a modified Delphi technique

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.OBJECTIVE: This study aimed to elucidate the top five key priorities and barriers to chronic care in the health system of Abu Dhabi, United Arab Emirates (UAE). DESIGN: A modified Delphi study was performed to reach consensus on priority areas and barriers to the development of the Chronic Care Model in the health system of Abu Dhabi. Individual wireless audience response devices (keypads) linked to a computer were used to reduce 28 priorities and 20 barriers to the top five during three iterative rounds over three consecutive days. SETTING: Chronic care services for patients with diabetes, cardiovascular diseases and cancer, in both private and publicly funded healthcare services in the emirate of Abu Dhabi. PARTICIPANTS: A purposive sample of 20 health systems' experts were recruited. They were front-line healthcare workers from the public and private sector working in the delivery of care for patients with diabetes, cardiovascular diseases and cancer. RESULTS: The 'overall organizational leadership in chronic illness care' was ranked as the most important priority to address (26.3%) and 'patient compliance' was ranked as the most important barrier (36.8%) to the development of the Chronic Care Model. CONCLUSIONS: This study has identified the current priorities and barriers to improving chronic care within Abu Dhabi's healthcare system. Our paper addresses the UAE's 2021 Agenda of achieving a world-class healthcare system, and findings may help inform strategic changes required to achieve this mission.publishersversionpublishe

Mapeamento de áreas potenciais para a instalação de um aterro sanitário na Região Metropolitana de Belém

The production of solid waste in Brazil has increased considerably, with the creation of a great number of dumps. Several socio-environmental impacts results from this inadequate disposal. The present work had the objective to evaluate, based on environmental, economic and social criteria, possible favorable areas for the installation of a sanitary landfill in the Metropolitan Region of Belém (MRB), state of Pará. To this end, data were processed using a Geographic Information System (GIS). A map with potential areas for landfill installation in the MRB was created, based on the criteria and weights assigned to each variable through map algebra methods. The results showed four areas in the municipality of Santa Bárbara and Santa Izabel as favorable for installation of the project, with characteristics that meet the criteria established in legislation (NBR 13896/1997).O Brasil tem registrado um aumento na produção de resíduos sólidos. Associado a isso, cresce o número de lixões por todo o país, bem como os impactos socioambientais decorrentes dessa disposição inadequada. Nesse sentido, esse trabalho tem como objetivo avaliar, a partir de critérios ambientais, econômicos e sociais, a melhor alternativa locacional para um aterro sanitário da região metropolitana de Belém (RMB), estado do Pará. Para alcançar o objetivo proposto, os dados obtidos foram processados em um Sistema de Informação Geográfica (SIG) e assim elaborado o mapa de aptidão das áreas potenciais para a instalação do aterro sanitário da RMB, a partir dos critérios e pesos atribuídos a cada variável com métodos de álgebra de mapas. Os resultados mostraram que 4 áreas são consideradas aptas no município de Santa Bárbara e Santa Izabel para a instalação do aterro sanitário, por atenderem aos critérios exigidos na legislação (NBR 13896/1997)

Medida de Porosidade em Compósitos B4C-Nb por Meio de Análise e Processamento Digital de Imagem

Constant research efforts have been conducted in materials selection to combine and improve the properties of interest, service life and production cost. In this context, boron carbide (B4C) stands out for having a high mechanical performance, being the material that has the fourth highest hardness (> 29.1GPa) among ceramic materials. However, porosity is seen as a limiting factor for the high performance of this group of materials, to which boron carbide is found. Porosity control is usually conducted through imprecise techniques, and indirect or costly measures for quantification. This work quantified the porosity of boron-niobium carbide (B4C-Nb) composites obtained from high pressure - high temperature (HPHT - high pressure high temperature) sintering process through analysis and digital image processing (PDI) by microscopy optical (MO) after surface preparation with controlled and automated parameters. The results obtained were compared with those obtained using the mercury intrusion porosimetry method. The semi-quantitative chemical characterization of the composites was performed using the Energy Dispersive Spectroscopy (EDS) technique.Esforços constantes de pesquisa têm sido conduzidos na seleção de materiais com o intuito de combinar e aprimorar as propriedades de interesse, o tempo de vida útil e o custo de produção. Nesse contexto, o carbeto de boro (B4C) se destaca por possuir um elevado desempenho mecânico, sendo o material que possui a quarta maior dureza (>29,1GPa) entre os materiais cerâmicos. Entretanto, a porosidade é vista como fator limitador do alto desempenho desse grupo de materiais, ao qual o B4C se encontra. O controle da porosidade é usualmente realizado por meio de técnicas imprecisas, de medidas indiretas ou de alto custo para a sua quantificação. Este trabalho objetivou quantificar a porosidade de compósitos de carbeto de boro-nióbio (B4C-Nb) obtidos por processo de sinterização em alta pressão – alta temperatura (HPHT- high pressure high temperature) através de análise e processamento digital de imagens (PDI) obtidas por microscopia ótica (MO) após preparação da superfície com parâmetros controlados e automatizados. Os resultados obtidos por PDI foram comparados com valores de densidade relativa obtidos por método de porosimetria por intrusão de mercúrio. Os compósitos foram observados por microscopia eletrônica de varredura (MEV) e submetidos a análise química semi-quantitativa por Energy Dispersive Spectroscopy (EDS) que confirmou os poros observados por MO

Análise Espacial da Vulnerabilidade Social com o Uso de Geotecnologias

The Amazon coastal zone is vulnerable to various natural and anthropogenic pressures. Social vulnerability refers to the different characteristics of the population exposed to a particular threat . Methodologies that analyze vulnerability through indicators and statistical support have been increasingly widespread. Thus, the objective of this study is to analyze social vulnerability using statistics and geoprocessing techniques. It was utilized The Principal Component Analysis (PCA) as the main method and later the Geographical Information System (GIS) in the amazon coastal zone, in the municipalities of Curuçá and Marapanim. The results showed the factors that had the highest influences on social vulnerability were age, education and density.. The approach presented can be used as a subsidy to the government in urban planning and management.A zona costeira Amazônia está vulnerável a diversas pressões naturais e antrópicas. A vulnerabilidade social refere-se as diferentes características da população expostas a uma determinada ameaça. As metodologias que analisam a vulnerabilidade através de indicadores e estatísticas têm sido cada vez mais difundidas. Assim, o objetivo desse trabalho é analisar a vulnerabilidade social através de estatísticas e geoprocessamento. Utilizou-se o método de Análises de Componentes Principais (ACP) e posteriormente os resultados foram inseridos em um Sistema de Informação Geográfica (SIG) para um estudo de caso na zona costeira amazônica, nos municípios de Curuçá e Marapanim. Foram identificados que os fatores idade, educação, densidade, responsável por domicílios, infraestrutura básica e moradia, renda e saneamento básico influenciam na vulnerabilidade social. Osfatores que tiveram as maiores influências na vulnerabilidade social foram a idade, educação e densidade. A abordagem apresentada pode ser utilizada como subsidio para o poder público na gestão e planejamento urbano

A Novel Participatory Community Health Awareness Program in Abu Dhabi

Community-based intervention (CBI) programs promote lifestyle changes, modify risk factors, and substantially improve public health. Social mobilization and community involvement improve health outcomes, reduce health disparities, and improve access to care and services. Health intervention program evaluations are essential to provide evidence-based strategies that can enhance the design and implementation of successful health promotion programs. Interventions that enable the United Arab Emirates (UAE) community to change and modify unhealthy behaviors were the priority of the last decade and are the health authorities' objectives. The Department of Health Abu Dhabi launched a wellness program to enable the community to adopt healthy behaviors. The Public Health Ambassadors program is a community-based health intervention program under the Abu Dhabi Public Health Centre, inaugurated in 2019. This paper describes the Public Health Ambassadors CBI conducted in Abu Dhabi. The implementation science framework was used to develop the intervention. The Public Health Ambassadors is one of the UAE's earliest and most successful CBIs. The program can be used as a model to encourage more health promotion interventions in the country and the region. The role of the program was highlighted during the COVID-19 pandemic. Voluntary community participation and social responsibilities are essential competencies promoted by this program.publishersversionepub_ahead_of_prin

an example of a Rapid Exchange Forum

Funding Information: We would like to thank all participants of the REFs who contributed information from their countries, thus providing up-to-date information to everybody who was interested. PHIRI is co-funded by the European Commission via the HORIZON 2020 programme GA 101018317, commissioned by DG RTD. Publisher Copyright: © 2024 The Author(s).Background: The COVID-19 pandemic demanded quick exchanges between experts and institutions supporting governments to provide evidence-based information in response to the crisis. Initially, there was no regular cross-country forum in the field of population health. This paper describes the set-up and benefits of implementing such a forum. Methods: A group of public health practitioners from academia, national public health institutes and ministries of health decided in April 2020 to meet bi-monthly to discuss a vast array of population health topics in a structured format called a Rapid Exchange Forum (REF). An ad-hoc mailing group was established to collect responses to questions brought forward in the forum from at least five countries within 24 h. This endeavour, which evolved as network of networks was awarded an EU grant in autumn 2020 and was called PHIRI (Population Health Information Research Infrastructure). Results: Responses from up to 31 countries were compiled and shared immediately via the European Health Information Portal. This exchange was complemented by special REFs that focused on the advantages and disadvantages of vaccination, for example. By July 2023, 54 REFs had taken place with topics going beyond COVID-19. Conclusion: The REF demonstrated its value for quick yet evidence-based cross-country exchange in times of crisis and was highly appreciated by countries and European Commission. It demonstrated its sustainability even after the acute crisis by expanding the topics covered and managing to continue exchange with the aim of capacity building and mutual learning, making it a true EU response and coordination mechanism.publishersversionpublishe

a sustainable strategy for strengthening capacity in health information

Funding Information: This research was co-funded by the \u2018Population Health Information Research Infrastructure\u2019 (PHIRI) Project funded by the Horizon 2020 research and innovation programme of the European Union (Grant Agreement No. 101018317) and the Funda\u00E7\u00E3o para a Ci\u00EAncia e a Tecnologia (FCT-MCTES) through project UIDB/00667/2020 (UNIDEMI). M.P. was supported by Funda\u00E7\u00E3o para a Ci\u00EAncia e a Tecnologia (2023.00994.BD). Publisher Copyright: © 2024 The Author(s).Background: Before the COVID-19 pandemic, a need for a uniform approach to health information (HI) knowledge in population health analysis across Europe was evident. The Population Health Information Research Infrastructure (PHIRI) emerged as a proactive initiative to strengthen European HI capacities. This article describes the achievements of PHIRI, highlighting its capacity-building activities and their contribution towards a sustainable strategy for the implementation of the European Health Data Space (EHDS). Methods: PHIRI collaboration established a work package for skill-building activities in population health in partnership with other organizations. Activities included webinars, workshops, sessions, training schools and courses for researchers and public administration workers from Europe and beyond. The primary goal of the activities was to examine the impact of COVID-19 on European health systems at both local and national levels, including healthcare facilities and policymaking entities. Results: Twelve activities were organized between October 2020 and the summer of 2023. In March 2023, the Spring School on Health Information was organized to share the knowledge achieved from PHIRI and other European Union-related projects. This event also validated the European Health Information Training Programme. Conclusions: PHIRI's findings emphasized the importance of equipping the workforce with core HI skills to improve health systems' preparedness and resilience. Through this research, it is possible to propose a strategy for building capacity that emphasizes the importance of providing training in human-machine dynamics. This approach will contribute to the sustainable implementation of the EHDS.publishersversionpublishe

ANÁLISE MULTITEMPORAL DA DINÂMICA DA PAISAGEM E DA ÁREA DE PRESERVAÇÃO PERMANENTE (APP) DA ILHA DE MOSQUEIRO/PA

MULTITEMPORAL ANALYSIS OF LANDSCAPE DYNAMICS AND PERMANENT PRESERVATION AREA (APP) OF MOSQUEIRO ISLAND/PA ANÁLISIS MULTITEMPORAL DE LA DINÁMICA DEL PAISAJE Y DE LA ÁREA DE PRESERVACIÓN PERMANENTE DE LA ISLA MOSQUEIRO/PARESUMOAs mudanças no uso e cobertura da terra causam impactos ambientais, principalmente em áreas de vegetação nativa. Assim, o objetivo deste artigo foi avaliar a mudança da paisagem e das Áreas de Preservação Permanentes (APPs) da Ilha de Mosqueiro em Belém, Pará. Para isso, aplicou-se o processamento e a classificação de imagens do satélite LANDSAT 5 e 8, dos sensores TM e OLI, dos últimos 34 anos, juntamente com trabalho de campo para validação das classes de uso e cobertura da terra. As imagens foram manipuladas em ambientes de Sistema de Informação Geográfica (SIG). Os resultados mostraram aumento significativo de 1.137,02 ha (5,4%) para 2.420,77 ha (11,4%) de urbanização, de 14,76 ha (0,1%) para 405,67 ha (1,9%) de atividade mineral, 489,06 ha (2,3%) para 2.966,09 ha (14%) de áreas de sucessão vegetativa e diminuição de floresta de 17.167 ha (81%) para 13.262,94 (62,6%). A APP apresentou apenas 5,52% de áreas em desacordo com a lei, constatando baixa degradação e conservação de 94,4%.Palavras-chave: Uso e Cobertura da Terra; Geoprocessamento; Belém. ABSTRACTChanges in land use and cover cause environmental impacts, especially in areas of native vegetation. Thus, the objective of this article was to evaluate the change in the landscape and the Permanent Preservation Areas (PPAs) of Mosqueiro Island in Belém, Pará. For this, image processing and classification from the LANDSAT 5 and 8 satellite, TM sensors OLI, from the last 34 years, from the last 34 years, was conducted and a field visit was carried out to validate the land use and cover classes. The images were manipulated in Geographic Information System (GIS) environments. The results showed a significant increase from 1,137.02 ha (5.4%) to 2,420.77 ha (11.4%) of urbanization, from 14.76 ha (0.1%) to 405.67 ha (1.9%) of mineral activity, 489.06 ha (2.3%) to 2,966.09 ha (14%) of areas of vegetative succession and forest decrease from 17,167 ha (81%) to 13,262.94 (62.6%). The APP presented only 5.52% of areas in disagreement with the law, showing low degradation and conservation of 94.4%.Keywords: Land Use/Cover; Geoprocessing; Belém.RESUMENLos cambios en el uso y cobertura del suelo provocan impactos ambientales, especialmente en áreas de vegetación nativa. Así, el objetivo de este artículo fue evaluar el cambio en el paisaje y las Áreas de Preservación Permanente (APPs) en la Isla Mosqueiro en Belém, Pará. Los metodos utilizados fueron el procesamiento y classificación de imágenes del satélite LANDSAT 5 y 8, sensores TM y OLI , de los últimos 34 años, junto con una visita de campo para validar las clases de uso y cobertura del suelo. Las imágenes fueron manipuladas en entornos de Sistemas de Información Geográfica (SIG). Los resultados mostraron un aumento significativo de 1.137,02 ha (5,4%) a 2.420,77 ha (11,4%) de urbanización, de 14,76 ha (0,1%) a 405,67 ha (1,9%) de actividad mineral, de 489,06 ha (2,3%) a 2.966,09 ha. (14%) de áreas de sucesión vegetativa y bosque disminuyen de 17,167 ha (81%) a 13,262.94 (62.6%). La APP presentó solo el 5,52% de áreas en desacuerdo con la ley, mostrando baja degradación y conservación del 94,4%.Palabras clave: Uso y Cobertura de la Tierra; Geoprocesamiento; Belém

Meningite bacteriana em idosos: Números dos últimos 10 anos no estado de Goiás

A meningite é a inflamação das membranas que recobrem o tecido encefálico, a dura máter, a pia máter e a aracnoide, especificamente a maior parte do cérebro e a medula espinhal. Tal processo geralmente decorre da presença de uma infecção prévia que alcança os tecidos encefálicos, e é mais comum nos extremos de idade, sendo, por motivos imunológicos e estruturais, mais prevalente na faixa pediátrica. Em adultos, acomete principalmente os idosos. Em todo caso, é uma doença com potencial de gravidade, tanto pelas sequelas que podem advir do comprometimento do tecido cerebral subjacente, quanto pela elevada taxa de mortalidade. A morbimortalidade, aliás, é ainda mais importante nos casos em que há o desenvolvimento de complicações locais ou sistêmicas, tais como distúrbios da coagulação, empiema, hipertensão intracraniana, herniação cerebral, convulsões, septicemia e falência orgânica genealizada. Os pacientes que sobrevivem podem ter sua qualidade de vida reduzida por sequelas importantes.A relativa raridade da meningite em adultos, ainda mais com complicações, torna desafiadora uma compreensão científica ampla sobre sua epidemiologia, sua história natural e seu processo fisiopatológico. Tendo tudo isso em vista, o objetivo do presente trabalho é indicar os números da meningite bacteriana em idosos nos últimos 10 anos no estado de Goiás, estabelecendo um comparativo com a literatura mais atual