions in health planning. It has become imperative to develop innovative approaches, frameworks and methods to support health planning. Thus, to address these identified gaps in the knowledge, this study aims to develop a conceptual planning framework for creating healthy communities and examine the impact of DSS in the Logan Beaudesert area. Specifically, the study aims to identify the key elements and domains of information that are needed to develop healthy communities, to develop a conceptual planning framework for creating healthy communities, to collaboratively develop and implement an online GIS-based Health DSS (i.e., HDSS), and to examine the impact of the HDSS on local decision-making processes. The study is based on a real-world case study of a community-based initiative that was established to improve public health outcomes and promote new ways of addressing chronic disease. The study involved the development of an online GIS-based health decision support system (HDSS), which was applied in the Logan Beaudesert region of Queensland, Australia. A planning framework was developed to account for the way in which information could be organised to contribute to a healthy community. The decision support system was developed within a unique settings-based initiative Logan Beaudesert Health Coalition (LBHC) designed to plan and improve the health capacity of Logan Beaudesert area in Queensland, Australia. This setting provided a suitable platform to apply a participatory research design to the development and implementation of the HDSS. Therefore, the HDSS was a pilot study examined the impact of this collaborative process, and the subsequent implementation of the HDSS on the way decision-making was perceived across the LBHC. As for the method, based on a systematic literature review, a comprehensive planning framework for creating healthy communities has been developed. This was followed by using a mixed method design, data were collected through both qualitative and quantitative methods. Specifically, data were collected by adopting a participatory action research (PAR) approach (i.e., PAR intervention) that informed the development and conceptualisation of the HDSS. A pre- and post-design was then used to determine the impact of the HDSS on decision-making. The findings of this study revealed a meaningful framework for organising information to guide planning for healthy communities. This conceptual framework provided a comprehensive system within which to organise existing data. The PAR process was useful in engaging stakeholders and decision-making in the development and implementation of the online GIS-based DSS. Through three PAR cycles, this study resulted in heightened awareness of online GIS-based DSS and openness to its implementation. It resulted in the development of a tailored system (i.e., HDSS) that addressed the local information and planning needs of the LBHC. In addition, the implementation of the DSS resulted in improved decision- making and greater satisfaction with decisions within the LBHC. For example, the study illustrated the culture in which decisions were made before and after the PAR intervention and what improvements have been observed after the application of the HDSS. In general, the findings indicated that decision-making processes are not merely informed (consequent of using the HDSS tool), but they also enhance the overall sense of ‗collaboration‘ in the health planning practice. For example, it was found that PAR intervention had a positive impact on the way decisions were made. The study revealed important features of the HDSS development and implementation process that will contribute to future research. Thus, the overall findings suggest that the HDSS is an effective tool, which would play an important role in the future for significantly improving the health planning practice.

Implementing an enhanced repository statistics system for QUT ePrints

Queensland University of Technology (QUT) was one of the first universities in Australia to establish an institutional repository. Launched in November 2003, the repository (QUT ePrints) uses the EPrints open source repository software (from Southampton) and has enjoyed the benefit of an institutional deposit mandate since January 2004. Currently (April 2012), the repository holds over 36,000 records, including 17,909 open access publications with another 2,434 publications embargoed but with mediated access enabled via the ‘Request a copy’ button which is a feature of the EPrints software. At QUT, the repository is managed by the library.QUT ePrints (http://eprints.qut.edu.au) The repository is embedded into a number of other systems at QUT including the staff profile system and the University’s research information system. It has also been integrated into a number of critical processes related to Government reporting and research assessment. Internally, senior research administrators often look to the repository for information to assist with decision-making and planning. While some statistics could be drawn from the advanced search feature and the existing download statistics feature, they were rarely at the level of granularity or aggregation required. Getting the information from the ‘back end’ of the repository was very time-consuming for the Library staff. In 2011, the Library funded a project to enhance the range of statistics which would be available from the public interface of QUT ePrints. The repository team conducted a series of focus groups and individual interviews to identify and prioritise functionality requirements for a new statistics ‘dashboard’. The participants included a mix research administrators, early career researchers and senior researchers. The repository team identified a number of business criteria (eg extensible, support available, skills required etc) and then gave each a weighting. After considering all the known options available, five software packages (IRStats, ePrintsStats, AWStats, BIRT and Google Urchin/Analytics) were thoroughly evaluated against a list of 69 criteria to determine which would be most suitable. The evaluation revealed that IRStats was the best fit for our requirements. It was deemed capable of meeting 21 out of the 31 high priority criteria. Consequently, IRStats was implemented as the basis for QUT ePrints’ new statistics dashboards which were launched in Open Access Week, October 2011. Statistics dashboards are now available at four levels; whole-of-repository level, organisational unit level, individual author level and individual item level. The data available includes, cumulative total deposits, time series deposits, deposits by item type, % fulltexts, % open access, cumulative downloads, time series downloads, downloads by item type, author ranking, paper ranking (by downloads), downloader geographic location, domains, internal v external downloads, citation data (from Scopus and Web of Science), most popular search terms, non-search referring websites. The data is displayed in charts, maps and table format. The new statistics dashboards are a great success. Feedback received from staff and students has been very positive. Individual researchers have said that they have found the information to be very useful when compiling a track record. It is now very easy for senior administrators (including the Deputy Vice Chancellor-Research) to compare the full-text deposit rates (i.e. mandate compliance rates) across organisational units. This has led to increased ‘encouragement’ from Heads of School and Deans in relation to the provision of full-text versions.

Integration of numerical models in geographic databases: the case of Sado estuary management

Geographic information systems (GIS) are now widely applied in coastal resource management. Their ability to organise and interface information from a large range of public and private data sources, and their ability to combine this information, using management criteria, to develop a comprehensive picture of the system explains the success of GIS in this area. The use of numerical models as a tool to improve coastal management is also widespread. Less usual is a GIS-based management to ol implementing a comprehensive management model and integrating a numerical modelling system into itself. In this paper such a methodology is proposed. A GIS-based management tool based on the DPSIR model is presented. An overview of the MOHID numerical modelling system is given and the method of integrating this model in the management tool is described. This system is applied to the Sado Estuary (Portugal). Some preliminary results of the integration are presented, demonstrating the capabilities of the management system.

Comparison Of Demand Pattern Calibration In Water Distribution Networks With Geographic And Non-Geographic Parameterization

Demands are one of the most uncertain parameters in a water distribution network model. A good calibration of the model demands leads to better solutions when using the model for any purpose. A demand pattern calibration methodology that uses a priori information has been developed for calibrating the behaviour of demand groups. Generally, the behaviours of demands in cities are mixed all over the network, contrary to smaller villages where demands are clearly sectorised in residential neighbourhoods, commercial zones and industrial sectors. Demand pattern calibration has a final use for leakage detection and isolation. Detecting a leakage in a pattern that covers nodes spread all over the network makes the isolation unfeasible. Besides, demands in the same zone may be more similar due to the common pressure of the area rather than for the type of contract. For this reason, the demand pattern calibration methodology is applied to a real network with synthetic non-geographic demands for calibrating geographic demand patterns. The results are compared with a previous work where the calibrated patterns were also non-geographic.

Digital proficiency and digital inclusion: Comparison between students of computer science, public relations and engineering

New information and communication technologies may be useful for providing more in-depth knowledge to students in many ways, whether through online multimedia educational material, or through online debates with colleagues, teachers and other area professionals in a synchronous or asynchronous manner. This paper focuses on participation in online discussion in e-learning courses for promoting learning. Although an important theoretical aspect, an analysis of literature reveals there are few studies evaluating the personal and social aspects of online course users in a quantitative manner. This paper aims to introduce a method for diagnosing inclusion and digital proficiency and other personal aspects of the student through a case study comparing Information System, Public Relations and Engineering students at a public university in Brazil. Statistical analysis and analysis of variances (ANOVA) were used as the methodology for data analysis in order to understand existing relations between the components of the proposed method. The survey methodology was also used, in its online format, as a research instrument. The method is based on using online questionnaires that diagnose digital proficiency and time management, level of extroversion and social skills of the students. According to the sample studied, there is no strong correlation between digital proficiency and individual characteristics tied to the use of time, level of extroversion and social skills of students. The differences in course grades for some components are partly due to subject 'Introduction to Economics' being offered to freshmen in Public Relations, whereas subject 'Economics in Engineering' is offered in the final semesters of Engineering and Information Systems courses. Therefore, the difference could be more tied to the respondent's age than to the course. Information Systems students were observed to be older, with access to computers and Internet at the workplace, compared to the other students who access the Internet more often from home. This paper presents a pilot study aimed at conducting a diagnosis that permits proposing actions for information and communication technology to contribute towards student education. Three levels of digital inclusion are described as a scale to measure whether information technology increases personal performance and professional knowledge and skills. This study may be useful for other readers interested in themes related to education in engineering. © 2013 IEEE.

Sudden Cardiac Death in Brazil: Study Based on Physicians' Perceptions of the Public Health Care System

Background: There are no available statistical data about sudden cardiac death in Brazil. Therefore, this study has been conducted to evaluate the incidence of sudden cardiac death in our population and its implications. Methods: The research methodology was based on Thurstone's Law of Comparative Judgment, whose premise is that the more an A stimulus differs from a B stimulus, the greater will be the number of people who will perceive this difference. This technique allows an estimation of actual occurrences from subjective perceptions, when compared to official statistics. Data were collected through telephone interviews conducted with Primary and Secondary Care physicians of the Public Health Service in the Metropolitan Area of Sao Paulo (MASP). Results: In the period from October 19, 2009, to October 28, 2009, 196 interviews were conducted. The incidence of 21,270 cases of sudden cardiac death per year was estimated by linear regression analysis of the physicians responses and data from the Mortality Information System of the Brazilian Ministry of Health, with the following correlation and determination coefficients: r = 0.98 and r2= 0.95 (95% confidence interval 0.81.0, P < 0.05). The lack of waiting list for specialized care and socioadministrative problems were considered the main barriers to tertiary care access. Conclusions: The incidence of sudden cardiac death in the MASP is high, and it was estimated as being higher than all other causes of deaths; the extrapolation technique based on the physicians perceptions was validated; and the most important bureaucratic barriers to patient referral to tertiary care have been identified. (PACE 2012; 35:13261331)

The computer aided system for planning efficient routes. Final report.

Indiana Department of Transportation, Indianapolis

Evaluation of public information countermeasures. Analytic study number 7.

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