Recenti progressi in medicina最新文献

To answer the question "How will technology change people's Home Care in the next 20 years?", a hybrid approach called Human-Centered Foresight was used. It allowed the multidisciplinary research team to define a road map with medium- and long-term goals from today until 2041.

The increase of Youth Mental health both internationally and locally has led the Department of Mental Health and Addictions of the Melegnano and Martesana Territorial Health Hospital, located in the southeast of the Milan area, to initiate an organizational and training process to revisit the care access for young people aged 14 to 24. The objective is to innovate the care pathway by optimizing diagnostic, care, and rehabilitative processes, while enhancing cross-departmental skills. The training program, which lasted one year and was led by a tutor, focused on analyzing organizational aspects, user needs, and existing constraints. The model called the "Gabbiano J" has been developed, offering a first access to services and consultation for psychiatric and addiction-related issues in a non-institutionalized setting aimed at early intervention. Its effectiveness is limited by scarce resources and funding, and it requires coordination between healthcare and social services. Continuous staff training and post-implementation outcome evaluation are also crucial.

Our purpose was to evaluate the approach of two different chatbots (ChatGPT and Gemini) to a list of questions about emergency department as a border area between hospital and territory. This study was performed in a single day, on 3 March 2024. Two different questions were sequentially type in Italian language, the same for each chatbot: definition of the emergency department as a border zone in Italy; possible solutions to the previous question. The second one was independent on the answers given by artificial intelligence. We noticed how two chatbots differently analyzed the problem by considering different aspects and proposing various solutions. We concluded that chatbots still need to receive additional informations in order to become a real tool to support strategic choices for the government of the emergency department and the regional and national healthcare and social and health care system.

The role of Real-World Evidence (RWE) concerns the entire drug lifecycle; despite widely recognised in the post-marketing, it is still debated in the pre-marketing, mainly as per the identification and analysis of target populations (TPs) for new drugs or indications. Through administrative healthcare databases, Research and Health Foundation (ReS), in collaboration with experts, develops algorithms to select and analyse TPs. As of March 2024, 85 TPs in 15 clinical areas have been analysed, of which oncology is the most represented. Findings on prevalence and incidence of specific diseases (or subpopulations), patient characteristics and costs directly charged to the Italian National Health Service, are provided. These are useful for healthcare institutions and pharmaceutical companies. In the future, efforts will focus on the development of tools based on artificial intelligence and synthetic data to improve analyses of TPs and support regulatory decisions on drugs.

In urban areas, environmental exposures to air pollution, extreme temperatures and noise as well as socio-economic inequalities are amplified. Urban green spaces offer dual benefits: they help mitigate climate change and improve public health by fostering connection to nature, reducing noise and air pollution, mitigating the urban heat island effect, and promoting physical activity. Within the 2023 "Cobenefici di Salute ed equità a supporto dei piani di risposta ai cambiamenti climatici in Italia" project funded by the Ministry of Health, we identified health indicators to assess climate action co-benefits, including those on cardiovascular disease mortality and morbidity, birth outcomes and mental health. An increase of 0.1 in the Normalized Difference Vegetation Index (NDVI) was found to be associated with a 3% reduction in cardiovascular mortality rates (95% CI: -4% to -1%). Such estimates will be applied in health impact assessment studies to help guide effective climate adaptation and public health strategies.

The data from recent years on chronic disease mortality in Rome's V district show a significant disparity compared to the city's central neighborhoods, with a 23% increase in chronic diseases and an 80% rise in diabetes cases. The 'Ambulatorio Popolare Roma Est', an autonomous healthcare facility founded in 2022 in Quarticciolo neighborhood, is run by over 30 volunteers, including medical specialists, therapists, nutritionists and students. The clinic provides free services such as medical consultations, psychological support and nutritional advice. Its goals are to improve access to healthcare, advocate for institutional support and empower the community through health education and social determinants. In 2023, 205 medical consultations were conducted with 55 new patients, mostly aged 60-75. Many faced obstacles like long wait times in National health service, denied appointments or lack of information in access the public system. The clinic emphasizes that the growing health needs in this area are being systematically ignored, leading to further health inequities in an already socially deprived neighborhood.

Informed consent is mandatory for an individual to receive a clinical service, yet the process is often still tough and twisty. This is a hot topic also for patient associations and thus PaLiNUro associaton set the objective to produce, with a multidisciplinary approach, a simple but comprehensive information note to the informed consent for people with urothelial cancer about to undergo to a radical cystectomy surgery. After assessing as not valid 12 information notes from nine Italian hospitals, the multidisciplinary group produced an eight-page document accompanied by a supplemental document for further details, both available on PaLiNUro website.

This analysis aims to describe the care pathways of patients with central nervous system (Cns) tumors during the last 30 days of life, using relevant indicators retrieved from regional healthcare information system data, compare these indicators with those of patients who died from other solid tumors, and assess the role of socioeconomic position (Sep) in accessing end-of-life care among Cns patients. The study included 2,795 patients who died from Cns tumors between 2015 and 2019. In the last 30 days of life, compared to the solid tumor cohort, Cns patients had less access to emergency services and hospitalizations. Regarding treatments, the percentage of opioid users was significantly lower than that of solid tumor patients. Concerning the role of Sep, Cns patients with a higher Sep were less likely to access the Emergency Room and more likely to receive antitumor. In conclusion, the analysis of administrative databases in epidemiology is essential in order to monitor care pathways targeted at highly vulnerable populations.