Monitorització Trailwalker

La ONG Intermon Oxfam organitza anualment una cursa solidària anomenada "Trailwalker" en la que una sèrie d'equips han de completar un recorregut de 100km en menys de 32h. S'ha dissenyat i implementat una solució de seguiment dels equips en cursa amb la creació d'una aplicació per dispositius Android que realitzen el posicionament a través de GPS o servei d'ubicació de Google, i envien les dades a un servidor central amb programari GIS ArcGIS, el qual s'utilitza per mostrar les dades en un visor HTML que utilitza l'API Javascript del mateix.

Sudden death among young people with first-episode psychosis: an 8-10 year follow-up study.

Individuals with first episode psychosis (FEP) experience high rates of premature mortality, in particular due to suicide. The study aims were to: a) Estimate the rate of sudden death among young people with FEP during an 8-10 year period following commencement of treatment; b) Examine and describe the socio-demographic and clinical characteristics associated with sudden death; and c) Examine the timing of death in relation to psychiatric treatment.This was a cohort study. The sample comprised 661 patients accepted into treatment at the Early Psychosis Prevention and Intervention Centre between 1/1/1998 and 31/12/2000. Demographic and clinical data were collected by examination of the medical files. Mortality data were collected via a search of the National Coroners Information System; the Victorian State Coroner's office and clinical files. Nineteen patients died and just over two thirds of deaths were classified as intentional self-harm or suicide. Death was associated with male gender, previous suicide attempt and greater symptom severity at last contact. People with FEP are at increased risk of premature death, in particular suicide. A previous suicide attempt was very common amongst those who died, suggesting that future research could focus upon the development of interventions for young people with FEP who engage in suicidal behaviour.

Cost effectiveness of a new combined immunosuppressive and antiviral regimen on the one-year follow-up of kidney transplant patients.

Background: Medical prescription after organ transplant must prevent both rejection and infectious complications. We assessed the 1-year effectiveness and cost of introducing a new combined regimen in kidney transplantation. Methods: Patients transplanted from January 2000 to March 2003 (Period 1) were compared to patients transplanted from April 2003 to July 2005 (Period 2). In period 1, patients were treated with Basiliximab, Cyclosporin, steroids and Mycophenolate (MMF) or Azathioprine. Prophylaxis with Valacyclovir was prescribed only in CMV D+/R- patients. In period 2, immunosuppressive drugs were Basiliximab, Tacrolimus, steroids and MMF. A 3-month universal CMV prophylaxis with Valganciclovir was used. Medical charts of outpatient visits allowed identifying drug, laboratory and radiological tests use, and hospital information system causes of hospitalisation and length of stay (LOS) over the first year after transplant. Patients with incomplete costs data were excluded. Results: 53 patients were analysed in period 1, and 60 in period 2. CMV serostatus patterns were not significantly different between the 2 periods. Over 12 months, acute rejection decreased from 22 patients (42%) in period 1 to 4 patients (7%) in period 2 (p<0.001), and CMV infection from 25 patients (47%) to 9 patients (15%, p<0.001). Average total rehospitalisation LOS decreased from 28±19 to 20±11 days (p<0.007). Average outpatient visits decreased from 49±10 to 39±8 (p<0.001). Average immunosuppression and CMV prophylaxis costs increased from US$ 18,362±6,546 to 24,637±5,457 (p<0.001), while average graft rejection costs decreased form US$ 4,135±9,164 to 585±2,850 (p=0.005), and average CMV treatment costs from US$ 2,043±5,545 to 91±293 (p=0.008). Average outpatient visits costs decreased from US$ 7,619±1,549 to 6,074±1,043 (p<0.001), and other hospital costs from US$ 3,801±6,519 to 1,196±3,146 (p=0.007). Altogether, average 1-year treatment costs decreased from US$ 35,961±14,916 to 32,584±6,211 (p=0.115). Cost-effectiveness ratios to avoid graft rejection and CMV infection decreased from US$ 61,482±9,292 to 34,911± 1,639 (p=0.006) and US$ 68,070±11,122 to 39,899±2,650 (p=0.015), respectively. Conclusion: The new combined regimen administered in period 2 was significantly more effective. Its additional cost was more than offset by savings linked with complications avoidance.

Systematic Identification of High Crash Locations Final Report, 2001

Federal and state policy makers increasingly emphasize the need to reduce highway crash rates. This emphasis is demonstrated in Iowa’s recently released draft Iowa Strategic Highway Safety Plan and by the U.S. Department of Transportation’s placement of “improved transportation safety” at the top of its list of strategic goals. Thus, finding improved methods to enhance highway safety has become a top priority at highway agencies. The objective of this project is to develop tools and procedures by which Iowa engineers can identify potentially hazardous roadway locations and designs, and to demonstrate the utility of these tools by developing candidate lists of high crash locations in the State. An initial task, building an integrated database to facilitate the tools and procedures, is an important product, in and of itself. Accordingly, the Iowa Department of Transportation (Iowa DOT) Geographic Information Management System (GIMS) and Geographic Information System Accident Analysis and Location System (GIS-ALAS) databases were integrated with available digital imagery. (The GIMS database contains roadway characteristics, e.g., lane width, surface and shoulder type, and traffic volume, for all public roadways. GIS-ALAS records include data, e.g., vehicles, drivers, roadway conditions, and the crash severity, for crashes occurring on public roadways during then past 10 years.)

Predictors of favorable results in pulmonary tuberculosis treatment (Recife, Pernambuco, Brazil, 2001-2004)

Based on data available in the Information System for Notifiable Diseases, predictive factors of favorable results were identified in the treatment of pulmonary tuberculosis, diagnosed between 2001 and 2004 and living in Recife-PE, Brazil. Uni- and multivariate logistic regression methods were used. In multivariate analysis, the following factors remained: Age (years), 0 to 9 (OR=4.27; p=0.001) and 10 to 19 (OR=1.78; p=0.011), greater chance of cure than over 60; Education (years), 8 to 11 (OR=1.52; p=0.049), greater chance of cure than no education; Type of entry, new cases (OR=3.31; p<0.001) and relapse (OR=3.32; p<0.001), greater chances of cure than restart after abandonment; Time (months) 2, 5-|6 (OR=9.15; p<0.001); 6-|9 (OR=27.28; p<0.001) and More than 9 (OR=24.78; p<0.001), greater chances of cure than less than 5; Health Unit District, DS I (OR=1.60; p=0.018) and DS IV (OR=2.87; p<0.001), greater chances of cure than DS VI.

Global alcohol exposure estimates by country, territory and region for 2005--a contribution to the Comparative Risk Assessment for the 2010 Global Burden of Disease Study.

AIMS: This study aimed to estimate the prevalence of life-time abstainers, former drinkers and current drinkers, adult per-capita consumption of alcohol and pattern of drinking scores, by country and Global Burden of Disease region for 2005, and to forecast these indicators for 2010. DESIGN: Statistical modelling based on survey data and routine statistics. SETTING AND PARTICIPANTS: A total of 241 countries and territories. MEASUREMENTS: Per-capita consumption data were obtained with the help of the World Health Organization's Global Information System on Alcohol and Health. Drinking status data were obtained from Gender, Alcohol and Culture: An International Study, the STEPwise approach to Surveillance study, the World Health Survey/Multi-Country Study and other surveys. Consumption and drinking status data were triangulated to estimate alcohol consumption across multiple categories. FINDINGS: In 2005 adult per-capita annual consumption of alcohol was 6.1 litres, with 1.7 litres stemming from unrecorded consumption; 17.1 litres of alcohol were consumed per drinker, 45.8% of all adults were life-time abstainers, 13.6% were former drinkers and 40.6% were current drinkers. Life-time abstention was most prevalent in North Africa/Middle East and South Asia. Eastern Europe and Southern sub-Saharan Africa had the most detrimental pattern of drinking scores, while drinkers in Europe (Eastern and Central) and sub-Saharan Africa (Southern and West) consumed the most alcohol. CONCLUSIONS: Just over 40% of the world's adult population consumes alcohol and the average consumption per drinker is 17.1 litres per year. However, the prevalence of abstention, level of alcohol consumption and patterns of drinking vary widely across regions of the world.

Association between GIS-based exposure to urban air pollution during pregnancy and birth weight in the INMA Sabadell Cohort

Background: There is growing evidence that traffic-related air pollution reduces birth weight. Improving exposure assessment is a key issue to advance in this research area.Objective: We investigated the effect of prenatal exposure to traffic-related air pollution via geographic information system (GIS) models on birth weight in 570 newborns from the INMA (Environment and Childhood) Sabadell cohort.Methods: We estimated pregnancy and trimester-specific exposures to nitrogen dioxide and aromatic hydrocarbons [benzene, toluene, ethylbenzene, m/p-xylene, and o-xylene (BTEX)] by using temporally adjusted land-use regression (LUR) models. We built models for NO2 and BTEX using four and three 1-week measurement campaigns, respectively, at 57 locations. We assessed the relationship between prenatal air pollution exposure and birth weight with linear regression models. We performed sensitivity analyses considering time spent at home and time spent in nonresidential outdoor environments during pregnancy.Results: In the overall cohort, neither NO2 nor BTEX exposure was significantly associated with birth weight in any of the exposure periods. When considering only women who spent < 2 hr/day in nonresidential outdoor environments, the estimated reductions in birth weight associated with an interquartile range increase in BTEX exposure levels were 77 g [95% confidence interval (CI), 7–146 g] and 102 g (95% CI, 28–176 g) for exposures during the whole pregnancy and the second trimester, respectively. The effects of NO2 exposure were less clear in this subset.Conclusions: The association of BTEX with reduced birth weight underscores the negative role of vehicle exhaust pollutants in reproductive health. Time–activity patterns during pregnancy complement GIS-based models in exposure assessment.

Executive Order Number SixA, September 1971

Establish Traffic Records and Criminal Justice Information System. (TRACIS)

Maternal mortality from hemorrhage in the State of Santa Catarina, Brazil

Hemorrhage represents a set of causes that focuses on women during the pregnancy and puerperal period, and that, with improper attention, results in death. The authors aimed to analyze maternal deaths related to hemorrhage that occurred in the state of Santa Catarina, Brazil. The data were obtained from the Mortality Information System and Live Births Information System from the Brazilian Ministry of Health. This was a descriptive study, in which 491 maternal deaths that occurred in the period 1997-2010 were analyzed. Of these, 61 were related to hemorrhage, corresponding to 12.42%; postpartum hemorrhage was the most prevalent cause, with 26 deaths, followed by placental abruption with 15, representing 67.21% of the cases. The maternal mortality from hemorrhage is a public health problem in the state of Santa Catarina, due to its high prevalence and the fact that its underlying causes are preventable.

Sistema de Gestão de Informação Portuária

Nos portos marítimos interactuam um conjunto de entidades independentes com missões e objectivos diferentes resultando em troca de muita informação que pode numa transacção económica internacional envolver para cima de dezenas de agentes e centenas de comunicações via papel, telefone ou fax. Torna-se cada vez mais evidente, que a gestão das transferências de informação pelos métodos tradicionais (em papel) não se compadece com as exigências actuais do comércio internacional marcado pela globalização, onde se exige dos portos um maior nível de competitividade. Neste contexto, o recurso às tecnologias de informação e comunicação tem-se revelado uma boa opção para a potenciação do negócio portuário através da minimização do tempo de espera dos navios e de erros humanos durante as operações portuárias, de redução do custo de passagem das mercadorias, da integração dos sistemas de informação da comunidade portuária etc. O presente trabalho pretende apresentar um modelo de Sistema de Gestão de Informação Portuária (SGIP) para os portos de Cabo Verde, constituído pelos módulos: Sistema de Gestão de Escalas de Navio no Porto (SGENP), Sistema de Seguimento de Contentor no Porto (SSCP) e Sistema de Seguimento de Mercadoria no Porto (SSMP). Além disso propõe padrões (normas) de interacção entre Sistemas de informação (SI) existentes no porto e regras de acesso via Web. Os requisitos do SGIP foram identificados a partir da análise do sistema portuário existente PMIS (Port Management Information System), do estudo dos SI utilizados nos portos internacionais nomeadamente nos portos de Marselha, Valência e Leixões e da análise dos processos relativos ao navio, mercadoria e contentores nos portos de Cabo Verde. Este trabalho permitiu identificar um conjunto de insuficiências no sistema PMIS que urge colmatar e relativamente aos SI de portos internacionais identificou algumas boas práticas na gestão da informação portuária que foram aproveitadas no novo sistema. Dada a amplitude do tema da tese, o trabalho apresenta apenas o protótipo exploratório do Sistema de Seguimento de Contentor no Porto (SSCP) sendo certo que esta estrutura servirá de base aos protótipos dos outros módulos a serem realizados fora do âmbito desta tese.

Iowa TOPSpro Data Dictionary, 2007

The purpose of the Iowa TOPSpro Data Dictionary is to provide a statewide-standardized set of instructions and definitions for coding Tracking Of Programs And Students (TOPSpro) forms and effectively utilizing the TOPSpro software. This document is designed to serve as a companion document to the TOPS Technical Manual produced by the Comprehensive Adult Student Assessment System (CASAS). The data dictionary integrates information from various data systems to provide uniform data sets and definitions that meet local, state and federal reporting mandates. The sources for the data dictionary are: (1) the National Reporting System (NRS) Guidelines, (2) standard practices utilized in Iowa’s adult literacy program, (3) selected definitions from the Workforce Investment Act of 1998, (4) input from the state level Management Information System (MIS) personnel, and (5) selected definitions from other Iowa state agencies.

Neonatal mortality in infants with low birth weigh

Objective To evaluate the factors associated with neonatal mortality in infant born with low birth weight. Method Cross-sectional study that analyzed data from 771 live births with low birth weight (<2500 g) in the city of Cuiabá, MT, in 2010, of whom 54 died in the neonatal period. We obtained data from the Information System on Live Births and Mortality, by integrated linkage. Results In multiple logistic regression, neonatal mortality was associated with: number of prenatal visits less than 7 (OR=3.80;CI:1,66-8,70); gestational age less than 37 weeks (OR=4.77;CI:1.48-15.38), Apgar score less than 7 at the 1st minute (OR=4.25;CI:1.84-9.81) and the 5th minute (OR=5.72,CI:2.24-14.60) and presence of congenital anomaly (OR=14.39;IC:2.72-76.09). Conclusion Neonatal mortality in infants with low birth weight is associated with avoidable factors through adequate attention to prenatal care, childbirth and infants.


Social determinants of hospitalizations for ambulatory care sensitive conditions in Guarulhos, São Paulo

The study goals present an overview of Hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) in Guarulhos, SP, from 2008 to 2012. This is an ecological study based on secondary data obtained from the Brazilian Hospital Information System, and supported by the Praxical Theory of Intervention of Collective Health Nursing. Applied descriptive statistics for analysis. It was observed that Guarulhos shows an upward trend in hospitalizations by ACSC (20% increase), the most frequent causes of heart failure (11.8%), cerebrovascular disease (10.6%) and angina (9.7%), most frequently in the age group ≥ 65years old, for both sexes. The results are similar to other Brazilian studies, but their analysis should extrapolate the biological limits and the supply of healthcare resources, focusing on the social determinants of the health-disease process.




Hospital admissions due to ambulatory care sensitive conditions among children by age group and health region

OBJECTIVE to describe hospital admissions for ambulatory care sensitive conditions in children under five years of age in the State of Paraná, Brazil by condition type, age group and health region. METHOD a temporal ecological study was conducted using data from the Unified Health System Hospital Information System for the period 2000 to 2011. Conditions were grouped in accordance with the list of ambulatory care sensitive conditions in Brazil. RESULTS there was an increase in the rate of admissions for ambulatory care sensitive conditions in all age groups in 50% of the health regions, with a marked increase in children under the age of one. Pneumonia, gastroenteritis and asthma were the main causes of admissions. There was an increase in the proportion of overall admissions accounted for by pneumonia and gastroenteritis. CONCLUSION the increase in admissions reveals the need for actions to improve access to primary healthcare and provide effective treatment of the main ambulatory care sensitive conditions in order to prevent hospital admissions among children.

Clinical characteristics and outcome of patients admitted to a medico-surgical ICU requiring non invasive ventilation (NIV) for hypercapnic respiratory failure

Introduction: Because it decreases intubation rate and mortality, NIV has become first-line treatment in case of hypercapnic respiratory failure (HRF). Whether this approach is equally successful for all categories of HRF patients is however debated. We assessed if any clinical characteristics of HRF patients were associated with NIV intensity, success, and outcome, in order to identify prognostic factors. Methods: Retrospective analysis of the clinical database (clinical information system and MDSi) of patients consecutively admitted to our medico-surgical ICU, presenting with HRF (defined as PaCO2 >50 mm Hg), and receiving NIV between January 2009 and December 2010. Demographic data, medical diagnoses (including documented chronic lung disease), reason for ICU hospitalization, recent surgical interventions, SAPS II and McCabe scores were extracted from the database. Total duration of NIV and the need for tracheal intubation during the 5 days following the first hypercapnia documentation, as well as ICU and hospital mortality were recorded. Results are reported as median [IQR]. Comparisons with Chi2 or Kruskal-Wallis tests, p <0.05 (*). Results: 164 patients were included, 45 (27.4%) of whom were intubated after 10 [2-34] hours, after having received 7 [2-19] hours of NIV. NIV successful patients received 15 [5-22] hours of NIV for up to 5 days. Intubation was correlated with increased ICU (20% vs. 3%, p <0.001) and hospital (46.7% vs. 30.2, p >0.05) mortality. Conclusions: A majority of patients requiring NIV for hypercapnic respiratory failure in our ICU have no diagnosed chronic pulmonary disease. These patients tend to have increased ICUand hospital mortality. The majority of patients were non-surgical, a feature correlated with increased hospital mortality. Beside usual predictors of severity such as age and SAPS II, absence of diagnosed chronic pulmonary disease and non-operative state appear to be associated with increased mortality. Further studies should explore whether these patients are indeed more prone to an adverse outcome and which therapeutic strategies might contribute to alter this course.