Risultati per: Babylon Health: il servizio anglosassone di Medicina Generale privato basato su app

Introduction
Dengue fever, the fastest-spreading mosquito-borne viral disease, poses a significant global public health challenge. Over the past two decades, its rapid spread has been driven by urbanisation, climate change and international travel, particularly affecting tropical and subtropical regions. Despite its considerable economic burden, effective antiviral treatments and vaccines remain unavailable. This study aims to bridge gaps in dengue fever management by systematically identifying and analysing strategies, challenges and solutions adopted within health systems worldwide.

Methods and analysis
This scoping review will adopt the methodological framework of Arksey and O’Malley. A comprehensive search will be conducted across databases including PubMed, Scopus, Web of Science, Embase and Cochrane Library, along with grey literature sources and manual reference list searches, covering the period from 2003 to 2024, limited to English-language publications. Search strategies will be developed using controlled vocabulary and key terms associated with various components of dengue fever management. Two independent reviewers will screen titles and abstracts based on predefined inclusion and exclusion criteria, followed by full text screening to determine final eligibility. A descriptive numerical analysis will summarise the characteristics of included studies, while a thematic analysis will provide an overview of the literature, encompassing strategies, challenges and solutions.

Ethics and dissemination
This study, approved by the Medical Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.REC.1403.142), adheres to ethical guidelines for handling publicly available data. All findings will be transparently reported and disseminated through peer-reviewed journals, relevant conferences and stakeholder engagement.

Objectives
This study systematically characterises policies related to the prevention and control of non-communicable diseases (NCDs) at the provincial primary healthcare (PHC) level, identifying key characteristics and potential gaps compared with national policies.

Study design
Policy review and thematic content analysis.

Methods
Policy documents from Guangdong and Heilongjiang provinces (2009–2023) were analysed using the WHO’s six building blocks framework. A total of 135 eligible documents were included, with thematic analysis conducted to categorise policies as ‘extension’ or ‘reduction’ based on their alignment with national directives.

Results
12 major policy initiatives were identified, with most themes reflecting provincial adaptations (‘extension’) of national strategies. Leadership and governance, medicines and technologies and service delivery received robust policy support, while health information systems lagged. Provincial policies demonstrated significant multisectoral collaboration, though gaps in health financing and workforce capacity persisted.

Conclusions
To strengthen PHC-based NCD control, future reforms must prioritise multisectoral collaboration, interoperable digital health systems and tailored health education. Addressing regional disparities in policy implementation is critical for equitable outcomes.

Background
Social networks are an important, although overlooked, component of community-based health promotion. Advances in social network research have highlighted different social network intervention (SNI) strategies to improve community-based health promotion. The aim of this project is to collaborate with community and policy stakeholders to explore how to best apply these SNI strategies to improve the resilience, health and well-being of adults in Amsterdam, and more broadly in the Netherlands.

Methods and analysis
To this end, we will collaboratively develop an intervention planning tool called the ‘Health in All Networks Simulator (HANS)’. This tool will be capable of virtually testing different SNI strategies and forecasting their possible impact on resilience, health and well-being. Taking a mixed-methods approach consisting of a combination of interviews, group model building workshops and agent-based modelling with members of two communities in Amsterdam and policy stakeholders, we will foster a shared learning process while ensuring ownership and relevance of HANS to ongoing community-based health promotion practice.

Ethics and dissemination
The research project has been approved by the research ethics committee of Wageningen University (approval numbers: 2024-039; 2024-226). HANS will be shared directly with stakeholders. The results will be made available to the public via open-access publications and conferences.

Objectives
Considerable resources are invested in health system innovation and strengthening. This calls for efforts to ensure the sustainability of such interventions. We conducted a scoping review to identify factors influencing the sustainability of externally funded health system strengthening interventions targeting primary healthcare, the sustainability outcomes observed in such interventions and the methods used to measure sustainability.

Design
Scoping review following the Joanna Briggs Institute scoping review guidelines.

Data sources
Web of Science, Ovid Medline and Embase databases were searched through 11 March 2024.

Eligibility criteria
Studies in English with no restriction on study type or country. Externally funded health system strengthening interventions targeting primary health systems and measuring sustainability.

Data extraction and synthesis
One reviewer screened all titles and abstracts, and two independent pairs of reviewers read full texts. Relevant study data were extracted from the articles and descriptively analysed.

Results
From the 6439 titles retrieved, eight eligible studies were identified and included in the final analysis. Only four studies presented a sustainability definition. Institutionalisation and continued programme activities were described four times as sustainability outcomes, followed by capacity building twice and continued health impact and benefits once. Sustainability was assessed in five studies after intervention completion and in three studies during the implementation period. The sustainability factors were mostly related to processes (n=19), inner context (n=18), intervention characteristics (n=12) and outer context (n=11), with stakeholder engagement and partnership (n=6) as well as funding (n=3) being the most reported factors.

Conclusion
This review highlights the limited documentation on the sustainability of externally funded health system strengthening interventions. Sustainability was mainly assessed retrospectively. Influencing factors spanned over all categories of the integrated sustainability framework, with stakeholder engagement and funding playing key roles. Planning for sustainability assessments with clear definitions, methods and timeframes can enhance evidence on achieving lasting impacts of health system strengthening interventions.

Registration
Open Science Framework, https://osf.io/hazqp/?view_only=d53472afbba447e790049d81ca60aa29.

Objectives
To assess the degree to which we can replicate a study between a regional and a national database of electronic health record data in the UK. The original study examined the risk factors associated with hospitalisation following COVID-19 infection in people with diabetes.

Design
A replication of a retrospective cohort study.

Setting
Observational electronic health record data from primary and secondary care sources in the UK. The original study used data from a large, urbanised region (Greater Manchester Care Record, Greater Manchester, UK—2.8 m patients). This replication study used a national database covering the whole of England, UK (NHS England’s Secure Data Environment service for England, accessed via the BHF Data Science Centre’s CVD-COVID-UK/COVID-IMPACT Consortium—54 m patients).

Participants
Individuals with a diagnosis of type 1 diabetes or type 2 diabetes prior to a positive COVID-19 test result. The matched controls (3:1) were individuals who had a positive COVID-19 test result, but who did not have a diagnosis of diabetes on the date of their positive COVID-19 test result. Matching was done on age at COVID-19 diagnosis, sex and approximate date of COVID-19 test.

Primary and secondary outcome measures
Hospitalisation within 28 days of a positive COVID-19 test.

Results
We found that many of the effect sizes did not show a statistically significant difference, but that some did. Where effect sizes were statistically significant in the regional study, then they remained significant in the national study and the effect size was the same direction and of similar magnitude.

Conclusions
There is some evidence that the findings from studies in smaller regional datasets can be extrapolated to a larger, national setting. However, there were some differences, and therefore replication studies remain an essential part of healthcare research.

Al via il nuovo progetto promosso da 1 Caffè Onlus con i medici internisti per l’umanizzazione delle cure

Progetto internisti-Caffè onlus per l’umanizzazione delle cure

New England Journal of Medicine, Volume 392, Issue 16, Page 1657-1659, April 24, 2025.

Introduction
There is growing public concern and emphasis on the potential negative implications of social media on adolescent mental health and the implementation of social media restrictions, despite limited and mixed evidence that predominantly originates from the Global North. In sub-Saharan Africa (SSA), where adolescent populations are rapidly expanding and adopting technology, research on social media and mental health is limited. This scoping review aims to map and describe the available evidence on social media use and mental health among adolescents in SSA.

Methods and analysis
This study employs the scoping review methodology from the Joanna Briggs Institute, following a five-stage process: (1) determining the research question, (2) creating a search strategy, (3) defining inclusion criteria, (4) extracting data, (5) conducting analysis, presentation, and (6) consultations. The search strategy will be applied to databases such as PsycINFO, PubMed (Medline and OVID), Web of Science, LILACS, Scopus, Google Scholar, ProQuest Dissertations and PsycINFO Extra, covering both empirical and grey literature. Articles will be independently assessed for eligibility with data extraction and charting performed using a standardised form. Visualisation tools, such as a heatmap for the prevalence of studies in SSA and a network diagram depicting relationships, will be used.

Ethics and dissemination
Ethics approval was not required for this review. Dissemination will occur through a peer-reviewed journal article, academic presentations and online news media in the form of a commentary which will be publicly available.

Introduction
Concussion affects over 400 000 Canadians annually, with a range of causes and impacts on health-related quality of life. Research to date has disproportionately focused on athletes, military personnel and level I trauma centre patients, and may not be applicable to the broader community. The TRANSCENDENT Concussion Research Program aims to address patient- and clinician-identified research priorities, through the integration of clinical data from patients of all ages and injury mechanisms, patient-reported outcomes and objective biomarkers across factors of intersectionality. Seeking guidance from our Community Advisory Committee will ensure meaningful patient partnership and research findings that are relevant to the wider concussion community.

Methods and analysis
This prospective observational cohort study will recruit 5500 participants over 5 years from three 360 Concussion Care clinic locations across Ontario, Canada, with a subset of participants enrolling in specific objective assessments including testing of autonomic function, exercise tolerance, vision, advanced neuroimaging and fluid biomarkers. Analysis will be predicated on pre-specified research questions, and data shared with the Ontario Brain Institute’s Brain-CODE database. This work will represent one of the largest concussion databases to date, and by sharing it, we will advance the field of concussion and prevent siloing within brain health research.

Ethics and dissemination
This study was approved by the Children’s Hospital of Eastern Ontario Research Ethics Board and preregistered on OSF (25 June 2024); https://doi.org/10.17605/OSF.IO/HYDZC. Dissemination of findings will be multifaceted, including conference presentations, peer-reviewed publications and sharing of adapted materials (eg, videos, infographics, plain language summaries) with community groups and key knowledge users.

Objectives
This study aimed to determine healthcare needs and care use (provision of healthcare) in adults with Bardet–Biedl syndrome (BBS) and the associations between care use and physical functioning, health status outcomes and distress.

Design
Cross-sectional study.

Setting
Outpatient hospital visits.

Participants
30 adults with BBS were included (50% women, aged 20–69 years) and assessed with the Needs and Provision Complexity Scale, Short Physical Performance Battery, EuroQoL five dimensions with five severity levels (EQ-5D-5L) and Hospital Anxiety and Depression Scale.

Results
The majority (80%) received disability benefits, 93% were overweight or obese and all had retinal dystrophy. Unmet needs (needs-gets) were found within the domains of rehabilitation (83%), social and family support (63%), healthcare (50%), personal care (47%) and the environment (40%). Significant correlations were observed between care use (gets) and worse physical performance (=–0.34, p

Introduction
A quarter of women experience heavy periods in their lifetime, often significantly impairing their well-being, productivity and quality of life.
Several treatment options are offered for heavy menstrual bleeding; however, there is limited evidence on the effectiveness, safety and cost of available treatments. We aim to conduct a comprehensive systematic review, network meta-analyses and health economic evaluation to compare all available treatment options while considering the views and treatment preferences of women with heavy menstrual bleeding.

Methods and analysis
We will systematically search electronic databases (MEDLINE, EMBASE, CENTRAL) as well as the grey literature, conference proceedings and trial registries to identify all relevant randomised trials that evaluated any medical or surgical treatment for women with heavy menstrual bleeding regardless of their cause compared with placebo or other active treatments.
We will perform pairwise and network meta-analyses using standard methods. We will report primarily on changes in menstrual blood loss (using Pictorial blood loss assessment chart scores or the Alkaline-Haematin method), quality-of-life measures, safety in addition to other important clinical outcomes.
We will develop a health economic model to evaluate the cost-effectiveness of available treatments within a healthcare perspective using data inputs from the planned meta-analyses. We will calculate the incremental cost per change in alternative outcomes and present the net monetary benefit for a range of cost-effectiveness thresholds for quality-adjusted life-year gained. We will conduct consultations and a discrete choice experiment involving patient representatives to capture the factors influencing women’s decision-making and treatment preferences in real life.

Ethics and dissemination
The project was approved by the UCL Institute for Women’s Health Low-Risk Research Ethics Committee (reference: 004_2023_24) and UCL Research Ethics Committee (ID 16351/003) for the planned patient involvement and qualitative research. We will produce an evidence-based decision aid toolkit and will publish the findings in peer-reviewed journals, as well as lay media outputs to inform health professionals, policymakers and the patient community.

PROSPERO registration numbers
https://doi.org/10.17605/OSF.IO/4MUSF, CRD42023468055, CRD42024519622, CRD42024520558 and CRD42024520634.

New England Journal of Medicine, Ahead of Print.

This Medical News article discusses a KFF poll about the public’s trust in artificial intelligence and its ability to provide accurate health information.

Objective
This study aimed to assess the pooled prevalence and factors of low birth weight among newborns in the top 20 countries with the highest infant mortality rates.

Design
We conducted a community-based cross-sectional analysis using data from Demography and Health Surveys across these countries. The final analysis included a weighted sample of 82 430 live births. We employed binary logistic regression to identify predictors of low birth weight, allowing for the interpretation of results as probabilities. This approach enhances the understanding of event likelihood, which is particularly valuable for policymakers. Statistical significance was determined at a 95% CI with p values

LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, plus) identifying individuals face numerous health care disparities, in terms of access and outcomes.1,2 Over 7% of the United States (U.S.) population identifies as LGBTQ+, yet health care providers (HCPs) receive scant training in LGBTQ+ health, rendering them ill-equipped to meet these health care needs.3,4 Basic understanding of sexual orientation and gender identity (SOGI) terminology is essential to provide culturally competent care to LGBTQ+ individuals.