ABSTRACT
Background: For almost two years, the Covid-19 pandemic has posed an enormous challenge to healthcare systems. Recurrent waves of disease brought the health systems to the limit of their resilience. Purpose(s): The Tele-Covid telemedicine care program was installed in December 2020 to monitor high-risk patients in home isolation. Close monitoring allows early detection of disease deterioration and timely intensification of therapy, ideally avoiding intensive care. Conversely, if the course of the disease is stable, unnecessary hospitalisation can be avoided, thus reducing the burden on the healthcare system. Method(s): Patient acquisition was performed in collaboration with the local public health service and primary care physicians. Covid-19 positive highrisk patients (age >65 years and/or severe comorbidities) from the greater Innsbruck area were fitted with an ear sensor-based home monitoring system. The ear sensor measures SpO2, respiratory rate, body temperature and heart rate. The monitoring team (25 medical students supervised by 6 physicians) provided continuous monitoring of vital signs (24/7). After validation of the measurements, the collected parameters were evaluated using a specially developed risk score. If a defined risk score was exceeded, the patient was contacted by telephone. The combination of the clinical condition and the risk score determined the further course of action: (a) wait and see, (b) notify the primary care physician, or (c) refer for inpatient admission. The program was active from December 2020 to March 2022. In Summer 2021, the program was temporarily paused due to the epidemiological situation. Result(s): A total of 132 patients (59.8% women) were monitored. The median age was 74 years (IQR: [67.3-80.8]). 91 patients (68.9%) had at least one relevant comorbidity. During the monitoring period, hospitalisation was required in 20 patients (15.2%), 3 of whom were transferred to the intensive care unit. Of the hospitalised patients, 3 (15%) patients died. During the same monitoring period, the Austrian Ministry of Health reported a mortality rate of 20.5% of all hospitalised patients in Austria aged 70-79 years. Subjectively, the patients felt safe due to close monitoring. Conclusion(s): The Tele-Covid program is the successful implementation of a remote monitoring system in a pandemic situation. In the future, a broad application of the program is feasible.
ABSTRACT
Background: The fight against fake news, mainly spread through Internet, is a major public health issue, even among undergraduate students. This study aims to evaluate the effectiveness of a website promoted by the Italian Federation of the Provincial Orders of the Medical Doctors as a first aid communication kit for health topics. Study design: Pre-post study using a web-based survey, conducted in April-May 2019 on Medical students and October-November 2020 on Communication Sciences students at the University of Florence (Italy). Methods: Undergraduate students of both schools were exposed to the use of the "dottoremaeveroche" website. Primary and secondary outcomes measures: the Italian-electronic Health Literacy Scale self-assessment tool was used to examine subjects' electronic Health literacy, and source quality. All responses were rated on a 5-point Likert scale. Changing in perception of abilities were examined using the Wilcoxon test. Results: The 362 participants felt moderately confident in electronic Health Literacy, with an initial Italian-electronic Health Literacy Scale overall mean score of 3.6±0.7 for medical and 3.2±0.8 for communication students. Medical students had a good idea of how to find helpful sources (3.9±0.8) and communication students felt confident in recognizing their quality (3.5±1.0). In contrast, their confidence in using Web information to make health decisions was low (medical: 2.9±1.1; communication: 2.8±1.1). All items improved significantly after "dottoremaeveroche" use (p<.001), with the overall mean score of Italian-electronic Health Literacy Scale increasing to 4.3±0.6 for medical and 4.1±0.8 for communication students. Conclusions: Low electronic health literacy levels can affect public health efforts, as seen during the COVID- 19 pandemic. The effectiveness of "dottoremaeveroche" among students showed the usefulness of online educational interventions that, if further implemented, could help combat the spread of infodemic.
ABSTRACT
Background: For almost two years, the Covid-19 pandemic has posed an enormous challenge to healthcare systems. Recurrent waves of disease brought the health systems to the limit of their resilience. Purpose: The Tele-Covid telemedicine care program was installed in December 2020 to monitor high-risk patients in home isolation. Close monitoring allows early detection of disease deterioration and timely intensification of therapy, ideally avoiding intensive care. Conversely, if the course of the disease is stable, unnecessary hospitalisation can be avoided, thus reducing the burden on the healthcare system. Methods: Patient acquisition was performed in collaboration with the local public health service and primary care physicians. Covid-19 positive high-risk patients (age >65 years and/or severe comorbidities) from the greater Innsbruck area were fitted with an ear sensor-based home monitoring system. The ear sensor measures SpO2, respiratory rate, body temperature and heart rate. The monitoring team (25 medical students supervised by 6 physicians) provided continuous monitoring of vital signs (24/7).After validation of the measurements, the collected parameters were evaluated using a specially developed risk score. If a defined risk score was exceeded, the patient was contacted by telephone. The combination of the clinical condition and the risk score determined the further course of action: (a) wait and see, (b) notify the primary care physician, or (c) refer for inpatient admission.The program was active from December 2020 to March 2022. In Summer 2021, the program was temporarily paused due to the epidemiological situation. Results: A total of 132 patients (59.8% women) were monitored. The median age was 74 years (IQR: [67.3–80.8]). 91 patients (68.9%) had at least one relevant comorbidity. During the monitoring period, hospitalisation was required in 20 patients (15.2%), 3 of whom were transferred to the intensive care unit. Of the hospitalised patients, 3 (15%) patients died. During the same monitoring period, the Austrian Ministry of Health reported a mortality rate of 20.5% of all hospitalised patients in Austria aged 70–79 years. Subjectively, the patients felt safe due to close monitoring. Conclusion: The Tele-Covid program is the successful implementation of a remote monitoring system in a pandemic situation. In the future, a broad application of the program is feasible. Funding Acknowledgement: Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Funded by the Region of the Tyrol
ABSTRACT
Background The COVID-19 infodemic is putting pressure on public health systems to control the pandemic. With the internet and social media playing a key role in emergency communication, digital health literacy (DHL) can be considered a determinant of health. This study aims to assess the impact of infodemic on the skills of medical students, for whom low levels of DHL may affect the ability to identify the best available medical evidence. Methods A cross-sectional web-based survey was conducted at the University of Florence (Italy) in Apr-May 2019 (pre-pandemic period) and in Nov-Dec 2020 (pandemic period) to investigate DHL skills. Two different cohorts of students, both in their first year of medical school, participated in the survey. The 8-item self-assessment tool (IT-eHEALS) with a 5-point Likert scale was used to examine DHL. The change in perception of ability between the two cohorts was examined using the Wilcoxon test. Results A total of 329 students participated in the survey in 2019 (F: 58.1%;mean age 20.6±2.1) and 341 in 2020 (F:61.9%;mean age 19.8±2.0). In 2019, participants’ DHL level was moderate with a IT-eHEALS overall mean score (MS) of 28.4±5.8. Students had a good idea of how to find helpful health information (MS 3.9±0.8) and how to use the web for this purpose (MS 3.8±0.9), but they were less confident about the usefulness of the information they received (MS 2.9±1.1). In 2020, the medical students’ DHL level deteriorated as the overall MS of IT-eHEALS decreased to 23.4±7.2 (p < 0.01). The scores of the IT-eHEALS items were significantly lower and students indicated that they found it difficult to assess the information they found (MS 2.4±1.1;p < 0.01). Conclusions DHL can contrast infodemic, but the latter in turn may have a negative impact on perceived DHL skills if personal knowledge base is not well structured. Training programmes for medical students as future health care providers should be reinforces to guide their practise. Key messages Assessing digital health literacy is the first step in directing public efforts towards empowering educational programmes to improve health literacy. Medical students, as future health professionals, should be able to use the best evidence to help their patients identify healthy beliefs and behaviours to manage in health emergencies.
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Background Violence against healthcare workers (HCWs) has gained increasing attention in recent years, both because it is on the rise and because there is growing concern about these incidents, which are classified as sentinel events by the Italian Ministry of Health. Since little is known about the actual burden of this phenomenon, especially during the stressful COVID-19 vaccination campaign, we decided to explore the problem in our region. Methods Between January and March 2022, in the 1.2 million-inhabitant Friuli Venezia Giulia region (Italy), we conducted an anonymous online survey to collected data on episodes of violence and their consequences for HCWs. Data from validated tools assessing characteristics of violent episodes and post-trauma impact were analyzed in conjunction with socio-demographic data of respondents. Results 200 HCWs participated in the survey, most of whom were women (72%), worked as nurses (107) or doctors (71), and had a mean age of 47 years. More than half of them (59%) reported at least one episode of violence, mainly in the form of a verbal assault (64%);there were no differences between victims. In 72 cases, these incidents affected the HCW’s private life, mainly disturbing sleep or concentration (68%). Most HCWs stated that inadequate communication was a trigger for the violence (97%). Although 80% of HCWs would readily report any violent incident, to improve the situation they called for certainty of action against the perpetrator (87%), more organizational support (85%), standard procedures (75%) and self-defense courses (75%). Conclusions Violence in COVID-19 vaccination campaign appears to be common and to affect both the personal and professional lives of HCWs. Improvements at the institutional and personal level could help to address this problem that affects the health workforce. Key messages • Given the growing public debate, violence in healthcare settings is an important issue that needs to be addressed in the coming years. • Assessing workplace violence and its associated risk factors will help focus on the strategies that can be usefully employed to prevent it in the future.
ABSTRACT
Background The struggle against fake medical news, nowadays widely spread by web sources, is a main issue in public health especially in a pandemic period. Even among medical students, there is a lack of eHealth literacy (eHL) skills to solve medical problems. The Italian Medical Doctors Federation (FNOMCeO) promoted a Web source as a first-aid communication kit for basic notions in health hot-topics named “dottoremaeveroche” (DMVEC). This study aims to evaluate its effectiveness in improving eHL. Methods Between April and November 2019, medical students from the University of Firenze (Italy) joined a cross-sectional web-based survey before and after accessing the DMVEC Web source. The 8-item self-assessment tool (IT-eHEALS) was used to examine subject's eHL, in addition to questions on source's features and its quality. All responses were rated on a 5-points Likert scale. Changing of abilities' perception was assessed using Wilcoxon test. Results A total of 329 joined the survey, 42% male, mean age of 20.6±2.1. Participants felt moderately confident in eHL, in fact the initial eHEALS overall mean score was 3.6± 0.7. Students had a good perception on how to find helpful health resources (mean score 3.9±0.8) and how to use the Internet to answer health questions (mean score 3.8±0.9), but their ability in using this information to make health decisions was low (mean score 2.9±1.1). All items improved after the use of DMVEC, with overall mean score of IT-eHEALS increasing to 4.3±0.6 (p < 0.0001). Regarding source's quality, mean score related to transparency of sources, an aspect underestimated at first, increased from 3.5±1.2 to 4.7±0.7 (p < 0.0001). Conclusions Low levels of eHL can damage public health efforts, as seen during COVID19 pandemic. DMVEC effectiveness in medical students demonstrated that the scaling up to the general population of online educational interventions, with further implementation, could help in tackling infodemic and fake news spreading. Key messages Moderate levels of eHL among medical students could reflect lower levels in general population, highlighting this as critical issue in public health. Educational programs addressed to Health professionals could be adapted and empowered considering general population as target.
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Introduction: Multi Drug Resistant microorganisms (MDR) have been a serious issue for public health for more than fifty years. Carbapenem resistant Klebsiella pneumoniae (KPC) is a highly lethal bacteria, with a mortality rate in order of 40% worldwide. Objectives: In this study we examined data collected from the MDR surveillance team to understand how this life-threating infection impacted during COVID-19 pandemic. Methods: A retrospective observational study was conducted at the about 950 beds Academic Hospital of Udine, Northeast of Italy. Data about new cases of KPC occurred from 2016 to 2021 were collected from internal datasets. Considering bed occupation, we calculated weekly incidence rate of KPC cases. Using Chi-square test, cumulative incidence rates before and after the 10th of October 2020, considered as the start of the 2nd COVID-19 wave in our hospital, were compared. Results: During the observation period, 255 new KPC cases were reported on a total of 1,235,177 days of hospitalization. Cumulative and mean incidence rates on the overall observation period resulted 2.064 and 2.075 new KPC cases per 10,000 hospitalization days, respectively. Cumulative incidence rate were calculated in 1.287 before and 7.467 after the second COVID-19 wave, being the two statistically different (p < 0.001, CI 95%). Conclusion: We observed a worrying rise of KPC infection incidence since the 2nd COVID-19 wave began, suggesting an increased KPC outbreaks risk during pandemic. This observation could be explained by a reduced effectiveness of personal protective equipment wore by healthcare workers or its unsuccessfulness in preventing cross infections within COVID units. Even during a pandemic, contact precautions should not be overlooked in healthcare settings and there is an urgent need to reinforce professionals' attention against the spread of MDR to prevent their rise. (Figure Presented).
ABSTRACT
Background The excessive amount of information (infodemic) about SARS-COV2 is a global challenge for healthcare authorities in tackling misinformation. Aim of the study was to investigate SARS-COV2 global and Italian web search amount made through a reliable information source during 2019-20 SARS-COV2 epidemic. Methods From December 15th, 2019 to February 23rd, 2020, we used Google Trends to analyze global changes in the volume of searches about “Coronavirus” in relation to reliable sources: “World Health Organization”, “WHO” and the Italian equivalents of “Ministry of Health” and “National Institute of Health”. Primary searches and associated queries (AQs) were analyzed by nation and Italian Region. Results Global interest on “Coronavirus” progressively rose from mid-January, with 2 peaks on days 28th and 31st, fell on February 20th and rose again until day 23rd. “WHO” searches fluctuated with no clear pattern but increased on January 26th and February 3rd. 'WHO' term was among the most frequent “Coronavirus” AQs and viceversa. Singapore, Italy and New Zealand were the most interested nations in “Coronavirus”, while China was at first place in “Coronavirus+WHO” searches. In Italy from January 21st interest in “Coronavirus” gradually increased, with peaks on days 28th and 31st and a higher peak on February 21st. The other terms showed a fluctuating trend, with peaks on January 31st for “WHO” and “Ministry of Health” and on February 21st for all of them. “Coronavirus” was most frequently AQ to “Italy” and “China”, while AQs for the other terms were “Coronavirus” and “WHO official website”. The most interested Italian Regions for “Coronavirus” and “Coronavirus+WHO” were Lazio and Friuli Venezia-Giulia, respectively. Conclusions Interest in SARS-COV2 globally increased during the considered period, especially within most affected areas. The associations between terms thus highlighted seems to confirm that the general population relies on trustworthy information sources. Key messages Infodemic can be at the same time a danger and an opportunity during global and local health emergencies. Health systems should take advantage of current search flow in order to foster reliable information sharing.