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Process mapping as a tool for home health network analysis.

Process mapping is a qualitative tool that allows service providers, policy makers, researchers, and other concerned stakeholders to get a "bird's eye view" of a home health care organizational network or a very focused, in-depth view of a component of such a network. It can be used to share knowledge about community resources directed at the older population, identify gaps in resource availability and access, and promote on-going collaborative interactions that encourage systemic policy reassessment and programmatic refinement. This article is a methodological description of process mapping, which explores its utility as a practice and research tool, illustrates its use in describing service-providing networks, and discusses some of the issues that are key to successfully using this methodology.

Community Health Planning↗

Illusions in reading maps by touch: reducing distance errors.

The study reports systematic distance errors in reading raised-line maps by touch, and how they can be reduced. We show that T-shaped road junctions produce the typical error due to overestimating the length of the bisecting road compared to the bisected road. The error was not reduced when the target location was marked initially by a symbol. However, it was eliminated by instructions to use both hands concurrently to scan the route relative to an external square frame surrounding the map layout and to the body midline. Road junctions, which resemble 'Müller-Lyer' configurations, produced a significant overestimation of the length of a road that ended in diverging side roads relative to underestimating a road section with converging side roads. Spatial anchor cues from landmarks along the route, either alone or in conjunction with the spatial frame instructions, eliminated the illusion equally. We discuss theoretical implications, and the use of map frames and landmarks as spatial guides to improve map use by touch.

Adolescent↗

The politics of pathology: how obesity became an epidemic disease.

Americans' recent weight gains have been widely described as an "obesity epidemic." Such a characterization, however, has many problems: the average American weight gain has been relatively low (eight to 12 pounds over the last 20 years), and the causal linkages between adiposity, morbidity, and mortality are unclear. Nevertheless, the media and numerous health officials continue to sound dire warnings that obesity has become an epidemic disease. In this article, I examine how and why America's growing weight became an "obesity epidemic." I find the disease characterization has less to do with the health consequences of excess weight and more with the various financial and political incentives of the weight loss industry, medical profession, and public health bureaucracy. This epidemic image was also assisted by the method of displaying information about weight gain with maps in PowerPoint slides. Such characterizations, I argue, are problematic. Given the inconclusive scientific evidence and the absence of a safe and effective weight loss regimen, calling America's growing weight an epidemic disease is likely to cause more harm than good.

Causality↗

Attentional filtering in the design of electronic map displays: a comparison of color coding, intensity coding, and decluttering techniques.

In a series of experiments color coding, intensity coding, and decluttering were compared in order to assess their potential benefits for accessing information from electronic map displays. Participants viewed electronic battlefield maps containing 5 classes of information discriminable by color or intensity, or, in the decluttering condition, displayed or removed entirely by a key press. Participants were asked questions requiring them to focus on objects within a class (objects presented at the same color or intensity) or to integrate data between objects in different classes (objects presented at different colors and intensities). The results suggested that the benefits of color and intensity coding appear to be in segregating the visual field rather than calling attention to the objects presented at a certain color or intensity. Interactivity proved to be a disadvantage; the time cost of information retrieval outweighed the time benefits of presenting less information on the display or even allowing map users to customize their displays. Potential applications of this research include a cost-benefit analysis for the use of 3 attentional filtering techniques and an attempt to quantitatively measure map complexity.

Analysis of Variance↗

Rehearsal versus map study as preparation for a flight navigation exercise.

A flight simulator and a computer-generated depiction of an environment with both natural and cultural features were used to teach and test navigation knowledge. Conditions of guided rehearsal, unguided rehearsal, and map study were used to familiarize participants with the navigation environment. A subsequent route-following test of navigation knowledge in the simulated environment showed that unguided rehearsal was better than map study or guided rehearsal for the development of route knowledge. In addition, a pointing task revealed that unguided mission rehearsal was as good as map study for the development of survey knowledge. Actual or potential applications of this research include the use of simulator-based mission rehearsal for military flight operations.

Adult↗

[Using indicators to identify regions with critical maternal health conditions].

OBJECTIVE: In early 2000 the Ministry of Health and Social Welfare of Bolivia brought together a group of experts who, using available information, developed a method that made it possible to identify critical maternal and neonatal health sections of the country and to create a map of the health situation and of the existing health-services capacity in the 112 provinces of Bolivia. The objective of this piece is to describe the method that those experts created and applied. METHODS: Two indices were created, one for the health situation and the other for the existing health-services capacity. The steps followed in this process were: 1) identifying the variables included in each index, 2) weighting the variables in each index, 3) creating a mathematical formula for each index, 4) preparing a list with the data from each province for the chosen variables and with the percentage for each province for each index, obtained by using the respective formula, 5) setting three continuous-data categories for each index, and 6) defining the taxonomy that was possible by combining the results of the two indices. RESULTS: Applying this approach, a national map of the maternal health situation and of the existing capacity in each of the 112 Bolivian provinces was developed. This made it possible to choose a small number of provinces where the Ministry of Health and Social Welfare could work with other institutions to carry out joint interventions. The 9 selected provinces have a total of 26 municipalities, which include 17 health districts and which have 29% of the population of the country, 33% of the maternal deaths, and an estimated 35% of the early neonatal deaths. CONCLUSIONS: Using available information, this method generated a map of the overall maternal health situation in the 112 provinces of Bolivia and made it possible to identify critical geographical areas for health interventions.

Bolivia↗

Geographic information systems: their application in animal disease control.

Geographic information systems (GIS) are computerised information systems that allow for the capture, storage, manipulation, analysis, display and reporting of geographically referenced data. They have been used in recent years for a wide variety of purposes, including town planning and environmental resource management. The technology has many features which make it ideal for use in animal disease control, including the ability to store information relating to demographic and causal factors and disease incidence on a geographical background, and a variety of spatial analysis functions. A number of possible veterinary applications are suggested, and three examples of the use of GIS in New Zealand are discussed.

Animal Diseases↗

On the wrong side of the tracts? Evaluating the accuracy of geocoding in public health research.

OBJECTIVES: This study sought to determine the accuracy of geocoding for public health databases. METHODS: A test file of 70 addresses, 50 of which involved errors, was generated, and the file was geocoded to the census tract and block group levels by 4 commercial geocoding firms. Also, the "real world" accuracy of the best-performing firm was evaluated. RESULTS: Accuracy rates in regard to geocoding of the test file ranged from 44% (95% confidence interval [CI] = 32%, 56%) to 84% (95% CI = 73%, 92%). The geocoding firm identified as having the best accuracy rate correctly geocoded 96% of the addresses obtained from the public health databases. CONCLUSIONS: Public health studies involving geocoded databases should evaluate and report on methods used to verify accuracy.

Abstracting and Indexing↗

Distorted cognitive maps: college students' misperceptions of nation size.

On a questionnaire 256 college students reported a number of distorted views concerning the sizes of nations in the world and these distortions appeared to generalize to geographic regions. Considering that individual cognitive maps are commonly used to assess new information about the global environment, these inherent distortions could significantly bias the students' views of the world.

Cognition↗

Computer-generated dot maps as an epidemiologic tool: investigating an outbreak of toxoplasmosis.

We used computer-generated dot maps to examine the spatial distribution of 94 Toxoplasma gondii infections associated with an outbreak in British Columbia, Canada. The incidence among patients served by one water distribution system was 3.52 times that of patients served by other sources. Acute T. gondii infection among 3, 812 pregnant women was associated with the incriminated distribution system.

Acute Disease↗

Descriptions and depictions of environments.

Subjects studied maps with the expectation that they would draw or describe them from memory. In fact, subjects did both. Order of drawing or describing landmarks revealed the mental organization of environments. Organization was quite similar across maps and descriptions of the same environments, revealing hierarchical structures based on spatial and functional features of the environments and on conventions for sequencing the landmarks.

Adult↗