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1.
Eur J Public Health ; 34(Supplement_1): i11-i28, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38946444

RESUMO

BACKGROUND: Contact tracing is a public health intervention implemented in synergy with other preventive measures to curb epidemics, like the coronavirus pandemic. The development and use of digital devices have increased worldwide to enhance the contact tracing process. The aim of the study was to evaluate the effectiveness and impact of tracking coronavirus disease 2019 (COVID-19) patients using digital solutions. METHODS: Observational studies on digital contact tracing (DCT), published 2020-21, in English were identified through a systematic literature review performed on nine online databases. An ad hoc form was used for data extraction of relevant information. Quality assessment of the included studies was performed with validated tools. A qualitative synthesis of the findings is reported. RESULTS: Over 8000 records were identified and 37 were included in the study: 24 modelling and 13 population-based studies. DCT improved the identification of close contacts of COVID-19 cases and reduced the effective reproduction number of COVID-19-related infections and deaths by over 60%. It impacted positively on societal and economic costs, in terms of lockdowns and use of resources, including staffing. Privacy and security issues were reported in 27 studies. CONCLUSIONS: DCT contributed to curbing the COVID-19 pandemic, especially with the high uptake rate of the devices and in combination with other public health measures, especially conventional contact tracing. The main barriers to the implementation of the devices are uptake rate, security and privacy issues. Public health digitalization and contact tracing are the keys to countries' emergency preparedness for future health crises.


Assuntos
COVID-19 , Busca de Comunicante , Pandemias , SARS-CoV-2 , COVID-19/prevenção & controle , COVID-19/epidemiologia , Humanos , Busca de Comunicante/métodos , Pandemias/prevenção & controle , Tecnologia Digital , Saúde Pública/métodos
2.
Eur J Public Health ; 34(Supplement_1): i29-i34, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38946446

RESUMO

BACKGROUND: Timely and high-quality population-level health information is needed to support evidence-informed decision-making, for planning and evaluation of prevention, care and cure activities as well as for research to generate new knowledge. FAIR (Findable, Accessible, Interoperable and Reusable) principles are one of the key elements supporting health research and making it more cost-effective through the reuse of already existing data. Currently, health data are in many countries dispersed and difficult to find and access. METHODS: Two EU Public Health Programmes co-funded Joint Actions, Information for Action (InfAct) and Population Health Information Research Infrastructure (PHIRI) have established a European Health Information Portal, a web-based service, to facilitate better findability, access, interoperability and reuse of existing health information. RESULTS: The European Health Information Portal (www.healthinformationportal.eu) has been established including sections on National Nodes, data sources, publications, health information projects within countries and across Europe, research networks and research infrastructures, ethical and legal issues for health information exchange and use, capacity-building activities in all areas of population health and a dedicated COVID-19 section. CONCLUSIONS: The European Health Information Portal, being a central place for a wide range of population health information from EU Member States, is an information source for researchers, policy-makers and other relevant stakeholders. It is important to ensure the sustainability of the portal, especially in light of the European Health Data Space (EHDS) Regulation proposal and its requirements regarding the secondary use of health data.


Assuntos
COVID-19 , Humanos , Europa (Continente) , COVID-19/prevenção & controle , SARS-CoV-2 , Disseminação de Informação/métodos , Saúde Pública , União Europeia
3.
Eur J Public Health ; 34(Supplement_1): i3-i10, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38946440

RESUMO

BACKGROUND: During the first epidemic wave, COVID-19 surveillance focused on quantifying the magnitude and the escalation of a growing global health crisis. The scientific community first assessed risk through basic indicators, such as the number of cases or rates of new cases and deaths, and later began using other direct impact indicators to conduct more detailed analyses. We aimed at synthesizing the scientific community's contribution to assessing the direct impact of the COVID-19 pandemic on population health through indicators reported in research papers. METHODS: We conducted a rapid scoping review to identify and describe health indicators included in articles published between January 2020 and June 2021, using one strategy to search PubMed, EMBASE and WHO COVID-19 databases. Sixteen experts from European public health institutions screened papers and retrieved indicator characteristics. We also asked in an online survey how the health indicators were added to and used in policy documents in Europe. RESULTS: After reviewing 3891 records, we selected a final sample of 67 articles and 233 indicators. We identified 52 (22.3%) morbidity indicators from 33 articles, 105 severity indicators (45.1%, 27 articles) and 68 mortality indicators (29.2%, 51). Respondents from 22 countries completed 31 questionnaires, and the majority reported morbidity indicators (29, 93.5%), followed by mortality indicators (26, 83.9%). CONCLUSIONS: The indicators collated here might be useful to assess the impact of future pandemics. Therefore, their measurement should be standardized to allow for comparisons between settings, countries and different populations.


Assuntos
COVID-19 , Humanos , COVID-19/mortalidade , COVID-19/epidemiologia , Europa (Continente)/epidemiologia , Indicadores Básicos de Saúde , Morbidade , Mortalidade/tendências , Pandemias , Índice de Gravidade de Doença
4.
Eur J Public Health ; 34(Supplement_1): i67-i73, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38946449

RESUMO

BACKGROUND: Resilience of national health systems in Europe remains a major concern in times of multiple crises and as more evidence is emerging relating to the indirect effects of the COVID-19 pandemic on health care utilization (HCU), resulting from de-prioritization of regular, non-pandemic healthcare services. Most extant studies focus on regional, disease specific or early pandemic HCU creating difficulties in comparing across multiple countries. We provide a comparatively broad definition of HCU across multiple countries, with potential to expand across regions and timeframes. METHODS: Using a cross-country federated research infrastructure (FRI), we examined HCU for acute cardiovascular events, elective surgeries and serious trauma. Aggregated data were used in forecast modelling to identify changes from predicted European age-standardized counts via fitted regressions (2017-19), compared against post-pandemic data. RESULTS: We found that elective surgeries were most affected, universally falling below predicted levels in 2020. For cardiovascular HCU, we found lower-than-expected cases in every region for heart attacks and displayed large sex differences. Serious trauma was the least impacted by the COVID-19 pandemic. CONCLUSION: The strength of this study comes from the use of the European Population Health Information Research Infrastructure's (PHIRI) FRI, allowing for rapid analysis of regional differences to assess indirect impacts of events such as pandemics. There are marked differences in the capacity of services to return to normal in terms of elective surgery; additionally, we found considerable differences between men and women which requires further research on potential sex or gender patterns of HCU during crises.


Assuntos
COVID-19 , Procedimentos Cirúrgicos Eletivos , Aceitação pelo Paciente de Cuidados de Saúde , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Europa (Continente)/epidemiologia , Masculino , Feminino , Estudos Retrospectivos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Pandemias , Pessoa de Meia-Idade , Adulto , Idoso , Ferimentos e Lesões/epidemiologia , Doenças Cardiovasculares/epidemiologia
5.
Int J Equity Health ; 22(1): 140, 2023 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-37507733

RESUMO

BACKGROUND: Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Area (EEA) countries. Therefore, the aim of the present study was to quantify health inequalities in age-standardized disability adjusted life years (DALY) rates for NCDs overall and 12 specific NCDs across 30 EEA countries between 1990 and 2019. Also, this study aimed to determine trends in health inequalities and to identify those NCDs where the inequalities were the highest. METHODS: DALY rate ratios were calculated to determine and compare inequalities between the 30 EEA countries, by sex, and across time. Annual rate of change was used to determine the differences in DALY rate between 1990 and 2019 for males and females. The Gini Coefficient (GC) was used to measure the DALY rate inequalities across countries, and the Slope Index of Inequality (SII) to estimate the average absolute difference in DALY rate across countries. RESULTS: Between 1990 and 2019, there was an overall declining trend in DALY rate, with larger declines among females compared to males. Among EEA countries, in 2019 the highest NCD DALY rate for both sexes were observed for Bulgaria. For the whole period, the highest DALY rate ratios were identified for digestive diseases, diabetes and kidney diseases, substance use disorders, cardiovascular diseases (CVD), and chronic respiratory diseases - representing the highest inequality between countries. In 2019, the highest DALY rate ratio was found between Bulgaria and Iceland for males. GC and SII indicated that the highest inequalities were due to CVD for most of the study period - however, overall levels of inequality were low. CONCLUSIONS: The inequality in level 1 NCDs DALYs rate is relatively low among all the countries. CVDs, digestive diseases, diabetes and kidney diseases, substance use disorders, and chronic respiratory diseases are the NCDs that exhibit higher levels of inequality across countries in the EEA. This might be mitigated by applying tailored preventive measures and enabling healthcare access.


Assuntos
Doenças Cardiovasculares , Doenças não Transmissíveis , Doenças Respiratórias , Masculino , Feminino , Humanos , Expectativa de Vida , Anos de Vida Ajustados por Qualidade de Vida , Doenças não Transmissíveis/epidemiologia , Carga Global da Doença , Doenças Cardiovasculares/epidemiologia , Doenças Respiratórias/epidemiologia , Saúde Global
6.
Appl Nurs Res ; 73: 151728, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37722796

RESUMO

BACKGROUND: Incivility in nursing education is present worldwide and impacts all those involved and the teacher-student relationship. The revised Incivility in Nursing Education (INE-R) is a validated and reliable instrument to measure academic incivility, but it is not available in Italian language. The aim of the study was to translate and validate the INE-R tool with an Italian sample. METHODS: The INE-R was translated from English into Italian, culturally adapted and piloted for content and linguistic clarity. The questionnaire was administered online to Nursing Faculty (NF) and Nursing Students (NS) of Sapienza University of Rome to assess uncivil behaviors and their frequency of occurrence. The psychometric properties of the Italian version were investigated. RESULTS: 79 Italians participated, of which 63.3 % were NS. Four-factor models provided the best fit for NF and NS scales. The models explained 78.2 % (NF) and 73.2 % (NS) of the variance of the scales. The Root Mean Square Error of Approximation for both models was 0.07, indicating an acceptable fit. INE-R reliability for all 48 NF and NS incivility items was 0.962 and 0.954, respectively. Measuring the degree of incivility and establishing codes of conduct were recommended. CONCLUSIONS: Incivility in nursing education negatively impacts the teaching-learning environment and could cause emotional or physical distress for those involved. Zero-tolerance policy regarding incivility, routine evaluation, and raising awareness among students and faculty could improve the quality of academic settings. The Italian INE-R is a valid and reliable tool that can be used to evaluate incivility in Italian nursing programs.


Assuntos
Educação em Enfermagem , Incivilidade , Estudantes de Enfermagem , Humanos , Reprodutibilidade dos Testes , Idioma
7.
Aging Clin Exp Res ; 33(4): 1145-1147, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33650071

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 has caused over 95 million confirmed cases of COVID-19 and over 2 million deaths worldwide. According to current literature data, older adults have higher risk of severe disease and mortality due to COVID-19. It is also known that older adults often do not present typical symptoms of diseases. The aim of the study was to assess if the prevalence of typical COVID-19-related symptoms varies by age group. METHODS: Medical charts of a random sample of COVID-19 patients dying in-hospital were retrieved through an integrated national surveillance system and reviewed by a group of researchers at the Italian National Institute of Health. Detailed information on COVID-19-related symptoms were extracted and analyzed. RESULTS: 3241 confirmed cases of COVID-19-related deaths were identified from 4391 reviewed medical charts. The mean number of COVID-19-related symptoms progressively declined with age, from 2.1 in patients aged < 60 years to 1.7 in those aged 90 years or older (p < 0.001). Moreover, fever, cough, and diarrhea significantly declined with increasing age. CONCLUSIONS: Older adults have atypical presentation of symptoms and may be paucisymptomatic. This may lead to a diagnostic and therapeutic delay which aggravates the prognosis of COVID-19. Special attention should be posed when assessing individuals aged 65 years and older with suspected COVID-19.


Assuntos
COVID-19 , Idoso , Idoso de 80 Anos ou mais , Febre , Humanos , Itália/epidemiologia , Prevalência , SARS-CoV-2
8.
Value Health ; 23(1): 114-126, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31952666

RESUMO

BACKGROUND: Monoclonal antibodies against epidermal growth factor receptor (EGFR) have proved beneficial for the treatment of metastatic colorectal cancer (mCRC), particularly when combined with predictive biomarkers of response. International guidelines recommend anti-EGFR therapy only for RAS (NRAS,KRAS) wild-type tumors because tumors with RAS mutations are unlikely to benefit. OBJECTIVES: We aimed to review the cost-effectiveness of RAS testing in mCRC patients before anti-EGFR therapy and to assess how well economic evaluations adhere to guidelines. METHODS: A systematic review of full economic evaluations comparing RAS testing with no testing was performed for articles published in English between 2000 and 2018. Study quality was assessed using the Quality of Health Economic Studies scale, and the British Medical Journal and the Philips checklists. RESULTS: Six economic evaluations (2 cost-effectiveness analyses, 2 cost-utility analyses, and 2 combined cost-effectiveness and cost-utility analyses) were included. All studies were of good quality and adopted the perspective of the healthcare system/payer; accordingly, only direct medical costs were considered. Four studies presented testing strategies with a favorable incremental cost-effectiveness ratio under the National Institute for Clinical Excellence (£20 000-£30 000/QALY) and the US ($50 000-$100 000/QALY) thresholds. CONCLUSIONS: Testing mCRC patients for RAS status and administering EGFR inhibitors only to patients with RAS wild-type tumors is a more cost-effective strategy than treating all patients without testing. The treatment of mCRC is becoming more personalized, which is essential to avoid inappropriate therapy and unnecessarily high healthcare costs. Future economic assessments should take into account other parameters that reflect the real world (eg, NRAS mutation analysis, toxicity of biological agents, genetic test sensitivity and specificity).


Assuntos
Neoplasias Colorretais/economia , Neoplasias Colorretais/genética , Análise Mutacional de DNA/economia , Genes ras , Custos de Cuidados de Saúde , Mutação , Testes Farmacogenômicos/economia , Variantes Farmacogenômicos , Medicina de Precisão/economia , Antineoplásicos Imunológicos/economia , Antineoplásicos Imunológicos/uso terapêutico , Tomada de Decisão Clínica , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Análise Custo-Benefício , Custos de Medicamentos , Receptores ErbB/antagonistas & inibidores , Predisposição Genética para Doença , Humanos , Metástase Neoplásica , Seleção de Pacientes , Fenótipo , Valor Preditivo dos Testes , Anos de Vida Ajustados por Qualidade de Vida
9.
J Cancer Educ ; 35(6): 1089-1093, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-31183766

RESUMO

Screening coverage is of concern in several countries, including Italy. The aim of the study is to assess predictors of participation in the mammography screening program at the Local Health Unit RMA (Rome, Italy). A telephone-based questionnaire was administered to randomly selected eligible women. The study population was interviewed by the personnel of the health center. Five hundred two women were interviewed, of which 264(52.6%) have attended the breast cancer screening program at least once. The attendees received the invitation letter more often than the non-attendees (88.3% vs. 77.7%; p = 0.002) and were more willing to participate (85.6% vs. 69.3%; p < 0.001). Employees were more among the non-attendees of the screening program (66% vs. 52.3%; p = 0.002). Age over-61 (OR = 2.75; 95%CI 1.84-4.09), receiving the invitation letter (OR = 2.54; 95%CI = 1.52-4.24), and intention to participate (OR = 3.09; 95%CI = 1.94-4.91) were significantly associated with participation in the screening program. Although the invitation rate of the Local Health Unit RMA has improved in recent years, the mammography uptake rate remains very low. The presence of opportunistic screening activities, younger age, and low educational status could explain the low participation rates. Organizational barriers (e.g., screening hours coinciding with work hours, screening facilities located far away) may also limit participation. Major efforts should be made towards the regulation of opportunistic screening activities and reorganization of the screening centers and communication strategies to better comply with the needs of the target population. In this light, the involvement of different healthcare professionals, especially general practitioners, and gynecologists, is crucial.


Assuntos
Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/estatística & dados numéricos , Mamografia/estatística & dados numéricos , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/psicologia , Comunicação , Estudos Transversais , Detecção Precoce de Câncer/psicologia , Feminino , Humanos , Itália/epidemiologia , Mamografia/psicologia , Pessoa de Meia-Idade , Prognóstico , Inquéritos e Questionários
10.
J Public Health (Oxf) ; 37(4): 737-40, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25538144

RESUMO

BACKGROUND: The aim was to evaluate the use of PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), CONSORT (Consolidated Standards of Reporting Trials) and STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) methods in reviews, clinical trials and observational studies, respectively, which were published in European journals within the field of Public Health (PH). METHODS: Papers published between 2010 and 2013 in seven PH journals were evaluated. The presence of the words PRISMA, STROBE and CONSORT was considered in the search criteria. RESULTS: In total, 2355 of 3456 retrieved articles were included: 1.5% appeared to follow the guidelines. The boundaries within which the criteria were applied are 0-100% for CONSORT, 0-0.6% for STROBE and 0-37% for PRISMA. CONCLUSIONS: A strong heterogeneity in the application of guideline statements was observed. A common agreement among journals regarding research-reporting methodologies could improve the quality of PH research publishing.


Assuntos
Guias como Assunto , Publicações Periódicas como Assunto , Saúde Pública , Políticas Editoriais , Europa (Continente) , Humanos
11.
ScientificWorldJournal ; 2015: 596164, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25685844

RESUMO

OBJECTIVES: Haemophilia A is a congenital disorder of coagulation that mainly affects males and causes a considerable use of resources, especially when hemophilic patients are treated with prophylaxis. The aim of the present review was to discuss and appraise the methodological aspects and results of published economic evaluations of haemophilia A treatments in the last decade. METHODS: The literature search, performed by consulting four engines, covered studies published between 2002 and 2014. Full economic evaluations published in English language were identified and included in the review. A quality assessment of the studies was also carried out based on Drummond's checklist. RESULTS: After careful evaluations of the identified records, 5 studies were reviewed. Primary and secondary prophylaxis resulted cost-effective compared to on-demand therapy: the ICER of primary prophylaxis ranged from € 40.236 to € 59.315/QALY gained, while the ICER of secondary prophylaxis was € 40.229/QALY gained. Furthermore, 60% were high quality and 40% were medium quality studies. CONCLUSIONS: The review underlines the cost-effectiveness of prophylaxis versus on-demand treatment and the different methodological approaches applied. Further economic evaluations are required with models that reflect the clinical reality and consumption of resources in each country.


Assuntos
Hemofilia A/economia , Efeitos Psicossociais da Doença , Análise Custo-Benefício , Custos de Medicamentos , Fator VIII/economia , Fator VIII/uso terapêutico , Custos de Cuidados de Saúde , Hemofilia A/tratamento farmacológico , Hemofilia A/prevenção & controle , Humanos , Masculino
12.
Orphanet J Rare Dis ; 19(1): 333, 2024 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-39252105

RESUMO

BACKGROUND: Initiatives aiming to assess the impact of rare diseases on population health might be hampered due to the complexity of disability-adjusted life years (DALYs) estimation. This study aimed to give insight into the epidemiological data sources and methodological approaches used in studies that estimated DALYs for chronic non-communicable rare diseases (CNCRD), and compare its results. METHODS: A literature strategy was developed for peer-review search in Embase and Medline, and also performed on grey literature databases and population health and/or rare disease-focused websites. We included studies that determined the burden of CNCRD listed on the Orphanet's and/or the Genetic and Rare Diseases information center (GARD) websites. We excluded communicable and occupational diseases, rare cancers, and cost-effectiveness/benefit studies. Two researchers independently screened the identified records and extracted data from the final included studies. We used the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) statement to assess the quality of reporting of the included studies. The data synthesis depicted the studies' characteristics, their distribution by geographic coverage and the group of disease(s) they focused on, the methods and data input sources used and estimated DALY per case. RESULTS: In total, 533 titles were screened, and 18 studies were included. These studies covered 19 different CNCRDs, of which most fell in the disease category "Diseases of the nervous system". Diverse methodological approaches and data input sources were observed among burden of CNCRD studies. A wide range of DALY per case was observed across the different studies and diseases included. CONCLUSIONS: A low number of burden of CNCRD studies was observed and most estimates resulted from multi-country studies, underlining the importance of international cooperation to further CNCRD research. This study revealed a lack of epidemiological data and harmonization of methods which hampers comparisons across burden of CNCRD studies.


Assuntos
Anos de Vida Ajustados por Deficiência , Doenças Raras , Humanos , Doenças Raras/epidemiologia , Doenças não Transmissíveis/epidemiologia , Doença Crônica , Efeitos Psicossociais da Doença , Anos de Vida Ajustados por Qualidade de Vida
13.
JMIR Res Protoc ; 13: e59900, 2024 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-39325529

RESUMO

BACKGROUND: Digital technologies have penetrated most workplaces. However, it is unclear how such digital technologies affect the physical health of older workers. OBJECTIVE: This scoping review aims to examine and summarize the evidence from scientific literature concerning the impact of digital technology on the physical health of older workers. METHODS: This scoping review will be conducted following recommendations outlined by Levac et al and will adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews) guidelines for reporting. Peer-reviewed papers written in English will be searched in the following databases: MEDLINE, Cochrane, ProQuest, Web of Science, Scopus, APA PsycInfo, and ERIH PLUS. The web-based systematic review platform Covidence will be used to create a data extraction template. It will cover the following items: study and participant characteristics, health measures, digital tool characteristics and usage, and research findings. Following the Population, Concept, and Context (PCC) framework, our review will focus on studies involving older workers aged 50 years or older, any form of digital technology (including teleworking and the use of digital tools at work), and how digital technologies affect physical health (such as vision loss, musculoskeletal disorders, and migraines). Studies that focus only on mental health will be excluded. Study selection based on title and abstract screening (first stage), full-text review (second stage), and data extraction (third stage) will be performed by a group of researchers, whereby each paper will be reviewed by at least 2 people. Any conflict regarding the inclusion or exclusion of a study and the data extraction will be resolved by discussion between the researchers who evaluated the papers; a third researcher will be involved if consensus is not reached. RESULTS: A preliminary search of MEDLINE, Epistemonikos, Cochrane, PROSPERO, and JBI Evidence Synthesis was conducted, and no current or ongoing systematic reviews or scoping reviews on the topic were identified. The results of the study are expected in April 2025. CONCLUSIONS: Our scoping review will seek to provide an overview of the available evidence and identify research gaps regarding the effect of digital technology and the use of digital tools in the work environment on the physical health of older workers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/59900.


Assuntos
Tecnologia Digital , Idoso , Humanos , Pessoa de Meia-Idade , Nível de Saúde , Literatura de Revisão como Assunto , Projetos de Pesquisa
14.
NPJ Digit Med ; 7(1): 229, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39191937

RESUMO

Regulatory frameworks for artificial intelligence (AI) are needed to mitigate risks while ensuring the ethical, secure, and effective implementation of AI technology in healthcare and population health. In this article, we present a synthesis of 141 binding policies applicable to AI in healthcare and population health in the EU and 10 European countries. The EU AI Act sets the overall regulatory framework for AI, while other legislations set social, health, and human rights standards, address the safety of technologies and the implementation of innovation, and ensure the protection and safe use of data. Regulation specifically pertaining to AI is still nascent and scarce, though a combination of data, technology, innovation, and health and human rights policy has already formed a baseline regulatory framework for AI in health. Future work should explore specific regulatory challenges, especially with respect to AI medical devices, data protection, and data enablement.

15.
Lancet Public Health ; 9(3): e166-e177, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38429016

RESUMO

BACKGROUND: Health inequalities have been associated with shorter lifespans. We aimed to investigate subnational geographical inequalities in all-cause years of life lost (YLLs) and the association between YLLs and socioeconomic factors, such as household income, risk of poverty, and educational attainment, in countries within the European Economic Area (EEA) before the COVID-19 pandemic. METHODS: In this ecological study, we extracted demographic and socioeconomic data from Eurostat for 1390 small regions and 285 basic regions for 32 countries in the EEA, which was complemented by a time-trend analysis of subnational regions within the EEA. Age-standardised YLL rates per 100 000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease study. Geographical inequalities were assessed using the Gini coefficient and slope index of inequality. Socioeconomic inequalities were assessed by investigating the association between socioeconomic factors (educational attainment, household income, and risk of poverty) and YLLs in 2019 using negative binomial mixed models. FINDINGS: Between Jan 1, 2009, and Dec 31, 2019, YLLs lowered in almost all subnational regions. The Gini coefficient of YLLs across all EEA regions was 14·2% (95% CI 13·6-14·8) for females and 17·0% (16·3 to 17·7) for males. Relative geographical inequalities in YLLs among women were highest in the UK (Gini coefficient 11·2% [95% CI 10·1-12·3]) and among men were highest in Belgium (10·8% [9·3-12·2]). The highest YLLs were observed in subnational regions with the lowest levels of educational attainment (incident rate ratio [IRR] 1·19 [1·13-1·26] for females; 1·22 [1·16-1·28] for males), household income (1·35 [95% CI 1·19-1·53]), and the highest poverty risk (1·25 [1·18-1·34]). INTERPRETATION: Differences in YLLs remain within, and between, EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing health inequities to improve overall disease burden within the EEA. FUNDING: Research Council of Norway; Development, and Innovation Fund of Hungary; Norwegian Institute of Public Medicine; and COST Action 18218 European Burden of Disease Network.


Assuntos
Expectativa de Vida , Pandemias , Masculino , Humanos , Feminino , Fatores Socioeconômicos , Europa (Continente)/epidemiologia , Pobreza
16.
Ig Sanita Pubbl ; 69(4): 387-402, 2013.
Artigo em Italiano | MEDLINE | ID: mdl-24091841

RESUMO

A questionnaire study was performed to evaluate the effectiveness of a continuing medical education course on influenza vaccination, held in October 2011, in changing physicians', medical students' and other health care workers' attitudes towards receiving vaccination for seasonal influenza. The questionnaire contained questions regarding influenza, influenza vaccination, and attitudes towards vaccination. Results show that course participants were more likely to get vaccinated against seasonal influenza in 2011 (i.e. following the course) with respect to 2010 and that all professional categories, except students, were positively influenced by the course.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/prevenção & controle , Saúde Pública/educação , Estudantes de Medicina/estatística & dados numéricos , Vacinação , Educação Médica Continuada , Pessoal de Saúde/psicologia , Humanos , Itália , Médicos/estatística & dados numéricos , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Vacinação/métodos
17.
Ann Ist Super Sanita ; 59(2): 114-121, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37337986

RESUMO

BACKGROUND: Although there are ongoing blood donation campaigns in Nigeria, the prevalence of voluntary blood donation is about 10% and there is limited information about the determinants of blood donation behavior, especially across rural-urban geographic areas. This study examines the rural-urban differences in willingness to donate blood. METHOD: A cross-sectional study addressing adults from three rural and three urban communities was performed in 2021 to evaluate willingness, knowledge, attitude and practice of blood donation. RESULTS: A total of 287 individuals were surveyed. Most of the respondents across all communities have never donated blood (72%). Females aged 18-25, highly educated, and from urban communities were more incline to donate blood compared to their counterparts. The main reasons for not donating blood for rural dwellers were: never thought of it (39% vs 34.7%) and no one asked (34.4% vs 17%); fear of needles was declared mostly by urban dwellers (21.8% vs 12.5%) (p=0.02). CONCLUSIONS: Willingness to donate blood varies across rural and urban communities and is influenced by socio-demographic characteristics. The gap between willingness to donate and actual blood donation has consequences for the establishment of blood transfusion services. Targeted public health interventions are required to enhance awareness and knowledge and modify attitudes towards blood donation.


Assuntos
Doação de Sangue , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Feminino , Humanos , Adolescente , Adulto Jovem , Nigéria , Estudos Transversais , Inquéritos e Questionários
18.
Healthcare (Basel) ; 11(13)2023 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-37444666

RESUMO

This research paper analyses the management and prevention of pre-eclampsia in Nigeria. Although efforts have been made to reduce outcomes due to pre-eclampsia, it still rears its head in the form of high maternal and perinatal morbidity and mortality. The aim of this review was to identify the main obstacles, gaps, and interventions related to the prevention and management of pre-eclampsia in order to be fully knowledgeable of the magnitude of the issue at the national level, to assess if current government policies are adequate and to recommend solutions. A search was performed on online databases and it was completed with hand searches related to the subject matter. Screening tests for early detection of pre-eclampsia are hardly available in Nigeria as many hospitals rely on the history of previous and current pregnancies, blood pressure monitoring and urinalysis-proteinuria. The administration of low-dose aspirin, antihypertensive drugs and magnesium sulphate, coupled with calcium in calcium deficit regions, was recommended. The main barriers to the wider implementation of these strategies are inadequacy of the antenatal care services in providing appropriate care, lack of resources and trained personnel, high healthcare costs, and low antennal care attendance. Improving education and awareness, use of low-cost screening modalities and low-dose aspirin can be deployed in developing countries to curb pre-eclampsia.

19.
Artigo em Inglês | MEDLINE | ID: mdl-36612884

RESUMO

Several innovative methods have been deployed worldwide to curb the COVID-19 pandemic. The aim of the study is to investigate which innovative methods are used to monitor COVID-19 health issues in Europe and related legislative and ethical aspects. An online questionnaire was administered to European countries' representatives of the project Population Health Information Research Infrastructure. Additional information was obtained from websites and documents provided by the respondents; an overview of the literature was also performed. Respondents from 14 countries participated in the study. Digital tools are used to monitor the spread of COVID-19 (13/14 countries) and vaccination coverage (12/14); for research, diagnostics, telehealth (14/14); to fight disinformation (11/14) and forecast the pandemic spread (4/14). The level of implementation of telehealth applications was mostly low/medium. Legislative and ethical issues were encountered in many countries, leading to institutional distrust. The COVID-19 pandemic has highlighted the need for timely and accurate health data for research purposes and policy planning. However, the use of innovative methods for population health monitoring and timely data collection has posed challenges to privacy and online security globally. Adequate regulatory oversight, targeted public health interventions, and fight against disinformation could improve the uptake rate and enhance countries' emergency preparedness.


Assuntos
COVID-19 , Telemedicina , Humanos , COVID-19/epidemiologia , Europa (Continente)/epidemiologia , Pandemias/prevenção & controle , SARS-CoV-2 , Telemedicina/métodos
20.
Artigo em Inglês | MEDLINE | ID: mdl-35409490

RESUMO

The COVID-19 pandemic has caused an overabundance of valid and invalid information to spread rapidly via traditional media as well as by internet and digital communication. Health literacy (HL) is the ability to access, understand, appraise, and apply health information, making it fundamental for finding, interpreting, and correctly using COVID-19 information. A cross-sectional study of a sample of 3500 participants representative of the Italian adult population aged 18+ years was conducted in Italy in 2021. A validated HL questionnaire was employed, including sections on coronavirus-related HL, general HL, sociodemographic characteristics, risk factors, and respondents' lifestyle. Of our sample, 49.3% had "excellent" levels of coronavirus-related HL and 50.7% had "sufficient" (20.7%) or "limited" (30.0%) levels. Although the overall HL-COVID level was high, many participants reported difficulties dealing with COVID-19 information; in particular, participants older than 65 years, with a low education level, living in southern regions of Italy, and with high financial deprivation. Targeted public information campaigns and the promotion of HL are required for better navigation of health information environments. The COVID-19 pandemic has highlighted the need to improve HL and to prepare the general population for future emergency and non-emergency situations, confirming that HL can be considered a social vaccine.


Assuntos
COVID-19 , Letramento em Saúde , Adulto , COVID-19/epidemiologia , Estudos Transversais , Humanos , Pandemias , SARS-CoV-2
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