The burgeoning field of transdisciplinary adaptation research in Quebec (1998-): a climate change-related public health narrative

This paper presents a public health narrative on Quebec's new climatic conditions and human health, and describes the transdisciplinary nature of the climate change adaptation research currently being adopted in Quebec, characterized by the three phases of problem identification, problem investigation, and problem transformation. A transdisciplinary approach is essential for dealing with complex ill-defined problems concerning human-environment interactions (for example, climate change), for allowing joint research, collective leadership, complex collaborations, and significant exchanges among scientists, decision makers, and knowledge users. Such an approach is widely supported in theory but has proved to be extremely difficult to implement in practice, and those who attempt it have met with heavy resistance, succeeding when they find the occasional opportunity within institutional or social contexts. In this paper we narrate the ongoing struggle involved in tackling the negative effects of climate change in multi-actor contexts at local and regional levels, a struggle that began in a quiet way in 1998. The paper will describe how public health adaptation research is supporting transdisciplinary action and implementation while also preparing for the future, and how this interaction to tackle a life-world problem (adaptation of the Quebec public health sector to climate change) in multi-actors contexts has progressively been established during the last 13 years. The first of the two sections introduces the social context of a Quebec undergoing climate changes. Current climatic conditions and expected changes will be described, and attendant health risks for the Quebec population. The second section addresses the scientific, institutional and normative dimensions of the problem. It corresponds to a "public health narrative" presented in three phases: (1) problem identification (1998-2002) beginning in northern Quebec; (2) problem investigation (2002-2006) in which the issues are successively explored, understood, and conceptualized for all of Quebec, and (3) problem transformation (2006-2009), which discusses major interactions among the stakeholders and the presentation of an Action Plan by a central actor, the Quebec government, in alliance with other stakeholders. In conclusion, we underline the importance, in the current context, of providing for a sustained transdisciplinary adaptation to climatic change. This paper should be helpful for (1) public health professionals confronted with establishing a transdisciplinary approach to a real-world problem other than climate change, (2) professionals in other sectors (such as public safety, built environment) confronted with climate change, who wish to implement transdisciplinary adaptive interventions and/or research, and (3) knowledge users (public and private actors; nongovernment organizations; citizens) from elsewhere in multi-contexts/environments/sectors who wish to promote complex collaborations (with us or not), collective leadership, and "transfrontier knowledge-to-action" for implementing climate change-related adaptation measures.

An open source web application for the surveillance and prevention of the impacts on public health of extreme meteorological events: the SUPREME system

BACKGROUND

Every year, many deaths or health problems are directly linked to heat waves. Consequently, numerous jurisdictions around the world have developed intervention plans that are employed during extreme heat events; beyond their emergency sections, these plans generally include preventive measures to be implemented each year. Over the last five years, local and regional information systems have been implemented in a few Canadian cities for surveillance purposes. However, until recently, no such systems existed at the provincial level. In the context of the Government of Quebec's 2006-2012 Action Plan on Climate Change, a real-time integrated system for the surveillance and monitoring of extreme heat events has been implemented on a provincial level. The system is a component of a broader approach that would also monitor the public health impacts of all types of extreme meteorological events.

RESULTS

After conducting a detailed needs analysis, the Quebec National Institute for Public Health developed and implemented an integrated web application leveraging open source software for the real-time Surveillance and Prevention of the impacts of Extreme Meteorological Events on public health, called the SUPREME system. Its first field use involved heat waves. This decision-support system is based on open source software and is composed of four modules: (1) data acquisition and integration, (2) risk analysis and alerts, (3), cartographic application, and (4) information dissemination - climate change and health portal. The system is available to health specialists through a secure web information portal and provides access to weather forecasts, historic and real-time indicators (including deaths and hospital admissions), alerts and various cartographic data used for conducting prevention activities and launching emergency measures.

CONCLUSIONS

The SUPREME system was implemented and used during the summer of 2010. It served as an important decision-making tool during the July 2010 heat wave in the province of Quebec, Canada. Planned improvements for 2011 include the integration of data related to other risk factors for other extreme events to the system. The next steps will be to provide access to the application to other groups of specialists that are involved in the prevention, monitoring, or analysis of extreme meteorological events and their effects on community health and well-being.

Interface-mediated interactions: entropic forces of curved membranes

Particles embedded in a fluctuating interface experience forces and torques mediated by the deformations and by the thermal fluctuations of the medium. Considering a system of two cylinders bound to a fluid membrane, we show that the entropic contribution enhances the curvature-mediated repulsion between the two cylinders. This is contrary to the usual attractive Casimir force in the absence of curvature-mediated interactions. For a large distance between the cylinders, we retrieve the renormalization of the surface tension of a flat membrane due to thermal fluctuations.

Do patients with recurrent episodes of campylobacteriosis differ from those with a single disease event?

BACKGROUND

Although Campylobacter is the leading cause of reported bacterial gastro-enteritis in industrialized countries, little is known on its recurrence. The objective of this study is to describe the risk and the patient characteristics of recurrent episodes of human campylobacteriosis reported in Quebec.

METHODS

Laboratory-confirmed cases of campylobacteriosis reported in the province of Quebec, Canada, through ongoing surveillance between 1996 and 2006 were analyzed. The risk of having a recurrent episode of campylobacteriosis was described using life table estimates. Logistic regression was used to assess if gender, age and patient residential location were associated with an increased risk of recurrence.

RESULTS

Compared to the baseline risk, the risk for a recurrent disease event was higher for a period of four years and followed a decreasing trend. This increased risk of a recurrent event was similar across gender, but higher for people from rural areas and lower for children under four years of age.

CONCLUSIONS

These results may suggest the absence of durable immunity or clinical resilience following a first episode of campylobacteriosis and periodical re-exposure, at least among cases reported through the surveillance system.

The voluntary control of facial action units in adults

We investigated adults' voluntary control of 20 facial action units theoretically associated with 6 basic emotions (happiness, fear, anger, surprise, sadness, and disgust). Twenty young adults were shown video excerpts of facial action units and asked to reproduce them as accurately as possible. Facial Action Coding System (FACS; Ekman & Friesen, 1978a) coding of the facial productions showed that young adults succeeded in activating 18 of the 20 target actions units, although they often coactivated other action units. Voluntary control was clearly better for some action units than for others, with a pattern of differences between action units consistent with previous work in children and adolescents.

[Research, impact and adaptation in public health for the new climate of Quebec]

After its modest beginnings focusing on arctic Quebec in 1999, the Quebec research programme on health and climate change became interested in the remainder of the province around 2002. The European heat wave in 2003 accelerated the pace of this programme and prompted the Quebec health sector's participation in the Ouranos Research Consortium. The research findings from the 2003-2006 period have directly fed into the health component of the Quebec government's climate change action plan (2006-2012), financed through the first carbon tax in the Americas. This component is planning for a series of adaptations to the health network and to some other public networks, which will apply to construction, the built environment and outdoor developments, clinical management methods and practices, public health surveillance as well as emergency preparedness. In this article, the authors describe how research is supporting action and implementation, while also preparing for the future, and how this interaction has progressively established itself over the last 10 years.

The association between farming activities, precipitation, and the risk of acute gastrointestinal illness in rural municipalities of Quebec, Canada: a cross-sectional study

Background

Increasing livestock density and animal manure spreading, along with climate factors such as heavy rainfall, may increase the risk of acute gastrointestinal illness (AGI). In this study we evaluated the association between farming activities, precipitation and AGI.

Methods

A cross-sectional telephone survey of randomly selected residents (n = 7006) of 54 rural municipalities in Quebec, Canada, was conducted between April 2007 and April 2008. AGI symptoms and several risk factors were investigated using a phone questionnaire. We calculated the monthly prevalence of AGI, and used multivariate logistic regression, adjusting for several demographic and risk factors, to evaluate the associations between AGI and both intensive farming activities and cumulative weekly precipitation. Cumulative precipitation over each week, from the first to sixth week prior to the onset of AGI, was analyzed to account for both the delayed effect of precipitation on AGI, and the incubation period of causal pathogens. Cumulative precipitation was treated as a four-category variable: high (≥90^th percentile), moderate (50^th to <90^th percentile), low (10^th to <50^th percentile), and very low (<10^th percentile) precipitation.

Results

The overall monthly prevalence of AGI was 5.6% (95% CI 5.0%-6.1%), peaking in winter and spring, and in children 0-4 years old. Living in a territory with intensive farming was negatively associated with AGI: adjusted odds ratio (OR) = 0.70 (95% CI 0.51-0.96). Compared to low precipitation periods, high precipitation periods in the fall (September, October, November) increased the risk of AGI three weeks later (OR = 2.20; 95% CI 1.09-4.44) while very low precipitation periods in the summer (June, July, August) increased the risk of AGI four weeks later (OR = 2.19; 95% CI 1.02-4.71). Further analysis supports the role of water source on the risk of AGI.

Conclusions

AGI poses a significant burden in Quebec rural municipalities with a peak in winter. Intensive farming activities were found to be negatively associated with AGI. However, high and very low precipitation levels were positively associated with the occurrence of AGI, especially during summer and fall. Thus, preventive public health actions during such climate events may be warranted.

Easier surveillance of climate-related health vulnerabilities through a Web-based spatial OLAP application

BACKGROUND

Climate change has a significant impact on population health. Population vulnerabilities depend on several determinants of different types, including biological, psychological, environmental, social and economic ones. Surveillance of climate-related health vulnerabilities must take into account these different factors, their interdependence, as well as their inherent spatial and temporal aspects on several scales, for informed analyses. Currently used technology includes commercial off-the-shelf Geographic Information Systems (GIS) and Database Management Systems with spatial extensions. It has been widely recognized that such OLTP (On-Line Transaction Processing) systems were not designed to support complex, multi-temporal and multi-scale analysis as required above. On-Line Analytical Processing (OLAP) is central to the field known as BI (Business Intelligence), a key field for such decision-support systems. In the last few years, we have seen a few projects that combine OLAP and GIS to improve spatio-temporal analysis and geographic knowledge discovery. This has given rise to SOLAP (Spatial OLAP) and a new research area. This paper presents how SOLAP and climate-related health vulnerability data were investigated and combined to facilitate surveillance.

RESULTS

Based on recent spatial decision-support technologies, this paper presents a spatio-temporal web-based application that goes beyond GIS applications with regard to speed, ease of use, and interactive analysis capabilities. It supports the multi-scale exploration and analysis of integrated socio-economic, health and environmental geospatial data over several periods. This project was meant to validate the potential of recent technologies to contribute to a better understanding of the interactions between public health and climate change, and to facilitate future decision-making by public health agencies and municipalities in Canada and elsewhere. The project also aimed at integrating an initial collection of geo-referenced multi-scale indicators that were identified by Canadian specialists and end-users as relevant for the surveillance of the public health impacts of climate change. This system was developed in a multidisciplinary context involving researchers, policy makers and practitioners, using BI and web-mapping concepts (more particularly SOLAP technologies), while exploring new solutions for frequent automatic updating of data and for providing contextual warnings for users (to minimize the risk of data misinterpretation). According to the project participants, the final system succeeds in facilitating surveillance activities in a way not achievable with today's GIS. Regarding the experiments on frequent automatic updating and contextual user warnings, the results obtained indicate that these are meaningful and achievable goals but they still require research and development for their successful implementation in the context of surveillance and multiple organizations.

CONCLUSION

Surveillance of climate-related health vulnerabilities may be more efficiently supported using a combination of BI and GIS concepts, and more specifically, SOLAP technologies (in that it facilitates and accelerates multi-scale spatial and temporal analysis to a point where a user can maintain an uninterrupted train of thought by focussing on "what" she/he wants (not on "how" to get it) and always obtain instant answers, including to the most complex queries that take minutes or hours with OLTP systems (e.g., aggregated, temporal, comparative)). The developed system respects Newell's cognitive band of 10 seconds when performing knowledge discovery (exploring data, looking for hypotheses, validating models). The developed system provides new operators for easily and rapidly exploring multidimensional data at different levels of granularity, for different regions and epochs, and for visualizing the results in synchronized maps, tables and charts. It is naturally adapted to deal with multiscale indicators such as those used in the surveillance community, as confirmed by this project's end-users.

Use of an internet "viral" marketing software platform in health promotion

BACKGROUND

Health-related websites have become a common tool for public health authorities to inform the general public of their health promotion information and programs. However, building traffic in the cluttered health Internet universe is becoming increasingly complex, costly, and challenging for governmental health promotion websites. In 2006, the Canadian Health Network (CHN), a cooperative program made up of the Public Health Agency of Canada (PHAC) and some 20 health non-governmental organizations (NGOs), was looking for an affordable marketing tool for the promotion of its website and contents to specific populations.

OBJECTIVE

To test new and innovative marketing tools for a health promotion website in Canada.

METHODS

Within the context and constraints of a governmental health promotion website, an adaptation of a commercial Internet viral marketing software platform was developed and implemented under the name "The Crazy Race". This process was done interactively between seven NGOs and the CHN staff. The communication objectives were (a) to provide a meaningful visit that could communicate important public health messages, and (b) to increase subscriptions to its e-newsletter. A nine-step standardized Web-user experience (Internet path) was thus defined and experimented with under a pre-determined operating budget of less then Can$50,000, mainly paid for by participating organizations on a pay-per-performance basis.

RESULTS

An initial group of 215 people were sent an invitation to participate in the campaign. Over its 15-day duration, the campaign generated by itself and without any media support a total of 110,200 Web user participants who registered and sent a total of 439,275 invitations (2% of the Canadian Web-user population of 21.8 million in 2006). The epidemic self-dissemination of the campaign occurred in both French and English populations and spread across all age groups. Two-thirds of the participants were women.

CONCLUSIONS

The use of an Internet viral marketing platform proved to be effective in bringing thousands of Web users to discover and explore a governmental health promotion website. The exponential growth of the person-to-person dissemination generated by the campaign indicates that public health messages have high viral propagation potential on the Internet ("virulence") when they are presented in the context of an enjoyable online game. This could constitute a promising method to create affordable mass audience public health campaigns, both in Canada and internationally.

The geosimulation of West Nile virus propagation: a multi-agent and climate sensitive tool for risk management in public health

Background

Since 1999, the expansion of the West Nile virus (WNV) epizooty has led public health authorities to build and operate surveillance systems in North America. These systems are very useful to collect data, but cannot be used to forecast the probable spread of the virus in coming years. Such forecasts, if proven reliable, would permit preventive measures to be put into place at the appropriate level of expected risk and at the appropriate time. It is within this context that the Multi-Agent GeoSimulation approach has been selected to develop a system that simulates the interactions of populations of mosquitoes and birds over space and time in relation to the spread and transmission of WNV. This simulation takes place in a virtual mapping environment representing a large administrative territory (e.g. province, state) and carried out under various climate scenarios in order to simulate the effects of vector control measures such as larviciding at scales of 1/20 000 or smaller.

Results

After setting some hypotheses, a conceptual model and system architecture were developed to describe the population dynamics and interactions of mosquitoes (genus Culex) and American crows, which were chosen as the main actors in the simulation. Based on a mathematical compartment model used to simulate the population dynamics, an operational prototype was developed for the Southern part of Quebec (Canada). The system allows users to modify the parameters of the model, to select various climate and larviciding scenarios, to visualize on a digital map the progression (on a weekly or daily basis) of the infection in and around the crows' roosts and to generate graphs showing the evolution of the populations. The basic units for visualisation are municipalities.

Conclusion

In all likelihood this system might be used to support short term decision-making related to WNV vector control measures, including the use of larvicides, according to climatic scenarios. Once fully calibrated in several real-life contexts, this promising approach opens the door to the study and management of other zoonotic diseases such as Lyme disease.

Use of residential wood heating in a context of climate change: a population survey in Québec (Canada)

Background

Wood heating is recommended in several countries as a climate change (CC) adaptation measure, mainly to increase the autonomy of households during power outages due to extreme climatic events. The aim of this study was to examine various perceptions and individual characteristics associated with wood heating through a survey about CC adaptations.

Methods

A telephone survey (n = 2,545) of adults living in the southern part of the province of Québec (Canada) was conducted in the early fall season of 2005. The questionnaire used closed questions and measured the respondents' beliefs and current adaptations about CC. Calibration weighting was used to adjust the data analysis for the respondent's age and language under stratified sampling based on health regions.

Results

More than three out of four respondents had access to a single source of energy at home, which was mainly electricity; 22.2% combined two sources or more; 18.5% heated with wood occasionally or daily during the winter. The prevalence of wood heating was higher in the peripheral regions than in the more urban regions, where there was a higher proportion of respondents living in apartments. The prevalence was also higher with participants completely disagreeing (38.5%) with the eventual prohibition of wood heating when there is smog in winter, compared to respondents somewhat disagreeing (24.2%) or agreeing (somewhat: 17.5%; completely: 10.4%) with the adoption of this strategy. It appears that the perception of living in a region susceptible to winter smog, smog warnings in the media, or the belief in the human contribution to CC, did not influence significantly wood heating practices.

Conclusion

Increased residential wood heating could very well become a maladaptation to climate change, given its known consequences on winter smog and respiratory health. It would thus be appropriate to implement a long-term national program on improved and controlled residential wood heating. This would constitute a "no-regrets" adaptation to climate change, while reducing air pollution and its associated health impacts.

The Integrated System for Public Health Monitoring of West Nile Virus (ISPHM-WNV): a real-time GIS for surveillance and decision-making

Background

After its first detection in North America in New York in 1999, West Nile virus was detected for the first time in 2002 in the province of Quebec, Canada. This situation forced the Government of Quebec to adopt a public health protection plan against the virus. The plan comprises several fields of intervention including the monitoring of human cases, Corvidae and mosquitoes in order to ensure the early detection of the presence of the virus in a particular area. To help support the monitoring activities, the Integrated System for Public Health Monitoring of West Nile Virus (ISPHM-WNV) has been developed.

Results

The ISPHM-WNV is a real-time geographic information system for public health surveillance of West Nile virus and includes information on Corvidae, mosquitoes, humans, horses, climate, and preventive larvicide interventions. It has been in operation in the province of Quebec, Canada, since May 2003. The ISPHM-WNV facilitates the collection, localization, management and analysis of monitoring data; it also allows for the display of the results of analyses on maps, tables and statistical diagrams.

Conclusion

The system is very helpful for field workers in all regions of the province, as well as for central authorities. It represents the common authoritative source of data for analysis, exchange and decision-making.

Free-energy formalism for particle adsorption

The equilibrium properties of particle adsorption is investigated theoretically. The model relies on a free-energy formulation which allows us to generalize the Maxwell-Boltzmann description to solutions for which the bulk volume fraction of potentially adsorbed particles is very high. As an application we consider the equilibrium physical adsorption of neutral and charged particles from solution onto two parallel adsorbing surfaces.

Jugement de l'authenticité des sourires et détection des indices faciaux

The smile is one of the most often expressed emotions during social interactions. It can be authentic, that is, associated with a joyful emotional state in the person expressing it, but it can also be false, that is, deliberately produced in the absence of that emotional state in order to deceive one or more individuals (Ekman, 1993). Even though the fake smile very much resembles the authentic smile, it generally does not constitute the perfect simile. The fake smile more often has a certain degree of asymmetry than the authentic smile (Ekman, Hager, & Friesen, 1981) and it uses the cheek raiser action less often than with the authentic smile (Ekman, Friesen, & O'Sullivan, 1988; Frank, Ekman, & Friesen, 1993). This study looked at the knowledge that adults have of these differences as well as their perceptive ability to detect them. The visual stimuli presented to participants were prepared using the Facial Action Coding System (Ekman & Friesen, 1978). Results show that participants detected the differences between the two types of smile and that detection was better using smile asymmetry than with the cheek raiser action. Analysis of the use of response categories in the detection task indicated that participants underestimated the differences between smiles when they were different and that this tendency was more apparent with the cheek raiser detection method than for asymmetry detection. Participants also demonstrated a better knowledge of smile asymmetry than cheek raiser action. The knowledge gathered suggests that the ability of the receptor to judge smile authenticity is limited by perceptive factors. However, the mediation analyses that we conducted show the judging smile authenticity is not limited to simple perceptive detection of facial clues. Detecting facial clues is a necessary condition for correctly assessing smile authenticity, but it does not explain the variance in these assessments. We believe that this variance would be due more to the importance that participants give to facial clues. Finally, our results show that the capacity to detect differences between authentic and fake smiles is not easy to change. Participants who received modified information on changes of appearance linked to the two facial parameters were not more likely to detect the differences than participants who did not receive information.

Echinoderms as bioindicators, bioassays, and impact assessment tools of sediment-associated metals and PCBs in the North Sea

The study assessed the occurrence, possible toxicity, and impact of sediment-associated metals and PCBs in the coastal zone of the southern North Sea using echinoderms as representatives of the macrobenthos. Metals and PCBs were analyzed in the sediments and in the body compartments of the starfish Asterias rubens from 11 stations. The general toxicity of sediment-associated contaminants was assessed by bioassays using embryonic and larval developments of both A. rubens and the sea urchin Psammechinus miliaris. The impact of contamination was assessed by measuring cellular immune responses of A. rubens collected in the same stations. Contamination of the starfish by metals and PCBs closely reflected that of the sediments. However, bioaccumulation was element-specific for metals and depended on the chlorination pattern for PCBs. The sediment-associated contaminants appeared to be toxic in both the A. rubens and P. miliaris developmental assays. Moreover, metals were shown to affect the immune responses of starfishes living in contaminated stations. The most significant effects on biological responses were recorded in the plumes of the Scheldt/Rhine/North Sea Canal and the Elbe/Weser Rivers.

[Etiological factors of generalized anxiety disorder]

Generalized Anxiety disorder (GAD) is a widespread psychiatric syndrome involving significant consequences on people's health. However, recent data show that this disorder has received little attention when compared to other anxiety disorders. A review of the publication on GAD also stated that the majority of research has been conducted on descriptive issues, whereas etiological factors received lower rates of publication. This may be explained by the fact that changes in the conceptualization of GAD slowed down the progression of researches focussing on the identification of factors implicated in the development and the maintenance of its symptoms. For example, in the third version of the Diagnostic and Statistical Manual of Mental disorders (DSM) published in 1980, GAD could only be assigned if patients had a persistent anxiety without reporting specific symptoms of other anxiety disorders (eg Specific Phobias, Panic Disorder, Obsessive-Compulsive Disorder). With DSM III-R and DSM IV, excessive worry became the central feature of GAD, which increased its diagnostic validity. Taking that into account, where do we stand in the comprehension of GAD? What are the etiological factors identified as playing a role in the development and the maintenance of GAD and its central feature, excessive and uncontrollable worry? The goal of this article consists to provide answers to these questions by reviewing the literature of the current knowledge of GAD and examining various theories and explanatory models available. Firstly, many studies suggest that environmental factors are implicated in the development and maintenance of GAD. However, the majority of researches rests on an out-of-date conceptualization of GAD. Furthermore, the nature of experimental designs used in researches limits their conclusion. The first environmental factor documented is negative life events. Researchers noted that the occurrence of one or more negative life events being significant and appearing in an unexpected way was associa-ted with an increase in the risk to develop a GAD (eg. Familial problems (eg conflicts, abuses), considered as chronic stress-inducing situations, have also been suggested as etiological factor of GAD. Among the other environmental factors identified are separation during childhood, role inversion during childhood, lack of social interactions, poor life satisfaction, and modeling of a relative having an anxiety disorder. The cognitive and behavioral approach has been widely used during the last two decades to precise the etiology of GAD. First of all, some studies have pointed out the function of worry, which is to suppress images associated with negative thoughts (eg. Thus, GAD patients seem to develop excessive worries in order to prevent more negative feeling associated with the images of a thought. Other authors suggested that a deficit of attention might be responsible of excessive worry. Finally, some cognitive variables such as intolerance of uncertainty, false beliefs about worry, negative problem orientation and cognitive avoidance have been suggested as playing a determinant role in the development and maintenance of GAD. In order to resume the empirical findings available in the literature, an etiological model gathering the cognitive, behavioral, and environmental factors implicated in GAD is proposed. This model suggests that GAD is the result of a psychological vulnerability activated by a tension resulting from a negative event. Finally, recommendations are brought concerning future researches on GAD and its central characteristic, excessive and uncontrollable worry.

Integrating GIS components with knowledge discovery technology for environmental health decision support

This paper presents a new category of decision-support tools that builds on today's Geographic Information Systems (GIS) and On-Line Analytical Processing (OLAP) technologies to facilitate Geographic Knowledge Discovery (GKD). This new category, named Spatial OLAP (SOLAP), has been an R&D topic for about 5 years in a few university labs and is now being implemented by early adopters in different fields, including public health where it provides numerous advantages. In this paper, we present an example of a SOLAP application in the field of environmental health: the ICEM-SE project. After having presented this example, we describe the design of this system and explain how it provides fast and easy access to the detailed and aggregated data that are needed for GKD and decision-making in public health. The SOLAP concept is also described and a comparison is made with traditional GIS applications.