ABSTRACT
Remote working is increasingly seen as an effective model in several countries in the last decade, mainly thanks to the development of information and communication technologies in support of common daily working tasks. The emergence of the COVID-19 pandemic has represented a pivotal moment for the adoption of remote working in multiple sectors, with positive effects on the environmental impacts caused by the daily commuting of workers. However, due to the fact that pandemic-induced remote working has represented a major forced experiment on a global scale, and that it has often been imposed rather than chosen by employees, workers' well-being has not always been ensured. This research work presents an analysis of a wide survey of remote workers in public administrations in four different provinces in Italy, with the aim of assessing the main characteristics of the users and the related environmental benefits. Survey data refer to remote workers before COVID-19, thus representing workers who have freely chosen to work from home for different reasons. The results of this work represent a useful tool with which to support the definition of new remote work strategies that could help policy makers reduce a part of the systematic mobility demand. We have also calculated average energy and emission savings to provide useful indicators for a preliminary estimation of the potential environmental benefits of remote working. Considering the entire sample of respondents, workers who would have commuted at least partially by car have saved on average 6 kg of CO2 per day thanks to remote working (with an average round-trip commuting distance of approximately 35 km). The current results will be supplemented by the results of a new survey underway, aimed at evaluating the differences of remote working experiences during the emergency response to COVID-19. © 2023 by the authors.
ABSTRACT
Background and Aims: The effect of the COVID pandemic on stroke networks performance are unclear, particularly with consideration of drip & ship versus mothership models. We systematically reviewed and metaanalyzed variations in stroke admissions, rate and timing of reperfusion treatments during the COVID pandemic versus the prepandemic timeframe. Methods: The systematic review followed registered protocol (PROSPERO-CRD42020211535), PRISMA and MOOSE guidelines. We searched MEDLINE, EMBASE and Cochrane CENTRAL until 9/10/ 2020, for studies reporting variations in ischemic stroke admissions, treatment rates and timing in COVID vs control-period. Primary outcome was the weekly admission incidence rate ratio (IRR=admissions during COVID-period/admissions during control-period). Secondary outcomes were (i) changes in rate of patients undergoing reperfusion treatment and (ii) time metrics for pre-and in-hospital phase. Results: Twenty-nine studies were included in qualitative synthesis, with 212960 patients observed for 532 cumulative weeks (325 control-period, 207 COVID-period). COVID-period was associated with a significant reduction in stroke admission rates (IRR=0.69, 95%CI, 0.61-0.79) and a higher relative presentation with large vessel occlusion stroke (RR=1.62, 95%CI, 1.24-2.12). Proportions of patients treated with intravenous thrombolysis remained unchanged, while endovascular treatment increased (RR=1.14, 95%CI, 1.02-1.28). Onset-to-door time was longer for drip&ship compared to mothership model (+32 minutes vs-12 minutes, pmeta-regression =.03). Conclusions: Despite a 35% drop in stroke admissions during the pandemic, proportions of patients receiving reperfusion and time-metrics were not inferior to control-period, justifying allocation of resources to keep stroke networks up and running.
ABSTRACT
The current pandemic was immediately characterized as an "extra-ordinary" (out of the ordinary) emergency in which everyone, in their own way, tried to find and bring out their own available resources. In this state of emergency, technology has assumed considerable importance: the only one capable of reducing, in every context and situation, the enormous distances unpredictably imposed. The total lockdown of the nation has contributed, in fact, to highlight the importance of technological support in reaching people. Starting from this reflection, Psicologi per i Popoli - Trentino ODV put forward the proposal to integrate technology into the daily working life of the emergency psychologist, starting from the idea that this can be a fundamental support in a time when there is no possibility of proximity and its important implications in the therapeutic relationship. "The virtual channel, although often limiting as it lacks some communicative dimensions and body language, is the one that today allows us to continue to promote the dimension of care, speech, relationship and prevent the worsening of pre-existing psychopathological situations, so how to provide an initial response and support to those who feel the need" (Di Giuseppe and Lauro, 2020).This contribution wants to share our experience of Psicologi per i Popoli Trentino ODV, with the population, in this sense. Our work was inside a remote psychological help and support service, called Vicini anche se lontani, inserted in the #Resta a casa, passo io service, activated by the Health and Social Policies Department of the Autonomous Province of Trento, in Italy, in collaboration with the Civil Protection. The Covid-19 epidemic represented the first experience of remote psychological intervention mediated by means of communication (telephone, smartphone, e-mail, instant messaging, videoconferencing platforms. etc.), thus opening new horizons and new operating methods.
ABSTRACT
BACKGROUND AND PURPOSE: Comorbidity of acute ischaemic stroke with Covid-19 is a challenging condition, potentially influencing the decision of whether to administer intravenous thrombolysis (IVT). We aimed to assess the 1-month outcome in ischaemic stroke patients with Covid-19 infection who received IVT alone or before thrombectomy (bridging therapy). METHODS: As a collaboration initiative promoted by the Italian Stroke Organization, all Italian stroke units (n = 190) were contacted and invited to participate in data collection on stroke patients with Covid-19 who received IVT. RESULTS: Seventy-five invited centers agreed to participate. Thirty patients received IVT alone and 17 received bridging therapy between 21 February 2020 and 30 April 2020 in 20 centers (n = 18, Northern Italy; n = 2, Central Italy). At 1 month, 14 (30.4%) patients died and 20 (62.5%) survivors had a modified Rankin Scale (mRS) score of 3 to 5. At 24 to 36 hours, asymptomatic intracerebral hemorrhage (ICH) was reported in eight (17.4%) patients and symptomatic ICH (sICH) in two (4.3%) patients. Causes of death were severe ischaemic stroke (n = 8), a new ischaemic stroke (n = 2), acute respiratory failure (n = 1), acute renal failure (n = 1), acute myocardial infarction (n = 1), and endocarditis (n = 1). In survivors with a 1-month mRS score of 3 to 5, baseline glucose level was higher, whereas endovascular procedure time in cases of bridging therapy was longer. Baseline National Institutes of Health Stroke Scale glucose and creatinine levels were higher in patients who died. CONCLUSIONS: Intravenous thrombolysis for patients with stroke and Covid-19 was not a rare event in the most affected areas by pandemic, and rates of 1-month unfavorable outcomes were high compared to previous data from the pre-Covid-19 literature. However, risk of sICH was not increased.