A soft systems approach of asthma management in children based on therapeutic education and e-learning.

One of the most common respiratory chronic diseases is asthma, with 5-16 % of world prevalence. In chronic disease, prevention, diagnosis, management, and palliation are the strategies for a care model; the patient-self management is fundamental with the so-called therapeutic education (TE) to train the patient in the necessary skills. The challenge of TE grows when the patient is a child or a person with special needs, even more in public health care in low- and middle-income countries. This is a problematic human situation, that needs soft system thinking. In this research, the analytic hierarchy process was used to determine the perceived importance of the factors that affect children's asthma health care in a public health institution in Mexico. The soft systems methodology (SSM) was applied to learn about the disease self-management, in order to obtain activities models and an action plan. According to AHP, human resources and education were percived as the most important among the factors that affect children health care within the institution. The perceived importance of two main subfactors (human resources training and TE) was around 34 %, which emphasizes the need to generate strategies for the improvement of the education of patients and health care providers. In MSS, the rich vision, the CATWOE, the root definition, and an activities model were proposed, including the application of an instructional design methodology (ADDIE) for the development of learning objects of asthma for children. Desirable and feasible actions and recommendations include the update of the national clinical practice guides, the use of control measures such as the Asthma Control Test, and a daily asthma diary to register the daily status of the breathing capacity, the drug administration, and the potential trigger events. The proposed model can be used as part of a systemic patient-and-family centered approach for chronic care model (CCM), particularly in diseases unsuitable for prevention interventions.

Suitable municipalities for biomass energy use in Colombia based on a multicriteria analysis from a sustainable development perspective.

Using renewable energies is a global strategy to mitigate the acceleration of global warming generated by industrial processes and is a sustainable way to diversify the energy matrix in all countries. Biomass is a renewable energy source that produces biofuels and generates electricity and heat. The primary purpose of this work is to identify the municipalities in Colombia where agricultural, livestock, and urban residual biomass could be suitable for energy generation in a sustainable and renewable way. To that end, we carried out a Geostatistical Multi-Criteria Decision Methodology using Analytical Hierarchy Processes such as Rank-Sum and Weighted Linear Combination, as well as considering a set of sustainable development indicators applied to official Colombian data. Two scenarios are considered for comparison purposes. The first one is according to expert criteria, and the second one considers The Sustainable Development Goals proposed by the United Nations. Under both proposed scenarios, 127 municipalities were found to be suitable for agricultural-urban residual biomass and 162 for livestock-urban residual biomass for energy generation. One of the main limitations for the use of urban biomass is that municipalities need to have sufficient production potential to fulfill their own energy needs. An additional comparison with previous works to evaluate the performance of the Multi-Criteria Decision Methodologies MCDM is also proposed.

To dream or not to dream in Havana: multi-criteria decision-making for material and energy recovery from municipal solid wastes.

Currently, solid waste management strategies in Havana are outdated. This paper aimed to select the most suitable alternative for integrating material recovery facilities (MRF) with waste-to-energy technologies in the city of Havana, Cuba. Seven scenarios were considered: combustion, gasification, and hydrothermal carbonization (HTC) with and without carbon capture, and anaerobic digestion (AD). The selection was based on environmental, techno-economic, and social parameters using an analytic hierarchy process (AHP) as a multi-criteria decision-making tool (MCDM). The MCDM-AHP accounted for qualitative criteria (based on experts' judgments) and quantitative (based on Aspen Plus simulation models). From the MRF, 63% of the input recyclable materials were recovered, representing an energy saving of 256 kW-h/tMSW. The AHP results showed that environmental criteria had the highest priority, resulting in ~63% and ~73% higher than social and techno-economic criteria, respectively. Likewise, from the techno-economic, environmental, and social sub-criteria analysis, investment risk, pollution, and work safety had the major concern compared with the other sub-criteria levels. Overall, MRF+AD was the most suitable scenario (21% preference) for treating Havana's municipal solid waste (MSW), followed by combustion and gasification with carbon capture, respectively. This study confirms that AD is a preference option for emerging economies like Cuba, mainly due to low environmental pollution, high social acceptance, and financial stability in the long term.

Spatial multicriteria approach to support water resources management with multiple sources in semi-arid areas in Brazil.

Semi-arid regions often face severe drought events that reduce agricultural and livestock production. In recent years, some international studies have used multicriteria decision analysis (MCDA) approaches combined with geographic information systems (GIS-MCDA) to support decision-makers in assessing the suitability of agricultural land for irrigation in semi-arid regions. Unlike previous studies, which have only considered a single source of water for crop irrigation, this study proposes a GIS-MCDA approach that considers all potentially available local water sources (e.g., groundwater, surface water, and wastewater) as possible alternatives for better multisource water resource management (MWRM) in regions facing water shortages. The geospatial multicriteria evaluation implemented in this study considers a series of technical, environmental, and agricultural productivity criteria using the analytical hierarchy process (AHP) method. Three independent baseline maps were generated, showing the spatial distribution of suitable areas for crop irrigation for each considered water source in the studied area. Surface water, groundwater, and wastewater offered suitable crop irrigation for 83%, 70%, and 26% of the study area, respectively. Overlapping these areas produced a final map showing all the feasible areas for each crop irrigation alternative at the same time. The MWRM approach considering all water sources increased the coverage of suitable areas to be irrigated in the study area by 2.2%, 20.4%, and more than 225% compared to considering surface water, groundwater, and wastewater, respectively, independently. The GIS-MCDA framework proposed in this study provides better support for decision-makers and stakeholders, favouring a reduction in possible conflicts over water scarcity, the diversification of irrigated crops, and an improvement in the quality-quantitative management of water resources in semi-arid regions.

Conservação de água em shopping centers: análise das percepções dos atores envolvidos nos projetos e gestão, com o uso do processo de hierarquia analítica / Water conservation in shopping centers: analysis of the perceptions of the actors involved in projects and management, using the analytical hierarchy process

RESUMO As áreas urbanas buscam novas opções de serviço de água, para garantir o abastecimento. A literatura acadêmica versa sobre o pensamento de que a crise hídrica está relacionada ao crescimento urbano; no entanto, o fator predominante é o aumento do consumo, independentemente do crescimento populacional, pois fatores comportamentais devem ser revistos a partir de simples hábitos diários. Os empresários não focam apenas nas questões de economia ou da discussão ambiental, de mais vale a garantia da autonomia, pois a insegurança hídrica é cada vez mais crescente. Empreendimentos como os shopping centers poderão consumir volumes de água equivalentes ao consumo de 5 mil pessoas. Para saber as percepções dos atores envolvidos no design e na gestão de shopping centers, este trabalho utilizou o método AHP, com a aplicação de questionários e resultados combinados. Dados resultantes demonstram que o conhecimento dos envolvidos nem sempre corresponde aos conceitos de conservação de água e que uma melhor sinergia entre a ciência e o mercado deve estar mais próxima.

ABSTRACT Urban areas seek new water service options, to ensure the supply. The academic literature deals with the thought that the water crisis is related to urban growth; however, the predominant factor is the increased consumption, regardless of population growth, as behavioral factors should be reviewed based on simple daily habits. Entrepreneurs do not focus only on economic issues or on top of environmental discussion, as well ensuring autonomy, as water insecurity is increasingly growing. Enterprises such as shopping malls may consume water volumes equivalent to the consumption of 5,000 people. In order to know the perceptions of the actors involved in the design and management of shopping malls, this work used the AHP method, with the application of questionnaires and combined results. Resulting data demonstrate that the knowledge of those involved does not always correspond to the concepts of water conservation and a better synergy between science and the market should be more forthcoming.

Flood hazard assessment in large plain basins with a scarce slope in the Pampean Plain, Argentina.

Floods are one of the most common natural phenomena and represent a serious hazard when they affect human activities. Structural measures are commonly used to mitigate them; however, these do not always give good results, mainly in plain areas with scarce slope. In this sense, the generation of a flood hazard map contributes to adequate hazard management and disaster prevention. The aim of this work is to evaluate the flood hazard areas in hydrological plain basins with scarce slope, taking as a case study the Samborombón river basin located in the Pampean Plain, Argentina. For this, a flood hazard map was made based on the analytical hierarchy process and using a GIS, taking into account physical aspects of the terrain, observations, and field measurements. Likewise, the map was validated using satellite images and the inhabitants in danger in the basin were quantified. The results show that the flood hazard areas correspond mainly to the floodplain of rivers and tributaries, while the main and secondary divide zones have low flood hazard sectors. On the other hand, numerous urban settlements were identified within flood hazard areas, these being urban settlements in the vicinity of old urban centers and new gated communities with high value homes, quantifying 1961 inhabitants at flood hazard and showing poor territorial planning. The methodology proposed gives to the management agencies the possibility of generating land use maps, as well as designing mitigation and contingency plans after a large rainfall event.

Analysis of Different Production Systems in Laying Hen Enterprises with Analytic Hierarchy Process in Turkey

The present study aimed to evaluated the enterprises engaged in conventional cage, enriched cage, free-range and organic egg production in Turkey in terms of four different criteria (profit, investment cost, animal welfare/health and sales/marketing) using the Analytical Hierarchy Process (AHP). For this purpose, the questionnaires through face-to-face interviews were conducted with a total of 64 producers who had been determined by random sampling method from 5 different regions included 17 Provinces between November 2016 and March 2019, and primary data were obtained. As a result, it has been found strategically significant that enterprises, to be engaged at the level of 47.0%, 20.0%, 18.0% and 15.0% in conventional, enriched, free-range and organic cage systems, respectively, in the market in terms of profit, investment cost, animal welfare/health and sales /marketing criteria. In addition, in the enterprises within the scope of the research, the profit, investment cost, sales/marketing and animal welfare/health criteria were determined as the dominant criteria at the level of 53.5%, 22.0%, 13.5% and 11.0% respectively. In conclusion, the conventional cage system is dominant with the rates of 55.0% for profit and 53.0% for investment cost criteria, and both of the conventional and enriched systems in terms of sales/marketing criteria are 38.5% dominant and the organic system in terms of animal welfare/health is 46.0% dominant.(AU)

Analysis of Different Production Systems in Laying Hen Enterprises with Analytic Hierarchy Process in Turkey

The present study aimed to evaluated the enterprises engaged in conventional cage, enriched cage, free-range and organic egg production in Turkey in terms of four different criteria (profit, investment cost, animal welfare/health and sales/marketing) using the Analytical Hierarchy Process (AHP). For this purpose, the questionnaires through face-to-face interviews were conducted with a total of 64 producers who had been determined by random sampling method from 5 different regions included 17 Provinces between November 2016 and March 2019, and primary data were obtained. As a result, it has been found strategically significant that enterprises, to be engaged at the level of 47.0%, 20.0%, 18.0% and 15.0% in conventional, enriched, free-range and organic cage systems, respectively, in the market in terms of profit, investment cost, animal welfare/health and sales /marketing criteria. In addition, in the enterprises within the scope of the research, the profit, investment cost, sales/marketing and animal welfare/health criteria were determined as the dominant criteria at the level of 53.5%, 22.0%, 13.5% and 11.0% respectively. In conclusion, the conventional cage system is dominant with the rates of 55.0% for profit and 53.0% for investment cost criteria, and both of the conventional and enriched systems in terms of sales/marketing criteria are 38.5% dominant and the organic system in terms of animal welfare/health is 46.0% dominant.

Sanitary landfill site selection using multi-criteria decision analysis and analytical hierarchy process: A case study in Azuay province, Ecuador.

Despite environmental regulations in Ecuador, particularly in the Province of Azuay, the solid waste final disposal management is still a socio-environmental problem, worsened by weak governance processes. The province has three sanitary landfills with almost expired service lives. The site selection was based on circumstantial reasons, which makes landfills more likely to cause environmental pollution and, therefore, have negative implications for public health. The largest landfill serves Cuenca and also leases service to other small cities. The remaining two are small and, accordingly, have limited technology and fewer resources. In this context, the main aim of this study is to evaluate the terrain of the province to find the most suitable area for landfill siting. A multi-criteria decision analysis, integrated with a geographical information system and analytical hierarchy process methodology, was conducted. Fourteen factors and seven constraints were simultaneously analysed, divided into technical, environmental, social, and economic categories; 15 of these criteria were from the Ecuadorian Unified Text of the Secondary Legislation of the Environmental Ministry. According to the results, 76.17% of the territory is not suitable for landfill implementation, and the unrestricted area represents the remaining 23.83%. The highest landfill suitability index (70-81%) is located in the south of the province in Santa Isabel, Oña, and Nabón cantons, which are dry and clay-rich areas.