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Farfán-Vargas HM, Espinoza-Morriberon D, Moya-Salazar MM, Contreras-Pulache H, Moya-Salazar J. Systematic review on the implementation of metrological assurance systems for medical devices in Latin America. Front Med (Lausanne) 2024; 11:1281199. [PMID: 38975055 PMCID: PMC11224529 DOI: 10.3389/fmed.2024.1281199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/05/2024] [Indexed: 07/09/2024] Open
Abstract
Background Metrology plays a crucial role in small healthcare service businesses to ensure the quality of products and services. While legal metrology in healthcare exists in some regions, it lacks harmonization. In other countries, there is limited presence of metrology in medical and biomedical engineering. We aimed to evaluate the implementation of metrological assurance systems for medical devices in Latin America. Methods A systematic review was conducted following PRISMA 2020 guidelines and registered with PROSPERO (CRD42022359284). Searches were performed across 13 databases from October 30th to November 3rd, 2022. The search equation was "(((quality assurance) AND (metrology)) AND (medical devices))." A total of 7,789 documents were identified, of which only 16 met the inclusion criteria. Results The majority of studies (75%) were conducted in Colombia, with a significant portion being undergraduate theses. The primary normative references used in the analyzed studies were ISO 10012 and ISO 17025, with the majority (68.75%) relying on national legislation for their approach. One study in Colombia referenced eight standards, and one in Brazil analyzed user involvement in medical device management. Among the included studies, 56.25% were conducted in healthcare institutions, mainly clinics. Most studies provided implementation guidelines, with ISO 10012 being prominent, alongside ISO 17025, which implicitly addresses ISO 9001 elements. Global bias was low across all studies. Conclusion Our results underscore the importance of metrological assurance in managing medical devices in Latin America. The utilization of international standards and national legislation illustrates the diverse approaches adopted by different institutions. Future research should focus on optimizing metrological practices to enhance quality and safety in healthcare.
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Affiliation(s)
- Harold M. Farfán-Vargas
- School of Biomedical Engineering, Faculty of Engineering, Universidad Tecnológica del Perú, Lima, Peru
| | - Dante Espinoza-Morriberon
- School of Biomedical Engineering, Faculty of Engineering, Universidad Tecnológica del Perú, Lima, Peru
| | - Marcia M. Moya-Salazar
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- Education Unit, Nesh Hubbs, Lima, Peru
| | | | - Jeel Moya-Salazar
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
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2
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Stokes K, Piaggio D, De Micco F, Zarro M, De Benedictis A, Tambone V, Moon M, Maccaro A, Pecchia L. The Use of Contact Tracing Technologies for Infection Prevention and Control Purposes in Nosocomial Settings: A Systematic Literature Review. Infect Dis Rep 2024; 16:519-530. [PMID: 38920895 PMCID: PMC11203438 DOI: 10.3390/idr16030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/29/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Pandemic management and preparedness are more needed than ever before and there is widespread governmental interest in learning from the COVID-19 pandemic in order to ensure the availability of evidence-based Infection Prevention and Control measures. Contact tracing is integral to Infection Prevention and Control, facilitating breaks in the chain of transmission in a targeted way, identifying individuals who have come into contact with an infected person, and providing them with instruction/advice relating to testing, medical advice and/or self-isolation. AIM This study aims to improve our understanding of the use of contact tracing technologies in healthcare settings. This research seeks to contribute to the field of Infection Prevention and Control by investigating how these technologies can mitigate the spread of nosocomial infections. Ultimately, this study aims to improve the quality and safety of healthcare delivery. METHODS A systematic literature review was conducted, and journal articles investigating the use of contact tracing technologies in healthcare settings were retrieved from databases held on the OvidSP platform between March and September 2022, with no date for a lower limit. RESULTS In total, 277 studies were retrieved and screened, and 14 studies were finally included in the systematic literature review. Most studies investigated proximity sensing technologies, reporting promising results. However, studies were limited by small sample sizes and confounding factors, revealing contact tracing technologies remain at a nascent stage. Investment in research and development of new testing technologies is necessary to strengthen national and international contact tracing capabilities. CONCLUSION This review aims to contribute to those who intend to create robust surveillance systems and implement infectious disease reporting protocols.
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Affiliation(s)
- Katy Stokes
- Applied Biomedical Signal Processing Intelligent eHealth Laboratory, School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (K.S.); (D.P.); (M.Z.); (A.M.); (L.P.)
| | - Davide Piaggio
- Applied Biomedical Signal Processing Intelligent eHealth Laboratory, School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (K.S.); (D.P.); (M.Z.); (A.M.); (L.P.)
| | - Francesco De Micco
- Research Unit of Bioethics and Humanities, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy;
- Department of Clinical Affair, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy;
| | - Marianna Zarro
- Applied Biomedical Signal Processing Intelligent eHealth Laboratory, School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (K.S.); (D.P.); (M.Z.); (A.M.); (L.P.)
| | - Anna De Benedictis
- Department of Clinical Affair, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy;
- Research Unit of Nursing Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
| | - Vittoradolfo Tambone
- Research Unit of Bioethics and Humanities, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy;
| | - Madison Moon
- Infection Prevention and Control Consultant, Toronto, M4Y 3C8, Canada;
| | - Alessia Maccaro
- Applied Biomedical Signal Processing Intelligent eHealth Laboratory, School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (K.S.); (D.P.); (M.Z.); (A.M.); (L.P.)
| | - Leandro Pecchia
- Applied Biomedical Signal Processing Intelligent eHealth Laboratory, School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (K.S.); (D.P.); (M.Z.); (A.M.); (L.P.)
- Biomedical Engineering (Electronic and Informatics Bioengineering), Università Campus Bio-Medico di Roma, 00128 Roma, Italy
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Rzewuska Díaz M, Locock L, Keen A, Melvin M, Myhill A, Ramsay C. Implementation of a Web-Based Outpatient Asynchronous Consultation Service: Mixed Methods Study. J Med Internet Res 2024; 26:e48092. [PMID: 38833695 PMCID: PMC11185905 DOI: 10.2196/48092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 12/15/2023] [Accepted: 03/12/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Asynchronous outpatient patient-to-provider communication is expanding in UK health care, requiring evaluation. During the pandemic, Aberdeen Royal Infirmary in Scotland expanded its outpatient asynchronous consultation service from dermatology (deployed in May 2020) to gastroenterology and pain management clinics. OBJECTIVE We conducted a mixed methods study using staff, patient, and public perspectives and National Health Service (NHS) numerical data to obtain a rounded picture of innovation as it happened. METHODS Focus groups (3 web-based and 1 face-to-face; n=22) assessed public readiness for this service, and 14 interviews with staff focused on service design and delivery. The service's effects were examined using NHS Grampian service use data, a patient satisfaction survey (n=66), and 6 follow-up patient interviews. Survey responses were descriptively analyzed. Demographics, acceptability, nonattendance rates, and appointment outcomes of users were compared across levels of area deprivation in which they live and medical specialties. Interviews and focus groups underwent theory-informed thematic analysis. RESULTS Staff anticipated a simple technical system transfer from dermatology to other receptive medical specialties, but despite a favorable setting and organizational assistance, it was complicated. Key implementation difficulties included pandemic-induced technical integration delays, misalignment with existing administrative processes, and discontinuity in project management. The pain management clinic began asynchronous consultations (digital appointments) in December 2021, followed by the gastroenterology clinic in February 2022. Staff quickly learned how to explain and use this service. It was thought to function better for pain management as it fitted preexisting practices. From May to September 2022, the dermatology (adult and pediatric), gastroenterology, and pain management clinics offered 1709 appointments to a range of patients (n=1417). Digital appointments reduced travel by an estimated 44,712 miles (~71,956.81 km) compared to the face-to-face mode. The deprivation profile of people who chose to use this service closely mirrored that of NHS Grampian's population overall. There was no evidence that deprivation impacted whether digital appointment users subsequently received treatment. Only 18% (12/66) of survey respondents were unhappy or very unhappy with being offered a digital appointment. The benefits mentioned included better access, convenience, decreased travel and waiting time, information sharing, and clinical flexibility. Overall, patients, the public, and staff recognized its potential as an NHS service but highlighted informed choice and flexibility. Better communication-including the use of the term assessment instead of appointment-may increase patient acceptance. CONCLUSIONS Asynchronous pain management and gastroenterology consultations are viable and acceptable. Implementing this service is easiest when existing administrative processes face minimal disruption, although continuous support is needed. This study can inform practical strategies for supporting staff in adopting asynchronous consultations (eg, preparing for nonlinearity and addressing task issues). Patients need clear explanations and access to technical support, along with varied consultation options, to ensure digital inclusion.
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Affiliation(s)
| | - Louise Locock
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Andrew Keen
- NHS Grampian, Grampian, Aberdeen, United Kingdom
| | - Mike Melvin
- Public Research Partner, University of Aberdeen, Aberdeen, United Kingdom
| | - Anthony Myhill
- Public Research Partner, University of Aberdeen, Aberdeen, United Kingdom
| | - Craig Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
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Navarro-Martínez O, Martinez-Millana A, Traver V. Use of tele-nursing in primary care: A qualitative study on its negative and positive aspects. Aten Primaria 2024; 56:102843. [PMID: 38215687 PMCID: PMC10827397 DOI: 10.1016/j.aprim.2023.102843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE To analyze the opinions of nursing professionals on the current limitations and future potential of digital tools in healthcare. DESIGN Qualitative and descriptive study. LOCATION The study took place during an asynchronous MOODLE course on the use of ICT in healthcare, specifically aimed at nursing professionals. PARTICIPANTS The number of nurses enrolled in the course was 150. METHODS A qualitative study was conducted focusing on the positive and negative aspects that telenursing can offer in the context of a Moodle training in new technologies for nurses. A thematic analysis was carried out following the method proposed by Braun and Clarke. RESULTS In the end 68 nurses participated in the forum. Their statements, opinions and perceptions were analyzed and 28 descriptive codes were obtained and subsequently categorized into positive and negative aspects. CONCLUSIONS Nurses positively value the usefulness of digital tools and identify a wide range of benefits of telenursing in daily practice. At the same time, they point out crucial limitations that may slow down the adoption of telenursing, pointing to areas for improvement such as training and digital literacy of both patients and professionals. They consider that telenursing can humanise care, but insist on the need to prevent its use from increasing health inequalities.
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Affiliation(s)
- Olga Navarro-Martínez
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Valencia, Spain; Instituto ITACA, Universitat Politècnica de València, Camino de Vera s/n, Valencia, Spain.
| | - Antonio Martinez-Millana
- Instituto ITACA, Universitat Politècnica de València, Camino de Vera s/n, Valencia, Spain; Grup de Salut Digital CAMFIC, Barcelona, Spain
| | - Vicente Traver
- Instituto ITACA, Universitat Politècnica de València, Camino de Vera s/n, Valencia, Spain
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De Micco F, De Benedictis A, Lettieri E, Tambone V. Editorial: Equitable digital medicine and home health care. Front Public Health 2023; 11:1251154. [PMID: 38192562 PMCID: PMC10773581 DOI: 10.3389/fpubh.2023.1251154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/01/2023] [Indexed: 01/10/2024] Open
Affiliation(s)
- Francesco De Micco
- Research Unit of Bioethics and Humanities, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Anna De Benedictis
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Nursing Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Emanuele Lettieri
- Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | - Vittoradolfo Tambone
- Research Unit of Bioethics and Humanities, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
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Travaini GV, De Micco F, Biscella F, Carminati E, Flutti E, Garavaglia F, Marino L, Zini A, Scendoni R, De Benedictis A. Stereotypes and Prejudices in Nursing Prison Activities: A Reflection. Healthcare (Basel) 2023; 11:healthcare11091288. [PMID: 37174830 PMCID: PMC10178679 DOI: 10.3390/healthcare11091288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND In the prison environment, the nursing profession has particularly complex peculiarities and aspects, so much so that prison nurses require advanced specialist skills and specific education. Can nurses' stereotypes and prejudices in prison settings affect nursing care? What are nurses' perceptions of the prison environment and people in detention? This study aims, on one hand, to outline the figure of the nurse in the prison environment and current regulations and, on the other hand, to explore whether and how stereotypes and prejudices may affect the way care is provided. METHODS Starting with an analysis of the literature, the authors administered a questionnaire to a group of nurses who shared data and reflections. RESULTS This study sheds a new light on nursing in the prison environment, exploring how nurses' stereotypes and prejudices may affect the care of patients. CONCLUSIONS It would be desirable to develop research in this field to enable a more conscious approach to a world that is still considered distant and dangerous, and to overcome the misperceptions and prejudices that may negatively affect the way of caring.
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Affiliation(s)
| | - Francesco De Micco
- Research Unit of Bioethics and Medical Humanities, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
- Department of Clinical Affair, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
| | - Francesca Biscella
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Elisa Carminati
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Emma Flutti
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | | | - Laura Marino
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Arianna Zini
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Roberto Scendoni
- Department of Law, University of Macerata, 62100 Macerata, Italy
| | - Anna De Benedictis
- Department of Clinical Affair, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Nursing Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Roma, Italy
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Scendoni R, Bury E, Lima Arrais Ribeiro I, Cingolani M, Cameriere R, De Benedictis A, De Micco F. Leading Pathogens Involved in Co-Infection and Super-Infection with COVID-19: Forensic Medicine Considerations after a Systematic Review and Meta-Analysis. Pathogens 2023; 12:pathogens12050646. [PMID: 37242315 DOI: 10.3390/pathogens12050646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023] Open
Abstract
The COVID-19 pandemic raised concerns about the potential for co-infection or over-infection with other respiratory infections, as they can complicate the diagnosis, treatment and prognosis of the disease. This is also a challenge for forensic pathologists, who may come across cases where the presence of co-infection or over-infection is suspected or confirmed, and it is important that they take this into account when determining the cause of death. The aim of this systematic review is to analyse the prevalence of each specific pathogen co-infecting or over-infecting patients with SARS-CoV-2 infection. In total, 575 studies were selected from the Scopus and Pub-Med online databases and 8 studies were included in a meta-analysis. Male gender, advanced age and nursing home care are risk factors associated with the development of co-infection, whereas age, tachypnoea, hypoxaemia and bacterial infection are predictors of mortality. Overall, however, having a SARS-CoV-2 infection does not represent a real risk for the development of co-infections/super-infections.
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Affiliation(s)
- Roberto Scendoni
- Department of Law, University of Macerata, 62100 Macerata, Italy
| | - Emanuele Bury
- Department of Law, University of Macerata, 62100 Macerata, Italy
| | | | | | - Roberto Cameriere
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
| | - Anna De Benedictis
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy
- Research Unit of Nursing Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
| | - Francesco De Micco
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy
- Research Unit of Bioethics and Humanities, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
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8
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Aulino G, Beccia F, Rega M, Siodambro C, Capece G, Boccia S, Lanzone A, Oliva A. Child maltreatment and management of pediatric patients during COVID-19 pandemic: Knowledge, awareness, and attitudes among students of medicine and surgery. A survey-based analysis. Front Public Health 2022; 10:968286. [PMID: 36203705 PMCID: PMC9531710 DOI: 10.3389/fpubh.2022.968286] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose of the study To assess perception, awareness, and attitudes regarding the medico-legal relevance of child maltreatment and management of pediatric patients during the COVID-19 pandemic in a cohort of medicine and surgery students, with a particular focus on child safety and maltreatment. Methods A cross-sectional, web-based survey was conducted through an anonymous questionnaire on the personal websites of Università Cattolica del Sacro Cuore medical students. Results The study included 1,166 participants, the majority of whom were experienced with child maltreatment and defensive medicine; only a small percentage was aware of the government's efforts to prevent child maltreatment and safeguard vaccination physicians. Moreover, there was no agreement on the use of telemedicine for non-serious pediatric patients or on the consequences it might have on their health. Finally, the detrimental impacts of lockdown on children's mental health are a major worry. Conclusions Knowledge of these themes is mainly implemented by deepening these concepts during the undergraduate studies since a high level of knowledge on child maltreatment and on the management of COVID-19 pandemic was significantly associated with clinical years of course. Specific seminars analyzing telemedicine and legislative protections concerning minors and those concerning vaccination doctors should be included in the study plan to raise awareness these concepts.
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Affiliation(s)
- Giovanni Aulino
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Flavia Beccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michele Rega
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Chiara Siodambro
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy,*Correspondence: Chiara Siodambro
| | - Giuseppe Capece
- Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy,Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Lanzone
- Unit of Obstetrics and Obstetric Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy
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Brichetto G, Tacchino A, Leocani L, Kos D. Impact of Covid-19 emergency on rehabilitation services for Multiple Sclerosis: An international RIMS survey. Mult Scler Relat Disord 2022; 67:104179. [PMID: 36130457 PMCID: PMC9474392 DOI: 10.1016/j.msard.2022.104179] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Abstract
Background Covid-19 pandemic greatly impacted on the healthcare systems worldwide with negative consequences on several aspects of clinical populations. For neurological chronic conditions such as Multiple Sclerosis (MS), rehabilitation activities have been suspended or postponed during the pandemic. Rehabilitation is crucial for people with MS (PwMS) because it promotes recovery from relapses and maximizes opportunities for social participation. To better understand the impact of Covid-19 emergency on rehabilitation services for MS, the European network for rehabilitation in MS (RIMS) disseminated a survey to healthcare professionals (HPs) and representatives of the MS rehabilitation services (RSs), to explore the two different perspectives on the delivery of rehabilitation in usual circumstances and during the Covid-19 emergency. Methods The online survey was distributed from July 9th to September 20th, 2020. Besides general information on the responders (e.g. location of center, and memebership to RIMS), information was collected on usual service delivery (e.g. settings, specialities, and types of treatment), the impact of Covid-19 circumstances (e.g. restrictions, use of personal protective equipment, and impact on work), and the use of technologiesin rehabilitation. Results Twenty-two representatives of MS rehabilitation services (RSs)and 143 health care professionals (HPs) responded. Most of RSs and HPs worked in services specialized for MS including a mixture of all usual rehabilitation settings (i.e. inpatient, outpatient and community setting). The majority of services adopted a multidisciplinary framework, including physical therapy, occupational therapy, social service, speech and language therapy, psychological support, dietary interventions, medical management, vocational rehabilitation and cognitive rehabilitaton. Overall, most of responders indicated they did not use technologies in their practice (e.g. for treatment or assessment). However, depending on the type of technology a low-to-medium percentage of responders declared to use some technologies before Covid-19 crisis (5-55% for RSs and 12-53% for HPs) and a low percentage planned the use after pandemic (0-14% for RSs and 1-10% for HPs). Moreover, for the responders the most feasible interventions deliverable through tele-rehabilitation were psychological support and dietary interventions, with psychological support considered the most necessary intervention to be remotely implemented. Moderate feasibility (30-60%) was reported for hands-off interventions (e.g. aerobic exercise and cognitive rehabilitation) whereas low feasibility (<30%) was reported for hands-on interventions. Feasibility was especially low when tools were used that are not adaptable at-home (e.g. hyperbaric oxygen therapy). Conclusion The Covid-19 pandemic has stimulated the MS healthcare professionals to find new solutions to deliver alternative interventions to PwMS. In this context, the role of telemedicine is crucial to continue rehabilitation services at home, and limit exposure to infection. However, most of healthcare professionals have not incorporated the use of technologies. Therefore, the implementation of digital health solutions in the clinical practice needs more attention towards education on the potentials of technologies for rehabilitation and simplification of the national healthcare system reimbursement procedures for the rehabilitation technologies use.
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Affiliation(s)
- Giampaolo Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy; AISM Rehabilitation Service of Liguria, Genoa, Italy; Rehabilitation in Multiple Sclerosis (RIMS).
| | - Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy; Rehabilitation in Multiple Sclerosis (RIMS)
| | - Letizia Leocani
- Rehabilitation in Multiple Sclerosis (RIMS); Vita-Salute San Raffaele University and Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), IRCCS-Scientific Institute San Raffaele, Milan, Italy
| | - Daphne Kos
- Rehabilitation in Multiple Sclerosis (RIMS); Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.; National Multiple Sclerosis Center Melsbroek, Melsbroek, Belgium
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Vaccines Administration in the Perspective of Patient Safety and Quality of Healthcare: Lesson from the Experience of an Italian Teaching Hospital for Pandemic Preparedness. Vaccines (Basel) 2022; 10:vaccines10091495. [PMID: 36146573 PMCID: PMC9500706 DOI: 10.3390/vaccines10091495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 01/12/2023] Open
Abstract
The development and administration of vaccines against COVID-19 was a key element in the fight against the pandemic, as it protected health systems and helped restore global economies. National implementation plans and vaccination strategies for COVID-19 vaccines ensured the immunization of large segments of the population in the shortest time. However, even before the start of the vaccination campaign, it was clear to decision-makers that the usual methods of vaccination were not suitable. The aim of this report is to share the experience of an Italian teaching hospital in the organisation of spaces and activities of healthcare workers to realise a safe vaccination campaign. An in-depth analysis of how the vaccination campaign was organised could be useful to understand strengths and weaknesses learnt from this experience and plan an effective, efficient, and resilient response to future pandemics right away. The adoption of a systemic clinical risk management (SCRM) could guarantee healthcare organizations a more adequate and resilient response in an ethics of a job well done perspective, allowing them to maintain high patient safety standards regardless of the contingent situation for which safety first should be the motto of a disaster response plan.
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Travaini GV, Pacchioni F, Bellumore S, Bosia M, De Micco F. Machine Learning and Criminal Justice: A Systematic Review of Advanced Methodology for Recidivism Risk Prediction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710594. [PMID: 36078307 PMCID: PMC9517748 DOI: 10.3390/ijerph191710594] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 05/29/2023]
Abstract
Recent evolution in the field of data science has revealed the potential utility of machine learning (ML) applied to criminal justice. Hence, the literature focused on finding better techniques to predict criminal recidivism risk is rapidly flourishing. However, it is difficult to make a state of the art for the application of ML in recidivism prediction. In this systematic review, out of 79 studies from Scopus and PubMed online databases we selected, 12 studies that guarantee the replicability of the models across different datasets and their applicability to recidivism prediction. The different datasets and ML techniques used in each of the 12 studies have been compared using the two selected metrics. This study shows how each method applied achieves good performance, with an average score of 0.81 for ACC and 0.74 for AUC. This systematic review highlights key points that could allow criminal justice professionals to routinely exploit predictions of recidivism risk based on ML techniques. These include the presence of performance metrics, the use of transparent algorithms or explainable artificial intelligence (XAI) techniques, as well as the high quality of input data.
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Affiliation(s)
| | - Federico Pacchioni
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Silvia Bellumore
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Marta Bosia
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesco De Micco
- Bioethics and Humanities Research Unit, Campus Bio-Medico University of Rome, 00128 Rome, Italy
- Department of Clinical Affairs, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
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