How the Italian NHS Is Fighting Against the COVID-19 Emergency.

No abstract available. Keywords: Covid-19, Italy, pandemic, healthcare systems, emergenc

Comparison of Deaths Rates for COVID-19 across Europe During the First Wave of the COVID-19 Pandemic.

Background: Europe overall suffered greatly in the early stages of the COVID-19 pandemic but the impact of different countries varied. Italy was in the forefront, but there too there were differences, with the Lombardy region the epicentre of the pandemic. Methods: We report Crude Mortality Rates (CMRs) from deaths reported as due to COVID-19 and, in five countries where age-specific data are available, Standardized Mortality Rates (SMRs) in the European Union and United Kingdom. Results: As of 30th August 2020, Belgium was the country with the highest cumulative CMR (86.3/100,000), but the Lombardy region reached almost double this figure (167.6/100,000), far ahead of the corresponding figure for the rest of Italy at 37.0/100,000. SMRs could be calculated for five countries (Italy, Portugal, Sweden, Germany, and Netherlands). Among them, Sweden had the highest SMR (61.6/100,000). The corresponding figures for Italy, Netherlands, Portugal and Germany were 50.2, 41.4, 15.9, and 10.1 per 100,000, respectively. Conclusion: It is clear that countries within Europe have performed very differently in their responses to the COVID-19 pandemic, but the many limitations in the available data must be addressed before a definitive assessment of the reasons for these differences can be made

Strengthening and promoting digital health practice: results from a Global Digital Health Partnership’s survey

Background and objectiveThe capacity to promote and disseminate the best evidence-based practices in terms of digital health innovations and technologies represents an important goal for countries and governments. To support the digital health maturity across countries the Global Digital Health Partnership (GDHP) was established in 2019. The mission of the GDHP is to facilitate global collaboration and knowledge-sharing in the design of digital health services, through the administration of surveys and white papers.ObjectiveThe scope of this study is to critically analyze and discuss results from the Evidence and Evaluation GDHP Work Stream’s survey, understand how governments and countries intend to address main obstacles to the digital health implementation, identify their strategies for a communication of effective digital health services, and promote the sharing of international based best practices on digital health.MethodsThis survey followed a cross-sectional study approach. A multiple-choice questionnaire was designed to gather data. Choices were extracted from research publications retrieved through a rapid review.ResultsOut of 29 countries receiving the survey, 10 returned it. On a scale from 1 to 5, eHealth systems/platforms (mean = 3.56) were indicated as the most important tool for centralized infrastructure to collect information on digital health, while primary care (mean = 4.0) represented the most voted item for healthcare services to collect information on digital health. Seven Countries out of 10 identified lack of organization, skepticism of clinicians, and accessibility of the population as a barriers to adopt digital health implementation, resulting to be the most voted items. Finally, the most endorsed priorities in digital health for Countries were the adoption of data-driven approaches (6 Countries), and telehealth (5 Countries).ConclusionThis survey highlighted the main tools and obstacles for countries to promote the implementation of evidence-based digital health innovations. Identifying strategies that would communicate the value of health care information technology to healthcare professionals are particularly imperative. Effective communication programs for clinicians and the general population in addition to improved digital health literacy (both for clinicians and citizens) will be the key for the real implementation of future digital health technologies

Is blockchain the breakthrough we are looking for to facilitate genomic data sharing? The European Union perspective

The recent progress of genomics research is providing unprecedented insight into human genetic variance, susceptibility to disease and risk stratification. Current trends predict that a massive amount of genomic data will be produced in the upcoming years which, when coupled with the fast-paced development of the field, will create new social, ethical, and legal challenges. In the complex legislative environment of the European Union, genomic data sharing policies will have to weigh the benefits of scientific discovery against the ethical risks posed by the act of sharing sensitive data. In this complex, interconnected environment, blockchain provides a unique and novel solution to accountability, traceability, and transparency issues regarding genomic data sharing. Implementing a distributed ledger technology-based database could empower both patients and citizens to responsibly use genomic data pertaining to them because it allows for a higher degree of control over the recipients of their data and their uses. The blockchain technology will engage both data owners and policymakers to address the multiple issues of genomic data sharing and allow us to redefine the way we look at genomics

A Systematic Review Identifying Adverse Health Outcomes and Mortality Rates Associated with Telehealth

Background: The literature supporting telehealth management is growing accelerated by the COVID-pandemic. We hypothesize that there are risks of adverse events associated with telehealth interventions. Methods: A review of PubMed (including MEDLINE), Embase, ISI (Web of Science), VHL/GHL, Scopus, Science Direct, and PsycINFO was conducted for all adverse events associated with telehealth from January 1, 1960 to March 1, 2021. This systematic review and meta-analyses were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Of 5,144 citations 78 published studies met criteria for quality evaluation and underwent full text abstraction including the qualitative synthesis. Of the 78 included studies 8 were included in the quantitative synthesis resulting in 2 meta-analyses. The results of the meta-analysis suggest that monitoring patients using telehealth techniques is associated with 40% lower mortality risks among patients suffering from heart failure, compared to those who received traditional care. The results of the random-effects meta-analysis showed the pooled relative risk of mortality to be 0.60, indicating that patients that underwent telemonitoring had a lower mortality risk compared with the patients that underwent usual care. Among patients with heart implants, patients who received telemonitoring had a 35% lower mortality risk compared to patients receiving traditional care. Conclusions: While RCTs of telehealth interventions demonstrate enhanced patient outcomes in a number of studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggest an important need for more complementary studies with consistent outcome assessments

European Health Data Space – an opportunity now to grasp the future of data-driven healthcare

Peer reviewedPostprin

Challenges facing mental health systems arising from the COVID-19 pandemic: Evidence from 14 European and North American countries

We assessed challenges that the COVID-19 pandemic presented for mental health systems and the responses to these challenges in 14 countries in Europe and North America. Experts from each country filled out a structured questionnaire with closed- and open-ended questions between January and June 2021. We conducted thematic analysis to investigate the qualitative responses to open-ended questions, and we summarized the responses to closed-ended survey items on changes in telemental health policies and regulations. Findings revealed that many countries grappled with the rising demand for mental health services against a backdrop of mental health provider shortages and challenges responding to workforce stress and burnout. All countries in our sample implemented new policies or initiatives to strengthen mental health service delivery - with more than two-thirds investing to bolster their specialized mental health care sector. There was a universal shift to telehealth to deliver a larger portion of mental health services in all 14 countries, which was facilitated by changes in national regulations and policies; 11 of the 14 participating countries relaxed regulations and 10 of 14 countries made changes to reimbursement policies to facilitate telemental health care. These findings provide a first step to assess the long-term challenges and re-organizational effect of the COVID-19 pandemic on mental health systems in Europe and North America

Valutazione di Health Technology Assessment del sistema di sanificazione biologico a base di probiotici del genere Bacillus (PCHS)

Le infezioni correlate all’assistenza: priorità per la salute pubblica Epidemiologia delle infezioni correlate all’assistenza in Italia e loro impatto per la salute pubblica Sistemi di sanificazione attualmente disponibili in Italia Il Probiotic Cleaning Hygiene System (PCHS): caratteristiche della tecnologia, aspetti di efficacia e sicurezza Un sistema di sanificazione a base di probiotici per la riduzione delle infezioni correlate all’assistenza e la resistenza antimicrobica: analisi dell’impatto sul budget Impatto ambientale per la salute pubblica degli attuali sistemi di sanificazione di ambienti/superfici in setting assistenziale e comunitario e potenziali benefici dei nuovi sistemi innovativi Analisi delle principali raccomandazioni nazionali su sanificazione e disinfezione degli ambienti sanitari Valutazione etica dell’utilizzo del Probiotic Cleaning Hygiene System (PCHS) in Italia Elementi chiave per il processo decisional

Effect of Lockdowns on Hospital Staff in a COVID Center: A Retrospective Observational Study

At the onset of the SARS-CoV-2 pandemic, individual and social measures were strengthened through restrictive non-pharmaceutical interventions, labelled with the term "lockdown". In Italy, there were two lockdowns (9 March 2020-3 May 2020 and 3 November 2020-27 March 2021). As part of preventive measures, healthcare workers and the administrative staff population of Policlinico A. Gemelli underwent nasopharyngeal swab tests from 1 March 2020 to 9 February 2022, a long time interval that includes the two aforementioned lockdowns. The population included 8958 people from 1 March 2020 to 31 December 2020; 8981 people from 1 January 2021 to 31 December 2021; and 8981 people from 1 January 2022 to 9 February 2022. We then analysed pseudo-anonymized data, using a retrospective observational approach to evaluate the impact of the lockdown on the incidence of SARS-CoV-2 infections within the population. Given the 14 day contagious period, the swab positivity rate (SPR) among the staff decreased significantly at the end of the first lockdown, every day prior to 18 May 2020, by 0.093 (p < 0.0001, CI = (-0.138--0.047)). After the fourteenth day post the end of the first lockdown (18 May 2020), the SPR increased daily at a rate of 0.024 (p < 0.0001, 95% CI = (0.013-0.034)). In addition, the SPR appeared to increase significantly every day prior to 17 November 2020 by 0.024 (p < 0.0001, CI = (0.013-0.034)). After the fourteenth day post the start of the second lockdown (17 November 2020), the SPR decreased daily at a rate of 0.039 (p < 0.0001, 95% CI = (-0.050--0.027)). These data demonstrate that, in our Institution, the lockdowns helped to both protect healthcare workers and maintain adequate standards of care for COVID and non-COVID patients for the duration of the state of emergency in Italy