Pub Date : 2020-10-01eCollection Date: 2020-09-01DOI: 10.37825/2239-9747.1023
C Dantas, N Machado, S Ortet, F Leandro, M Burnard, C Grünloh, A Grguric, V Hörmann, L Fiorini, F Cavallo, E Rovini, R Scano, M Pocs
This manuscript presents a model and the methodology to understand and define the ethical management of the large-scale implementation of ICT solutions for Active and Healthy Ageing. Based on project expertise, including experience from the Pharaon project Horizon 2020, this model includes an understanding of the main ethical challenges and the development of the necessary guidelines, measures, and tools for different stakeholder profiles. This model extends beyond conventional ethical guidelines, providing a methodology to actively discuss ethical and societal challenges within a project based on interactive and iterative dialogue between the entire value-chain of stakeholders. One of the cornerstones in the analysis of challenges is focused attention on policy and societal issues that emerge during a project. Accordingly, the model includes targeted reflections and tools delivered in the context of the recent Covid-19 pandemic. The tools developed in this process are organised in a guide that can be actively used throughout large-scale implementation projects related to ICT solutions.
{"title":"The Iterative Model of Ethical Analysis for Large-Scale Implementation Of ICT Solutions.","authors":"C Dantas, N Machado, S Ortet, F Leandro, M Burnard, C Grünloh, A Grguric, V Hörmann, L Fiorini, F Cavallo, E Rovini, R Scano, M Pocs","doi":"10.37825/2239-9747.1023","DOIUrl":"https://doi.org/10.37825/2239-9747.1023","url":null,"abstract":"<p><p>This manuscript presents a model and the methodology to understand and define the ethical management of the large-scale implementation of ICT solutions for Active and Healthy Ageing. Based on project expertise, including experience from the Pharaon project Horizon 2020, this model includes an understanding of the main ethical challenges and the development of the necessary guidelines, measures, and tools for different stakeholder profiles. This model extends beyond conventional ethical guidelines, providing a methodology to actively discuss ethical and societal challenges within a project based on interactive and iterative dialogue between the entire value-chain of stakeholders. One of the cornerstones in the analysis of challenges is focused attention on policy and societal issues that emerge during a project. Accordingly, the model includes targeted reflections and tools delivered in the context of the recent Covid-19 pandemic. The tools developed in this process are organised in a guide that can be actively used throughout large-scale implementation projects related to ICT solutions.</p>","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39356327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01eCollection Date: 2020-09-01DOI: 10.37825/2239-9747.1021
W H Van Staalduinen, J G Ganzarain, C Dantas, F Rodriguez, K Stiehr, J Schulze, C Fernandez-Rivera, P Kelly, J McGrory, C Pritchard, D Berry, M Zallio, A Ciesla, M Ulanicka, S Renaux, M Guzy
To develop trainings on the implementation of smart healthy age-friendly environments for people who aim to support, for example, their parents, their neighbours or local community, there are precautionary measures that have to be taken into account: the role of the facilitator (volunteer or self-employed), the level of skills, the needs of the end-users, training content and methodologies together with the sustainability of the learning. This article examines these aspects, based on desk research and expert interviews in the Smart Healthy Age-Friendly Environments (SHAFE) fields.
{"title":"Learning to implement Smart Healthy Age-Friendly Environments.","authors":"W H Van Staalduinen, J G Ganzarain, C Dantas, F Rodriguez, K Stiehr, J Schulze, C Fernandez-Rivera, P Kelly, J McGrory, C Pritchard, D Berry, M Zallio, A Ciesla, M Ulanicka, S Renaux, M Guzy","doi":"10.37825/2239-9747.1021","DOIUrl":"https://doi.org/10.37825/2239-9747.1021","url":null,"abstract":"<p><p>To develop trainings on the implementation of smart healthy age-friendly environments for people who aim to support, for example, their parents, their neighbours or local community, there are precautionary measures that have to be taken into account: the role of the facilitator (volunteer or self-employed), the level of skills, the needs of the end-users, training content and methodologies together with the sustainability of the learning. This article examines these aspects, based on desk research and expert interviews in the Smart Healthy Age-Friendly Environments (SHAFE) fields.</p>","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39356329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01eCollection Date: 2020-09-01DOI: 10.37825/2239-9747.1002
C Ciacci, O Piazza
{"title":"Decluttering.","authors":"C Ciacci, O Piazza","doi":"10.37825/2239-9747.1002","DOIUrl":"https://doi.org/10.37825/2239-9747.1002","url":null,"abstract":"","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39356331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01eCollection Date: 2020-09-01DOI: 10.37825/2239-9747.1016
M Illario, G Tramontano, V De Luca, O Piazza
{"title":"Good practices for a \"Decade for Active and Healthy Ageing\": Little drops make the mighty oceanLittle Things, Julia Carney.","authors":"M Illario, G Tramontano, V De Luca, O Piazza","doi":"10.37825/2239-9747.1016","DOIUrl":"10.37825/2239-9747.1016","url":null,"abstract":"","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01eCollection Date: 2020-09-01DOI: 10.37825/2239-9747.1015
G Scarpati, D Baldassarre, F Oliva, G Pascale, O Piazza
Monitoring and measuring magnesium (Mg) values are essential to prevent the development of numerous complications in perioperative medicine and critically ill patients. Although previous studies suggest that measuring free ionized magnesium (iMg) is more useful for estimating Mg status, clinicians currently rely on measurement of total serum magnesium to determine if supplemental magnesium is needed. In this review, we analyzed the recent literature to decide whether it is better to measure ionized serum Mg or total serum Mg when assessing magnesium status, whether iMg predicts clinical outcome, and what are the difficulties in measuring serum iMg levels in intensive care patients and perioperative medicine.
{"title":"Ionized or Total Magnesium levels, what should we measure in critical ill patients?","authors":"G Scarpati, D Baldassarre, F Oliva, G Pascale, O Piazza","doi":"10.37825/2239-9747.1015","DOIUrl":"10.37825/2239-9747.1015","url":null,"abstract":"<p><p>Monitoring and measuring magnesium (Mg) values are essential to prevent the development of numerous complications in perioperative medicine and critically ill patients. Although previous studies suggest that measuring free ionized magnesium (iMg) is more useful for estimating Mg status, clinicians currently rely on measurement of total serum magnesium to determine if supplemental magnesium is needed. In this review, we analyzed the recent literature to decide whether it is better to measure ionized serum Mg or total serum Mg when assessing magnesium status, whether iMg predicts clinical outcome, and what are the difficulties in measuring serum iMg levels in intensive care patients and perioperative medicine.</p>","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01eCollection Date: 2020-09-01DOI: 10.37825/2239-9747.1019
M Illario, V De Luca, A Cano, D Tramontano
Despite it is generally recognized the beneficial role of physical activity, large portion of the population is physically inactive. Very alarmingly, the well-known gender gap in physical activity is constantly increasing. Several barriers obstacle women to perform physical activity although exercising would be of paramount importance for their health in particular during pregnancy and menopause. In addition to physical health benefits, physical activity may influence well-being and resilience, greatly impacting on quality of life. Here we explore the relationship between physical activity resilience and well-being in a group of 1107 female residents in the Metropolitan area of Naples.
{"title":"Go for it! Exercising makes you happy and strong.","authors":"M Illario, V De Luca, A Cano, D Tramontano","doi":"10.37825/2239-9747.1019","DOIUrl":"https://doi.org/10.37825/2239-9747.1019","url":null,"abstract":"<p><p>Despite it is generally recognized the beneficial role of physical activity, large portion of the population is physically inactive. Very alarmingly, the well-known gender gap in physical activity is constantly increasing. Several barriers obstacle women to perform physical activity although exercising would be of paramount importance for their health in particular during pregnancy and menopause. In addition to physical health benefits, physical activity may influence well-being and resilience, greatly impacting on quality of life. Here we explore the relationship between physical activity resilience and well-being in a group of 1107 female residents in the Metropolitan area of Naples.</p>","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Iaconetta, P. De Luca, A. Scarpa, C. Cassandro, E. Cassandro
The aim of this work is to clarify the incidence of meningitis/encephalitis in SARS-CoV-2 patients. We conducted an initial search in PubMed using the Medical Subject Headings (MeSH) terms "meningitis," and "encephalitis,", and "COVID-19" to affirm the need for a review on the topic of the relationship between meningitis/encephalitis and SARS-CoV-2 infection. We included case series, case reports and review articles of COVID-19 patients with these neurological symptoms. Through PubMed database we identified 110 records. After removal of duplicates, we screened 70 record, and 43 were excluded because they focused on different SARS-CoV-2 neurological complications. For eligibility, we assessed 27 full-text articles which met inclusion criteria. Seven articles were excluded, and twenty studies were included in the narrative review, in which encephalitis and/or meningitis case reports/case series were reported. Neurological manifestations of COVID-19 are not rare, especially meningoencephalitis; the hypoxic/metabolic changes produced by the inflammatory response against the virus cytokine storm can lead to encephalopathy, and the presence of comorbidities and other neurological diseases, such as Alzheimer's disease, predispose to these metabolic changes. Further study are needed to investigate the biological mechanisms of neurological complications of COVID-19.
{"title":"Meningoencephalitis Associated with SARS-Coronavirus-2.","authors":"G. Iaconetta, P. De Luca, A. Scarpa, C. Cassandro, E. Cassandro","doi":"10.37825/2239-9747.1007","DOIUrl":"https://doi.org/10.37825/2239-9747.1007","url":null,"abstract":"The aim of this work is to clarify the incidence of meningitis/encephalitis in SARS-CoV-2 patients. We conducted an initial search in PubMed using the Medical Subject Headings (MeSH) terms \"meningitis,\" and \"encephalitis,\", and \"COVID-19\" to affirm the need for a review on the topic of the relationship between meningitis/encephalitis and SARS-CoV-2 infection. We included case series, case reports and review articles of COVID-19 patients with these neurological symptoms. Through PubMed database we identified 110 records. After removal of duplicates, we screened 70 record, and 43 were excluded because they focused on different SARS-CoV-2 neurological complications. For eligibility, we assessed 27 full-text articles which met inclusion criteria. Seven articles were excluded, and twenty studies were included in the narrative review, in which encephalitis and/or meningitis case reports/case series were reported. Neurological manifestations of COVID-19 are not rare, especially meningoencephalitis; the hypoxic/metabolic changes produced by the inflammatory response against the virus cytokine storm can lead to encephalopathy, and the presence of comorbidities and other neurological diseases, such as Alzheimer's disease, predispose to these metabolic changes. Further study are needed to investigate the biological mechanisms of neurological complications of COVID-19.","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47553661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Head and Neck Surgery Residency During Covid-19 Pandemic. Lessons from Southern Italy.","authors":"P. De Luca","doi":"10.37825/2239-9747.1008","DOIUrl":"https://doi.org/10.37825/2239-9747.1008","url":null,"abstract":"","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46143154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Rea, T. Valente, R. Lieto, G. Bocchini, E. Marchiori, A. Pinto, A. Maglio, A. Vatrella
Covid-19 (coronavirus disease 2019) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On 30 January 2020 the World Health Organization (WHO) declared that the outbreak of Covid-19 realizes a public health emergency of international concern. Because of the primary involvement of the respiratory system, chest CT is strongly recommended in suspected Covid-19 cases, for both initial and follow-up. We present the case of a Covid-19 patient, a 57-year-old man, with a typical HRCT course of OP reaction.
{"title":"The Many Faces of Covid-19: Organizing Pneumonia (OP) Pattern HRCT Features","authors":"G. Rea, T. Valente, R. Lieto, G. Bocchini, E. Marchiori, A. Pinto, A. Maglio, A. Vatrella","doi":"10.37825/2239-9747.1001","DOIUrl":"https://doi.org/10.37825/2239-9747.1001","url":null,"abstract":"Covid-19 (coronavirus disease 2019) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On 30 January 2020 the World Health Organization (WHO) declared that the outbreak of Covid-19 realizes a public health emergency of international concern. Because of the primary involvement of the respiratory system, chest CT is strongly recommended in suspected Covid-19 cases, for both initial and follow-up. We present the case of a Covid-19 patient, a 57-year-old man, with a typical HRCT course of OP reaction.","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70044368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
"Age (is) an important factor in making the terrible choice of who will receive scarce resources in a pandemic.", wrote Professor Arthur Caplan, Director of the section of Medical Ethics at the New York UniversityGrossman School of Medicine [1]. This opinion, if extrapolated from its context, would be immediately rejected as inhuman and unacceptable by anyone, medical or lay people, young or old. However, in Italy, the SARSCoV-2 pandemic was marked by the severe lack of personal protective equipment (PPE), mechanical ventilators, hospital beds and in particular ICU beds, and this resulted in an inevitable selection of patients. ICU physicians, often by themselves, face this situation, when ER request exceeds the availability of beds and mechanical ventilators in the area, also before the pandemic. This problem has been aggravated by COVID19, and it is now known and feared by the large audience. If maximizing the number of saved lives is the common societal objective, and when epidemiological and clinical data support the risk of failure, can age lawfully be used for the allocation of a valuable resource as a mechanic ventilator? Simplifying, if there is an equal need between two patients, age can be the decisive element in defining the priority of treatment: lifesaving procedures, such as intubating and ventilating, will be carried out only in younger patients, reserving only less invasive or palliative treatments for the elderly. Following this principle, the elderly, lesser valued citizens, would give young people the right to play their game of life, as defined by the principle of “fair innings”, or fair life expectancy. Is the age of patients the right choice when it is selected as a triage criterion? In my opinion, age must never be the main factor that determines a person's right to intensive care, since it is an unreliable and insufficient index of the patient's ability to respond to intensive care and to recover autonomy functional. A healthy 75-year-old cannot be denied access to resuscitation treatment on the basis of age alone, although elderly patients with severe respiratory insufficiency secondary to COVID-19 have a high probability of dying despite intensive care and, consequently, they may have a lower priority for admission to intensive care in conditions of irremediable and extreme shortage of beds. The Italian Society of Anesthesia (SIAARTI) has published a document entitled "clinical ethics recommendations for the breakdown of intensive care treatments, in exceptional circumstances limited to resources" in partial agreement with Professor Caplan. In this document, the principle of "saving limited resources, which can become extremely scarce, for those who have a much greater chance of survival and life expectancy, in order to maximize the benefits for the greatest number of people" is stated. COVID 19 acute respiratory disease in frail elderly patients has a long course, and outcomes are more malignant than in healthy young su
{"title":"Saving Limited Resources During Covid-19 Pandemic","authors":"Ornella Piazza","doi":"10.37825/2239-9747.1003","DOIUrl":"https://doi.org/10.37825/2239-9747.1003","url":null,"abstract":"\"Age (is) an important factor in making the terrible choice of who will receive scarce resources in a pandemic.\", wrote Professor Arthur Caplan, Director of the section of Medical Ethics at the New York UniversityGrossman School of Medicine [1]. This opinion, if extrapolated from its context, would be immediately rejected as inhuman and unacceptable by anyone, medical or lay people, young or old. However, in Italy, the SARSCoV-2 pandemic was marked by the severe lack of personal protective equipment (PPE), mechanical ventilators, hospital beds and in particular ICU beds, and this resulted in an inevitable selection of patients. ICU physicians, often by themselves, face this situation, when ER request exceeds the availability of beds and mechanical ventilators in the area, also before the pandemic. This problem has been aggravated by COVID19, and it is now known and feared by the large audience. If maximizing the number of saved lives is the common societal objective, and when epidemiological and clinical data support the risk of failure, can age lawfully be used for the allocation of a valuable resource as a mechanic ventilator? Simplifying, if there is an equal need between two patients, age can be the decisive element in defining the priority of treatment: lifesaving procedures, such as intubating and ventilating, will be carried out only in younger patients, reserving only less invasive or palliative treatments for the elderly. Following this principle, the elderly, lesser valued citizens, would give young people the right to play their game of life, as defined by the principle of “fair innings”, or fair life expectancy. Is the age of patients the right choice when it is selected as a triage criterion? In my opinion, age must never be the main factor that determines a person's right to intensive care, since it is an unreliable and insufficient index of the patient's ability to respond to intensive care and to recover autonomy functional. A healthy 75-year-old cannot be denied access to resuscitation treatment on the basis of age alone, although elderly patients with severe respiratory insufficiency secondary to COVID-19 have a high probability of dying despite intensive care and, consequently, they may have a lower priority for admission to intensive care in conditions of irremediable and extreme shortage of beds. The Italian Society of Anesthesia (SIAARTI) has published a document entitled \"clinical ethics recommendations for the breakdown of intensive care treatments, in exceptional circumstances limited to resources\" in partial agreement with Professor Caplan. In this document, the principle of \"saving limited resources, which can become extremely scarce, for those who have a much greater chance of survival and life expectancy, in order to maximize the benefits for the greatest number of people\" is stated. COVID 19 acute respiratory disease in frail elderly patients has a long course, and outcomes are more malignant than in healthy young su","PeriodicalId":54170,"journal":{"name":"Translational Medicine at UniSa","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70044609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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