Personalized Integrated Care for Frail Seniors Within the Pharaon Project: The Italian Pilot Site

Technology plays an important role into the life of older people. With the increase of age, they are experiencing physical and cognitive frailties and they require assistance for the management of their daily activities. In this sense, digital technologies could offer a holistic ecosystem which could empower their daily life 24 h decreasing the caregiver burden. Multi-domains researchers are joining their efforts to propose a selection of services. In this context, this paper introduces the large scale pilot Pharaon project, pointing out the attention on the Italian pilot site. Within the Italian pilot, a personalized and integrated care service was and will be investigated in the forthcoming years to meet the challenge of older population. Particularly, the paper introduces the methodology and the actions performed to face the covid-19 pandemic which affect the first stage of the process, the service domains, and the methodology applied. Additionally, the paper presents and discusses the key performance indicators related to impact, business, social and clinical domains and how the technology is used within the Italian pilot to support the population during the pandemic emergency. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The Relationship between Gender Role, Job Role, and Risk and Protective Factors for Posttraumatic Stress Symptomatology among Healthcare Workers during the First Wave of COVID-19

Background: The emotional experiences of healthcare workers during the first wave of COVID-19 warrant further investigation especially regarding gender differences. The purpose of this study was to determine the relationship between gender role, job role and risk and protective factors for the development of Post Traumatic Stress Disorder (PTSD). Methods: A total of 521 healthcare workers completed the survey during the first pandemic wave. Psychosocial Index (PSI) was used to assess stress, well-being, distress, illness behaviour, and quality of life;the distress caused by stressful events was evaluated with the Impact of Event Scale – Revised (IES-R) and resilience was measured with the Connor-Davidson resilience scale (CD RISC). Results: Associations were found between female gender and distress with and without sleep disturbance (p<0.0001). Assessment of PTSD symptoms showed significance on symptoms of avoidance (p=0.0006), intrusiveness of thought (p=0.0016), and hyperarousal (p=0.003) to the disadvantage of female compared to male. Nurses emerged as the most vulnerable professional role about distress (p<0.0001), sleep disturbance (p<0.0001), and abnormal illness behaviors (p<0.0001). Finally, the study of post-traumatic symptomatology showed significance for avoidance (p=0.0072), intrusive thinking (p=0.0071), and hyperarousal (p=0.0019) to the disadvantage of the medical and nursing role in the female gender compared to the medical and nursing role in the male gender and other professional role in the female gender. Conclusions: Such findings suggest, there are differences in gender, rather than professional role and resilience factor, in emotional management in a particularly stressful condition, such as that of the first pandemic wave © 2022. by the Author(s);licensee Mediterranean Journal of Clinical Psychology, Messina, Italy. This article is an open access article, licensed under a Creative Commons Attribution 4.0 Unported License

Changes in Emergency Department Visits for Opioid-Related Diagnosis, Opioid Overdose and Buprenorphine Use Across 14 US Emergency Departments During the SARS-CoV-2 Pandemic

Study Objectives: To identify changes in emergency department (ED) visits for opioid-related diagnoses, opioid overdose, and the use of buprenorphine in EDs during the SARS-CoV-2 pandemic. Methods: Electronic health data was collected from 14 geographically distinct emergency departments for ED visits between August 31, 2019 and August 30, 2020. Variables collected include age, sex, race, ICD-10 discharge codes, buprenorphine administrations, buprenorphine prescriptions and SARS-CoV-2 hospital admission rate. The category of opioid-related diagnoses included ED visits with ICD-10 codes for opioid use disorder, opioid dependence, opioid withdrawal, opioid overdose and/or opioid-related infection. Opioid-related infection visits were tabulated as ED visits with ICD-10 code for abscess, cellulitis, endocarditis or osteomyelitis and concurrent ICD-10 code of opioid-related diagnosis for the current ED visit or in the medical history. We used descriptive statistics and paired t-test to evaluate for differences in ED visits for opioid-related diagnoses, opioid overdose and rate of buprenorphine administrations and/or prescriptions between in visit with opioid-related diagnosis between August 31, 2019-February 29, 2020 and March 1, 2020-August 30, 2020. Spearman correlation was used to assess the association of outcomes with hospital SARS-CoV-2 burden from January 1, 2020 through August 30, 2020. Results: We collected information on a total of 911,738 ED visits between August 31, 2019- August 30, 2020 from 14 EDs Total ED visits with opioid-related diagnoses by ICD-10 code were 9,788, including 3,198 for opioid overdose, 1,745 for opioid withdrawal, and 431 for opioid-related infection (Figure 1). Between August 31, 2019-February 29, 2020 and March 1, 2020-August 30, 2020 (N = 13 sites), there was an increase in ED visits for OUD-related visits per 10,000 visits (130.8 (SE: 24.2) vs 101.8 (SE: 21.8);p=0.002) and an increase in ED visits for opioid overdose per 10,000 ED visits (40.8 (SE: 10.3) vs 27.4 (SE: 6.1);p=0.02). No change was detected in the rate of buprenorphine administration and/or prescriptions: 25.8 (SE: 5.3) vs 25.1 (5.5);p=0.80. From January to August 2020, significant correlations were observed between inpatient hospital SARS-CoV-2 rates and ED visits with a positive correlation between opioid-related diagnoses per 10,000 (Spearman r=0.92, p= <0.0001) and opioid overdose per 10,000 visits (r=0.90, p=<0.0001);a negative correlation was found for the rate of ED administration and/or prescription of buprenorphine (r=-0.37, p=0.03). Conclusions: ED visits for opioid-related diagnoses and opioid overdose per 10,000 ED visits increased in EDs between March 1, 2020 – August 30, 2020 compared to the preceding 6 months and correlated with inpatient SARS-CoV-2 burden. Although the overall rate of buprenorphine administered and/or prescribed from the ED highlights a significant practice change in EDs over recent years, buprenorphine provision in EDs did not increase despite likely treatment service disruptions during this period of SARS-CoV-2. [Formula presented]