The overcrowding of first aid facilities creates considerable hardship and problems which have repercussions on patients’ wellbeing, the time needed for a diagnosis, and on the quality of the assistance. The basic objective of this contribution, based on the data collected by the Hospital Policlinico Umberto I in Rome (Lazio region, Italy), is to carry out a territorial screening of the municipality using GIS applications and spatial analyses aimed at reducing—in terms of triage—code white (inappropriate) attendances, after having identified the areas of greatest provenance of improperly used emergency room access. Working in a GIS environment and using functions for geocoding, we have tested an experimental model aimed at giving a close-up geographical-sanitary look at the situation: recognizing the territorial sectors in Rome which contribute to amplifying the Policlinico Umberto I emergency room overcrowding; leading up to an improvement of the situation; promoting greater awareness and knowledge of the services available on the territory, a closer relationship between patient and regular doctor (general practitioner, GP) or Local Healthcare Unit and a more efficient functioning of the emergency room. In particular, we have elaborated a “source” map from which derive all the others and it is a dot map on which all the codes white have been geolocalized on a satellite image through geocoding. We have produced three sets made up of three digital cartographic elaborations each, constructed on the census sections, the census areas and the sub-municipal areas, according to data aggregation, for absolute and relative values, and using different templates. Finally, following the same methodology and steps, we elaborated another dot map about all the codes red to provide another kind of information and input for social utility. In the near future, this system could be tested on a platform that spatially analyzes the emergency department (ED) accesses in near-real-time in order to facilitate the identification of critical territorial issues and intervene in a shorter time to regulate the influx of patients to the ED.
This paper—which is contextualized in the discussion on the methodological pluralism and the main topics of medical geography, the complexity theory in geographies of health, the remaking of medical geography and ad hoc systems of data elaboration—focuses on radio base stations (RBSs) as sources of electromagnetic fields, to provide GIS applications and simplifying-prudential models that are able to identify areas that could potentially be exposed to hazard. After highlighting some specific aspects regarding RBSs and their characteristics and summarizing the results of a number of studies concerning the possible effects of electromagnetic fields on health, we have taken an area of north-east Rome with a high population and building density as a case study, and we have provided some methodological and applicative exemplifications for different situations and types of antennas. Through specific functionalities and criteria, drawing inspiration from a precautionary principle, these exemplifications show some particular cases in order to support: possible risk factor identification, surveillance and spatial analysis; correlation analysis between potential risk factors and outbreak of diseases and symptoms; measurement campaigns in heavily exposed areas and buildings; education policies and prevention actions. From an operative viewpoint, we have: conducted some field surveys and recorded data and images with specific geotechnological and geomatics instruments; retraced the routes by geobrowsers and basemaps and harmonized and joined up the materials in a GIS environment; used different functions to define, on aero-satellite images, concentric circular buffer zones starting from each RBS, and geographically and geometrically delimited the connected areas subject to high and different exposure levels; produced digital applications and tested prime three-dimensional models, in addition to a video from a bird’s eye view perspective, able to show the buildings in the different buffer zones and which are subject to a hazard hierarchy due to exposure to an RBS. A similar GIS-based model—reproposable with methodological adjustments to other polluting sources—can make it possible to conceive a dynamic and multiscale digital system functional in terms of strategic planning, decision-making and public health promotion in a performant digital health information system.
ABSTRACT. In this paper we provide an overview of the main causes of death in the province of Rome in 1981 and, showing the most relevant variations which have been recorded over time. Using ArcGIS 9.2 software, we have drawn up several medical-geographical thematic maps and specific land use maps which corroborate the temporal and spatial analysis, and which provide suggestions about the relation between causes of death and certain risk factors. Particular attention is given to the diseases of the circulatory system and neoplasms which caused, respectively, 38.4% and 32.6% of deaths in 2007 and which followed substantially different trends. Then, we focus on the city of Rome, where we examine the evolution of land use between 1980 and 2001 in order to investigate, by means of detailed screening, the changes recorded in a city where, in 2007, 67% of the inhabitants of Rome province lived.
Objective Coronavirus disease 2019 demonstrated the inconsistencies in adequately responding to biological threats on a global scale due to a lack of powerful tools for assessing various factors in the formation of the epidemic situation and its forecasting. Decision support systems have a role in overcoming the challenges in health monitoring systems in light of current or future epidemic outbreaks. This paper focuses on some applied examples of logistic planning, a key service of the Earth Cognitive System for Coronavirus Disease 2019 project, here presented, evidencing the added value of artificial intelligence algorithms towards predictive hypotheses in tackling health emergencies. Methods Earth Cognitive System for Coronavirus Disease 2019 is a decision support system designed to support healthcare institutions in monitoring, management and forecasting activities through artificial intelligence, social media analytics, geospatial analysis and satellite imaging. The monitoring, management and prediction of medical equipment logistic needs rely on machine learning to predict the regional risk classification colour codes, the emergency rooms attendances, and the forecast of regional medical supplies, synergically enhancing geospatial and temporal dimensions. Results The overall performance of the regional risk colour code classifier yielded a high value of the macro-average F1-score (0.82) and an accuracy of 85%. The prediction of the emergency rooms attendances for the Lazio region yielded a very low root mean square error (<11 patients) and a high positive correlation with the actual values for the major hospitals of the Lazio region which admit about 90% of the region's patients. The prediction of the medicinal purchases for the regions of Lazio and Piemonte has yielded a low root mean squared percentage error of 16%. Conclusions Accurate forecasting of the evolution of new cases and drug utilisation enables the resulting excess demand throughout the supply chain to be managed more effectively. Forecasting during a pandemic becomes essential for effective government decision-making, managing supply chain resources, and for informing tough policy decisions.
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