Cost analysis of opt-in consent procedures for the Texas statewide immunization information system, ImmTrac

Background. Childhood immunization programs have dramatically reduced the morbidity and mortality associated with vaccine-preventable diseases. Proper documentation of immunizations that have been administered is essential to prevent duplicate immunization of children. To help improve documentation, immunization information systems (IISs) have been developed. IISs are comprehensive repositories of immunization information for children residing within a geographic region. The two models for participation in an IIS are voluntary inclusion, or "opt-in," and voluntary exclusion, or "opt-out." In an opt-in system, consent must be obtained for each participant, conversely, in an opt-out IIS, all children are included unless procedures to exclude the child are completed. Consent requirements for participation vary by state; the Texas IIS, ImmTrac, is an opt-in system.^ Objectives. The specific objectives are to: (1) Evaluate the variance among the time and costs associated with collecting ImmTrac consent at public and private birthing hospitals in the Greater Houston area; (2) Estimate the total costs associated with collecting ImmTrac consent at selected public and private birthing hospitals in the Greater Houston area; (3) Describe the alternative opt-out process for collecting ImmTrac consent at birth and discuss the associated cost savings relative to an opt-in system.^ Methods. Existing time-motion studies (n=281) conducted between October, 2006 and August, 2007 at 8 birthing hospitals in the Greater Houston area were used to assess the time and costs associated with obtaining ImmTrac consent at birth. All data analyzed are deidentified and contain no personal information. Variations in time and costs at each location were assessed and total costs per child and costs per year were estimated. The cost of an alternative opt-out system was also calculated.^ Results. The median time required by birth registrars to complete consent procedures varied from 72-285 seconds per child. The annual costs associated with obtaining consent for 388,285 newborns in ImmTrac's opt-in consent process were estimated at $702,000. The corresponding costs of the proposed opt-out system were estimated to total $194,000 per year. ^ Conclusions. Substantial variation in the time and costs associated with completion of ImmTrac consent procedures were observed. Changing to an opt-out system for participation could represent significant cost savings. ^

Using small area estimation and geographic information systems technology to target health services for the uninsured

The three articles that comprise this dissertation describe how small area estimation and geographic information systems (GIS) technologies can be integrated to provide useful information about the number of uninsured and where they are located. Comprehensive data about the numbers and characteristics of the uninsured are typically only available from surveys. Utilization and administrative data are poor proxies from which to develop this information. Those who cannot access services are unlikely to be fully captured, either by health care provider utilization data or by state and local administrative data. In the absence of direct measures, a well-developed estimation of the local uninsured count or rate can prove valuable when assessing the unmet health service needs of this population. However, the fact that these are “estimates” increases the chances that results will be rejected or, at best, treated with suspicion. The visual impact and spatial analysis capabilities afforded by geographic information systems (GIS) technology can strengthen the likelihood of acceptance of area estimates by those most likely to benefit from the information, including health planners and policy makers. ^ The first article describes how uninsured estimates are currently being performed in the Houston metropolitan region. It details the synthetic model used to calculate numbers and percentages of uninsured, and how the resulting estimates are integrated into a GIS. The second article compares the estimation method of the first article with one currently used by the Texas State Data Center to estimate numbers of uninsured for all Texas counties. Estimates are developed for census tracts in Harris County, using both models with the same data sets. The results are statistically compared. The third article describes a new, revised synthetic method that is being tested to provide uninsured estimates at sub-county levels for eight counties in the Houston metropolitan area. It is being designed to replicate the same categorical results provided by a current U.S. Census Bureau estimation method. The estimates calculated by this revised model are compared to the most recent U.S. Census Bureau estimates, using the same areas and population categories. ^

Correlation of tuberculosis and human immunodeficiency virus in Harris County, Texas from 2009 through 2010 using Geographic Information Systems

A population based ecological study was conducted to identify areas with a high number of TB and HIV new diagnoses in Harris County, Texas from 2009 through 2010 by applying Geographic Information Systems to determine whether distinguished spatial patterns exist at the census tract level through the use of exploratory mapping. As of 2010, Texas has the fourth highest occurrence of new diagnoses of HIV/AIDS and TB.[31] The Texas Department of State Health Services (DSHS) has identified HIV infected persons as a high risk population for TB in Harris County.[29] In order to explore this relationship further, GIS was utilized to identify spatial trends. ^ The specific aims were to map TB and HIV new diagnoses rates and spatially identify hotspots and high value clusters at the census tract level. The potential association between HIV and TB was analyzed using spatial autocorrelation and linear regression analysis. The spatial statistics used were ArcGIS 9.3 Hotspot Analysis and Cluster and Outlier Analysis. Spatial autocorrelation was determined through Global Moran's I and linear regression analysis. ^ Hotspots and clusters of TB and HIV are located within the same spatial areas of Harris County. The areas with high value clusters and hotspots for each infection are located within the central downtown area of the city of Houston. There is an additional hotspot area of TB located directly north of I-10 and a hotspot area of HIV northeast of Interstate 610. ^ The Moran's I Index of 0.17 (Z score = 3.6 standard deviations, p-value = 0.01) suggests that TB is statistically clustered with a less than 1% chance that this pattern is due to random chance. However, there were a high number of features with no neighbors which may invalidate the statistical properties of the test. Linear regression analysis indicated that HIV new diagnoses rates (β=−0.006, SE=0.147, p=0.970) and census tracts (β=0.000, SE=0.000, p=0.866) were not significant predictors of TB new diagnoses rates. ^ Mapping products indicate that census tracts with overlapping hotspots and high value clusters of TB and HIV should be a targeted focus for prevention efforts, most particularly within central Harris County. While the statistical association was not confirmed, evidence suggests that there is a relationship between HIV and TB within this two year period.^

Integration of temporal and semantic components into the Geographic Information. Part II: Methodology

The overall objective of this research project is to enrich geographic data with temporal and semantic components in order to significantly improve spatio-temporal analysis of geographic phenomena. To achieve this goal, we intend to establish and incorporate three new layers (structures) into the core of the Geographic Information by using mark-up languages as well as defining a set of methods and tools for enriching the system to make it able to retrieve and exploit such layers (semantic-temporal, geosemantic, and incremental spatio-temporal). Besides these layers, we also propose a set of models (temporal and spatial) and two semantic engines that make the most of the enriched geographic data. The roots of the project and its definition have been previously presented in Siabato & Manso-Callejo 2011. In this new position paper, we extend such work by delineating clearly the methodology and the foundations on which we will base to define the main components of this research: the spatial model, the temporal model, the semantic layers, and the semantic engines. By putting together the former paper and this new work we try to present a comprehensive description of the whole process, from pinpointing the basic problem to describing and assessing the solution. In this new article we just mention the methods and the background to describe how we intend to define the components and integrate them into the GI.

Automated incident management plan using geographic information systems technology for traffic management centers. Final report.

Texas Department of Transportation, Austin

Social construction of Geographic Information Systems. (Volumes I and II)

Geographic Information Systems (GIS) is an emerging information technology (IT) which promises to have large scale influences in how spatially distributed resources are managed. It has had applications in the management of issues as diverse as recovering from the disaster of Hurricane Andrew to aiding military operations in Desert Storm. Implementation of GIS systems is an important issue because there are high cost and time involvement in setting them up. An important component of the implementation problem is the "meaning" different groups of people who are influencing the implementation give to the technology. The research was based on the theory of (theoretical stance to the problem was based on the) "Social Construction of Knowledge" systems which assumes knowledge systems are subject to sociological analysis both in usage and in content. An interpretive research approach was adopted to inductively derive a model which explains how the "meanings" of a GIS are socially constructed. The research design entailed a comparative case analysis over two county sites which were using the same GIS for a variety of purposes. A total of 75 in-depth interviews were conducted to elicit interpretations of GIS. Results indicate that differences in how geographers and data-processors view the technology lead to different implementation patterns in the two sites.

A Geographic Perspective of Cuban Landscapes

Beginning in the era of the Spanish conquest and taking the reader right up to the present day, this book focuses on how the landscape of Cuba has changed and evolved into the environment we see today. It illustrates the range of factors – economic, political and cultural – that have determined Cuba’s physical geography, and explores the shifting conservation measures which have been instituted in response to new methods in agriculture and land management. The text uses historical documents, fieldwork, Geographic Information System (GIS) data and remotely-sensed satellite imagery to detail Cuba’s extensive land-use history as well as its potential future. The author goes further to analyze the manner, speed and methods of landscape change, and examines the historical context and governing agendas that have had an impact on the relationship between Cuba’s inhabitants and their island. Gebelein also assesses the key role played by agricultural production in the framework of international trade required to sustain Cuba’s people and its economy. The book concludes with a review of current efforts by Cuban and other research scientists, as well as private investors, conservation managers and university professors who are involved in shaping Cuba’s evolving landscape and managing it during the country’s possible transition to a more politically diverse, enfranchised and open polity.

Geographic Expansion of Lyme Disease in the Southeastern United States, 2000-2014.

Background.  The majority of Lyme disease cases in the United States are acquired on the east coast between northern Virginia and New England. In recent years the geographic extent of Lyme disease has been expanding, raising the prospect of Lyme disease becoming endemic in the southeast. Methods.  We collected confirmed and probable cases of Lyme disease from 2000 through 2014 from the Virginia Department of Health and North Carolina Department of Public Health and entered them in a geographic information system. We performed spatial and spatiotemporal cluster analyses to characterize Lyme disease expansion. Results.  There was a marked increase in Lyme disease cases in Virginia, particularly from 2007 onwards. Northern Virginia experienced intensification and geographic expansion of Lyme disease cases. The most notable area of expansion was to the southwest along the Appalachian Mountains with development of a new disease cluster in the southern Virginia mountain region. Conclusions.  The geographic distribution of Lyme disease cases significantly expanded in Virginia between 2000 and 2014, particularly southward in the Virginia mountain ranges. If these trends continue, North Carolina can expect autochthonous Lyme disease transmission in its mountain region in the coming years.

GIS technologies and spatial organization patterns among hunter-gatherers: an archaeological case study from Southern Patagonia (southern South America)

This paper discusses some aspects of hunter-gatherer spatial organization in southern South Patagonia, in later times to 10,000 cal yr BP. Various methods of spatial analysis, elaborated with a Geographic Information System (GIS) were applied to the distributional pattern of archaeological sites with radiocarbon dates. The shift in the distributional pattern of chronological information was assessed in conjunction with other lines of evidence within a biogeographic framework. Accordingly, the varying degrees of occupation and integration of coastal and interior spaces in human spatial organization are explained in association with the adaptive strategies hunter-gatherers have used over time. Both are part of the same human response to changes in risk and uncertainty variability in the region in terms of resource availability and environmental dynamics.

Capacity analysis in CDMA systems using GIS based planning tools

We show a simulation model for capacity analysis in mobile systems using a geographic information system (GIS) based tool, used for coverage calculations and frequency assignment, and MATLAB. The model was developed initially for “narrowband” CDMA and TDMA, but was modified for WCDMA. We show also some results for a specific case in “narrowband” CDMA

Application of GIS in potential beekeeping assessment: Case study of Montesinho Natural Park (Portugal)

Planners require solutions that address routine work needs and seems essential to improving efficiency and productivity. There are a great number of different factors related to beekeeper activity as well the quality and productivity of different bee products. The spatial analysis is a powerful tool for overlap and relates various levels of information on a map, and consequently a very useful for beekeeping activity planning. This work proposes and applies a methodology to potential beekeeping assessment in Montesinho Natural Park, a region in the northwest of Portugal. The beekeeping potential maps were developed with the following data sources: legal standards, vegetation, land use, topography, water resources, roads, electromagnetic fields, and some honey physico-chemical analysis. The design and implementation of spatial analysis model based on Geographic Information System (GIS) to beekeeping planning activities has already been described by Anjos et al (2014). Spatial analysis techniques allows to define the potential beekeeper map supporting the beekeeper management in this region. Anjos O, Silva G, Roque N, Fernandez P, 2014. GIS based analysis to support the beekeeping planning. Book of abstracts of the International Symposium on Bee Products 3rd edition – Annual meeting of the International Honey Commission (IHC), Faculty of medicine, University of Rijeka, p:61

Geography, History and Natural Sciences: an interdisciplinary teaching approach with GIS

Geographic Information System (GIS) is a technology that deals with location to support better representations and decision making. It has a long tradition in several planning areas, such as urbanism, environment, riskiness, transportation, archeology or tourism. In academics context higher education has followed that evolution. Despite of their potentialities in education, GIS technologies at the elementary and secondary have been underused. Empowering graduates to learn with GIS and to manipulate spatial data can effectively facilitate the teaching of critical thinking. Likewise it has been recognized that GIS tools can be incorporated as an interdisciplinary pedagogical tool. Nevertheless more practical examples on how GIS tools can enhance teaching and learning process, namely to promote interdisciplinary approaches. The proposed paper presents some results obtained from the project “Each thing in its place: the science in time and space”. This project results from the effort of three professors of Geography, History and Natural Sciences in the context of Didactics of World Knowledge curricular unit to enhance interdisciplinarity through Geographic Information Technologies (GIT). Implemented during the last three years this action-research project developed the research practice using GIS to create an interdisciplinary attitude in the future primary education teachers. More than teaching GIS the authors were focused on teaching with GIS to create an integrated vision where spatial data representation linked the space, the time and natural sciences. Accumulated experience reveals that those technologies can motivate students to learn and facilitating teacher’s interdisciplinary work.

Feasibility assessment of sugarcane expansion in southwest Goiás, Brazil based on the GIS technology.

The current study approaches the sugarcane culture expansion in Southwestern Goiás, especially in Mineiros, Quirinópolis and Rio Verde counties, which represent different times and responses to this process. The current logistics structure and future prospects for sugarcane and its derivatives transportation are studied at national level with emphasis to the aforementioned micro-region. Maps showing land use and land cover in three different years were generated from Landsat TM-5 satellite images and they were used to analyze the dynamics of changes in land use and in land cover. The region is marked by strong and rapid growth in the agricultural sector and its sugar-energy industry has been expanding in recent years, although with different aspects among its counties. Since it is a promising region in this sector, due to the favorable soil and weather conditions to the crop, the region requires more investment and planning in logistics to ensure production flow and to make it stronger within domestic and foreign markets.

[evaluation Of Data On Live Birth Certificates From The Information System On Live Births (sinasc) In Campinas, São Paulo, 2009].

To assess the completeness and reliability of the Information System on Live Births (Sinasc) data. A cross-sectional analysis of the reliability and completeness of Sinasc's data was performed using a sample of Live Birth Certificate (LBC) from 2009, related to births from Campinas, Southeast Brazil. For data analysis, hospitals were grouped according to category of service (Unified National Health System, private or both), 600 LBCs were randomly selected and the data were collected in LBC-copies through mothers and newborns' hospital records and by telephone interviews. The completeness of LBCs was evaluated, calculating the percentage of blank fields, and the LBCs agreement comparing the originals with the copies was evaluated by Kappa and intraclass correlation coefficients. The percentage of completeness of LBCs ranged from 99.8%-100%. For the most items, the agreement was excellent. However, the agreement was acceptable for marital status, maternal education and newborn infants' race/color, low for prenatal visits and presence of birth defects, and very low for the number of deceased children. The results showed that the municipality Sinasc is reliable for most of the studied variables. Investments in training of the professionals are suggested in an attempt to improve system capacity to support planning and implementation of health activities for the benefit of maternal and child population.