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This study explores the use of digital technologies in assessing frailty and Quality of Life (QoL) in older adults within the Italian healthcare system. The "Prevention Days for Healthy Ageing" organized by the Reference Site "Roma - Tor Vergata" employed online tools, Sunfrail+ and SF-12, for assessing frailty and QoL in 136 older adults. Sunfrail+ generated an average of 2.71 positive alerts at baseline and 0.77 in the 2-level. Associations were found between positive alerts and SF-12 physical/mental indexes. Correlations existed between Sunfrail secondary tools (e.g., Time Up and Go) and QoL indexes. Sunfrail+ is a valuable tool for Family and Community Nurses and proposes future integration into a streamlined app for self-administration by seniors, promoting timely interventions.

This paper explores the ageing population in Italy, where older adults account for more than 14 million individuals (in January 2023) and constitute 24.1 % of the total population. Frailty, a condition encompassing biological, psychological, social, and economic challenges, is recognised as a significant public health issue. The study introduces the Short Functional Geriatric Evaluation (SFGE) as a large-scale screening tool for frailty in community-dwelling older individuals. A Confirmatory Factor Analysis (CFA) was conducted on the SFGE. The CFA scrutinises the construct validity of SFGE using a sample population from the "Long Live the Elderly!" program in Italy. Initial results indicate an acceptable fit, prompting the incorporation of Modification Indices to enhance model performance. The refined CFA demonstrates that the SFGE model effectively captures the multidimensional nature of frailty. The text underscores the timeliness of identifying frailty, emphasising the need for simple, fast, and predictive tools to screen large populations efficiently., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: High positive end-expiratory pressure (PEEP>10 cmH 2 O) is commonly used in mechanically ventilated hypoxemic patients with COVID-19. However, some epidemiological and physiological studies indirectly suggest that using a lower PEEP may primarily and beneficially decrease lung hyperinflation in this population. Herein we directly quantified the effect of decreasing PEEP from 15 to 10 cmH 2 O on lung hyperinflation and collapse in mechanically ventilated patients with COVID-19., Methods: Twenty mechanically ventilated patients with COVID-19 underwent a lung computed tomography (CT) at PEEP of 15 and 10 cmH 2 O. The effect of decreasing PEEP on lung hyperinflation and collapse was directly quantified as the change in the over-aerated (density below -900 HU) and non-aerated (density above -100 HU) lung volumes. The net response to decreasing PEEP was computed as the sum of the change in those two compartments and expressed as the change in the "pathologic" lung volume. If the pathologic lung volume decreased (i.e., hyperinflation decreased more than collapse increased) when PEEP was decreased, the net response was considered positive; otherwise, it was considered negative., Results: On average, the ratio of arterial tension to inspiratory fraction of oxygen (PaO 2 :FiO 2 ) in the overall study population was 137 (119-162) mmHg. In 11 (55%) patients, the net response to decreasing PEEP was positive. Their over-aerated lung volume decreased by 159 (98-186) mL, while the non-aerated lung volume increased by only 58 (31-91) mL. In nine (45%) patients, the net response was negative. Their over-aerated lung volume decreased by 46 (18-72) mL, but their non-aerated lung volume increased by 107 (44-121) mL., Conclusion: In 20 patients with COVID-19 the net response to decreasing PEEP, as assessed with lung CT, was variable. In approximately half of them it was positive (and possibly beneficial), with a decrease in hyperinflation larger than the increase in collapse., (© 2024 Acta Anaesthesiologica Scandinavica Foundation.)

Background: International guidelines suggest using a higher (> 10 cm H 2 O) positive end-expiratory pressure (PEEP) in patients with moderate-to-severe ARDS due to COVID-19. However, even if oxygenation generally improves with a higher PEEP, compliance, and Paco 2 frequently do not, as if recruitment was small., Research Question: Is the potential for lung recruitment small in patients with early ARDS due to COVID-19?, Study Design and Methods: Forty patients with ARDS due to COVID-19 were studied in the supine position within 3 days of endotracheal intubation. They all underwent a PEEP trial, in which oxygenation, compliance, and Paco 2 were measured with 5, 10, and 15 cm H 2 O of PEEP, and all other ventilatory settings unchanged. Twenty underwent a whole-lung static CT scan at 5 and 45 cm H 2 O, and the other 20 at 5 and 15 cm H 2 O of airway pressure. Recruitment and hyperinflation were defined as a decrease in the volume of the non-aerated (density above -100 HU) and an increase in the volume of the over-aerated (density below -900 HU) lung compartments, respectively., Results: From 5 to 15 cm H 2 O, oxygenation improved in 36 (90%) patients but compliance only in 11 (28%) and Paco 2 only in 14 (35%). From 5 to 45 cm H 2 O, recruitment was 351 (161-462) mL and hyperinflation 465 (220-681) mL. From 5 to 15 cm H 2 O, recruitment was 168 (110-202) mL and hyperinflation 121 (63-270) mL. Hyperinflation variably developed in all patients and exceeded recruitment in more than half of them., Interpretation: Patients with early ARDS due to COVID-19, ventilated in the supine position, present with a large potential for lung recruitment. Even so, their compliance and Paco 2 do not generally improve with a higher PEEP, possibly because of hyperinflation., (Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)