The effects of primary care monitoring strategies on COVID-19 related hospitalisation and mortality: a retrospective electronic medical records review in a northern Italian province, the MAGMA study.

BACKGROUND: Most symptomatic SARS-CoV-2 infections produce mild to moderate symptoms. Although most patients are managed in the outpatient setting, little is known about the effect of general practitioners' (GP) management strategies on the outcomes of COVID-19 outpatients in Italy. OBJECTIVES: Describe the management of Italian GPs of SARS-CoV-2 infected adult patients and explore whether GP active care and monitoring are associated with reducing hospitalisation and death. METHODS: Retrospective observational study of SARS-CoV-2 infected adult outpatients managed by GPs in Modena (Italy) from March 2020 to April 2021. Information on management and monitoring strategies, patients' socio-demographic characteristics, comorbidities, and outcomes (hospitalisation and death due to COVID-19) were retrieved through an electronic medical record review and analysed descriptively and through multiple logistic regression. RESULTS: Out of the 5340 patients from 46 GPs included in the study, 3014 (56%) received remote monitoring, and 840 (16%) had at least one home visit. More than 85% of severe or critical patients were actively monitored (73% daily) and 52% were visited at home. Changes over time in patients' therapeutic management were observed in concordance with the guidelines' release. Active daily remote monitoring and home visits were strongly associated with reduced hospitalisation rate (OR 0.52, 95% CI 0.33-0.80 and OR 0.50, 95% CI 0.33-0.78 respectively). CONCLUSION: GPs effectively managed an increasing number of outpatients during the first waves of the pandemic. Active monitoring and home visits were associated with reduced hospitalisation in COVID-19 outpatients.

[Formula: see text] Developmental dyslexia: How taxonomic and thematic organization affect working memory recall.

Semantic long-term memory (LTM) representations can be distinguished in two main classes: taxonomic (i.e., abstract) and thematic (i.e., concrete, experiential). In typically developing children, taxonomies are usually acquired after thematic representations. In the current study, we investigated how LTM semantic representations modulate working memory (WM) recall in children with developmental dyslexia (DD). A sample of children with DD from primary and secondary school paired with a control group for age, gender, schooling, and IQ was administered a semantic WM (SWM) dual task. Here, children had to listen to groups of lists composed of words semantically related (taxonomic, e.g., shop- drugstore-coffee; or thematic, e.g., light-heat-fire) or arbitrarily related, and afterward to recall the last words among each group. Both taxonomic and thematic organizations supported recall in the two groups of children. More specifically, data showed that in typically developing children the taxonomic organization boosted WM recall (vs. the thematic one). On the contrary, in children with DD, the taxonomic organization did not better support recall and yielded effects similar to thematic organization. In children with DD, abstract taxonomic knowledge seems to be less frequently used than thematic knowledge. Findings contribute to sketch memory functioning across different memory systems in DD.

[Characteristics of patients admitted to a Division of Internal Medicine. Is hospital the best setting of care?]. / Caratteristiche dei pazienti ricoverati in un Reparto per Acuti di Medicina Interna. E l'ospedale il luogo più idoneo di cura?

The aim of this study was to describe the characteristics of institutionalized patients, the patterns of admission, hospital stay and discharge and the extent of resource utilization before, during and after hospitalization, in an Acute Division of Internal Medicine of a university hospital. All adult patients admitted to the division were consecutively enrolled during a 3-month study period. Patients underwent a multidimensional assessment and data collection concerning admission and discharge patterns, resource utilization, and discharge diagnosis. Three hundred and eighteen patients, with an average age of 73.8 years, entered in the study; the rate of patients both affected by severe cognitive and functional impairment was high (29.9%); 3-4 comorbidity classes were estimated in 70.8% of patients; the most frequent diagnoses at discharge were gastrointestinal (major diagnostic category 6), liver and pancreas diseases (major diagnostic category 7); despite the high rate of comorbidity and severity of illness, the average diagnosis-related groups was low (1.15 +/- 0.59) and also the levels of nursing and personal care provided in the hospital were low (21 +/- 15 and 19 +/- 16, respectively). Median length of stay was 9 days and 3-4 comorbidity classes significantly prolonged hospitalization (p < 0.01). The main critical aspects concerning hospital admissions were the low rates of general practitioner requests of admission (26.7%), the high rates of unplanned readmissions (17.9%) and inappropriate recovery (12.6%). Concerning discharge, only 18.5% of patients had assisted discharges despite the high rates of patients with functional impairment; difficulties at discharge were estimated in 15.0% of patients. Our data suggest to improve the relation between hospital and primary health services in order to assure appropriateness of patient care and optimal use of a specialistic division.