Use of emergency services in response to a flood: an account of the aftermath of the May 2023 flood in Romagna, Italy.

Background: Extreme weather events due to human activities have significantly increased the frequency and severity of hydrological disasters like floods, impacting human health and healthcare systems worldwide. This study analyses the patterns of emergency service utilisation of the May 2023 flood in Romagna, Italy, and specifically investigates the differences in emergency department (ED) visits and mortality between individuals exposed and not exposed to the flood.

Methods: A retrospective cohort study was conducted including 813 724 citizens of Romagna, Italy, from 15 May to 31 August 2023 (ie, 14 weeks after flood inception).

Evaluating the impact of robotic-assisted total knee arthroplasty on quality of care through patient-reported outcome measures in a third-level hospital in Italy: A prospective cohort study.

Background: With the shift towards personalized medicine, understanding the impact of robotic-assisted total knee arthroplasty (TKA) on patient-reported outcome measures (PROMs) is essential for evaluating its effectiveness and patient satisfaction. The QUAROB (Quality-assessment-of-ROBotic-orthopedic-surgery) study aims at assessing the impact of robotic surgery on quality of care and joint functionality at 6 months post-surgery among patients undergoing robotic-assisted TKA.

Methods: This observational, prospective cohort study included patients from Ravenna Hospital, Italy, who underwent elective robotic TKA (2022-2023), and a historical cohort who underwent traditional TKA (2019).

Historical Southern Hemisphere biomass burning variability inferred from ice core carbon monoxide records.

Biomass burning plays an important role in climate-forcing and atmospheric chemistry. The drivers of fire activity over the past two centuries, however, are hotly debated and fueled by poor constraints on the magnitude and trends of preindustrial fire regimes. As a powerful tracer of biomass burning, reconstructions of paleoatmospheric carbon monoxide (CO) can provide valuable information on the evolution of fire activity across the preindustrial to industrial transition.

[How to optimize Audit&Feedback: experience from the EASY-NET programme].

This is the second of a series of papers dedicated to the EASY-NET research programme (NET-2016-02364191). The rationale, structure and methodologies are described in the previous contribution. Scientific literature demonstrated that Audit & Feedback (A&F) is an effective strategy for continuous quality improvement and its effectiveness varies considerably according to factors that are currently little known.

Exploring physician engagement in health care organizations: a scoping review.

Rationale: Enhancing health system effectiveness, efficiency, and appropriateness is a management priority in most world countries. Scholars and practitioners have focused on physician engagement to facilitate such outcomes.

Objectives: Our research was intended to: 1) unravel the definition of physician engagement; 2) understand the factors that promote or impede it; 3) shed light on the implications of physician engagement on organizational performance, quality, and safety; and 4) discuss the tools to measure physician engagement.

[The EASY-NET research programme: background, structure, and methodology].

This is the first contribution of a series of interventions describing the EASY-NET research program (Bando Ricerca Finalizzata 2016, funds 2014-2015; NET-2016-02364191). Here, the objective is to illustrate the background and the research question, the structure and organization, the methodologies and the expected results of the programme. The main theme is audit&feedback (A&F), a proven and widespread technique for improving the quality of health care.

Patterns of utilisation of specialist care after SARS-Cov-2 infection: a retrospective cohort study.

Objective: To explore the pattern of health services utilisation of people who had had a documented SARS-Cov-2 infection.

Design: Retrospective cohort study.

Setting: The Italian province of Reggio Emilia.

End-of-life care in cancer patients: how much drug therapy and how much palliative care? Record linkage study in Northern Italy.

Objectives: Investigating end-of-life use of anticancer drugs and of palliative care services.

Design: Population based cohort linked to mortality registry and administrative databases.

Setting: Emilia-Romagna Region (Northern Italy).

The effects of centralizing cancer surgery on postoperative mortality: A systematic review and meta-analysis.

Objectives: To review the evidence of the effects of centralization of cancer surgery on postoperative mortality.

Methods: We searched Medline, Embase, Cinahl, Cochrane and Scopus (up to November 2019) for studies that (i) assessed the effects of centralization of cancer surgery policies on in-hospital or 30-day mortality, or (ii) described changes in both postoperative mortality for a surgical intervention and degree of centralization using reduction in the number of hospitals or increases in the proportion of patients undergoing cancer surgery at high volume hospitals as proxy. PRISMA guidelines were followed.

[A&F to monitor and promote quality in healthcare during the COVID-19 emergency: the EASY-NET work].

We are presenting here the findings of the reaction to the COVID-19 epidemic during the period March to June 2020 of those centres participating in the research EASY-NET which is on-going in Italy, funded by the Ministry of Health and co-founded by the Regional Health Authorities. The objective of EASY-NET is to evaluate the effectiveness of the audit and feedback (A&F) strategies in different clinical and organizational settings in seven regions. As a negative consequence of the COVID-19 epidemic, the activities of the project have suddenly slowed down; nevertheless, the COVID-19 epidemic represented an opportunity to apply the A&F methodology and support the healthcare within the regional authorities in order to manage and monitor the impact of this new disease.

[A&F in EASY-NET: a bridge between clinicians and epidemiologists for a more virtuous exchange of information.].

The first of a series of four online meetings entitled "A&F CONNECTIONS. In practice and in response to Covid-19", as part of the EASY-NET network program on the topic of Audit & Feedback (A&F), was an opportunity to present and discuss the first results of a survey carried out by the area working on A&F, to describe the characteristics of A&F interventions in the EASY-NET context. A reflection on the preliminary results of the investigation and on the cultural dimension of the importance of creating a bridge between the world of clinicians and the world of epidemiology, for a real and virtuous exchange of information.

Association between Exposure to Influenza Vaccination and COVID-19 Diagnosis and Outcomes.

We explored whether influenza vaccination (IV) affects susceptibility to SARS-CoV-2 infection and clinical outcomes in COVID-19 patients in 17,608 residents of the Italian province of Reggio Emilia undergoing a SARS-CoV-2 test. Exposure to IV was ascertained and the strength of the association with SARS-CoV-2 positivity expressed with odds ratios (OR). Rates of hospitalisations and death in those found positive were assessed and hazard ratios (HR) were estimated.

Bratislava Statement: consensus recommendations for improving pancreatic cancer care.

Pancreatic cancer is one of the most lethal tumours, and it is the fourth cause of cancer death in Europe. Despite its important public health impact, no effective treatments exist, nor are there high-visibility research efforts to improve care. This alarming situation is emblematic of a larger group of cancer diseases, known as neglected cancers.

[Engaging clinicians to identify and prioritize disinvestment opportunities in the treatment of neurodegenerative diseases: a qualitative study.].

Introduction: The overuse of health care interventions is a problem which has clinical and economic implications. On a clinical level this means that ineffective interventions or effective interventions in inappropriate clinical indications are used. On an economic level it refers to allocative inefficiency which implies that these resources could possibly be used for interventions of major clinical utility.

Characteristics and outcomes of a cohort of COVID-19 patients in the Province of Reggio Emilia, Italy.

This is a population-based prospective cohort study on archive data describing the age- and sex-specific prevalence of COVID-19 and its prognostic factors. All 2653 symptomatic patients tested positive for SARS-CoV-2 from February 27 to April 2, 2020 in the Reggio Emilia province, Italy, were included. COVID-19 cumulative incidence, hospitalization and death rates, and adjusted hazard ratios (HR) with 95% confidence interval (95% CI) were calculated according to sociodemographic and clinical characteristics.

No increasing risk of a limnic eruption at Lake Kivu: Intercomparison study reveals gas concentrations close to steady state.

Lake Kivu, East Africa, is well known for its huge reservoir of dissolved methane (CH4) and carbon dioxide (CO2) in the stratified deep waters (below 250 m). The methane concentrations of up to ~ 20 mmol/l are sufficiently high for commercial gas extraction and power production. In view of the projected extraction capacity of up to several hundred MW in the next decades, reliable and accurate gas measurement techniques are required to closely monitor the evolution of gas concentrations.

Sub-Ocean: Subsea Dissolved Methane Measurements Using an Embedded Laser Spectrometer Technology.

We present a novel instrument, the Sub-Ocean probe, allowing in situ and continuous measurements of dissolved methane in seawater. It relies on an optical feedback cavity enhanced absorption technique designed for trace gas measurements and coupled to a patent-pending sample extraction method. The considerable advantage of the instrument compared with existing ones lies in its fast response time of the order of 30 s, that makes this probe ideal for fast and continuous 3D-mapping of dissolved methane in water.

Overuse in cancer care: do European studies provide information useful to support policies?

Health services overuse has been acknowledged as a relevant policy issue. In this study, we assessed the informative value of research on the quality of cancer care, exploring to what extent it is actually concerned with care overuse, thus providing policy-makers with sound estimates of overuse prevalence. We searched Medline for European studies, reporting information on the rate of use of diagnostic or therapeutic procedures/interventions in breast, colorectal, lung and prostate cancer patients, published in English between 2006 and 2016.

[PRIER II. The Emilia-Romagna Research and Innovation Programme].

The Emilia-Romagna Programme for Research and Innovation "PRIER" was born in 2005 with the aim of increasing cultural and operational conditions for the development of clinical research, useful both to the Regional Health Service (SSR) and to the private sectors of pharmaceutical and biomedical areas. In this context, the PRIER had from the beginning a double connotation: a space where the SSR can explore issues related to the development of its own research capacity; and a context where new possible ways of relating and comparison with the pharmaceutical and biomedical industry are tested. Over the years the activities of PRIER were defined by: initiatives to strengthen the system of research in SSR; development of tools to monitor activities of the research; production of clinical-organizational recommendations for the governance of innovation.

Interventions to reduce waiting times for elective procedures.

Background: Long waiting times for elective healthcare procedures may cause distress among patients, may have adverse health consequences and may be perceived as inappropriate delivery and planning of health care.

Objectives: To assess the effectiveness of interventions aimed at reducing waiting times for elective care, both diagnostic and therapeutic.

Search Methods: We searched the following electronic databases: Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1946-), EMBASE (1947-), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ABI Inform, the Canadian Research Index, the Science, Social Sciences and Humanities Citation Indexes, a series of databases via Proquest: Dissertations & Theses (including UK & Ireland), EconLit, PAIS (Public Affairs International), Political Science Collection, Nursing Collection, Sociological Abstracts, Social Services Abstracts and Worldwide Political Science Abstracts.

Forecasting future needs and optimal allocation of medical residency positions: the Emilia-Romagna Region case study.

Objectives: Italian regional health authorities annually negotiate the number of residency grants to be financed by the National government and the number and mix of supplementary grants to be funded by the regional budget. This study provides regional decision-makers with a requirement model to forecast the future demand of specialists at the regional level.

Methods: We have developed a system dynamics (SD) model that projects the evolution of the supply of medical specialists and three demand scenarios across the planning horizon (2030).

Processes, contexts, and rationale for disinvestment: a protocol for a critical interpretive synthesis.

Background: Practical solutions are needed to support the appropriate use of available health system resources as countries are continually pressured to 'do more with less' in health care. Increasingly, health systems and organizations are exploring the reassessment of possibly obsolete, inefficient, or ineffective health system resources and potentially redirecting funds to those that are more effective and efficient. Such processes are often referred to as 'disinvestment'.