ABSTRACT
Background A healthy diet plays a major role in supporting the immune system which is critical to protect the host from pathogenic organisms. To date, evidence on the relationship between dietary habits and the risk of SARS-CoV-2 infection is still scarce. Methods Analyses on 1,096 participants from the Moli-sani Study (2005-2010) who were re-examined in 2017-2020, and in January-September 2021. Food intake was assessed in 2017-2020 using a 188-item FFQ. Adherence to Mediterranean diet (MD) was evaluated using the Mediterranean Diet Score (MDS) ranging from 0 to 9. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for incident SARS-CoV-2 infection in association with dietary factors. Results Out of 1,096 participants, 90 either reported to have tested positive for COVID-19 or were positive for anti-SARS-CoV-2 antibodies before receiving any COVID-19 vaccine. In a multivariable-adjusted model controlled for known risk factors, a 1-point increase in MDS was associated, though not significantly, with lower risk of SARS-CoV-2 infection (OR = 0.90;95%CI 0.78-1.04). Among individual dietary components, a high consumption of vegetables or fruits and nuts was associated with lower odds of SARS-CoV-2 infection (OR = 0.57;0.34-0.96 and OR = 0.61;0.37-1.00, respectively). High fish intake was otherwise linked to increased risk of infection (OR = 2.05;1.25-3.36). Nutritional factors associated with reduced risk of infection were dietary fibre (OR = 0.50;0.27-0.93 for 10 g/d increase), vegetable proteins (OR = 0.56;0.33-0.94 for 10 g/d increase) and vitamin C (OR = 0.94;0.89-0.99 for 10 g/d increase). Conclusions Adherence to MD was suggestive of a lower risk of SARS-CoV-2 infection. In particular, large amounts of fruit and vegetables were associated with reduced odds of being infected, as well as diets rich in fibre, vegetable proteins and Vitamin C. Key messages Diets rich in vegetables, fruits, Vitamin C and fibre were independently associated with lower risk of SARS-CoV-2 infection. Nutrition could represent an effective strategy at the population level to contribute to the protection against SARS-CoV-2 infection.
ABSTRACT
The current COVID-19 pandemic has accelerated the use of digital technologies, in all sectors and in particular in healthcare. In this scenario, in fact, telemedicine systems have been adopted to remotely monitor and manage infected patients or patients subjected to quarantine regulations. In Tuscany region, Italy, SatNav E@syCare, a telemonitoring platform resulted from the integration of E@syCare, designed for chronic patients, and satellite technologies, has been experimented, receiving positive feedback both from doctors and patients. Such a system could be used also in long-term care, for monitoring chronic patients, providing characterisation and customisation of medical devices according to the patients’ chronic conditions and implementing an expert system, which generates personalised monitoring and treatment plans, to support physicians at the moment of enrolment. The pandemic experience could then be a lesson learnt promoting the adoption of smart telemedicine platforms for the care of chronic patients. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
The hypothesis that State boredom (SB) - the experience of boredom in the moment - can be considered as one of the risk factors for engaging in addictive behaviors has been further supported by the studies conducted during the COVID-19 related lockdown. Moreover, the issue of gender-related differences and similarities in SB is in debate. However, to deeply assess SB, it is fundamental having sound measurement instruments. One of the mostly used and brief instruments employed internationally to assess SB is the Short Form of the Multidimensional State Boredom Scale (MSBS-SF), but evidence regarding its psychometric properties among young adults, who are particularly at-risk for the development of behavioral addictions, is lacking. In particular, the functioning of the scale across genders is unknown in this age group. As a result, we used item response theory (IRT) to investigate psychometric functioning, with a specific focus on gender invariance, of the MSBS-SF among young adults. Eight hundred and twenty five Italian young adults (73% female;Mage = 25.61, SD = 4.53) were recruited. A confirmatory factor analysis demonstrated the unidimensionality of the scale, and IRT analyses indicated that the scale was sufficiently informative. Differential item functioning (DIF) across genders showed that items had an equivalent functioning across male and female respondents. Additionally, significant and positive relationships with hypersexual behavior were found. Overall, this study offers evidence that the MSBS-SF is a valuable and useful scale for measuring SB among male and female young adults.
ABSTRACT
Telemedicine is becoming increasingly important in recent years, especially in chronic diseases treatment. Thanks to these platforms, it is possible to assist patients remotely, being continuously monitored according to personalized care plans as if they were at the hospital. The characteristics of telemedicine platforms resulted extremely useful when Covid-19 pandemic broke out. Intense monitoring of patients at home, social distancing, and resource rationalization provided great help to medical personnel and healthcare systems. This novel disease, however, has posed new challenges, given by the quicker evolution of a patient's clinical status with respect to chronic diseases. In particular, the updates of the care plan performed remotely by doctors need to be immediately delivered to monitoring kits located at the patient's home, in order to adjust the monitoring plan of the target patient. Since this update is a critical operation, acknowledgment strategies are required to guarantee feedbacks upon delivery. Immediate updates can be achieved via a push notification system. In this paper, we present a push notification system based on HiveMQ Community Edition message broker, that provides end-to-end positive (ACK) and negative (NACK) acknowledgments, strict authentication, and authorization of users and messages, security, data consistency, and privacy. The realized system has been integrated and tested in the E@syCare telemedicine platform certified as a medical device, but it can be easily adopted by any other telemedicine solutions, as long as they can perform web service requests to the authentication server and integrate HiveMQ client library in their software components. © 2022 IEEE.
ABSTRACT
In the framework of the Covid-19 pandemic, digital technology has played a key role in the healthcare sector, becoming essential for improving the quality of care and well-being of individuals and populations. In this scenario, telemedicine platforms have enabled remote monitoring, reducing the contacts between patients and doctors and automating health processes. In this paper, we present the experience of SatNav E@syCare, a telemedicine platform enhanced with new functionalities to respond to the outbreak. In particular, Global Navigation Satellite System technology has been added to the system to geo-tag vital parameters, together with the possibility of digitizing examinations (e.g., lung ultrasound), planning access to the territory, automatically managing patient visits and monitoring patient physical activity. The system has been used by general practitioners and doctors of continuity care in different ways according to the phase of the pandemic and the adopted model of care (patient self-measurements vs home visits). More than 2000 patients of all ages have been monitored with SatNav E@syCare. Among the doctors involved in the project, more than 90% are using the system for at least one hour per day, leading to a reduction of time spent to manage patients. Moreover, the system has simplified their daily work, thanks to the digitization of information and sharing of data with colleagues. In their opinion, in a non-pandemic future, the use of the system will introduce benefits both for patients and healthcare professionals in the monitoring of chronic conditions on the territory. © 2022 IEEE.
ABSTRACT
Telemedicine platforms have been largely used to manage multiple problems during the Covid-19 pandemic. In fact, they have given the possibility of remotely monitoring infected and high-risk patients, reducing hospitalisations. Telemonitoring systems with Global Navigation Satellite System technology allow to geo-localise all patients' measurements and enable the tracking of positions. These data can be used for contact tracing or to support doctors in epidemiological analysis. This paper presents the integration of satellite technologies in an existing telemedicine system (E@syCare), during the current outbreak. In particular, the platform has been enhanced with GPS, to geo-tag all vital parameters collected by the tablet gateway and the smartwatch. Geographical data are processed, after a request through the improved web-based medical interface based on some filters (e.g., vital parameters and their thresholds, considered period of time, and maximum cluster radius), with two sequential clustering algorithms. Agglomerative Clustering is used to find the optimal number of clusters given a maximum radius, and K-Means to effectively generate the predefined number of clusters. Resulting clusters are shown on an interactive epidemiological map in the webbased medical interface. This additional feature gives the possibility to healthcare authorities to correlate the spread of a disease or a virus with specific geographical areas or environmental conditions, to monitor fitness/movement habits of patients (also when the pandemic is over), and to track contact among patients. ©2021 IEEE.
ABSTRACT
Objective: To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March-3 May 2020). Design: Retrospective observational study. Setting: Italy. Participants: We analysed 2992 subjects (mean age 57.9 +or- 15.3 years, 40.4% men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325;2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms. UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement.
ABSTRACT
The current Covid-19 pandemic has limited direct contacts among people, since the virus is usually widespread by the drops of saliva. Then, this world outbreak has brought the need to track patients' positions, especially to verify the respect of quarantine regulations for infected people and for their strict contacts. Moreover, the conditions of elderly and high risk patients should be continuously monitored, minimising, at the same time, the exposure of general practitioners. Among the several solutions available on the market, telemedicine seems to be an optimal support for remote monitoring, limiting the contacts between doctors and patients, and fast reaction to worsening of clinical conditions. Telemedicine platforms can also integrate Global Navigation Satellite System technology embedded in wrist devices, to add new functionalities, useful even when the pandemic is over. In this paper, we present the smartwatch integration in the already consolidated E@syCare telemedicine platform, with the aim of tracking patients' positions and monitoring outdoor and indoor fitness sessions. The smartwatch, equipped with WearOS, should have GPS receiver, heart rate sensor and accelerometer and the developed application installed. It randomly collects positions, for patients subjected to quarantine regulations, generating an alarm in case of violation. From the GUI, the user can start fitness sessions, independently or according to the care plan. Positions and fitness sessions are downloaded by the handheld device, and become available for further analysis by the doctors. Nowadays, the platform has been already delivered to 60 patients with the support of European Space Agency (ESA). © 2021 IEEE.