Smart City and Well-Being: Opinions by the Guest Editors

As with technology, the concept of the Smart City has evolved over time in line with digitisation processes and the changing needs of cities and their inhabitants. Indeed, it was in the early 1980s when discussions first arose regarding the role that information technology would play in the development of conventional urban activities [1–3]. Some thirty years later, in 2009, the concept of the Smart City was first defined when, in Rio de Janeiro, a plan came into effect that employed technological innovation and waste management to improve the quality of life in the city by minimizing wastage [4]. This is a true evolution in which the vision of the traditional city is superseded by a more modern urban reality creating an ideal, highly automated ecosystem in which Information and Communication Technologies (ICT) take on the role of the core infrastructure of a Smart City [5–7]. The technological and techno-centric revolution, currently dictated by the market, may, however, result in a decrease in inclusivity and at the same time an increase in the digital divide. Moreover, a Smart City that is too heavily based on technological solutions runs the risk of becoming disconnected from policies with a real impact on urban contexts [8]. The term ‘Smart City’ encapsulates a conception of urban reality that transcends technological boundaries and aims to raise the standards of sustainability, liveability and economic dynamism of the cities of the future [9,10]

Family Medicine and Primary Healthcare: The Past, Present and Future.

As defined by the World Health Organisation in the conference held in Alma Ata, Kazakhstan, in 1978, "Primary health care is essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination" [...]

Use of digital technologies in public health: a narrative review.

BACKGROUND AND AIM Websites, social media networks and mobile applications constitute important communication tools, while simultaneously enabling the population to increase their knowledge of health issues. This study aims to describe digital health experiences in Public Health to examine the different possible uses of digital technologies by Public Health Operators (PHOs) and Health Care Workers (HCWs) and the role these tools play in the efficiency of the health interventions undertaken. METHODS A narrative literature survey was conducted by consulting the PubMed and Scopus databases to find articles relevant to the topic of interest. The selection criteria adopted for manuscript screening involved including the survey studies dealing with the use of digital means such as new media in Public Health, published between 1 January 2012 and 31 May 2021. RESULTS Based on the keywords, 2,019 manuscripts were identified, of which 45 were included. The articles were grouped according to the digital tool (social media network, mobile application and websites) employed by PHOs and/or HCWs in health promotion initiatives. Specifically, this was broken down into: i) the use of social media in public health: 24 articles, ii) the use of mobile applications: 10 articles, iii) the use of websites: 8 articles and iv) the use of the three digital tools combined: 3 articles. CONCLUSIONS The results of this study indicate that digital technologies may play a useful role in Public Health to improve communication between health professionals and patients, provide quality care even remotely and facilitate the achievement of health outcomes for the population from a Health Literacy perspective

Artificial Intelligence and Public Health: Evaluating ChatGPT Responses to Vaccination Myths and Misconceptions.

Artificial intelligence (AI) tools, such as ChatGPT, are the subject of intense debate regarding their possible applications in contexts such as health care. This study evaluates the Correctness, Clarity, and Exhaustiveness of the answers provided by ChatGPT on the topic of vaccination. The World Health Organization's 11 "myths and misconceptions" about vaccinations were administered to both the free (GPT-3.5) and paid version (GPT-4.0) of ChatGPT. The AI tool's responses were evaluated qualitatively and quantitatively, in reference to those myth and misconceptions provided by WHO, independently by two expert Raters. The agreement between the Raters was significant for both versions (p of K < 0.05). Overall, ChatGPT responses were easy to understand and 85.4% accurate although one of the questions was misinterpreted. Qualitatively, the GPT-4.0 responses were superior to the GPT-3.5 responses in terms of Correctness, Clarity, and Exhaustiveness (Δ = 5.6%, 17.9%, 9.3%, respectively). The study shows that, if appropriately questioned, AI tools can represent a useful aid in the health care field. However, when consulted by non-expert users, without the support of expert medical advice, these tools are not free from the risk of eliciting misleading responses. Moreover, given the existing social divide in information access, the improved accuracy of answers from the paid version raises further ethical issues

A Systematic Review of Clinical Practice Guidelines for Caries Prevention following the AGREE II Checklist.

Untreated oral diseases are detrimental to overall well-being and quality of life and are in close relationship with social and economic consequences. The presence of strong evidence for caries primary and secondary prevention is a compulsory tool for the development of clinical practice guidelines (CPGs). This paper was aimed to assess systematically the importance of clinical practice guidelines in caries prevention management considering both the adult and pediatric populations and evaluate them using the Appraisal of Guidelines for Research and Evaluation (AGREE II) Checklist. Records were extracted from EMBASE, SCOPUS, PubMed/Medline and seven other relevant guideline databases between 6 January and 14 February 2023. Two reviewers independently conducted the appraisal using the web-based platform My AGREE PLUS. Twenty-one guidelines/papers met the inclusion criteria and were reviewed. Eight CPGs included both primary and secondary prevention interventions, whereas thirteen presented a single preventive model. Overall, 12 guidelines were published in the USA. The mean AGREE II scores ranged from 35.4% to 84.3%. Of the total twenty-one included guidelines, twelve were classified as "Recommended", ranging from 56.3% to 84.3%, the others were described as "Recommended with modification", ranging from 35.4% to 68.9%. From the AGREE II analysis carried out, the CPGs included in this survey adopted a punctual methodological rigor but lacked applicative power. The present survey showed that the public, as the primary beneficiary, played a limited role in the development of the twenty-one CPGs. Hence, methodological improvement can better support high-quality CPG development in the future

How the COVID-19 Pandemic Affects Risk Awareness in Dentists: A Scoping Review

Dentists are on the frontline of infection, especially when it comes to respiratory viruses like the new coronavirus. The purpose of this paper is to conduct a scoping review to better understand dentists’ risk awareness, awareness of COVID-19 symptoms, preventive measures, and effective methods of COVID-19 infection prevention and management. This paper systematically assesses the published literature on dentistry and COVID-19. Various electronic databases including Ovid MEDLINE, Scopus, Embase, and MEDLINE via PubMed were searched up to 9 September 2021. Overall, 39 papers were included. Almost the entirety of dentists (94.5%) reported awareness of the three most common COVID-19 symptoms, and a risk awareness score of about 90% was shown, while 88.2% of dentists reported adopting preventive measures. More than 50% did not want to treat infected people. While 70.3% of dentists recommended usage of N95 masks, the rate of dentists using them was below 40%. Sufficient awareness of risks during the pandemic was found in dentists. Although they were using preventive measures, there remains upside potential for adopting all recommended measures. Further, the usage of N95 masks is improvable, even though the benefit of wearing them could not be confirmed

Inequalities in caries among pre-school Italian children with different background.

BACKGROUND The study was aimed to describe caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background and to explore the potential presence of a social gradient. METHODS The ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.8% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) was estimated by mean a standardized self-submitted questionnaire filled-in by parents. The Slope Index of Inequality (SII) based on regression of the mid-point value of caries experiences score for each SES group was calculated and a social gradient was generated, children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic and logistic regression) were used to elucidate the associations between all explanatory variables and caries prevalence. RESULTS Overall, 54.4% (95%CI 46.7-58.3%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.6% vs 41.6% p < 0.01) and to the area of living (p = 0.03). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z = 5.24, p < 0.01). Children in the highest household income group had lower levels of caries. In multivariate analysis, Immigrant status, the highest parents' occupational and educational level, only one kid in the family, living in the North-Western Italian area and a high household income, were statistically significant associated (p = 0.01) to caries prevalence. The social gradient was statistically significant associated (p < 0.01) to the different caries levels and experience in children with European background. CONCLUSIONS Data show how caries in preschool children is an unsolved public health problem especially in those with a non-European background

Social deprivation indexes and anti-influenza vaccination coverage in the elderly in Sardinia, Italy, with a focus on the Sassari municipality

The aim of the present study was to evaluate the relationship between social deprivation indices and anti-influenza vaccine coverage in the Sardinian elderly population (over 65yearsold).This relationship was firstly observed in a regional context. An already-known deprivation index was used, and its trivial relationship with the anti-influenza vaccine coverage was evaluated. Secondly, the same relationship was assessed for the homogeneous area of the Municipality of Sassari. This required adoption of an ad hoc deprivation index, which allowed us to stratify the population into deprivation groups and to correlate the vaccine coverage to socio-economic variables.Results showed that the regional anti-influenza vaccine coverage linearly increased with the decrease in the deprivation. This trend was confirmed for the Municipality of Sassari. Pearson's analysis highlighted factors that significantly correlate to vaccine coverage.In Sardinia, the relationship between anti-influenza vaccination coverage and socio-economic health status was consistent with the international panorama, therefore highlighting the necessity to arrange interventions to promote vaccination coverage in the elderly population

Efficacy of HAF toothpastes in primary and permanent dentitions. A 2-years triple-blind RCT

Objectives: The aim of this RCT was to compare the caries preventive efficacy and the slowing down of previous caries lesions of toothpastes containing fluoride biomimetic hydroxyapatite (HA) complex compared to sodium monofluorophosphate fluoridated toothpastes in Italian schoolchildren. To validate this hypothesis a triple-blind randomized clinical trial was designed. Methods: In total 610 children (4-5 and 6-7 years) were enrolled. Four toothpastes, two containing fluoride-substituted hydroxyapatite (HAF) (1000 and 1450 ppmF) and magnesium-, strontium-, carbonate-substituted hydroxyapatite, in a chitosan matrix and two Mono fluoridated toothpastes (1000 and 1450 ppmF) were randomly administered during 24 months to two groups with younger children (Gyoung) and to two groups with older children (Gold), those containing 1450 ppmF. ICDAS was used to score lesions as initial (up to score 2), moderate (scores 3-4) and severe (scores 5-6). The children were instructed to brush for two minutes three times/day. Caries examination was repeated at 12 and 24 months. The efficacy of the treatment was assessed by calculating the reduction in Risk Ratio (RR) and the number needed to treat (NNT). Results; Overall, 518 patients (Gyoung = 268; Gold = 250) concluded the trial. The drop-rate was 11.84% for Gyoung and 17.22% for Gold. The caries increment at 24-month evaluation was statistically lower in the primary dentition in the HAF arms compared to the traditional fluoridated arms (0.18 vs 0.27 p = 0.04 in Gyoung and 0.16 vs 0.30 p = 0.01 in Gold for severe lesions). In the permanent dentition (Gold), caries increase was also statistically lower in the HAF arm, both for initial and severe lesions (0.09 vs 0.17 p = 0.02 and 0.18 vs 0.28 p = 0.01, respectively). In primary dentition, children receiving HAF Toothpaste had a RR of 39% (Gyoung) and 38% (Gold), compared to children receiving traditional Toothpastes. The RR in the permanent dentition was 29% in children treated with HAF toothpaste. Conclusions; The use of toothpastes containing biomimetic hydroxyapatite and fluoride reduces caries increment in children over a period of 2 years more than traditional fluoridated toothpastes. Keywords: Caries; Fluoride; Hydroxyapatite; Pediatric de

Oral Health Survey in Burundi; Evaluation of the Caries Experience in Schoolchildren Using the DMFT Index.

Background and objectives: There are no data on oral health in the population of Burundi. This study aimed to describe the oral health status of schoolchildren in Burundi using the dmft/DMFT index for the first time. Materials and methods: The study was designed as a cross-sectional population-based epidemiological survey. The survey was designed according to the WHO methodology for oral health surveys. Oral examinations were conducted in school rooms using a dental mirror, probe, and headlight. The following characteristics of primary dentition status were recorded: decayed (d/D), missing (m/M), and filled (f/F) teeth, and the dmft/DMFT (d + m + f t/D + M + F T) index was calculated for each subject. Quantitative and qualitative variables were represented by measures of position and variability. One-way ANOVA was used to assess differences between parametric variables. Logistic regression was performed for total caries experience and gender, age groups, living area, and geographical provinces. Results: A total of 1902 children were examined, 1007 (52.94%) six-year-olds and 895 (47.06%) in the older group. The dmft/DMFT and subgroups were statistically significantly different in terms of age groups, living areas, and geographical regions (dmft/DMFT d-subgroup and D-subgroup p < 0.01), but only for DMFT for sex. The ORs estimated by logistic regression by total caries experience showed a protective effect for 12 year old subjects and those living in southern provinces, an OR of 0.52 (95%CI 0.43-0.64) and an OR of 0.26 (95%CI 0.21-0.32), respectively. Conclusions: Dental caries in African countries, including Burundi, remains a major problem affecting the general health and wellbeing of the population. Tackling untreated caries requires a multifaceted approach, including strengthening oral health infrastructure, promoting oral health education, providing affordable dental services, and encouraging healthier eating habits