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1. Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: evidence from a systematic review

Author

Damiani G, Salvatori E, Silvestrini G, Ivanova I, Bojovic L, Iodice L, and Ricciardi W

Subjects
Systematic review, hospital readmission, older patients, socioeconomic factors., Geriatrics, RC952-954.6
Abstract

Gianfranco Damiani,1 Eleonora Salvatori,1 Giulia Silvestrini,1 Ivana Ivanova,2 Luka Bojovic,3 Lanfranco Iodice,1 Walter Ricciardi1 1Department of Public Health, Università Cattolica Sacro Cuore, Rome, Italy; 2ERAWEB Project, Faculty of Medicine, Saints Cyril and Methodius University of Skopje, Skopje, Macedonia; 3ERAWEB Project, Faculty of Medicine, University of Nis, Nis, Serbia Purpose: Cardiovascular diseases are the leading cause of death and disability worldwide. Among these diseases, heart failure (HF) and acute myocardial infarction (AMI) are the most common causes of hospitalization. Therefore, readmission for HF and AMI is receiving increasing attention. Several socioeconomic factors could affect readmissions in this target group, and thus, a systematic review was conducted to identify the effect of socioeconomic factors on the risk for readmission in people aged 65 years and older with HF or AMI.Methods: The search was carried out by querying an electronic database and hand searching. Studies with an association between the risk for readmission and at least one socioeconomic factor in patients aged 65 years or older who are affected by HF or AMI were included. A quality assessment was conducted independently by two reviewers. The agreement was quantified by Cohen’s Kappa statistic. The outcomes of studies were categorized in the short-term and the long-term, according to the follow-up period of readmission. A positive association was reported if an increase in the risk for readmission among disadvantaged patients was found. A cumulative effect of socioeconomic factors was computed by considering the association for each study and the number of available studies.Results: A total of eleven articles were included in the review. They were mainly published in the United States. All the articles analyzed patients who were hospitalized for HF, and four of them also analyzed patients with AMI. Seven studies (63.6%) were found for the short-term outcome, and four studies (36.4%) were found for the long-term outcome. For the short-term outcome, race/ethnicity and marital status showed a positive cumulative effect on the risk for readmission. Regarding the educational level of a patient, no effect was found.Conclusion: Among the socioeconomic factors, mainly race/ethnicity and marital status affect the risk for readmission in elderly people with HF or AMI. Multidisciplinary hospital-based quality initiatives, disease management, and care transition programs are a priority for health care systems to achieve better coordination. Keywords: chronic conditions, cardiovascular disease (CVD), re-hospitalization, disparities, older patients, socioeconomic factors

Published
2015

2. Quality of dementia clinical guidelines and relevance to the care of older people with comorbidity: evidence from the literature

Author

Damiani G, Silvestrini G, Trozzi L, Maci D, Iodice L, and Ricciardi W

Subjects
Dementia, Clinical Guidelines, Quality, Older, Comorbidity, Geriatrics, RC952-954.6
Abstract

Gianfranco Damiani, Giulia Silvestrini, Lucrezia Trozzi, Donatella Maci, Lanfranco Iodice, Walter Ricciardi Department of Public Health, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, Rome, Italy Purpose: The aim of this paper was to explore the applicability of dementia clinical guidelines (CGs) to older patients, to patients with one or several comorbidities, and to both targets in order to evaluate if an association between the applicability and quality of the CGs exists.Materials and methods: A systematic search strategy conducted on electronic databases identified CGs on diagnosis and treatment of dementia published from 2000 to 2013. In addition, websites of organizations devoted to the treatment and awareness of dementia were searched. The quality of evidence was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Two investigators independently scored the relevance of the CGs by means of a specific tool. Descriptive and inferential analyses were performed (Mann–Whitney test, 0.05 α-level).Results: Twenty-two CGs met our inclusion criteria. On average, the quality of the CGs was higher than 70% in three of six domains measured by the AGREE tool. The domains with lower mean scores (less than 50%) were “Applicability” and “Editorial independence”. Considering applicability to older patients, 20 CGs (91%) addressed issues of treatment for older patients, five of them (23%) classified older patients by age, and 13 CGs (60%) addressed issues of comorbidity. Only seven (32%) discussed the quality of evidence for patients with multiple comorbid conditions. Thirteen CGs (60%) reported recommendations for patients with at least one comorbid condition, while seven of them (32%) reported on several comorbid conditions. No statistically significant association between CG quality and relevance to care of older people with or without comorbidity was found (P>0.05).Conclusion: This study showed that dementia CGs poorly address treatment for older patients with comorbidities, regardless of their quality. Therefore, they scarcely satisfy the need of modern clinical practice. Keywords: dementia, clinical guidelines, quality, older, comorbidity

Published
2014

4. Rationale and design of the CV-PREVITAL study: an Italian multiple cohort randomised controlled trial investigating innovative digital strategies in primary cardiovascular prevention

Author

Baldassarre, D, Iacoviello, L, Baetta, R, Roncaglioni, M, Condorelli, G, Remuzzi, G, Gensini, G, Frati, L, Ricciardi, W, Conaldi, P, Uccelli, A, Blandini, F, Bosari, S, Scambia, G, Fini, M, Di Malta, A, Amato, M, Veglia, F, Bonomi, A, Klersy, C, Colazzo, F, Pengo, M, Gorini, F, Auteri, L, Ferrante, G, Baviera, M, Ambrosio, G, Catapano, A, Gialluisi, A, Malavazos, A, Castelvecchio, S, Corsi-Romanelli, M, Cardani, R, La Rovere, M, Agnese, V, Pane, B, Prati, D, Spinardi, L, Liuzzo, G, Arbustini, E, Volterrani, M, Visconti, M, Werba, J, Genovese, S, Bilo, G, Invitti, C, Di Blasio, A, Lombardi, C, Faini, A, Rosa, D, Ojeda-Fernandez, L, Foresta, A, De Curtis, A, Di Castelnuovo, A, Scalvini, S, Pierobon, A, Gorini, A, Valenti, L, Luzi, L, Racca, A, Bandi, M, Tremoli, E, Menicanti, L, Parati, G, Pompilio, G, Colombo, G, Vavassori, C, Biondi, M, Frigerio, B, Ravani, A, Sansaro, D, Coggi, D, Romandini, A, Giroli, M, Giuliani, M, Bonmi, A, Rondinelli, M, Trudu, C, Cinieri, C, Monturano, M, Colazo, F, Inviti, C, Di Blasi, A, Torlasco, C, Gilardini, L, Soranna, D, Zambon, A, Perger, E, Zanotti, L, Badano, L, Cova, L, Gentilini, D, Grappiolo, L, Condoreli, G, Ferante, G, Papa, L, Savevski, V, Ieva, F, Romano, I, Remzzi, G, Ojeda, L, Clerici, F, Palumbo, A, Genini, G, Catpano, A, Mattioli, R, Longhi, E, Mantovani, L, Madotto, F, Bonaccio, M, Gianfagna, F, Ghulam, A, Magnacca, S, Noro, F, Costanzo, S, Esposito, S, Orlandi, S, Persichillo, M, Bracone, F, Panzera, T, Ruggiero, E, Parisi, R, Franciosa, S, Morelli, M, De Rita, F, Cerletti, C, de Gaetano, G, Donati, M, Mencanti, L, Romanelli, M, Cerri, A, Dubini, C, Trevisan, M, Renna, L, Milani, V, Boveri, S, Giubbilini, P, Ramputi, L, Baroni, I, De Angeli, G, Riciardi, W, Olmetti, F, Bussotti, M, Gaetano, C, Baiardi, P, Bachetti, T, Balbi, M, Comini, L, Lorenzoni, M, Olivares, A, Traversi, E, Garre, C, Sideri, R, Clemenza, F, Gentile, G, Caruana, G, Cuscino, N, Di Gesaro, G, Greco, A, Loddo, I, Tuzzolino, F, Ucelli, A, Palombo, D, Spinella, G, Mozzetta, G, Ameri, P, Zoppoli, G, Finotello, A, Porto, I, Pratesi, G, Bladini, F, Spnardi, L, Clerici, M, Pelusi, S, Bianco, C, Carpani, R, Periti, G, Margarita, S, Lanza, G, Severino, A, Pedicino, D, D'Amario, D, D'Aiello, A, Vinci, R, Bonanni, A, Brecciaroli, M, Filomia, S, Pastorino, R, Boccia, S, Urbani, A, Sanguinetti, M, Santoliquido, A, Proto, L, Tarquini, D, Grimaldi, M, Leonardi, S, Elia, A, Currao, A, Urtis, M, Di Toro, A, Giuliani, L, Caminiti, G, Marcolongo, F, Sposato, B, Guadagni, F, Morsella, V, Marziale, A, Protti, G, Baldassarre D., Iacoviello L., Baetta R., Roncaglioni M. C., Condorelli G., Remuzzi G., Gensini G., Frati L., Ricciardi W., Conaldi P. G., Uccelli A., Blandini F., Bosari S., Scambia G., Fini M., Di Malta A., Amato M., Veglia F., Bonomi A., Klersy C., Colazzo F., Pengo M., Gorini F., Auteri L., Ferrante G., Baviera M., Ambrosio G., Catapano A., Gialluisi A., Malavazos A. E., Castelvecchio S., Corsi-Romanelli M. M., Cardani R., La Rovere M. T., Agnese V., Pane B., Prati D., Spinardi L., Liuzzo G., Arbustini E., Volterrani M., Visconti M., Werba J. P., Genovese S., Bilo G., Invitti C., Di Blasio A., Lombardi C., Faini A., Rosa D., Ojeda-Fernandez L., Foresta A., De Curtis A., Di Castelnuovo A., Scalvini S., Pierobon A., Gorini A., Valenti L., Luzi L., Racca A., Bandi M., Tremoli E., Menicanti L., Parati G., Pompilio G., Colombo G., Vavassori C., Biondi M. L., Frigerio B., Ravani A., Sansaro D., Coggi D., Romandini A., Giroli M., Giuliani M., Bonmi A., Rondinelli M., Trudu C., Cinieri C., Monturano M., Colazo F., Inviti C., Di Blasi A., Torlasco C., Gilardini L., Soranna D., Zambon A., Perger E., Zanotti L., Badano L., Cova L., Gentilini D., Grappiolo L., Condoreli G., Ferante G., Papa L., Savevski V., Ieva F., Romano I., Remzzi G., Ojeda L., Clerici F., Palumbo A., Genini G. F., Catpano A., Mattioli R., Longhi E., Mantovani L. G., Madotto F., Bonaccio M., Gianfagna F., Ghulam A., Magnacca S., Noro F., Costanzo S., Esposito S., Orlandi S., Persichillo M., Bracone F., Panzera T., Ruggiero E., Parisi R., Franciosa S., Morelli M., De Rita F., Cerletti C., de Gaetano G., Donati M. B., Mencanti L., Romanelli M. M. C., Cerri A., Dubini C., Trevisan M. B., Renna L. V., Milani V., Boveri S., Giubbilini P., Ramputi L., Baroni I., De Angeli G., Riciardi W., Olmetti F., Bussotti M., Gaetano C., Baiardi P., Bachetti T., Balbi M., Comini L., Lorenzoni M., Olivares A., Traversi E., Garre C., Sideri R., Clemenza F., Gentile G., Caruana G., Cuscino N., Di Gesaro G., Greco A., Loddo I., Tuzzolino F., Ucelli A., Palombo D., Spinella G., Mozzetta G., Ameri P., Zoppoli G., Finotello A., Porto I., Pratesi G., Bladini F., Spnardi L., Clerici M., Pelusi S., Bianco C., Carpani R., Periti G., Margarita S., Lanza G. A., Severino A., Pedicino D., D'Amario D., D'Aiello A., Vinci R., Bonanni A., Brecciaroli M., Filomia S., Pastorino R., Boccia S., Urbani A., Sanguinetti M., Santoliquido A., Proto L., Tarquini D., Grimaldi M. C., Leonardi S., Elia A., Currao A., Urtis M., Di Toro A., Giuliani L., Caminiti G., Marcolongo F., Sposato B., Guadagni F., Morsella V., Marziale A., Protti G., Baldassarre, D, Iacoviello, L, Baetta, R, Roncaglioni, M, Condorelli, G, Remuzzi, G, Gensini, G, Frati, L, Ricciardi, W, Conaldi, P, Uccelli, A, Blandini, F, Bosari, S, Scambia, G, Fini, M, Di Malta, A, Amato, M, Veglia, F, Bonomi, A, Klersy, C, Colazzo, F, Pengo, M, Gorini, F, Auteri, L, Ferrante, G, Baviera, M, Ambrosio, G, Catapano, A, Gialluisi, A, Malavazos, A, Castelvecchio, S, Corsi-Romanelli, M, Cardani, R, La Rovere, M, Agnese, V, Pane, B, Prati, D, Spinardi, L, Liuzzo, G, Arbustini, E, Volterrani, M, Visconti, M, Werba, J, Genovese, S, Bilo, G, Invitti, C, Di Blasio, A, Lombardi, C, Faini, A, Rosa, D, Ojeda-Fernandez, L, Foresta, A, De Curtis, A, Di Castelnuovo, A, Scalvini, S, Pierobon, A, Gorini, A, Valenti, L, Luzi, L, Racca, A, Bandi, M, Tremoli, E, Menicanti, L, Parati, G, Pompilio, G, Colombo, G, Vavassori, C, Biondi, M, Frigerio, B, Ravani, A, Sansaro, D, Coggi, D, Romandini, A, Giroli, M, Giuliani, M, Bonmi, A, Rondinelli, M, Trudu, C, Cinieri, C, Monturano, M, Colazo, F, Inviti, C, Di Blasi, A, Torlasco, C, Gilardini, L, Soranna, D, Zambon, A, Perger, E, Zanotti, L, Badano, L, Cova, L, Gentilini, D, Grappiolo, L, Condoreli, G, Ferante, G, Papa, L, Savevski, V, Ieva, F, Romano, I, Remzzi, G, Ojeda, L, Clerici, F, Palumbo, A, Genini, G, Catpano, A, Mattioli, R, Longhi, E, Mantovani, L, Madotto, F, Bonaccio, M, Gianfagna, F, Ghulam, A, Magnacca, S, Noro, F, Costanzo, S, Esposito, S, Orlandi, S, Persichillo, M, Bracone, F, Panzera, T, Ruggiero, E, Parisi, R, Franciosa, S, Morelli, M, De Rita, F, Cerletti, C, de Gaetano, G, Donati, M, Mencanti, L, Romanelli, M, Cerri, A, Dubini, C, Trevisan, M, Renna, L, Milani, V, Boveri, S, Giubbilini, P, Ramputi, L, Baroni, I, De Angeli, G, Riciardi, W, Olmetti, F, Bussotti, M, Gaetano, C, Baiardi, P, Bachetti, T, Balbi, M, Comini, L, Lorenzoni, M, Olivares, A, Traversi, E, Garre, C, Sideri, R, Clemenza, F, Gentile, G, Caruana, G, Cuscino, N, Di Gesaro, G, Greco, A, Loddo, I, Tuzzolino, F, Ucelli, A, Palombo, D, Spinella, G, Mozzetta, G, Ameri, P, Zoppoli, G, Finotello, A, Porto, I, Pratesi, G, Bladini, F, Spnardi, L, Clerici, M, Pelusi, S, Bianco, C, Carpani, R, Periti, G, Margarita, S, Lanza, G, Severino, A, Pedicino, D, D'Amario, D, D'Aiello, A, Vinci, R, Bonanni, A, Brecciaroli, M, Filomia, S, Pastorino, R, Boccia, S, Urbani, A, Sanguinetti, M, Santoliquido, A, Proto, L, Tarquini, D, Grimaldi, M, Leonardi, S, Elia, A, Currao, A, Urtis, M, Di Toro, A, Giuliani, L, Caminiti, G, Marcolongo, F, Sposato, B, Guadagni, F, Morsella, V, Marziale, A, Protti, G, Baldassarre D., Iacoviello L., Baetta R., Roncaglioni M. C., Condorelli G., Remuzzi G., Gensini G., Frati L., Ricciardi W., Conaldi P. G., Uccelli A., Blandini F., Bosari S., Scambia G., Fini M., Di Malta A., Amato M., Veglia F., Bonomi A., Klersy C., Colazzo F., Pengo M., Gorini F., Auteri L., Ferrante G., Baviera M., Ambrosio G., Catapano A., Gialluisi A., Malavazos A. E., Castelvecchio S., Corsi-Romanelli M. M., Cardani R., La Rovere M. T., Agnese V., Pane B., Prati D., Spinardi L., Liuzzo G., Arbustini E., Volterrani M., Visconti M., Werba J. P., Genovese S., Bilo G., Invitti C., Di Blasio A., Lombardi C., Faini A., Rosa D., Ojeda-Fernandez L., Foresta A., De Curtis A., Di Castelnuovo A., Scalvini S., Pierobon A., Gorini A., Valenti L., Luzi L., Racca A., Bandi M., Tremoli E., Menicanti L., Parati G., Pompilio G., Colombo G., Vavassori C., Biondi M. L., Frigerio B., Ravani A., Sansaro D., Coggi D., Romandini A., Giroli M., Giuliani M., Bonmi A., Rondinelli M., Trudu C., Cinieri C., Monturano M., Colazo F., Inviti C., Di Blasi A., Torlasco C., Gilardini L., Soranna D., Zambon A., Perger E., Zanotti L., Badano L., Cova L., Gentilini D., Grappiolo L., Condoreli G., Ferante G., Papa L., Savevski V., Ieva F., Romano I., Remzzi G., Ojeda L., Clerici F., Palumbo A., Genini G. F., Catpano A., Mattioli R., Longhi E., Mantovani L. G., Madotto F., Bonaccio M., Gianfagna F., Ghulam A., Magnacca S., Noro F., Costanzo S., Esposito S., Orlandi S., Persichillo M., Bracone F., Panzera T., Ruggiero E., Parisi R., Franciosa S., Morelli M., De Rita F., Cerletti C., de Gaetano G., Donati M. B., Mencanti L., Romanelli M. M. C., Cerri A., Dubini C., Trevisan M. B., Renna L. V., Milani V., Boveri S., Giubbilini P., Ramputi L., Baroni I., De Angeli G., Riciardi W., Olmetti F., Bussotti M., Gaetano C., Baiardi P., Bachetti T., Balbi M., Comini L., Lorenzoni M., Olivares A., Traversi E., Garre C., Sideri R., Clemenza F., Gentile G., Caruana G., Cuscino N., Di Gesaro G., Greco A., Loddo I., Tuzzolino F., Ucelli A., Palombo D., Spinella G., Mozzetta G., Ameri P., Zoppoli G., Finotello A., Porto I., Pratesi G., Bladini F., Spnardi L., Clerici M., Pelusi S., Bianco C., Carpani R., Periti G., Margarita S., Lanza G. A., Severino A., Pedicino D., D'Amario D., D'Aiello A., Vinci R., Bonanni A., Brecciaroli M., Filomia S., Pastorino R., Boccia S., Urbani A., Sanguinetti M., Santoliquido A., Proto L., Tarquini D., Grimaldi M. C., Leonardi S., Elia A., Currao A., Urtis M., Di Toro A., Giuliani L., Caminiti G., Marcolongo F., Sposato B., Guadagni F., Morsella V., Marziale A., and Protti G.

Abstract

Introduction Prevention of cardiovascular disease (CVD) is of key importance in reducing morbidity, disability and mortality worldwide. Observational studies suggest that digital health interventions can be an effective strategy to reduce cardiovascular (CV) risk. However, evidence from large randomised clinical trials is lacking. Methods and analysis The CV-PREVITAL study is a multicentre, prospective, randomised, controlled, open-label interventional trial designed to compare the effectiveness of an educational and motivational mobile health (mHealth) intervention versus usual care in reducing CV risk. The intervention aims at improving diet, physical activity, sleep quality, psycho-behavioural aspects, as well as promoting smoking cessation and adherence to pharmacological treatment for CV risk factors. The trial aims to enrol approximately 80 000 subjects without overt CVDs referring to general practitioners' offices, community pharmacies or clinics of Scientific Institute for Research, Hospitalization and Health Care (Italian acronym IRCCS) affiliated with the Italian Cardiology Network. All participants are evaluated at baseline and after 12 months to assess the effectiveness of the intervention on short-term endpoints, namely improvement in CV risk score and reduction of major CV risk factors. Beyond the funded life of the study, a long-term (7 years) follow-up is also planned to assess the effectiveness of the intervention on the incidence of major adverse CV events. A series of ancillary studies designed to evaluate the effect of the mHealth intervention on additional risk biomarkers are also performed. Ethics and dissemination This study received ethics approval from the ethics committee of the coordinating centre (Monzino Cardiology Center; R1256/20-CCM 1319) and from all other relevant IRBs and ethics committees. Findings are disseminated through scientific meetings and peer-reviewed journals and via social media. Partners are informed about the study's

Published
2023

10. Knowledge, attitudes and behaviors of the Italian population towards Neisseria meningitidis, Streptococcus pneumoniae and HPV diseases and vaccinations: A cross-sectional multicentre study

Author

de Waure, C., Quaranta, G., Ianuale, C., Panatto, D., Amicizia, D., Apprato, L., Campanella, P., Colotto, M., De Meo, C., Di Nardo, F., Frisicale, E.M., La Milia, D.I., Rizzitelli, E., Aquilani, S., Briata, M.P., Frumento, V., Marensi, L., Spadea, A., Turello, V., Gasparini, R., and Ricciardi, W.

Published
2016
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11. Clinical governance: An in-depth scientometric analysis

Author

Adduci, Andrea, Perilli, Alessio, Durante, F., De Mattia, Egidio, Cicchetti, Americo, Ricciardi, Walter, De Belvis, Antonio, Adduci A., Perilli A., de Mattia E., Cicchetti A. (ORCID:0000-0002-4633-9195), Ricciardi W. (ORCID:0000-0002-5655-688X), de Belvis A. (ORCID:0000-0003-4456-1937), Adduci, Andrea, Perilli, Alessio, Durante, F., De Mattia, Egidio, Cicchetti, Americo, Ricciardi, Walter, De Belvis, Antonio, Adduci A., Perilli A., de Mattia E., Cicchetti A. (ORCID:0000-0002-4633-9195), Ricciardi W. (ORCID:0000-0002-5655-688X), and de Belvis A. (ORCID:0000-0003-4456-1937)

Abstract

Objective: To analyze the research status of clinical governance (CG); the most productive authors, countries and organizations; connections among research themes. Methods: We used a ‘funnel model’, consisting of 3 layers describing various CG domains and settings. We retrieved bibliometric data from 1998 to 2021 from the Scopus database. Text mining, visual analysis, descriptive statistics and data visualization were performed. Citation bursts were detected. Results: The total number of studies was 2429. On a global scale, there is a swinging trend in publications, with four peaks detected (2000, 2009, 2013, 2021). Citation burst keywords include: “national health service”, “medical audit”, “psychological aspect”, “quality improvement” and “surveys and questionnaires”. UK is the most productive and cited country. The most active organizations were in the UK, Australia, USA, Italy and Iran. The most productive journals and authors were identified. The most frequent keywords identified were ‘health care quality’, ‘clinical governance’, ‘organization and management’ and ‘medical audit’. Research trends for each CG domain and setting type were reported. Conclusion: By using scientometric methodology, we created a thorough scientific picture on CG, including the mapping of pivotal concepts as a function of time.

Published
2023

12. Process control: simply a matter of efficiency or of survival and costs? A single-centre quality improvement project in living donor renal transplant

Author

Paoletti, Fabio, Vittori, G., Jaser, A., Zanoni, N. R., Ricciardi, Walter, Citterio, Franco, De Belvis, Antonio, Paoletti F., Ricciardi W. (ORCID:0000-0002-5655-688X), Citterio Franco (ORCID:0000-0003-0489-6337), De Belvis A. (ORCID:0000-0003-4456-1937), Paoletti, Fabio, Vittori, G., Jaser, A., Zanoni, N. R., Ricciardi, Walter, Citterio, Franco, De Belvis, Antonio, Paoletti F., Ricciardi W. (ORCID:0000-0002-5655-688X), Citterio Franco (ORCID:0000-0003-0489-6337), and De Belvis A. (ORCID:0000-0003-4456-1937)

Abstract

Background: Rising incidence and prevalence of end-stage renal disease is a worldwide concern for sustainability of healthcare systems and societies. Living donor renal transplant [LDRT] provides highest health achievements and cost containment than any alternative form of renal replacement therapy. Nonetheless, about 25% of potential LDRTs are missed for causes directly related with inadequate timing in donor assessment. Our quality improvement (QI) project implement process control tools and strategy aiming at reducing total evaluation time for donor candidates and minimizing dialysis exposure for intended recipients, which are the two main determinants of clinical outcomes and costs. Methods: The study includes patients who underwent donor nephrectomy between January 1, 2017 and December 31, 2021. Six Sigma DMAIC approach was adopted to assess Base Case performance (Jan2017-Jun2019) and to design and implement our QI project. Study of current state analysis focused on distribution of time intervals within the assessment process, analysis of roles and impacts of involved healthcare providers and identification of targets of improvement. Improved Scenario (Jul2019-Dec2021) was assessed in terms of total lead time reduction, total pre-transplantation dialysis exposure and costs reduction, and increase in pre-emptive transplantations. The study was reported following SQUIRE 2.0 Guidelines for QI projects. Results: Study population includes 63 patients, 37 in Base Case and 26 in Improved Scenario. Total lead time reduced from a median of 293 to 166 days and this in turn reduced pre-transplantation dialysis exposure and costs by 45%. Rate of potential pre-emptive donors’ loss changes from 44% to 27%. Conclusions: Lean methodology is an effective tool to improve quality and efficiency of healthcare processes, in the interest of patients, healthcare professionals and payers.

Published
2023

13. Workplace violence against healthcare workers: an umbrella review of systematic reviews and meta-analyses

Author

Rossi, Maria Francesca, Beccia, Flavia, Cittadini, Francesca, Amantea, Carlotta, Aulino, Giovanni, Santoro, Paolo Emilio, Borrelli, Ivan, Oliva, Antonio, Ricciardi, Walter, Moscato, Umberto, Gualano, M R, Rossi, M F, Beccia, F, Cittadini, F (ORCID:0000-0002-2773-9492), Amantea, C, Aulino, G, Santoro, P E (ORCID:0000-0002-6052-088X), Borrelli, I (ORCID:0000-0002-6361-8823), Oliva, A (ORCID:0000-0001-7120-616X), Ricciardi, W (ORCID:0000-0002-5655-688X), Moscato, U (ORCID:0000-0002-2568-3966), Rossi, Maria Francesca, Beccia, Flavia, Cittadini, Francesca, Amantea, Carlotta, Aulino, Giovanni, Santoro, Paolo Emilio, Borrelli, Ivan, Oliva, Antonio, Ricciardi, Walter, Moscato, Umberto, Gualano, M R, Rossi, M F, Beccia, F, Cittadini, F (ORCID:0000-0002-2773-9492), Amantea, C, Aulino, G, Santoro, P E (ORCID:0000-0002-6052-088X), Borrelli, I (ORCID:0000-0002-6361-8823), Oliva, A (ORCID:0000-0001-7120-616X), Ricciardi, W (ORCID:0000-0002-5655-688X), and Moscato, U (ORCID:0000-0002-2568-3966)

Abstract

Objectives: The aim of this umbrella review of systematic reviews and meta-analyses was to address workplace violence (WPV) against healthcare workers (HCWs). Several systematic reviews exist in the literature, but the diversity of settings, population considered, and type of violence investigated make it difficult to gain insight and use the vast amount of available data to implement policies to tackle WPV. With this in mind, we conducted an umbrella review of systematic reviews and meta-analyses on WPV against HCWs to examine the global prevalence of the phenomena and its features. Study design and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and ISI Web of Science were searched for relevant systematic reviews and meta-analyses published in English up to November 2022. Data on authors, year, country, violence type, prevalence (pooled and not), setting, population, and specific considerations were extracted. Results: A total of 32 systematic reviews were included, 19 of which performed a meta-analysis, investigating overall, physical, and non-physical violence. Even considering the variability of the data, the COVID-19 pandemic has exacerbated the scale of the problem. From our review, we found that overall violence prevalence among HCWs was reported to be as high as 78.9%, and nurses working in psychiatric wards were the professionals most impacted. Conclusion: In conclusion, this umbrella review revealed a high prevalence of WPV among HCWs, which varies between countries, population subgroups, and detection methods. Strengthening recognition of the problem could lead to appropriate local and international strategies to address it.

Published
2023

14. Public health leadership in the COVID-19 era: How does it fit? A scoping review

Author

Osti, Tommaso, Valz Gris, Angelica, Corona, Valerio Flavio, Villani, Leonardo, D'Ambrosio, Floriana, Lomazzi, M., Favaretti, Carlo, Cascini, Fidelia, Gualano, M. R., Ricciardi, Walter, Osti T., Valz Gris A., Corona V. F., Villani L. (ORCID:0000-0001-9375-8731), D'Ambrosio F., Favaretti C., Cascini F. (ORCID:0000-0001-6499-0734), Ricciardi W. (ORCID:0000-0002-5655-688X), Osti, Tommaso, Valz Gris, Angelica, Corona, Valerio Flavio, Villani, Leonardo, D'Ambrosio, Floriana, Lomazzi, M., Favaretti, Carlo, Cascini, Fidelia, Gualano, M. R., Ricciardi, Walter, Osti T., Valz Gris A., Corona V. F., Villani L. (ORCID:0000-0001-9375-8731), D'Ambrosio F., Favaretti C., Cascini F. (ORCID:0000-0001-6499-0734), and Ricciardi W. (ORCID:0000-0002-5655-688X)

Abstract

The COVID-19 pandemic has put a lot of pressure on all the world's health systems and public health leaders who have often found themselves unprepared to handle an emergency of this magnitude. This study aims to bring together published evidence on the qualities required to leaders to deal with a public health issue like the COVID-19 pandemic. This scoping literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A search of relevant articles was performed in the PubMed, Scopus and Web of Science databases. A total of 2499 records were screened, and 45 articles were included, from which 93 characteristics of effective leadership were extrapolated and grouped into 6 clusters. The qualities most frequently reported in the articles were human traits and emotional intelligence (46.7%) and communication skills such as transparency and reliability (48.9%). Responsiveness and preparedness (40%), management skills (33.3%) and team working (35.6%) are considered by a significant percentage of the articles as necessary for the construction of rapid and effective measures in response to the emergency. A considerable proportion of articles also highlighted the need for leaders capable of making evidence-based decisions and driving innovation (31.1%). Although identifying leaders who possess all the skills described in this study appears complex, determining the key characteristics of effective public health leadership in a crisis, such as the COVID-19 pandemic, is useful not only in selecting future leaders but also in implementing training and education programmes for the public health workforce.

Published
2023

15. A survey of experts on personalized medicine landscape in European Union and China

Author

Hoxhaj, Ilda, Beccia, Flavia, Morsella, Alisha, Cadeddu, Chiara, Ricciardi, Walter, Boccia, Stefania, Hoxhaj I, Beccia F, Morsella A, Cadeddu C (ORCID:0000-0003-0149-1078), Ricciardi W (ORCID:0000-0002-5655-688X), Boccia S. (ORCID:0000-0002-1864-749X), Hoxhaj, Ilda, Beccia, Flavia, Morsella, Alisha, Cadeddu, Chiara, Ricciardi, Walter, Boccia, Stefania, Hoxhaj I, Beccia F, Morsella A, Cadeddu C (ORCID:0000-0003-0149-1078), Ricciardi W (ORCID:0000-0002-5655-688X), and Boccia S. (ORCID:0000-0002-1864-749X)

Abstract

Introduction: Personalized Medicine (PM) is one of the main priorities of the research agenda of the European Commission and the focus of the European Coordination and Support Action titled "Integrating China into the International Consortium for Personalized Medicine" (IC2PerMed). Similar to the European focus, PM is a current priority of the Chinese Government, through dedicated policies and its five-year investment plans. In the context of IC2PerMed, we implemented a survey to understand the state of the art of the implementation of PM related policies in EU and China, and to identify opportunities for future Sino-European collaborations. Methods: The survey was elaborated by the IC2PerMed consortium and validated by a focus group of experts. The final version, in English and Chinese, was administered online to a pool of accurately selected experts. Participation was anonymous and voluntary. The survey consists of 19 questions in 3 sections: (1) personal information; (2) policy in PM; (3) facilitating and hindering factors for Sino-European collaboration in PM. Results: Forty-seven experts completed the survey, 27 from Europe and 20 from China. Only four participants were aware of the implementation of PM-related policies in their working country. Expert reported that PM areas with greatest policy impact so far were: Big Data and digital solutions; citizen and patient literacy; and translational research. The main obstacles found were the lack of shared investment strategies and the limited application of scientific developments in clinical practice. Aligning European and Chinese efforts, finding common ground across cultural, social, and language barriers, were considered as actions needed to enhance efforts in applying PM strategies internationally. Conclusion: To achieve efficiency and sustainability of health systems, it remains crucial to transform PM into an opportunity for all citizens and patients with the commitment of all the stakeholders involved. The

Published
2023

41. Influenza and pneumococcal vaccinations are not associated to COVID-19 outcomes among patients admitted to a university hospital

Author

Pastorino, R., Villani, L., La Milia, D. I., Ieraci, R., Chini, F., Volpe, E., Barca, A., Fusco, D., Laurenti, P., Ricciardi, W., Boccia, S., Pastorino R. (ORCID:0000-0001-5013-0733), Villani L. (ORCID:0000-0001-9375-8731), La Milia D. I., Ieraci R., Fusco D., Laurenti P. (ORCID:0000-0002-8532-0593), Ricciardi W. (ORCID:0000-0002-5655-688X), Boccia S. (ORCID:0000-0002-1864-749X), Pastorino, R., Villani, L., La Milia, D. I., Ieraci, R., Chini, F., Volpe, E., Barca, A., Fusco, D., Laurenti, P., Ricciardi, W., Boccia, S., Pastorino R. (ORCID:0000-0001-5013-0733), Villani L. (ORCID:0000-0001-9375-8731), La Milia D. I., Ieraci R., Fusco D., Laurenti P. (ORCID:0000-0002-8532-0593), Ricciardi W. (ORCID:0000-0002-5655-688X), and Boccia S. (ORCID:0000-0002-1864-749X)

Abstract

In order to reduce the burden on healthcare systems and to support differential diagnosis with COVID-19, influenza and pneumococcal vaccinations were strongly recommended during the COVID-19 pandemic, especially in vulnerable groups. However, no univocal and conclusive evidence on the relationship between influenza and pneumococcal vaccinations and COVID‐19 outcomes exists. We evaluated the association between such vaccinations, COVID-19 hospitalization, intensive care unit admissions and deaths in a cohort (N = 741) of COVID-19 patients who had access to the emergency room of a large Italian University hospital between March 1, 2020 and June 1, 2020. Results show that influenza and pneumococcal vaccinations did not affect hospitalization, intensive care unit admission and deaths in COVID-19 patients in the overall sample and in those ≥65 years. The same pattern of results was confirmed considering timing of influenza vaccine administration, vaccination type, and number of uptakes in the last five vaccination campaigns. In conclusion, our study does not support an impact of influenza and pneumococcal vaccinations on COVID-19 outcomes.

Published
2021

42. Legal responsibility of vaccinating doctor

Author

Beccia, F., Amantea, C., Rossi, M. F., Daniele, A., Santoro, P. E., Borrelli, I., Marazza, M., Boccia, S., Ricciardi, W., Moscato, U., Beccia F., Amantea C., Rossi M. F., Santoro P. E. (ORCID:0000-0002-6052-088X), Borrelli I. (ORCID:0000-0002-6361-8823), Marazza M. (ORCID:0000-0002-0765-4774), Boccia S. (ORCID:0000-0002-1864-749X), Ricciardi W. (ORCID:0000-0002-5655-688X), Moscato U. (ORCID:0000-0002-2568-3966), Beccia, F., Amantea, C., Rossi, M. F., Daniele, A., Santoro, P. E., Borrelli, I., Marazza, M., Boccia, S., Ricciardi, W., Moscato, U., Beccia F., Amantea C., Rossi M. F., Santoro P. E. (ORCID:0000-0002-6052-088X), Borrelli I. (ORCID:0000-0002-6361-8823), Marazza M. (ORCID:0000-0002-0765-4774), Boccia S. (ORCID:0000-0002-1864-749X), Ricciardi W. (ORCID:0000-0002-5655-688X), and Moscato U. (ORCID:0000-0002-2568-3966)

Abstract

LEGAL RESPONSIBILITY OF VACCINATING DOCTOR. The legal responsibility of the vaccinating doctor is one of the central issues in the current setting of the Covid-19 pandemic. The aim of this statement is to outline the profiles of the medical legal liability, with a focus on the figure of the vaccinating physician, in criminal, civil, and disciplinary terms, based on the Italian legislation in force. The vaccinating doctor responds for his work in the field of vaccination in the same way as any other health service should perform (diagnostic, therapeutic, etc.). Helpful in this context is the adoption of the L. 76/2021; it was developed to find a balance between safeguarding the person privacy and greater guarantees for the doctor. This law introduces a criminal shield that can put a limit to litigation, curbing the phenomenon of so-called defensive medicine. The climate of uncertainty and fear of legal repercussions for the doctors, and the constant updating and redefinition of the indications of operability in the vaccination campaigns, underline the need to focus on the knowledge of the responsibilities and the safeguard of the vaccinating doctors. In addition to the regulatory cornerstones, the statement also addresses the issue of informed consent and the role of the occupational doctor as a central figure in the vaccination campaign in the workplace.

Published
2021

44. Italy: Health System Review

Author

De Belvis, Antonio, Meregaglia, M., Morsella, Alisha, Adduci, Andrea, Perilli, Alessio, Cascini, Fidelia, Solipaca, A., Fattore, G., Ricciardi, Walter, Maresso, A., Scarpetti, Giada, de Belvis A. (ORCID:0000-0003-4456-1937), Morsella A., Adduci A., Perilli A., Cascini F. (ORCID:0000-0001-6499-0734), Ricciardi W. (ORCID:0000-0002-5655-688X), Scarpetti G., De Belvis, Antonio, Meregaglia, M., Morsella, Alisha, Adduci, Andrea, Perilli, Alessio, Cascini, Fidelia, Solipaca, A., Fattore, G., Ricciardi, Walter, Maresso, A., Scarpetti, Giada, de Belvis A. (ORCID:0000-0003-4456-1937), Morsella A., Adduci A., Perilli A., Cascini F. (ORCID:0000-0001-6499-0734), Ricciardi W. (ORCID:0000-0002-5655-688X), and Scarpetti G.

Abstract

This analysis of the Italian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Italy has a regionalized National Health Service (SSN) that provides universal coverage largely free of charge at the point of delivery, though certain services and goods require a co-payment. Life expectancy in Italy is historically among the highest in the EU. However, regional differences in health indicators are marked, as well as in per capita spending, distribution of health professionals and in the quality of health services. Overall, Italy's health spending per capita is lower than the EU average and is among the lowest in western European countries. Private spending has increased in recent years, although this trend was halted in 2020 during the coronavirus disease 2019 (COVID-19) pandemic. A key focus of health policies in recent decades was to promote a shift away from unnecessary inpatient care, with a considerable reduction of acute hospital beds and stagnating overall growth in health personnel. However, this was not counterbalanced by a sufficient strengthening of community services in order to cope with the ageing population's needs and related chronic conditions burden. This had important repercussions during the COVID-19 emergency, as the health system felt the impact of previous reductions in hospital beds and capacity and underinvestment in community-based care. Reorganizing hospital and community care will require a strong alignment between central and regional authorities. The COVID-19 crisis also highlighted several issues pre-dating the pandemic that need to be addressed to improve the sustainability and resilience of the SSN. The main outstanding challenges for the health system are linked to addressing historic underinvestment in the health workforce, modernizing outdated infrastructure and equipment, and enhancing information infrastructure. Italy's Nat

Published
2022

45. A cross-country comparison of Covid-19 containment measures and their effects on the epidemic curves

Author

Cascini, Fidelia, Failla, Giovanna, Gobbi, C, Pallini, E, Hui, J, Wang, Lx, Villani, Leonardo, Quentin, W, Boccia, Stefania, Ricciardi, Walter, Cascini, F (ORCID:0000-0001-6499-0734), Failla, G, Villani, L (ORCID:0000-0001-9375-8731), Boccia, S (ORCID:0000-0002-1864-749X), Ricciardi, W (ORCID:0000-0002-5655-688X), Cascini, Fidelia, Failla, Giovanna, Gobbi, C, Pallini, E, Hui, J, Wang, Lx, Villani, Leonardo, Quentin, W, Boccia, Stefania, Ricciardi, Walter, Cascini, F (ORCID:0000-0001-6499-0734), Failla, G, Villani, L (ORCID:0000-0001-9375-8731), Boccia, S (ORCID:0000-0002-1864-749X), and Ricciardi, W (ORCID:0000-0002-5655-688X)

Abstract

Background European countries are still searching to eliminate or contain the Covid-19 pandemic. A variety of approaches have achieved different levels of success in limiting the spread of the disease early and preventing avoidable deaths. Governmental policy responses may explain these differences and this study aims to describe evidence about the effectiveness of containment measures throughout the course of the pandemic in five European countries (France, Germany, Italy, Spain and the UK). Methods The research approach adopted consisted of three steps: 1) Build a Containment Index (C.I.) that considers nine parameters to make an assessment on the strength of measures; 2) Develop dynamic epidemiological models for forecasting purposes; 3) Predict case numbers by assuming containment measures remain constant for a period of 30 days. Results Our analysis revealed that in the five European countries we compared, the use of different approaches definitively affected the effectiveness of containment measures for the Covid-19 pandemic. Conclusion The evidence found in our research can be useful to inform policy makers' decisions when deciding to introduce or relax containment measures and their timing, both during the current pandemic or in addressing possible future health crises.

Published
2022

46. Approaches to priority identification in digital health in ten countries of the Global Digital Health Partnership

Author

Cascini, Fidelia, Altamura, Gerardo Andrea, Failla, Giovanna, Gentili, Andrea, Puleo, Valeria, Melnyk, Andriy, Causio, Francesco Andrea, Ricciardi, Walter, Cascini F. (ORCID:0000-0001-6499-0734), Altamura G., Failla G., Gentili A., Puleo V., Melnyk A., Causio F., Ricciardi W. (ORCID:0000-0002-5655-688X), Cascini, Fidelia, Altamura, Gerardo Andrea, Failla, Giovanna, Gentili, Andrea, Puleo, Valeria, Melnyk, Andriy, Causio, Francesco Andrea, Ricciardi, Walter, Cascini F. (ORCID:0000-0001-6499-0734), Altamura G., Failla G., Gentili A., Puleo V., Melnyk A., Causio F., and Ricciardi W. (ORCID:0000-0002-5655-688X)

Abstract

Background: To promote shared digital health best practices in a global context, as agreed within the Global Digital Health Partnership (GDHP), one of the most important topics to evaluate is the ability to detect what participating countries believe to be priorities suitable to improve their healthcare systems. No previously published scientific papers investigated these aspects as a cross-country comparison. Objective: The aim of this paper is to present results concerning the priorities identification section of the Evidence and Evaluation survey addressed to GDHP members in 2021, comparing countries’ initiatives and perspectives for the future of digital health based on internationally agreed developments. Methods: This survey followed a cross-sectional study approach. An online survey was addressed to the stakeholders of 29 major countries. Results: Ten out of 29 countries answered the survey. The mean global score of 3.54 out of 5, calculated on the whole data set, demonstrates how the global attention to a digital evolution in health is shared by most of the evaluated countries. Conclusion: The resulting insights on the differences between digital health priority identification among different GDHP countries serves as a starting point to coordinate further progress on digital health worldwide and foster evidence-based collaboration.

Published
2022

47. Scoping review of the current landscape of AI-based applications in clinical trials

Author

Cascini, Fidelia, Beccia, Flavia, Causio, Francesco Andrea, Melnyk, Andriy, Zaino, Andrea, Ricciardi, Walter, Cascini F. (ORCID:0000-0001-6499-0734), Beccia F., Causio F. A., Melnyk A., Zaino A., Ricciardi W. (ORCID:0000-0002-5655-688X), Cascini, Fidelia, Beccia, Flavia, Causio, Francesco Andrea, Melnyk, Andriy, Zaino, Andrea, Ricciardi, Walter, Cascini F. (ORCID:0000-0001-6499-0734), Beccia F., Causio F. A., Melnyk A., Zaino A., and Ricciardi W. (ORCID:0000-0002-5655-688X)

Abstract

Background: Clinical trials are essential for bringing new drugs, technologies and procedures to the market and clinical practice. Considering the design and the four-phase development, only 10% of them complete the entire process, partly due to the increasing costs and complexity of clinical trials. This low completion rate has a huge negative impact in terms of population health, quality of care and health economics and sustainability. Automating some of the process' tasks with artificial intelligence (AI) tools could optimize some of the most burdensome ones, like patient selection, matching and enrollment; better patient selection could also reduce harmful treatment side effects. Although the pharmaceutical industry is embracing artificial AI tools, there is little evidence in the literature of their application in clinical trials. Methods: To address this issue, we performed a scoping review. Following the PRISMA-ScR guidelines, we performed a search on PubMed for articles on the implementation of AI in the development of clinical trials. Results: The search yielded 772 articles, of which 15 were included. The articles were published between 2019 and 2022 and the results were presented descriptively. About half of the studies addressed the topic of patient recruitment; 12 articles reported specific examples of AI applications; five studies presented a quantitative estimate of the effectiveness of these tools. Conclusion: All studies present encouraging results on the implementation of AI-based applications to the development of clinical trials. AI-based applications have a lot of potential, but more studies are needed to validate these tools and facilitate their adoption.

Published
2022

48. A multinational Delphi consensus to end the COVID-19 public health threat

Author

Lazarus, J. V., Romero, D., Kopka, C. J., Karim, S. A., Abu-Raddad, L. J., Almeida, G., Baptista-Leite, R., Barocas, J. A., Barreto, M. L., Bar-Yam, Y., Bassat, Q., Batista, C., Bazilian, M., Chiou, S. -T., del Rio, C., Dore, G. J., Gao, G. F., Gostin, L. O., Hellard, M., Jimenez, J. L., Kang, G., Lee, N., Maticic, M., Mckee, M., Nsanzimana, S., Oliu-Barton, M., Pradelski, B., Pyzik, O., Rabin, K., Raina, S., Rashid, S. F., Rathe, M., Saenz, R., Singh, S., Trock-Hempler, M., Villapol, S., Yap, P., Binagwaho, A., Kamarulzaman, A., El-Mohandes, A., Barreto, M., Abdulla, S., Addleman, S., Aghayeva, G., Agius, R., Ahmed, M., Ramy, M. A., Aide, P., Aleman, S., Alfred, J. -P., Ali, S., Aliaga, J., Aloudat, T., Alqahtani, S. A., Al-Salman, J., Amuasi, J. H., Agrawal, A., Anwar, W., Araujo-Jorge, T., Artaza, O., Asadi, L., Awuku, Y., Baker, M., Barberia, L., Bascolo, E., Belcher, P., Bell, L., Benzaken, A., Bergholtz, E., Bhadelia, N., Bhan, A., Bilodeau, S., Bitran, R., Bluyssen, P., Bosman, A., Bozza, F. A., Brinkmann, M. M., Brown, A., Mellado, B., Bukusi, E., Bullen, C., Buonanno, G., Burgess, R., Butler, M., Byakika-Kibwika, P., Cabieses, B., Carlsson, G., Cascini, Fidelia, Chabala, C., Chakroun, M., Cheng, K. K., Chetty, A., Chumachenko, D., Consalves, G., Conway Morris, A., Cordie, A., Corrah, T., Crabtree-Ramirez, B., Dashdorj, N., Davidovitch, N., de Souza, L. E., Dhariwal, A. C., Druica, E., Ergonul, O., Erondu, N. A., Essar, M. Y., Ewing, A., Fanjul, G., Feierstein, D., Feigl-Ding, E., Figueroa, R., Figueroa, J. P., Fisher, D., Flores, W., Forero-Pena, D. A., Frumkin, H., Gamkrelidze, A., Gandhi, M., Garcia, P., Garcia-Basteiro, A. L., Garcia-Sastre, A., Garg, S., Gbeasor-Komlanvi, F. A., Gershenson, C., Gilada, I., Giovanella, L., Gonzalez, M., Green, M. S., Greenhalgh, T., Griffin, P., Griffin, S., Grinsztejn, B., Anand, T., Guerra, G., Guinto, R., Gujski, M., Guner, R., Hamdy, A., Hancean, M. -G., Haniffa, A., Hartigan-Go, K. Y., Hassan, H. K., Hay, S. I., Heino, M. T. J., Hel, Z., Hotez, P., Hu, J., Hukic, M., Ijsselmuiden, C., Iroko, D., Iskarous, M., Izugbara, C., Jacobs, C., Jadad, A. R., Jehan, F., Jordan, A., Jroundi, I., Kain, K., Kamberi, F., Karamov, E., Karan, A., Katz, R., Katzourakis, A., Kazembe, A., Khamis, F., Khamzayev, K., Khanyola, J., Khunti, K., Kiguli-Malwadde, E., Kim, W. J., Kirenga, B. J., Klimovsky, D., Kmush, B. L., Knaul, F., Kogevinas, M., Kristensen, F., Kumar, D., Kumar, R., Kvalsvig, A., Lacerda, M. V., Lal, A., Lawton, T., Lemery, J., Leonardi, A. J., Li, Y., Lottvall, J., Lounis, M., Maceira, D., Macintyre, C. R., Madani, A., Magiorkinis, G., Malekzadeh, R., Choisy, M., Marcelin, J. R., Marks, G. B., Marr, L., Marrazzo, J., Martina, A., Martin-Moreno, J. M., Mateos, C., Mayxay, M., Mazarati, J. B., Mboup, S., Mcdonald, J., Mcmillan, F., Mechili, E., Medici, A., Davis, S. L. M., Meier, P., Memish, Z. A., Menon, J., Menon, P., Mesiano-Crookston, J., Michie, S., Mikolasevic, I., Milicevic, O., Mishra, A. K., Mohamed, R., Mokdad, A. H., Monroy-Valle, M., Morawska, L., Moschos, S. A., Motawea, K., Mousavi, S. H., Mumtaz, G., Munene, P. K., Munoz Almagro, C., Muriuki, J., Muyingo, S., Naniche, D., Naylor, C. D., Ndembi, N., Nemec, J., Nesteruk, I., Ngaruiya, C., Nguyen, H., Nikolova, D., Nitzan, D., Norheim, O., Noushad, M., Ntoumi, F., Nyborg, G. A., Ochodo, E., Odabasi, Z., Okwen, M. P., Olivia, K., Ong, D. S. Y., Opara, I., Orozco, M., Oshitani, H., Pagel, C., Pai, M., Palsdottir, B., Papatheodoridis, G., Paraskevis, D., Leigh, J. P., Pecoul, B., Peichl, A., Perez-Then, E., Duc, P. P., Philippe, C., Pineda Rojas, A., Pladsen, C., Pozniak, A., Quiroga, R., Qureshi, H., Rampal, S., Ranney, M., Rathe, L., Ratzan, S., Raventos, H., Rees, H., Reis, R., Ricciardi, Walter, Rizk, N., Robalo, M., Robertson, E., Robinson, L., Rokx, C., Ros, T., Rottingen, J. -A., Rubin, M., Ruxrungtam, K., Sadirova, S., Saha, S., Salgado, N., Sanchez, L., Sangaramoorthy, T., Santamaria-Ulloa, C., Santos, R., Sawaf, B., Schneider, M. F., Schooley, R. T., Sener, A., Sepulveda, J., Shah, J., Shibani, M., Shoib, S., Sikazwe, I., Simaitis, A., Gill, A. S., Skhvitaridze, N., Sokolovic, M., Solomon, R., Solorzano, X., Springer, S. A., Srol, J., Staines, A., Stelfox, H. T., Strathdee, S., Sulaiman, L. H., Sutton, B., Svanaes, D., Swed, S., Sypsa, V., Sorensen, K., Tajudeen, R., Tan, A., Tang, J., Tanner, M., Sethi, T., Temmerman, M., Than, K. K., Tinto, H., Tometissi, S. P., Torres, I., Tshering, K. P., Tsiodras, S., Tsofa, B., Vahlne, A., Vargas, J. R., Bernal, I. D. V., Ventura, D., Vilasanjuan, R., Vipond, J., Wamala-Andersson, S., Wargocki, P., West, R., Weyand, A., White, T. M., Wolff, G., Yao, M., Yates, C. A., Yeboah, G., Yee-Sin, L., Yi, S., Teo, Y. -Y., Yong, P., Zamora-Mesia, V., Ovrehus, A., Cascini F. (ORCID:0000-0001-6499-0734), Ricciardi W. (ORCID:0000-0002-5655-688X), Lazarus, J. V., Romero, D., Kopka, C. J., Karim, S. A., Abu-Raddad, L. J., Almeida, G., Baptista-Leite, R., Barocas, J. A., Barreto, M. L., Bar-Yam, Y., Bassat, Q., Batista, C., Bazilian, M., Chiou, S. -T., del Rio, C., Dore, G. J., Gao, G. F., Gostin, L. O., Hellard, M., Jimenez, J. L., Kang, G., Lee, N., Maticic, M., Mckee, M., Nsanzimana, S., Oliu-Barton, M., Pradelski, B., Pyzik, O., Rabin, K., Raina, S., Rashid, S. F., Rathe, M., Saenz, R., Singh, S., Trock-Hempler, M., Villapol, S., Yap, P., Binagwaho, A., Kamarulzaman, A., El-Mohandes, A., Barreto, M., Abdulla, S., Addleman, S., Aghayeva, G., Agius, R., Ahmed, M., Ramy, M. A., Aide, P., Aleman, S., Alfred, J. -P., Ali, S., Aliaga, J., Aloudat, T., Alqahtani, S. A., Al-Salman, J., Amuasi, J. H., Agrawal, A., Anwar, W., Araujo-Jorge, T., Artaza, O., Asadi, L., Awuku, Y., Baker, M., Barberia, L., Bascolo, E., Belcher, P., Bell, L., Benzaken, A., Bergholtz, E., Bhadelia, N., Bhan, A., Bilodeau, S., Bitran, R., Bluyssen, P., Bosman, A., Bozza, F. A., Brinkmann, M. M., Brown, A., Mellado, B., Bukusi, E., Bullen, C., Buonanno, G., Burgess, R., Butler, M., Byakika-Kibwika, P., Cabieses, B., Carlsson, G., Cascini, Fidelia, Chabala, C., Chakroun, M., Cheng, K. K., Chetty, A., Chumachenko, D., Consalves, G., Conway Morris, A., Cordie, A., Corrah, T., Crabtree-Ramirez, B., Dashdorj, N., Davidovitch, N., de Souza, L. E., Dhariwal, A. C., Druica, E., Ergonul, O., Erondu, N. A., Essar, M. Y., Ewing, A., Fanjul, G., Feierstein, D., Feigl-Ding, E., Figueroa, R., Figueroa, J. P., Fisher, D., Flores, W., Forero-Pena, D. A., Frumkin, H., Gamkrelidze, A., Gandhi, M., Garcia, P., Garcia-Basteiro, A. L., Garcia-Sastre, A., Garg, S., Gbeasor-Komlanvi, F. A., Gershenson, C., Gilada, I., Giovanella, L., Gonzalez, M., Green, M. S., Greenhalgh, T., Griffin, P., Griffin, S., Grinsztejn, B., Anand, T., Guerra, G., Guinto, R., Gujski, M., Guner, R., Hamdy, A., Hancean, M. -G., Haniffa, A., Hartigan-Go, K. Y., Hassan, H. K., Hay, S. I., Heino, M. T. J., Hel, Z., Hotez, P., Hu, J., Hukic, M., Ijsselmuiden, C., Iroko, D., Iskarous, M., Izugbara, C., Jacobs, C., Jadad, A. R., Jehan, F., Jordan, A., Jroundi, I., Kain, K., Kamberi, F., Karamov, E., Karan, A., Katz, R., Katzourakis, A., Kazembe, A., Khamis, F., Khamzayev, K., Khanyola, J., Khunti, K., Kiguli-Malwadde, E., Kim, W. J., Kirenga, B. J., Klimovsky, D., Kmush, B. L., Knaul, F., Kogevinas, M., Kristensen, F., Kumar, D., Kumar, R., Kvalsvig, A., Lacerda, M. V., Lal, A., Lawton, T., Lemery, J., Leonardi, A. J., Li, Y., Lottvall, J., Lounis, M., Maceira, D., Macintyre, C. R., Madani, A., Magiorkinis, G., Malekzadeh, R., Choisy, M., Marcelin, J. R., Marks, G. B., Marr, L., Marrazzo, J., Martina, A., Martin-Moreno, J. M., Mateos, C., Mayxay, M., Mazarati, J. B., Mboup, S., Mcdonald, J., Mcmillan, F., Mechili, E., Medici, A., Davis, S. L. M., Meier, P., Memish, Z. A., Menon, J., Menon, P., Mesiano-Crookston, J., Michie, S., Mikolasevic, I., Milicevic, O., Mishra, A. K., Mohamed, R., Mokdad, A. H., Monroy-Valle, M., Morawska, L., Moschos, S. A., Motawea, K., Mousavi, S. H., Mumtaz, G., Munene, P. K., Munoz Almagro, C., Muriuki, J., Muyingo, S., Naniche, D., Naylor, C. D., Ndembi, N., Nemec, J., Nesteruk, I., Ngaruiya, C., Nguyen, H., Nikolova, D., Nitzan, D., Norheim, O., Noushad, M., Ntoumi, F., Nyborg, G. A., Ochodo, E., Odabasi, Z., Okwen, M. P., Olivia, K., Ong, D. S. Y., Opara, I., Orozco, M., Oshitani, H., Pagel, C., Pai, M., Palsdottir, B., Papatheodoridis, G., Paraskevis, D., Leigh, J. P., Pecoul, B., Peichl, A., Perez-Then, E., Duc, P. P., Philippe, C., Pineda Rojas, A., Pladsen, C., Pozniak, A., Quiroga, R., Qureshi, H., Rampal, S., Ranney, M., Rathe, L., Ratzan, S., Raventos, H., Rees, H., Reis, R., Ricciardi, Walter, Rizk, N., Robalo, M., Robertson, E., Robinson, L., Rokx, C., Ros, T., Rottingen, J. -A., Rubin, M., Ruxrungtam, K., Sadirova, S., Saha, S., Salgado, N., Sanchez, L., Sangaramoorthy, T., Santamaria-Ulloa, C., Santos, R., Sawaf, B., Schneider, M. F., Schooley, R. T., Sener, A., Sepulveda, J., Shah, J., Shibani, M., Shoib, S., Sikazwe, I., Simaitis, A., Gill, A. S., Skhvitaridze, N., Sokolovic, M., Solomon, R., Solorzano, X., Springer, S. A., Srol, J., Staines, A., Stelfox, H. T., Strathdee, S., Sulaiman, L. H., Sutton, B., Svanaes, D., Swed, S., Sypsa, V., Sorensen, K., Tajudeen, R., Tan, A., Tang, J., Tanner, M., Sethi, T., Temmerman, M., Than, K. K., Tinto, H., Tometissi, S. P., Torres, I., Tshering, K. P., Tsiodras, S., Tsofa, B., Vahlne, A., Vargas, J. R., Bernal, I. D. V., Ventura, D., Vilasanjuan, R., Vipond, J., Wamala-Andersson, S., Wargocki, P., West, R., Weyand, A., White, T. M., Wolff, G., Yao, M., Yates, C. A., Yeboah, G., Yee-Sin, L., Yi, S., Teo, Y. -Y., Yong, P., Zamora-Mesia, V., Ovrehus, A., Cascini F. (ORCID:0000-0001-6499-0734), and Ricciardi W. (ORCID:0000-0002-5655-688X)

Abstract

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.

Published
2022

49. Post-Acute COVID-19 Sequelae in a Working Population at One Year Follow-Up: A Wide Range of Impacts from an Italian Sample

Author

Buonsenso, Danilo, Gualano, M. R., Rossi, Maria Francesca, Valz Gris, Angelica, Sisti, Leuconoe Grazia, Borrelli, Ivan, Santoro, Paolo Emilio, Tumminello, Antonio, Gentili, C., Malorni, W., Valentini, Piero, Ricciardi, Walter, Moscato, Umberto, Buonsenso D., Rossi M. F., Valz Gris A., Sisti L. G., Borrelli I. (ORCID:0000-0002-6361-8823), Santoro P. E. (ORCID:0000-0002-6052-088X), Tumminello A., Valentini P. (ORCID:0000-0001-6095-9510), Ricciardi W. (ORCID:0000-0002-5655-688X), Moscato U. (ORCID:0000-0002-2568-3966), Buonsenso, Danilo, Gualano, M. R., Rossi, Maria Francesca, Valz Gris, Angelica, Sisti, Leuconoe Grazia, Borrelli, Ivan, Santoro, Paolo Emilio, Tumminello, Antonio, Gentili, C., Malorni, W., Valentini, Piero, Ricciardi, Walter, Moscato, Umberto, Buonsenso D., Rossi M. F., Valz Gris A., Sisti L. G., Borrelli I. (ORCID:0000-0002-6361-8823), Santoro P. E. (ORCID:0000-0002-6052-088X), Tumminello A., Valentini P. (ORCID:0000-0001-6095-9510), Ricciardi W. (ORCID:0000-0002-5655-688X), and Moscato U. (ORCID:0000-0002-2568-3966)

Abstract

Long COVID-19 is a term used to describe the symptomatic sequelae that develop after suffering from COVID-19. Very few studies have investigated the impact of COVID-19 sequelae on employment status. The aim of this research was to characterise sequelae of COVID-19 in a population of workers who tested positive for COVID-19, with a follow-up within one year of the acute illness, and to analyse the possible association between this and changes in the workers' occupational status. In this retrospective cohort study, a questionnaire was administered to 155 workers; descriptive, univariate (chi-square tests), and multivariate (logistic regression model) analyses were carried out. The mean age was 46.48 years (SD +/- 7.302); 76 participants were males (49.7%), and 33 participants reported being current smokers (21.3%). Overall, 19.0% of patients reported not feeling fully recovered at follow-up, and 13.7% reported a change in their job status after COVID-19. A change in occupational status was associated with being a smoker (OR 4.106, CI [1.406-11.990], p = 0.010); hospital stay was associated with age > 46 years in a statistically significant way (p = 0.025) and with not feeling fully recovered at follow-up (p = 0.003). A persistent worsening in anxiety was more common in women (p = 0.028). This study identifies smoking as a risk factor for workers not able to resume their job; furthermore, occupational physicians should monitor mental health more closely after COVID-19, particularly in female workers.

Published
2022

50. Impact of hospital mergers: a systematic review focusing on healthcare quality measures

Author

Mariani, Marco, Sisti, Leuconoe Grazia, Isonne, C., Nardi, A., Mete, Rosario, Ricciardi, Walter, Villari, Paolo, De Vito, C., Damiani, Gianfranco, Mariani M., Sisti L. G., Mete R., Ricciardi W. (ORCID:0000-0002-5655-688X), Villari P., Damiani G. (ORCID:0000-0003-3028-6188), Mariani, Marco, Sisti, Leuconoe Grazia, Isonne, C., Nardi, A., Mete, Rosario, Ricciardi, Walter, Villari, Paolo, De Vito, C., Damiani, Gianfranco, Mariani M., Sisti L. G., Mete R., Ricciardi W. (ORCID:0000-0002-5655-688X), Villari P., and Damiani G. (ORCID:0000-0003-3028-6188)

Abstract

Background: Despite mergers have increasingly affected hospitals in the recent decades, literature on the impact of hospitals mergers on healthcare quality measures (HQM) is still lacking. Our research aimed to systematically review evidence regarding the impact of hospital mergers on HQM focusing especially on process indicators and clinical outcomes. Methods: The search was carried out until January 2020 using the Population, Intervention, Comparison and Outcome model, querying electronic databases (MEDLINE, Scopus, Web Of Science) and refining the search with hand search. Studies that assessed HQM of hospitals that have undergone a merger were included. HQMs were analyzed through a narrative synthesis and a strength of the evidence analysis based on the quality of the studies and the consistency of the findings. Results: The 16 articles, included in the narrative synthesis, reported inconsistent findings and few statistically significant results. All indicators analyzed showed an insufficient strength of evidence to achieve conclusive results. However, a tendency in the decrease of the number of beds, hospital staff and inpatient admissions and an increase in both mortality and readmission rate for acute myocardial infarction and stroke emerged in our analysis. Conclusions: In our study, there is no strong evidence of improvement or worsening of HQM in hospital mergers. Since a limited amount of studies currently exists, additional studies are needed. In the meanwhile, hospital managers involved in mergers should adopt a clear evaluation framework with indicators that help to periodically and systematically assess HQM ascertaining that mergers ensure and primarily do not reduce the quality of care.

Published
2022

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