Telemedicine as technoinnovation to tackle COVID-19: A bibliometric analysis

Telemedicine has become fundamental for the challenges posed to healthcare. This set of instruments turns pivotal for facing one of the most relevant emergencies in human history: the COVID-19 pandemic. The multisectoral crisis led to a vigorously sustained adoption of innovations, including telemedicine technology. Telehealth was proven, in this context, to be a relevant tool to reduce healthcare costs, reduce not-needed hospitalizations, and improve the results in health care. Some barriers such as the costs of technologies, patient privacy and technical literacy have slowed down telemedicine adoption. Amidst the COVID-19 era, telemedicine calls for a managerial duty to change healthcare's organizational models. The present work aims to explore the growing literature to illuminate the relationships between telemedicine, innovations and healthcare in the COVID-19 framework. A bibliometric analysis of the existing literature based on 285 published works in 2019–2020 is put forward with the aim to detect the relevant literature, themes and approaches on telemedicine and COVID-19. Making use of community detection on the co-occurrence keywords network, we identify the "semantic cores” in the literature representing the relevant results on critical themes. The sorting implications are important for researchers and policymakers by mapping the existing literature and results in evidence-based analysis. We provide the key communities as the "semantic core” of the publications and results for the considered period. This allows for future research to be oriented towards perduring health policies that could lead to the adoption of telemedicine technologies in a post-pandemic scenario. © 2021

Effects of the COVID-19 outbreak on the use and perceptions of metropolitan agricultural parks - evidence from Milan and Naples of urban and environmental resilience

This article describes the multi-function of the metropolitan agricultural parks (MAPs) in Milan (Parco Agricolo Sud Milano) and Naples (Parco De Filippo) and their resilience within the last COVID-19 lockdown period. These parks play an important role in the urban regeneration and social inclusion processes in their relative metropolitan areas. Nevertheless, the restrictions imposed to limit COVID-19 contagions have imposed their closure or severely limited their activities, with evident consequences for the local population's well-being. This study's novelty is twofold: it is the first study examining the resilience and sustainability impact of MAPs during COVID-19;additionally, it is the first survey making use of Milan and Naples practices. The work uses primary and secondary data and mixed methods. Exploiting a document analysis and the elaboration of a semi-structured interview with the directors, the article lists the multiple functions of the parks and underlines their multidimensional governance vocations for fostering sustainable development - environmental, economic and social functions. The study also reveals that, during the lockdown, the parks' activities were strongly reduced or restructured. Recreational and educational activities were lifted in Parco Agricolo Sud in Milan whilst local farms restructured their food supply and fostered their network and linkages with the urban distribution channels. MAP in Naples had to stop its activities and reorganize into a smart-working system. Lastly, our study found that economic and farm network activities were resumed with greater urgency in Milan, whereas in Naples the recovery of the social practices has taken on greater importance.

Early spontaneous pneumothorax, pneumomediastinum and pneumorrhachis in an adolescent with SARS-CoV-2 infection.

We report a case of spontaneous pneumomediastinum, pneumothorax, emphysema subcutaneous and pneumorrhachis, occurring in an adolescent resulting positive to SARS-CoV-2 nasopharyngeal swab. At the admission in Emergency Department, the child presented with left cervical and sternal pain, without respiratory symptoms. Radiological studies showed sizeable pneumomediastinum, bilateral apical pneumothorax, massive emphysema subcutaneous and pneumorrhachis. Patients' clinical conditions stood stable during the monitoring and he only needed conservative management. To our knowledge, this is the first description of spontaneous pneumomediastinum, pneumothorax, emphysema subcutaneous and pneumorrhachis, in a COVID-19 adolescent without concomitant pneumonia.

Telephone consultation during Coronavirus outbreak in a Pediatric Emergency Department: methodological approach of a tertiary care center in a COVID-19 hospital setting.

OBJECTIVE: A computerized system of telephone consultation has been experimented at the Pediatric Emergency Department (ED) of Policlinico Gemelli Hospital in Rome during the outbreak of Coronavirus Disease 2019 (COVID-19). MATERIALS AND METHODS: Twenty monothematic items with a series of questions to evaluate child's clinical conditions have been set up in order to evaluate the different situations according to their severity. All items were highlighted according to conventional scores corresponding to the different answers (yes/no) given by the child's parents. This system has been implemented with large diffusion of computer programs and applications by the availability of a computer station in every ED room. RESULTS: The system allows healthcare workers to establish the medical check-up urgency which may be immediate, within the next 24 hours or scheduled in the pediatric ward. Therefore, it has been implemented a telephone triage consultation with a standardized method. CONCLUSIONS: Telephone consultation during outbreaks, considering the risks of contagion, allows healthcare workers to decrease the concern of families and to reduce indiscriminate access to ED. The remote approach will not solve logistic and setting problems related to COVID-19 outbreak17, but it would be a valid tool to improve medical evaluation without deep change in infrastructure and clinical organization.