bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a web platform for COVID-19 integrated care: an experience from an Italian Region
Authors: Di Martino G , Di Biagio R , Soldato G , Del Papa J , Porfilio I , Stella A , Polidoro I , Fabiani L , Caponetti A , Ruotolo L 
Published: October 2021

Abstract

Issue
After the announcement of Public Health Emergency of International Concern about COVID19 by WHO, health authorities need to implement strategies to face the emergency. These responses included early diagnosis, patient isolation, quarantine and symptomatic monitoring of contacts. In this context, integrated care and telemedicine are the best instruments for COVID management.

Description of the problem
The COVID19 epidemic needs a real time integration of epidemiological, clinical and laboratoristic data, in order to better manage patients and to improve public health surveillance. Based on a tool previosly used by GPs for flu vaccination and diabetes integrated care, the Local Health Authority of Pescara, Abruzzo Region, Italy, developed a web-based platform (QuickwebConnect), accessible to public health practitioners (PHP), GPs, infectious diseases physicians and laboratories, in order to integrate information about COVID19 patients. This platform contain individual-level information on patients with laboratory-confirmed COVID19, symptoms, reported onset dates, and basic demographics. Information are in real time accessible to all actors involved in the process. In addition, GPs can use this tool to directly book diagnostic tests for symptomatic or suspected patients.

Results
With the use of this platform, the management of pandemic emergency was improved, allowing direct management of epidemic data both at person and population level. The real time evaluation of clinical and epidemiological data improved patients care, clinical survellance of COVID19 contacts and development of tailored preventive measure in areas with high incidence.

Lessons
COVID19 patients care need to be quick, needing the integrate support of different actors. In addition, public health actions have to be supported by strong data. The use of a cost-effective web platform allow physician and PHP to better manage patiens and develope focused interventions.

Key messages
Integrated care and telemedicine are best instruments for COVID management. The real time evaluation of data aimed to develop tailored preventive measure.
Use and effectiveness of Digital Contact Tracing during COVID-19 pandemic: a systematic review
Authors: Pegollo L , Mazza C , Girardi D , Maggioni E , Valente G , Gaeta M , Odone A 
Published: October 2021

Abstract

Background
Contact tracing (CT) is a pillar of infection control during outbreaks and its implementation has been great ally in the context of the COVID-19 pandemic that pressured national health systems. Digital CT (DCT) aids manual CT by logging proximity contacts and timely notifying contacts of positive cases, contributing to greater epidemic. We aim to systematically review and critically appraise the available evidence on adoption, effectiveness, acceptance and barriers to access of available CT apps.

Methods
We conducted a systematic literature review by means of Pubmed, Embase, Cochrane and Web of Science and applying the PRISMA guidelines. We classified studies according to selected characteristics (eg, original data, mathematical models, policy papers, overview of the experience with national CT apps) in order to better outline our results.

Results
Our queries yielded 1201 articles, of which 790 remained after duplicates' removal. After applying a priori selected inclusion criteria, 428 (54.17%) were eliminated after screening by title and abstract. 362 records were included in our study: of them 33.7% were original studies, 54.1% were opinion papers not reporting quantitative data, 14.91% were mathematical models, 6% were systematic reviews on DCT-related topics. Among original studies, 11.47% described national experiences and 25.40% discussed adoption dynamics.

Conclusions
DCT adoption still faces several cultural, normative and technical barriers, ranging from adoption mandates to privacy issues, to device compatibility. Overall, scant evidence is available on the impact of DCT in controlling infection spread and wide heterogeneity persists within studies in term of design and assessed outcomes Future research is needed based on shared evaluation frameworks.

Key messages
Digital contact tracing apps are a powerful but underestimated tool to counter epidemiological emergencies. Future epidemiological challenges will require a shared implementation and evaluation protocol for digital contact tracing apps.
Premature mortality attributable to tobacco smoking among Tunisian adults in 2016
Authors: Cherif I , Khiari H , Mallekh R , Hsairi M 
Published: October 2021

Abstract

Background
Tobacco smoking is a major risk factor for several debilitating health conditions, causing thus premature deaths and disability. Globally, 8 million deaths, mainly occurring in low and middle income countries, are attributable to tobacco use each year. We aimed in this study to estimate the premature mortality attributable to current cigarettes smoking among Tunisian adults aged 35-69 years.

Methods
The population attributable fraction (PAF) method was used to estimate the number of premature deaths attributable to smoking. The estimates for the total number of deaths in Tunisia in 2016 by causes were obtained from the health metrics database. The current cigarettes smoking prevalence was taken from a nationally representative household survey conducted in 2016 and the used relative risks were obtained from the cancer prevention study II of the American Cancer Society.

Results
A total of 3219 premature deaths were attributable to current cigarettes smoking accounting for 23.1% (34.2% in men and 2.1% in women) of the total number of deaths. The leading causes of premature mortality attributable to smoking were lung cancers (PAF= 79.6%), chronic obstructive pulmonary diseases (PAF= 54.5%) and upper aerodigestive tract cancers (PAF= 54.3%).

Conclusions
Nearly a quarter of premature deaths in Tunisia in 2016 were attributable to tobacco smoking. This underscores the need to enhance the MPOWER measures application mainly through the promotion of anti-tobacco awareness campaigns and the reimbursement of smoking cessation treatments.

Key messages
Tobacco smoking were responsible for a significant percentage of premature deaths mainly among Tunisian men in 2016. Our results highlight the urge to enhance the MPOWER measures application in Tunisia.
Estimated direct costs of renal cancer by stage and care phase: a whole disease modeljuj
Authors: Buja A , De Luca G , Gatti M , Bonaldi F , Gardi M , Bortolami A , Sepulcri M , Baldo V , Scioni M , Basso U 
Published: October 2021

Abstract

Background
Renal cell carcinoma (RCC) is the seventh most common neoplasm in high-income countries. New clinical pathways have been developed to deal with this tumor, which include costly drugs that pose an economic threat to the sustainability of healthcare services. This study provides an estimate of the direct costs of care for patients with RCC by stage of disease (early vs advanced) at diagnosis, and disease management phase along the pathway recommended by local and international guidelines.

Methods
Considering the clinical pathway for RCC adopted in the Veneto region (north-east Italy) and the latest guidelines, we developed a very detailed “whole-disease” model that covers the probabilities of all potentially necessary diagnostic and therapeutic action involved in the management of RCC. Based on the cost of each procedure according to the Veneto Regional Authority's official reimbursement tariffs, we estimated the total and average per-patient costs by stage of disease (early or advanced) and phase of its management.

Results
In the first year after diagnosis, the mean expected cost of a patient with RCC is €12,991 if it is localized or locally-advanced, and reaches €40,586 if it is advanced. For early disease, the main cost is incurred by surgery, whereas medical therapy (first and second line) and supportive care become increasingly important for metastatic disease.

Conclusions
It is crucially important to examine the direct costs of care for RCC, and to predict the burden on healthcare services of new oncological therapies and treatments, as the findings could be useful for policy-makers planning the allocation of resources.

Key messages
An estimation of the direct costs of renal cell carcinoma, and in general for cancer, appears fundamental to predict the burden of new oncological therapies and treatments on healthcare services. Our model could represent a useful tool for policy-makers in the optimization of resources allocation, especially in a time of budget constraints.
Investigation of Epidemiological Characteristics of Patients over Age 65 with Covid-19 ın a City
Authors: Gokce A , Ozer A , Soyiler V , Gundogdu ME 
Published: October 2021

Abstract

Background
The population aged ≥65 is important because of the higher mortality rate and a riskier clinical course of COVID-19 in this patient group. This study aimed to examine the epidemiological characteristics, clinical conditions and factors affecting the clinical status of patients over 65 with COVID-19 in the Bingol province.

Methods
Study was conducted between March and December 2020 in the Bingol province using the data of 3,521 patients over age 65 who were positive for SARS-CoV-2 as per RT-PCR results. The study commenced after obtaining necessary institutional permissions and the ethics committee approval. In the study, independent variables were age, gender, presence of chronic diseases whereas dependent variables were mortality status, presence of pneumonia. Chi-square test and binominal logistic regression analysis were used for statistical analysis. In all evaluations, p &lt; 0.05 was considered significant.

Results
The median age of the patients participating in the study was 72(65-102) and the case fatality rate was 2%. The mortality rates were significantly higher in patients aged between 75-84 and those aged &gt;85 as well as patients who had a chronic disease, diabetes and ischemic heart disease compared to the other groups (p &lt; 0.05). According to the regression analysis, mortality rate was 2.6-fold higher in males than in females and 24.3-fold higher in patients with pneumonia than in those without pneumonia (p &lt; 0.05).

Conclusions
Among the patients in the study group, mortality rate was found to be higher in males, those in the advanced age group and those with pneumonia and chronic diseases. Therefore, if possible, patients with these characteristics should be followed more closely in a hospital setting during the pandemic.

Key messages
Mortality rates are higher in patients with COVID-19 who have a chronic disease, diabetes or ischemic heart disease. Age, gender and presence of pneumonia are among the important factors in the course of COVID-19.
Assessment of the nutritional status in patients with acute diverticulitis
Authors: Giorgetti G , Fabiocchi F , D'Avino A , Tursi A , Brandimarte MA , Paoloni A , Meucci T , Parrocchia S , Brandimarte G , Nasi G 
Published: October 2021

Abstract

Background
The study evaluated the implementation of a screening strategy on all hospitalizations for diverticular disease (DD) of the colon with particular reference to acute diverticulitis (AD) regarding nutritional status.

Methods
The Nutritional Risk Security (NRS2002) system, was used, preselecting those with AD by the nurses of the nutrition team on the same day of admission from 1/01 to 31/12/2017 at the S. Eugenio Hospital in Rome. Patients (pts) with positive pre-screening were referred for additional evaluation performed by a dietician.

Results
AD was observed in 133 pts, 58% women, out of a total sample of 4667. The NRS2002 was applied to all, finding a positive screening test in 97 (72.9%) pts of whom a severely compromised nutritional status (NRS2002 score&gt;3) in 61 pts (62.9%). Each patient tested positive was given initial nutritional support: oral supplements (17 pts, 17.52%), enteral nutrition (22 pts 22.68%), total parenteral nutrition (58 pts 59.8%). The mean length of hospital stay was 6.9 days, although was significantly longer for pts with NRS2002 positive (mean of 18 day). NRS2002 score can be a significant predictor of disease severity and outcome, operating independently of BMI, since a total score ≥3 can predict length of hospital stay.

Conclusions
The study confirmed that NRS2002 is a useful screening tool for identifying nutritional risk AD pts in hospital wards and allowed to select pts who needed a more careful monitoring program, diet therapy and possibly nutrition artificial. Furthermore, it showed an increasing and underestimated risk of malnutrition in a large number of pts hospitalized and that NRS2002 screening is a good predictor of some socio-health indicators such as hospital stay.

Key messages
There is an increasing and underestimated risk of malnutrition in a large number of patients hospitalized. NRS2002 is a useful screening tool for identifying nutritional risk and a good predictor of some socio-health indicators such as hospital stay.
Environmental Factors Affecting Cognitive Function Among Community-dwelling Older Adults
Authors: Motohiro A , Abe T , Okuyama K , Kumakura S 
Published: October 2021

Abstract

Background
Although neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect among older adults living in rural areas. This longitudinal study aimed to investigate the effect of neighborhood environmental factors on cognitive decline among rural older adults.

Methods
The data of 503 older adults aged &gt; 60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were measured using geographic information system. Logistic regression examined the effect of each neighborhood environmental factor (in quartiles: Q1-Q4) on cognitive decline.

Results
A total of 57 (11.3%) participants demonstrated a decrease in cognitive function at follow up. Elevation (Odds ratio (OR): 3.37, 95% Confidence Interval (CI): 1.11-10.20 for Q3 vs. Q1; OR: 5.43, 95% CI: 1.89-15.56 for Q4 vs. Q1) and hilliness (OR: 3.45, 95% CI: 1.46-8.11 for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. Residential density and distance to a community center were not associated with cognitive decline.

Conclusions
Elevated and hilly environments may increase risk of cognitive decline among rural older adults.

Key messages
Residents in mountainous regions tend to have limited accessibility to various living centers. Those who live in elevated and hilly areas within the mountainous regions may have further limited accessibility and availability of locations where they can interact with others.
Rewilding European urban spaces
Authors: Evans M 
Published: October 2021

Abstract

Background
In the context of global climate change, deforestation, biodiversity loss, and the impact of urban living on public health, the rewilding of urban areas and surrounding spaces may offer a host of benefits for physical and mental health as well as improvements to environmental and planetary health. This review offers a contemporary appraisal of the role and impact of rewilding urban areas within Europe, considering the success of existing policies and offering suggestions for future projects.

Findings
Rewilding projects across Europe vary in scale and intensity. Given ongoing urbanisation across much of Europe, there is increasing need for green and natural spaces. Protection and enhancement of natural spaces, development of newly rewilded areas, and increased connectedness of natural spaces represent ways to increase prevalence and access to such spaces. Rewilding offers a number of potential benefits to human health, including restoration of biodiversity which may support food security, and sequestration of carbon dioxide which plays an important role in reducing climate change. Green spaces in cities counteract heat island effects and help to maintain temperatures. There are also documented benefits to mental health and faster recovery times from illness.

Lessons
There is scope to improve rewilding projects to enhance their success across Europe. Current limitations to rewilding projects include:
The lack of a clear definition of rewilding and the broad scope of projects that fall under this concept. Challenges in monitoring and evaluation, and the need for a clear framework for effective evaluation of such projects. Increased and improved communication and advocacy.

Key messages
Rewilding offers a range of potential benefits to human and planetary health, and there is increasing interest in such projects. There are limitations to rewilding projects that must be overcome in order to improve policy and practice in this area.
Staying active during Covid-19 crisis: why it would have been important to keep public parks opened
Authors: Porcherie M , Roué Le Gall A , Thomas MF , Montiège Q , Faure E , Rican S , Vaillant Z , Simos J , Cantoreggi N 
Published: October 2021

Abstract

Background
In 2020, the Covid 19 pandemic and associated restrictions, including limited access to public urban green space (UGS), have led to a decrease in the ability of city dwellers to engage in physical activity. In France, more than 52% people reported being physically active in urban parks. Based on the GREENH-City research carried out in cities of the French network of WHO healthy cities, this presentation aims to show that UGS, depending on different drivers, can support a wide variety of physical activities, but also offer multiple other functions that contribute more or less directly to the health of the population.

Methods
A qualitative survey was conducted among users of 3 different parks in each of the 6 selected cities with both observations and semi-directive interviews and a thematic analyzes were performed. Observed activities were classified into 8 groups including physical activity (non-sport, sports). Interview's analysis aimed to describe the reasons for coming and the type of activity made.

Results
186 observations and 591 recorded and unrecorded interviews with individuals or groups were conducted in the 18 parks. 24 types of physical activity have been described as possible uses of UGS. The most important, regardless of UGS location, is children activities in playgrounds. The most common activities are walking (with a social function) and jogging (individual function). Proximity and the accessibility are two reasons for use.

Conclusions
UGS are an open access amenity for physical activities. From a social justice perspective, policy makers should ensure that every neighborhood is sufficiently close to an UGS. In addition to promoting physical activity, UGS also serve an important social function and impact the collective physical and mental health of the population in many other ways (e.g., as environmental risk regulators). Their coping role during crisis for population would worth to be studied further.

Key messages
Proximity and accessibility should shape local policies related to UGS renewal towards more equity. Different typologies of urban parks at the city level can offer multiple functions, including facilitation of physical activity that contribute to the health of the population.
Gender-linked determinants for utilization of long-term care in community-dwelling adults in Germany
Authors: Steinbeisser K , Schwarzkopf L , Grill E , Schwettmann L , Peters A , Seidl H 
Published: October 2021

Abstract

Background
The number of people using long-term care (LTC) is increasing steadily worldwide. Hence, demand for adequate services is rising. The purpose of this exploratory study was to identify relevant gender-linked determinants for utilization of LTC in community-dwelling older adults.

Methods
We examined 4077 females (52.7%) and males ≥ 65 years old (range: 65-97) between 2011/12 (t1) and 2016 (t2). Data originated from the population-based Cooperative Health Research in the Region of Augsburg (KORA)-Age study in Germany. A descriptive analysis assessed the amount of LTC used. Cross-sectional generalized estimating equation logistic models identified determinants for utilization of (in)formal LTC. Determinants for transition to LTC between t1 and t2 were examined using a longitudinal logistic regression model. Potential determinants were chosen according to Andersen's Behavioral Model of Health Services Use.

Results
At t2, 820 (20.1%) were LTC users with 527 (64.3%) being female. The average amount of informal LTC was higher in males (158.0 minutes/day (m/d) (SD: 270.5) vs. 70.1 m/d (SD: 152.8)), whereas the amount of formal LTC was higher in females (89.7 m/d (SD: 224.7) vs. 28.5 m/d (SD: 23.3)). In both genders, higher age, multimorbidity, and disability were associated with utilization of and transition to LTC. Living alone was significantly associated with utilization of (formal) LTC in both genders, but its effect was almost two times stronger in males (men: OR: 3.48 (CI: 2.05-5.90) vs females: OR: 1.83 (CI: 1.25-2.69)). Thus, ‘living alone' is considered the essential gender-linked determinant.

Conclusions
Gender-linked determinants must be considered when establishing demand-oriented policies. Future health programs should specifically target older individuals, especially males, living alone to improve their capabilities in activities of daily living to allow them to remain living longer and more independently within community settings.

Key messages
Older individuals, especially men, living alone should be targeted in future health programs. Females tend to use a higher amount of formal long-term care than males.