Measuring Spatial Subdivisions in Urban Mobility with Mobile Phone Data

Urban population grows constantly. By 2050 two thirds of the world population will reside in urban areas. This growth is faster and more complex than the ability of cities to measure and plan for their sustainability. To understand what makes a city inclusive for all, we define a methodology to identify and characterize spatial subdivisions: areas with over- and under-representation of specific population groups, named hot and cold spots respectively. Using aggregated mobile phone data, we apply this methodology to the city of Barcelona to assess the mobility of three groups of people: women, elders, and tourists. We find that, within the three groups, cold spots have a lower diversity of amenities and services than hot spots. Also, cold spots of women and tourists tend to have lower population income. These insights apply to the floating population of Barcelona, thus augmenting the scope of how inclusiveness can be analyzed in the city.Comment: 10 pages, 10 figures. To be presented at the Data Science for Social Good workshop at The Web Conference 202

The challenges and possibilities of reflective learning in higher education. Research focused from the perspective of university students on four different degree courses

Despite an increase in university teaching practices based on reflective learning methodology (RL), only very few studies are found in the context of higher education aimed at determining students? perception of this approach to teaching and learning. The aim of this research was to ascertain the opinions of students on different university degree courses regarding the challenges, difficulties and contributions arising from the application of reflective learning methodology in their learning process so as to propose strategies for improving education. The study was carried out on four Bachelor degree courses at the University of Girona: Social Education, Environmental Sciences, Nursing and Psychology. The research was conducted in two stages. In the first (2011-12 academic year), a questionnaire was administered to 162 students (43 from Social Education; 33 from Environmental Sciences; 31 from Nursing; and 55 from Psychology). One section of the questionnaire was specifically devoted to studying the perceptions of students participating in various RL experiences regarding the main difficulties they faced and the contributions of the RL to their learning process. Among the highlighted difficulties was the fact that RL requires a work process they are not used to and their lack of reflective writing skills. Among the contributions, the students felt that RL results in more complex and selfregulated knowledge, develops greater dynamic capabilities and increases the degree of reflection on learning processes and areas for improvement. In the second stage of the study (2012-13 academic year), four focus groups were held with students who had participated in the previous years? experience with the aim of gaining further insight into their perceptions regarding the challenges and contributions of RL. A total of 20 students participated, all of whom gave informed written consent. The sessions were recorded and transcribed in full and a thematic content analysis was performed. In all four groups the students stated that the experience had allowed them to improve their learning and become aware of their current situation and areas for improvement. As for the challenges, they cited difficulties in understanding the aims and purpose of RL, particularly at the beginning of the experience, together with problems experienced in writing about it, doubts about the level of openness required and uncertainty about how they would be assessed. The research conducted suggested that RL has significant potential to connect academic activity with professional action. It also provided working guidelines for improving experiences carried out on the basis of RL. These include the need to clarify the methodology and present arguments for its use, so that students understand the type of work it will mean for them and the objectives they pursued. Students should also be provided with sufficiently clear guidelines regarding how they will be assessed (in relation to both activities and level of reflection). There is a need to build a group climate based on mutual trust, continuous feedback and the establishment of a support process that maintains this trust throughout the learning process

A city of cities: Measuring how 15-minutes urban accessibility shapes human mobility in Barcelona

As cities expand, human mobility has become a central focus of urban planning and policy making to make cities more inclusive and sustainable. Initiatives such as the "15-minutes city" have been put in place to shift the attention from monocentric city configurations to polycentric structures, increasing the availability and diversity of local urban amenities. Ultimately they expect to increase local walkability and increase mobility within residential areas. While we know how urban amenities influence human mobility at the city level, little is known about spatial variations in this relationship. Here, we use mobile phone, census, and volunteered geographical data to measure geographic variations in the relationship between origin-destination flows and local urban accessibility in Barcelona. Using a Negative Binomial Geographically Weighted Regression model, we show that, globally, people tend to visit neighborhoods with better access to education and retail. Locally, these and other features change in sign and magnitude through the different neighborhoods of the city in ways that are not explained by administrative boundaries, and that provide deeper insights regarding urban characteristics such as rental prices. In conclusion, our work suggests that the qualities of a 15-minutes city can be measured at scale, delivering actionable insights on the polycentric structure of cities, and how people use and access this structure.Comment: 32 pages, 7 figure

High frequency of acute decompensation and cancer in patients with compensated cirrhosis due to nonalcoholic fatty liver disease : A retrospective cohort study

The natural history of compensated cirrhosis due to nonalcoholic fatty liver disease (NAFLD) has not been completely characterized. The aim of the present study was to assess the incidence and risk factors of acute decompensation of cirrhosis, hepatocellular carcinoma, and extrahepatic cancers. This was a multicenter, retrospective, cohort study including 449 patients with compensated cirrhosis due to NAFLD. We calculated cumulative incidences and used competitive risk analysis to determine the risk factors associated with decompensation and cancer development. Over a median of 39 months of follow-up, 124 patients (28%) presented acute decompensation. The most frequent decompensation was ascites (21%) followed by hepatic encephalopathy (15%), variceal bleeding (9%), and spontaneous bacterial peritonitis (3%). Acute-on-chronic liver failure was diagnosed in 6% of patients during follow-up. Liver function parameters and specifically an albumin level below 40 g/L were independently associated with an increased risk of decompensation. The presence of ischemic heart disease was independently associated with acute decompensation. Seventy-eight patients (18%) developed hepatocellular carcinoma or extrahepatic cancers during follow-up (51 and 27, respectively). Conclusion : Patients with compensated cirrhosis due to NAFLD are at high risk of severe liver complications, such as the development of acute decompensation, in a relative short follow-up time. This population is at high risk of hepatic and extrahepatic cancers. The analysis of a large contemporary cohort of 449 patients with compensated cirrhosis due to non-alcoholic fatty liver disease shows a high frequency of acute decompensations (AD) and development of cancer during 39 months of follow-up. Almost 28% of the cohort developed acute decompensation and 18% developed hepatocellular carcinoma (HCC) or extrahepatic cancer. Predictors of decompensation are mainly related to liver function and portal hypertension

Improving the detection of infectious diseases in at-risk migrants with an innovative integrated multi-infection screening digital decision support tool (IS-MiHealth) in primary care : a pilot cluster-randomized-controlled trial

There are major shortfalls in the identification and screening of at-risk migrant groups. This study aims to evaluate the effectiveness of a new digital tool (IS-MiHealth) integrated into the electronic patient record system of primary care centres in detecting prevalent migrant infections. IS-MiHealth provides targeted recommendations to health professionals for screening multiple infections, including human immunodeficiency virus (HIV), hepatitis B and C, active tuberculosis (TB), Chagas disease, strongyloidiasis and schistosomiasis, based on patient characteristics (including variables of country of origin, age and sex). A pragmatic pilot cluster-randomized-controlled trial was deployed from March to December 2018. Eight primary care centres in Catalonia, Spain, were randomly allocated 1:1 to use of the digital tool for screening, or to routine care. The primary outcome was the monthly diagnostic yield of all aggregated infections. Intervention and control sites were compared before and after implementation with respect to their monthly diagnostic yield using regression models. This study is registered on international standard randomised controlled trial number (ISRCTN) (ISRCTN14795012). A total of 15 780 migrants registered across the eight centres had at least one visit during the intervention period (March-December 2018), of which 14 598 (92.51%) fulfilled the criteria to be screened for at least one infection. There were 210 (2.57%) individuals from the intervention group with new diagnoses compared with 113 (1.49%) from the control group [odds ratio: 2.08, 95% confidence interval (CI) 1.63-2.64, P < 0.001]. The intervention centres raised their overall monthly diagnosis rate to 5.80 (95% CI 1.23-10.38, P = 0.013) extra diagnoses compared with the control centres. This monthly increase in diagnosis in intervention centres was also observed if we consider all cases together of HIV, hepatitis B and C, and active TB cases [2.72 (95% CI 0.43-5.00); P = 0.02] and was observed as well for the parasitic infections' group (Chagas disease, strongyloidiasis and schistosomiasis) 2.58 (95% CI 1.60-3.57; P < 0.001). The IS-MiHealth increased screening rate and diagnostic yield for key infections in migrants in a population-based primary care setting. Further testing and development of this new tool is warranted in larger trials and in other countries

LiverScreen project: study protocol for screening for liver fibrosis in the general population in European countries

Background: The development of liver cirrhosis is usually an asymptomatic process until late stages when complications occur. The potential reversibility of the disease is dependent on early diagnosis of liver fibrosis and timely targeted treatment. Recently, the use of non-invasive tools has been suggested for screening of liver fibrosis, especially in subjects with risk factors for chronic liver disease. Nevertheless, large population-based studies with cost-effectiveness analyses are still lacking to support the widespread use of such tools. The aim of this study is to investigate whether non-invasive liver stiffness measurement in the general population is useful to identify subjects with asymptomatic, advanced chronic liver disease. Methods: This study aims to include 30,000 subjects from eight European countries. Subjects from the general population aged ≥ 40 years without known liver disease will be invited to participate in the study either through phone calls/letters or through their primary care center. In the first study visit, subjects will undergo bloodwork as well as hepatic fat quantification and liver stiffness measurement (LSM) by vibration-controlled transient elastography. If LSM is ≥ 8 kPa and/or if ALT levels are ≥1.5 x upper limit of normal, subjects will be referred to hospital for further evaluation and consideration of liver biopsy. The primary outcome is the percentage of subjects with LSM ≥ 8kPa. In addition, a health economic evaluation will be performed to assess the cost-effectiveness and budget impact of such an intervention. The project is funded by the European Commission H2020 program. Discussion: This study comes at an especially important time, as the burden of chronic liver diseases is expected to increase in the coming years. There is consequently an urgent need to change our current approach, from diagnosing the disease late when the impact of interventions may be limited to diagnosing the disease earlier, when the patient is asymptomatic and free of complications, and the disease potentially reversible. Ultimately, the LiverScreen study will serve as a basis from which diagnostic pathways can be developed and adapted to the specific socio-economic and healthcare conditions in each country

Population screening for liver fibrosis: towards early diagnosis and intervention for chronic liver diseases

Cirrhosis, highly prevalent worldwide, develops after years of hepatic inflammation triggering progressive fibrosis. Currently, the main etiologies of cirrhosis are non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ALD), although chronic hepatitis B and C infections are still major etiological factors in some areas of the world. Recent studies have shown that liver fibrosis can be assessed with relatively high accuracy non-invasively by serological tests, transient elastography, and radiological methods. These modalities may be utilized for screening for liver fibrosis in at-risk populations. Thus far, a limited number of population-based studies using non-invasive tests in different areas of the world indicate that a significant percentage of subjects without known liver disease (around 5% in general populations and a higher rate -18 to 27%- in populations with risk factors for liver disease) have significant undetected liver fibrosis or established cirrhosis. Larger international studies are required to show the harms and benefits before concluding that screening for liver fibrosis should be applied to populations at risk for chronic liver diseases. Screening for liver fibrosis has the potential for changing the current approach from diagnosing chronic liver diseases late when patients have already developed complications of cirrhosis to diagnosing liver fibrosis in asymptomatic subjects providing the opportunity of preventing disease progression

Colon capsule endoscopy versus CT colonography in FIT-positive colorectal cancer screening subjects: a prospective randomised trial-the VICOCA study

Background: Colon capsule endoscopy (CCE) and CT colonography (CTC) are minimally invasive techniques for colorectal cancer (CRC) screening. Our objective is to compare CCE and CTC for the identification of patients with colorectal neoplasia among participants in a CRC screening programme with positive faecal immunochemical test (FIT). Primary outcome was to compare the performance of CCE and CTC in detecting patients with neoplastic lesions. Methods: The VICOCA study is a prospective, single-centre, randomised trial conducted from March 2014 to May 2016; 662 individuals were invited and 349 were randomised to CCE or CTC before colonoscopy. Endoscopists were blinded to the results of CCE and CTC. Results: Three hundred forty-nine individuals were included: 173 in the CCE group and 176 in the CTC group. Two hundred ninety individuals agreed to participate: 147 in the CCE group and 143 in the CTC group. In the intention-toscreen analysis, sensitivity, specificity and positive and negative predictive values for the identification of individuals with colorectal neoplasia were 98.1%, 76.6%, 93.7% and 92.0% in the CCE group and 64.9%, 95.7%, 96.8% and 57.7% in the CTC group. In terms of detecting significant neoplastic lesions, the sensitivity of CCE and CTC was 96.1% and 79.3%, respectively. Detection rate for advanced colorectal neoplasm was higher in the CCE group than in the CTC group (100% and 93.1%, respectively; RR = 1.07; p = 0.08). Both CCE and CTC identified all patients with cancer. CCE detected more patients with any lesion than CTC (98.6% and 81.0%, respectively; RR = 1.22; p = 0.002). Conclusion: Although both techniques seem to be similar in detecting patients with advanced colorectal neoplasms, CCE is more sensitive for the detection of any neoplastic lesion

Aula d'Ecologia : cicles de conferències 1999 i 2000

Descripció del recurs: 13 juny 2007Conté: Rafael Argullol, Natura i ciutat en el canvi de mil·lenni ; Antoni Lloret, Energies per al segle XXI ; Jorge Wagensberg, Investigació científica i sostenibilitat: l'experiència amazònica ; Manuel Ludevid, El paper de les empreses en la societat sostenible ; Rafael Grasa, El paper de les ONG en la societat sostenible ; Luis Ángel Fernández Hermana, La comunicació en la transició cap a una societat sostenible ; Frederic Ximeno, Estratègies i eines de planificació territorial cap a una ciutat sostenible ; José Luis Porcuna, Estratègies agroecològiques cap a una agricultura sostenible ; Josep Germain, Estratègia catalana per a la biodiversitat ; Carles Gràcia, Els boscos i el funcionament sostenible del planeta ; Manuel Herce, El territori de la ciutat: criteris de sostenibilitat, ordenació i urbanització ; Josep Enric Llebot, Ciència i política del canvi climàtic ; Àlex Aguilar, L'extinció de les espècies: entre la ignorància i la tolerància ; Josep Olives, La ciutat com a idea d'equilibri ; Anna Cabré, Demografia i migracions al segle XXI: què és raonable preveure? ; Manolis Kogevinas, Càncer i exposicions mediambientals ; Ramon Arandes, L'aprofitament de les aigües del subsòl de Barcelona ; Rafael Simó, L'oceà i l'atmosfera, inseparables davant el canvi climàtic global ; Joan Caylà, Sobre el possible impacte mundial de la sida en la dècada 2000-2010 ; Jordi Serra Raventós, Ocupació del litoral i implicacions sobre el territori ; Joan Manuel Vilaplana, Catàstrofes i societat ; Montserrat Vilà, Causes i conseqüències de les invasions biològiques ; Josep Egozcue, Clonatge humà: tècnica i ètica ; Millán M. Millán, Contaminación fotoquímica en la cuenca mediterránea: revisión de los resultados de proyectos de investigación europeos ; Jaume Terradas i José Ángel Burriel, Mapa ecològic de Barcelona

Improving the detection of infectious diseases in at-risk migrants with an innovative integrated multi-infection screening digital decision support tool (IS-MiHealth) in primary care: A pilot cluster-randomized controlled trial.

BACKGROUND: There are major shortfalls in the identification and screening of at-risk migrant groups. This study aims to evaluate the effectiveness of a new digital tool (IS-MiHealth) integrated into the electronic patient record system of primary care centres in detecting prevalent migrant infections. IS-MiHealth provides targeted recommendations to health professionals for screening multiple infections, including HIV, hepatitis B and C, active tuberculosis, Chagas disease, strongyloidiasis, and schistosomiasis, based on patient characteristics (including variables of country of origin, age, sex). METHODS: A pragmatic pilot cluster-randomised controlled trial was deployed from March to December 2018. Eight primary care centres in Catalonia, Spain, were randomly allocated 1:1 to use of the digital tool for screening, or to routine care. The primary outcome was the monthly diagnostic yield of all aggregated infections. Intervention and control sites were compared before and after implementation with respect to their monthly diagnostic yield using regression models. This study is registered on ISRCTN (ISRCTN14795012). RESULTS: 15780 migrants registered across the 8 centres had at least one visit during the intervention period (March to December 2018), of which 14 598 (92.51%) fulfilled the criteria to be screened for at least one infection. There were 210 (2.57%) individuals from the intervention group with new diagnoses compared with 113 (1.49%) from the control group (OR:2.08 95%CI 1.63-2.64, p < 0.001). The intervention centres raised their overall monthly diagnosis rate to 5.80 (95%CI 1.23-10.38, p = 0.013) extra diagnoses compared to the control centres. This monthly increase in diagnosis in intervention centres was also observed if we consider all cases together of HIV, hepatitis B and C, and active TB cases (2.72,[95%CI 0.43-5.00]; p = 0.02) and was observed as well for the parasitic infections´ group (Chagas disease, strongyloidiasis, and schistosomiasis) 2.58 (95%CI 1.60-3.57; p < 0.001). CONCLUSIONS: The IS-MiHealth increased screening rate and diagnostic yield for key infections in migrants in a population-based primary care setting. Further testing and development of this new tool is warranted in larger trials and in other countries