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Com o aumento da complexidade das sociedades humanas, o impacto resultante de situações de crise pode ser muito significativo, sobretudo tendo em conta a história de situações passadas. Como se viu com a Pandemia do COVID-19, muitas destas situações transformaram-se em situações de risco à segurança nacional. O planeamento, a comunicação e a preparação são cruciais, bem como o uso adequado das tecnologias de informação e apoio à decisão. Perante o risco de ameaças, sobretudo aquelas às quais Portugal é vulnerável, é necessária uma maior articulação entre as autoridades nacionais e as comunidades de especialistas. Neste artigo explorar-se-á como se podem criar lideranças capacitadas para a ação ágil e concertada no terreno, e como é que o papel das novas tecnologias, pode apoiar o desenvolvimento de cenários de tomada de decisão. O artigo examina como é que as novas tecnologias, nomeadamente os “drones” e Inteligência Artificial, poderão ser instrumentos importantes no apoio aos decisores, e argumenta que a resiliência do sistema e a articulação entre equipas de decisores e especialistas poderá produzir um impacto positivo sobre a tomada de decisão.

Funding: This research is funded by Fundação para a Ciência e Tecnologia 2022.01888.PTDC. Introduction: The rising incidence of skin cancer over the years has made it a significant public and occupational health issue. However, skin cancer is highly preventable, mainly through reduced exposure to solar ultraviolet radiation (UVR), which can be achieved by a variety of individual and collective protective measures and interventions. The relative risk associated with different patterns of exposure to solar UVR differs for the subtypes of keratinocyte cancers (KC). Specifically, whether the exposure is intermittent or continuous, and occurs in an occupational or leisure/recreational setting. The main aim of the study using this protocol is to contribute to raising public and policy awareness on solar UVR-inflicted occupational skin cancers in Lisbon. This will be achieved by performing direct measurements of the solar UVR dose received by outdoor workers using a digital platform. Results will likely contribute to further understanding the risk estimates for keratinocyte cancer estimations in this population. Methods: A prospective observational study will be conducted in Lisbon, Portugal. Personal electronic dosimeters (GENESIS-UV system) integrated with a digital platform will be used to assess occupational solar UVR doses of gardeners, masons, and gravediggers of the municipality of Lisbon. Two hundred and ten outdoor workers will be selected to wear the dosimeter for 1 month each, between April and October during their daily working hours. A digital web-based platform that offers private access to information through dashboard visualization will provide information for the outdoor workers and facilitate communication with the participants. Discussion: The expected results of the overall proposal comprise the occupational solar UVR doses, expressed in standard erythemal dose (SEDs) per day of outdoor work for 7 months. Study data will provide outdoor workers with information on their personal solar UVR exposure during their working hours and an estimate of their risk of developing skin cancer. It is expected that the occupational solar UVR doses of the outdoor workers in Portugal will be above the threshold of 1 to 1.33 SED/day, due to the latitude of Lisbon and the nature of the occupations. The results prospectively should flow into the design of adequate prevention campaigns for skin cancer in outdoor workers. publishersversion published

Funding Information: L.V.L. would like to acknowledge Fundação para a Ciência e a Tecnologia (FCT—MCTES) for its financial support via the project UIDB/00667/2020 (UNIDEMI). Publisher Copyright: © 2023 by the authors. European cities should address the climate change challenges, improving quality of life and reducing costs. They need potential smart and digital approaches. Public health (PH) has recognized climate change as a major challenge. The development of urban policies should be guided by evidence-based PH practices. The environmental health determinants and the climate crisis now represent a clear PH threat. The core of the Smart City is sustainability, and its basic condition is active PH. The inclusion of public health into the pillars of the Smart City concept to contribute toward mitigating PH crises, such as the COVID-19 pandemic, is a framework for action. Design Science Research Methodology (DSRM) is used to elicit a Smart Public Health City (SPHEC) framework. A set of PH and smart city experts participated in the DSRM process, using diabetes as a case study. The European Green Deal served as a blueprint for this transformational change toward a healthier and more sustainable city. The SPHEC framework was defined by elucidating clearly the several dimensions of the PH functions within a digital city, via the identification of a set of digital PH services that are required to support the SPHEC framework. This allows for an assessment of the actual benefits that are obtained with the digital health services, and provides evidence for guiding decision-making. The role of digital PH services emerges from the analysis of the SPHEC framework, through the development of proper digital health services within the smart city, strengthening capacity and resilience in future climate emergencies, and motivating policy makers to take this challenge more seriously. publishersversion published

Funding Information: This study was partly financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. Publisher Copyright: Copyright © 2023 Silva, Silva, Lopes, Araújo, Figueirêdo, Bay, Lapão, Xavier and Uchôa. Introduction: The use of digital health interventions has expanded, particularly in home-based primary care (HBPC), following the increase in the older adult population and the need to respond to the higher demand of chronic conditions, weakness and loss of autonomy of this population. There was an even greater demand with COVID-19 and subsequent isolation/social distancing measures for this risk group. The objective of this study is to map and identify the uses and types of digital health interventions and their reported impacts on the quality of HBPC for older adults worldwide. Methods and analysis: This is a scoping review protocol which will enable a rigorous, transparent and reliable synthesis of knowledge. The review will be developed from the theoretical perspective of Arksey and O'malley, with updates by Levac and Peters and respective collaborators based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Data from white literature will be extracted from multidisciplinary health databases such as: the Virtual Health Library, LILACS, MEDLINE/PubMed, Scopus, Web of Science, Cinahl and Embase; while Google Scholar will be used for gray literature. No date limit or language restrictions will be determined. The quantitative data will be analyzed through descriptive statistics and qualitative data through thematic analysis. The results will be submitted to stakeholder consultation for preliminary sharing of the study and will later be disseminated through publication in open access scientific journals, scientific events and academic and community journals. The full scoping review report will present the main impacts, challenges, opportunities and gaps found in publications related to the use of digital technologies in primary home care. Discussion: The organization of this protocol will increase the methodological rigor, quality, transparency and accuracy of scoping reviews, reducing the risk of bias. publishersversion published

This poster was presented at the 2nd Annual Summit of the Comprehensive Health Research Center in Évora, Portugal. Abstract Objective: The European Public Health Information Portal (PHIRI - Horizon 2020) aims at setting-up a research infrastructure to facilitate and generate the best available evidence for research on population health and well-being of populations as impacted by COVID-19. The Portal is a one-stop-shop, where Health Information (HI) Capacity Building is one of the services provided, to promote health information research and tackle HI inequalities between the Member States. The CHRC Team’s work aims at contributing to the development of a catalogue of services on population health capacity building in health information and COVID-19. Methods: Through a desk research and literature review, the activities were collected by three stages: 1) the search for the main HI institutions & organizations; 2) the activities shared by these sources on their official websites and 3) the detailed collection of information on each activity (description and technical information). Results: A website on HI capacity building was developed and the materials and courses found European materials and address different languages. They also focus on courses and materials about population health and non-pharmaceutical approaches to managing the COVID-19 pandemic - e.g., vaccination, lockdown plans, data analysis, etc. A European School on Health Information (ESHI) was established. Conclusions: The activities developed reached some recommendations on the sustainability for the HI in Europe. The roadmap for sustainability on HI Capacity Building mainly addresses the identified HI needs across Europe, from which the ESHI has emerged. &nbsp

©Cícera Renata Diniz Vieira Silva, Rayssa Horácio Lopes, Osvaldo de Goes Bay Jr, Claudia Santos Martiniano, Miguel Fuentealba-Torres, Ricardo Alexandre Arcêncio, Luís Velez Lapão, Sonia Dias, Severina Alice da Costa Uchoa. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 31.05.2022. BACKGROUND: The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown. OBJECTIVE: The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic. METHODS: We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis. RESULTS: A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies. CONCLUSIONS: The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service. publishersversion published

© 2022. The Author(s). BACKGROUND: In Europe, data on population health is fragmented, difficult to access, project-based and prone to health information inequalities in terms of availability, accessibility and especially in quality between and within countries. This situation is further exacerbated and exposed by the recent COVID-19 pandemic. The Joint Action on Health Information (InfAct) that builds on previous works of the BRIDGE Health project, carried out collaborative action to set up a sustainable infrastructure for health information in the European Union (EU). The aim of this paper is to present InfAct's proposal for a sustainable research infrastructure, the Distributed Infrastructure on Population Health (DIPoH), which includes the setup of a Health Information Portal on population health to be maintained beyond InfAct's time span. METHODS: The strategy for the proposal was based on three components: scientific initiatives and proposals to improve Health Information Systems (HIS), exploration of technical acceptability and feasibility, and finally obtaining high-level political support.. The technical exploration (Technical Dialogues-TD) was assumed by technical experts proposed by the countries, and political guidance was provided by the Assembly of Members (AoM), which gathered representatives from Ministries of Health and Science of EU/EEA countries. The results from the AoM and the TD were integrated in the sustainability plan compiling all the major outputs of InfAct. RESULTS: The InfAct sustainability plan was organized in three main sections: a proposal of a new research infrastructure on population health (the DIPoH), new health information tools and innovative proposals for HIS, and a comprehensive capacity building programme. These activities were carried out in InfAct and are being further developed in the Population Health Information Research Infrastructure (PHIRI). PHIRI is a practical rollout of DIPoH facilitating and generating the best available evidence for research on health and wellbeing of populations as impacted by COVID-19. CONCLUSIONS: The sustainability plan received wide support from Member States and was recognized to have an added value at EU level. Nevertheless, there were several aspects which still need to be considered for the near future such as: (i) a commitment of stable financial and political support by Member States (MSs), (ii) the availability of resources at regional, national and European level to deal with innovations, and (iii) a more direct involvement from EU and international institutions such as the European Centre for Disease Prevention and Control (ECDC), the World Health Organization (WHO) and the Organisation for Economic Cooperation and Development OECD for providing support and sustainable contributions. publishersversion published

IntroductionThe use of digital health interventions has expanded, particularly in home-based primary care (HBPC) following the increase in the older adult population and the need to respond to the higher demand of chronic conditions and health frailties of this population. There was an even greater demand with COVID-19 and subsequent isolation/social distancing measures for this risk group. The objective of this study is to map and identify the uses and types of digital health interventions and their reported impacts on the quality of HBPC for older adults worldwide.Methods and analysisThis is a scoping review protocol which will enable a rigorous, transparent and reliable synthesis of knowledge. The review will be developed in the theoretical perspective of Arksey and O’malley, with updates by Levac et al. and Peters et al. based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Data from whiteliterature will be extracted from multidisciplinary health databases such as: the Virtual Health Library, LILACS, PubMed, Scopus, Web of Science, CINAHL and Embase; while Google Scholar will be used for gray literature. No date limit or language restrictions will be determined. The quantitative data will be analyzed through descriptive statistics and qualitative data through thematic analysis. The results will be submitted to stakeholder consultation for preliminary sharing of the study and will later be disseminated through publication in open access scientific journals, scientific events and academic and community journals. The full scoping review report will present the main impacts, challenges, opportunities and gaps found in publications related to the use of digital technologies in primary home care.DiscussionThe organization of this protocol will increase the methodological rigor, quality, transparency and accuracy of scoping reviews, reducing the risk of bias.

Funding Information: This research was partially supported by Fundação para a Ciência e Tecnologia (FCT) for funds to Global Health and Tropical Medicine (GHTM) (UID/04413/2020 to LVL). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. In this study, a design science research methodology was used aiming at designing, im-plementing and evaluating a digital health service to complement the provision of healthcare for elderly people with balance disorders and risk of falling. An explanatory sequential mixed methods study allowed to identify and explore the dissatisfaction with electronic medical records and the opportunity for using digital health solutions. The suggested recommendations helped to elaborate and develop “BALANCE”, a digital service implemented on the METHIS platform, which was re-cently validated for remote monitoring of chronic patients in primary healthcare. “BALANCE” pro-vides clinical and interactive data, questionnaire pre and post-balance rehabilitation, tutorial videos with balance exercises and patient-recorded videos of the exercises. This digital service was demon-strated, including five elderly patients with clinical recommendations for balance rehabilitation at home. Finally, the authors conducted two focus groups with the participants and their caregivers as well as with physicians. The focus groups aimed at exploring their satisfaction level, needs of adjustment in the “BALANCE” service and strategies for applicability. The digital healthcare service evaluation revealed a significant potential for clinical applicability of this digital solution for elderly people with balance disorders and risk of falling. publishersversion published

Funding Information: MP received support from the Portuguese National Funds through FITEC – Programa Interface, with reference CIT INOV – INESC INOVAÇÃO. Funding was also provided from the PhD program in Industrial Management, NOVA Science and Technology Faculty. Funding Information: MP and LVL acknowledge Fundação para a Ciência e a Tecnologia (FCT-MCTES) for its financial support via the project UIDB/00667/2020 (UNIDEMI). Background: The digital age, with digital sensors, the Internet of Things (IoT), and big data tools, has opened new opportunities for improving the delivery of health care services, with remote monitoring systems playing a crucial role and improving access to patients. The versatility of these systems has been demonstrated during the current COVID-19 pandemic. Health remote monitoring systems (HRMS) present various advantages such as the reduction in patient load at hospitals and health centers. Patients that would most benefit from HRMS are those with chronic diseases, older adults, and patients that experience less severe symptoms recovering from SARS-CoV-2 viral infection. Objective: This paper aimed to perform a systematic review of the literature of HRMS in primary health care (PHC) settings, identifying the current status of the digitalization of health processes, remote data acquisition, and interactions between health care personnel and patients. Methods: A systematic literature review was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to identify articles that explored interventions with HRMS in patients with chronic diseases in the PHC setting. Results: The literature review yielded 123 publications, 18 of which met the predefined inclusion criteria. The selected articles highlighted that sensors and wearables are already being used in multiple scenarios related to chronic disease management at the PHC level. The studies focused mostly on patients with diabetes (9/26, 35%) and cardiovascular diseases (7/26, 27%). During the evaluation of the implementation of these interventions, the major difficulty that stood out was the integration of information into already existing systems in the PHC infrastructure and in changing working processes of PHC professionals (83%). Conclusions: The PHC context integrates multidisciplinary teams and patients with often complex, chronic pathologies. Despite the theoretical framework, objective identification of problems, and involvement of stakeholders in the design and implementation processes, these interventions mostly fail to scale up. Despite the inherent limitations of conducting a systematic literature review, the small number of studies in the PHC context is a relevant limitation. This study aimed to demonstrate the importance of matching technological development to the working PHC processes in interventions regarding the use of sensors and wearables for remote monitoring as a source of information for chronic disease management, so that information with clinical value is not lost along the way. publishersversion published

Funding Information: This project (PrimaryCare@COVID-19: Digital Platform for Supporting Chronic Patients and COVID-19 consultations and Monitoring in Primary Care) was funded by the Funda??o para a Ci?ncia e Tecnologia (Ministry of Science of Technology, Portugal) under the Research4COVID-19 program. Funding Information: This project (PrimaryCare@COVID-19: Digital Platform for Supporting Chronic Patients and COVID-19 consultations and Monitoring in Primary Care) was funded by the Fundação para a Ciência e Tecnologia (Ministry of Science of Technology, Portugal) under the Research4COVID-19 program. Publisher Copyright: © 2021 Luís Velez Lapão, Mariana Peyroteo, Melanie Maia, Jorge Seixas, João Gregório, Miguel Mira da Silva, Bruno Heleno, Jorge César Correia. Background: The COVID-19 pandemic is straining health systems and disrupting the delivery of health care services, in particular, for older adults and people with chronic conditions, who are particularly vulnerable to COVID-19 infection. Objective: The aim of this project was to support primary health care provision with a digital health platform that will allow primary care physicians and nurses to remotely manage the care of patients with chronic diseases or COVID-19 infections. Methods: For the rapid design and implementation of a digital platform to support primary health care services, we followed the Design Science implementation framework: (1) problem identification and motivation, (2) definition of the objectives aligned with goal-oriented care, (3) artefact design and development based on Scrum, (4) solution demonstration, (5) evaluation, and (6) communication. Results: The digital platform was developed for the specific objectives of the project and successfully piloted in 3 primary health care centers in the Lisbon Health Region. Health professionals (n=53) were able to remotely manage their first patients safely and thoroughly, with high degrees of satisfaction. Conclusions: Although still in the first steps of implementation, its positive uptake, by both health care providers and patients, is a promising result. There were several limitations including the low number of participating health care units. Further research is planned to deploy the platform to many more primary health care centers and evaluate the impact on patient's health related outcomes. publishersversion published

The Population Health Information Research Infrastructure (PHIRI) on COVID-19 seeks to lay the foundation of a federated research infrastructure on population health to support research across Europe to underpin public health policy decisions in current and future pandemics or crises. Through Work Package 9 (WP9), PHIRI aims at gaining insights in possible future health impacts of the COVID-19 outbreak, by building capacity on foresight studies. A foresight study refers to a broad range of methodologies to describe possible futures. This report presents a brief overview of the results from Task 9.1. “Overview of current foresight activities in Europe and beyond”. This task was led by Universidade NOVA deLisboa (DGS/UNL), in collaboration with other task Partners: National Institute for Public Health and the Environment in the Netherlands (RIVM), Austrian Public Health Institute (GÖG), and the Croatian Institute of Public Health (CIPH). This report aims to present a general mapping of foresight studies in Europe, but also includes international studies and studies from other non-European countries.