Alessia Beccacece

Background: Nursing home (NH) residents have a high burden of multimorbidity and disability and are frequently hospitalized. Comprehensive geriatric assessment might reduce hospitalization. However, few geriatricians are working in NHs. Technology might be used to overcome this problem. Objective: This study aims to verify if a geriatric telemanagement model improves patient outcomes in NH residents recently discharged from the hospital. Methods: Clinical outcomes of NH residents recently discharged from the hospital are compared before and after the implementation of GTM, where a geriatrician evaluates each patient during televisits with NH staff and discusses the case with the general practitioner. NH residents aged ≥70 years readmitted to NHs after hospitalization in the 3 years prior to the COVID-19 pandemic (2017‐2019) represent the control group enrolled in the retrospective preintervention phase. The primary outcome of the study is the hospital readmission rate during 6-month follow-up. Health technology assessment evaluates the cost-effectiveness of model implementation. Results: A total of 333 NH residents were included in the preintervention retrospective study. Data collection started in February 2022 and was completed in February 2023. A total of 104 NH residents were recruited in the intervention study, from March 2024 to March 2025. Data analysis is currently in progress. Conclusions: Currently, NHs in Italy are striving to manage the complexity of older patients who are often hospitalized. A geriatric telemanagement model might reduce hospitalizations, and therefore negative outcomes, as well as health care costs in this vulnerable population.

West Nile Virus (WNV) is becoming a significant and enduring public health menace in Europe, propelled by climate changes and accelerated population aging. Most infections are asymptomatic but older adults are more prone to develop neuroinvasive disease, which is characterized by high morbidity and mortality, as well as long-term neurological disturbances and disability. To date, there is still no licensed human vaccine or specific antiviral treatment, and management is mostly supportive. This review brings together the most recent information about WNV epidemiology, pathogenesis, and clinical manifestations, with a special focus on older people in Europe. We critically analyze current and novel pharmaceutical strategies, encompassing drug repurposing, nucleoside analogues, interferon-based therapies, peptides, monoclonal antibodies, and host-directed agents, emphasizing their therapeutic potential alongside the challenges presented by age-related pharmacokinetic and immunological alterations. We also discuss some important gaps in the current evidence base, such as the frequent exclusion of older adults from clinical studies and the lack of a coordinated clinical trial infrastructure that can be quickly activated during seasonal outbreaks. Lastly, we suggest a framework that combines systematic antiviral screening with the creation of a Europe-wide network of clinical trial readiness that is built into current One Health surveillance systems.

Chronic exposure to ambient air pollution has been related to increased mortality in the general population [1]. After the outbreak of the SARS-CoV-2 pandemic in 2019, there has been a fast proliferation of epidemiological studies linking ambient air pollution to coronavirus disease 2019 (COVID-19) incidence or adverse prognosis [2]. It has been hypothesised that ambient air pollution might increase human vulnerability to viruses by reducing immune defences, promoting a low-level chronic inflammatory state, or leading to chronic diseases [3]. Most studies have applied ecological designs, and failed to account for key individual-level or area-level determinants of COVID-19 spread or severity, such as demographic characteristics of the studied populations, socioeconomic or clinical susceptibility, and area-level proxies of disease spread such as mobility or population density [4].