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1.
Front Public Health ; 10: 786662, 2022.
Article in English | MEDLINE | ID: covidwho-1775991

ABSTRACT

Objectives: To provide a new value-based immunization approach collating the available scientific evidence on the topic. Methods: Four value pillars (personal, allocative, technical, and societal) applied to vaccination field were investigated. A systematic literature review was performed querying three database from December 24th, 2010 to May 27th, 2020. It included studies on vaccine-preventable diseases (VPDs) that mentioned the term value in any part and which were conducted in advanced economies. An in-depth analysis was performed on studies addressing value as key element. Results: Overall, 107 studies were considered. Approximately half of the studies addressed value as a key element but in most of cases (83.3%) only a single pillar was assessed. Furthermore, the majority of papers addressed the technical value by looking only at classical methods for economic assessment of vaccinations whereas very few dealt with societal and allocative pillars. Conclusions: Estimating the vaccinations value is very complex, even though their usefulness is certain. The assessment of the whole value of vaccines and vaccinations is still limited to some domains and should encompass the wider impact on economic growth and societies.


Subject(s)
Cost-Benefit Analysis , Vaccination , Vaccines , Delivery of Health Care , Humans , Vaccination/economics , Vaccines/economics
2.
Dermatol Ther ; : e15460, 2022 Mar 20.
Article in English | MEDLINE | ID: covidwho-1752530

ABSTRACT

To avoid exposure to SARS-COV-2, healthcare professionals must use personal protective equipment (PPE). Their use has been related to a series of adverse effects; the most frequent adverse events were headache, dyspnoea, and pressure injuries. Skin adverse effects are very common, including contact dermatitis, itching, erythema, and acneiform eruptions. The objective of this study is to evaluate the skin problems caused by personal protection equipment (PPE) in health care workers (HCWs) and to individuate eventual risk factors. From May to June 2020 a retrospective observational multi-centric study conducted by an online survey sent by email, involving 10 hospital centers, was performed. We considered as independent variables gender and age, occupational group and sector, time of utilization, type and material of PPE. We tested 3 types of PPE: gloves, bonnet, and mask for different time of utilization (<1, 1-3, 3-6, >6 h). We performed a multiple logistic regression model to correlate them with skin adverse events occurrence. Among all the 1184 participants, 292 workers reported a dermatological pathology: 45 (15.41%) had psoriasis, 54 (18.49%) eczema, 38 (13.01%) acne, 48 (16.44%) seborrheic dermatitis, and 107 (36.64%) other. In our sample previous inflammatory dermatological conditions, female sex, prolonged use of PPE were significant risk factors for developing skin related adverse events considering all the PPE considered. The use of PPE is still mandatory in the hospital setting and skin adverse reactions still represent a global problem. Although data from Europe are limited, our study highlighted the importance of the problem of PPE skin reactions in a large sample of Italian healthcare professionals.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323374

ABSTRACT

Italy was the first European country to implement a national quarantine, with 71 days of total lockdown as a result of the COVID-19 outbreak. This study investigated the effects of the COVID-19 pandemic on the mental health and psychological well-being of a sample of Italian university students. A cross-sectional survey was conducted in the period immediately following the end of lockdown through the administration of a questionnaire on the personal websites of students attending their undergraduate courses at Università Cattolica del Sacro Cuore.The Patient Health Engagement Scale, the Self-Rating Anxiety Scale, and the Self-Rating Depression Scale were used to assess engagement, anxiety symptoms, and depression symptoms, respectively.The sample size was 501, of whom 35.33% were classified as anxious and 72.93% as depressed, although with a prevalence of mild symptoms. Over 90% of respondents reported understanding the preventive measures of the lockdown despite over 70% suffering from the impossibility of seeing their friends and partners. Over 55% of students would have been willing to contribute much more to facing the pandemic. An increase in the occurrences of anxiety was associated with being female, being students of the Rome campus (Central Italy), suffering from the impossibility of attending university, distance from colleagues, and the impossibility of seeing one’s partner. Performing physical activity reduced such a probability. Borderline risk factors for the occurrence of depression were being a student at the Rome campus and suffering from the distance to one’s fellow students.Funding Statement: No funding was received for this study.Declaration of Interests: All authors confirm that they have no conflicts of interest or competing interests.Ethics Approval Statement: The protocol of the study was approved by the Ethics Committee of the Policlinico Universitario A. Gemelli IRCCS and by the Internal Board of the University.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323373

ABSTRACT

Europe suffered greatly in the early stages of the COVID-19 pandemic. Italy was in the forefront, with its Lombardy region especially badly affected. However, European countries have been impacted to quite different degrees. We report Crude Mortality Rates (CMRs) and, in five countries supplying comparable age-specific data, Standardized Mortality Rates (SMRs) from deaths reported as due to COVID-19 in the European Union and United Kingdom. As of 21 st July 2020, Belgium was the country with the highest cumulative CMR (85.6/100,000), but Lombardy region was at almost double this value (167.0/100,000), while corresponding figure for the rest of Italy was 36.3/100,000. SMRs could be calculated for five countries (Italy, Portugal, Sweden, Germany and Netherlands). Among them, Sweden had the highest SMR (60.7/100,000). The corresponding figures for Italy, Netherlands, Portugal and Germany were 48.2/100,000, 41.0/100,000, 15.1/100,000 and 10.0/100,000 respectively. It is clear that countries within Europe have performed very differently in their responses to the COVID-19 pandemic, but the many limitations in the available data must be addressed before a definitive detailed assessment of the reasons can be made.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-316949

ABSTRACT

Background: : Suspending ordinary care activities during the COVID-19 pandemic made it necessary to find alternative routes to comply with care recommendations not only for acute health needs but also for patients requiring follow-up and multidisciplinary visits. We present the ‘Contactless’ model, a comprehensive operational tool including a plurality of services delivered remotely, structured according to a complexity gradient, aimed to cover diagnostic procedures and monitor disease progression in chronic pediatric patients. Methods: : A multidisciplinary and multiprofessional project team was recruited, in collaboration with patients’ associations, to map a panel of available Evidence-Based solutions and address individual needs in full respect of the concept of personalized medicine. The solutions include a number of services from videoconsultations to more structure videotraining sessions. Results: : A modular framework made up of four three Macro-levels of complexity - Contactless Basic, Intermediate and Advanced - was displayed as an incremental set of services and operational planning establishing each phase, from factors influencing eligibility to the delivery of the most accurate and complex levels of care. Conclusion: : The multimodal, multidisciplinary ‘Contactless’ model allowed the inclusion of all Units of our Pediatric Department and families with children with disability or complex chronic conditions. The strengths of this project rely on its replicability outside of pediatrics and in the limited resources needed to practically impact patients, caregivers and professionals involved in the process of care. Its implementation in the future may contribute to reduce the duration of hospital admissions, money and parental absence from work.

6.
Front Public Health ; 9: 815415, 2021.
Article in English | MEDLINE | ID: covidwho-1686577

ABSTRACT

Introduction: Working during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions. Materials and Methods: An online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables. Results: Two types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38-2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49-2.78, p < 0.001), which acted as risk factors. Discussion: The enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs.


Subject(s)
COVID-19 , Personal Protective Equipment , Female , Health Personnel , Humans , Pandemics , SARS-CoV-2
7.
Int J Environ Res Public Health ; 19(3)2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-1624970

ABSTRACT

Worldwide, the management of health emergencies requires a high degree of preparedness and resilience on the part of governments and health systems. Indeed, disasters are becoming increasingly common, with significant health, social, and economic impacts. Living in a globalized world also means that emergencies that occur in one country often have an international, in some cases global, spread: the COVID-19 pandemic is a cogent example. The key elements in emergency management are central governance, coordination, investment of resources before the emergency occurs, and preparedness to deal with it at all levels. However, several factors might condition the response to the emergency, highlighting, as for Italy, strengths and weaknesses. In this context, policies and regulation of actions to be implemented at international and national level must be up-to-date, clear, transparent and, above all, feasible and implementable. Likewise, the allocation of resources to develop adequate preparedness plans is critical. Due to COVID-19 pandemic, the European Commission proposed the temporary recovery instrument NextGenerationEU, as well as a targeted reinforcement of the European Union's long-term budget for the period 2021-2027. The pandemic highlighted that it is necessary to interrupt the continuous defunding of the health sector, allocating funds especially in prevention, training and information activities: indeed, a greater and more aware public attention on health risks and on the impacts of emergencies can help to promote virtuous changes, sharing contents and information that act as a guide for the population.


Subject(s)
COVID-19 , Pandemics , Humans , Pandemics/prevention & control , Policy , Public Health , SARS-CoV-2
9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-294395

ABSTRACT

Telehealth (e.g., the delivery and facilitation of health and health-related services via telecommunications and digital communication technologies) has been evolving for the past two decades. Faced with a global pandemic in 2020, the healthcare world was forced to rapidly utilize telehealth platforms to be able to reduce COVID-19 transmission and continue providing healthcare to those who need it. This study aimed to identify the risk of adverse events associated with telehealth usage. A systematic literature review was conducted using PRISMA guidelines and checklist, using a variety of research databases. In both quantitative and qualitative data synthesis, we found encouraging evidence highlighting the safety of telehealth in comparison to traditional practice. Future research should focus on collecting data in a longer time context. This is necessary to continue monitoring the potential risks associated with its’ application, specific to the class of telehealth tool and to the patient population. The findings in the literature, synthesized in this review, can be utilized to direct interventional measures and policymaking to advance the utilization of telehealth.<br><br>Funding: None to declare. <br><br>Declaration of Interest: None to declare.

11.
Health Policy ; 2021 Oct 06.
Article in English | MEDLINE | ID: covidwho-1540637

ABSTRACT

Provider payment mechanisms were adjusted in many countries in response to the COVID-19 pandemic in 2020. Our objective was to review adjustments for hospitals and healthcare professionals across 20 countries. We developed an analytical framework distinguishing between payment adjustments compensating income loss and those covering extra costs related to COVID-19. Information was extracted from the Covid-19 Health System Response Monitor (HSRM) and classified according to the framework. We found that income loss was not a problem in countries where professionals were paid by salary or capitation and hospitals received global budgets. In countries where payment was based on activity, income loss was compensated through budgets and higher fees. New FFS payments were introduced to incentivize remote services. Payments for COVID-19 related costs included new fees for out- and inpatient services but also new PD and DRG tariffs for hospitals. Budgets covered the costs of adjusting wards, creating new (ICU) beds, and hiring staff. We conclude that public payers assumed most of the COVID-19-related financial risk. In view of future pandemics policymakers should work to increase resilience of payment systems by: (1) having systems in place to rapidly adjust payment systems; (2) being aware of the economic incentives created by these adjustments such as cost-containment or increasing the number of patients or services, that can result in unintended consequences such as risk selection or overprovision of care; and (3) periodically evaluating the effects of payment adjustments on access and quality of care.

12.
Eurohealth ; 27(1):4-9, 2021.
Article in English | WHOIRIS | ID: covidwho-1505194

ABSTRACT

The COVID-19 pandemic has emphasised that calls for clearer mandates and leadership from health authorities has gone unheard for decades. Preventable occurrences in response to the pandemic depict that countries in the WHO European Region suffer from various issues that undermine public health leadership – a necessary capacity to navigate extraordinary times, such as these. What remains clear is that there is a dire need for public health to be reinforced and enabled to ensure effective public health responses. Furthermore, internal siloes within the field must be broken down and collaboration within and across sectors nurtured, to help build up resilience to handle future emergencies.

13.
Viruses ; 13(11)2021 11 04.
Article in English | MEDLINE | ID: covidwho-1502533

ABSTRACT

The COVID-19 pandemic has deeply influenced sanitization procedures, and high-level disinfection has been massively used to prevent SARS-CoV-2 spread, with potential negative impact on the environment and on the threat of antimicrobial resistance (AMR). Aiming to overcome these concerns, yet preserving the effectiveness of sanitization against enveloped viruses, we assessed the antiviral properties of the Probiotic Cleaning Hygiene System (PCHS), an eco-sustainable probiotic-based detergent previously proven to stably abate pathogen contamination and AMR. PCHS (diluted 1:10, 1:50 and 1:100) was tested in comparison to common disinfectants (70% ethanol and 0.5% sodium hypochlorite), in suspension and carrier tests, according with the European UNI EN 14476:2019 and UNI EN 16777:2019 standards. Human alpha- and beta-coronaviruses hCoV-229E and SARS-CoV-2, human herpesvirus type 1, human and animal influenza viruses, and vaccinia virus were included in the study. The results showed that PCHS was able to inactivate 99.99% of all tested viruses within 1-2 h of contact, both in suspension and on surface. Notably, while control disinfectants became inactive within 2 h after application, the PCHS antiviral action persisted up to 24 h post-application, suggesting that its use may effectively allow a continuous prevention of virus spread via contaminated environment, without worsening environmental pollution and AMR concern.


Subject(s)
Disinfection/methods , Probiotics/pharmacology , Sanitation/methods , Virus Diseases/prevention & control , Viruses/drug effects , Animals , Antiviral Agents/pharmacology , COVID-19/prevention & control , COVID-19/virology , Coronavirus 229E, Human/drug effects , Disinfectants/pharmacology , Environmental Microbiology , Herpesvirus 1, Human/drug effects , Humans , Orthomyxoviridae/drug effects , SARS-CoV-2/drug effects , Vaccinia virus/drug effects , Virus Diseases/virology
14.
Lancet ; 398(10317): 2193-2206, 2021 12 11.
Article in English | MEDLINE | ID: covidwho-1475153

ABSTRACT

40 years ago, Italy saw the birth of a national, universal health-care system (Servizio Sanitario Nazionale [SSN]), which provides a full range of health-care services with a free choice of providers. The SSN is consistently rated within the Organisation for Economic Co-operation and Development among the highest countries for life expectancy and among the lowest in health-care spending as a proportion of gross domestic product. Italy appears to be in an envious position. However, a rapidly ageing population, increasing prevalence of chronic diseases, rising demand, and the COVID-19 pandemic have exposed weaknesses in the system. These weaknesses are linked to the often tumultuous history of the nation and the health-care system, in which innovation and initiative often lead to spiralling costs and difficulties, followed by austere cost-containment measures. We describe how the tenuous balance of centralised versus regional control has shifted over time to create not one, but 20 different health systems, exacerbating differences in access to care across regions. We explore how Italy can rise to the challenges ahead, providing recommendations for systemic change, with emphasis on data-driven planning, prevention, and research; integrated care and technology; and investments in personnel. The evolution of the SSN is characterised by an ongoing struggle to balance centralisation and decentralisation in a health-care system, a dilemma faced by many nations. If in times of emergency, planning, coordination, and control by the central government can guarantee uniformity of provider behaviour and access to care, during non-emergency times, we believe that a balance can be found provided that autonomy is paired with accountability in achieving certain objectives, and that the central government develops the skills and, therefore, the legitimacy, to formulate health policies of a national nature. These processes would provide local governments with the strategic means to develop local plans and programmes, and the knowledge and tools to coordinate local initiatives for eventual transfer to the larger system.


Subject(s)
COVID-19/economics , Federal Government/history , Local Government , Social Responsibility , State Medicine/history , Universal Health Care , Cost Control/economics , Health Policy , History, 20th Century , History, 21st Century , Humans , Italy
15.
Health policy (Amsterdam, Netherlands) ; 2021.
Article in English | EuropePMC | ID: covidwho-1451802

ABSTRACT

Provider payment mechanisms were adjusted in many countries in response to the COVID-19 pandemic in 2020. Our objective was to review adjustments for hospitals and healthcare professionals across 20 countries. We developed an analytical framework distinguishing between payment adjustments compensating income loss and those covering extra costs related to COVID-19. Information was extracted from the Covid-19 Health System Response Monitor (HSRM) and classified according to the framework. We found that income loss was not a problem in countries where professionals were paid by salary or capitation and hospitals received global budgets. In countries where payment was based on activity, income loss was compensated through budgets and higher fees. New FFS payments were introduced to incentivize remote services. Payments for COVID-19 related costs included new fees for out- and inpatient services but also new PD and DRG tariffs for hospitals. Budgets covered the costs of adjusting wards, creating new (ICU) beds, and hiring staff. We conclude that public payers assumed most of the COVID-19-related financial risk. In view of future pandemics policymakers should work to increase resilience of payment systems by: (1) having systems in place to rapidly adjust payment systems;(2) being aware of the economic incentives created by these adjustments such as cost-containment or increasing the number of patients or services, that can result in unintended consequences such as risk selection or overprovision of care;and (3) periodically evaluating the effects of payment adjustments on access and quality of care.

16.
Mol Oncol ; 15(10): 2507-2543, 2021 10.
Article in English | MEDLINE | ID: covidwho-1445781

ABSTRACT

Key stakeholders from the cancer research continuum met in May 2021 at the European Cancer Research Summit in Porto to discuss priorities and specific action points required for the successful implementation of the European Cancer Mission and Europe's Beating Cancer Plan (EBCP). Speakers presented a unified view about the need to establish high-quality, networked infrastructures to decrease cancer incidence, increase the cure rate, improve patient's survival and quality of life, and deal with research and care inequalities across the European Union (EU). These infrastructures, featuring Comprehensive Cancer Centres (CCCs) as key components, will integrate care, prevention and research across the entire cancer continuum to support the development of personalized/precision cancer medicine in Europe. The three pillars of the recommended European infrastructures - namely translational research, clinical/prevention trials and outcomes research - were pondered at length. Speakers addressing the future needs of translational research focused on the prospects of multiomics assisted preclinical research, progress in Molecular and Digital Pathology, immunotherapy, liquid biopsy and science data. The clinical/prevention trial session presented the requirements for next-generation, multicentric trials entailing unified strategies for patient stratification, imaging, and biospecimen acquisition and storage. The third session highlighted the need for establishing outcomes research infrastructures to cover primary prevention, early detection, clinical effectiveness of innovations, health-related quality-of-life assessment, survivorship research and health economics. An important outcome of the Summit was the presentation of the Porto Declaration, which called for a collective and committed action throughout Europe to develop the cancer research infrastructures indispensable for fostering innovation and decreasing inequalities within and between member states. Moreover, the Summit guidelines will assist decision making in the context of a unique EU-wide cancer initiative that, if expertly implemented, will decrease the cancer death toll and improve the quality of life of those confronted with cancer, and this is carried out at an affordable cost.


Subject(s)
Neoplasms , Quality of Life , Europe/epidemiology , Humans , Neoplasms/epidemiology , Neoplasms/prevention & control , Precision Medicine
17.
EClinicalMedicine ; 40: 101113, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1385455

ABSTRACT

BACKGROUND: High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. METHODS: A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication. FINDINGS: Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies.Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world. INTERPRETATION: A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

18.
Contemp Clin Trials Commun ; 23: 100837, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1363945

ABSTRACT

The provisions adopted in Italy for clinical trials on medicinal products and medical devices for the epidemiological emergency caused by COVID-19 had an impact also on the functioning of Ethics Committees (ECs). All COVID-19 clinical trials are evaluated preliminarily by the Technical Scientific Committee of the Italian Medicines Agency (AIFA). They are then evaluated by the Clinical Trial Office of the Competent Authority (AIFA) and by the EC of the Lazzaro Spallanzani National Institute for Infectious Diseases. On the basis of this experience, several parties have recommended the adoption of a new structure that envisages the involvement of a single EC for the activation of new studies, similar to the system put in place for studies on COVID-19. Rather than a single EC with jurisdiction over the entire country, we could envisage the accreditation of a certain number of ECs, possibly subdivided by therapeutic fields, with the trials to be evaluated distributed among them, so that each is authorised to issue an opinion that is valid nationally.

19.
BMJ Glob Health ; 6(8)2021 08.
Article in English | MEDLINE | ID: covidwho-1350019

ABSTRACT

The objectives of the study were to calculate the standardised mortality rates (SMRs) for COVID-19 in European Union/European Economic Area countries plus the UK and Switzerland and to evaluate the correlation between SMRs and selected indicators in the first versus the subsequent waves until 23 June 2021. We used indirect standardisation (using Italy as the reference) to compute SMRs and considered 16 indicators of health and social well-being, health system capacity and COVID-19 response. The highest SMRs were in Belgium, the UK and Spain in the first wave (1.20-1.84) and in Hungary, Czechia and Slovakia in the subsequent waves (2.50-2.69). Human Development Index (HDI), life expectancy, urbanisation and healthcare expenditure had positive correlations with SMR in the first wave (rho=0.30-0.46), but negative correlations (rho=-0.67 to -0.47) in the subsequent waves. Retail/recreation mobility and transit mobility were negatively correlated with SMR in the first wave, while transit mobility was inversely correlated with SMR in the subsequent waves. The first wave hit most hard countries with high HDI, high life expectancy, high urbanisation, high health expenditures and high tourism. This pattern may reflect higher early community seeding and circulation of the virus. Conversely, in the subsequent waves, this pattern was completely inversed: countries with more resources and better health status did better than eastern European countries. While major SMR differences existed across countries in the first wave, these differences largely dissipated by 23 June 2021, with few exceptions.


Subject(s)
COVID-19 , Delivery of Health Care , Europe/epidemiology , Humans , Italy , SARS-CoV-2
20.
J Pers Med ; 11(4)2021 Apr 16.
Article in English | MEDLINE | ID: covidwho-1241274

ABSTRACT

The development and implementation of the approaches of personalized medicine for disease prevention are still at infancy, although preventive activities in healthcare represent a key pillar to guarantee health system sustainability. There is an increasing interest in finding informative markers that indicate the disease risk before the manifestation of the disease (primary prevention) or for early disease detection (secondary prevention). Recently, the systematic collection and study of clinical phenotypes and biomarkers consented to the advance of Rehabilomics in tertiary prevention. It consents to identify relevant molecular and physiological factors that can be linked to plasticity, treatment response, and natural recovery. Implementation of these approaches would open avenues to identify people at high risk and enable new preventive lifestyle interventions or early treatments targeted to their individual genomic profile, personalizing prevention and rehabilitation. The integration of personalized medicine into prevention may benefit citizens, patients, healthcare professionals, healthcare authorities, and industry, and ultimately will seek to contribute to better health and quality of life for Europe's citizens.

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