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BACKGROUND To support the Swiss Federal Office of Public Health (FOPH) national pediatric COVID-19 testing strategy, we created an online public health decision tool for caregivers and healthcare workers. OBJECTIVE To describe the development and usage of www.coronabambini.ch as an example of a pediatric electronic public health application and to explore its potential in providing information on disease epidemiology and public health policy implementation. METHODS We developed and maintained a non-commercial online decision support tool, www.coronabambini.ch, based on the FOPH pediatric COVID-19 guidelines around testing and school/daycare attendance. We analyzed the online decision tool as well as a voluntary follow-up survey from October 2020 to September 2021 to explore its potential as a surveillance tool for public health policy and epidemiology. RESULTS 68’269 users accessed the tool and 52’726 filled out the complete online decision tool. 3% (1’399/52’726) filled out a voluntary follow-up survey via mail after 14 days. 92% (18’797/20’330) of users were parents. Certain dynamics of the pandemic and changes in testing strategies were reflected in the data captured by the tool: gastrointestinal symptoms were reported more frequently in the younger age groups (13% (3’308/26’180) in children 0-5 years, 9% (3’934/42’089) in children ≥6years, X 2=184, P= CONCLUSIONS www.coronabambini.ch played a central role during the COVID-19 pandemic in Switzerland through supporting testing decisions for children. Certain patterns in epidemiology and adherence to public health policy could be depicted showing the potential of digital decision support as public health tools.

Still little is known about the 24-hr pattern of transient lower esophageal sphincter relaxations (TLESRs), particularly in patients with GERD. The aim of our study was to evaluate the 24-hr esophageal and LES motor pattern and esophageal pH and to identify the relationship between TLESRs and gastroesophageal reflux in healthy subjects and in GERD patients. Ten healthy subjects and nine patients with esophagitis (grade I–II) underwent a 24-hr pH manometric recording by means of a portable electronic device. The recording aimed at identifying the temporal relationships between reflux episodes and LES motor events. The GERD patients showed a greater number of either reflux episodes or TLESRs during the 24 hr as compared to controls. While most refluxes occurred during TLESRs in both groups, a small percentage of TLESRs was followed by reflux episodes in healthy people, with only a slight increase in GERD patients. In conclusion, although representing an important motor pattern during gastroesophageal reflux both in healthy subjects and in patients with GERD, TLESR could probably be considered one of the pathophysiologic mechanisms of gastroesophageal reflux more than the primary cause of reflux episodes.

An increasing number of elderly patients are admitted to the hospital for critical diseases and the gap between supply and demand of intensive care resources is a growing problem. To meet this challenge, 4 beds in a 24-bed acute care for the elderly (ACE) medical unit were dedicated to a subintensive care unit (SICU). Severely ill elderly medical patients, requiring a higher level of care than provided in ordinary wards, are admitted. The aim of the study was to describe the characteristics of the setting and to discuss its usefulness based on data obtained after the first period of implementation.This article describes the development, management, economics and patient characteristics of the SICU. Patient care combines the ACE model with a highly specialised medical care. Patients admitted to the SICU are compared with patients treated in the ordinary ACE unit before the SICU opened. All patients received a multidimensional evaluation, including demographics, main diagnosis, number of chronic somatic diseases, Charlson index, APACHE II score, APACHE-APS subscore, number of currently administered drugs, serum albumin, cognitive status (Mini-Mental State Examination), depression (Geriatric Depression Scale) and functional status (basic and instrumental activities of daily living). Ward physicians performed assessment and collection of data.During the first 16 months, 489 patients were admitted, 401 according to the selection criteria (60 +/- years and APACHE II scoreor =5 and/or APACHE-APS scoreor =3). Mean age was 78.1 years, mean APACHE II score 14.5 (moderate severity) and non-invasive mechanical ventilation was received by 87 (21.7%). The most common diagnoses were respiratory failure, cardiac disease and stroke. Mean length of stay in the SICU was 61.8 h, and 6.0 days in the hospital. Compared with ACE-unit patients admitted during 2002 (n=1380), SICU patients were obviously more seriously ill (APACHE II score 14.5 vs 6.7). When comparing patients of same illness severity (APACHE-APS scoreor =3) (n=125), patients treated in the SICU had lower in-hospital mortality than those treated in the ordinary ACE ward (12.5 vs 19.2%). Only a few patients (3.5%) were transferred to the intensive care unit as a consequence of increased severity of illness.The SICU is an innovative method to treat frail elderly patients with more severe conditions. Low hospital mortality compared with that of severe patients in the ACE unit supports the usefulness of this model. It could be implemented in medical units of large hospitals in order to give optimal care and advanced interventions to the frail elderly and to avoid intensive care unit overcrowding.

L’elaborato finale di Francesca Morvillo presenta alcuni profili di straordinaria contemporaneità anche rispetto al dibattito processualpenalistico e offre molti spunti attualizzanti in tema di diritto penitenziario. L’approdo al lavoro di tesi per l’autrice è il culmine di un percorso universitario improntato all’assoluta eccellenza che segue la sua predilezione naturale per le discipline penalistiche. Il linguaggio è tecnico, asciutto, curato, la struttura del lavoro è rigorosa e ordinata. Talune osservazioni critiche si mostrano subito estremamente attuali, ben potendo collocarsi nella discussione odierna sulle misure di sicurezza e sul mai risolto senso della pena. Sin dalle prime battute emerge con chiarezza la piena consapevolezza della multifunzionalità della sanzione penale, che deve abbinare alle esigenze punitive quelle di ravvedimento e di risocializzazione che si fanno più forti quando si guardi ai minorenni, oggetto di attenzione privilegiata e costante da parte di Francesca Morvillo.

Il testo indaga nella rappresentazione letteraria contemporanea delle donne che uccidono per difendersi. La modalità del crimine proposto nella finzione letteraria è il criterio con cui si dividono in tre gruppi alcuni romanzi del XXI secolo di autrici di origini diverse che condividono la scrittura femminile della violenza esercitata dalle donne. La loro origine e l'ambientazione di romanzi permette di tracciare una sorta di topografia della violenza femminile come forma de giustizia per propria mano. The text investigates the contemporary literary representation of women who kill to defend themselves. The mode of the crime proposed in literary fiction is the criterion by which some 21st century novels by authors of different origins who share the female writing of violence by women are divided into three groups. Their origins and the setting of novels allow us to trace a kind of topography of female violence as a form of justice at one's own hand. El texto investiga la representación literaria contemporánea de las mujeres que matan para defenderse. La modaldidad del crimen propuesto en la ficción literaria es el criterio por el que se dividen en tres grupos algunas novelas del siglo XXI de autoras de distinta procedencia que comparten la escritura femenina de la violencia de las mujeres. Sus orígenes y el escenario de las novelas permiten trazar una especie de topografía de la violencia femenina como forma de justicia por propia mano.

Il contributo ripercorre gli argomenti utilizzati per negare l'applicazione della legittima difesa alle donne che sono arrivate ad uccidere per difendersi dalla violenza di cui sono state a lungo vittime da parte del loro partner. Il confronto con le soluzioni giurisprudenziali adottate in altri Paesi ma anche nel nostro ordinamento, sia pure in maniera sporadica, dimostrano che la legittima difesa può essere applicata in questi casi, se solo si riescono a superare quei pregiudizi e stereotipi che in questo, come in altri ambiti, condizionano il giudizio sulle donne