An integrated framework for the geographic surveillance of chronic disease

<p>Abstract</p> <p>Background</p> <p>Geographic public health surveillance is concerned with describing and disseminating geographic information about disease and other measures of health to policy makers and the public. While methodological developments in the geographical analysis of disease are numerous, few have been integrated into a framework that also considers the effects of case ascertainment bias on the effectiveness of chronic disease surveillance.</p> <p>Results</p> <p>We present a framework for the geographic surveillance of chronic disease that integrates methodological developments in the spatial statistical analysis and case ascertainment. The framework uses an hierarchical approach to organize and model health information derived from an administrative health data system, and importantly, supports the detection and analysis of case ascertainment bias in geographic data. We test the framework on asthmatic data from Alberta, Canada. We observe high prevalence in south-western Alberta, particularly among Aboriginal females. We also observe that persons likely mistaken for asthmatics tend to be distributed in a pattern similar to asthmatics, suggesting that there may be an underlying social vulnerability to a variety of respiratory illnesses, or the presence of a diagnostic practice style effect. Finally, we note that clustering of asthmatics tends to occur at small geographic scales, while clustering of persons mistaken for asthmatics tends to occur at larger geographic scales.</p> <p>Conclusion</p> <p>Routine and ongoing geographic surveillance of chronic diseases is critical to developing an understanding of underlying epidemiology, and is critical to informing policy makers and the public about the health of the population.</p

Síntesis de flavonoles

El presente trabajo trata sobre la síntesisde un cierto número de flavonoles empleando el métodode Kuhn y Loew. También se ha aplicado dicho método a la síntesisde una flavona. El método de Kuhn y Loew es una modificacióndel método de Robinson y consiste en condensar unaomega-benzoiloxiacetofenona con un anhídrido de ácido aromáticoempleando como catalizador básico la trietilamina. Parainteriorizarnos con dicho método hemos sintetizado la galangina, 7-hidroxiflavonol e isoramnetina obteniendo dichosflavonoles con buen rendimiento. A continuación se sintetizó por primeravez la ombuina; un nuevo flavonol que fué hallado en formade glucósido (ombuósido) en las hojas del ombú. Se obtuvosatisfactoriamente dicho flavonol que resultó idéntico a laombuina natural obtenida por hidrólisis del ombuósido. Para conocer mejor los flavonoles queposeen un grupo metoxilo en el carbono 4' y un grupo hidroxiloen el carbono 3'(estructura correspondiente a la isovainillina)se han sintetizado 3 nuevos flavonoles que poseenésta estructura y son la 4'-metilquercetina; 4',5,7-trimetilquercetinay 3',7-hidroxi-4'-metoxiflavonol. Finalmente se ha deseado saber si elmétodo de Kuhn y Loew puede aplicarse a la síntesis deflavonas. A tal efecto hemos sintetizado la 7-hidroxiflavonapero se obtuvo en menor rendimiento que empleando elmétodo de Robinson. Para la preparación de los flavonolesse emplearon sin inconveniente los acetilderivados delos anhidridos de los ácidos aromáticos hidroxiladosen lugar de los benzoilderivados como se hizo hasta ahora. También se han preparado los siguientes nuevos derivadosde los ácidos vainíllico e isovainíllico: El cloruro del ácido acetilisovainíllico, el anhídrido del ácido acetilvaiíllico y el anhídrido del ácido acetilisovainíllico.Fil: Schopflocher, Nicolás G.. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina

The Alberta Ambassador Program: delivering Health Technology Assessment results to rural practitioners

BACKGROUND: The purpose of Health Technology Assessment (HTA) is to make the best possible summary of the evidence regarding specific health interventions in order to influence health care and policy decisions. The need for decision makers to find relevant HTA data when it is needed is a barrier to its usefulness. These barriers are highest in rural areas and amongst isolated practitioners. METHODS: A multidisciplinary team developed an interactive case-based instructional strategy on the topic of chronic non-cancer pain (CNCP) management using clinical evidence derived by HTA. The evidence for each of 18 CNCP interventions was distilled into single-sheet summaries. Clinicians and HTA specialists ('Ambassadors') conducted 11 two-hour interactive sessions on CNCP in eight of Alberta's nine health regions. Pre- and post-session evaluations were conducted. RESULTS: The sessions were attended by 130 individuals representing 14 health and administrative disciplines. The ambassador model was well received. The use of content experts as ambassadors was highly rated. The educational strategy was judged to be effective. Awareness of the best evidence in CNCP management was increased. Although some participants reported practice changes as a result of the workshops, the program was not designed to measure changes in patient outcome. CONCLUSION: The ambassador program was successful in increasing awareness of the best evidence in CNCP management, and positively influenced treatment decisions. Its teaching methods were felt to be unique and innovative by participants. Its methods could be applied to other clinical content areas in order to increase the uptake of the results of HTA

Session 2-1-A: A Longitudinal Study of Alberta Electronic Machine Gamblers

Outline of the LLLP What is the LLLP? Launched in 2006 the LLLP is a five age cohort, four data collection wave longitudinal study that examines the incidence and determinants of gambling and problem gambling. The study was guided by four broad research questions: 1.What are the normal patterns of continuity and discontinuity in gambling and problem gambling behavior? 2.What bio-psychological variables and behavior patterns are most predictive of current and future responsible and problem gambling? 3.Are there distinct sub-groupings of gamblers and problem gamblers with different trajectories and predictors? 4.What etiological model of problem gambling is best supported by the longitudinal findings

Enhancing Educators’ skills for promoting Critical Thinking in their classroom discourses: A randomized control trial

The literature reveals that educators find it challenging to foster critical thinking (CT) in their students if they have not learned how to use CT in their educational system or training. This paper reports findings from a national research project that was undertaken to enhance the educators’ ability to promote CT in their teaching practices. Using a randomized control trial design with a pre- and post-test, 91 educators from 14 of the 17 schools of nursing in Pakistan consented to enroll in the study and 72 completed the study. The intervention included 40 hours of learning experience during two workshops that focused on CT. Data were collected, pre- and post-intervention, via observations and audiotaping of the participants teaching sessions for 60-90 minutes. The data obtained was assessed for the educators’ level of questioning, teaching strategies, and facilitation skills. Data were analyzed using descriptive and inferential statistics. Compared with the pre- intervention data, findings from the post-intervention data in the experimental group revealed positive changes in their pedagogical skills, including a significant increase in the number of higher order questions that are considered important for developing students’ CT skills. This study affirms that educators must have structured training to use and foster CT in their teaching practices

Session 1-3-F: The Alberta Cohorts of Gambling Behaviors An Update

Objectives 1.Experience with recruitment & retention of five cohorts 2.Patterns of continuity & discontinuity in gambling behaviors as well as patterns of recovery from problems? 3. Biopsychosocial variables (risks & resilience) predicting the spectrum of gambling behaviors from responsible to problematic

Prevalence and corrrelates of 12- month prescription drug misuse in Alberta

Objective: We examined the prevalence and correlates of prescription drug misuse (PDM) in a population-based sample of adults from Alberta. Methods: Data were collected from 3511 adults in Alberta aged 18 years and older in 2002 using a computer-aided telephone survey; the survey response rate was 57.4%. Results: The prevalence of 12-month PDM in Alberta was 8.2% in 2002. Opiates were the most frequently misused drug class, followed by sedatives, stimulants, and tranquilizers. Current disability was particularly associated with PDM. Odds of PDM were also elevated among adult students and adults with a high school diploma relative to adults with a post-secondary degree. Past-year problem gambling, illicit drug use, and alcohol use and dependence were each associated with PDM, while past-year binge drinking and daily smoking were not. Conclusions: Findings suggest PDM was an important public health concern in Alberta in 2002. Estimates suggest prescription use and misuse have increased substantially in Canada since that time. There is an urgent need for an ongoing assessment of this evolving problem so that effective prevention and therapeutic strategies can be developed.Ye

Ahorro energético en el consumo de gas residencial mediante aislamiento térmico en la construcción

Se determinaron los coeficientes volumétricos de pérdidas de calor, tanto en una vivienda “tipo casa” como en otra “tipo edificio”, considerando tres sistemas constructivos diferentes utilizados frecuentemente en el país. Se verificaron luego éstos mismos, pero aislando el techo y los muros con 3” y 2” respectivamente, de un aislante térmico convencional de conductividad media. Además, se cambiaron las carpinterías de vidrio simple por doble vidriado hermético. La tipología utilizada es una vivienda de 3 ambientes de aproximadamente 60 m² de superficie; obtenida como promedio de datos del Censo 2001, como así también de las cantidades de viviendas tipo “Hogares Casas” y tipo “Hogares Departamentos” relevados en cada Provincia. La demanda de gas en millones de m³ por día, destinada a calefacción para uso residencial y la cantidad de usuarios registrados, correspondientes al año 2006, fueron recabadas de ENARGAS. Como resultado, se estimó un ahorro de aproximadamente 40% aislando muros y techos; valor que puede superar el 50% si también se emplea doble vidriado hermético en las carpinterías.Volumetric heat loss coefficient was determined not only for a detached house but also for a unit in an apartment building. Three different construction systems usually used in our country were considered. Then, the same construction systems with added conventional 3” roof insulation and 2” wall insulation of medium thermal conductivity were analyzed. In addition, single glazing windows were changed for insulated double glazing ones. The pattern is a housing consisting of three rooms about 60 m² obtained as average from Census 2001 data, as well as the amount of single-unit and multi-unit dwellings taken form data of each Province. Daily gas demand for residential use, in millions of m³, and amount of registered users, were obtained from ENARGAS during 2006. As a result, savings of about 40% were obtained by roof and wall insulation; this value may exceed 50% if insulated double glazing windows are used.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES