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" [...]

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 This is a true evolution in which the vision of the traditional city is superseded by a more modern urban reality creating an ideal, highly automated ecosystem in which Information and Communication Technologies (ICT) take on the role of the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]

Parathyroid Hormone (PTH)-Related Peptides Family: An Intriguing Role in the Central Nervous System

: Parathyroid Hormone (PTH) plays a crucial role in the maintenance of calcium homeostasis directly acting on bone and kidneys and indirectly on the intestine. However, a large family of PTH-related peptides exists that exerts other physiological effects on different tissues and organs, such as the Central Nervous System (CNS). In humans, PTH-related peptides are Parathyroid Hormone (PTH), PTH-like hormones (PTHrP and PTHLH), and tuberoinfundibular peptide of 39 (TIP39 or PTH2). With different affinities, these ligands can bind parathyroid receptor type 1 (PTH1R) and type 2 (PTH2R), which are part of the type II G-protein-coupled-receptors (GPCRs) family. The PTH/PTHrP/PTH1R system has been found to be expressed in many areas of the brain (hippocampus, amygdala, hypothalamus, caudate nucleus, corpus callosum, subthalamic nucleus, thalamus, substantia nigra, cerebellum), and literature data suggest the system exercises a protective action against neuroinflammation and neurodegeneration, with positive effects on memory and hyperalgesia. TIP39 is a small peptide belonging to the PTH-related family with a high affinity for PTH2R in the CNS. The TIP39/PTH2R system has been proposed to mediate many regulatory and functional roles in the brain and to modulate auditory, nociceptive, and sexual maturation functions. This review aims to summarize the knowledge of PTH-related peptides distribution and functions in the CNS and to highlight the gaps that still need to be filled

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

Epidemiology of hydatidosis in the province of Sassari, Italy

Cystic echinococcosis is endemic in certain parts of the world, including Sardinia, Italy. It was performed a study in the province of Sassari in order to evaluate the incidence of the infection in man and the effects of control programs since 1964 to 2002. Data obtained by surgical records, hospital discharge forms, radiological and pathological files were collected using a case report form. During the years 1964- 2002, 2702 new cases were identified (average annual incidence: 17 per 100,000) and 1981 (73.3%) were submitted to surgical treatment. In 57.3% municipalities no cases were observed during the years 1998- 2002. Males are more affected (56.2%), mostly farmers-shepherdess (68.6 per 100,000) and pensioners (59.6 per 100,000). Control measures led to a significant decline in the incidence rate of hydatidosis during the period 1964-2002, dropping by 27.6 per 100,000. The mean age of surgical patients increased during the years of surveillance, such as the surgical liver/lung ratio as a consequence of a cohort effect. The durability of control programs is the corner stone for obtaining a significant decrease of this infection

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

Air Quality and Environmental Effects Due to COVID-19 in Tehran, Iran: Lessons for Sustainability

The 2019 coronavirus disease (COVID-19) global pandemic spread can be considered a disastrous crisis that, in a given geographical area, significantly affects the increase in mortality rate with direct and indirect impacts on different scales and social, economic, political, and ecological factors. The effects of this crisis can be more intense in urban areas with high population density. Due to the more significant presence of vulnerable groups, the risk of death increases significantly. This research describes the environmental impacts of the COVID-19 pandemic in the city of Tehran, the 37th most populated city in the world. The concentration of six air pollutants (carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), particulate matter with a diameter of 10 microns (PM10), sulfur dioxide (SO2), particulate matter with a diameter of fewer than 2.5 microns (PM2.5) and the Air Quality Index (AQI) were measured in 22 urban regions of Tehran before (20 March) and from (21 March to 10 February) the lockdown, in air pollution evaluation stations. In order to conduct this research, first, the values of the air pollutant indices of the 22 districts of Tehran in the two previous periods (before 20 March) and during quarantine (21 March to 10 February) were obtained from the air pollution measurement stations of the 22 districts of Tehran, together with the results. After the operationalization and quantification of the indicators according to the research objectives, they were entered into the ArcGIS environment, and the spatial analysis of each pollutant was performed, before and during the quarantine. Finally, it was found that the AQI was reduced from 74.95 to 54.15

Prevalence study of Legionella spp. contamination in ferries and cruise ships

BACKGROUND: In the last years, international traffic volume has significantly increased, raising the risk for acquisition of infectious diseases. Among travel-associated infections, increased incidence of legionellosis has been reported among travellers. Aim of our study was: to describe the frequency and severity of Legionella spp. contamination in ferries and cruise ships; to compare the levels of contamination with those indicated by the Italian ministerial guidelines for control and prevention of legionellosis, in order to assess health risks and to adopt control measures. METHOD: A prevalence study was carried out on 9 ships docked at the seaports of northern Sardinia in 2004. Water samples were collected from critical sites: passenger cabins, crew cabins, kitchens, coffee bars, rooms of the central air conditioning system. It was performed a qualitative and quantitative identification of Legionella spp. and a chemical, physical and bacteriological analysis of water samples. RESULTS: Forty-two percent (38/90) water samples were contaminated by Legionella spp.. Positive samples were mainly drawn from showers (24/44), washbasins (10/22). L. pneumophila was isolated in 42/44 samples (95.5%), followed by L. micdadei (4.5%). Strains were identified as L. pneumophila serogroup 6 (45.2%; 19 samples), 2–14 (42.9%), 5 (7.1%) and 3 (4.8%). Legionella spp. load was high; 77.8% of the water samples contained > 10(4 )CFU/L. Low residual free chlorine concentration (0–0,2 mg/L) was associated to a contamination of the 50% of the water samples. CONCLUSION: Legionella is an ubiquitous bacterium that could create problems for public health. We identified Legionella spp. in 6/7 ferries. Microbial load was predominantly high (> 10(4 )CFU/L or ranging from 10(3 )to 10(4 )CFU/L). It is matter of concern when passengers are subjects at risk because of Legionella spp. is an opportunist that can survive in freshwater systems; high bacterial load might be an important variable related to disease's occurrence. High level of contamination required disinfecting measures, but does not lead to a definitive solution to the problem. Therefore, it is important to identify a person responsible for health safety in order to control the risk from exposure and to apply preventive measures, according to European and Italian guidelines

Perchè prima l’Italia? Aspetti medici, geografici e pianificatori del Covid-19

Why was Italy hit first among western countries? The organized research broughttogether the attention of doctors, geographers and planners to try tounderstand the origins of Covid-19 in Italy. Analyzing various data at theprovincial level, we tried to include how environmental, geographical,socio-economic variables played a role in the 2020 pandemic in Italy