1) An exploratory study was conducted in a median area of Madrid using both quantitative and qualitative methods to examine the social and physical environment related to cardiovascular health.
2) Quantitative data from over 14,000 primary care records showed the prevalence of cardiovascular diseases and risk factors in the population. Qualitative interviews provided insights into local perceptions of health and environment.
3) Initial results were presented on the food, physical activity, and tobacco environments. Measures of food availability and walkability/bikeability were collected. Interviews suggested themes around sociodemographics, diet, and physical activity patterns.
El Heart Healthy Hoods (HHH) es un proyecto de investigación que estudia como se relaciona el entorno urbano físico y social con la salud de la población
El Heart Healthy Hoods (HHH) es un proyecto de investigación que estudia como se relaciona el entorno urbano físico y social con la salud de la población
At the end of this presentation the attendant is expected to:
Define Epidemiology.
Identify the main issues in the definition.
Discuss the uses of Epidemiology.
Definition and Historical Glimpse of Public Health
Ancient Greece (500-323 BC)
Roman Empire (23 BC – 476 AD)
Middle Ages (476-1450 AD)
Birth of Modern Medicine (1650-1800 AD)
Great Sanitary Awakening (1800s-1900s)
Modern Public Health (1900 AD & onward)
Presented by Hung Nguyen-Viet and Jakob Zinsstag at a technical workshop of the Food and Agriculture Organization of the United Nations (FAO) regional initiative on One Health, Bangkok, Thailand, 11–13 October 2017.
The Role of the Veterinarian in One Health ProgramDr. Fakhar
Today’s veterinarians are the only doctors educated to protect the health of both animals and people. They work hard to address the health and needs of every species of animal and they also play a critical role in environmental protection, food safety, animal welfare and public health.
Presented By:
Dr. Fakhar-e-Alam Kulyar
DVM, M.Phil CMS
University of Agriculture Faisalabad
Contact: fakharealam786@hotmail.com
Background; Social Class has shown relation with admissions at Emergency Departments. To assess whether there is a relationship between the level of triage and the social class of patients who attend the emergency department and whether there are other variables that can modulate this association. Methods Observational study with 1000 patients was carried out between May and July 2018 in the Emergency Department of the University Hospital Arnau de Vilanova in Lleida. Sociodemographic variables such as age, gender, country of origin and marital status were analyzed. The triage level and the main explanatory variable was social class. Social class was calculated based on the CSO-SEE 2012 scale. Results 49.4% were male and the average age was 51.7 years. Most of the patients (66.6%) attended the emergency department under their own volition and the most common triage levels were level III or Emergency (45%). There is a significant relationship between age and triage level. The younger patients had a lower triage level (p <0.001). The percentage of patients with lower social class who attended the emergency department for minor reasons was 42% higher compared to the rest of the patients (RR = 1.42; 1.21-1.67 95% CI, p <0.001). Conclusions; Patients with a lower socioeconomic class go to the Emergency Department for less serious pathologies.
Presentation by Fred Unger at a training course for the Philippine Council for Agriculture, Aquatic and Natural Resources Research and Development (PCAARRD) project team, Pampanga, the Philippines, 30-31 July 2014.
From a seminar I gave in my first year MD in Shivamogga Institute of Medical Sciences.
Oxford Textbook of Public Health and Textbook of Preventive Medicine and Public Health by Maxcy, Rosenau and Last are my references.
Might help readers learn the evolution of the concept of public health.
At the end of this presentation the attendant is expected to:
Define Epidemiology.
Identify the main issues in the definition.
Discuss the uses of Epidemiology.
Definition and Historical Glimpse of Public Health
Ancient Greece (500-323 BC)
Roman Empire (23 BC – 476 AD)
Middle Ages (476-1450 AD)
Birth of Modern Medicine (1650-1800 AD)
Great Sanitary Awakening (1800s-1900s)
Modern Public Health (1900 AD & onward)
Presented by Hung Nguyen-Viet and Jakob Zinsstag at a technical workshop of the Food and Agriculture Organization of the United Nations (FAO) regional initiative on One Health, Bangkok, Thailand, 11–13 October 2017.
The Role of the Veterinarian in One Health ProgramDr. Fakhar
Today’s veterinarians are the only doctors educated to protect the health of both animals and people. They work hard to address the health and needs of every species of animal and they also play a critical role in environmental protection, food safety, animal welfare and public health.
Presented By:
Dr. Fakhar-e-Alam Kulyar
DVM, M.Phil CMS
University of Agriculture Faisalabad
Contact: fakharealam786@hotmail.com
Background; Social Class has shown relation with admissions at Emergency Departments. To assess whether there is a relationship between the level of triage and the social class of patients who attend the emergency department and whether there are other variables that can modulate this association. Methods Observational study with 1000 patients was carried out between May and July 2018 in the Emergency Department of the University Hospital Arnau de Vilanova in Lleida. Sociodemographic variables such as age, gender, country of origin and marital status were analyzed. The triage level and the main explanatory variable was social class. Social class was calculated based on the CSO-SEE 2012 scale. Results 49.4% were male and the average age was 51.7 years. Most of the patients (66.6%) attended the emergency department under their own volition and the most common triage levels were level III or Emergency (45%). There is a significant relationship between age and triage level. The younger patients had a lower triage level (p <0.001). The percentage of patients with lower social class who attended the emergency department for minor reasons was 42% higher compared to the rest of the patients (RR = 1.42; 1.21-1.67 95% CI, p <0.001). Conclusions; Patients with a lower socioeconomic class go to the Emergency Department for less serious pathologies.
Presentation by Fred Unger at a training course for the Philippine Council for Agriculture, Aquatic and Natural Resources Research and Development (PCAARRD) project team, Pampanga, the Philippines, 30-31 July 2014.
From a seminar I gave in my first year MD in Shivamogga Institute of Medical Sciences.
Oxford Textbook of Public Health and Textbook of Preventive Medicine and Public Health by Maxcy, Rosenau and Last are my references.
Might help readers learn the evolution of the concept of public health.
Professor Teresa Sordé, Member of the IMPACT-EV project research team and Pro...IrishHumanitiesAlliance
From the IHA Impact in the Humanities event 8 June held in QUB and co-sponsored by InterTradeIreland.
Panel Two: Impact in Horizon 2020 and the EU
How is Impact conceptualised and captured at the EU level, in programmes such as Horizon 2020, and how does this affect academics, research officers and policy makers at the national level?
Ministerial lunch: Migration and health in the WHO European Region - presentation delivered by Dr Santino Severoni, Coordinator, Public Health and Migration, on 14 September 2015, at the 65th session of the WHO Regional Committee for Europe (Vilnius, Lithuania, 14–17 September 2015)
EUR-HUMAN, EGPRN - Leipzig, October 2016Elena Petelos
European Refugees - Human Movement and Advisory Network (EUR-HUMAN) - A capacity-building CHAFEA-funded project with a multinational interdisciplinary consortium (Coordinator: CSFM, University of Crete). Presentation at the European General Practice Network
Presentation by Jo Ward, North West Social Prescribing Network Co-Chair: Social Prescribing Network and creative health agenda at the Health, wellbeing and the environment event on Monday 28 January 2019 at The Isla Gladstone Conservatory, Liverpool
Communication and Dissemination activities and Gender aspects in horizon 2020...Heart Healthy Hoods
Comunicación y género en Proyectos europeos. Presentación de Jesús Rojo de la Fundación para el Conocimiento Madri+d en la Escuela Nacional de Sanidad.
Availability, Accessibility, Visibility of consumption, promotion and adverti...Heart Healthy Hoods
This presentation shows the project conducted in Barcelona by the Public Health Agency (Agència Salut Pública de Barcelona, ASPB) related to accessibility, visibility of consumption and promotion of alcohol among youths in the urban environment
Alcohol outlet density, health inequalities and policy traslation: findings f...Heart Healthy Hoods
Scotland has highest britain's alcohol-related deaths. In this presentation, it is showed a project conducted in the city of Edinburgh which is focused on the study of alcohol outlet density, health inequalities and policy translations.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Urban Environment and Cardiovascular Health: ERC Project Heart Healthy Hoods
1. Centre for Global NCDs Seminar Series
November 14 2016
Urban Environment and
Cardiovascular Health: ERC Project
Heart Healthy Hoods
Manuel Franco MD, PhD
Associate Professor
School of Medicine, University of Alcala, Spain
Adjunct Associate Professor
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
2. http://hhhproject.eu
First, some questions
• Let´s think first about the place where you live/work
• Let´s think now about the opportunities for being
physically active and mantain a healthy diet
where you live
• Let´s think now about the social norms regarding
physical activity and diet where you live
3. http://hhhproject.eu
Second, some reflections
about Madrid
• Opportunities / resources for being
physically active and mantain a healthy diet
in Madrid
• Social norms regarding physical activity
and diet in Madrid
5. http://hhhproject.eu
Physical activity environment in
Madrid, HHH study
International Journal of Epidemiology 2015, Franco M
Miguel, 45 years old, lives
in Villaverde, Madrid. Low-
income area.
Miguel goes out for a walk
every afternoon to the
park. “I used to run all the
distance of the bike lane
but I started having knee
problems and now I prefer
walking. When I am in a
good mood I can walk all
the way to the next large
neighbourhood.”
6. http://hhhproject.eu
Food environment in Madrid,
HHH study
International Journal of Epidemiology 2015, Franco M In press
María, 45 ys, resident of
Villaverde. Low-income
area.
María and her friends
meet twice per week to
have a dinner snack at
the Dehesa Boyal park, a
pinewood and main park
in San Cristobal. María
lives in Spain for the last
4 years, unemployed for
the last 8 months, and
she often thinks about
coming back to the
Dominican Republic
where her family lives.
7. http://hhhproject.eu
Opportunities for NCDs prevention within
Urban Health Research
1. By 2050: 66% of the world population will live in cities
2. Challenge of aging and chronic diseases already in our cities
3. Social determinants as working conditions, unemployment
and poverty are clearly patent in our cities
4. Segregation patterns and health inequalities are social
phenomena measurable in our cities
5. Cities, municipalities, districts, offer great (structural)1
opportunities to improve population health
6. New sources and types of health and urban data, allong with
novel methodologies and interdisciplinary teams
7. Urban health research is directly linked to action
(1) Franco, Bilal and Diez-Roux, J Epidemiol Comm Health 2015
8. Social and Physical Urban
Environment and CV Health:
The Much Needed
Population Approach
Manuel Franco MD, PhD
Starting Grant 2013
Start Date April 1st 2014
9. ERC Starting Grants
FUNDING 1.5 million € for 5 years
OBJECTIVE To encourage independent careers of excellent
investigators providing enough support in the critical
moment (starting to develop their own team).
ELEGIBILITY PI must have a PhD degree in the last 2 to 7 years.
Available to non-EU researchers.
REQUISITES At least one relevant publication without his/her
thesis advisor
At least 50% effort
PROFILE High potential, project with potential social
Impact in Europe.
10. Presenter’s Name
Date
Physical
Environment
Social
Environment
SOCIAL
EPIDEMIOLOGY
Studies social determinants of disease
Methodologies from Social Sciences and Public Health
Focus on population preventive approach
Addresses growing social inequalities in health
First cause of death in Europe (47% of all deaths in 2010)
Increasing prevalence (50 mill. patients in 2009 in Europe)
Rising social and economic costs (196 billion € in 2009)
Traditional medical preventive approaches are individual
Cardiovascular
Health
12. http://hhhproject.eu
To study the impact of the
social and physical environment in terms of
tobacco, alcohol, food and physical activity
on residents cardiovascular health
Heart Healthy Hoods
Overall Objectives
13. http://hhhproject.eu
1. To include a qualitative approach to understand the
context and meanings of the urban environment in
relation to cardiovascular health
2. To develop measurements to characterize the
social and physical urban environments in a
systematic and accurate fashion
3. To understand the already known relation between
the urban environment and cardiovascular health in
the United States with this relation in Europe
Heart Healthy Hoods
Secondary Objectives
14. http://hhhproject.eu
To provide scientific evidence to researchers, the
general population and policy makers to intervene at
the population level to prevent the first cause of
death in Europe.
HHH overarching objective
Policy and research implications
18. http://hhhproject.eu
Madrid City
21 Districts
128 Neighborhoods
2.412 Census Sections (≅1.500 ps)
3,2 Mill. Residents
HHH will analyze the Integrated
Primary Care Health System
Electronic Health Records
Database of 1,4 million residents
40-75 ys. old
19. http://hhhproject.eu
HHH Study Design
Baseline Visit
Cohort
Study
1st Database
Mining
Population-
based EHR
study
4 yr follow up
2,576 participants Final Visit
Final Database
Mining
1,4 million people
Environment
Tobacco
Alcohol
Food
Physical Activity
1st Assessment 2nd AssessmentNeighborhoods
Multilevel Association
Analysis
23. http://hhhproject.eu
Resumen calendario global del estudio
Corte 2016
Seguimiento
2017
Corte 2018
Seguimiento
2019
Visita clínica +
Encuesta
telefónica
Recoger algunos
datos de Historia
clínica
Visita clínica +
Encuesta
telefónica
Recoger algunos
datos de
Historia clínica
24. http://hhhproject.eu
Visita 1
Visita Telefónica
• Dieta
• Tabaco
• Alcohol
• Actividad Física
¿Precisa
Analítica?
NO
SI
Analítica +
Visita 2 (Entrega
de resultados)
Flujo de visitas
Abrir en HCE episodio
A97
26. http://hhhproject.eu
a) Mixed Methods Exploratory Study in a Median
Area of Madrid (Usama Billal)
b) Results by domains
a) Food
b) Physical Activity
c) Tobacco
d) Alcohol
c) Results by working groups
a) Urban Geography
b) Participatory Action Research PHOTOVOICE
HHH Analyses and Results
27. http://hhhproject.eu
Selecting average neighborhoods for cross-
city comparisons in Urban Health studies:
the Median Neighborhood Index
Bilal U, Diez J, Cebrecos A, Franco M (Submitted)
Median Neighborhood Index (MNI)
Average rank distance to the median neighborhood in each
city in four sociodemographic and urban form variables:
aging (% > 65 years old), education (% with college
education), segregation (% foreign-born for Spain, or %
non-White for the US), and urban form (population density)
29. http://hhhproject.eu
Objectives
1. To describe the cardiovascular health profile of
a population over 15,000 residents living in an area,
analyzing the Madrid Primary Health Care System
electronic health records.
2. To explore different quantitative and qualitative
measurements characterizing the social and
physical urban environment in relation to food,
alcohol, tobacco and physical activity.
31. http://hhhproject.eu
Methods (quantitative)
• Cardiovascular Disease:
– Whole population (>99%) EHR through universal health system.
– Validated (1) data on physician-diagnosed: diabetes, hypertension,
dyslipidemia, smoking and obesity.
• Urban environment
– Food: location and type of food stores and food services, directly
measured healthy food availability (brief NEMS-S)
– Physical activity: SPACES audit tool for walkability and bikeability,
SOPARC audit tool for open spaces.
– Alcohol and tobacco: location and type of retailers
References: (1) de Burgos Lunar et al, BMC Med Res Methodol, 2013.
32. http://hhhproject.eu
Methods (qualitative)
• 11 semi-structured interviews with key informants:
4 long-term residents, 2 recent immigrants, 1 teacher,
1 community activist, 1 health care provider, 1 public
health officer, 1 local food store owner
• Questions on health and the environment, focusing
on sociodemographics, food, alcohol, tobacco and
physical activity.
• Analysis by triangulation incorporating an
interpretative phenomenological analysis.
33. http://hhhproject.eu
Methods (integration)
• Geographic Information Systems
– Directly collected data + Secondary administrative data
– Joined to street sections by relational union or overlaid as
administrative boundaries/blocks.
• Mixed Methods Approach: merging approach
– Provides insights on quantitative findings
• Quantitative -> qualitative
– Guides future quantitative data collection (formative)
• Qualitative -> quantitative.
35. http://hhhproject.eu
Exploratory Study Sociodemographic Profile
Primary Health Care Records
• Total Pilot Area Population: 15,751
• Population in the Primary Care Health System Geocoded to
census section level: 14,857 (95%)
– Possibility of analyzing data for 1.4 million people
36. http://hhhproject.eu
• Population 45-106 ys. old: 7,252
• Sex: 59% Women
• Diabetes Prevalence: 12%
• Diabetes Control (HbA1c<7): 63%
• Hypertension Prevalence: 34%
• Obesity (BMI >30): 20%
• Dyslipidemia, all types: 32%
Exploratory Study Cardiovascular Profile
Primary Health Care Records
37. http://hhhproject.eu
a) Mixed Methods Exploratory Study in a Madrid Median Area
b) Results by domains
a) Food (Julia Diez)
b) Physical Activity
c) Tobacco
d) Alcohol
c) Results by working groups
a) Urban Geography
b) Participatory Action Research PHOTOVOICE
HHH Analyses and Results
39. http://hhhproject.eu
Conceptual framework
Urban Food Environment
• Diet is a cardiovascular risk
factor influenced by the local
food environment
• Local food environments are a
critical influence, that may
restrict or increase people’s
abilities to make healthy
eating decisions.
• Conceptual framework from:
Franco M., Bilal U., Díez J.
(2016). Food Environment. In
The Encyclopedia of Food and
Health. B. Caballero, Finglas, P.,
and Toldrá, F. (Eds) Academic
Press, Oxford: 3: 22-26
41. http://hhhproject.eu
Food environment measures
• Objective. To develop a system to characterize, and track changes of the
local food environment, using in-store audits and secondary databases
• Methods.
1) Ground-truthing (in-store audits)
• Observers assessed all food stores present in all 42 census sections
June-July 2016, using an adapted version of the NEMS-S tool to
better reflect a Mediterranean food environment
• We integrated the NEMS-S tool in a web-based app
42. http://hhhproject.eu
2) Secondary database
• Public database “Censo de Locales”, updated monthly and freely
accessible from the city council.
• We selected all food stores located within the 42 census sections,
derived through their code provided in the database.
• We matched the food stores assessed on field and those listed in the
database based on GPS coordinates and business name and address.
• We assessed the level of agreement between the secondary database
and on field observations (sensitivity analysis, and PPV analysis) by
store type and by census section-SES
Food environment measures
45. http://hhhproject.eu
a) Mixed Methods Exploratory Study in a Madrid Median Area
b) Results by domains
a) Food
b) Physical Activity (Pedro Gullón)
c) Tobacco
d) Alcohol
c) Results by working groups
a) Urban Geography
b) Participatory Action Research PHOTOVOICE
HHH Analyses and Results
47. http://hhhproject.eu
Madrid Systematic Pedestrian and
Cycling Environment Scan (M-SPACES)
- Function
- Safety
- Aesthetics
- Destinations
M-SPACES AUDIT TOOL
Pedro Gullón et al. September 2015 Journal of Urban Health,
51. Pedro Gullón, Usama Bilal, Alba Cebrecos, Hannah M. Badland,
Francisco Escobar, Iñaki Galán, Manuel Franco
Socioeconomic Determinants of Small-
Area Walkability in a European city like
Madrid: The Heart Healthy Hoods
Project
52. http://hhhproject.eu
Figure 1. Spatial distribution of Walkability Index (a)
and Socio-Economic Status Index (b) by deciles in
the census section (N=2415) of the city of Madrid
54. http://hhhproject.eu
a) Mixed Methods Exploratory Study in a Madrid Median Area
b) Results by domains
a) Food
b) Physical Activity
c) Tobacco (Xisca Sureda)
d) Alcohol
c) Results by working groups
a) Urban Geography
b) Participatory Action Research PHOTOVOICE
HHH Analyses and Results
55. Tobacco retail environment,
outdoor smoke-free policies
and smoking
HHH Ancillary Study
PI: Xisca Sureda
Co-investigators: M. Franco, U. Bilal, FJ Escobar, A Navas, E. Fernández
Alcalá University, ICO Barcelona, Johns Hopkins Bloomberg School of Public
Health, Columbia University
Funding: European Research Council Starting Grant 2013 HeartHealthyHoods
Agreement n. 336893 and Instituto de Salud Carlos III (PI15/02146)
56. Tobacco in HHH
Urban determinants of smoking behaviour
http://hhhproject.eu
Availability &
Accessibility
Second-hand smoke
exposure in terraces
of hospitality venues
Smoking behaviour
Self-reported
second-hand smoke
exposure
Urban environments Individual behaviours
Signs of tobacco
consumption in
outdoor places
Neighborhoodsocioeconomic
characteristics
Individualsocioeconomic
characteristics
58. http://hhhproject.eu
Measurements and variables: Systematic Social Observation in 42
neighborhoods in Madrid
lugar fecha hora
área
(m2)
altura
(m)
ventilación señales
olor a
tabaco
cenicero cenizas
personal
fumando
usuarios
fumando
observaciones
Indicators of the presence of tobacco smoking: number of smokers, presence of
ashtrays, presence of cigarette butts and tobacco smell, presence of tobacco vending
machines, hours of sales in places where you can get tobacco.
Information for every
measurement
sampling: location, area,
outdoor or quasi-outdoor
space, smoke-free zone
signage
Tobacco consumption signs outdoors
59. SHS exposure outdoor hospitality
venues
http://hhhproject.eu
PM 2.5 measurements
Measurements and variables: Tobacco Airborne Markers
Airborne nicotine
We measured a total of 79 outdoor
terraces in 42 neighborhoods
People smoking in a covered terraces
60. http://hhhproject.eu
a) Mixed Methods Exploratory Study in a Madrid Median Area
b) Results by domains
a) Food
b) Physical Activity
c) Tobacco
• Alcohol (Madrid, Barcelona, Edinburgh, Baltimore)
a) Results by working groups
a) Urban Geography
b) Participatory Action Research PHOTOVOICE
HHH Analyses and Results
61. Alcohol in HHH
Urban determinants of alcohol behaviour
Sureda X, Villalbí JR, Espelt A, Franco M. Living under the influence: Normalization of alcohol consumption in our cities. Gac Sanit (in press)
63. OHCITIES Validation Results
http://hhhproject.eu
92 on-premise alcohol outlets
(50% bars and 20% restaurants)
53,7% with promotion
associated to the outlet
We measured 180 items in 92 On-Premise and 24 off-premise
alcohol outlets in 7 census sections in Madrid
24 off-premise alcohol outlets
(54% grocery stores)
88,2% with promotion
associated to the outlet
64. http://hhhproject.eu
7 alcohol promotion in public
spaces (57% sponsorship)
58 signs of alcohol consumption
Time to complete one census section: between 225 and 87 minutes depending on
the total number of alcohol-related elements in the urban environment.
Time to complete each item: on and off-premises aprox. 5-10 min; promotion and
signs of alcohol consumption in public spaces aprox. 3 min
OHCITIES Validation Results
65. http://hhhproject.eu
a) Mixed Methods Exploratory Study in a Madrid Median Area
b) Results by domains
a) Food
b) Physical Activity
c) Tobacco
d) Alcohol (Xisca Sureda)
c) Results by working groups
a) Urban Geography (Alba Cebrecos)
b) Participatory Action Research PHOTOVOICE
HHH Analyses and Results
66. http://hhhproject.eu
The aim was to design and implement a multicomponent
method based on Geographic Information Systems to
characterize and evaluate environmental correlates of obesity:
the food and the physical activity urban environments.
70. Manuel Franco, Principal Investigator
Understanding community food
environment through Photovoice:
a participatory action research project
in Villaverde, Madrid
Co-funded by
71. http://hhhproject.eu
WORLDVIEWVaccination
programmeurgently needed
to tackletyphoid in Nepal p.267
ASTRONOMYGasgiant is
lowest- massexoplanet
imaged directly p.268
NEUROSCIENCEDreams
spark visual activity
in thebrain p.269
Riseof thecitizen scientist
From theoceanstothesoil, technology ischanging thepart that amateurscan play in research.
But thisgreater involvement raisesconcernsthat must beaddressed.
S
cienceisnotjustforscientiststhesedays.Goingonascuba-diving
holidaythissummer?Sharethetemperaturedatafromyourdive
computerwithresearcherseagertoplugholesinsparserecordsfor
inshoreareas.Nervousaboutpossiblepollutionfromanearbyfracking
project?Easeyourconcernsbyhelpingtocollectandanalyseairsamples
aspart of amonitoringproject.Stuck at homeastherain poursdown?
LogontotheInternetandspendacoupleofhoursfoldingproteinsand
RNA tohelpuniversityscientistsworkout howbiologydoesit.
Citizensciencehascomealongwayfromthefirst distributed-
computingprojectsthathooveredupspareprocessingpoweronhome
Technologycanmakescientistsofusall.Datachurnedout bythe
rapidspreadofconsumergadgetsequippedwithsatellitenavigation,
camerasandasuiteofothersensors,andtheeaseofsharingtheresults
digitally,aredrivingtheboomincitizenscience.Volunteerscanalready
identifywhalesongsfromrecordings,reportlitterandinvasivespecies,
andsendintheskeletonsoffishtheyhavecaughtandconsumed.But
thereismoretobeingascientist,ofcourse,thancollectingandsharing
data—especiallyif theresultsaretobeusedtohelpdeterminepolicy.
Criticshaveraisedconcernsabout dataquality,andsomestudies
dofindthat volunteersarelessabletoidentifyplant speciesthanare
EDITORIALS
THISWEEK
Citizen Science
77. http://hhhproject.eu
Photovoice Publications
1. “Understanding the local food environment: a participatory Photovoice
project in a low-income area in Madrid, Spain” Under review
2. “Barriers and facilitators for accessing healthy foods: a mixed methods
study using GIS, on field measures and photovoice” In progress
3. “Translating participatory research into food policy recommendations:
The Photovoice Villaverde Food Project in Madrid.” In progress
4. “Photovoice as a tool to gain empowerment? : Evaluating the
transformative potential of a Participatory Action Research project in
Villaverde (Madrid) for their female participants.” In progress
5. “Improving the retail food environment in cities. A stakeholder public
discussion in Madrid: The Heart Healthy Hoods Project.” In progress
78. http://hhhproject.eu
HHH Current
Scientific Achievements
• 7 international papers and 3 book chapters
• Bilingual photobook and public exhibition
• 4 funded ancillary studies
• 3 Predoctoral and one Erasmus master fellowships
• Intramural: 2 communications awards
• 4 travel grants for US (Joel Gittelsohn and Luisa
Borrell) and UK researchers (Daniel Lewis and
Jamie Pearce)
79. http://hhhproject.eu
HHH future scientific steps
Waiting on grants:
• Photovoice on urban environment and physical activity
• Alcohol Urban Environment in Madrid and Barcelona
(Collaboration: Madrid, Barcelona, Edinburgh, Baltimore)
Working on training grant:
• Cardiovascular Prevention and Policy Research Initiative for
Europe and Latin America (CAPRIELA)
• Liverpool, Utrecht, Lima and Buenos Aires
Open for collaborations with LSHTM researchers
80. http://hhhproject.eu
• Participants
• Whole HHH Madrid team and collaborations
• Different funding agencies:
• European Research Council
• Fundación Mapfre
• Ayuntamiento de Madrid
• Fondo de Investigación Sanitaria
• Plan Nacional de Investigación
• Center for a Livable Future, Johns Hopkins
• LSHTM Centre for Global NCDs
Acknowledgements
82. Centre for Global NCDs Seminar Series
November 14 2016
¡ Gracias !
Manuel Franco MD, PhD
for the HHH investigators
Editor's Notes
el logo arriba y abajo queda repetido. Propongo quitar la chapa y centrar el título
Mapa de 1937 delimitando zonas por nivel de seguridad, que tenían un efecto directo en la compra de casas y las hipotecas que se daban.
Empresas seleccionaban exclusivamente residentes blancos para las áreas de nueva construcción.
Estas politicas de segregacion activa se mantuvieron desde 1890 hasta 1950
Mapa de 1937 delimitando zonas por nivel de seguridad, que tenían un efecto directo en la compra de casas y las hipotecas que se daban.
Empresas seleccionaban exclusivamente residentes blancos para las áreas de nueva construcción.
Estas politicas de segregacion activa se mantuvieron desde 1890 hasta 1950
Mapa de 1937 delimitando zonas por nivel de seguridad, que tenían un efecto directo en la compra de casas y las hipotecas que se daban.
Empresas seleccionaban exclusivamente residentes blancos para las áreas de nueva construcción.
Estas politicas de segregacion activa se mantuvieron desde 1890 hasta 1950
Mapa de 1937 delimitando zonas por nivel de seguridad, que tenían un efecto directo en la compra de casas y las hipotecas que se daban.
Empresas seleccionaban exclusivamente residentes blancos para las áreas de nueva construcción.
Estas politicas de segregacion activa se mantuvieron desde 1890 hasta 1950
Mapa de 1937 delimitando zonas por nivel de seguridad, que tenían un efecto directo en la compra de casas y las hipotecas que se daban.
Empresas seleccionaban exclusivamente residentes blancos para las áreas de nueva construcción.
Estas politicas de segregacion activa se mantuvieron desde 1890 hasta 1950
el logo arriba y abajo queda repetido. Propongo quitar la chapa y centrar el título
Te propongo cambiar le orden de las diapos 6 y 7 --> introducir primero CV health y social epidemiology para despues presentar la 7 para ver como se relacionan una con la otra. La 7 sirve para introducir el marco conceptual...la 6 más bien como justificaicón del estudio
Hacer un poco más pequeña la imagen para dejar márgenes
Repasar animacion! Porque al final sale el titulo de la diapo...valorar si el tñitulo sale desde el principio
porque el segundo punto en cursiva? uniformizar el fomrato (letra/tamañao de las diapos) --> las diapos de objetivos tienen letra diferente
creo que le segundo objetivo más que un objetivo en si podría ponerse com un apartado al final de Public Health // POlicy implication of the study
using a qualitative approach
aqui de pronto aparece nuestra "interdisciplinaridad" -->sugiero comentarlo en metodos y dejar la descripcion del team para el final de la presentación
Incluso en el comité asesor nacional e internacional INTERDISCIPLINARIDAD
Tipo de estudio--> aqui parece que solo se hace cohort y population --> debría presentarse la metodología cualitativa, systemactic observation... A lo mejor podrías añadir una diapo de como se hace el environmental assessment
HHH preguntas?
hay mas apartados....publications, HHH and media...no salen en el seminar outline...
quitar Intro European Research Council por un punto que sea HHH introducción --> dentro de introducción ya explicarás la financiación de este proyecto
hay mas apartados....publications, HHH and media...no salen en el seminar outline...
quitar Intro European Research Council por un punto que sea HHH introducción --> dentro de introducción ya explicarás la financiación de este proyecto
hay mas apartados....publications, HHH and media...no salen en el seminar outline...
quitar Intro European Research Council por un punto que sea HHH introducción --> dentro de introducción ya explicarás la financiación de este proyecto
hay mas apartados....publications, HHH and media...no salen en el seminar outline...
quitar Intro European Research Council por un punto que sea HHH introducción --> dentro de introducción ya explicarás la financiación de este proyecto
tnemos que mejorar los apartados de cada parte del piloto que se ha hecho y unificar el formato....comenzar con objetivo, poblacion estudio...
Intro para empezar a hablar del food environment
Diapo: Our conceptual framework to study the influence of the local food environment on population diet quality. In the HHH, we are currently focusing on both the community and the consumer food environment (how many food stores have residents´available in their neighborhood? Of what type? What kind of healthy food products can they within these food stores? At which Price? Do they need a car to Access them? …)
(No sé si quieres hablar del piloto…)
Data collection took place between march-june 2013, by one trained observer (a.k.a me) in 12 census sections.
We classified and conducted a direct auditing of all food stores present, using the Nutrition Environment Measurement in Stores (NEMS-S) left panel (number and type of food stores, we identified 44 food stores)
We then computed a Healthy Food Availability Index for each store following ascoring system that ranges from 0–28, with a higher score indicating a greater availability of healthy foods right panel (Supermarkets scored highest in terms of Healthy Food Availability (25.5 out of 28) and convenience stores the lowest (7.5 out of 28)).
On the NEMS-S:
is widely recognized as a robust and valid tool for assessing the community and consumer nutrition environment, with high reliability and validity.
It measures the availability, quality and cost of healthy foods options (compared to unhealthy food options) within 11 main food categories, based on a mainstream American diet
It is considered a “pseudo-gold standard” to assess directly on field the community or consumer food environment.
We aimed to understand cross-national differences in the local food environment between Madrid and Baltimore by comparing an average neighborhood in each city in terms of food store types, healthy food availability, and residents' pedestrian access.
Method: Throughout a street network analysis (200m, 400m and 800m) of food stores with high healthy food availability, we estimated residents' pedestrian accessibility.
Results: In Madrid, 77% of the residents lived within less than 200m from a food store with high healthy food availability. In contrast, 95% of Baltimore's residents lived further than 400m from these stores.
La herramienta que hemos usado se denomina SPACES (systematic pedestrian and cycling environment scan). Esa herramienta fue desarrollada por investigadores de Australia mediante un método Delphi, y modificada por un grupo de Nueva Zelanda. En nuestro caso, hemos hecho pequeñas modificaciones por comodidad que no afectan a los pesos finales.
El SPACES se va rellenando por el investigador a ambos lados de la calle
El SPACES divide en 4 factores el entorno urbano de las calles para andar o usar la bicicleta: función, seguridad, estética y destinos. Estos se dividen asimismo en elementos e ítems (lo que medimos directamente con el formulario). Poniendo el ejemplo de entorno para andar:
Función se refiere a los aspectos más físicos de la calle, incluyendo los aspectos de la acera (tipo de pavimento, cuesta y continuidad son lo que más cuenta) , la situación, y la infraestructura que ayuda a andar (asientos y árboles).
Seguridad abarca aspectos de seguridad personal (visibilidad, farolas, grafitis…), regulación de tráfico (señales, carriles, cruces…).
Estética incluye aspectos más “subjetivos” , como el grado de dificultad y el atractivo de la calle; como también incluye vistas y los elementos que hacen más “bonita” la calle.
Los destinos son todos aquellos sitios de la calle que puedan motivarte a ir a ello (y que no sean casas), como las paradas de transporte público, tiendas, parques, servicios públicos…
hay mas apartados....publications, HHH and media...no salen en el seminar outline...
quitar Intro European Research Council por un punto que sea HHH introducción --> dentro de introducción ya explicarás la financiación de este proyecto
Thank you JR for invite me today to present this Project that we are goin to conduct in Madrid city in the next few month
En los últimos años ha habido especial interés en cómo el entorno social, urbano y cultural contribuye a la conformación de los resultados en salud y factores de riesgo comportamentales.
la accesibilidad al tabaco (en términos de densidad de puntos de venta de tabaco, proximidad a los puntos de venta, tipo de localización dónde adquirir tabaco y horarios de venta al público) ha estado mucho más desregulada. Aunque existe todavía poco literatura del tema se ha vistos que la densidad de puntos de venta de tabaco y la ubicación de éstos también podría influir en las características de consumo de tabaco. Ademas diversos estudios han demostrado también la posible relación entre el gradiente socioeconómico del barrio o lugar de residencia con una distribución desigual de la accesibilidad al tabaco.
En el mapa vemos la densidad de estancos por cada 10,000 habitantes para cada uno de los 128 barrios del municipio de Madrid utilizando los datos del comisionado para el mercado de tabacos (2013) y la proporción de población con bajo nivel educativo por barrio (obtenido de los datos del padrón municipal de Madrid (2014). Los resultados mostraron un aumento de la densidad de estancos a mayor población con menos nivel educativo (Ver mapas anexo) .
Se realizarán medidas de 45 minutos en la localización de interés ( y 15 min en la zona control) y las concentraciones de PM2.5 se expresarán en microgramos por metro cúbico (µg/m3).
En los últimos años ha habido especial interés en cómo el entorno social, urbano y cultural contribuye a la conformación de los resultados en salud y factores de riesgo comportamentales.
El objectivo de este estudio fue integrar datos de los entornos de alimentacion y de actividad física mediante el uso de SIG.
Convertimos datos puntuales y lineales en una superfície matemàtica continua de todo el àrea de estudio (uno para cada dominio)
¿Cómo lo hicimos?
SPACES es una herramienta de medición diseñada por Pikora para estudiar la disposición de una calle a facilitar la caminabilidad a los transeúntes. En este estudio se utilizó la herramienta adaptada por P.Gullón para la ciudad de Madrid (M_SPACES).
Todas las tiendas de alimentación fueron medidas utilizando la herramienta NEMS diseñada por Glanz en su versión abreviada. A partir de estas medidas se calculó un índice de disponibilidad de alimentos saludables que varía de 0 – 27.5 (puntuaciones mas altas, tiendas más saludables)
Toda la info obtenida de la observación social se geolocalizó y se integró dentro de un GIS que nos permitió calcular superficies de densidad de Kernel.
h: bandwith (determina el grado de suavidad)
n: number of cases (sample size)
x-Xi= distancia geográfica entre el caso Xi y otro caso
K= Kernel function ( en este caso se utiliza la quadratica K(t)=3/4(1-t^2)
(conceptualmente) sobre cada punto ajusta una superficie curva suave . El valor de la superficie es más alta en la localización del punto y disminuye al aumentar la distancia desde el punto, llegando a cero en el limite del bandwith desde el punto. El espacio debajo de la superficie es igual al valor HFAI para cada punto. La densidad en cada celda de la imagen de salida se calcula sumando los valores de todas las superficies del Kernel en el que se superponen
Caracterización a nivel de sección censal por ser la unidad administrativa más pequeña en la que se encuentran las estadísticas sociodemográficas.
Characterization created by using natural Jenks grouped the census sections into 4 categories about themselves according to the average score: low (17.7 to 21.6), medium-low (21.7 to 30.8), medium-high (30.9 to 35.1) and high (35.2 to 43.8).
4.2% de la población vive en una sección caracterizada como saludable. Un 41% vive en unas sección caracterizada como poco saludable
Incluso en el comité asesor nacional e internacional INTERDISCIPLINARIDAD
el logo arriba y abajo queda repetido. Propongo quitar la chapa y centrar el título
